EVALUATION OF THE BALTIMORE HEALTH CORPS PILOT: An Economic and Public ...

EVALUATION OF THE

BALTIMORE HEALTH CORPS

PILOT:

An Economic and

Public Health

Response

to the Coronavirus

Summer 2022

Submitted to:

Baltimore Civic Fund

One N. Charles Street, Suite 1600

Baltimore, MD 21201

Submitted by:

Abt Associates

6130 Executive Boulevard

Rockville, MD 20852

Brandon M. Scott

Mayor

About This Report

This is the Final Report to follow the Early Lessons Report for the Baltimore Health Corps Pilot Study. Readers

are encouraged to review the Early Lessons Report for a detailed description of the formation of the Pilot

Study, the role of each partner, as well as findings from the first year of the Pilot Study. This report is based

on research funded by a consortium of funders listed below. The findings, views, and conclusions contained

within are those solely of the authors.

Authors

Seri P. Irazola, PhD ¨C Principal Investigator

Nicole Maddox, PhD

Brianna Fadden, BS

Hilda Ndirangu, MHS

Pete Knepper, PhD

Funders

Abell Foundation

Hoff berger Foundation

The Annie E. Casey Foundation

Johns Hopkins Bloomberg School of Public Health

Baltimore City allocation of United

States¡¯ Coronavirus Aid, Relief, and

Economic Security Act funds

Kaiser Permanente

Baltimore Community Foundation

Open Society Institute ¨C Baltimore

Baltimore Ravens

PepsiCo Foundation

Bank of America

Leonard & Helen R. Stulman Charitable Foundation

Baltimore Gas and Electric/Exelon

Rauch Foundation

Bloomberg Philanthropies

T. Rowe Price Foundation

Jacob & Hilda Bluestein Foundation

The Rockefeller Foundation

CareFirst BlueCross BlueShield

The Harry and Jeanette Weinberg Foundation

France-Merrick Foundation

Goldseker Foundation

Maryland Department of Labor

Table of Contents

Executive Summary.............................................................7

SECTION 1

Background and Understanding............................... 24

SECTION 2

Evaluation Design.............................................................40

SECTION 3

Evaluation Findings.......................................................... 50

SECTION 4

Discussion and Recommendations.......................... 92

APPENDIX A

Funding Reports for the

Baltimore Health Corps Pilot .................................... 101

APPENDIX B

Terms of Reference:

Monitoring and Evaluation of

Baltimore Health Corps Pilot.....................................103

APPENDIX C

Focus Group Instrument.............................................. 112

APPENDIX D

Key Contact Tracing

Performance Indicators................................................116

APPENDIX E

Completeness of

Contact Tracing by Race...............................................119

APPENDIX F

Job Descriptions for the

Baltimore Health Corps Initiative............................120

APPENDIX G

Survey Results.................................................................. 154

BACK MATTER

References.........................................................................160

ABT ASSOCIATES I Evaluation of the Baltimore Health Corps Pilot: An Economic and Public Health Response to the Coronavirus

Acknowledgments

On behalf of the authors and Abt Associate¡¯s Leadership Team, we sincerely thank the many individuals and

organizations who provided evaluation support to our researchers. We are grateful for the many phone calls

and text messages, the coordination of partners¡¯ schedules, the identification of individuals to participate

in our focus group, the gentle ¡°nudges¡± to survey respondents to increase response rates, and for providing

thorough feedback, data, and supporting documentation. Specifically, we thank the Baltimore Health Corps

(BHC) fiscal sponsors ¨C HyeSook Chung, Emily Duncan, and Cassandra Sullivan ¨C for their ongoing perseverance that allowed our team to securely receive, process, and analyze BHC data. We also want to thank

the Baltimore City Health Department (BCHD), the Mayor¡¯s Office of Employment Development (MOED),

and HealthCare Access Maryland (HCAM) for providing thoughtful insight and review of our instruments

and products. In particular, we are grateful for the review and input by Rachel Brash, Darcy Phelan-Emrick,

John Ford, Anna Schauer, and others. We would also like to thank the University of Maryland¡¯s Department

of Health Policy and Management Health Systems and Policy Research Lab for executing a thorough formative analysis of the BHC, and providing the Early Lessons Report to document BHC¡¯s progress from July

2020 until June 2021.0F Lastly, we are especially grateful to the Community Health Workers (CHWs) who

took the time to respond to one or both of our surveys, and of course, for all of the critical work you carried

out across the duration of COVID-19 and its variants.

Front Matter

4

ABT ASSOCIATES I Evaluation of the Baltimore Health Corps Pilot: An Economic and Public Health Response to the Coronavirus

Preface

It was just two years ago that the first case of the 2019 novel Coronavirus (later regarded as COVID-19) was

detected in the United States. Shortly thereafter, in March 2020, when the World Health Organization

(WHO) declared COVID-19 to be a pandemic, the US government responded by declaring a nationwide emergency. Following, US citizens witnessed unthinkable events in their communities: school district closures,

state-mandated closures of restaurants, bars, and gyms, social distancing measures, and mandates to wear

masks ¨C were just a few of such events. To make matters worse, in May of 2020, the US unemployment rate

spiked to 14.7 percent ¨C the worst rate since the Great Depression. Because many of these closures were

in the hospitality industry, it hit low-income and minority workers disproportionately ¨C delivering both an

economic impact, as well as a public health crisis.

While many communities awaited guidance from their state and local government officials, Baltimore City

sought to address the concurrent economic and public health crises caused by COVID-19 through an ambitious Community Health Worker (CHW) employment development initiative that trained and employed

hundreds of residents while supporting the City¡¯s emergency response. Creating the Baltimore Health Corps

(BHC) aimed to generate sustainable, long-term career trajectories for individuals who lost work during this

emergency. Moreover, the proposed model sought to reduce inequity by intentionally hiring citizens who

represented the diversity of Baltimore City itself; therefore, the candidate pool included those citizens who

were unemployed, underemployed, or furloughed, with great variability in candidate background, ethnicity,

skill-level, and geographic location within Greater Baltimore. Throughout the rapidly changing landscape

of COVID-19 and its variants, BHC maintained flexibility and steadfastness which enabled the core partners

to respond to the continuing pandemic. For example, while the jobs were originally planned to last eight

months, they were extended through September and then again through the end of 2021. This demonstrated

the thoughtful reflection points, and a commitment to both BHC, and Baltimore¡¯s most vulnerable residents.

The adaptability of the BHC enriches our understanding of post-BHC employment, as a large number of

CHWs are still working for the BHC partners. Ultimately, the BHC was an intricate, proactive initiative that

immediately addressed the needs of Baltimore City during this lengthy period of uncertainty.

With the passage of the American Rescue Plan Act (ARPA) of 2021 that provides funding for COVID-related

expenditures, the BHC should be considered a model program for other jurisdictions to replicate in response

to COVID.

Front Matter

5

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