On December 16th HC3 convened 100 community leaders and stakeholders for a presentation and panel discussion addressing Chicago’s community violence as a public health focus.
Sheila Regan (COO, Acclivus) and LeVon Stone, Sr. (CEO, Acclivus) kicked-off the event with an organization overview presentation. David Mendell (Author and Journalist) then moderated a discussion featuring five distinguished panelists:
Clarisol Duque, Chicago Chief of Staff, Office of U.S. Senator Dick Durbin
LeVon Stone, Sr., CEO, Acclivus
Sheila Regan, COO, Acclivus
Karen Teitelbaum, CEO, Sinai Health System
Mamta Swaroop, MD FACS, Associate Professor of Surgery and Director, Center for Global Surgery, Institute for Global Health and Global Surgery Program Director, Division of Trauma & Critical Care, Northwestern University Feinberg School of Medicine
David Smith, CEO and Founder of Third Horizon Strategies and Co-Founder of the Health Care Council of Chicago, provided final remarks.
Acclivus uses a multi-disciplinary public health approach to provide health and well-being services to Chicago area communities at most risk for violence. A few notable features are as follows:
Their hospital intervention model provides centralized, around-the-clock support to victims, offering support and advocacy to patients and their networks at a critical time.
Acclivus’ hospital response program, which reaches patients in the critical “golden hour” after admittance, is the cornerstone of its violence prevention and intervention services.
The team is comprised of trained community members with lived experience and similar backgrounds, which offers patients credibility and a trustworthy role model that inspires a sense of hope.
Acclivus current utilizes data collection and analysis methods that transcend hospital, city, and state registries, allowing for closer patient tracking and connection to vital services.
On December 12, HC3 announced a partnership between Acclivus, Forward Health Group and NowPow to enhance Acclivus’ services.
Augmenting Acclivus’ current platform will essentially create a unique city-wide tool for understanding and managing the public health epidemic of community violence in Chicago. The information will house data that will highlight critical opportunities for advocacy geared towards healthy equity and economic development of marginalized communities in partnership with critical community stakeholders.
Trauma and the patient experience at the hospital
Dr. Swaroop said, “We all experience strength differently, but we experience crisis the same.”
In the Emergency Department (ED), the goal is always immediate intervention to stabilize the patient. According to Karen Teitelbaum, hospital personnel have to employ different interventions based on where the patient is at within the hospital system.
Karen also said, “There is a need for strong behavioral health interventions to support the PTSD that accompanies victims and victim’s families.” The Schwab Rehab Hospital plays a large role as a bridge between the acute episode and the future of care needs. The peer mentoring programming at Schwab allows patients to receive care and support from peers who have shared experiences.
Sheila Regan noted, “timeliness of the intervention is important; must be as quick as possible. We [Acclivus] come from a hospital perspective and therefore, understand the hospital challenges. We are contracted as employees of the hospital. We handle the intervention in the hospital and work with 20 community outreach groups to provide community-level support.”
LeVon Stone, Sr. shared that they have expanded their efforts outside of the ED to work with partners like the Chicago Police Department (CPD) and others to get alerts for violent incidences in order to ensure they are reaching patients in the critical time of crisis and can start the intervention sooner. If law enforcement relays a message to Acclivus directly, they can dispatch to the hospital quicker to intervene.
The HEAL (Hospital Engagement, Action, and Leadership) Initiative
Clarisol Duque shared that Senator Durbin invited the CEOs of 10 the Chicago-area’s largest hospitals to convene to address community violence, recognizing that hospitals were taking significant steps to reduce gun violence and the health disparities that violence in communities causes.
In October 2018, Senator Durbin and those 10 hospitals launched the HEAL Initiative – a three-year project to make a measurable difference in Chicago's neighborhoods with the highest rates of violence, poverty, and inequality.
In its first year HEAL focused on understanding what each of the various institutions were doing. Collectively, the hospitals made 16 commitments on actions to uplift the community. They are also discussing how to measure and sustain collective impact, specifically geared towards improving the economic impact of 18 communities.
Community outreach and resources on the streets
The city has pledge $11 Million to support street interventions.
LeVon Stone, Sr. said, “We need to increase health education and ensure people promote the resources, so people are aware.” Talking about his own experiences, he noted that initially, he was biased against law enforcement. However, through strong mentors and his work in the community he has rebuilt trust and a better rapport. Others need to have these ‘shifts’ to make hand-offs easier.
“People look at Acclivus differently, because it is led by someone [LeVon] who has lived experience,” said Sheila Regan.
To engage in the community, Sinai hosted listening sessions which were very well-attended according to Karen Teitelbaum. Karen recalled that one of the community comments from a resident in Little Village remarked that “everybody here has to have ESP and they said nobody feels safe ever, 24 hours a day.” Karen emphasized, “We must listen to the community and hear how they want to get this problem solved.”
LeVon Stone, Sr. pointed out that there is currently a lot of community buy-in. “Trust comes from when the community is hearing their own voice,” he said. “Since Acclivus is from the community, they act as a voice.”
Clarisol Duque emphasized the need for transparency. “There’s a history of lack of trust with the community and politics,” she said. “We are working with the Illinois Hospital Association (IHA) to partner and learn how to make these programs successful.”
The role of education and partnering with CPS
According to Sheila Regan, 30 percent of the patients Acclivus sees do not have a GED or High School Degree. The organization’s interventions are focused more on the parents because those are the primary targets/victims. While the organization has some relationships with the school systems, they are not formal. “We do not work with adolescents as our work does not resonate,” she said.
Dr. Swaroop shared that Northwestern currently partners with seven CPS schools to teach TRUE course – a course that provides training and teaches kids first responder skills, so they feel empowered in the event they face real emergency.
The role of advocacy and policy
Karen Teitelbaum responded to an audience questions stressing that, “This is a key initiative for Sinai. We typically work with legislators when we do advocacy and outreach.”
LeVon Stone, Sr. noted that Acclivus had a meeting with previous Mayor Rahm Emmanuel, but that it is “hard to tell what’s transparent.” “We are trying to become more solutions-driven rather than problem-driven,” said LeVon. “There is momentum, but overall there is trial and error in the process as we align the policy work.”
Tracking progress and continuing to evolve
·Sheila Regan shared that Acclivus treats community violence like a chronic disease, addressing protective factors to help buffer against negative health outcomes. The work is intentionally systems-driven in order to be sustainable. “We have a database and we track when patients are admitted into different hospitals, which is even more [patient information] than a hospital will see,” Shelia said.
Acclivus is focused on improving people’s social position, education level, employment level and helping people get people uninsured. Sheila and LeVon believe their partnership with NowPow and Forward Health Group will help demonstrate ROI.
David Smith noted that as we analyze this work as prevention versus intervention, we need to think of it more as a primary and secondary prevention.
He suggested that there are five tasks we can and need to get done:
1. Scale the amount of hospitals who interact in this work across the city, as Sinai does.
2. Connect to resources, by dispatching and allocating hyper local community members, as Acclivus does.
3. Enable and improve the use of technology (e.g., helping to reconcile when someone is moving through the system and being admitted at two different facilities.)
4. Enhance Acclivus’ technology in concert with hospitals to connect the infrastructure at the political and government levels.
5. Reinvest in ROIs and make the Acclivus model financially self-sustaining so it is no longer beholden to philanthropic support.
“We need to treat this like a chronic disease,” David Smith said. “Collaboration is key, and there are too many folks in this city that care for this to fail. We must be patient. Change takes time.”