By Rina Breakstone, LCSW, Psychosocial Services Manager, TRUST Health Center – LifeLong Medical Care

Last December, my team and I traveled from sunny California to brave Chicago’s blustery winter to attend Putting Care at the Center 2018. Bundled up in scarves and gloves, we attended workshops, plenaries, the Beehive, and the keynote sessions. For two and a half days, my brain was racing in an attempt to absorb all of the information I was taking in, and I left in awe of the creativity and fortitude of my colleagues doing this work all across the country. I returned to California inspired to improve the ways we recruit, train, and support front line staff at the primary care clinic where I supervise an intensive case management pilot program.

Trained as a social worker with nearly a decade of experience working in the field of complex care, many of the conference’s key themes were not new to me: the principles of harm reduction and trauma informed care are of paramount importance; it is invaluable to involve stakeholders in the development of services; and high quality data is needed to evaluate the efficacy of programs. But as a newly minted supervisor for three community health workers (CHWs) at LifeLong Medical Care’s TRUST Health Center (TRUST) in Oakland, I knew that I had a new set of skills to learn. I attended Putting Care at the Center eager to learn from the existing experts in this field and return home with best practices to implement at TRUST. 

From Alameda County EMS Corps and Highland Hospital’s complex care team, I learned the value of recruiting CHWs from within the community that is receiving services, as well as the crucial role CHWs often play as a bridge between patients and medical providers. I am excited to report that TRUST Health Center is currently collaborating with the Alameda County EMS Corps to hire new community health workers (CHWs) and health coaches. We have also implemented a bimonthly case conference between the CHWs and the medical team in order to better collaborate and support the patients at our clinic who are experiencing the most medical complexity.

I left the workshop from the Penn Center for Community Health Workers (One Size Does Not Fit All: Adapting Evidence-Based Interventions to Fit Local Contexts) excited about new ways to identify the right CHWs to hire and how to tailor supervision to fit the individualized needs of each CHW. I have been in conversation with our clinic team about who we want to hire, the ways in which we advertise for new positions, and where we disseminate the job postings. As a supervisor I allow space for CHWs to process personal and professional challenges and we discuss ways to avoid burnout and compassion fatigue. I also support the use of taking mental health days and explore ways to develop flexible work schedules to accommodate CHWs’ responsibilities outside of work. Additionally, we have incorporated regular social outings to help enhance team bonding and reduce workplace stress. 

In another workshop, the Boston team who facilitated the Engaging the Workforce of Tomorrow in the Problems of Today session reminded me that I am not alone in this work. There are successful CHW programs in existence all across the country where individuals who have been failed by traditional healthcare and social service systems are getting the support and care that they deserve. This work cannot be done in isolation nor does it have to be. There is great value in learning from my predecessors and engaging colleagues to identify creative solutions.

I left Putting Care at the Center with these words and themes buzzing through my mind: nimbleness, iterative processes, flexibility, innovation, reflection, and curiosity. Six months later, these concepts are still fresh in my mind and we have successfully implemented new systems to improve the recruitment, training, and support of CHWs at TRUST. My team and I are looking forward to attending next year’s conference in Memphis in order to continue improving the ways in which we provide care to our community. 

This blog post was developed by a scholarship recipient from the Camden Coalition’s National Center for Complex Health and Social Needs conference Putting Care at the Center 2018. Register for this year’s conference at  


Rina Breakstone, LCSW, currently works as the Health Homes Manager at LifeLong Medical Care’s TRUST Health Center in Oakland, CA, a partnership between LifeLong and Alameda County’s Health Care for the Homeless. Rina completed her Master of Social Welfare at UC Berkeley and has worked as a Medical Social Worker in primary care and hospital settings. The work of the Camden Coalition of Healthcare Providers and its National Center for Complex Health and Social Needs greatly resonates with Rina’s passion for complex care and her dedication to both clinical practice and improving systems of care. Born and raised in the Bay Area, Rina is committed to addressing health disparities and improving the wellbeing and vitality of her community.