[Danielle Balocca]: Hey Medford Bites listeners. Hope you're all having a great summer. Some exciting new updates will be coming to the podcast in the next couple of weeks. We would really like to hear your feedback about what you think about the podcast and how it's going. What can we improve? What do you want to hear more of? Please send us an email at medfordpod at gmail.com and rate and review the podcast on Apple Podcasts. We welcome any and all feedback. Today's episode includes an interview with Alicia Lagambina about the work she does as the community social worker for Medford. I've included additional information in the show notes. I hope you enjoy. All right, thank you so much for joining me today. If you don't mind just introducing yourself with your name and pronouns and just a bit about who you are.
[SPEAKER_01]: Hi, my name is Alicia Lagambina. She, her, and hers. And I am the community social worker for the City of Medford's Health Department in the Office of Prevention and Outreach. And I'm also a lifelong Medford resident.
[Danielle Balocca]: Great. Thank you, Alicia. So the first question that I ask everybody on the podcast is just to share your favorite place to eat in Medford and what you like to eat there.
[SPEAKER_01]: My favorite place to eat in Medford has to be Bob's, and I get a chicken parm sub every time I get takeout from there.
[Danielle Balocca]: That sounds really good. Okay, so if you could just tell us a little bit about your role at the city, what your job entails, kind of what you do here.
[SPEAKER_01]: Okay, so my position is new. I went from being the community recovery coach out of the health department. I transitioned during COVID to the at-risk coordinator and kind of helping those services be connected to those with limited access to the great federal funding coming and being solidified as the community social worker. We do a variety of things. The most The most important thing that we have done is our substance use recovery and harm reduction initiatives. We work with the Medford Police Department and we do door knocks after an individual in the community has overdosed. We provide overdose prevention training, naloxone to that person or their family in the event that another overdose would occur. We do one-on-one individual recovery coaching here at City Hall. We also have a peer recovery group that meets every Wednesday from 4.30 to 5.30 here at City Hall. and we have dinner. It's very informal, family dinner style check-in with residents who are seeking their place in recovery. We support families who call us and have a loved one who is living with a substance use disorder or have some concerning behaviors that they're worried about. So substance use, in terms of my role, is huge and definitely something that we consistently want to broaden our services surrounding. We do have some programming where somebody who is interested in recovery, we help them with job placements, recovery home scholarships so that they could pay their first or a couple months rent and remain in recovery. And we, you know, help them with basic needs and gift cards and bus passes. We're starting a job readiness program, as well as hoping to, in the works is coordinating with the mayor, such as the housing meeting that they had, we would like to have an employment one. So those who are unemployed or underemployed in the resources available. So we're trying to dip into the career opportunity realm as it's directly connected to the people that we work with who are living with substance use. The social work aspect kind of came out of the fact that I'm a social worker and I work for the health department and so a lot of the needs of the communities are directly related to social determinants of health and we see a lot of concerning issues in the community and usually what happens is that the health department, the building department, office of community development or veterans office are wondering like what can we do to help connect this person to resources. Outside of the substance use initiative, we don't provide any actual assistance here. So I'd like to make that clear. There's no emergency housing fund that I know of. But what we do is we connect those two resources in the community as well as case manage them. So it's not enough to just connect somebody with resource and make a resource list. It certainly wasn't during the pandemic where offices were closing and there were different routes to get services. and receive services or connect with services. So we do a lot of advocacy for those who are looking for services. So we follow up with the community providers and we say, hey, what's going on? And we follow that with the person. A lot of what we do is just support people while they're going through this time that's difficult for them. We do a lot of brief supportive counseling just for those who are really experiencing some anxiety, really experiencing a stressful time. And so we get a lot of calls surrounding that without even the resource management.
