Part of the long-term funding challenge is quantifying what workers like Scott do in a day, especially if it’s not directly related to COVID or other infectious diseases. How do you tabulate the difference in your client’s life when you’re preparing a bed for their kids, a laptop for their school, or using FEMA funds to pay for a funeral after a loved one dies from COVID? How do you spend a dollar on comprehensive services that might keep a family afloat, especially in the absence of a public health emergency?

As Scott likes to point out, most of the time she’s helping people use the resources they already have available.

Dennis Smith of the National Association of Community Health Workers worries that even though programs like Illinois are working to help address health inequities, they may go the way of many Affordable Care Act grants. In 2013, she worked as a community health worker in Connecticut and helped reduce the uninsured rate by 50 percent in her area. But when the money runs out, the show disappears.

North Carolina is an example of a state that has designed community health worker programs inspired by the pandemic to be more durable, she said.Nationally, however, Congress has yet to approve more funding for COVID tests and vaccines — for long-term public health investments, much less.

Meanwhile, Scott can’t help but worry about Christina Lewis, 40, and others.

As she leaves Lewis’ mobile home after putting down a pile of groceries, Scott reminds Lewis to keep wearing her mask even as everyone else takes off theirs. Scott cited her own family as an example, saying they all wore masks in public despite people “looking at me like I had five heads.”

Lewis said Scott’s help — bringing groceries, discussing the budget — was invaluable. Lewis has been staying home throughout the pandemic to protect her 5-year-old daughter, Briella, who was born prematurely and has chronic lung disease. Amid rising inflation, the struggle to stay afloat is far from over. Briella knows to turn off the lights as soon as she leaves the room. And now they’re looking at rising gasoline prices.

“I already knew I was going to have to buy a bike,” Lewis said.

For the past few months, Scott has been listening and comforting Lewis as she weeps over the stress of making ends meet and losing her family to Covid-19. Scott isn’t sure what will happen to all of her clients if her support goes away.

“What happens to people when it goes away?” Scott asked.

Kaiser Health News is a national health policy news service. It is an independent editorial project of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.