Abell Salutes: Health Leads

May 2011 / Salutes / Health and Human Services

Where doctors identify patient’s unmet resource problems, and college students help solve them.

“Like hitting the public health jackpot.”

In an anteroom off of the reception area of the Harriet Lane Children’s Center of The Johns Hopkins Hospital, three Hopkins undergrads are seated at a counter, engaged one-on-one in conversation with patients. The patients have just seen a doctor, who has “prescribed” a social service, just as he or she has prescribed a medicine, and suddenly, following the visit, now have a bewildering list of things they need outside of any medical regime. But they are mostly poor and disadvantaged; they lack the wherewithal to work the societal systems and make things happen in an increasingly complex world. They do not know where to turn. Visiting this desk on this day, they have turned to the right place: the three Hopkins students are trained in the art of where to find anything and how to make things happen, easing the way for these patients to get on with their lives. 

These young people — and there are more than 300 of them at work in the program in any given year in Baltimore alone — are not your father’s social workers, or health counselors, or educational advisors. Working in a program called Health Leads (formerly Project HEALTH), they are redefining traditional social services, acting in all these capacities to one degree or another, to provide practical guidance to the varying and disparate (non-medical) needs of patients.

One patient, for example, may be in a desperate situation with a sick child, no heat and unpaid utility bills; another is up against it after breaking up with his live-in girl friend, moving out and lacking a way to support himself and his young daughter. Other life crises shared over the counter include hunger, obstacles to earning a GED, and sudden homelessness. In each case: what to do, where to go?

Working with a stack of directories, a computer, and a Roledex, the student assigned to a case will locate, identify, hasten along, cajole, make things happen and become a positive force in changing their patients’ lives. Says Joshua Sharfstein, M.D., Maryland Secretary of Health, “The program lines up tremendous resources against a tremendous need.” 

Dr. Sharfstein learned about Health Leads when he was doing his pediatric residency at a hospital in Boston, where the service was started in 1996 by Harvard College graduate Rebecca Onie, who still runs the organization out of its headquarters there. Sharfstein said he encouraged Onie to expand Health Leads to Baltimore 2006, where for the first time the program is being integrated with a public health agency and the quasi-public agency Baltimore HealthCare Access, rather than with a hospital’s pediatric offices. Funds to cover Health Leads first two years in Baltimore — $250,000 total–came from local groups, including Leonard E. Stulman Charitable Foundation and The Abell Foundation. “To be able to line up the energy of these college students with people who desperately need help is like hitting the public jackpot,” said Dr. Sharfstein, noting the more than 8,000 children and adults served by the program in Baltimore each year.

On this particular day at the counter, Student A sees Tanya (not her real name,) a 19-year old single mother who is in school five days a week. “She came to me the moment she stepped out of her doctor’s office across the hall. The doctor, taking in her health situation, had taken into account, too, her life situation, and written a ‘prescription’ to deal with both. One prescription would be going to her pharmacist, the other to me. The doctor recommended day-care for her 14-month old child, vouchers and a job. I was able to give her instructions on how to obtain vouchers and child care and how to connect with the nearest department of Social Services. She told me a month or so later, ‘I got your instructions. I got the vouchers. I got the child care I asked for. I can’t thank you enough.’”

Student B worked with Kandasmy (also not her real name). “Kandasmy is a woman with two children– one in elementary school and another in her late teens– who came to me with her problems. The older daughter has sickle cell anemia and has been in and out of the hospital. The mother could only work some of the time, caught between caring for her child in school; and going to and from the hospital to be with her older daughter. Her heat and utility bills were in danger of being cut off so the first thing I did was get her daughter emergency bus tokens—so she could mange her own transportation, and provide some relief for her mother. I then was able to work, successfully, with the utility company so that they would not shut off her utilities. I then helped her switch to a job with better pay and more flexible hours. I helped her get her younger child into an after school tutoring program. Months later she told me, ‘I’m really grateful that there is someone out there who would go the extra mile for me.’

Student C reported that “My client’s son lost his health insurance when he moved from Maryland to Rhode Island to attend high school and she was exhausted from trying and failing to get it reinstated. After her primary care provider referred her to us I was able to work with her providers and our legal advisor, and to get her son’s health insurance reinstated in Maryland. Within a month, the client told me, ‘I can’t believe someone as young as you could have such a huge impact on my life!’”

The students’ effectiveness is not a matter of hit-or miss; they have been trained to do their jobs and trained well. According to Mark Marino, Executive Director of Health Leads Baltimore, “All volunteers undergo at least 16 hours of pre-service training by Health Leads staff, social workers, physicians, lawyers, and community leaders to ensure they have the skills to serve clients in an effective, culturally competent manner. Volunteers also participate in weekly on-campus ‘reflection sessions’ to deepen their understanding of the health care system and the link between health and poverty; to build a community of peers committed to tackling these issues; and to tie their work in the clinic to their career aspirations.”

Abell Salutes Mark Marino, Executive Director of Health Leads Baltimore, all of Health Leads Baltimore staff, and all of the students from Johns Hopkins, Loyola University, and the University of Maryland, Baltimore County who are helping the Baltimore community “hit the public health jackpot.”