[Saxophone begins playing] [Debra Hickman] Hi, I'm Reverend Debra Hickman-Arnette. So many of you only know me as Reverend Debra Hickman, but almost a year ago, I got married to Charles Arnette. And we are approaching our anniversary, and it's a wonderful thing to share with all of you that have been so wonderful to me in so many different ways, and just looking forward that I will run into each of you in one place or another sooner or later. [Saxophone music fades] My name is Debra Hickman, and today we are at Sisters Together And Reaching. STAR began in 1991 to help African American women and their families living with HIV/AIDS in Baltimore. We worked with churches to make sure that they understood the background of HIV and AIDS and explain what we saw as their role to help HIV positive Black women that did not have any place to go. Hero (which was Health Education Resource Organization) used to see a lot of white gay men, but they were not seeing Black women whether they were straight or gay. We came about at a time when there was a necessity for our agency. We would go to their homes and clean them from top to bottom because they were too sick to do that. We worked with the University of Maryland Law Center to help people set up directives that if anything happened to them, this is where their child is to go. We started hiring people that were HIV positive. We had a total of five persons that died from HIV, and we still have some persons that used to work with us that are still out there struggling to stay alive. Today, our clients are executive directors of their own companies, have written books, have families, bought homes, have cars, and have things they didn’t have. Our wildest dream was that everybody that we came in contact with would be able to survive. Have we had a lot of deaths? Yes, we did. People succumbed to AIDS and sometimes just having HIV alone. It’s been one of those worlds where it’s bittersweet. I ran into Linda Dunbar, VP of Nursing for John’s Hopkins Healthcare. She had a group of CHWs and also a group of care managers. Leon and I told her that we had this grant to help abate the cost of healthcare from overutilization. I said to her, “You have CHWs and care managers already, but the institutional CHWs can’t do what the community based CHWs do. We are looking to hire from community, train them as CHWs, and then deploy them, but we need a starting ground.” She took on the three groups with the idea that there would be a group of people from each of the communities around here. They would directly knock on their neighbors’ doors on a daily basis to check if they were okay, if they had food, if they were sick, if they needed to get to the hospital. Whereas before we would get our work directly from the list of high utilizers that Hopkins gave us. That’s our genesis with the CHWs. I do have to backtrack and say, in actuality, we have had CHWs since 1991; however, we did not call them that. We called them outreach workers. I feel as though we have the capacity and the wherewithal to bring people in, get them trained as CHWs, and then work with insurance carriers to help them understand that they can get more from working with us. We can become more like a deployment agency where people will always have a salary instead of always writing grants to keep CHWs employed. It’s a matter of insurance companies understanding that they have to be willing to pay for CHW services. CHWs are not on that list of things that they will cover, but CHWs will actually cut the cost of healthcare. While hospitals want to believe that they can hire their own CHWs and get the same results that we have gotten working in the community, it’s actually different. The training is different, as well as what they can do, what they can’t do, and how you actually supervise them. They do need supervision. Here at STAR, we’ve had great supervisors. Will Torriente and Tracy Barnes Malone are excellent supervisors, and they love the work. They have the fire in their belly. In my terms, I define a CHW as someone that actually knows the community, its leaders, and the resources in it. They have a deep and passionate desire to make certain that healthcare is taking place and to keep people from being evicted from their homes, losing their jobs, or any of those things. They are the trusted vessels in their community because they know the community since they come from it. The community allows them to come in, whereas they will not allow others that do not look like them to come into their homes. I think that that’s one of the things that STAR has been good at over our 30-year history. We’ve gained the respect of the community because we actually show up to deliver what we said we would deliver. It might take a little bit of time to get you from here to there, or to convince you that you need to work on yourself. We are not here to tell you what to do or to do things to you, but we are here to work with you. With is the operative word. When I start to work with you, I am listening; I am carrying you in my heart; I am going to help you to manifest the space you need and the things you need to survive. If you look around, you’ll see that people in the community have always been taking care of people in community. It’s not something new, but it is something that is finally getting its just due. The community has always done the work to heal itself and help itself stay healthy.