When Government Is Not the Solution: The Role of Community Organizations in Outreach

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Relationships among the stakeholders who make human service delivery possible on the Texas-Mexico border are complex.These relationships should be viewed through various lenses, each contributing meaningfully to a comprehensive understanding of how service delivery works: the goals of humanitarian service organizations, the policies of federal, state, and local governments, especially as they relate to immigration, and finally, the sentiments of local communities (Glier et al., 2020).All three are essential in understanding and addressing community needs, but they do not always cooperate harmoniously.The interests of human service agencies sometimes conflict with a strict observance of laws on the one hand, or of catering to the best interests of a region on the other.Such conflicts can have the tendency to heighten the perception of inefficient or incompetent government.There are also times, however, when coordination among human services, governmental agencies, and the community works efficiently.Our study describes the benefits of coordinating services in the economically challenged border region of South Texas.At the heart of this coordination is the power of reciprocity, or mutually beneficial exchange, which makes coproduction possible.
Coproduction means government and nonprofit collaboration in the provision of public services.Increasing government reliance on nonprofits for the provision of services has been observed by many scholars in public administration and other fields (Cheng, 2018).Nabatchi et al. (2017) observe that this collaboration takes a variety of forms in practice-so various, in fact, that their definition is an 'umbrella concept' capturing all situations in which "state actors and lay actors work together to produce benefits" (p.769).As such, coproduction has received increasing scholarly attention-indeed, "a global resurgence of interest"-in recent years (Nabatchi et al., 2017, p. 766;Gazley & Guo, 2020).For governments, the appeal of coproduction is the promise of a combination of cost reduction and improved quality of services (Alford, 2014).For proponents of coproduction, the public's willingness to contribute in efficient and creative ways to human service delivery is itself a public resource.Improved quality services appeal to the public, as does the hope that cost reductions in service provision will lead to a lowering of taxes, an indirect public benefit.The practice of coproduction continues to be promising, and the concept of coproduction helps to explain the value of our examples for contract failure theory.

Contract Failure Theory
Originally introduced as an explanation for the existence and proliferation of nonprofit organizations (Hansmann, 1980), contract failure theory presupposes consumer awareness of nonprofit status as well as, importantly, consumer perception that nonprofits are more trustworthy than for-profits.The theory is straightforward: in environments characterized by information asymmetry-specifically, where consumers of, or contributors to, a good or service are not in a position to judge whether the product or service has been delivered adequately-consumers are more likely to trust nonprofit organizations than for-profit ones.Why?Because nonprofits, unlike for-profits, lack the incentive to increase their profit margin by underdelivering on promises and then keeping that cost savings for themselves.When consumers or contributors cannot confirm whether the recipient of their funds is keeping its promises, they incline towards consuming from or contributing to those organizations that they believe have the least incentive to take advantage of their blind spot.Handy et al. (2010) find that "nonprofits are perceived as more trustworthy than for-profits or government organizations" and that "donors, as indirect consumers, will prefer to donate (time and money) to nonprofits than for-profit or government organizations" (p.870).Contract failure theory provides an explanation for why governments would rely on the assistance of nonprofits to provide services: nonprofits are perceived as more trustworthy than governments.
Since governments are not for-profit enterprises, it might seem that the argument does not apply.Yet a certain kind of asymmetry-a power asymmetry-characterizes a government's relationship with residents and citizens.Hansmann (1980) had theorized that contract failure can exist also in the case of public goods.The grounds for consumer distrust in for-profit organizations might be somewhat different than the nature of a population's distrust in government, but it is nonetheless distrust.
Like other nonprofits, a government does not exist to make money.It does, however, have the option to make its presence or demands compulsory in the lives of those whom it serves; and this option, if exercised, can be defended with a monopoly on the legitimate use of force.(Take taxes, for example: above a certain modest level of income, filing taxes is required; should one who owes be caught evading this obligation, there are potential consequences.)Whereas a forprofit enterprise might be inclined to take advantage of an information asymmetry, a government might be tempted to take advantage of its power asymmetry.And yet they often do not.Thus, we theorize that increasing government dependence on nonprofits, despite government's clear advantages in power and resources, speaks to a growing awareness by government of the advantage in trust that nonprofits are perceived to have among residents and citizens.Government reliance on nonprofit coproduction of public goods, including the good that is mere compliance with the law, leverages the trust in nonprofits that contract failure theory presupposes.This reliance in turn provides indirect support for contract failure theory.
Our theorizing raises many questions for research.Among those questions are the following, which we believe the case studies described in this article help to answer: under what conditions are governments more likely to seek the help of nonprofits for the sake of coproduction?Which kinds of nonprofits and community organizations are likely to be chosen for the work of coproduction?What factors contribute to the success of the work involved in coproduction?We hope to shed light on answers to these questions in what follows.These questions are raised and answered through case studies in the context of contract failure theory and, as we contend, expand the reach of that theory.
The case studies in this paper describe three initiatives that illustrate successful coproduction in borderlands through cooperation and trust: the 2020 Census outreach, the Volunteer Income Tax Assistance (VITA) program, and the Juntos for Better Health program.The outreach performed by these coalitions provides examples of how to address several interrelated problems regarding distrust in the government: (a) the problem of nonparticipation in the census arising from the presence of a citizenship question on the census (Kissam et al., 2019), (b) the problem of tax filing compliance arising from distrust in the Internal Revenue Service and their e-filing systems (McLeod & Pippin, 2009), and (c) the problem of distrust-and therefore non-participation-in health care and medical research (Smirnoff et al., 2018).
All three provide models of government and nonprofit coproduction benefitting the local community.Each initiative produces a specific benefit, requires and perpetuates trust in nonprofits, and illustrates government preference for reliance on nonprofits despite its advantage in power.On the basis of the outreach performed by these coalitions during the pandemic, we think that through coordinated teamwork, nonprofit and community organizations can under certain conditions assist in the production of public goods even more effectively than can government itself, especially in borderlands.

