Duffy Doings: Spring 2022 by DuffyHealthCenter

Duffy Doings RESTORING HEALTH, REBUILDING LIVES

In From the Streets Providing shelter and support to unsheltered individuals throughout the winter months

SPRING 2022

Building Trust for 25 Years A note from Heidi Nelson, CEO

t was almost a year ago now that we sat down as a Management Team to discuss our “Hedgehog Concept,” a notion that comes from leadership guru Jim Collins. It is a simple, crystalline concept that flows from a deep understanding of the intersection of three questions: What do we do best? What drives our economic engine? What are we deeply passionate about? Here is what we came up with: The Duffy Health Center team excels at creating trusting relationships with the most marginalized persons in our community, facilitating the provision of health care for the whole person. Since the moment we put this into words, it has proven to be true time and time again. Each day at Duffy Health Center, we witness the impact of the trusting relationships we’ve built over the past 25 years: with individual stakeholders throughout our community, who have a vested interest in caring for the most vulnerable among us; with our partner agencies, who bring their own expertise to support our patients’ complex needs; with our staff, whose service to our mission and commitment to our work is second-to-none; and most importantly, with the individuals who have entrusted us with their care. As I reflect upon Duffy Health Center’s 25 years of service - of which I’ve been around for 11 - I realize that the ability to build trusting relationships has been the “secret sauce” all along. From the earliest days of the “clinic in a closet” at the NOAH Shelter, then operated by the Housing Assistance Corporation (today called St. Joseph’s House, operated by Catholic Social Services), our founders built

Duffy Health Center Board of Directors Kathleen Bresette, President Susan Harrington, Vice President John Murphy, Treasurer Paulette Shaw Querner, Clerk James J. Cullen Miguel R. DaSilva Jeffrey Haddad Christine Johnson-Staub Chester H. Mohr, MD 2

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Stuart Murphy Vanessa Proc Kurt E. Raber Mary Rahal Olympia Ramos Peter Scarafile Richard N. Smillie Corrie Vilsaint, Ph.D. Honorary Members: Dr. Hub Mathewson Dr. Neil Ringler Andrew Singer, Esq.

trust with the most vulnerable in our community by providing compassionate care at a time when they were most marginalized, many unable to obtain any meaningful health care. Those who came before us set the precedent for the work we do today. They were tenaciously visionary, determined to get every individual in our community connected to the care they needed to restore their health and rebuild their lives. I speak for the entire Duffy team when I say that it is an honor to continue this work. Of course, our work would not be possible without the support of our community. Each of you have your own role in Duffy’s history, whether you’ve been engaged since the beginning or you’ve just recently become involved. We are acutely aware that the work described in the upcoming pages does not happen in a vacuum, and it does not happen without the philanthropic and programmatic support of those in our community who invest in our work. We are so grateful. Be well,

Heidi R. Nelson, FACHE CEO, Duffy Health Center

A Penny in a Pond The influential factors that shaped the founder of Duffy Health Center

r. Arthur Bickford arrived at a career in medicine through a less-than-traditional path. Perhaps that set the tone for Duffy Health Center’s founder from a young age; when friends and family reflect on his personality, they share that he was an “outside the box” kind of guy. “You didn’t have to teach Arthur to think outside the box,” reflects his wife, Reverend Connie Bickford. “In fact, if you ever got him in the box you, put the lid on!”

Early Years Arthur Bickford turned 18 in 1943: his senior year of high school and the middle of World War II. The school graduated his entire class early so that they could go into the service. He was enlisted in the Army, and during the process of sorting out who would go where, it was asked who had ever used a microscope. Arthur raised his hand, and that was how he became a medic in the United States Army. After a quick training, Arthur was shipped out to the Philippines, where they were putting together a massive hospital to prepare for the expected invasion of Japan. He and other young medics were assigned to a doctor who taught medicine at Johns Hopkins University. Being that they were outside of an active war zone, the doctor decided that he was going to do what he knew best: teach these young men medicine. He went out on the wards in the local hospital to find all the interesting cases to show them, and he even got them into classes at the University of the Philippines. Arthur Bickford was doing spinal taps as a medic - something he never did again until late in his formal medical training. Connie reflects, “If you have a teacher, and that’s what they do, whoever is around them is going to get taught. Just by being who that man was, he influenced Arthur’s life, then Arthur influenced other lives. It’s like dropping a penny in a pond and seeing the ripples go out from it.” When Arthur came home, he went to college then continued on to Tufts Medical School. He eventually established his own medical practice in Yarmouth, Massachusetts.

