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Outreach builds trust, improves health care access for the vulnerable

ROGERS, Ark. — Forced onto the streets by poverty, Tiffany Anderson and her husband took shelter in a tent for six months and then in a car for two months before weather forced another move — this time to a run-down motel where some families double up with six to eight occupants to a room.

Sr. Lisa Atkins, RSM, of Mercy Northwest Arkansas, speaks with John Aydelotte in November 2017 about securing a room for him at a motel in Rogers, Ark., where she ministers to the near-homeless. Marc F. Henning/© CHA

"It got cold and it was starting to snow, so my husband and I moved into the motel," she recalls. "It was the cheapest long-term place we could find that wasn't our car. It's not a really nice place to live but it had a roof and a bed, a shower and heat." The motel, in severe disrepair, also had leaking ceilings, faulty electrical fixtures, spotty water service and erratic heat, holes in the walls, roaches and mice.

It was at the motel that Anderson first met Sr. Lisa Atkins, RSM, a health liaison for the Mercy system in Northwest Arkansas. As part of her job, Sr. Atkins established a ministry for the homeless about two years ago in Rogers and in nearby Bentonville. In Rogers, as in communities across the country, homeless people on society's margins often shuttle between outright homelessness, low-cost motels and temporary stays with friends and extended family.

Sr. Atkins organizes a weekly free hot meal program at the motel where Anderson lived as a way to build trust with the vulnerable occupants and let them know about social services and medical services available through Mercy and other community nonprofits.

Each Thursday evening, Sr. Atkins and volunteers from Mercy, from churches and nonprofits set up serving tables and dish up Styrofoam boxes of food to about 80 individuals.

Hidden poverty
When the meal program started, Anderson and her husband had part-time jobs at McDonald's and Anderson staffed the front desk at the motel part-time in exchange for reduced rent. Over time, Sr. Atkins and Mercy volunteer Cinthia Vlaovich helped the couple transform their lives. They found a landlord willing to rent a two-bedroom apartment to the couple despite a lack of references and credit. They found someone to donate a car.

With recent job experience, transportation and a reference from Sr. Atkins, Anderson got a steady job as a barista on the campus of Mercy Hospital Northwest Arkansas in Rogers. Anderson calls the job "one of the best I've ever had." She has newfound confidence, a good paycheck and health insurance.

Most important to her, she has regained custody of her 8-year-old daughter, who had been living with relatives. Anderson, who lived at the motel from 2013 until last year, now volunteers to help serve the weekly meal when she can. "Anything to help the cause," says Anderson, who is buoyant about her life changes. "I'm just very thankful to Mercy. They helped us out tremendously. If there's a crisis, they help people."

Sr. Atkins worked as a nurse practitioner for 10 years at Mercy Convenient Care in Bentonville, before starting her ministry for the homeless. "We are bringing the healing ministry of Jesus Christ … out into the heart of the community," she says.

In Northwest Arkansas, Sr. Atkins sees poverty and despair side-by-side with affluence. Benton County, which includes Bentonville and Rogers, is home to the headquarters of the world's largest retailer, Wal-Mart Stores. Fayetteville, in adjacent Washington County, is home to the University of Arkansas. Tyson Foods makes its international headquarters in Springdale, which straddles Benton and Washington counties.

"There are huge extremes in Northwest Arkansas between those who are impoverished and those who are wealthy," Sr. Atkins says. Some people "aren't conscious of the extreme poverty that's here because it's hidden. In a big city, you see it. It's not so obvious here."

Alarming circumstances
Mercy started its helping mission at the motel where Anderson lived after hearing reports by the Children's Advocacy Center of Benton County, which helps child abuse victims and their families. The nonprofit reported to police what Sr. Atkins calls "a horrendous situation."

From left, Dale and Deb Bennett and Diana Hartung of Bland Chapel United Methodist Church offer boxed meals to a trio of boys as part of Mercy's outreach to the near-homeless at a motel in Rogers, Ark. Marc F. Henning/© CHA

"They were seeing an alarming pattern of children and women being abused in significant numbers at this local motel in Rogers," Sr. Atkins says, adding, "Our hearts were moved at Mercy. We went out and gave flu shots for free, and we saw the sadness and fear in the women's and children's eyes and other people living at the motel."

Sr. Atkins conducted a needs assessment and went door-to-door, talking to 35 to 40 families.

"Some of the residents are transient, some are homeless, some have lived there three years, some have eight in a room," Sr. Atkins says. "Most of the rooms do not have a microwave or refrigerator." Sr. Atkins says food insecurity is pervasive in the area. "One in five children go to bed hungry in Northwest Arkansas," she says.

Long-term residents "are stuck in this vicious cycle," Sr. Atkins says. "Many are elderly or on disability (assistance). They don't want to be in a motel; it's all they can afford."

The region's shortage of subsidized government housing gives people with little means few options for housing. "There's a long list for (government subsidized) housing and the waiting time is very long; so, in the meantime, these people are living in motels hoping to make it every day," Atkins says.

As part of Mercy's outreach to the homeless, social advocates — as Sr. Atkins calls them — connect people at the motel to area resources: dental and medical care, access to food stamps, parenting and finance classes and one of the few available affordable apartment complexes. The volunteer advocates are primarily Mercy employees and individuals from social service and church groups. They build personal relationships with homeless people they are helping and provide a familiar caring presence.