Methodology
Because the coproduction under consideration in this paper occurred in natural settings and would have occurred regardless of whether it was written about in an article, researchers were inclined from the first to take a qualitative rather than a quantitative approach."Qualitative research is the systematic inquiry into social phenomena in natural settings" (Teherani et al., 2015, p. 669).Qualitative research papers generally use words rather than numbers to portray data (Punch, 2014).As such, they tend to be somewhat longer than quantitative ones, especially if they include 'thick description' of the phenomena being studied.'Thick description' enables rich, detailed pictures of the mechanisms and relationships at work and provides a fertile soil for theorizing about how those same mechanisms and relationships might work in other contexts.
Of the variety of ways qualitative research may be conducted, we chose a case study approach.Like other qualitative research methods, case studies are flexible ways of exploring phenomena with a view to describing and explaining relationships, individual experiences, and group norms.Stake (1995) divides case studies into three main kinds: intrinsic, instrumental, and collective.Intrinsic case studies are those presenting a unique phenomenon.Our case studies do not present a phenomenon unique in themselves, as increasing government reliance on nonprofits for the provision of services has been observed now for some time in various contexts (Cheng, 2018).The case studies presented here are, rather, instrumental in that they help to acquire a greater appreciation of a known phenomenon.And since there are only two, it would be something of a stretch to describe them as collective.Thus, our case studies are instrumental.
Our case studies present examples of government relying on nonprofits for coproduction in the provision of public services.We think this government reliance can be explained by contract failure theory.In the scholarly literature to date, contract failure theory has generally been used to explain the proliferation of nonprofits in free-market societies.It explains this proliferation by observing that the public is often at an information disadvantage regarding whether for-profit corporations have lived up to their end of an exchange.Our goal in this paper is to take this theory and show how it can also help to explain why governments, which have an asymmetrical advantage in power and a monopoly on the legitimate use of force, nevertheless choose to enlist the help of nonprofits to provide public goods. 1If information asymmetry leads to distrust, why would power asymmetry not also do so?Survey and historical data, as well as perhaps interviews with government officials, would be the ideal instruments to test this assumption empirically, but one must work with what one has.
To make this case, it was necessary to show that trust was an essential component in the cooperation in our examples.Once that was shown, it was reasonable to claim that governments would desire to leverage this trust to assist in providing public goods.To describe the mechanisms of trust involved in coproduction, we used our case studies to answer three related questions: what are the conditions under which coproduction is a useful strategy?What are the characteristics of groups who are likely to be perceived by governments as useful partners in coproduction?And what are the factors that contribute to the success of coproduction?The first case study, wherein a coalition of nonprofits and community organizations combine resources to promote Census 2020, allows us to answer all three questions; the second, wherein a similar coalition combines resources to do healthcare outreach, helps to provide a fuller answer to the third. 2 The mechanisms of cooperation all reveal the importance of trust, and trust is the link between cooperation and contract failure theory.We believe the application of contract failure theory to explain coproduction expands the reach and usefulness of this theory.

Coproduction in Borderlands
The perception of nonprofit trustworthiness is likely to be more pronounced in borderlands.This is so for a variety of reasons.These reasons suggest that a location in borderlands is one of the conditions under which governments are more likely to perceive the efficacy of, and to choose, strategic coproduction with nonprofits.While we provide no empirical test of this likelihood in this paper, we think our case study provides grounds for reasonable belief that this likelihood obtains and, moreover, that it is especially useful there.
Many non-citizens live in borderlands, as do many first-generation immigrant families, many of whom know or are related to non-citizens.According to Lee (2019), non-citizen engagement with authority is selective: "noncitizens are more comfortable with nonprofits, religious institutions, transnational associations, and using social media to connect for services" (p.272).This makes sense.Those who are concerned with the potential for abrupt changes in citizenship status for themselves or those who are dear to them might interact differently-or, out of fear, not at all-with government agencies.Aside from this, there are issues of language and convenience: nonprofits specializing in services for those who speak English as a second language may design their programs and initiatives with this population foremost in mind and thus be more ready and able to provide for their needs and concerns.Local nonprofits are usually more familiar with the unique population to be served.Finally, dealing with government or its agents can be intimidating; citizens and noncitizens alike are aware that government and its agents are likely to be on the lookout for noncompliance with the law.
Today, many native-born American citizens report a distrust of the government.And recent polling has shown that Americans generally (not just on the border region) are aware of their fellow citizens' increasing distrust of the government (Rainie et al., 2019).For Latinos in particular, and especially those living in border regions-whose distrust should not be confused with a lack of patriotism 3 -the racialization of immigration policies is one of several issues that can lead them to be less trusting of governmental services (Cruz et al., 2018;Michelson, 2007).In addition, Rocha et al. (2015) found heavy-handed immigration enforcement, especially among otherwise non-criminal populations, to be associated with more negative political orientations among both native-and foreign-born Latinos.
Research suggests that community and nonprofit organizations may serve as buffers between restrictive or demanding governmental laws and those living in border regions, increasing both levels of knowledge and compliance among residents (Allen & McNeely, 2017).Local nonprofits often perform outreach after having received financial support from government, yet their localized arrangements demonstrate independence from government (Brown & Troutt, 2004).It would not be surprising if the civic footprint of nonprofits was higher in communities with higher immigrant populations.Borderlands provide an especially fertile ground for the growth of nonprofit coproduction in human service delivery.
All stakeholders along the border-human service agencies, governments, and residents of communities-exist in a dynamic political environment in which conflicting public perceptions enjoy widespread support.Often these perceptions betray contradictory goals, contrary assumptions, and clashing political rhetoric, especially as it relates to helping undocumented individuals or contributing to human trafficking and smuggling.In such an environment, public trust, "an essential elixir for public life and neighborly relations," is hard to gain, not only for governments and for nonprofits but also for residents between each other (Rainie et al., 2019, p. 3).In this kind of environment, research has shown that nonprofits are generally more trusted than governments as well as more responsive to circumstances of uncertainty (Witesman & Fernandez, 2012).Governmental agencies often possess financial means to support large-scale projects with the potential for meaningful impact.These resources are well spent in funding nonprofit organizations who are trusted in the community.

Region of South Texas
South Texas has seen enormous population growth since the 1990s.Since growth occurs yearly and the U. S. Census is taken every ten years, areas of frequent population change inevitably create periodic disparities between government funding and representation, on the one hand, and the real political and social needs of area residents and local communities on the other.These disparities can be especially troubling for South Texas, as socioeconomic indicators place it among the poorest areas of the nation.Notwithstanding the significant growth in population and employment over the past two decades, economic indicators show that development in the region continues to lag Texas and the United States.According to 2019 U.S. Census data, roughly one out of four people live below the poverty level.As shown in Table 1, dramatic differences exist in per capita income, poverty levels, and English proficiency between residents of South Texas and residents throughout the State of Texas.
The poverty rate in Laredo (25.7%) is significantly higher than the State of Texas (14.9%) and is over twice the national rate (11.8%).The per capita income in Laredo is $17,326, which is much lower than that of the State of Texas ($30,143) or the nation ($32,621).
Variables such as low voter turnout, low rates of self-reporting in the census, and a significant number of people not filing taxes-despite the likelihood that there would be eligible for substantial tax refunds, including the Earned Income Credit-further exacerbate factors leading to high poverty rates.The poverty rate in Laredo (25.7%) and Zapata (19.5%) is  ($32,621).Poverty aside, these factors indicate that government is less likely to be present and effective in the region.This reduced presence and effectiveness is exacerbated by comparatively lower levels of broadband access in the area.As a general trend, more and more governmental services were already being advertised, promoted, and delivered online prior to the coronavirus pandemic.The response to COVID-19 pressed this transition into overdrive, exerting enormous pressure on government, businesses, and nonprofit organizations alike to transition into the digital age more fully and immediately and deliver services online wherever possible.Finally, the region is 95.5% Hispanic.Spanish is the household language for 90% of homes.In Webb County, only 66.7% of those 25 and older have a high school diploma or higher, compared to 82.3% in Texas and 87% nationally.