Founding Duffy Health Center While in seminary in the 1990s, Dr. Bickford’s wife Connie spent a semester taking classes in India. Dr. Bickford took several months away from his practice to go with her. While there, he worked with a local doctor to provide care. That was when he truly realized how many people

in the world are in desperate need of medical care. It was when the Bickfords returned from India that Arthur began volunteering his time at what was then the NOAH shelter in Hyannis (St. Joseph’s House today). Recognizing the unmet medical needs of guests at the shelter, Dr. Bickford and a nurse practitioner from the Visiting Nurse Association established a weekly, 2-hour medical clinic. They dispensed basic first aid, antibiotics, medical advice, and clean socks, working out of a small closet in the shelter. The more often they went, the more they saw what a huge need there was for medical care for the local population experiencing homelessness. “The whole medical community seemed to realize the value of the work being done at the shelter,” reflects Connie. “It was a time when the need was there and people were beginning to understand it. Cape Cod Hospital had a lot of people showing up at the Emergency Room for health care, and they realized that wasn’t sustainable. The hospital got behind the clinic at the NOAH shelter and began helping to supply some of what was needed. People began to really see that if there was a place for health care for people who couldn’t pay for it, who couldn’t maybe follow regular protocols and needed different kinds of follow-up, our community would be better off.” Dr. Bickford used his influence within the medical community to get other doctors to volunteer at the shelter. He really felt that everyone deserved good medical care, and it didn’t matter if they had a home, or a primary care provider, or anything else. He had a passion for caring for “the least of these” - people who don’t have the ability to care for themselves for whatever reason. We continue to feel the ripple effects of Dr. Bickford’s influence today, more than 25 years after he first established the “clinic in a closet.” We are extremely grateful for his vision and leadership, to the professor who sparked his passion for medicine, and to his wife Reverend Connie Bickford for her continued support and her time sharing this story. Duffy Doings 3

On Board: Dr. Mathewson Serving our community through medical expertise

r. Herbert Mathewson, affectionately known as “Hub,” has been involved with Duffy Health Center since its very earliest days. In his current role as an Honorary Board Member, he serves as one of the unofficial Duffy historians in our midst. Hub began the interview for this piece by asking, “How did you decide that 2022 is the 25th anniversary?” Anyone who knows the story of our organization knows that the work began well before 1997, but it wasn’t until that year that the “clinic in a closet” was officially incorporated as a nonprofit organization in the state of Massachusetts, by the name of O’Neill Health Center. Dr. Mathewson is a pediatrician by training, and originally came to Cape Cod to work as part of the Hyannis Pediatric Group. It was a few years after he first came to the Cape, when he was volunteering on Cape Cod Hospital’s utilization review committee, that he first met Dr. Arthur Bickford. Within a few years of first meeting, Dr. Mathewson had become the first Medical Director of Cape Cod Hospital and Dr. Bickford had started a medical clinic that operated out of a closet at the NOAH Shelter, providing basic medical care to individuals experiencing homelessness. Dr. Bickford was recruiting physicians to back up the two nurse practitioners who were running the clinic two evenings each week, and approached Dr. Mathewson for support. “I quickly realized my pediatrics background was useless, so I became involved with recruiting other physicians, internists and specialists to volunteer their time,” recalls Hub. “Arthur Bickford’s modus operandi was to see a need and commit to fixing it, then figure out how to pay for it later. He was the chief funding service in the early years, and he got Cape Cod Hospital to give money, supplies and basic medications.” Several people describe Dr. Arthur Bickford as a “good arm-twister,” and he was determined to make this clinic work because he recognized the need. He was able to get the attention of Cape Cod Hospital CEO Jim Lyons, who could get the attention of the Board of Trustees. Dr. Bickford convinced them that this endeavor would keep people out of the emergency room, which was true. “Eventually the operation got so big that we really needed to get organized, so we formed a Board of directors that included Jim Lyons as CEO of Cape Cod Hospital, myself

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as Medical Director, and we looked to recruit others. Jeff Dykens (current Duffy CFO),worked in the hospital’s finance department, and he would sit with us in the basement of the old Cape Cod Bank and Trust and try to figure out how we were going to pay for all of this.” As the clinic outgrew the space in the NOAH Shelter, it was finally necessary to transform the operation from less of a “ma and pa” to a more formal, modern-day operation. “The transition was not easy, and it didn’t come without turmoil. Dr. Neil Ringler was the first Board Chair and functionally acted like an Executive Director. He deserves a great deal of appreciation for shepherding the change of the organization. He’s data driven and knew how to bring people together to cooperate,” says Hub. Today, Dr. Mathewson and Dr. Ringler continue to serve as active members of Duffy Health Center’s Board of Directors, despite their “honorary” roles. When asked why he has remained involved all this time, Hub explains, “It’s a dynamic place, and it’s always provided good services. I’m so familiar with it, and I enjoy reminding everyone of the history. None of Duffy’s success was automatic.” We are grateful to Dr. Hub Mathewson for the vital role he played in establishing the clinic that would become Duffy Health Center; for his many years of continued service; and for keeping us all in line with his reminders of the history of the organization we are so honored to be part of!