[Danielle Balocca]: It sounds like there is a comprehensive idea around supporting folks that are seeking recovery in various stages of substance use and recovery. I think this is one of those things that people know is a problem, but they don't know what it means in terms of impact to their community unless it's affecting them. I think I didn't know about your position before I came across it with something with work. sort of knowing that this problem, which I think can be really personal, these things that can be sort of like hidden within families or like different groups, like it's, I think it's really important to know that something like this exists at the city level and that you're, you're not just sort of like hearing what people are going through and like sending them off to a program, but you're like sitting with them, you're having meetings where you provide dinner, and I think it's, it's helpful to know. And I wonder if you could say, like, if you had any estimate of like how many folks you serve with this program.
[SPEAKER_01]: I don't have my stats up. Let me start by saying there's a couple ways to... for someone to come in contact with the community social worker. So through the co-response, we had the at-risk referral form. And so that was interdepartmental through the city, as well as anybody from the community could do that. So we have like these patches of data of how many initial contacts, and we also have the multilingual resource line. So the community liaison speaking a variety of languages, Arabic, Spanish, Portuguese, Haitian Creole, they will respond in the person's language and be able to connect that way. And all the social service calls that go to that come to me and all the health-related COVID vaccinations will go to the public health nurse. So there's a couple of So through these various avenues of kind of getting connected to me, we've served, I actually had my numbers up for housing. So it's also, we run stats based on their needs. So housing, food insecurity, substance use, mental health, children, elder. So we kind of have this really messy database of data, which we are working on. We're collaborating with Tufts for our practice evaluation of what we're doing here and also like better ways for us to get this good data that I think the city needs. I think the city would should hear about the stories that we are hearing about. So that's another aspect of my job is to just bring the social work perspective, bring what I'm hearing to those who make the decisions, the stakeholders, the grant funding. And so it's funny because I'm one of the only people that have direct contact with populations who need assistance. So we have a social worker at the Council on Aging, we have some family workers in the city. So when there is a discussion surrounding social service needs, they kind of call me in as the expert, but I'm not. I'm just the only person who is working with these populations. So those who are homeless in Medford, those with housing instability, those with food insecurity. so a variety of issues so they'll call on me and it's good because I get to tell them in real time what I'm seeing and what so right now we're kind of working on this a population of those who are unhoused and the community we're finding spots where they are where there's evidence clothes shopping carts, and we've been doing some direct outreach this week. So we've made backpacks of Cheez-Its and Gatorade, and more so to just engage with these individuals, tell them about the cooling centers that are going on right now, which are highly underutilized. But, you know, it's hard to make contact with a population that needs something when we're, you know, the way that we communicate with the public is highly, you know, technical.
[Danielle Balocca]: Yeah, it's a big job. Yeah. And I think you mentioned social determinants of health. And I think I'm glad that you brought that up. And what you're speaking to is like, I think this perception sometimes of folks who who use drugs, who use substances, this being a moral failing and we just need to get them to stop using and then all their problems will be solved. But I like how you're speaking to all these other issues. People don't just use drugs and alcohol because it's fun or whatever, but there can be lots of underlying reasons and then lots of underlying challenges that would help someone achieve recovery, like having a home being one of them, for sure.
[SPEAKER_01]: We have an open path to recovery program. We have a program for those who want to achieve sobriety and need certain resources to get there. But we also have a population who don't necessarily want to stop drinking. They want to work on employment or housing. And we support that. And we support them in other ways. So if we can help them make a doctor's appointment, if we can help those with giving them access to naloxone, telling them when their needle exchange is. So we're navigating this harm reduction world right now, which seems really scary to people. But it is just limiting the health effects. It's a public health initiative. So we're limiting negative health consequences for the people that we're working with. whether they want to be abstinent from substances or not. So that's a population that we've been working with in terms of mitigating the harmfulness of the alcohol use. And definitely something that I'd like to see bigger in Medford. Harm reduction is huge. I mean, it can be applied to anything. It can be applied to teens. It's a good principle. to, you know, to a population where they, you know, worthlessness could be there. There's a lot of really emotional things to just be open to where they are and, you know, what they want, because we are our best, you know, advice givers. We know ourselves the best. So, and just, you know, reinstating some self-determination that people know what's best for them with what they have.