Unique Challenges of Coproduction
Distrust of government is especially acute in the age of e-government and e-services (Morgeson et al., 2011).In South Texas, this distrust is compounded because area residents have one of the lowest levels of access to broadband in the United States.According to the 2018 American Community Survey, 42.5% of households in Webb County, Texas, have broadband internet access, as compared to 85% nationally (U.S. Census Bureau, 2018).Senior citizens especially lack experience with technology.They are also more likely than other groups to be fearful of scams related to sharing sensitive information over the internet, which is not to say they are also adept at avoiding them (Hilbert, 2018).Low access to and experience with broadband and internet services presented challenges for all three programs.
For census outreach, this challenge was relatively new.It had not been a major factor in census reporting in 2000, as the roll-out of the online census response option in that year-the first year the internet was used to collect census data-was deliberately not well advertised. 4In 2020, however, the online response option was advertised widely: video guides were available in 59 languages and most households were urged to submit their census responses online via internet (U.S. Census Bureau, 2020).Given the low levels of broadband access in South Texas, the hesitancy for making in-person contact due to COVID-19, and the distrust of supplying government or its representatives with highly personal household information-especially regarding citizenship in borderlands-underserved residents in the area were in danger of being overlooked and undercounted.
For tax filing compliance for the VITA program, the challenge was in a way wholly new.The use of technology other than pen, ink, and paper has long been involved in the work of tax collection in the United States: the IRS has used computers to process tax returns since 1961, and 1986 saw the inception of electronically filed individual tax returns.By 1991, there were at least 15 tax preparation software options available for purchase in the United States (Garber, 2013).Since then, the number of returns filed electronically has increased dramatically. 5 Pandemic conditions, however, provided strong incentive for VITA programs to provide volunteer tax preparation service in a way that did not require any in-person contact whatsoever.In the process that was developed in this VITA program, volunteers prepared returns in real time while taxpayers watched the preparation of their own returns over the internet on a shared Webex screen.Taxpayers then signed the relevant consent forms using a feature on the Webex interface that allowed them to take control of the screen and type in (print) as well as sign their names-a wholly new process for both VITA volunteers and clients in this program.According to program representatives, volunteers prepared over 500 returns this way during the 2021 filing season.
The IRS approved this contactless service delivery method, which it had not designed, prior to the start of the tax season.That it reviewed and approved this method at all suggests the IRS is open to innovation in terms of the planning and design of its public services.This kind of 'cogovernance'-codesigning, specifically-between nonprofits and government agencies remains an underexplored area of research.A recent study suggests that nonprofit involvement in the planning and design of public services has become more common, not only because of the COVID-19 pandemic, but also because of increasing government reliance on nonprofit financing of public services (Cheng, 2018).The program's wholly contactless tax return preparation and its implementation by community volunteers are examples of popular involvement in the design and delivery of a government service.

Importance of the Census
The decennial census is critically important to numerous aspects of American government, from political representation to economic development, from infrastructure investment to service allocation.The decennial census provides the foundational data from which congressional districts are drawn; it plays a crucial role in ensuring fair and equal national representation for populations in each state.In so doing, it gives added rhetorical and logical force to the idea that national legislation embodies the will of the people.No less importantly, census data also provides the securest foundation available for the allocation of federal funding to states and to areas within states with demonstrated need.Funds for infrastructure, such as roads and highways, and for social programs, such as SNAP, Head Start, Medicare, Medicaid, and scores of others, are divided up according to population data.Social Security, the lynchpin of the U.S. social safety net, plans current and future disbursements according to census data.Lastly, government agencies at all levels (federal, state, county, and city), businesses, nonprofits, researchers, community volunteer organizations, and ordinary citizens use census data to make decisions in both their short-and long-term strategic planning and daily operations.
With an accurate census count so key to the performance of government and the nonprofit sector, it is no exaggeration to claim that inaccuracies-specifically, undercounts-threaten the political and economic wellbeing of a place or region.Politically, undercounts have the potential to undermine the perceived fairness of the legislative process by distorting representation at the national level.An error between half a percent and two percent can translate into lost congressional seats (Seeskin & Spencer, 2018).Supposing the state in which seats are lost is a swing state, effects are national and more far-reaching.Economically, undercounts mean that infrastructure is overtaxed, programs are underfunded compared to demand, and considerable swaths of the population remain underserved.Over the course of a decade, estimates of lost funding range in the billions of dollars. 6An inaccurate and undercounted population also creates the potential for what researchers call misalignments of funding, which is where money, even when allocated, is not accurately directed to correctly targeted demographics or locales (Strane & Griffis, 2018).Census undercounts matter.

