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'This is our community'                              Reaching out: FPCN staffers Germaine Gould, Leslie Burton and Joi Goodman (L to R), were among those who came together to assist a women with unique challenges at the Abbotsford-Falls Health Center.

Staffers at RHD's Family Practice and Counseling Network became used to seeing this lady, sitting outside on the street. She was homeless, begging for food and loose change and clinging to a cat.

A number of staff members reached out to her, a lady we knew only as Alice. They provided her with a meal, a few dollars, some clothing, and food for her cat. But for months she refused to come inside and get health care, until one day, finally, she decided to walk into the health center. And so began an extraordinary tale of how we respond to the needs of our community — even when, or especially when, they can be particularly challenging.

“I met her in the hallway,” said Germaine Gould, the health center’s outreach & resource coordinator. “She had the cat. I went to Donna (Torrisi, Family Practice and Counseling Network executive director) because it had odor; could we bring this cat in? But the cat gave her comfort. And Donna decided, well, let’s let her come in.”

The staff was immediately drawn to her.

“She’s the type of person that when you meet her you want to do everything you can to help her — she’s a sweetheart, but because she’s homeless the really good side of her personality is often overlooked,” said Joi Goodman, Abbotsford-Falls clinical case manager.

“She’s a beautiful young lady; her spirit is good,” Gould said. “I’m in recovery myself, so I’m open to know anyone can be in her shoes. People don’t know how close we are to living a life like hers.”

Nurse practitioner Leslie Burton provided for her health care needs. Gould, Goodman, Certified Peer Specialist Ricky Wyche and Behavioral Health Consultant in Primary Care Rosemary Crisfulla worked to address her behavioral health issues, and Gould volunteered to serve as her home case manager. They helped her secure housing, move her belongings into her new home, and took up donations to provide her with clothing and food.

Abbotsford-Falls is part of RHD’s Family Practice and Counseling Network (FPCN). The Network of five nurse-managed health centers provides primary and behavioral health care to public housing residents and surrounding communities, serving an often uninsured and vulnerable population.

“Now, this was an extreme case,” Goodman said. “But we had the resources to be able to help her. And if you can’t serve people like her, why are you here? Why are you a community health center? This is our community. She’s part of our community.”

Gould realized that the first thing they needed to address were hygiene concerns. The team noticed that she was in relatively good physical health, but suffered from a number of behavioral health problems.

Gould began to work with her on eliminating some destructive behaviors. Crisfulla reached out to Carolyn Truesdale, FPCN Director of Behavioral Health, and described what Crisfulla acknowledged was truly a “constellation of needs.”

“When I mentioned her attachment to her cat, Carolyn just said: ‘Well, then we will have to find a therapist who likes cats,’” Crisfulla said. “That really exemplifies the team’s approach and the center’s commitment to providing comprehensive person-centered care to an underserved and vulnerable population — working to truly improve an individual’s quality of life, to care for a community one person at a time.”

Other staffers at Abbotsford-Falls quickly stepped in.

“People collectively went through their closets to see what they could bring in, people who had never even met her; it took on its own sort of life,” said Goodman.

“Everybody pitched in,” Gould said. “We took donations to get her a fan, even a stroller for her cat.”

Gradually Alice began to greet the staff warmly, and attend her medical appointments. She showed interest in the nurses and even asked Gould to bring her a book so that she could learn more about nursing.

“You used to know she was here because you could smell the cat; you’d smell its odor,” Goodman said. “She was here the other day and no one knew she was here — a complete transformation.

“She is just so grateful and so excited for everything that’s happening for her. She’s excited to start her life back over again.”

We can’t know the future with any client. But if we work to empower people, give them a chance, support them as they work to build better lives for themselves, we know that amazing things will happen.

“She’s very appreciative for what the center has done for her and so am I,” Gould said. “It’s a blessing that this program allows you to do work like this, and support people in this way. A lot of places are not going to do what we do. It doesn’t matter how many resources you have. You have to have heart.”