SOCIAL SERVICES

COVID-19 disrupted the social safety net here in Marin and across the U.S. Individuals experienced unemployment, gaps in health coverage, homelessness, and an array of additional issues that required the assistance of social services organizations.

Marin HHS’ Division of Social Services faced the daunting task of trying to help maintain the foundation of social services support for the county’s most vulnerable residents. At the onset, leaders established their pandemic response by trusting various sources, including national health organizations, the state, and Marin’s public health agency, and, most importantly, relying on their internal expertise in dealing with these complex issues.

The pandemic disproportionately affected Marin families, who were most at risk. Food insecurity was a primary example. In March 2020, applications for food assistance benefits from the State of California’s CalFresh program increased by more than 3,000 clients in Marin. The rapid rise in CalFresh registration was directly related to the COVID-19 pandemic and the resulting economic hardship experienced by lower-income residents.

The county partnered with local restaurants to provide meals through the Great Plates Delivered initiative. Twenty restaurants fed more than 700 seniors aged 60 and older at a high risk of COVID-19 breakfast, lunch, and dinner Monday through Friday. This FEMA-sponsored program stimulated the economy by bringing employees back to work from the restaurant, hospitality, and transportation industries.

Other social service programs saw a sharp increase as COVID-19 infections increased. Medi-Cal enrollment soared to more than 51,000 beneficiaries, referrals to Adult Protective Services increased by 10 percent, and referrals to Children and Family Services decreased by 20 percent. This drop in referrals was perhaps the most concerning as children transitioned to distance learning, and mandated reporters did not have eyes on their students. However, this wasn’t the only challenge social services faced.

Balancing disaster services work with the division’s daily work may have been their biggest challenge. Because their daily work had dramatically increased, it became a nearly impossible task to serve two constituencies with the high level of service they had always provided. Vacancy rates were on the rise, and worker fatigue set in. In future crises, division leadership can reflect on the staffing lessons learned to avoid staff attrition and workforce burnout.

The old saying, “It is a marathon and not a sprint,” was driven home by COVID-19. Knowing the need to pace ourselves, be mindful of self-care, and be equitable in the division of labor so as not to burn out the best and brightest, and always meet the client’s and community’s needs to the best of our ability was the lesson of the day.

Most wouldn’t have believed it possible to assemble and operate a Public Assistance call center remotely before March 2020. However, that’s precisely what they did without the luxury of a strategic plan and a comfortable go-live timeline. As the need for benefits increased, so did the commitment of staff who stepped up, met the moment, and dealt with various complex client needs with kindness, patience, and compassion. Colleagues supported each other professionally and personally in remarkable ways. Everyone had to figure out a new work-life balance, a way to do self-care, and how to help their workforce through the new normal. The division’s performance during the COVID-19 pandemic has left an indelible mark on its response to the pandemic.

The pandemic has lasted much longer than anyone ever predicted however, the commitment of the Division of Social Services to the residents of Marin County is forever. Our outstanding personnel is our strength, and they will continue to achieve remarkable feats during any crisis and beyond.

Whole Person Care

Long before the coronavirus put a grip on the health of Marin residents, another preexisting health crisis confronted the county: Homelessness. These two unique health challenges coalesced here in Marin with the onset of COVID-19. The job of Marin’s HHS Whole Person Care (WPC) Division became just a bit more demanding as they now went to battle on two fronts.

Knowledge of the virus became known by WPC staff members as they attended to their daily work routines and activities. Some heard about COVID-19 from news reports, while others received the gravity of the information firsthand. One staff member said, “I was on a team presenting at the management forum at Kerner when our presentation was cut short by Dr. Santora. She gave everyone an update about this “COVID thing” we kept hearing about.” A few days later, on March 12, 2020, that same staff member was reassigned — as hundreds of other county employees would also be in the days to come — to the emergency operations center (EOC).

Everyone on the WPC team received new assignments to the EOC. The move came at a cost, as almost all of the division’s work was put on hold. Luckily, WPC’s primary consultants filled the void during the early months. Nonetheless, some staff were grievously impacted by the high stress, demanding workload, the constant state of change, and the confusion they faced. Much rebuilding needed to be done as staff slowly returned to their positions in the late summer of 2020.

The aftermath of these reassignments lingered on. One staff member said, “Being part of the COVID-19 response was quite traumatizing, in ways I still find difficult to describe. It was exciting! I used so many of my skills and felt meaningful and connected – I can’t say I regret doing it. But it took years off my life. It was so stressful and difficult.”