Formation of the Coalition for Census Promotion
Despite the power asymmetry between governments and local organizations, governments show discretion in choosing local organizations on which to rely for coproduction.Insofar as the examples in this paper illustrate that discretion, it appears the following factors are especially important to possess: a demonstrated record of past performance in the community, the organizational capacity to reach the population to be served, experienced organizational leadership, proficient and accurate record-keeping, and a willingness to work with government bureaucracies.Though this last characteristic, the fortitude required to work simultaneously with different bureaucracies larger than one's own organization, may seem like an afterthought, it is crucial. 7 Members of the coalition described in this paper have these characteristics.They are all similarly situated in the local community.They have varying levels of experience, history, and reach, but they pursue their goals by similar means, rely frequently on volunteer effort, and follow a non-business model of operation.Their leaders are familiar with the challenges of running nonprofit and volunteer organizations.As such, they are in a position to recognize each other's unique needs and capacities as well as to cooperate for the sake of coproduction.Perhaps most importantly, those representing the organizations, both those who are present at scenes of daily interaction as well as those who work behind the scenes, possess 'meaningful experiential similarities' with target populations, which, as research as shown, helps to ensure trust and is a singular advantage in coproduction (Sabir & Pillemer, 2014). 8Coalition partner organizations have the local know-how and, more importantly, trust of many underrepresented and underserved communities throughout the area.
Aside from the U.S. Census Bureau, which provided physical and electronic forms, promotional material, and guidelines for completion; Texas A&M International University, which obtained and managed the grant; and Methodist Healthcare Ministries, which provided the grant funds; four organizations worked together to promote the Census on this project: • Azteca Economic Development and Preservation Corporation ("Azteca"), a 501(c)(3); • Helping to Ensure Laredo's Prosperity ("HELP"), also a 501 (c)(3); Founded in 2017, HELP is a registered public charity created to promote financial education in the Laredo community.They are experienced at outreach, especially in teaching financial seminars, and they have a strong relationship with El Consulado De México en Laredo-the Mexican embassy in Laredo.Given the volume of trade that crosses the border in both directions at Laredo, the largest land port in the United States, 9 the ambassadorship in Laredo is an important position in the eyes of the Mexican government.Through their association with the embassy, and because their governing board has long experience in living and working in the community-one of their board members is a Mexican citizen who lives in Laredo and operates the VITA site hosted by El Consulado-HELP's outreach is becoming one of the most trusted among migrants in the region.In service to the census initiative, HELP performed outreach on social media, in person at advertised census completion events, which they arranged, and served as liaisons for the colonias.They also spearheaded Back to School events that led to successful enumeration.HELP is a member of the VITA Coalition, too.
The VITA program in Laredo has over 20 years of experience serving the underserved, lowincome, limited English proficient, and mostly Hispanic (95%) population in Webb and Zapata counties.The VITA program is delivered by an association of community stakeholders in Webb and Zapata counties known as the Laredo Family Economic Success Coalition (LFESC), which operates like a 501(c)(3) but does not have official nonprofit status.Its members sign a non-financial Memorandum of Understanding signaling their participation in the LFESC; each member elects to participate in unique ways in accordance with their capacity and intention by providing resources to be used in the service of VITA's general mission.VITA's mission is to make a positive difference in the lives of low-to-moderate income families by assisting them in becoming financially stable and self-sufficient.
The primary service provided by the VITA program in service to this mission is free tax preparation by IRS-certified volunteers.Volunteers are recruited from the community, local high schools, Texas A&M International University, and Laredo College.Before they prepare, volunteers must first attain IRS certification, which is provided by the program.In accordance with the guidelines in place by its government sponsor, the U. S. Internal Revenue Service (IRS), which provides the organizing guidelines for over 9,000 VITA sites across the country, 10 the program is marketed in general towards those who are eligible for the Earned Income Tax Credit; in Webb and Zapata counties, it is marketed to families and individuals with adjusted gross income (AGI) of $66,000 or less.To this population especially, then, VITA provides assistance.As may be inferred from the demographic information described above, this target population includes the majority of the population in both counties.In addition, VITA's member organizations-Azteca and HELP, among many others-provide services that include promoting federal tax benefits and providing classes in financial literacy, asset building, and home ownership, which are recognized ways to fight poverty and promote financial well-being.
Providing free tax preparation in South Texas through VITA provides a unique case study in community involvement.VITA partners engage in working and planning together mainly through voluntary cooperation and coordination.A truly authoritative command structure operating over all members simultaneously is unfeasible due to the variety of organizations and their size, each of which are subject to their own structures of hierarchy and command.
During the 2020 season, for example, VITA boasted many for-profit and nonprofit organizations among its members and official supporters.Together, this coalition of partners possessed the organizational capacity, experience, and similarities with the target population to provide a concerted effort in the places where the message of census participation needs to be loudest.By lending their networks, training their staff, and modifying their best practices to promote the U.S. Census in 2020, these organizations illustrated the power of cooperation, trust, and successful coproduction in action.

Factors Contributing to the Success of Coproduction
In describing the characteristics of community organizations and nonprofits that make them good candidates for government partnerships, one is inevitably led also to indicate some of the factors that contribute to the success of coproduction.Since one of the factors is working with organizations of a certain kind, there is some conceptual overlap in the answers to the questions of which characteristics make organizations likely choices for coproduction and what factors contribute to its success.But apart from what has already been said above, we would like to emphasize four factors that especially contribute to success: openness to expert opinion, motivation in the form of self-interest well understood, a volunteer base that by and large resembles the target population in demographic characteristics, and willingness to collaborate. 11Of these three, motivation is perhaps the most important, since a job done less well than it might have been done (from failure to incorporate expert opinion or lack of willingness to collaborate) is still almost always better than a job not done at all (due to a complete failure of motivation).We contend that an old but still valuable idea best helps to explain the kind of motivation at the heart of successful coproduction: self-interest well understood.
As for expert opinion, while it is reasonable to believe that the people most engaged with economic development and social advocacy have the most insight on community dynamics, the teams also looked to expert opinion on causal factors for underrepresentation in the areas of interest.In addition to figuring out feasible extant and future alternative modes of engaging the public, the coalition, led by Texas A&M International University (TAMIU), collaborated to extend existing institutional and community networks and to enhance public awareness of services.The vision of researchers at TAMIU provided the overarching goal for the Census Outreach project, and buildings on campus provided a convenient meeting location-in accordance with local and state COVID-19 standards, of course-for planning and strategy sessions.At these meetings, coalition member representatives devised strategies that enabled meaningful cooperation and therefore maximum impact on the community.Finally, TAMIU researchers also developed and wrote the grant through which Census Outreach teamwork was funded.
Concerning motivation, famed social observer Alexis de Tocqueville described long ago the concept of "self-interest well understood," which, in his view, Americans used to combat the atomizing and excessive individualism to which modern democratic regimes are prone.The idea of self-interest well understood is that one seeks one's own benefit in and through elevating or benefitting others instead of alone or at others' expense.Tocqueville thought that among Americans this "doctrine," as he called it, was "universally accepted"; acute observers found it "at the foundation of all actions" and "encountered not less in the mouth of the poor man than in that of the rich" (Tocqueville, 2000, pp. 501-502).Its ubiquitous presence in the American psyche was often accompanied, however, by an innocent but salutary selfmisunderstanding, which he expressed as follows: Americans…are pleased to explain almost all the actions of their life with the aid of self-interest well understood; they complacently show how the enlightened love of themselves constantly brings them to aid each other and disposes them willingly to sacrifice a part of their time and their wealth to the good of the state.I think that in this it often happens that they do not do themselves justice; for one sometimes sees citizens in the United States as elsewhere abandoning themselves to the disinterested and unreflective sparks that are natural to man; but the Americans scarcely avow that they yield to movements of this kind; they would rather do honor to their philosophy than to themselves (p.502).
This remarkable insight from a foreign-and for that reason possibly more clear-eyed-visitor suggests that those motivated by this kind of American spirit do not like to admit how often, and to what extent, they are disposed and eager to help others without thinking of their own advantage.Many would sooner hide their susceptibility to self-sacrifice, to those 'disinterested and unreflective sparks,' by pointing to the benefits they personally derive from their labors, to avoid any imputation that they sacrifice their self-interest for another's good, which in truth they are often inclined to do unreflectively.This is a pleasing compliment from Tocqueville, not only because it is nice to be flattered (quite apart from the question of actual merit), but also because it complicates our idea of the American psyche where we are prone to seeing, or to thinking we ought to see, American greed and selfishness.The joint efforts of the coalitions described in this paper suggest that the tradition of associating voluntarily for the public good is alive and well in the United States and elsewhere.
None of the observable cooperation we describe in this paper would have occurred without the funding each of the organizations involved received in a grant from Methodist Healthcare Ministries.These funds were used to promote the census, of course, but also, in small part, to further the organizations' broader goals and missions and pay for salary support and labor costs.Since the organizations were attempting to get more money and services for the region through census promotion, and since their promotion efforts were themselves motivated at least in part by the promise and delivery of monies for their programs, this parallel alignment helps to illustrates Tocqueville's doctrine of self-interest well understood in action.That this cooperative and, to use Tocqueville's word, 'enlightened' self-interest occurred along the Texas-Mexico border, was delivered by Mexican as well as American citizens, and enlisted the volunteer efforts of first-generation Mexican Americans suggests that Tocqueville's insight is more generalizable and transferable than commonly thought.Although few worked for free and some worked for nothing, all worked for the common good.