"We let them know we see their goodness and help them reclaim their own God-given good and God-given potential, let them know they're OK even in the middle of such distress and poverty," Sr. Atkins says. Since the ministry arrived at the motel, no cases of abuse of a resident have been reported to the police and other crime is down as well, she says.

People care
"It literally takes a village to have a meal out there every Thursday," Sr. Atkins says. "We couldn't do this without the community. The ministry would be nowhere if the community did not embrace this."

About 25 community partner organizations rotate donating and serving food. Among Mercy's main partners is Restoration Village, which provides women and children in crisis a safe home and services.

Among the ministry's successes, 10 families including Anderson and her husband have moved out of homelessness into permanent housing. The priority is in finding stable housing for women and children. A landlord willing to take a chance on people in need has opened up some apartments.

"They go on our word to take the tenants," Sr. Atkins explains. "They don't ask about their credit. Theywill accept folks as long as they are not violent offenders."

Grant money and donations help pay for the deposit, first month rent and utilities and then the new renters must be responsible for their housing costs. Most of the new renters have volunteers working with them to help them achieve firmer financial footing.

Because of the program's success in Rogers, Mercy's homeless outreach ministry, in partnership with churches and volunteers, expanded into a motel in Bentonville in October.

Sr. Atkins says Northwest Arkansas has the resources necessary to address poverty, homelessness and the lack of affordable housing. Trying to build the collective will to interrupt generational poverty is a key part of the ministry's mission.

"We at Mercy are serving as a catalyst to raise consciousness," Sr. Atkins says. "As a community we need to invest our resources and time and energy into finding just solutions." Sr. Atkins carries this message to churches and conferences, and she regularly visits homeless shelters and centers in Rogers and Springdale to do health screenings.

"We've got a lot of work to do, we're scraping the surface here," she says.

Mercy cares for vulnerable in McAuley Clinic Without Walls ROGERS, Ark. — Dr. Lisa Low learned that people at a local homeless shelter could not obtain primary health care in 2015, around the time a community health needs assessment by Mercy Hospital Northwest Arkansas showed that access to primary care — especially for people without insurance — was a concern in the hospital's service area. Clinic Without Walls coordinator Elizabeth Hernandez interviews a new participant to the program. Marc F. Henning/© CHA People were "falling through the cracks of the health care system," says Low, who is medical director of community health for Mercy – Northwest Arkansas. A family physician at Mercy for 18 years, she has a master's degree in public health. "It's hard for people who don't have insurance to get primary care," Low says. "We wanted a better way to help community members get into our clinics. Some people don't want to come in. Some may not speak English. Others don't know how to go about getting insurance. If they don't have a job, even if they're here legally, they still need help."  Mercy considered establishing a free primary care clinic, but after Mercy doctors told Low that they would rather treat uninsured patients in their own Mercy offices and clinics, Mercy created McAuley Clinic Without Walls. It is not a place, nor is it a mobile unit. Instead, 14 Mercy doctors accept Clinic Without Walls patients as part of their regular caseload. Mercy pays for all care for most patients, including referrals to specialists. Some patients pay a much reduced, sliding-scale fee. The providers have offices in Centerton, Lowell, Bentonville and Rogers. The program pairs some of the most vulnerable, uninsured patients with primary care doctors with whom they can build an ongoing relationship. "We feel like it's a very cost-effective alternative to a free clinic," Low adds. "You do not have to build a building … and doctors can see the patients in their offices. "It is good for patients — it preserves their dignity to be seen in a regular doctor's office," Low says. "It's good for physicians because their patients can get all the services they need.  We feel it benefits everybody who's involved." McAuley Clinic Without Walls accepts patients 18 or older. Community health coordinator Elizabeth Hernandez is the program's only full-time employee. Based in Rogers, she gets patient referrals from county health departments, shelters and community service organizations and from her Mercy colleague Sr. Lisa Atkins, RSM. Sr. Atkins, a nurse practitioner and community health liaison, leads a Mercy outreach ministry to the homeless. "This is how we're able to get some people who are homeless into our clinics and get the medical care they need at Mercy," Sr. Atkins says. Hernandez collects financial information from potential patients, then sends it to Mercy's financial assistance team to determine if patients qualify for the program. She assigns new patients to a primary care doctor and makes the first appointment, monitoring referrals to specialists. Hernandez revisits patients' program eligibility every six months. Low explains: "Someone may be able to get Medicaid or find a job." In that case, the program would have helped bridge a gap in financial and health security and the patient's improved financial status would free up a place for another needy patient in the McAuley Clinic Without Walls program. During the year and a half it has been in operation, McAuley Clinic Without Walls has enrolled about 100 patients, Hernandez says. The patient roster includes immigrants without legal status, immigrants holding green cards and people living in homeless shelters. The majority of McAuley patients are Hispanic, and health navigator Hernandez is fluent in Spanish and English. Some patients are poultry factory workers from the Marshall Islands. McAuley Clinic without Walls is growing by about 10 patients each month. Patients have a range of chronic health problems — high blood pressure, diabetes, kidney and cardiac issues, among them, Low says. For one woman whose visa had expired and who could not afford health care, the program made it possible for her to have surgery to remove dangerous nodules on her thyroid. The clinic takes its name from the founder of Sisters of Mercy, the Venerable Catherine McAuley, who spent her inheritance aiding the poor in 19th century Ireland. —MARGARET GILLERMAN

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