[Danielle Balocca]: And you all do, do you do Naloxone trainings?
[SPEAKER_01]: We do, so we do group ones, we do one-on-ones, we give away free Naloxone and we have done a couple of community-wide ones, but anyone can come by or make an appointment to get one. So we have this substance use program, and we're working on this social services program, and I always kind of like to plug what I am seeing. So I am seeing a lot of homelessness, and we are seeing a lot of hoarding disorders and cluttering affecting those of age. which is really concerning. So I work with the health department and the building department and we We rally around these situations and try to find the best course of action because we want people to live independently and healthy in their own homes. And that's something that the city, we all share that ideal. We have a hub table that meets every Tuesday. And so any agency that provides social services to the city, including our community mental health providers, Department of Children and Families, the public schools have come, DMH, so we have all these providers come and if there is a high-risk case usually brought forth by the police, so the police that fire the EMTs are also there and we all kind of rally around this individual family or dwelling, and we make a team to outreach that person in this crisis moment, elevated risk moment really, and just offer services, you know, and just provide the information, offer it at no, you know, you have to do it kind of message.
[Danielle Balocca]: And you bring up a good point, and I'm wondering if it's okay to ask about, I think something that is on a lot of people's minds is this idea of intersection of social work, mental health, and the police. And it sounds like the hub that you're describing involves all of those people. And so could you describe kind of what Medford's doing to sort of combine those services?
[SPEAKER_01]: Yep. So I was, I had the, It was great to be here through two different administrations at the police station and I will say that our police station now is very welcoming to the idea that social workers and clinicians should be interfacing with those with mental health and substance use and being offered services and de-escalation and the whole thing. Right now we have the recovery coach who goes for overdose door knocks and offers resources and naloxone and as well as myself to provide anybody the police or any department with connections to social services and we also now officially as of yesterday have our three jail diversion clinicians and they're going to be, if not already, corresponding with the police for mental health interactions. And so I work closely with them. I'm located at the police station on Thursdays. I work closely with them. And it's been really great to see it unfold. First, there's a huge capacity for this work. Mental health is its own job, and over here with the substance use and the other social determinants of health, there's a huge capacity of work to have this many people and more. And so the police are now having this unit, And these mental health clinicians with experience are going out and interfacing with families. We have a day clinician, an evening clinician, as well as a youth and families clinician. And so this is fairly new within the last year. Total godsend. So that is a grant through DMH. They're contracted through Elliott, so they have that connection to the resources of our community health agency that serves Medford.
[Danielle Balocca]: So if the sort of primary reason for someone getting attention from the police is like a mental health, substance use, some sort of related cause that these clinicians can sort of try to intervene and get the support that this person needs rather than sending them to jail.
[SPEAKER_01]: Yep, so the whole aim is to avoid... jail time and possibly avoid involuntary commitment on the substance use and mental health side by having that person, because it can be traumatic. It is traumatic. And having those individuals speak to someone and get services in that time and not cause the community more trauma, who's already facing a lot of mental health issues.
[Danielle Balocca]: Well, you've been here for a long time in this, as like a social work sort of position with the city. I wonder if you can talk about like a piece of it or like a time or project that you're kind of most proud of.
[SPEAKER_01]: I mean, Substance Use is definitely our baby here. But as we move forward, I think just solidifying this position so that we can work on programming for the city that has a connection to the population that they serve. A huge part of this is just being a part of the team who is seeing what's going on and advising the top that this is what we're seeing and this is what we need help with. And so having those connections. And I think the other thing is this weekly group. We have a solid group of people in Medford who come to the group and for any other reason this is the group that they attend and not much else and they feel there's trust there and you know and I think that's something that I'm super proud of and you know my supervisor the office of prevention and Outreach Manager Penny, funnily, she is everything to this city. So she is responsible for this office, for our positions, for advocating for services, for taking our word for it and advocating to the administration. And she also has several grants, which I would be really hard to describe, but just about emergency preparedness and climate resiliency and social determinants of health and equity and all these things. So she's responsible for the community liaisons. She's responsible for most of our prevention. grants that are servicing like regionally substance use prevention. She's responsible for writing for the jail diversion clinicians. I mean and so on and so on. We have a grant through RISE that helps fund our work here with substance use to be able to provide those scholarships and so she's really the brains and the behind this operation and she also really believes in like serving the community you know and it can get political when we work for the city but her main her main goal is always to this is about serving the city and i really like that about political players who have that ideology like it can be messy we can yeah but this you know this is what's best for the community so i'm going to fight for this that sounds great and it sounds like there's some like
[Danielle Balocca]: ideas in the works for the future. So if there was something that you thought like here's something that we could improve upon or like a step that would like help us move towards that equity space. Are there anything that you're noticing or anything you would name?
