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John Fuse, Community Health Worker with the Berrien County Health Department, stands outside the department's building in Benton Harbor.
Having a sense of rapport and a close trust with one’s healthcare provider is crucial. Many patients have found rapport, respect, and reliability with their community health workers (CHWs). These are folks who live in the same community they serve. Many of these peer coaches have direct, first-hand experience in the very personal and private topics they’re helping people with. John Fuse is one of them.
Fuse is a community health worker at
Berrien County Health Department (BCHD). He interacts daily with returning, new, and potential clients. Before he conducts an
HIV test — available on a sliding scale fee — he holds a pre-testing session to help bond with the clients and build trust.
“In that time, they’re checking out to see whether they can trust me,” Fuse says. “They’re checking out to see whether I’m fake or real, and compassionate, and that they’re just not a number.”
Fuse says most community healthcare workers work in nontraditional settings, meeting with folks in more natural settings than a traditional office or waiting room. A big part of his job is outreach.
“I do outreach at gay pride events, at the Boys and Girls Club, at local high schools, Lake Michigan College, with the cannabis shops, and at the farmers markets,” Fuse says. “We’re trying to understand and remove the barriers. We’re finding out that we’re having to critique what our perspectives are, to try and reach people to help them get into care.”
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John Fuse
Fuse and the staff at BCHD hope that through HIV education and prevention, they can show people that there is a true hope for living, despite difficult-to-hear diagnoses. For Fuse, it’s an extra special care he has for the community, his hometown.
“The reason why I have compassion and love for this role is because I was born in this community,” he says.
After moving to Texas, Fuse worked in various health care roles including nurse technician, the emergency room, and later, social work.
“My thrive for life and helping people continues,” he says. “I love working here as a community health care worker. I love the people, and love what I do.”
Though that zest for life he provides through his role, Fuse reflects a positive light and outlook during a time that feels very dark for many patients receiving HIV-positive test results. Fuse works closely with clients, counseling them, educating on medication options, and working to refer them to additional services like food banks, rehabilitation, and other specialty programs and providers.
“I try to talk from a strength-based perspective, giving them hope and lifting them up,” Fuse says.
Although everyone handles their results differently, he works hard to keep a level of trust in a nonjudgmental zone for all clients to help them process in a way that’s comfortable for them. Shock, dismay, disgust, depression, ostracization, and even suicide can be common reactions. Fuse loves seeing folks turn their lives around and enjoy life again. He says it brightens him up when people find new information and new ways of living.
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Dionne Rigozzi, BS, RN, and John Fuse
Fuse and his supervisor, Dionne Rigozzi, RN, a clinical and community health services supervisor at BCHD have made a pact to help even more people.
“We’re going to somehow, someway, come up with a plan and funding to open up a shelter for people that are unhoused, for people with chronic illnesses,” Rigozzi says.”It doesn’t matter if they’re HIV positive or not.”
Fuse and Rigozzi hope to model it after a similar housing, the
Ruth Ellis Clairmount Center in Detroit. The center includes 42 units of long-term, supportive housing as well as health and wellness services, therapy, HIV care, and mental health treatment.
“We thought, ‘Wouldn’t it be awesome if we could replicate something like that here in our own community? In Benton Harbor, we’re not a very big city and we’re kind of rural,” Rigozzi says. Our area that we cover for Berrien County goes all the way down to New Buffalo, 30 miles west of here. We also have a Niles office that’s right on the South Bend, Indiana border. We have a lot of little communities that are all scattered.”
The goal is to encourage and empower everyone of their own personal choices in their healthcare journey. Rigozzi and Fuse realize it’s a lofty goal, but they’re in it for the long haul — inspired to create change and community. They hope everyone can feel part of that community, no matter what their initial barriers might be, including language. BCHD has an in-house interpreter for Spanish and Arabic, as well as online interpreters and phone translation services for clients, too.
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Whether it’s the same race or socioeconomic background, CHWs with similar experiences provide a sense of relatability and representation.
Washtenaw County CHWs relate to the clients they serve
Susan Ringler-Cerniglia, public information officer at
Washtenaw County Health Department (WCHD), works to share public information across different websites and social media channels on the work being done in community prevention and protection programs, mental health campaigns, and more.
“Community health workers are most often referred to as someone that shares the sort of demographic or experience with the population that they’re serving,” Ringler-Cerniglia says.
Whether it’s the same race or socioeconomic background, CHWs with similar experiences provide a sense of relatability and representation. As trust in government is at a low point, Ringler-Cerniglia says this support is incredibly valuable when dealing with complex health issues.
“The idea is that there’s more built-in trust in that process and a better ability to understand where that person seeking services is at and what their experiences have been,” she says. “Being able to have that foundation of ‘I know where you’ve been. I understand what’s going on and can help you connect to available resources’ can be an incredible asset.”
One asset available to residents, the
Washtenaw Health Project helps people navigate health care coverage if they don’t qualify for Medicaid or can’t find an affordable option on the marketplace.
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CHWs help ensure basic needs like food, housing, and health care are provided.Ebony Curry, a lead community health worker with the Washtenaw Health Project, had experience working with the unhoused population and wanted to help people connect with even more resources.
“We are long-term case managers working with people in the community who have complex health conditions and/or social determinants of health challenges,” Curry says. “We monitor and work with individual clients to help them achieve the goals they want to achieve. That can be access to healthcare, transportation, working
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Ebony Currywith doctors and trying to improve their health, home visits, etc. This can include making a phone call or more hands-on assistance where we help them apply for resources, explain the application process, walk them through the application process, connect them to other resources, or do hand-off referrals.”
Curry and her colleagues help clients with everything from WIC, housing, car repairs and transportation, and medical equipment. She says that building that level of trust with clients helps them work collaboratively on individual goals and interests. Making sure basic needs like food, housing, and health care are provided is crucial, but it’s something that Curry sees lacking in many communities. Witnessing that gap is one of the harder parts of her job, but she enjoys connecting folks with vital needs. She also enjoys working with other agencies and organizations to promote change in policies and procedures and open up accessibility and eligibility to more community members.
Washtenaw County also utilizes community health workers and educators in their
Healthy Neighborhoods Team and
Prescription for Health team, focusing on helping with food insecurity or food-related chronic conditions.
Curry concludes. “When someone didn’t even know that these resources or services existed, and we’re able to connect them, that’s one of my favorite things.”
Sarah Spohn is a Lansing native, but every day finds a new, interesting person, place, or thing in towns all over Michigan, leaving her truly smitten with the mitten. She received her degrees in journalism and professional communications and provides coverage for various publications locally, regionally, and nationally — writing stories on small businesses, arts and culture, dining, community, and anything Michigan-made. You can find her in a record shop, a local concert, or eating one too many desserts at a bakery. If by chance, she’s not at any of those places, you can contact her at [email protected].
Photos by John Grap.
Ebony Curry photo courtesy the subject.
The Yours, Mine, and Ours — Public Health series highlights how our state's public health agencies keep us healthy, safe, and informed about issues impacting physical and mental health in our communities, homes, workplaces, and schools. The series is made possible with funding from the Michigan Association for Local Public Health.