As part of the Center for Patient and Consumer Engagement, we look for successful examples of patient and family engagement. After seeing Sharon Elliot-Bynum’s presentation at the North Carolina Institute of Medicine Task Force on Patient and Family Engagement about CAARE, Inc., I was excited to have the opportunity to visit the center in Durham, NC and share what I learned about and observed. – Maureen Maurer, Center Advisor
A powerful example of how to redesign and re-conceptualize health care, CAARE, Inc promotes a holistic and community approach to health, making it as easy as possible for people to engage in their care and make all aspects of their lives healthier.
When asked about how others could replicate CAARE’s success in their communities, Sharon Elliott-Bynum, Executive Director, responded, “Intention. Integrity. Inclusion.” After spending several hours with her, it was clear what she meant by these words.
Driven by a passion and love for their community, Sharon Elliott-Bynum and her late sister, Patricia Amaechi, co-founded CAARE at their kitchen table after church in the mid-1990s. They sought to address disparities in care access by providing effective prevention and case management services to at-risk persons and their families. Over the past two decades, CAARE has not only provided preventive and clinical services, but also seeks to address the social and human factors that contribute to disparities. Envisioned as a one-stop shop, CAARE converted a 23,000 square foot factory to a community-based organization that offers multiple services to improve the health of community members.
CAARE’s Jeanne Hopkins Lucas Education and Wellness Center includes a Free Clinic with 3 clinic rooms served by volunteer health care providers and a lab. Services focus on 5 of the most severe health disparities – HIV/AIDS, diabetes, high blood pressure, obesity, and cancer. CAARE recently opened a dental clinic, staffed by a volunteer dentist. And the Center also offers holistic services at no-cost, such as acupuncture, EFT Tapping, and massage, and reiki. Yet, wellness does not end with these clinical services – CAARE also has a free gym with a personal trainer twice a week and daily exercise classes, such as Zumba, line dance, African dance, and yoga.
CAARE’s support services include a substance abuse comprehensive outpatient treatment program, case management, and individual, group, or family counseling and support. CAARE conducts HIV counseling and testing (with results in 20 minutes) and community education and outreach, including HIV education, street community outreach, risk reduction sessions, health fairs and screening, and peer education services.
CAARE’s food pantry is open Monday-Friday and works with local farmers and community-based organizations to distribute fresh fruits and vegetables. A community kitchen on site prepares hot meals daily and serves as a space where community members can hold cooking classes. The Benefit Bank program is a free service that helps people connect with state and federal benefits, tax credits, and other public funds.
CAARE’s job readiness programs prepare individuals for the workplace and include on-site GED classes, computer classes, and job training classes. CAARE is a NC Job Link and Job Search Center. They recently opened the Community Entrepreneurial Organization, with cubicles, computers, equipment, and on-site consultants to help people start their own business.
CAARE’s veteran transition program offers decent affordable housing for male veterans who are transitioning back into civilian life. CAARE is currently building an on-site 15 bed dormitory, with a spacious community room, two offices for work, and a private bedroom and connected bathroom for each veteran.
CAARE’s Cathy Hughes Community Connection Center is a placewhere community members can celebrate special life events, convene meetings, thank volunteers, or hold daily exercise classes.
All of these services did not appear easily. At each stage, Sharon and Patricia had a vision of what was possible and worked to remove or circumvent barriers along the way. Limited resources were not a barrier. Fear of failing was not a barrier. Their intentions were pure and grounded in faith and purpose.
CAARE’s leadership and staff listen to and respond to the expressed needs of individuals in the community – almost invisible people with little or no access to health care services and who have a limited voice in traditional health care. For example:
- Individuals in recovery find it difficult to get a job? CAARE becomes a NC Job Link and Job Search center, holds GED classes on site, and opens the Community Entrepreneurial Center.
- A 7-year old says she wants a space for children? CAARE turns a storage room into a creative space where children can play with toys and board games, write and draw on blackboards, read, and hang out.
- Women feel uncomfortable using the machines and weights in the gym? Hold daily exercise and dance classes in the community room. Find a personal trainer to help women learn how to use equipment. Reserve time for Muslim women to exercise at a time when men will not see them uncovered.
- HIV positive women need a space to socialize and hold their support groups when a grant at a local university runs out? Create a coffee corner, with comfortable chairs, tables, and books.
- People want experience with gardening and landscaping? CAARE is working to create a hydroponic garden in their backyard.
CAARE seeks to make it as easy as possible for individuals to engage in their health and care, to support themselves and each other. By listening and responding in this way, staff members at CAARE feel that they earn the trust of the individuals they serve – who want to come back, and when able, give back to others.
When you walk in, the front room is spacious and welcoming. The walls are painted warm colors of red and yellow. There is limited information posted about services as to not stigmatize clients. A person sitting at the front desk welcomes and helps clients navigate where they need to go. Respect, dignity, and caring for individuals are clear from the design of the space, but also the way staff members carry themselves and treat the individuals who come to CAARE.
Inclusion also means mobilizing community resources and volunteers. It means working with local business and community-based organizations to get supplies and resources for construction. It means working with allied health, business, and child development programs at local universities, whose students gain experience while providing services and building programs at CAARE. It means that the folks who are usually the highest paid in health care –doctors, nurses, dentists—are volunteers, and their experiences providing services are also important. They have the equipment and support they need to do their jobs effectively.