A Google search back in 2013 started things off. Typing in “Philadelphia,” “homeless” and “church,” Ian McCurry, then a freshman in the University of Pennsylvania’s School of Nursing, found a way to reach out to a vulnerable community that he could assist and support using his growing knowledge of health care. He soon found that he was learning as much from the homeless people he served as they did from him.
“Over the years I became a familiar face, and once they figured out I was a nursing student, suddenly all their health questions were coming my way,” says McCurry. “I started to ask them questions back, like, Where are you getting your health care, what does your insurance picture look like, or do you have a primary care provider.”
Their answers told McCurry, that, although resources existed to provide homeless and other underserved populations with health insurance and care, the resources weren’t always making their way to the people who needed them.
Now, McCurry and friend and classmate Marcus Henderson are aiming to make those connections a reality for a group of homeless people in the shelter system of the non-profit Bethesda Project.
Their vision has earned them a 2017 Penn President’s Engagement Prize for their project, “Homeless Health and Nursing: Building Community Partnerships for a Healthier Future.” McCurry and Henderson will receive mentoring from Terri Lipman, assistant dean for community engagement and the Miriam Stirl Endowed Term Professor of Nutrition in Penn Nursing, who herself has a long track record of leading community health programs.
The President’s Engagement Prizes, awarded to Penn seniors annually since 2015 by Penn President Amy Gutmann, are supported by Trustee Judith Bollinger and William G. Bollinger, Trustee Lee Spelman Doty and George E. Doty Jr. and Emeritus Trustee James S. Riepe and Gail Petty Riepe. Winners receive as much as $100,000 to implement the project, plus a $50,000 stipend for each team member.
Henderson, a Philadelphia native, and McCurry, from Somerset, Mass., both entered the nursing field clear-eyed, after transformative experiences as young people. Henderson himself became a caregiver to his great-grandmother and great-aunt while he was still in grade school.
“As a 12-year-old boy I was one of their primary caregivers,” he says. “Each and every day after school I went home to give my family relief, so they could do what they needed to do that day, and I would provide personal care, hygiene care, medications, you name it. It was a life-changing experience for me to be able to care for family members at such an intimate level. Being able to use that connection to care for other people is really why I went into nursing.”
McCurry was influenced by his mother, a nurse practitioner, professor and former emergency department nurse. As a teen, he worked as a counselor at a camp for adults with intellectual disabilities, and later went on to work for the state of Massachusetts as a direct care provider for adults with disabilities.
“The lines between direct care and nursing were very blurred,” McCurry says. “It became clear that I wanted to work with individuals through their illnesses when they really need assistance.”
Henderson and McCurry didn’t apply for the Penn President’s Engagement Prize on a whim. Their proposal is the outgrowth of years of work in the area of increasing health equity and access to health care.
Both had been working at Penn Nursing’s Center for Health Equity Research since their sophomore years. Assisting Lipman and professor Janet Deatrick, they performed research and organized training sessions in health disparities.
In addition, Henderson grew his understanding of public health and community work through an internship with the U.S. Department of Health and Human Services and during a placement as a school nurse in a Philadelphia high school. Meanwhile, McCurry delved deeper into the health-care-access needs of underserved populations though increasing responsibilities in the Old First Reformed Church’s homeless outreach ministry.
Together they developed the idea for their project, aiming to bridge the health-care gaps of homeless people using resources already available in the community. In addition to the Bethesda Project, they’ve enlisted partners including the American Public Health Association, the National Nurse-led Care Consortium and the Center for Community Health Care Workers at Penn. Along the way they won funding to conduct a health-needs assessment in the shelters from Penn’s Office of Nursing Research and earned a spot in the competitive Philadelphia Social Innovations Lab to develop their skills in social entrepreneurship.
Key to the project’s implementation will be their reliance on community health workers, who will interact dynamically and directly with the homeless individuals in a variety of supportive ways.
“These are the people in the community who are natural helpers,” McCurry says. “They’re the type of people you see at a church fair or bringing soup to a sick neighbor. We’ll train them to navigate the health-care system so they can work with us to maximize health outcomes.”
“These individuals have shared life experiences with the people they’re working with,” Henderson adds. “They can have a deeper and more fruitful connection than any nurse going in and preaching about what to do is going to.”
From now until July 1, when support form the Prize kicks in, they’ll be finalizing their program based on the results of focus groups with Bethesda staff and shelter residents. Then, they’ll devote a few months to recruiting the workers, training them and embedding themselves in the community they’ll be serving.
“We want to build trust with the community so that, when we get to the point where we’re starting to implement the project, we already have that rapport,” Henderson says.
They’ll also be offering seminars to staff at the Bethesda Project on subjects such as navigating the health-care system and supporting patients with chronic illnesses like diabetes or cardiovascular disease.
“These are things that we’ve learned in Penn Nursing so much that we take for granted,” McCurry says, “but social workers may not have the same background. So we’ll be bringing our knowledge from nursing to supplement their expertise.”
Henderson and McCurry have grand amibitions; their goals include enrolling at least 90 percent of Bethesda Project residents in health-insurance plans, connecting at least 80 percent with primary-care providers and at least 80 percent with a mental-health-care providers. They’re also designing a model to ensure their efforts will be sustainable, even after the year is completed.
“If this works for a year that's good but what have you really accomplished? So we’re working to be sure we can keep this going,” McCurry says.
They’re also hopeful that the basic structure of their project might serve as a model for others tackling health-care challenges in vulnerable groups.
“It’s a model we hope will translate well,” Henderson says. “I’m a product of the Philadelphia School District, and I’ve said this is something you could do in a school throughout the year.”
As the pair’s mentor, Lipman hopes to apply what she learned mentoring another PEP winner, Jodi Feinberg, and help McCurry and Henderson tackle the challenges that are certain to arise as the year unfolds. Having worked with them and seen their proposal take shape during the last two years, she’s convinced their work will have an impact.
“They’re an incredible team,” says Lipman. “I feel very honored to be their mentor and am thrilled for them and for the University. I'm confident that they will be successful and really improve the health care in this population in Philadelphia.”
For both students, the prize feels like the culmination of years of hard work. And, for Henderson, a first-generation college student, it’s also an example to others.
“For me, not only being the first one in my family to go to college, but to go to an Ivy League school and now to be honored with something like this….” He smiles. “For my younger siblings, I’ve really set the bar.”