Success in Promoting Census Participation
The VITA program provided the key operational link between these organizations in action.This made sense for a few reasons.First, the VITA program has accumulated substantial trust from the community over the past two decades.Its presence in Webb and Zapata counties grows steadily.VITA's services are free, and no resident is compelled to use or seek out VITA for assistance in complying with tax law.In fact, in seeking assistance with their tax returns area residents have many choices, including paid tax preparers, like H&R Block or Liberty Tax Service, and free or cheap tax preparation software online, which is made available each tax season to all willing to pay the fee and prepare their taxes themselves.Despite the variety of for-profit tax preparation options in the region, however, client lists at VITA sites continue to expand.According to program representatives, the program prepared over 4,400 tax returns in 2017; in 2018, over 4,800; in 2019, over 5,700; and in 2020, over 6,200.Given the voluntary nature of a client's choice to use VITA, area residents demonstrate their increasing trust in VITA by taking advantage of its services.Increasing public use betokens increasing public trust.
This growing trust is even more remarkable given the nature of tax return preparation, which is a personal and deeply revealing window into the lives of others in several respects.This is especially so in borderlands, as tax return preparers are required by law to broach the question of citizenship during return preparation.In 2020, this was a political sore spot for participation in the census-though not for VITA-even though the actual question never made it onto the census completion forms.As part of the process of having their taxes prepared by the VITA program each year, taxpayers are required to indicate on VITA's intake sheetthe first component required by the IRS to be completed as part of the preparation processwhether they, their spouse, and their dependents, are U.S. citizens.Citizenship status is also required to be indicated on the tax return itself; the answer has tax implications.For example, if either taxpayer or spouse has an ITIN (instead of a Social Security number) the couple is not eligible to claim the Earned Income Tax Credit when filing jointly.
Although persons who have a filing requirement are legally obliged to file their taxes, whereas participation in the census is, by contrast, optional, and although the one is done every year and the other once every ten, we believe increasing and willing participation in the VITA program, when contrasted with the likely resistance to participating in the census from the local population due to the threat of the citizenship question, provides support for our contention that community and nonprofit organizations can under certain conditions be more effective in accomplishing government objectives than government itself.What would only be given with unwilling hesitation-or, in some cases, simply refused to be given-to a government worker with a federal ID badge is given willingly and routinely every year to a volunteer from the community.Since the information on both tax returns and the census is highly sensitive, VITA makes a natural bridge from one to other, especially among persons who are likely to have trust issues: if they pay their taxes-and it is likely they do unless they are paid under the table-they already provide this sensitive information to the government through VITA to get back all or a portion of the federal taxes they paid throughout the calendar year; in many cases-most cases, in fact-they receive much more.VITA's success with outreach in hard-to-reach areas made them an outstanding partner for encouraging people to complete the census.
Despite much resistance from Covid-19 sweeping the South Texas region as well as serious concerns with the local population about responding to the census questionnaire, our team made significant inroads to getting a higher-than-expected census response rate in Webb County.Because only U.S. Census employees were allowed to offer direct assistance in helping respondents complete their census questionnaire, local agencies were contracted to perform direct outreach and support for official census workers.The primary benefit VITA provided to census outreach was their existing network of ties within the community.Almost all VITA staff, coordinators, and volunteers are bilingual.While these partners are not directly affiliated with this project, their work through the VITA program would have allowed for information related to the census to be shared at the tax sites, which it was.Taxpayers were made aware of the opportunity to complete the census at VITA tax sites because VITA promoted the opportunity along with its free tax preparation services through social media campaigns.It commissioned commercials for posting online, to which were appended brief pitches for completing the census.VITA's paid support staff created dozens of flyers for print distribution as well as posts for Twitter, Instagram and Facebook, posts that received over 10,000 views.
VITA also promoted the opportunity complete the census at its tax sites during their hours of operation.Tax sites operate with the permission of the owner or manager of the brick-andmortar location.The sites are always managed by a Site Coordinator, who is employed either by the VITA program or by the partner organization itself.Site Coordinators are assisted in their turn by volunteers, who work for free, preparing and reviewing the prepared returns in accordance with IRS guidelines.At certain tax sites, taxpayers who were present were reminded about the opportunity to complete the census and were provided access to a laptop set aside for the sole purpose of completing the census.If they had arrived early for their appointment, they had the opportunity to complete it while they waited; they could also complete it after their appointment if they so wished.VITA Site Coordinators were authorized to set aside a space at their tax site for the completion of the census.
The volunteers at AHEC, whose task was to call homes in neighborhoods with low census response rates, were trained to do the following while on the call: (a) remind members of households to complete the 2020 census, (b) offer options for completing the 2020 census, such as over the phone (in English or in Spanish), online at www.2020Census.gov,or by in person attendance at the AHEC Drive-In 2020 Census event held each Saturday during the month of August in the City of Laredo, and (c) express appreciation for their time and support of the 2020 census.Over the course of seven weeks, the volunteer team made 9,466 phone calls to residents of the region.
Azteca coordinated the mail outs and social media to regions that had lowest response rates.
Using their logo as the source of this information was helpful, as this organization has a long history of providing support to area residents.Employees of Azteca called clients to stress the importance of completing the census and discussed locations where individuals could receive assistance.HELP served as the trusted liaison with the 'Back to School' efforts and food banks.We found that having census enumerators at the food banks appeared to be one of the most successful events in increasing individual participation in the 2020 census.
In sum, the collection of organizations worked in unison to provide a message to the community that census participation is necessary and an accurate, complete count benefits the region.Each of these agencies has a history of supporting specific geographic regions and providing various services that many see as difficult to deliver.Additionally, all put their reputation on the line by stating that the census would be confidential and would benefit the community.The agencies have a long history of acting to benefit public health and welfare in local communities, a history that contributed to their success in this region.

