Common Ground Health Clinic

Common Ground started on September 9, 2005 just days after hurricane Katrina devastated the Gulf Coast. Due to the humanitarian disaster and apparent lack of governmental response, two community activists, Sharon Johnson and Malik Rahim put out a call for healthcare workers to help meet the overwhelming need. The clinic started as a first aid station with the arrival of “Street Medics”, which are first responders that gained notoriety through mass mobilizations of the anti-globalization movement. Nurses, physicians, herbalists, acupuncturists, EMTs social workers and community activists came from around the world to volunteer at Common Ground Health Clinic.

Ebony Gustave: Can you give a brief overview of what Common Ground Clinic is and what inspired the development of it.

Magon Jackson: The clinic started post Hurricane Katrina in the Algiers area, which is the West Bank side of New Orleans once you cross over to the Greater New Orleans Bridge. A community leader by the name of Malik Rahim, saw the need for care, supplies, and resources in that area post-Katrina. He gathered a few people locally and also put out a word to anyone else for the cry, for help. In doing so, a tremendous amount of volunteers came from everywhere. When I say everywhere, I mean everywhere, people were coming from India to volunteer their services. A lot of them were already medical professionals - they may have been EMT or paramedics. They were extreme health workers - they used walkie talkies, went to people's homes, assessed blood pressure concerns, and other things that were going on simply because there was no availability for health care resources at that time. It also developed further into supplies, clothing, and different food items that people may have needed or nonperishable items.

In 2010, they started the process to become federally funded, it’s about a three year process. In 2013 they were approved for federal funding and Common Ground became a federally qualified health center. We had two locations at one point, but now we are just down to one, which is in Gretna, still in the West Bank area of New Orleans. We are planning on opening up another secondary location in Algiers again so that we can be on our home turf and serve the community there as well.

We offer basic healthcare services. We also provide behavioral health and today actually a psychiatrist came on board so we can address even more mental health issues. We know those issues are prevalent post-Katrina as well as what's going on with COVID-19. We do COVID-19 testing here as well. It is exciting, we have a pretty good team and I've met so many people. I have been here since 2006.

Ebony Gustave: What are some of the main distinctions between Common Ground and going to a conventional doctor's office?

Magon Jackson: The clinic, by having such grassroots roots, it is almost embedded into our orientation processes and just the organizational behavior here. The mentality that the people who work here have is more concerned about the holistic effects of treatment to the patient. It is not just medical - letting them know everything will be alright, everything will be managed. It's more so, what's going on in your life, how can we learn more about you? A patient is not just a medical record number, they are a name.

Most people don't realize this but when you build relationships like that with a patient basis, it makes care that much easier. It makes care that much more acceptable because these people are community people who have already experienced disparities and barriers to care, they don't need another one. When you're able to dismantle that on some level, they're able to receive the information and education that you're trying to give them for the well-being of their own health. It makes it better for you to actually treat, to ask questions and they can be open and honest with letting you know if anything abnormal is going on. Whereas with any other healthcare facility, I honestly can say that they just feel like another number. They're just like, OK, well, let me just get this visit. That would be the most distinctive difference with Common Ground simply because of how it started. It is still ingrained into the framework of the employees and it reflects with the patients that we serve.

Ebony: The doctors at the clinic also are from the community, right?

Magon: Yes, our nurse practitioner is. The chief medical officer is from out of state, but she's been working in the New Orleans area for a while and she's done some traveling abroad in Africa, serving people of a different nationality that are of low income or have some major disparity in regards to health care. We have another gynecologist who is definitely from the area. She knows a lot of the patients that are coming in and out, which is wonderful because in regards to gynecology, you have to think of women's health. There are so many issues that go on with women, especially women of color. So it's good to know that they have someone here that's from the area, understands the lingo, so to speak, and the different terms that they will use to describe different ailments or whatnot. When speaking with the younger generation with regards to care, you have to be in the know in order to to really build a type of rapport with them, to get them in the proper habits of good health care practices.

Ebony: What type of financial and human capital were provided to get the clinic started and how is it currently funded? You briefly touched on that in the beginning but if you can elaborate a little bit, please.

Magon: In the very beginning, when the cry was put out, it was a cry, literally...it was like, please help us. Along with volunteers came donations. These donations came from various places. If it was a medical supply company, they would donate the medical supplies. If it was from a philanthropist or some type of angel investor and they wanted to remain anonymous, they would just donate a certain amount of funds. That is literally how the clinic sustained itself.

Maybe about two to three years after that, they began filing for different grants that were out there for the community. There were grants for produce, we had a gardening program here. Grants to teach the community how to garden and produce their own produce. The thing I can say about grant money is like when it's gone, it's gone. You have to constantly seek and search out different grants to maintain your funding. I believe this is what created the urgency and the desire to want federal funding because it was something that was consistent.

After they did all that with the grant funding, they applied for federal funding and it took about three years but they got it. Since 2013, we have been federally funded through a portion of the government entitled Human Resources Security Administration (HRSA). Ryan White is a young man who was born with HIV and they developed the entire grant funding program behind him but HRSA is the name of that government branch that provides that money. We do not receive Ryan White money because we do not treat HIV, but there are many federally qualified health centers (FQHC) that do. So you have the branch of Ryan White and you also have the branch of community health centers and that's where we fall in. Anytime you look up FQHCs, you will see the names of them in various states and Common Ground will be listed as one for the state of Louisiana.

