CCLP presented our fourth Policy Forum event discussing tax credits in Colorado.
Recent articles
NHeLP and CCLP file for expedited review of civil rights violations in Colorado
On Sept 16, NHeLP and CCLP submitted a complaint to the Office for Civil Rights in the U.S. Department of Health and Human Services, addressing the ongoing discriminatory provision of case management services for individuals with disabilities in Colorado.
CCLP’s 26th birthday party recap
CCLP celebrated our 26th birthday party while reflecting on another year of successes on behalf of Coloradans experiencing poverty.
Small business displacement and Business Navigators
CCLP partnered with the city and county of Denver to administer a two-year program connecting Denver’s historically underinvested businesses with guides to programs, resources, and services available to them.
On the ground: From social work to healthcare advocacy
For a long time, I was certain social work was my calling. I believed that no other work would be as fulfilling, that this was where I could make the most difference. Certainly, the need was great, and I knew I wasn’t choosing an easy career path, but I was determined to help people through some of the hardest life challenges.
Right out of my bachelor’s degree program I obtained employment as a case manager for a non-profit behavioral health provider in Arapahoe and Douglas counties. I assisted individuals stepping down from inpatient levels of care to outpatient services. I worked with clients to get them connected to appointments, behavioral health services, housing vouchers, food stamps, Medicaid/Medicare, social security, and so much more, ensuring individual stability and helping them reach their goals for self-sufficiency.
Helping people of all ages, from four years old to 98, filled my cup. This is what I felt I was destined to do.
Then came the COVID-19 pandemic.
The virus brought a public mental health crisis of a scale never seen in modern history. It also brought new policies, new technologies, new ways of doing things. Telemedicine was supposed to solve for some of the issues. But it didn’t always work. It was brand new for most of our agency. Trying to reach clients who did not have internet access or phones proved nearly impossible, and necessitated going home to home after all, in the midst of a dangerous public health emergency. But the needs were great, and growing day by day. Caseloads increased. Appointments had to be booked further and further out, even months apart.
For a typical case manager in the social work field, the maximum caseload one can reasonably manage works out to no more than 75 clients. Beyond that point, the quality of care suffers, availability diminishes, and social workers themselves begin to burn out. By the time I reached my two-year anniversary at the agency, my caseload was 148 clients.
Social worker turnover has always been high; though it is meaningful, important work, it’s also incredibly difficult and emotionally taxing. And for a line of work requiring a bachelor’s degree education at minimum, the pay is shockingly low, insufficient to cover basic necessities, let alone pay back expensive student loans. For my part, I realized I could not help others when I could not help myself. Despite long hours, I couldn’t pay my bills. I felt my own mental health disintegrating. And so, I left the agency to do indirect care at a behavioral health hospital. I went from a non-profit to a for-profit organization in order to be paid a living wage. I still wanted to help, but knew I needed something different.
I thought that my social work training would be more effective in an inpatient setting, where I would be able to get to the root causes and help in crisis situations. But if anything, the systemic problems I saw in this environment were even worse than what I saw at the agency. I encountered patients trying to show they were “suicidal enough” to be approved by Medicaid in order to access inpatient level of care, only to then be denied coverage because they had a “criminal” history. To the system I witnessed, it didn’t matter that the patient needed care, that the patient wanted to live, that the patient wanted to thrive. All that mattered was what insurance, if any, they had.
The failures were frustrating, outrageous, and incessant. I realized they couldn’t be addressed one patient at a time — certainly not in a system that so often refused to provide care to those who needed it. That was when I realized that systemic issues required systemic solutions. With my MSW in tow, I knew where I was supposed to go next: into policy.
Shifting to policy work, and coming to CCLP in particular, has given me the opportunity to take what I know is happening on the ground, and to use my knowledge to advocate for those patients I couldn’t help in the field. Today, I’m working alongside colleagues at CCLP and around the state to decrease disparities and increase access for behavioral health services across Colorado.
This is only the beginning of my engagement in healthcare policy. I know maneuvering through the behavioral health system is an ongoing battle for so many Coloradans. I learned so much through the challenges of my direct care experience. But I have only begun to learn how the system really works as a whole, and how much the on-the-ground reality truly differs from how the systems were designed and intended to work. My direct care service work provided me insight into how our systems currently work, and where the gaps in care and equity are.
At CCLP, we’ve been examining just how state laws and regulations compare to individual and family experiences with accessing behavioral health services. Understanding the nature of the problems gives us the best opportunity to make policy changes to improve access and outcomes for Coloradans. Stay tuned for the next entry in this series, where I’ll share some of the findings of that work.