What Determines Health? Understanding the factors that impact our patients’ well-being

n the most basic level, most of us understand the factors that determine our health: from a young age we’re told that certain behaviors are good for us and others are bad; we review our family health history at almost every doctor’s appointment; we’re encouraged to eat healthy foods and exercise regularly. While these factors certainly play a role in one’s wellbeing, it is increasingly common to place importance on Social Determinants of Health (SDOH) in understanding an individual’s ability to attain and maintain good health. SDOH are the economic and social systems that affect conditions of daily life, impact health, and contribute to health inequities and access to resources. They are the non-medical factors of health, which have a major impact on well-being and quality of life. Examples of SDOH include: • • • • • •

Access to safe housing and transportation Education, job opportunities, and income Access to nutritious foods and physical activity opportunities Air and water quality Racism, discrimination, and violence Language and literacy skills*

As illustrated in the graphic at right, only 20% of what determines a person’s health is the health care that they receive. Half of what contributes to health outcomes is the socioeconomic and environmental factors surrounding them, such as family support, education levels, and access to community resources. An example provided by the U.S. Department of Health and Human Services perfectly

Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved 4/11/2022, from https:// health.gov/healthypeople/objectives-and-data/social-determinants-health

illustrates the impact of SDOH inequities: “People who don’t have access to grocery stores with healthy foods are less likely to have good nutrition. That raises their risk of health conditions like heart disease, diabetes, and obesity — and even lowers life expectancy relative to people who do have access to healthy foods.” (https://health.gov/ healthypeople/priority-areas/social-determinants-health) At Duffy Health Center, we witness health disparities every day that are caused by inequities in SDOH. In an effort to better understand our patients’ individual circumstances, we have begun to use an assessment tool called PRAPARE: Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences. The form is a standardized and validated assessment tool to collect SDOH information and is part of a proven method to collect, track, and respond to SDOH. As we integrate the use of the PRAPARE form into our practice, we are gathering vital information that helps us understand our patients’ lives. This information, in turn, will inform current care and services at Duffy Health Center. It will allow us to design patient-specific and population-level interventions as we document in greater detail the complexity of circumstances around our patients’ health. We look forward to sharing more information about the Social Determinants of Health impacting our patients in order to shine a light on the barriers that so many of our neighbors face in living a healthy life. Learn more about how organizations in our community are addressing SDOH by listening to our podcast on the topic, Health Matters: Cape Cod. Available on Spotify and iTunes! * (https://health.gov/healthypeople/priority-areas/social-determinants-health) Duffy Doings 5

In From the Streets Providing shelter for unsheltered individuals during cold weather months

s we finally emerge from the long Cape Cod winter, we are eager to put cold days behind us and focus on the beauty of spring and the warm promise of summer. Several individuals in our community have the opportunity to see the spring and summer because the work done by Duffy Case Managers throughout the winter months (team pictured on front cover). Each year, they dedicate hours and hours - including on-call hours on nights and weekends - to ensure that individuals experiencing homelessness in our community are not left out in freezing temperatures and inclement weather. Their work to facilitate the provision of warm, safe shelter for these individuals literally saves lives. This work is part of In From the Streets (IFTS), a community-wide program that offers temporary shelter in local motel rooms for individuals experiencing homelessness who need shelter from cold weather. Duffy has managed the program for nearly 10 years, and our close collaboration with community partners – human service providers, police departments and the faith community – has made this initiative a successful regional effort, with two motel partners in Falmouth, one in Hyannis and one in Yarmouth. This winter, with support from Cape Cod’s state legislative delegation, Duffy received an Emergency Solutions grant of $317,000 from the Department of Housing and Community Development (DHCD) for the program. A grant at this level demonstrates a recognition of the program’s impact, and we are grateful to the delegation

and the leadership of Senator Julian Cyr for their work to secure this funding for our region. Surprisingly, the sizable grant did not meet the full needs program - at one point this winter, there were almost 60 individuals in the motel for 2 months straight. Funding was supplemented by foundations and invidual donors. IFTS is activated any time the overnight temperature is forecast to drop below 32 degrees; it has also been used as an isolation program during the COVID pandemic for individuals who have nowhere to isolate. After a daily briefing on the forecast, the network of case managers and community partners works quickly to accommodate those they know are living outdoors, and Duffy Case Managers facilitate referrals and intake for the program. They are also the liaison between guests and motel management, administering program guidelines, supporting behavior management, and ensuring a safe environment for all guests. They do all of this on top of their regular Case Management responsibilities (more information on these programs on pages 8-9). While sheltered in the mid-Cape motels, individuals receive daily meals from Faith Family Kitchen, a program of the Cape Cod Council of Churches. They also receive ongoing support from Duffy Case Managers, whether they were previously engaged with Duffy or not. This is a vital component of the program, as one of the secondary goals is that individuals leave their motel stay with a connection to services at Duffy Health Center and other human services agencies in the community, to support them in moving from homelessness to housing. Cape Cod is fortunate to have local motel owners who understand the complexity of the individuals being served by this program. They get to know them as they would any longterm guest, and become invested in supporting their success. During one winter storm, staff at the Tidewater Inn in Yarmouth took it upon themselves to prepare soup for the guests. The owners of the Hyannis

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Host are known to form personal connections and offer advice and moral support to individuals staying with them. The Admiralty Inn and Suites in Falmouth is another strong partner in this program. As one motel owner stated, “We are proud to assist the neediest in our community. We do not do this for publicity. We do it because if we can help, we should help.” The program operates in a simliar fashion in Falmouth. While Duffy provides administrative oversight, Falmouth Human Services provides case management along with outreach workers from Housing Assistance Corporation and meals are provided by Belonging to Each Other. The stability offered by the motel stays during the winter months can truly have a positive impact on individuals’ ability to focus on personal wellness goals. “People live in a lot of chaos when they don’t know where they’re going to sleep at night, especially when it’s cold,” shares Kara Feidelseit, Case Manager who supports the In From the Streets Program. “During these winter months when we were able to provide shelter for them, we saw the benefits that stability can bring to their situations. They could unpack their bags, put things in drawers. Many came to Duffy for appointments they typically may have missed. When they have access to their own private space, they have the opportunity to work on what they need to do to improve their lives.”