Health Care Outreach
We turn now to the other prong of our study of cooperation and trust through the lens of contract failure theory, which involves health care outreach.Given the high rates of poverty and low levels of education that persist in the region, it may come as no surprise that significant education, economic, and language disparities restrict access to healthcare and healthcare-related social services.This side of our case study allows us to add to the factors that contribute to the success of the work involved in coproduction.It shows, in particular, that one of the things that contributes to that success is collaboration: when nonprofits seek out other groups that are trusted in the community in order to share in the work, they are more likely to succeed.Nonprofits, like governments, can leverage existing trust in other nonprofits and community organizations to accomplish the work of coproduction.As we shall see, this requires convincing the leaders of such organizations to obtain buy-in.
It is almost impossible to overlook the general importance as well as the increased politicization of the idea of universal healthcare in the United States in recent years.This trend has been fostered by, and has helped to increase, distrust of government, too.Increasing politicization may also be a contributing cause of distrust among underserved populations in South Texas.While a recent study provided more confirmation of what many observers often note, namely that persons with lower income vote significantly less often than do those with higher incomes, one of its key findings was that the main reasons for not voting reported by those with lower incomes were similar to the reasons given by their more well-off counterparts: "lack of interest in campaign issues or feeling their vote will not matter" (Hartley, 2020, p. 9).Thus, being from the poor part of town is not necessarily an indication that the political winds do not blow in one's neighbourhood: poverty alone does not make one immune to the distrust in government that arises from the politicization of healthcare.
Poverty does, however, create barriers for low-income persons that do not exist for the sons and daughters of more fortunate circumstances.Recent Laredo and Webb County Community Needs and Workforce Assessments (CNAs) indicate the use of preventive health care services is low in general among the Mexican American population; both South Texas in general and Webb County in particular, which are heavily Hispanic, illustrate this disparity.There is also an evident increase of uninsured and underinsured individuals-especially women, children, and the elderly-since the last CNA in 2013.Clearly, poverty, which is pervasive along the state's southern border with Mexico, places border residents at high risk for poor health status.
In addition to having thirty-one percent (31.8) of residents living below the federal poverty level, Webb County is home to more than 60 colonias, which are unincorporated settlements of land along the Texas-Mexico border.According to one report, many colonias "lack some of the most basic living necessities such as drinking water and sewer systems, electricity, paved roads, and safe and sanitary housing.Over 25,000 colonias residents rely on an episodic system of care depending on funding and strained social programs with limited capacity" (Health Resources in Action, Inc., 2019, p. 1).The disparity of healthcare services is especially pronounced in the colonias, where the need to provide quality, efficient preventive health care information and services is more than evident.If the demand for it is to be realized, a preventive health care model must meet people where they live, work, and play-ideally by obtaining information from community leaders they trust.

Distrust of Health Care Outreach
Many residents of South Texas, especially those in the colonias, would seem to lack the luxury of ideological objections to the provision of healthcare services.This may not, however, prevent them from feeling them.Some political objections are hard to capture in survey data.
On the face of it, healthcare is supposed to be advantageous for the health of those to whom it is provided; yet as recent political experience in the United States revealed, many Americans object in principle to the government's push for universal health coverage.Why?Here, political philosophers John Locke and Alexis de Tocqueville provide clues to the American psyche.The more private nature of health care suggests that here, even more than in the case of the census, the government's power asymmetry should be handled with care by those who administer it.
Compared to citizenship, taxes, and the census, healthcare involves matters that are even more personal; it involves the human body.Bodies are the property of their owners in a more profound and individual way than membership in a political community and the use of its money.As both this membership and this money-citizenship and standardized currency-are created by government, citizens may be said to have and use them by consent; in requiring taxes to be paid and in regulating citizenship, it may plausibly be said that a government controls resources and distinctions it already owns.Our bodies, however, are ours prior to our consent; "every man has a property in his own person: this nobody has any right to but himself" (Locke, 2003, p. 111).Accordingly, in legislating matters pertaining to healthcare, government concerns itself with resources that individuals are more likely to understand as uniquely theirs (or perhaps God's-at any rate not the government's).This is especially so in America, where John Locke's philosophy of natural rights, a source of inspiration for Jefferson and others in writing the Declaration of Independence, still infuses national discourse concerning the limits of political legitimacy.Locke is one of many theorists whose ideas and rhetoric inform our national discussion or 'rights talk,' which is pervasive in America if not always clear-headed (Glendon, 1993).Thus, although perhaps counterintuitive, it is nonetheless true that laws pertaining to the regulation of the health of human bodies, however benevolent and well-intentioned, are likely to be viewed in the United States with more suspicion and distrust than elsewhere.
This elevated sense of personal ownership in oneself cannot help but make residents sensitive to the boundaries of their personal freedoms.Since freedom in America means "the limited license for an individual to do as he or she pleases" (Koritansky, 1999, p. viii), the question of a law's intent may be, psychologically speaking, less salient than the fact that a law exists in the first place.According to those whose objections in the name of liberty we highlight here (as a possible cause of distrust of those who would attempt healthcare outreach), that such laws exist at all is one more step towards the "subjection in small affairs" that, for Alexis de Tocqueville, characterized the kind of despotism democratic nations have to fear, should it arise in the future-as it might, Tocqueville warned, from within the bosom of a democratic nation (Tocqueville, 2000, p. 665).The problem, not always easy to express for those who feel it, is the feeling of being thwarted in the use of one's own will by being forced to accept legal regulations, and penalties for noncompliance, in matters deeply personal and, in a word, 'small'-feelings not likely to be lessened, but even perhaps heightened, by the rhetoric of advocates who pitch such regulations as best for the common good, or as improved access to that which we already have a right as well as a need, or finally, as simply more rational, equitable, and fair. 12It is plausible that this feeling, however expressed, is a contributing factor to distrust of healthcare outreach in South Texas and elsewhere.But the model for healthcare outreach described below is, we think, effective in beginning to overcome this and other kinds of distrust of healthcare outreach, and this is part of its strategic value.Choosing to leverage existing trust between providers and clientele, and not to rely solely on its advantage in coercive power, is a surer way for governments to succeed.

