David Kears (MSW ’70), who has been serving as the Special Assistant to the County Administrator for Alameda County since his official retirement from the government office in 2009, compares the healthcare system to the old Johnny Cash song, “One Piece at a Time.”
“It was about a person who wanted a Cadillac but couldn’t afford it, so he stole a piece one a time,” he says. “In the ’50s, cars were different every year, so when he finally had all the pieces to put together, it looked like hell--and that’s our healthcare system. We built it, and we end up correcting its flaws one issue at a time, so there’s not a lot of logic or integrity. We have a system that is really designed to deal with failure.”
Kears, however, is not feeling hopeless about the future of the system, which, he says, is really "much like the present." "Large numbers of people are going to provide services to others, but the challenge is how do you configure that?" he asks. "How do you connect the dots? How do you get organizations to act like how we think individuals and families should act? It’s important to interact and engage to make things better."
His sense of optimism about the work is clear in his reflection on the role of county social services. “We’re here to help people and to see that their lives are better,” he says. “The work is still about relationship building, getting along, working with people, listening and responding appropriately.”
A veteran of the public and mental health sectors, Kears spent more than 23 years as the agency director of Alameda County Health Care Services, overseeing the departments of Indigent Care, Public Health, Environmental Health Services and Behavioral Health Care Services, which includes the divisions of Mental Health and Alcohol and Drug Services.
His decades of county service, which first began in 1974 as a psychiatric social worker, has showed him that by continually evaluating “how things fit together and how things work,” systems and their underlying infrastructure can be effectively changed for the better. “In order for changes to healthcare to succeed, we’re going to have to look to greater integrated services,” he says. “I’m going to assume that most of what is inspired in the national health reform is moving towards a more rational configuration of services that guarantees people some reasonable degree of coverage and access.”
This fundamental belief in the mission of public healthcare agencies, combined with his dedication to finding improved and more effective ways to serve clients, have accounted for the high level of respect and praise he has received for his distinguished career in Alameda County. Among his accolades is the 2011 Alumni of the Year Award, which was bestowed to Kears at the UC Berkeley Social Welfare Alumni Association’s Annual Awards Dinner.
Kears’ commitment to the East Bay and its communities started long before his career at Alameda County. “I was born in Oakland, and I always wanted to go to Cal,” he says. “When I came home from kindergarten, I told my mother I was going to go to the University of California because I had a teacher whom I was very much impressed with – and she said that’s where she went.” He made good on his plans as a five-year-old, completing his Berkeley undergraduate degree in Sociology, followed by his MSW degree with a specialization in psychiatric casework.
Among his most important experiences during his time at the School of Social Welfare was his off-campus work. Responsible for supporting his family while completing his graduate education, Kears spent 20 hours a week in a work-study position at the East Oakland Parrish, working with youth and assisting the group of community churches in their efforts to reorganize and mobilize the housing projects in the poor neighborhoods of East Oakland.
“That work was the best thing that ever happened to me at Cal,” he says. “I got a feel for what I liked and enjoyed and what I wanted to do with my life.”
Kears served his field placements at Sonoma State Hospital, where he worked with the developmentally disabled, and the Children's Guidance Clinic in Palo Alto. “I showed up at Sonoma, and the supervisor said, ‘There’s an immediate need in the secured ward, a difficult ward. We need you there.’ I go there, and another social worker tells me, 'If I were you, I’d try to get a transfer as soon as possible.’”
Kears did not request a transfer, but instead launched his career as a psychiatric social work upon graduation at Napa State Hospital, advancing to the rank of assistant program manager. During his four-year tenure at the hospital, he is noted for expanding and revising its ward programs as well as improving relationships with counties.
"I remember when I met him he had such a passion for people who had a persistent, serious mental illness," says Dr. Marye Thomas, the director of Alameda County Behavioral Health Care Services and Kears' colleague of more than 30 years. "He strived to get them what they needed in the way of community services and developed programs that were alternatives to state hospitals. It started our path as a county towards community-based kinds of treatment that allowed clients to continue to be connected to their community, and allowed us to facilitate their connection to their families."
In 1986, Kears assuned the County agency director position, which at that time included the responsibility of acting director of Highland General Hospital. The various roles he has taken on since then include chair of Safe Passages, a City of Oakland-based initiative to improve outcomes for children and youth; member of the First 5 California State Commission, on which he served until he retired in 2009; and current member of the School of Social Welfare Advisory Board.
Kears explains that his ability to improve systems and move processes forward is very much tied to his faith in those around him. “If there’s one lesson that I’ve built out of my career is that if you believe in yourself and, most importantly, if you believe in others, you get the most out of them – whether they’re clients, colleagues, other departments or politicians,” he says. “As soon as you move away from that, as soon as you start focusing on what’s wrong with everything, then you’ve lost. Your ability to mobilize and get people towards working for something better is lost.”
Another of Kears' long-time colleagues, retired CEO of Alameda County Medical Center Michael Smart, notes that his friend has always had an "incredible political instinct." "Working in public situations, you have to develop this instinct, but Dave's was particularly acute," says Smart.
Smart adds, "Dave was always willing to make tough decisions and to take the heat. He was also always willing to walk down that road with you when you were the one who needed to make the tough decision."
Kears is exceptionally modest about his career accomplishments, especially regarding his ascending ranks within Alameda County. “It’s important to realize that you shouldn’t just look at the position,” he says. “You can do tremendous things and never rise above direct-line services. You can add enormous value if there’s a venue for you to express your ideas and be heard, listen to people and incorporate your ideas.”
“I am very proud to be a social worker,” he adds. “My social welfare degree gave me opportunities that I couldn’t get through other programs. Relationship building and communication -- all these skills came to the forefront of my education and my work.”