There's about six or seven of us down here now and I believe Common Ground was the third one in this area.

Ebony: How do you think the framework of Common Ground was changed after being federally funded?

Magon: It stipulated a lot of regulations. Once you deal with the government, they have regulations and things that you cannot do and you have to follow within those rules.

So there are few programs that we cannot bill for, it’s not acceptable but there are ways to work around that. You just have to really be intuitive and figure ways out to get the service to the community as well as follow within the guidelines. They are very strict and what you don’t want to do is lose your funding because you begin on that search again for just regular random grants that are far and few between. Post Katrina they were plentiful, but now no, there is not that many.

To maintain the federal funding, we have to stay within a lot of regulations. So it's a lot of paperwork people have to sign when it’s a first time patient or different codes and things that are associated with certain types of care that you give. As long as we focus on giving the proper care, we can get the training and a framework on the back end done and maintain what we have.

Ebony: You spoke about one of the challenges of running a free health clinic was keeping up with the grants, can you touch on some of the other challenges.

Magon: At some point we couldn't handle the load of people. You would see that so many people literally being lined up trying to get into the clinic and you're trying to service everyone but you don't want to experience too much burnout with the staff. When we were free, everyone was a volunteer, nobody was getting paid so they were just doing this on their own merit. That is very tiresome, you have brain fatigue, you're worn out.

Also, with free services it can be abused by those who don't even need free services, who do have the opportunity to go and get additional health care somewhere else. It's very disheartening to know that there are people out there who will do things like that, but it's the reality of it. Everybody's not a beautiful person on the inside, they just want to take the easiest way out and get things for free.

Ebony: How did your experience with Hurricane Katrina provide more resiliency for the pandemic that we're currently in?

Magon: I can honestly say it's a difference, but it can’t hold a candle to after Katrina - it really cannot. You have government involvement with the pandemic, after Katrina it was almost like the government ignored this entire area. People were pleading for help and weren't able to get it. With the pandemic you have people aggressively trying to share information of better ways to do things. FQHCs are talking to other FQHCs because we are a community health clinic so all of us are servicing those who have some form of disparity like multiple chronic illnesses. So you're still trying to see irregular patients and deal with the COVID crisis so they’re sharing information. After Katrina, there was absolutely none of that. There was one hospital open, I believe and it was only like the emergency room. There were no clinics open, Common Ground just popped up because of a cry out for help.

Ebony: There were some government agencies that came over it to try to help with but Common Ground was actually doing more work than they were.

Magon: Yes, at the time Red Cross or whatever FEMA was doing - giving money out to certain facilities and things of that nature. There's still a government process with paperwork involved, making sure this person actually qualifies for whatever relief that they were trying to get. Common Ground was simply a free clinic that was giving out health services, clothing, supplies, and medication because we had medications that had been donated. That was it, there was nothing in between Common Ground and the community.

Ebony: What kind of tools does Common Ground offer the community to take preventative health measures?

Magon: We started a healthy eating education series where we partnered with Louisiana State University Agricultural Center and we had an instructor to come out and we would have people meet once a month. Yes it was once a month. I was having it once a month. We would do educational pieces on nutrition and how to cook certain meals that were healthy. We would give them different things like measuring cups or a cookbook with food that actually tastes good but were reasonably priced so you aren’t spending a whole lot of money trying to make a healthy meal for your family or just for you as an individual. Things that were very quickly made so that maybe someone who's elderly and lived alone could prepare themselves. We started that in January, but with COVID they shut down the library and kitchen area we were utilizing. The moment that we're able to start that again we will definitely get right back into that. The patients were loving it, it was fun. I attended three of those classes because the staff actually has access to the classes, it was not just limited to the patients or the community, we want everyone to be healthy. It is interesting to see how the patients will react to seeing the medical assistant sitting there getting the same education and those same tips applied to themselves.

Another tool that we have is a resource guide. That was put together maybe three years after Common Ground started but it’s consistently being revised. The last revision that I did on it was in January 2019. That resource guide took 30 volunteers to put together because what they did was contact places that are not listed on Google, organizations that only have time frames that were seasonal or something like that, but they compiled it all into one resource guide. You could literally look for anything within the community in that resource guide. Other FQHCs requested our resource guide because it was information that was pertinent to the care of the patient bases that we were all serving. Right now, the way it’s being utilized is that if a patient requested a copy of it, we can give them a digital copy of it or print it out, it’s about 120 pages.

We utilize social media to disperse information based upon health focused awareness for that month. This month we picked Hepatitis and last month it was men's health. It was all types of resources in regards to men's health, different statistics that were applicable to the community that we serve, different resources that they could utilize as men in the community and health issues that affected men directly. So that's the type of stuff that we would do monthly. In May we did mental health so we talked about a lot of mental health resources. Next month is going to be child immunizations, so we're going to talk about things about immunization and vaccines. We also have a diabetic educator here that talks a lot with the patients if they are newly diagnosed as a diabetic.