With the support of Duffy Case Managers, success has come for at least four of the individuals assisted through the In From the Streets program this winter. We learned recently that one motivated couple was able to quickly complete paperwork to secure a unit through the Barnstable Housing Authority, as soon as it became available. Another couple had their name pulled for a section 8 certificate for Sandwich, and will soon start the screening process for a one bedroom apartment. These successes are rare in the current housing market, but we continue to find creative solutions for those in need. In From the Streets Case Managers on the front cover include: (L-R) Kara Feidelseit, Karen Danskin, Leah Morrissey, Nellie McDowell and Arlene Crosby.

This powerful piece of art was created by local artist Claudia Smith-Jacobs.

Thank You! To Our Motel Partners The Hyannis Host The Tidewater Inn The Admiralty Inn and Suites

To Our Food Partners Faith Family Kitchen and its volunteers Belonging to Each Other Cape Cod Council of Churches Medical Reserve Corps

To Our Safety Partners All Cape Security Barnstable Police Department Falmouth Police Department

To Program Funders

The Mary and Redwood Wright Fund of The Cape Cod Foundation Jean Nichols Charitable Trust The Sean M. Gannon Memorial Fund of The Cape Cod Foundation Duffy Doings 7

Our Professional Team of Case Managers

uffy Health Center’s approach to patient care can be envisioned as a three-legged stool: our multidisciplinary team seeks to address patients’ needs on the biological, psychological, and social levels. Duffy Case Managers, who represent the social leg of the stool, provide support in myriad ways and are often a patient’s most trusted confidante on their Duffy care team. While Case Managers’ welcoming, respectful, and nonjudgmental approach is consistent with all Duffy staff, what makes their role unique is the outreach component of their work. In our Duffy values, we say that we “meet patients at their self-defined point of need” - on their path to recovery; on the path to physical wellbeing; on their journey with mental health challenges. Case Managers meet patients where they are both figuratively and literally. Much of their work is done outside the four walls

of 94 Main Street; they attend collaborative outreach programs, visit clients in their homes, physically assist them in accessing needed shelter. They play an integral role in ensuring that members of our community - current Duffy patients or not - receive the care and services that they need. Duffy’s Case Management team is comprised of true professionals in their field. They are intimately involved in assessment, care planning and monitoring the plan. They practice navigating the delicate balance of wanting what’s best for their clients while also understanding the art of behavior change: the client must be invested in making a change, otherwise it won’t stick. There are mulitple programs within the Case Management department, through which team members work with clients in-depth and long-term.

Outreach Duffy staff perform outreach at various locations throughout the community, including faith-based institutions that provide drop-in centers for people experiencing or at risk of homelessness, campsites, motels, and other locations where individuals may meet. Our Case Managers work collaboratively with law enforcement, state agencies, and other local providers to engage individuals in services. The strategy is particularly effective with individuals experiencing homelessness who may be uncomfortable in a traditional medical setting due to substance use disorder, mental health struggles or other traumas. Meeting people on neutral ground provides an opportunity to tell them what services Duffy Health Center offers in a low-pressure environment, without any expectation of commitment. “I do it in a casual way,” shares Outreach Case Manager Arlene Crosby, “But the next time I see them they’ll have more questions, they’ll want to follow up.” “I really like meeting people in the little alleyways, the

Housing First Housing First is a national model whereby stable housing is provided as a first step in services for individuals experiencing homelessness. By eliminating the chaos of homelessness, Housing First participants are able to more effectively address underlying behavioral health and 8

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Arlene Crosby talks with two clients outside Duffy. streets, the bandstand, outside of a church,” says Arlene. “Most people that I engage with want to learn more about Duffy; most have heard my name, which is helpful. It’s a good time to discuss options, to educate people on what Duffy has to offer, with no judgment. We collaborate closely with many other organizations, like Vinfen and Barnstable Police Department. It really works because we’re a team. We’re aware of the needs, and we do the very best we can with the rest of our community to get people’s needs met.”

medical issues. Housing First is an evidence-based practice and has been a factor in national and state funding shifts away from emergency shelters and towards permanent, supportive housing models. Duffy Health Center was the first Cape-based organization to adopt the Housing First model.