[SPEAKER_01]: I think we've come a long way in terms of English literacy and English as a second language and really reaching out to those populations. I feel strongly that it's not a population's job to reach out to us. It is our job to reach out to certain populations and we have some really deep-rooted cultural and linguistic groups in Medford and you know it it's not okay for them to not know about services available or be unable to access them due to you know a language barrier and I think that was a huge goal of ours that everything be translated and you know, there are communities with more languages and more people who speak other languages and you go into their city hall and they've got like every language and you know, I hate to think that someone would come into this space even to pay a parking ticket and just be unable to. So we've worked really strongly on everything, especially resources be translated. So there was a project in the spring where we took some of the groups, the community organizations in Medford, and we translated some really important things about them and what they provide the community, so, in a flyer. So Anna is the MVP coordinator, and so we have, you know, what happens at the library. The library, you can rent a laptop. I think that's really important for people to know. So the Medford Rec Center, Medford Family Network, us here, you know, so the tricky thing that I learned through it is that a lot of the languages or definitions that we say aren't really translatable. So wellness isn't an easy translatable term. I think in one culture, a sort of equivalent was like unburdening oneself. So it's really interesting to think about, we think of like your mental health wellness. Well, that's not, you know, sometimes a term that's easily translatable. Some cultures, they have mental illness and then they have a work ethic. I don't want to speak to any other culture or be an expert in it, but just the translation of trying to figure out how to put this out there where this culture would understand what we would like to say was really eye-opening. I didn't even think, even when I was writing the substance use like short description, they were like, this is not translatable.
[Danielle Balocca]: Yeah, no, like a lot of the jargon that we use totally in like some of these terms. I think also like the value system that, you know, in different communities. So like, you want me to talk about how I feel? Like, I don't do that.
[SPEAKER_01]: Yeah, the connotation of some of the things that we're providing resources and they just, you know, there was a better way. Sure. We want to get people. hooked up with resources.
[Danielle Balocca]: Yeah, I mean it sounds like you're being really creative and it's a cool program. I'm wondering too if there's any like the best way to get in touch with you or City Hall if somebody has a need or concern that relates to substance use, mental health, any of these resources?
[SPEAKER_01]: Yeah, so we have the multilingual resource line, and you can call that and leave a message in any language, really. And that's 781-475-5644. Or you can put a request for services on medfordma.org, and that will also come to me. Or we have a outreach cell phone, but it's office hours. So if you would like to get in touch with myself or the community recovery coach, 71-654-5635. And if I hadn't mentioned, his name's Jeff Gibson, and he's a complete asset of caring and compassionate outreach work in Medford. So if you do see him with a couple of bags passing them out in Medford Square, make sure you, you know, say hi. And, you know, we love this community, so.
[Danielle Balocca]: Well, Alicia, thank you so much. This has been really enlightening. I appreciate your time. Hopefully we can connect again soon. Thanks so much to Alicia. Be sure to check out the show notes if you want to access any of the information and resources mentioned in today's show. Thanks so much for listening to today's episode. And as always, if you have feedback about this episode or ideas for future episodes, you can email medfordpod at gmail.com. You can also subscribe, rate, and review the podcast on Spotify and Apple podcasts. Thanks so much for listening. Guys, what's the name of the podcast? Never Bites!