John Fuse, a public health worker for the Berrien County Health Department, stands outside the department’s building in Benton Harbor.
Having a sense of rapport and close trust with the health care provider is crucial. Many patients have found understanding, respect and trust with their community health workers (CHWs). These are people who live in the same community they serve. Many of these peer coaches have direct, first-hand experience in the very personal and personal topics they help people with. John Fuse is one of them.
Fuse is a community health worker Berrien County Health Department (BCHD). He interacts daily with returning, new and potential customers. Before conducting HIV test — offered on a sliding scale fee — it conducts a pre-test session to help establish rapport with customers and build trust.
“During this time, they’re testing whether they can trust me,” says Fuse. “They’re checking to see if I’m fake or real, and if I’m compassionate, and that they’re just not a number.”
Fuse says most community health workers work in non-traditional settings, meeting people in more natural settings than a traditional office or waiting room. A large part of his work is promotion.
“I speak at gay parades, at the Boys and Girls Club, at local high schools, Lake Michigan College, at cannabis stores and at farmers markets,” says Fuse. “We’re trying to understand and remove barriers. We’re finding that we have to critique what our perspectives are, to try to reach out to people to help them get into care.”
John Fuse
Fuse and BCHD staff hope that through HIV education and prevention, they can show people that there is real hope for life despite hard-to-hear diagnoses. For Fuse, it’s an extra special care he takes for the community, his hometown.
“The reason I have compassion and love for this role is because I was born into this community,” he says.
After moving to Texas, Fuse worked in a variety of health care roles, including nursing, emergency room and later social work.
“My life and helping people goes on,” he says. “I love working here as a community health worker. I love people and I love what I do.
Despite the zest for life she provides through her role, Fuse shines a positive light and perspective during a time that feels very dark for many patients receiving HIV-positive test results. Fuse works closely with clients, counseling them, educating them about treatment options and working to refer them to additional services such as food banks, rehabilitation and other specialized programs and providers.
“I try to speak from a perspective of strength, giving them hope and lifting them up,” says Fuse.
Although everyone deals with their results differently, he works hard to maintain a level of trust in a non-judgmental zone for all clients to help them process in a way that they are comfortable with. Shock, horror, disgust, depression, ostracism and even suicide can be common reactions. Fuse loves seeing people turn their lives around and enjoy life again. He says it lights him up when people find new information and new ways of living.
Dion Rigozzi, BS, RN, and John Fuse
Fuse and its leader, Dionne Rigozzi, RN, chief of clinical and community health services at BCHD, have made a pact to help even more people.
“We’re going to come up with some way, some way, a plan and funding to open a shelter for the unsheltered, for people with chronic illnesses,” Rigozzi says. “It doesn’t matter if they’re HIV positive or not.”
Fuse and Rigozzi hope to model it after a similar hull, the Ruth Ellis Clairmount Center in Detroit. The center includes 42 long-term care housing units as well as health and wellness services, therapy, HIV care and mental health treatment.
“We thought, ‘Wouldn’t it be great if we could replicate something like this here in our community?’ In Benton Harbor, we’re not a very big city and we’re kind of rural,” says Rigozzi. Our coverage area for Berrien County goes all the way to New Buffalo, 30 miles west of here. We also have an office in Niles, which is right on the border of South Bend, Indiana. We have a lot of small communities that are spread out.”
The goal is to encourage and empower everyone to make their own personal choices in their health care. Rigozzi and Fuse realize it’s a lofty goal, but they’re in it for the long haul—inspired to create change and community. They hope that everyone can feel part of this community, regardless of initial barriers, including language. BCHD has an in-house interpreter for Spanish and Arabic, as well as online interpreters and telephone interpreting services for clients. 
Whether of the same race or socioeconomic background, CHWs with similar experiences provide a sense of connectedness and representation.
CHWs in Washtenaw County are connected to the clients they serve
Susan Ringler-Chernilia, Public Information Officer at Washtenaw County Health Department (WCHD), works to share public information on various websites and social media channels about the work being done in community prevention and protection programs, mental health campaigns, and more.
“Community health workers are most often referred to as people who share demographic characteristics or experiences with the population they serve,” says Ringler-Cerniglia.
Whether of the same race or socioeconomic background, CHWs with similar experiences provide a sense of connectedness and representation. With trust in government at a low point, Ringler-Cerniglia says this support is incredibly valuable when dealing with complex health issues.
“The idea is that there’s more built-in trust in that process and a better ability to understand where that person seeking services is and what their experience is,” she says. “To be able to have that foundation of ‘I know where you’ve been.’ I understand what’s going on and being able to help connect you with available resources can be an incredible asset.”
One asset available to residents, the Washtenaw Health Project helps people navigate health coverage if they don’t qualify for Medicaid or can’t find an affordable option in the marketplace.
CHWs help provide basic needs such as food, shelter and health care.Eboni Curry, lead community health worker at the Washtenaw Health Project, had experience working with the homeless population and wanted to help connect people to even more resources.
“We are long-term case managers working with people in the community who have complex health conditions and/or social determinants of health challenges,” Currie says. “We monitor and work with individual clients to help them achieve the goals they want to achieve. This could be access to healthcare, transport, work 
Ebony currywith doctors and trying to improve their health, home visits, etc. This could include a phone call or more hands-on assistance where we help them apply for resources, explain the application process, walk them through the application process, connect them to other resources, or make referrals.”
Curry and her colleagues help clients with everything from WIC, housing, auto repair and transportation, and medical equipment. She says building this level of trust with clients helps them work together on individual goals and interests. Providing basic needs like food, housing and healthcare is critical, but it’s something Currie says is lacking in many communities. Witnessing that gap is one of the more difficult parts of her job, but she loves connecting people with vital needs. She also enjoys working with other agencies and organizations to promote change in policies and procedures and open accessibility and eligibility to more community members.
Washtenaw County also uses community health workers and educators The Healthy Neighborhoods team and Recipe for health team, focusing on helping with food insecurity or chronic food-related illnesses.
Curry concludes. “When someone doesn’t even know these resources or services exist and we can connect them, that’s one of my favorite things.”
Sara Spohn is originally from Lansing, but every day she finds a new, interesting person, place or thing in cities all over Michigan, leaving her truly blown away by the gauntlet. She earned her degrees in journalism and professional communications and provides coverage for a variety of local, regional and national publications — writing stories about small business, arts and culture, dining, community and all things Michigan. You can find her at a record store, at a local concert, or eating too many desserts at a bakery. If by any chance she is not at any of these locations, you can reach her at [email protected].
Photos by John Grapp.
Ebony Curry’s photo is contributed by the theme.
The Yours, Mine and Ours — Public Health series highlights how our state health agencies keep us healthy, safe and informed about issues affecting physical and mental health in our communities, homes, workplaces and schools. The series is made possible with funding from Michigan Local Public Health Association.