Duffy’s Housing First Case Managers, Leah Morrissey and Nellie McDowell, are fierce advocates for their clients. They work with local public and private housing authorities as well as private landlords to help clients achieve and maintain successful tenancies. Their responsibilities include everything from screening to determine eligibility for housing options through the region’s coordinated entry system to tenancy preservation for housed clients. They visit apartments with their clients during the housing search, perform inspections based on the program’s parameters, and work closely with them on transitioning into their new homes. They educate their clients on tenants’ rights and advocate for them when necessary. “This is one of the most exasperating yet humbling and rewarding jobs I’ve had,” shares Nellie. “Nothing is better than a client that’s really done the work and they get the news that they got the place, or you’re there with them as they’re signing the lease. That helps you sleep at night. We take on a lot of stress for it to not be on them, since they

have so much else to deal with.” The Housing First program has resulted in a decrease in risk behaviors and utilization of public services and increased positive connections to preventive health services and to the community. Once a client is housed, Case Management through Nellie McDowell and Leah Morrissey Duffy is ongoing. Our goal is health and overall wellbeing, and while housing is a piece of that, Leah and Nellie continue to support clients as they navigate the full range of services at offered at Duffy and in our community.

Behavioral Health Community Partners Patients with the most significant behavioral health needs receive specialized support from Duffy Health Center Case Managers as they navigate the health care system. Support offered by Case Managers includes care coordination and care management; support of transitions of care; and connection to social services and community resources so that patients can live independently. Individuals who qualify for the Behavioral Health Community Partners program have at least one diagnosis of substance use disorder, post-traumatic stress disorder, or a mood disorder. They also have a history of utilization of detoxification programs, methadone, or Department of Mental Health involvement.

Community Health Workers The Community Health Worker role is an important element of Duffy Health Center’s Case Management services. Based on a national model, the Community Health Worker is an embedded, trusted peer who provides culturally and linguistically appropriate health education, navigation, and advocacy to Duffy’s patients and clients. The value of Community Health Workers is that they are viewed by patients as members of the same community, given their lived experience. Working with a peer allows clients to build a deeper level of trust, thus enabling the Community Health Worker to assist the care team with patient outreach and offer health education to assist individuals in meeting their goals.

For individuals living with severe mental health diagnoses, it can be difficult to navigate the health care system. This can lead to a higher rate of visits to the Emergency Department, both due to a lack of care management and a lack of understanding of how the system functions. The Behavioral Health Community Partners program was created by MassHealth to cut down on visits to the Emergency Department that were not emergent in nature. Duffy Health Center’s Care Coordinators connect clients to providers and community resources, assisting them in managing those relationships and their care, thus improving care maintenance and reducing the rate of usage of the Emergency Department, a cost-saving measure for the entire health care system. Another important aspect of the Community Health Worker role is addressing the Social Determinants of Health with patients. These are the non-medical factors that influence health outcomes; the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These can include access to education and transportation, income, family support, and more. Duffy Health Center recently received a grant from the Massachusetts League of Community Health Centers to add two Community Health Workers to our team. The new team members have already proven instrumental in assisting patients as they navigate external referrals and begin to gather information on our patients’ Social Determinants of Health. The connections our CHWs make with patients are invaluable to our patients’ success. Duffy Doings 9

Duffy Achieves Advocacy Center of Excellence Gold Status From the National Association of Community Health Centers: Achieving a Gold ACE status requires serious dedication to and prioritization of advocacy at your health center. Much of the extraordinary, innovative work that health centers have been doing for the last fifty years and will continue to do into the future rely on federal, state, and local support. Health centers must cultivate a culture of advocacy and integrate it into the daily routine of the health center. Duffy Health Center has demonstrated this with tremendous effect. Duffy Health Center is now part of an elite group that serves as an example to other Community Health Centers striving to achieve advocacy excellence. The amount of effort and time needed to achieve this requires hardworking, engaged staff and supportive leadership—the two pieces of the puzzle necessary for a successful and robust advocacy program, both of which you have. Thank you for your leadership. Duffy’s work to institutionalize advocacy increases coordination and engagement at your health center; it also strengthens the Health Center Movement and enables greater success nationally.

An Update from our DEI Committee

Our Diversity, Equity and Inclusion (DEI) Logo

Since its inception in fall 2020, Duffy Health Center’s staff-led DEI committee and Duffy leadership made a commitment to: • • • •

carefully examine our policies and procedures to identify and reconcile structural racism, increase the representation of Black, Indigenous, People of Color on our staff and our board to more fully represent the populations we serve, implement meaningful trainings for new hires and ongoing trainings for staff and board on issues of DEI, and undertake reviews of care to ensure access to and equitable delivery of all health care services we provide.

The work has been thoughtful and intentional. In order to accomplish this, the committee created a detailed plan to guide the work. We have created working groups to take on the priorities in the plan. Current working groups include: 1. 2. 3. 4. 5. 6. 7.