Ebony: What value do you see in health autonomy, especially for minority communities?

Magon: As much value as you can possibly give it, a person needs to know what they have the right to and they have the right to their own body. They have the right to their own treatment and care.

I find that with an older generation, they tend to just agree and accept whatever a doctor or nurse may be telling them. Whereas a younger generation they are a bit more defiant, they'll question things because they're raised in a time of information. They're going to go Google something and try to figure it out or talk to other people before they'll just readily accept whatever is given to them. I think it's especially important in the day and age that we're in right now. There's so many things going on. There's so many mixed messages. I don't want to say distrust a provider, but you should know that whatever provider is saying to you, you have the right to fact check, you have the right to double check. There's nothing wrong with asking a question. Is in your best interest to ask a question because if something is not lining up right with you, it may be for some very small reason that can be easily explained but if the question is never asked, you will never know.

To empower a patient to know that they actually have control I think is beneficial for everyone, especially the patient. A provider will be more confident with exchanging or giving directions to a patient that they know will thoroughly look through what it is that they're explaining to them and come back possibly with other questions to confirm things. They are following along with a treatment plan not just because they say this is what the treatment plan is going to be but because it aligns with what they need for themselves and they understand what it is that they need for themselves.

You have to incorporate all of the cultural differences, the racial differences, all of these things play a part in care. When you're speaking with the patient and when the patient is receiving information from you. We have a lot of bilingual staff here. We service about 50 percent Spanish speaking population. Having information available from bilingual staff allows for further explanation in a cultural sense and know that they really understand what it is that is going to happen or needs to happen for the betterment of their care. We try our best to empower our patients. You're the boss here, it's your body, your life. You can help us, help you in making good decisions for your care.

Ebony: Can you please share a story of a patient who benefited from Common Ground that was turned away from the traditional healthcare system?

Magon: There was a patient, a year after Katrina when a lot of hospitals began opening up and other health facilities. The patient was experiencing something going on upper respiratory wise. They went to the E.R. and the wait in the E.R. at that time was - you better bring snacks because you were going to sit for a while. Usually issues with your heart, breathing, or immediate bleeding is taken on as an emergency in a hospital situation but something was going on with everybody. So if everything is an emergency, then nothing is an emergency at that point.

The patient explained that they said I need to see somebody now and they were like we’ll get to you when we can get to you, you’ll be okay just have a seat right here.

The patient left and came to Common Ground which has different protocols. If somebody looks like they're visibly struggling to breathe you assess them immediately. This patient was assessed immediately, they did a chest X-ray, and sent the patient via ambulance to DIS, which is diagnostic imaging services. They would take walk-ins for imagery, we had a partnership with them. They found out that the patient had walking pneumonia and pretty much saved their life, she was very grateful and thankful.

The patient came back about two weeks later and decided to sing praises of Common Ground and become a volunteer. That patient was me! Common Ground saved my life so I am indebted to Common Ground. That's how I found out about Common Ground sitting in the E.R. struggling to breathe. I'm very, very happy that Common Ground was there.

I had been working in healthcare for a couple of years before I had even come to Common Ground. The first thing that the nurse practitioner asks me after they assess me and before the chest x-ray was - how is everything at home? I had to take a step back, I was like what do you mean how is everything at home? They really were concerned about my mental health and my emotional health and it just made me cry because I was in an abusive relationship at the time.

Those people and these people here now are so caring. It is few and far between to find people who work in healthcare that are here for the right reason. Most of the people that I run into, their heart is not in helping the people. It's just in the position of knowing that healthcare is an environment that is sustainable because people will always be ill, people will always need care. There’s a little bit of security in working in health care. The people here, they care, they care about the people.

Ebony: A lot of mutual aid groups have developed out of the pandemic but whether or not they'll sustain themselves is to be determined. What advice would you give to people looking to sustain a community clinic long after a crisis?

Magon: Find the difference that you really have amongst whatever is in your local area, or if you just want to look at it nationally. Whatever that difference is, stick with it and just keep focusing on that when you're servicing people in the community. That will pay off in the long run, your identity is going to last far longer than anything else. I am more than sure there will be other issues that will arise, hopefully not a pandemic, but other health issues that may arise or social issues that you may play a huge part in.

If you remain who you are throughout all of it, your consistency is going to prove to be your sustaining factor. When you're trying to make changes just to adapt to what everybody else or what the world is doing, it doesn't work out for you. You have to remain consistent, there's no reason for you to just completely change your identity every three months or every year just so you can be suitable for someone else's taste. Once you develop that brand, so to speak, about you and who you are, just remain that and stick with it and it will definitely pay off. You just have to be consistent.

Do a needs assessment, just a little survey with a few questions. Find out what it is that the community actually needs and when you do that, you identify what those barriers are and you can see what it is that you are already doing that can fulfill that need. Along with that, make sure you got some funds coming in from somewhere. Try to plan out at least two to three years worth of funding so that you don't have to worry about that stress because that is a stress you don't want at all. As long as you are sticking to who you are and your identity and planning that out, you will definitely be sustainable.