Juntos for Better Health: Mission, Challenges, Strategies
Providing substantial access to health care in the region by meeting people where they are in need requires collaboration between multiple organizations to break down the barriers of distrust (Martinez-Gomez et al., 2019).Research indicates healthcare disparities are also related to social determinants such as educational and social-economic levels, lack of insurance, irregular use of care, legal barriers, language, and cultural barriers, among many others.Community distrust plays a major role in how service providers are viewed, which in turn has an impact on their receptiveness towards services.For nonprofits, community organizations, and government alike to be successful in reaching disenfranchised populations, a community-based participatory approach must be taken, wherein organizations make the effort to go out into the community and meet people where they live, work, and play (Martinez-Gomez et al., 2019).There must be a mindset on the part of advocates and providers of going to the people-as distinguished from their going to the providers-to eliminate many of the barriers that currently impede service delivery.In this strategy, and because of the greater touchiness of this subject matter, the importance of volunteers who by and large resemble the target population in demographic characteristics is even more important than in census promotion.
As an organization, the Juntos for Better Health [Juntos] et al., 2006), traveling teams to provide screenings and referrals, supported additional personnel to increase health care capacity, created a shared system of resources, and improved patient knowledge of these three illnesses (Health Resources in Action, Inc., 2019, p. i).
Juntos succeeded by adopting a back-to-basics community approach requiring outreach personnel to hit the streets.Outreach team members knocked on the doors of hundreds of local organizations to reach as many as possible of the local population.In particular, the Juntos approach leveraged the trust participants had with participating community organizations.As a result, Juntos service providers-medical, behavioral, and case management teams-worked alongside local nonprofit community organizations to meet the need for preventive health care and continuity of care in the community.Juntos teamed up with almost 300 local organizations such as schools, community centers, soup kitchens, shelters, faith-based organizations, clubs, support groups, including the warehouse industry (a major infrastructure in Laredo) among many other organizations.
Gaining the support of local organizations did not come easily.The process involved a great investment of time and many face-to-face meetings.The Juntos outreach team usually took the first steps to go to out to the local organizations for introductions.Local organizations are often small and lacking in resources, including especially adequate personnel; the time available to administrators and service personnel was often quite limited.By being the first to reach out and remaining flexible with their meeting schedules, the team eliminated the time constraint barrier placed on many local organizations.The Juntos team then worked to obtain leader buy-in to host the services and to promote and recruit participants.This was, in some respects, the hardest challenge of all-harder even than overcoming participant distrust of government at the grassroots level.
The outreach team met with major hesitation from many organization leaders as well as a palpable sense of guardedness.Leaders and administrators wondered what benefit, if any, there would be for participants, but most importantly they asked about all harm that might come from their involvement or promotion of the service.The nature of their questions revealed their familiarity with a discouraging phenomenon: underserved and disenfranchised populations are often sought out for their sheer size and demographic qualities as a 'golden ticket' for funding requests, since they check off all the right boxes (underserved, uninsured, poor, undereducated, chronically ill, ethnic minority, etc.).Unfortunately, too often they do not see many of the benefits they are promised.There appeared to be a consensus among local organizations that projects geared towards special populations are 'fly by night' kinds of projects: here today, gone tomorrow, using the target population for their own personal gain and agendas.This would be an example of self-interest not well understood.This perception revealed a sincere desire on the part of local organization leadership to assist real people in meaningful ways, but it also showed that there were very real barriers for Juntos to overcome.
The Juntos community outreach team worked to gain the trust of site administrators and their willingness to host the team and promote the services.They understood and respected the trusting relationship these administrators had built with their existing clients-most of whom formed a part of our target population-and sought to be a resource instead of a burden.The Juntos team was able to build rapport and trust with site administrators, allowing a true community-participatory approach to develop.Juntos relied on local organizations to host the traveling team as well as for the site personnel to promote, recruit, and remind participants of their appointment.This was a calculated move, as the intention was not to give site personnel more work, but rather leverage the already existing relationship between site personnel and their clients or consumers to eliminate barriers resulting from lack of trust towards the project team.In turn, the health care team provided the actual service, including health screenings, referrals, patient navigation into medical homes, patient education, and follow-up calls to noncompliant individuals.By working towards breaking down barriers of distrust through a community-based outreach participatory approach, Juntos gained close to 300 community partnerships serving over 60,000 individuals.The Juntos team gained great acceptance within community organizations and among residents.
This type of success can only come from building relationships with local community organizations who have acquired a reputation for caring for those in need.Local organizations which have been integrated and accepted in the community are the key to successful implementation of services as well as to the acquisition of knowledge of the community's needs and resources.Appropriate personnel for the teams were selected with care and with a view to cultural sensitivity.Once selected, the team succeeded in changing the mindset of healthcare providers and leadership of what a healthcare setting is.It is vital to the community that public health policy and systems recognize the importance of remaining focused on the target population and the context in which they live, work, and play to guide public health policy and providers in developing strategies and programs aimed at improving community health.

Special Challenge of COVID-19
Because of their dependence on cooperation, community and nonprofit organizations always face a great deal of uncertainty, and this is especially so in the era of Covid-19 (Maher et al., 2020).Since their everyday work is typically in-person, tangible, and constant, the conditions brought about by the coronavirus pandemic threaten nonprofit budgets and the success of their respective missions for a variety of reasons.Limited assessments have been conducted on COVID-19 vaccine hesitancy among the American adult population.The reasons for why people do not vaccinate are complex, but among the issues are distrust-especially from movements perceived to be politically inclined-and lack of awareness of what the vaccinepreventable disease can do, not to mention a barrage of targeted misinformation about vaccines.Despite this complexity, vaccine hesitancy may be addressed with simple health education efforts.Patient education campaigns delivered by trusted messengers might succeed at ensuring a robust vaccination information effort.Surveys related to Hispanic trust in health messengers reveal that approximately two-thirds of Hispanic adults say they trust their local public health department, local organizations, their own doctors, and the CDC (Kearney et al., 2021).Hispanic individuals living in rural areas, however, with typically lower household incomes and lower levels of education, are more likely to be hesitant about receiving the COVID-19 vaccine (Khubchandani et al., 2021).Rural populations have proven to be a difficult to reach sector population and have a history of being among the hardest to count for the U.S. Census, due to language issues, distrust of the government, and other reasons.
The COVID-19 pandemic presents unique challenges in regard to vaccine hesitancy and the inability of providers to reach disenfranchised populations, such as the elderly and Hispanic in rural areas.Vaccine mandates are hard to enforce in such areas.They are also an example of the government's use of its asymmetrical balance of coercive power.As such, it would neither be surprising if they foster and exacerbate distrust nor, in a polarized political climate, give rise to unnecessary and ideological resistance.Based on the case studies described in this article, we think adopting a community-based participatory outreach model would be preferable for organizations, including governments, seeking to promote and deliver the vaccine.

