By Teresa Cutts
To hear a human, it may work better to listen with your heart than your ears. It’s even more powerful if a community health worker, a physician champion and CEO, a former school principal all listen with their hearts. That’s the success in San Bernardino, CA at Loma Linda University Health’s (LLUH) clinic for the under-served and a healthcare certificate program that partners with a local Indian tribe.
Every town is tough in its own way. San Bernardino is a tough town in many ways. It’s the third largest bankrupt city in the United States, just now crawling out of that debacle. Only 25 percent of the students make it to college and health disparities are abominable. LLUH’s Health Social Action Corps Health Systems (SACHS) clinic for the under-served and it’s complementary San Miguel Gateway College (SMGC) listens to the heartbeat of the community and finds a way.
In the 1960s access to healthcare for the under-served (then primarily migrant farm workers and hippies) was already a problem. Medical students at LLUH (including the current LLUH CEO, Dr. Richard Hart, one of the many heart-driven leaders there) started an evening clinic for the poor then, that has alternately floundered and flourished for almost 50 years. In the 1990s the clinic’s volume exploded when the Norton Air Force base closed, eviscerating the local economy. LLUH negotiated to take over a 43,000 square foot clinic on the former base drawing the academy deeply into the community.
The need for both primary and specialty care continued to grow and plans were made to build and fund a new facility to house the SACHS clinic, which now has both primary care and up to 28 different types of specialist trainees on site.Dr. Hart proudly notes that SACHS has moved from being a “worthy side cause” to a signature program at LLUH, a truly mission-based organization.
Building a new facility for the clinical endeavors (the Norton clinic still functions) in the heart of San Bernardino was further enhanced by co-locating the San Miguel Gateway College (SMGC) in the clinic’s top floor. SMGC trains ancillary medical professionals (community health workers, medical assistants, nursing assistants, pharmacy technicians, surgical technicians), notably recruiting strongly from the local community high schools. The primary qualification for admission is a high school diploma/GED, with many scholarships and grants awarded. For Arwyn Wild (former high school principal, sitting at left) the deeply compassionate yet pragmatic Executive Director of SMGC, their heart focus is more on building career ladders and growing the students’ skills and knowledge than picking the students with the highest grades. One student with a 1.7 GPA and was still hugely successful, and that’s because SGMC closely coaches and mentors these young people, knowing that even one person in an under-served family can lift the whole family out of poverty.
There’s another level of care to the heart focused mission of the clinic: synergy between the LLUH medical professionals across all of its schools and community members. In monthly Community Grand Rounds, community health workers share with the more traditional medical trainees, a local “medical immersion” experience unto itself. How does Arwyn know that the community has embraced the SGMC and clinic as their own? In contrast to other neighboring institutions there has been almost no vandalism or problems in the 3 years they have been on site. And they designed the building to be as luxurious as any concierge medicine clinic. No skimping on materials or costs in providing a physical plant to care for the poor. The building is even rated “silver” by LEEDS (highly sustainable and green). The Community Resource Room provides free internet access to all (not just patients), serves as a clearing house for other social services, and local groups host grief recovery classes in the only chapel in an FQHC in this country. Community gardening occurs on site, with a new certificate in urban gardening being offered. So economic, community and workforce development are all integrated with health care.
The Gateway College is a launching pad for unlikely superstars such as Community Health Worker Silvia Ortega (left). A master of “hearing with your heart,” she graduated from SMGC and is now working in LLUH’s neo-natal intensive care unit, helping not only these precious babies, but their whole families. Silvia calls herself a “rootologist”: someone who knows she must get to the root of the problems for these families, many often already struggling who then go into survival mode when a sick baby is born.
Silvia recently discerned the root problem of a large family who had a baby in the NICU but were homeless: the disabled father’s lack of self-esteem and worth in not providing for his family.Through Silvia’s relationship building, coaching and advocacy, taking “time and trust,” she was able to help the family find housing and the father got his back pay from a disability claim expedited.
Hearing from the heart seems to be working well for LLUH, from its latest graduate superstar CHW, Silvia, to the ED of SMGC, on through to its current CEO. And they aren’t the only ones that listen with the heart and act on what they hear. The San Miguel Band of Mission Indians tribal leaders remembered Lyra George, a little-known LLUH female physician who rode on horseback to remote villages to provide care for them over a century ago. The tribe donated $10M to the building and work, seeing the value that both the clinic and SGMC offers to their community. A true intergenerational blessing.