Find them. Tell them the truth. Walk them in. Get them back.
That is the entire product. It is not complicated. It has just never been anybody’s paid job.
We knock on the door
Canal residents, hired as W-2 employees from the first hour — paid hourly, in money, with health coverage. No quotas, no commissions, no credits, and no 1099s. This is our core work, so the people doing it are employees. That is not a technicality; it is what makes their own coverage real.
We tell them what is already true
“The clinic will see you. They will not ask for papers. They will not ask for insurance. They will not turn you away, and they charge what you can pay.” Said in Spanish, on your steps, by someone from your block. This sentence is the product. It costs nothing and almost nobody has heard it.
We walk them in — literally
Not a referral. Not a phone number on a flyer. A person who goes with you the first time, because the first time is the hard one.
We do the forms
Sliding-scale application. Medi-Cal renewal if you still have it — that one is permanent if you miss it. Patient-assistance paperwork for medications, which is free money almost nobody claims because the forms are long and in English.
We get them back for the second visit
The second appointment is where care actually starts, and it is where nearly everyone disappears. Chasing it is unglamorous, and it is most of the value we create.
We remove the barrier that was never medical
A ride. Rent during a bad month. Groceries. Childcare during treatment. Our founder watched patients in Atlanta fail cancer treatment over exactly these — not because the medicine failed. Our mutual aid fund pays for those. It never pays a medical bill.
Clinical care stays with clinicians
Our people never diagnose, advise, or triage. Anything that looks like a red flag goes straight to a licensed nurse or physician at the clinic. We are the walk to the door. We are not the doctor.
Volunteer → W-2. Never 1099.
People ask why we don’t start workers as contractors. Three reasons, and they all matter.
The law says no
California’s ABC test requires that contract work fall outside our usual business. Community health navigation is our usual business. There is no lawful contractor version of this role.
It would kill the coverage
Contractors get no employer health insurance. Employer coverage is the one door still open to undocumented neighbors. A 1099 would trade away the whole point to save payroll tax.
Billing requires supervision
A supervising provider must order and oversee the work. Someone you supervise is an employee. You cannot bill for a contractor you do not direct.
The real ladder in: volunteer (genuine, unpaid) → part-time W-2, even five hours a week → full-time W-2 with benefits → certification. We keep 1099 for what it is meant for: independent specialists with their own practice and their own clients.
Fix the price. Don’t ration the patient.
We will never trade work for medicine or make anyone earn a prescription. We attack what the drug costs instead.
| Path | Who it serves | Notes |
|---|---|---|
| Medi-Cal renewal | Currently enrolled | Highest-value action. Permanent if missed. |
| Still-eligible categories | Under 19, pregnant (+12 mo), former foster youth <26 | Eligible regardless of status. |
| Emergency / pregnancy Medi-Cal | Undocumented adults | Still open after the freeze. |
| 340B via FQHC partner | Partner clinic patients | Cheapest real path. Requires a nonprofit FQHC partner. |
| Patient assistance programs | Low income, most statuses | Free brand drugs. Underused because the paperwork is hard. |
| Hospital charity care | Anyone with a hospital bill | Legally required. No citizenship needed — income-based. Can erase a bill entirely. |
| Cash-price tools | Uninsured | Cost Plus, GoodRx, TrumpRx.gov (a referral site listing cash prices; bypasses insurance). |
If you have a hospital bill, you may not owe it.
Nonprofit hospitals are required by federal law to have a written financial assistance policy. Not encouraged — required, as a condition of their tax exemption.
And here is the part that matters in this neighborhood: those policies do not require citizenship or legal residency. Eligibility is based on income and household size. A hospital cannot condition emergency care, or your right to apply for assistance, on your immigration status. Most nonprofit hospitals provide free care at or below 200% of the federal poverty guideline — and roughly half of this neighborhood is under that line.
Which means a great many people in the Canal are carrying hospital bills they were never required to pay, and were eligible to have erased.
So why doesn’t it happen? Because hospitals set their own criteria and they vary enormously. Because the applications ask for residency proof and documentation that are hard for this neighborhood to produce. Because nobody tells you the policy exists, and the bill in your mailbox certainly doesn’t. Because it takes a person, an afternoon, and knowing the policy is there at all.
That is the third large, legally-mandated benefit sitting unclaimed in the Canal — alongside Medi-Cal renewals and free medication from drug makers. We did not build any of them. We do not need to. We need to walk people to them.
What we will not do
Designed in, not disclaimed later.
Never condition help on work.
Need alone decides aid. A job is separate, voluntary, and paid in money. You may have both. Neither is ever the price of the other.
Never pay in credits or scrip.
Wages are money — spendable anywhere, on anything, because they are yours.
Never set fundraising quotas.
No commissions, no daily targets, no panhandling.
Never show a donor what you bought.
Pharmacy receipts reveal medical conditions. Donors see categories and totals — never your name against a receipt.