Environment of Care Clinical Care Policies LGBTQIA+ Workforce & Board Sustainability Programs & Communications

A logo is a way to brand specific initiatives, lend them importance and make them stand out from other aspects of our work. The Duffy DEI Committee chose to incorporate the Progress Pride Flag in its logo to illustrate the committee and organization’s work toward equity and inclusion for all members of our community. Coordinating with Duffy branding demonstrates the agency’s commitment to the work. Designed in 2018 by Graphic designer Daniel Quasar, the flag emphasizes inclusion and progression. Quasar’s Progress Pride Flag added five arrow-shaped lines to the six-colored Rainbow Flag, which is widely recognized as the symbol of lesbian, gay, bisexual and transgender (LGBTQ+) community. The flag includes black and brown stripes to represent marginalized LGBTQ+ communities of color, along with the colors pink, light blue and white, which are used on the Transgender Pride Flag. (https://grpride.org/product/ progress-pride-flag/)

If you’d like to support these efforts, please contact Sara Grambach at sgrambach@duffyhealthcenter.org or (508) 771-7517 ext. 104. 10

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“I feel like a person again.” How our work makes an impact One of the most gratifying parts of our work at Duffy Health Center is seeing our patients make strides in restoring their health and rebuilding their lives. When they share those experiences with us, it reminds us what an honor it is to do the work we do.

You don’t bother taking care of it, and you don’t want to take it in for service because you feel like they’re going to tell you it’s going to cost a lot of money. But when you can come in and be seen, and have someone tell you that your teeth are okay, your liver is okay, you’re motivated to put in the work to keep yourself well. What were some of the reasons you sought care at Duffy Health Center? I’m lucky enough to have a family member who convinced me to come in. Before I knew what Duffy was, I had a close friend who came here for mental health problems. I didn’t think it was for me – I didn’t know there were services available for just a regular person like me.

Tell us a little about yourself. My name is Brittany and I’ve been a patient at Duffy Health Center for about one year. I began my journey at Duffy for help getting sober, but they’ve done so much more than that for me. They’ve referred me for dental work that was needed, fixed my medication so I can live a more productive life, and I’ve been able to access Eye Movement Desensitization and Reprocessing (EMDR) therapy, which has freed me from so many burdens. My gratitude is through the roof. I’ve done Alcoholics Anonymous on and off for years, but I had trouble working through trauma. I really needed the help of a professional. When I came to Duffy, I had just gone through 2 years of chemotherapy and cancer treatments. I was really feeling like a number and not a person. When you have a cancer diagnosis at my age, you need some extra TLC. I can’t believe how much I feel like an individual patient at Duffy. I feel like I’m a person again. Everyone cares, from the front desk all the way through. What is your relationship with Duffy Health Center? What services do you access here? I access Medication Assisted Treatment for Substance Use, Behavioral Health, Primary Care, and when I first became a patient I got help from Connections to get set up with health insurance. A lot of what keeps people sick is that things are too difficult to sign up for and no one helps you. That’s what makes Duffy different. When you’re in addiction, it’s like your body is a junky car.

Duffy brought me back to life. Other places might save your life, but Duffy will bring you back to life. What are some things you appreciate about Duffy? The staff are all friendly, and I really feel safe. While I was in the waiting room a couple weeks ago, I saw another patient who seemed like they didn’t have some of the stuff they needed to get by on the street. A staff member came out and gave the person a backpack so they could carry all their stuff. That was just an above and beyond thing to do. And during COVID, I didn’t even have to worry about figuring out the vaccine because they called me to come be vaccinated. Vaccine availability was amazing. What are a couple of things you would like to share with people who don’t know much about Duffy? I tell people a lot about EMDR and how much it’s done for me and how much trauma therapy can help out. Also, mental health can be enough to go to Duffy; you don’t have to be addicted to a drug. Duffy staff communicate well with each other – my therapist talks to my primary care provider, they talk to the nurse who gives me Vivitrol. It really makes you feel like there’s a care team around you. In your words, what is it that we do at Duffy Health Center? Duffy brought me back to life. Other places might save your life, but Duffy will bring you back to life. Thank you to Brittany for sharing her story. Duffy Doings

Positive Community Impact Collaborating with the Barnstable Police Department to help those in need

f you drive down Main Street in Hyannis, you are likely to pass a few police vehicles. You may pass one where an officer is seated, speaking to a person outside her window and giving out a fist bump. You may pass an empty vehicle and find an officer outside, chatting and joking with individuals who have come to get a warm cup of coffee or lunch at the Salvation Army. You may find one in the Duffy parking lot, the officer talking with one of our patients about their recovery goals. “We work with a lot of folks who don’t have much trust in the police,” says Officer Danielle St. Peter. “To have people show that they trust us, that’s why we do what we do. I don’t know how to explain it... but I know I’ve succeeded when someone trusts me.” Officer St. Peter is referring to the work of the Community Impact Unit (CIU), a team within the Barnstable Police Department (BPD) that leads the way in community policing. The team is made up of Sergeant Mark Butler, Officer Danielle St. Peter and Officer Scott Leger along with part-time BPD mental health therapist Justine Podurgiel. The team’s goal is to keep our community safe through meaningful relationships with individuals and collaborative partnerships with organizations like Duffy Health Center. The CIU was established in 2014 in response to Hyannisarea social service agencies, BPD and Barnstable town government’s desire to help the population of individuals experiencing homelessness in the area. “One of the first steps was understanding homelessness,” says Sgt. Butler. “The moniker oversimplifies the issue. These are people without housing, but it’s in conjunction with mental health challenges, substance use disorders, and more. BPD leadership recognized that it would be shortsighted not to address the root of the problem.”