Conclusion
Trust between public and government entities is critical; without it, communities become paralyzed in their ability to act collectively and for the greater good.Government entities can rely on public organizations, specifically nonprofit organizations (NPOs), to meet diverse public needs and demands.AbouAssi et al. ( 2019) indicate governments and nonprofits have developed an interdependent and collaborative relationship to meet public demands.The case studies here also suggest that this relationship is likely to be especially effective under conditions where distrust is already high or likely to be so.Distrust is likely to be high in borderlands, where poverty is more pronounced and access to the infrastructure and resources that make e-government possible are scarcer.Distrust is also likely to be high when the compliance demanded by the law concerns sensitive personal issues, like health care, in a time characterized by ideological polarization and hyper partisanship.Under such conditions, coproduction may become a prudent and effective strategy for making headway in delivering public goods and increasing compliance with the law.
In coproducing public goods some groups will prove more effective than others.Our case studies suggest that a demonstrated record of past performance in the community, the organizational capacity to reach the population to be served, and experienced organizational leadership are key characteristics of successful nonprofit and community organizations.There is also the mundane but essential business of proficient and accurate record-keeping and a willingness to work with government bureaucracies, activities which are not for the faint of heart.In working together with government, such groups augment their potential for success when they are open to expert opinion, willing to collaborate, and can claim a volunteer base that by and large resembles the target population in demographic characteristics.And perhaps above all, self-interest well understood contributes to their being effective over the long term.
The success of the coalitions in both case studies illustrates the power of the idea of selfinterest well understood in action.In these cases, the cooperation made possible by selfinterest well understood suggests that the government was wise to pursue a strategy of coproduction in a borderland, as distinguished from relying for results on the asymmetrical balance of its coercive power.Recognizing that the trust it placed in nonprofit and community organizations was not misplaced will likely increase the desirability of coproduction as a strategy for producing public goods in future years.As a result, trust in nonprofits-on the part of governments, citizens, and residents-will likely grow, making them even more appealing as government partners.
The mechanisms at work in our case studies suggest a reciprocal and positive correlation between levels of trust and strategies of coproduction.This correlation, in turn, while predicted by and supportive of contract failure theory, expands the reach of that theory by suggesting that citizen trust in governments compared to nonprofits operates in much the same way as does consumer trust in for-profits compared to nonprofits, but for different reasons.It is reasonable to assume that power asymmetries give rise to distrust, that certain factors aggravate that distrust, and that government administrators give thought to how best to achieve their goals.Working with trusted community organizations to produce public goods softens the harsher side of government without sacrificing any of the sovereignty with which it is invested to procure the public good.
Notes 1. Were it not for difficulties in face-to-face communication raised by the COVID-19 pandemic, we might have had more data showing the real-world results of the coalition's success in cooperation.But while a limiting factor, we decided this need not be a deficiency preventing us from sharing our results.In each case the researchers were able to observe up close the overcoming of the challenges of cooperation that made coproduction possible, and this cooperation itself constitutes much of the data we wished to share.For Census 2000, if those from Puerto Rico and other predominantly Spanish speakers wished to complete the census online, they had to do so in English (Whitworth, 2002).By 2020, however, Spanish versions of both the online and paper census forms were readily available.2. In this paper, the answers to the questions are based only on our case studies; other studies may answer the questions in different and yet useful ways.3.In an empirical study of survey data, which compared the patriotism of immigrants with that of native-born citizens, Nowrasteh and Forrester (2019) found that immigrants often had a more positive view of American government and history than did native-born citizens.4. For Census 2000, if those from Puerto Rico and other predominantly Spanish speakers wished to complete the census online, they had to do so in English (Whitworth, 2002).By 2020, however, Spanish versions of both the online and paper census forms were readily available.5.In 1986, 25,000 tax returns were filed electronically ('e-filed'); by 2011, over 100 million were e-filed (Internal Revenue Service, 2011).By 2020, the number rose to over 190 million, nearly 150 million of which were individual returns (Internal Revenue Service, 2021).6. Reamer (2018) estimates that Texas loses over $1,000 per year for every resident who is not counted in the census.With a population of almost 30 million, a 1% undercount in Texas means an estimated 300,000 persons not counted and $300 million in lost funding per year.7. The leadership challenges involved in navigating the bureaucratic requirements and guidelines created and enforced by various levels of government with which local organizations are required to cooperate, and from which they obtain the resources that make coproduction possible, would merit a paper all its own.Sometimes these requirements conflict.In many cases, these requirements have the unintended effect of dampening idealism by simultaneously limiting the strategic options available to nonprofit leaders while increasing their burden of accurate record-keeping and reliable performance measurement.8. To cite a different example that illustrates the same insight, high rates of foreign-born nativity, especially from Latin America, are related to distrust in the safety of drinking water (Pierce & Gonzalez, 2017).In South Texas, there have been specific incidents where water quality that was approved by governmental entities was indeed considered unsafe after facing further scrutiny (Satija & Ura, 2015).Though eventually there was compliance with water safety regulations after restructured analysis, incidents like this harm public trust in those on government payroll, and they show how informed members of the community, as distinguished from government officials, can become comparatively more trusted sources of information (Wallace, 2017).9.In 2019, Laredo was also dubbed the largest of all ports in the United States, not including illegal drug traffic (Wallace, 2019).10.According to the IRS, there were over 9,000 individual VITA sites operating in the nation in 2020.In 2021, due to the pandemic, a few thousand fewer were active-roughly 5,500 (M.Coombs, personal communication, July 29, 2021).11.Willingness to collaborate is discussed in the section on health care outreach below.12.During and after the political struggle to launch the Affordable Care Act in 2010, reasons like these were colored by the act's political opponents as attempts to whitewash a 'government takeover' of healthcare (Adair & Holan, 2010).

Table 1 .
Economic Profile of Target Area Area Health Education Center ("AHEC") of the Mid Rio Grande Border Area of Texas, Inc., an outreach program under the University of Texas Health Science Center at San Antonio that seeks to increase the number of trained health care workers in the region.with Accion Texas, the leading micro lender in Texas, and with Business Community Lenders (BCL) of Texas.Their outreach with federal housing programs creates additional opportunities for residents with low-to-moderate income.Importantly, Azteca operates one of only two VITA sites that stay open after the tax filing deadline.For the 2020 Census promotion initiative, Azteca disseminated flyers throughout the community and worked with the U.S. Census staff to set up enumeration sites during the reporting period.
development designed to preserve the cultural roots and economic integrity of neighborhoods in Laredo.Specifically, through collaboration with the U.S. Department of Housing and Urban Development, the Texas Department of Housing and Community Affairs, and the City of Laredo, Azteca helps to secure affordable housing and financial opportunities for low-income individuals.To provide small loans to those who desire to start a business in Laredo, this nonprofit works These included Azteca Economic Development & Preservation Corporation, Catholic Charities of the Diocese of Laredo, City of Laredo Public Libraries, Entrevision Communications, Goodwill Industries of San Antonio, H-E-B Grocery Company, the Internal Revenue Service (VITA's government sponsor), International Bank of Commerce, Laredo College, Laredo Independent School District, South Texas Food Bank, Texas A&M International University, Texas Community Bank, WorkforceSolutions for South Texas, and Zapata County Independent School District.Given the diversity of interests and organizations represented here, VITA has found it best to let each organization determine whether, how, and how often it wishes to contribute to VITA's mission.Since 2002, the Area Health Education Center (AHEC) has conducted community health seminars in the area and provided hands-on learning opportunities for future healthcare workers through volunteer programs.Although not a VITA partner, AHEC's local healthcare initiatives have led to strong and extensive ties to community networks throughout the area.It is the only organization of its kind for hundreds of miles.Additionally, they have a considerable and talented corps of college student volunteers, drawn mostly from South Texas, who, given their background-most are bilingual-were nicely positioned to engage area residents to participate in the census.As we shall see, AHEC assisted in maximizing the impact of grant dollars by incentivizing 44 volunteers with stipends to call homes in neighborhoods with a low response rate based on the 2020 Census hard-to-count map data.
possesses the mindset described above.According to Health Resources in Action, Inc., which provided a comprehensive evaluation in April 2019 of the program's effectiveness, Juntos is: