National Nurses Week: On The Front line of Care for Those Without A Home

When Cedric was released from the hospital following a 6-month stay due to major surgery and complications, he needed a place to recover and set all of his follow-up care appointments. Cedric was without a home at the time.

Denise McDaniel with Jorge at Pathway Recuperative Care

At National Health Foundation’s Pathway Recuperative Care program, Cedric found a place to recover from his health issues and more; Denise McDaniel, LVN, the Medical Coordinator at Pathway Recuperative Care’s Los Angeles location, treated him with love and kindness.

“At Pathway Recuperative Care, our nursing staff provides medical oversight which means we keep a close watch on their health to ensure they are healing appropriately and that all of their follow-up medical appointments are set and met,” shared Kelly Bruno, President and CEO of National Health Foundation (NHF), “more importantly, we care. We care deeply that our clients have an interruption in homelessness and if this triggers a desire to be connected with services to find their way into a permanent and stable housing situation, we walk that journey with them as well. But it is our exceptional nursing staff that is on the front line of delivering that life-changing care.”

For Denise and her counterpart at Pathway Recuperative Care’s San Gabriel Valley location, Tammy Grimes, LVN, a typical day involves caring for numerous clients while working with social workers and support staff as stable housing is secured.

“I get so excited when we have arranged for housing for a client. It gives them the opportunity to focus on something other than where they will lay their head each night,” shared Tammy. For Denise, the joy of seeing the smile on an individual’s face when they receive housing is the favorite part of her job.

Working with individuals who are without a home has brought Denise and Tammy face to face with the most common misconceptions about this population, “I see people fearing those without a home and that is something I would love to change,” shared Denise. For Tammy, the notion that everyone who is without a home is on drugs or alcohol is far from the truth, “ The truth is everyone has a story and they are all different.”

Denise is inspired by her clients’ tenacity, “I’m always humbled by the people I work with. They are willing to try and start over from scratch.” Tammy’s thoughts turn to the fundamental need for housing, “Living conditions make treating and coping with health issues more difficult. Health cannot be a priority if the individual is focused on their safety and where they will sleep at night. Mortality is higher living on the street.” Both nurses have one wish for their clients: Stable housing in a community that is safe and loving.

For Bruno, having exceptional staff working with clients has raised the bar of what compassionate care looks like, “On behalf of all of us at NHF, I salute our nurses and thank them for delivering far more than health. Through their compassion, strength and the love for what they do, they deliver a deep caring that is life-changing and inspiring to us all.”

At The Intersection of Health and Education: National Health Foundation’s Be A STAR Program

National research has identified a significant link between education and health. High school graduates live longer, healthier lives than dropouts. College graduates have even longer life spans, better access to health care, better dietary and health practices, and overall better health. Unfortunately, about a quarter of California counties have high school dropout rates close to 20 percent or more, including Los Angeles at 17 percent. While there are numerous factors contributing to the dropout rate, one third of female dropouts say that pregnancy or becoming a parent played a role in their decision to leave school. Girls most at risk for teen pregnancy are Latinas from low income communities. There is critical need for education and support services to reach these adolescent girls at the greatest risk for pregnancy and subsequent dropout before they get pregnant, ultimately breaking the cycle of teenage pregnancy. 

With this information, National Health Foundation has implemented the Go Harold’s Way; Be a STAR (Successful Teens Acting Responsibly) Girls Program. Goals of this program include reducing the incidence of pregnancy, improving high school graduation/completion and connecting participants to health and social services and resources in their community. Since its implementation, NHF has provided more than 700 students with the tools and education they need to prevent unwanted pregnancies and abilities to make healthy life choices. 

Haydee and Yvonne are two participants of the Be a STAR Girls program at Ramona High School and are set to graduate in 2018. For Haydee, the program gave her key information she did not have access to beforehand, “I learned there’s many ways to prevent pregnancy and learned all the parts of the female anatomy and what they do. I feel confident about my reproductive health because I’m more informed about different topics that we learned in class.” The weekly topics touched on birth control and STDs as well as how to plan for the future. Yvonne admitted that before being in the program, ‘ditching school’ was a chronic issue. “Before coming to Ramona I was ditching a lot of school and now I come to class every day and will graduate next year. My plans after graduating school are to get a job and go to community college to help me have a career later in life.” In addition to committing to her future, Yvonne has a deeper appreciation for her body and her health, “In the Be a STAR class we got to talk about our physical bodies and how a woman’s body looks on the inside. We also lean to be more confident about our bodies. I now know how to protect myself from getting an STD.”When not in school Yvonne enjoys playing basketball with friends while Haydee likes to try new things. Both students have expressed that this program has given them the confidence to be able to make healthy decisions when it comes to their reproductive health. After graduation, both Haydee and Yvonne plan to attend community college laying the path for their future careers.

                                               

Access to Fresh Foods is Taking Root in Historic South Los Angeles

March is National Nutrition Month. It is also the month that National Health Foundation is beginning to offer nutrition education classes in Historic South Los Angeles. As part of the Champions for Change Healthy Communities Initiative grant received from the Los Angeles County Department of Public Health, NHF will be conducting 30 minute to 1 hour long nutrition education classes at schools in the community with students and parents. Led by our trained and expert staff, these classes are intended to educate South LA residents about the importance of healthy eating and physical activity. Classes will cover topics such as the USDA’s MyPlate guidelines, the importance of drinking water, reading and understanding food labels, shopping for healthy food on a budget and everyday activities that can help maintain weight and fend off disease.

These classes are one part of the healthy story that is emerging from within South LA.  Our Health Academy students have worked with two, and are currently assessing 8, local food markets to see how they advertise and sell healthy options. They collaborate with store owners to improve the visibility of healthy foods, such as fruits and vegetables, and offer help with marketing these options to the community. Their efforts are working! More healthy foods are visible to consumers and one market owner has even changed his food procurement process to receive healthy food from a local produce distributor, making these healthy options more available and cheaper to the community. 

Together, these two approaches are intended to tackle the social determinant of health that is access to healthy and nutritious food. South LA is considered a food desert with few healthy food options available. Furthermore, food insecurity is an issue that many in the community face. The nutrition education classes are being offered with the expectation of shifting the trend of obesity and heart disease in the community.  By reinforcing the positive changes happening in South LA, including the availability of fresh produce at corner markets, we will ensure that every individual and every family has the access to the knowledge and ability to eat healthy and live their best, healthiest life.

Health and Dignity for the Homeless

Nancy Hu, a Social Worker with California Hospital Medical Center, Dignity Health, would like to see lower readmission rates, reinfections and fewer visits to the emergency department for her patients. Nancy works with patients who are about to be discharged from the hospital and the majority of her caseload is individuals who are without a home.

“I see myself as someone who advocates for my patients and collaborates with the nurses, doctors and case managers to work towards a safe discharge,” shared Nancy, “The challenge is that when someone is not able to heal in a clean and safe environment, it puts the person at a much greater risk of another hospitalization and further exacerbating their illness, all of which can be prevented.”

Since 2015, National Health Foundation’s Pathways Recuperative Care has become one avenue for safe discharge of homeless patients from partner hospitals. Pathways offers temporary housing with medical oversight to individuals who are without a home. The advantage for patients is that they can heal safely and are given the support needed to adhere to follow-up care schedules. For partnering hospitals the advantage is peace of mind, “The hospital feels reassured that the patients are able to go somewhere clean and safe to heal while getting assistance with follow-up appointments and housing,” says Nancy.

Not every homeless patient opts for accepting Recuperative Care and not all are a fit. As a social worker, Nancy assesses each patient who is homeless to see if they are appropriate for recuperative care, if they are motivated to get housing, and those who wish to recover from their medical condition. Not all homeless patients want to be housed, “Personally, it makes me sad because it doesn’t have to be that way. But I also know that we all have rights to make choices that we feel is best for ourselves and to choose to take help when it is offered.”

On any given day, Nancy is balancing and prioritizing between a victim of crime, someone who is homeless and being discharged while it is cold and raining outside, and another who is dealing with a life changing/altering diagnosis. We at National Health Foundation’s Pathways Recuperative Care are grateful to Nancy and Social Workers everywhere who are providing essential care to patients at their most vulnerable; upon discharge from the hospital.

Flor’s Mini Market Gets Fresh With National Health Foundation’s Community Health Liaisons

Flor’s Mini Market is a neighborhood corner store that is one block from Thomas Jefferson High School in Historic South Central Los Angeles. It’s a favorite among high school students who frequently stop by to purchase a bite to eat before class or during lunchtime. Her merchandise mix is typical of a ‘tienda’ with must have home and personal products as well as some food and beverage inventory. Until recently, the food for sale was mostly packaged with few healthy food options. In a community that is both a food desert (with few healthy food retail choices) and a food swamp (categorized by a prevalence of unhealthy food outlets), markets such as Flor’s have come to represent unique opportunities and key potential partners in the effort to improve access to healthy, affordable foods in South Los Angeles.

Recently, Flor joined the Community Markets Purchasing Real and Affordable Foods (COMPRA foods) program, an innovative food distribution system that caters to small businesses that want to offer healthy food and leverages their collective purchases to secure better prices and quality products from wholesalers. During the first delivery of fresh produce last week, Flor was approached by a dynamic group of high school students known as the Community Health Liaisons (CHL). As part of  National Health Foundation’s (NHF’s) BUILD Health L.A. Initiative, CHL youth   

work with neighborhood markets to help corner store owners introduce healthy produce, and better merchandise fresh fruits and vegetables. CHL’s help store owners make small, gradual changes by providing technical assistance that can help overcome the challenge of introducing new inventory and taking on new risk.

Two CHL youth, Ariana Vega and Melissa Villarruel, ‘adopted’ Flor’s Mini Market to help the store owner adjust to the demands of selling perishable healthy produce and help to ensure changes are profitable and sustainable, with the overall goal of increasing the availability of fresh, quality fruits and vegetables in their neighborhood. During this initial meeting, the CHL’s helped Flor inventory produce shipment and begin using marketing strategies to promote fruits and vegetables in-store.  Together they carved out space in the store for the produce and used baskets and other materials to entice consumers to consider adding fresh fruits and vegetables to their purchases. Within a week, the students will check back with Flor see how things are going and modify their strategies as needed.

The students are keenly aware of the alarming prevalence of obesity, heart disease and diabetes in their community. For NHF, the BUILD Health Initiative presents an opportunity for partners to come together and improve the health of the community from within. By working with local high schools, NHF is able to directly connect with the energy of youth from the community. NHF brings CHL youth together with community partners such as Leadership for Urban Renewal Network (LURN), Los Angeles Food Policy Council, and Los Angeles Department of Public Health among others to share knowledge and to craft innovative solutions to build a healthier South Los Angeles overall.  The students will continue to monitor their efforts to glean important outcomes, however, their efforts have already been well received by storeowners and the community alike.

For Ariana and Melissa, the experience of working with Flor left them inspired, “I felt really good knowing that we would be able to help her not only to sell her produce but also some of the other merchandise in her store,” shared Ariana. Melissa had this to say about her experience, “The level of excitement I had from helping Flor was inexplicable, it felt as if I were riding a roller coaster, or the feeling when you just learn to drive; it felt great!”

 To read Ariana’s account of her work with Flor, please click here.

Increasing Opportunities for Exercise in Historic South Los Angeles

On February 13^th, 2017, Central Avenue Jazz Park in Historic South Central Los Angeles was transformed into an outdoor fitness space with community members and instructors moving through workouts designed to increase cardiovascular capacity, boost energy levels and increase the feeling of wellbeing. For community member Claudia Durango, it was a welcomed event, “This is going to be really good for the community; we just need to continue having people show up.” The new program is part of the rollout of National Health Foundation’s (NHF) BUILD Health LA Initiative Community Action Plan for Historic South Central.

In 2016, NHF’s BUILD Health LA Community Health Liaisons, a group of local high school students and their mentors, surveyed the community to understand residents’ barriers to health. The results of the survey were captured in the Community Action Plan that aims to improve the health of the community through methods that have been identified by the community’s residents and that capitalize on partnerships and the assets available.

Historic South Central Los Angeles is 6 square miles, and is home to roughly 103,000 people. In this community, there are no gyms and there is only 0.4 acres of park space for every 100,000 people. Along with having limited access to open space, this community is considered both a food desert (with few healthy food retail choices) and a food swamp (categorized by a prevalence of unhealthy food outlets). Obesity and diabetes are common in this community, and while physicians recommend healthy eating and exercise, these lifestyle changes are challenging to practice with what is available in the community.

One of the needs the Community Action Plan addresses is for programs to keep residents physically active. Many stated that the classes that were available were too expensive and that the free programs had extensive waitlists of residents eager to join. We learned that these residents want to exercise and they will – if the opportunity is there.

As a result, we partnered with 3WINS Fitness, an innovative program spearheaded by Dr. Loy and Kinesiology students from California State University, Northridge. 3WINS Fitness “adopts” parks in Los Angeles, and sends Kinesiology students to teach community members how to exercise while nurturing a community mentality that leads to friendships, accountability and results!

In addition to 3WINS Fitness, NHF also partnered with California Hospital Medical Center, LA County Department of Public Health, LA City Parks and Recreation, Newton Community Police Station, All People’s Community Center, and A Place Called Home, to launch the fitness program. Classes take place Mondays, Wednesdays, and Fridays at Central Avenue Jazz Park and All People’s Community Center.

Community members are thrilled with this new opportunity and have already built great rapport with the instructors from 3WINS. For NHF, the program represents a new way of delivering health to the community. “By creating an opportunity for the community to express their needs and actively engage in finding solutions to the health barriers they were experiencing, they are bringing about healthy changes from within,” shared NHF CEO Kelly Bruno.

Consistency is always the key with taking on a new behavior, but we are sure that with this new partnership and with the different components of the BUILD Health LA Initiative and Community Action Plan, the residents in Historic South Central Los Angeles will have new opportunities to live a healthier lifestyle.

High School Health Activist Has Sights Set on Health Career

Aracely Ortiz, 2nd from left, presenting Health Academy's Cafeteria Makeover Project during the 

Youth Summit hosted by LACDPH, April 2015

Aracely Ortiz first heard about the Health Academy during a recruitment presentation in class when she was in 9^th grade. It was also Health Academy’s first year at Thomas Jefferson Senior High. “I wasn’t really involved in anything else at that time,” she explains, “but Health Academy just sounded different from all the other groups I’d heard about, so I decided to go for it.”

She went on to submit an application and sat through an interview, and in the spring semester of 2014, Aracely became a member, or “youth leader,” of the brand-new Health Academy program. After attending a few meetings and experiencing first-hand what the program was about, she was hooked. “At first I was debating whether to continue or not, but everyone in the program was so nice and supportive. It felt like a good place to be.”

Through Health Academy, Aracely learned some unexpected things about her community. She learned how her neighborhood is often considered a food desert or food swamp because of the prevalence of fast food restaurants and liquor stores compared to full-service grocery stores that sell fresh fruits and vegetables. While discussing food swamps, she said, “it was definitely eye-opening. I thought that we already had a lot of things in our community, but now I’ve realized that we don’t have as much as we should.”

Since realizing this, Aracely has actively worked to improve access to healthy food for her school and her community. She often shares information she learns through Health Academy with her family and friends. “I always show my parents the healthy food recipes I get from Health Academy, and we’ve started making them at home… I’ve also taught my parents how to read nutrition labels, and it’s something we look at now when we shop for food”.

Aracely has also taken on leadership roles in several Health Academy initiatives, such as implementing Smarter Lunchroom strategies in the school cafeteria and the Mini Farm Stand project. Throughout her participation, Aracely has been an important voice for her fellow students and community members. One moment she feels particularly proud of was attending a youth summit hosted by the Los Angeles County Department of Public Health during her sophomore year, where she presented her team’s Cafeteria Makeover project to other high school students from across the County. “We made changes in the cafeteria that year that decreased the wait times for getting lunch and also got students more excited about the cafeteria food. More students started participating in the school lunch program, and I like to think our project helped… I felt really proud of how we presented our project and I think we were able to give other schools some good ideas.”

Her experience with Health Academy encouraged Aracely to be even more involved in school. Aside from Health Academy, she is now also an active member of her school’s Gay-Straight Alliance chapter, Student Leadership and ROTC. Now a senior, Aracely is in her fourth and final year in Health Academy, where her role has expanded to include Youth Social Media Manager. In this position, she will work with other Health Academy students to create and post content for the NHF Health Academy Instagram page. Aracely is also getting ready for college next year and has already received acceptance letters from California State University, Dominguez Hills and Loyola Marymount University. She aspires to become a nurse someday, and credits her involvement in Health Academy for inspiring her interest in the health field. 

Aracely is one of over a hundred students that has participated in Health Academy which is going into its fourth year through funding from the Los Angeles County Department of Public Health. Recently, National Health Foundation received another Department of Public Health grant, the Champions for Change – Healthy Communities Initiative, to expand Health Academy to another Los Angeles high school; allowing NHF’s Health Academy and its proven benefits to reach many more students like Aracely, their families and the community.

Winter Clothing Drive for Recuperative Care

National Health Foundation is hosting a Winter Clothing Drive for Recuperative Care Program participants. These men and women are continuing to heal after a hospital stay and are transitioning to stable housing after having been homeless. Many come to our program without the basic necessities such as a change of clothes and cold weather apparel. Kindly consider sharing what you can! We will collect donations through January 30th.

ITEMS NEEDED FOR DONATIONS (both men and women)

Underwear (bras, panties, men’s boxer shorts-30-32, 34-36, 38-40, 40-42, 44-46)

T-shirts: Medium, Large, X-Large and XXL, XXXL

Sweat Pants: Medium, Large, X-Large and XXL, XXXL

Sweat Shirts: Medium, Large, X-Large and XXL, XXXL

White Tube Socks: Women Sizes 6-10 and Men Sizes 9-12

New or Gently Worn Coats- All Sizes

We are accepting donations at our recuperative care facility at:
5136 W Washington blvd. 90016, on Monday through Friday, 9-4

Partnering for a Healthier South LA

National Health Foundation (NHF) and partners know firsthand that to improve the health of individuals and underserved communities the work cannot be done alone. Collaboration is necessary, and forming multi-sectoral partnerships to align resources, leverage partnerships, and synergize upstream prevention efforts -  is key to building a healthier community.

Under the BUILD Health LA initiative, NHF and partners have come together to address the health disparities and inequities faced by the South Central LA community. Together, BUILD partners envision Historic South Los Angeles as a community that defies the odds and becomes an oasis of fresh, healthy foods and inviting urban space. The BUILD initiative attempts to build on past efforts to create an inviting community where youth, families and adults can access healthy food, be physically active outside, and are supported in maintaining a healthy lifestyle that results in decreasing the prevalence of obesity and subsequently diabetes and cardiovascular disease. Furthermore, this partnership believes in the ambition and potential of the youth in this community. Central to this work, is the commitment and emphasis on youth involvement, empowering youth to take action towards improving social, environmental, and economic conditions in their neighborhood to impact community health.

At present, a new forged partnership with COmmunity Markets Purchasing Real and Affordable Foods (COMPRA Foods) has caused great excitement to the BUILD efforts. COMPRA Foods is a purchasing cooperative and produce distribution program designed to meet the needs of small grocers in low-income neighborhoods. COMPRA Foods was developed, and is lead, by Leadership for Urban Renewal Network (LURN), the Los Angeles Food Policy Council (LAFPC), and the Asian Pacific Islander Obesity Prevention Alliance (APIOPA). The COMPRA Foods team will provide leadership to the BUILD initiative in engaging small markets to offer fresh, healthy food options.

Other BUILD Health LA partners include: Santee Education Complex and Thomas Jefferson High Schools who are providing access to youth for participation; 3WINS program at California StateUniversity, Northridge, who are providing kinesiology student volunteers to facilitate fitness programming; All People’s Community Center, A Place CalledHome and L.A.U.R.A., who will each host new fitness programming and will conduct outreach to the community to expose neighbors to the positive changes being implemented; and South Central Family Health Center and St. John’s Well Childand Family Center, who will conduct outreach, disseminate marketing materials, and food vouchers to drive community members to embrace the implemented upstream healthy changes in the community.

Through BUILD, the project team is moving South LA toward supporting healthier lifestyles. In

addition, by training and supporting youth Community Health Liaisons to drive much of this change, the project creates a cadre of local leaders who will understand potential for upstream improvements and have the skills to influence them.

Together, NHF and partners are TAKING ACTION to decrease the prevalence of obesity, diabetes and cardiovascular disease in Historic South Central LA by creating new solutions to community health!

A COMPRA Foods van filled with healthy produce

Recently, NHF met up with Rudy Espinoza, LURN Founder and Executive Director, and his team at LURN Headquarters. Here’s what they had to say about the new partnership and how LURN’s work through COMPRA Foods, connects with the BUILD Health LA initiative.

What is it about the BUILD community action plan that is in line with LURN’s mission?

Alike the BUILD Health LA initiative, LURN is dedicated to binging people together to design, build, and promote sustainable communities that allow everyone to live to their greatest potential. For example, through the COMPRA Foods program, LURN is invested in finding creative opportunities to bring more fresh produce and healthier food options into underserved communities like South LA to build a healthier community, and a healthier Los Angeles overall.

What are the goals for COMPRA?

With little to no access to major grocery stores in neighborhoods like Historic South Central Los Angeles, COMPRA Foods aims to amplify the capacity of small convenience stores to carry affordable and healthy produce. Currently, COMPRA is a grant funded initiative, supported by funders such as USDA, the Department of Public Health, the Ahmanson Foundation, and the Kresge Foundation. “We have a vision that COMPRA can become the next stand-alone social enterprise, much like Amazon fresh, for local grocers and small convenience stores.” This would mean more access to fresh, quality, fruits and vegetables at a low-price for store owners, and residents alike, who frequent and shop at these local stores.

What has the community response to COMPRA been?”
Once in the COMPRA Foods program, small convenience store owners often see the value and cost savings of entering the cooperative. This is due by enlarge to the fact that small food retailers source their food products from "big-box" grocers, paying full price for these products and then marking them up for sale in their own establishments. This often occurs because entrepreneurs lack relationships with distributors who can deliver produce to their businesses at wholesale prices. Small and mid-size farmers who may be interested in selling their produce directly to these establishments also lack the relationships and efficient distribution systems that can connect them to the hundreds of stores in low-income, "food deserts”. This service gap between growers, distribution companies, and small food retailers impacts low-income consumers tremendously. Because there are few major grocery stores in some low-income communities, families are required to buy food at elevated costs found at small grocers who themselves lack low-cost alternatives to sourcing the produce they offer. In contrast, by entering the COMPRA Foods program, small market owners find support and are connected with small to large wholesale food distributors that provide them with the accessibility and affordability to sell fresh, healthy produce in their stores at a low-price to residents.

What does BUILD bring to LURN?
Through the BUILD Heath LA initiative, one part-time staff member will be hired to manage and expand the COMPRA Foods program to include 16 small markets within Historic South Central LA. Specifically, as a main focus in the first year, youth Community Health Liaisons and the project partners will conduct assessments of 22 local markets (out of the community’s 224 markets) to determine their viability and interest in participating in a food purchasing collaborative with expectations that a minimum of 16 will enter into the collaborative by the end of the first year. After three months of training, the anticipated goal is that each participating store will increase their healthy food options as measured by a cooperative order tracking system.

This supports LURN’s three-year program outcomes for COMPRA, which include: (1) engaging 60 small grocers and convenience stores in the Los Angeles Promise Zone area; (2) equipping 30 small stores to purchase produce and healthy snacks; (3) broker partnerships with 3 local farmers, produce wholesalers, and healthy snack purveyors; and (4) deliver food weekly to more than 30 small grocers and provide marketing and product placement assistance. This with an overall arching goal of reaching 30,000 residents and encouraging them to purchase health