Left to right: Sergeant Mark Butler, Officer Danielle St. Peter & Officer Scott Leger outside Duffy Health Center. pressure off the patrol side.” The team is proactive in their outreach and interventions: they hold a weekly meeting with representatives from Duffy Health Center, Vinfen, Housing Assistance Corporation, the Salvation Army and the local adult shelter, St. Joseph House. All of these organizations serve a similar population, with many clients overlapping for different services. The meeting provides unstructured time for triage: everyone brings the names of people on their radar, people they are concerned about. The team works together to make sure people are safe and that they get the types of services they need. “Knowing that I can pick up the phone and call any one of the team members is so valuable,” says Arlene Crosby, Case Manager at Duffy Health Center. “I can get information on behalf of a client. We’re able to offer the best we can to those in our community who need it.”

Members of the CIU are often found doing outreach to individuals experiencing homelessness, but they are constantly listening to the radio. If they hear a call come through regarding someone they’re familiar with, or someone experiencing a mental health crisis, they will go.

“Our goal is to try to help people rather than punish them,” explains Officer Leger. “We want to intervene so they don’t get sent off to jail for certain behaviors. They know we’ll be honest with them; we’re not going to immediately throw handcuffs on them, we’ll encourage them to make the right decisions and offer help if they need it.”

“Our team made a transition from enforcement to outreach,” explains Officer St. Peter. “We serve to bridge the gap between the population of individuals experiencing homelessness and the services that exist for them. When we get calls for service, we can make connections with our community partners like Duffy and Vinfen. Providing this type of intervention takes the

Sergeant Butler adds, “It’s finding a balance between wearing a uniform and having enforcement powers if you need to use them, but using our presence to point them in the right direction - hopefully not into the back of a police car. We understand that any one of us could find ourselves in their circumstances. A few bad decisions or unforeseeable life events and any one of us could be

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there.” One time each month, the group of partners is joined by representatives from Cape Cod Hospital’s Psychiatric Center, Bay Cove Human Services, the local chapter of the National Alliance on Mental Illness and representatives from the Barnstable District Court. The group is called the Community Crisis Intervention Team, and while its focus is mostly on procedures, they do discuss how to support individuals from time to time. The team is based on a national model that is 20 years old, traditionally with a focus on mental health response. Knowing the challenges in our community, BPD and its partners have expanded the focus to include homelessness and substance use disorder. At a time when the calls BPD receives are increasingly related to mental health crises, the addition of a mental health therapist who responds with the team shows a true commitment to this type of policing. “Having a therapist with us takes the edge off right away,” says Sgt. Butler. “Bringing her along shows that we care.”

family from a different perspective than the officers. I collaborate with them on what the next steps should be. I can explain that I’m here for them, to support them, but I’m a colleague of the police officers and I’m here because they want me to support the individual in this time of need.” The CIU’s approach to policing is truly appreciated by all members of the Duffy Health Center team, largely because we can see the positive impact of their interactions on the individuals we serve. “It’s great for clients to see a different face of BPD,” says Arlene. “They see a small team doing big things. The CIU brings more coordination on behalf of service providers, more motivation on behalf of clients, and a strong team to support the individual in making decisions.” Thank you to the Community Impact Unit of the Barnstable Police Department for their partnership!

Justine adds, “I can observe the person, the systems, the

Fifth Annual Attorney General’s Award for Distinguished Service in Community Policing In March 2022, Barnstable Police Officer Danielle St. Peter received the Fifth Annual Attorney General’s Award for Distinguished Service in Community Policing, one of only 18 recipients in the United States, and one of two from Massachusetts. The award recognizes rank and file law enforcement officers for their exceptional efforts in effective community policing. This year, there were 185 nominations from 145 agencies, recommending a total of 347 individual officers, deputies and troopers. Officer St. Peter was one of only four recipients for innovations in community policing. A portion of the award reads, “Officer Danielle St. Peter’s commitment to the Barnstable Police Community Impact Unit (CIU) has dramatically benefited local residents. The CIU works with partner agencies to bring medical care, substance abuse treatment, mental health counseling and housing services to homeless and disadvantaged populations.

St. Peter routinely assumes the role of case manager, counselor and problem solver by using an individualized approach to de-escalate tense situations and connect people with services tailored to their needs.” “St. Peter’s upbeat attitude, conflict resolution skills, patience and work ethic are part of her extreme effectiveness and a true demonstration of community policing.” Officer St. Peter has been a member of the Community Impact Unit since 2018, and a Barnstable Police Officer since 2011. She is a member of the department’s Peer Support Unit, a Mental Health First Aid Instructor, and has attended training in Human Trafficking Awareness, Suicide Prevention and Interventions, Trauma to Addictions, Crisis and Group Crisis Interventions, and Gang Awareness and recognition, among others. She is a proud life-long resident of Barnstable. (This piece written with excerpts from the 3/18/2022 press release issued by the Barnstable Police Department.)