Ironically, COVID-19 brought out the best in some. One shared sentiment was that working with intelligent people who care was beautiful. It was what they already loved about their jobs. Working directly with the community was great, and retrieving old skills from mothballs, like speaking Spanish, was fun! Existing partnerships strengthened, and new relationships were launched.

The lessons learned were plentiful about how to self-manage and support the clients. The staff who knew how to set limits as a self-preservation tool quickly saw that strategy crumble under the spotlight of challenging projects. One team member said, “I love to lead significant, complex, mission-critical projects. COVID taught me that there is such a thing as a project that’s too big and complex for me to feel I can master. That was humbling.” The work was hard.

There were many barriers for clients. They kept getting sicker after they checked into a designated motel for isolation and quarantine. There was urgent staff runs for life-saving medication, late-night consultations with hospital social workers, calls to 911, and all without sufficient medical support. At times it felt so scary. That’s how it felt to work on the frontlines and lead a big part of Care and Shelter. The clients of WPC contended with many challenging issues, including loss of support and resources, isolation, community criticism, and more.

The social isolation of COVID-19 impacted everyone, but for people experiencing homelessness, this impact was even more severe. The unhoused were cut off from their usual sources of interactions, case management ceased or went virtual, libraries closed, and access to technology and its power source disappeared. Deaths of despair seem to increase in this community, rivaling the number of COVID-19 deaths in Marin.

The California Health Care Foundation reports that more than 150,000 people experience homelessness on any given day in California. In Marin, as of July 2022, that number is 1,121. Fortunately, the county avoided dramatic increases during the pandemic due to its proactive approach through investments and a system transformation of county and community partners to support and house our most vulnerable community members.

The upside of COVID-19 has to be the introduction of the HomeKey funding source. The county applied for and was awarded funds for three HomeKey projects increasing the number of permanent supportive housing units in Marin County by 130, plus expanding our scattered site housing slots by an additional 71 beds. Since the onset of the pandemic, the monthly rate of housing people has increased by 56 percent, and more than 281 persons were relocated to permanent housing.

Although COVID-19 tested our staff to its limits, we are proud of the many accomplishments of our team and the many lives saved and improved through our work.

Stories Of Service

These are the heartwarming stories of Marin County employees who acting as disaster service workers, battled the coronavirus, collaborated with our community partners, supported each other, and put their lives on the line daily. They are the dedicated employees of Marin HHS who worked to overcome extraordinary challenges and save lives.

From Cheers to Tears

By Amanda Hyslop

Edited by Kat Richter

I will not lie and say it has been an easy 15 months. Although I was one of the fortunate ones who never caught COVID-19, I did feel its weight on me mentally. When the news began reporting how the virus was gripping the nation, there was a level of uneasiness I had not felt before. A melancholy I had not been accustomed to rose in my body, and I began not to sleep.

Looking back, this is when the cocktail of pandemic fatigue settled in. I was sick of hearing the news about people angry for having to wear masks, people shaming other people for not wearing masks, and people blaming people for having COVID. The reaction to COVID became highly politicized. It was difficult to hear anyone with a human, pragmatic, and compassionate response until I started working with the Marin Medical Reserve Corps.

Instantly I was struck by the leaders of the Marin Civic Center POD, who created an ecosystem where listening, learning, and leaping were the norm. A fireman sitting next to me put it wisely; the COVID-19 vaccine POD was like building a plane while taking off. Whereas in January, I was sitting down drawing up vaccines, handwriting my name and lot numbers, as well as vaccine number two return date, by April, I was handed basins of pre-loaded syringes, administering vaccines while the information on the CDC vaccine card was being inputted digitally.

From cheers to tears, everyone working was in such a good mood, proud to participate, and inspired to be a part of the solution. The people coming in to get their shots were appreciative. The firefighters put on tunes; we had Aloha Fridays. I was told that vaccinating against COVID-19 was the happiest place to be in medicine.

As corny as this may sound, volunteering at MMRC and seeing the fantastic public heroes in action has reignited my confidence in America and the American people. It has also rekindled optimism for this world again. Biden took office and asked us Americans to summon our better angels, and we did that here in Marin. I tell my friends and family that there are angels among us, and they take the shape of public health workers, firefighters, nurses, doctors, county employees, parks, and law enforcement. Their wings are so enormous that you must clip them down, or they will fly away. I appreciate the MMRC opportunity to participate in such a well-organized operation in this historic time.