The Duffy Health Center team congratulates Officer St. Peter on this recognition. It is truly well-deserved!

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Since 2000, Falmouth Road Race, Inc. has helped charity partners raise over $50 million and bring awareness to their causes. The Numbers for Nonprofits charity runner program not only assists charities in raising much-needed funds, it also brings people together and provides deeper meaning to running the ASICS Falmouth Road Race.

Meet the Members of the 2022 Team Duffy Health Center!

Amanda McGerigle Sarah Lapsley-Martin & Brenna Lapsley Therapist at Duffy Friends of Duffy, sisters running in memory of their brother Chris

Kara Feidelseit Case Manager at Duffy

Jennifer Linck Therapist at Duffy

Larry Feidelseit Friend of Duffy & Kara’s Dad!

Samantha Cronin Jeremy Wurzburg Andrew Singer Honorary Duffy Mental Health Counselor, Program Supervisor, Alternative Peer Group Alternative Peer Group Board member

Carrie Sullivan Nurse Practitioner at Duffy

Maura Crowley Friend of Duffy

David Burke Friend of Duffy & former CFO

Andrew Burke Friend of Duffy & David’s son!

Dr. Lisa Jones Jessica Baecker Chief Medical Officer Running in memory at Duffy of Chris Lapsley

Andy Roberts Case Manager at Duffy

Sara Grambach Duffy Director of Development

Christina Wiseman Duffy Marketing & Communications

Help Team Duffy Reach Our Goal! We would love to have our community’s support as we embark on our 7-mile run! If you’d like to support Team Duffy in reaching our goal of $25,000, please visit DuffyHealthCenter.org/FRR to make a donation. You can give to an individual runner or to the entire team - all funds will directly support Duffy Health Center’s programs and services. 14

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25 Years of Investment What inspires the Duffy family to continue their support of our work

uffy Properties is a family-owned and run real estate company based in Waltham, Massachusetts. They specialize in development and acquisition, construction, and property management. So how did a community health center in Hyannis come to share its name with this off-Cape business? A big Irish family, of course. In the first half of the 20th century, Peter and Florence Duffy moved from Prince Edward Island, Canada, to the Boston area, changing from a career in farming to one in building. As their family grew, their five sons followed in their father’s footsteps and established Duffy Brothers Construction. “Having a big family was key to the Duffy brothers’ success,” shares Bob Duffy, Jr., Director of Commercial Real Estate at Duffy Properties. “Family means everything; we all support each other. There is a need to look out for your siblings and the children of your siblings.” The brothers’ niece and Bob Jr.’s cousin, Judy BestLavigniac, was a nurse practitioner and became involved in the operation of a volunteer clinic in Hyannis in the early 1990s. The clinic was for individuals experiencing homelessness, and operated out of the NOAH Shelter, run by the Housing Assistance Corporation at that time. The clinic grew quickly as the depth of need was identified, and when it was incorporated as the O’Neill Health Center in 1997, Judy became the first Executive Director. To support her in this endeavor, her uncles and Duffy Brothers Construction (today called Duffy Properties) made a significant gift in memory of Judy’s mother and grandmother, Mary Elene Duffy and Florence “Florrie” Helene McNally. “There’s a history of people in our family in the medical field - in fact, all three of my children are now medical professionals,” says Bob. “We see the medical field as a very noble profession. We all have a respect and admiration for those who use medicine to make other people’s lives better. The clinic made a big impression on my dad and his brothers.” Since their initial gift, the Duffy family’s support for the mission of Duffy Health Center has continued. Both Duffy Properties and individual members of the Duffy family have been incredibly generous to the organization throughout its 25 year history. In 2006, the health center’s name was changed to honor the Duffy family’s generosity.

Bob Duffy, Jr.

“When I visit, I’m always impressed with the Duffy facility and with the integrated model of care, especially incorporating psychology,” reflects Bob. “It’s amazing the good work that Duffy can do with the amount of money you actually have. It’s a huge multiplier. You could give a dollar to somebody else and they do a dollar’s worth of good, but I feel like when you give a dollar to Duffy they do $10 worth of good. Every dollar just really gets put to great use.” Through their many years of support for Duffy Health Center, it seems that the Duffys may be developing a sense of philanthropy in the next generation. Cousins in Bob Jr.’s kids’ generation have attended Duffy events and learned about the impact of Duffy Health Center’s work. A couple have done summer internships with our team and one is currently working as a nurse at Duffy. Others have begun their own philanthropic investment in our work. “Part of our success had to do with having a big family who would always help each other out,” reflects Bob. “Not many people have big familes like my dad’s generation anymore, but maybe Duffy Health Center can be a substitute for that. Supporting Duffy helps the greater good.” Thank you to the Duffy Family for their years of support, and for their generous $25,000 matching gift in celebration of our anniversary year!

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94 Main Street Hyannis, MA 02601

Save the Date! Join us to celebrate Duffy Health Center’s 25th Anniversary Thursday, November 3rd, 2022 Wychmere Beach Club | Harwich Port, MA Details to follow!

Thank You to Our Sponsors For their ongoing support of our work!

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