This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

Several Michigan health systems and community-based organizations are innovating ways to increase health care access for the state’s most vulnerable residents in their own communities. Three recently launched projects illustrate how thinking outside the box can increase wellness and quality of life for people who have had few or no options for quality health care in the past: Residents in Action's (RIA) homeless shelter in Jackson, Eastside Community Network's Stoudamire Wellness Hub in Detroit, and Packard Health Clinic at West Willow in Ypsilanti Township.

Residents in Action: Neighbors serving neighbors

A group of Jackson residents who mobilized in March of 2020, RIA addresses emerging issues impacting their neighborhoods. One of those issues is homelessness — and ensuring that the unhoused have health care needs met.
Residents in Action's homeless shelter.
"We serve those who are living in poverty and those who have historically experienced inequity. Unfortunately, that represents a lot of people in the Black community and other minority groups," says RIA founder and CEO Tashia Carter. "We manage the placement of homeless folks in hotels and make sure they have food and basic needs items. We also coordinate with the professional systems for vaccinations and other clinical screenings. In addition to that, we help them navigate social services to ensure that they are connected to the resources that they needed."

From November 2022 through March 2023, RIA worked with the city of Jackson to place people experiencing homelessness in hotels. When the city bought the former T.A. Wilson School in Jackson, RIA proposed using it as a 32-bed homeless shelter. The city agreed and also installed 10 64-square-foot tiny pallet homes outside the school. Carter and her colleagues set right to work offering a variety of health care services.
Inside a pallet house at Residents in Action's homeless shelter.
"We helped [shelter occupants] make their doctor's appointments, get their meds, and be connected to community mental health," she says. "We had a lot of unmedicated schizophrenics walk through our door. We were able to help get them stabilized on their meds."

RIA works with a long list of collaborators including the city of Jackson, Jackson’s Community Action Agency, Henry Ford Jackson Hospital, Jackson Community Foundation, and Jackson Health Network. Every week, staff from the Jackson County Michigan Department of Health and Human Services office visited the Wilson site to ensure that shelter occupants had Medicaid and other assistance they qualified for, while the Community Action Agency helped occupants access a housing voucher program. In addition, RIA connected occupants with the Center for Family Health so they could establish a primary care provider.

The Wilson project operated at full steam from November 2023 to March 2024, but lack of funding has since resulted in scaled-back operations. The center is now open overnight, from 8 p.m. to 10 a.m., and operates with limited staffing funded by donations to RIA.

"When the city budget and project were exhausted, RIA decided to stay open to prevent people from being released to the street," Carter says. 

Carter recalls a shelter occupant with diabetes who was living in his van. He needed several medical procedures that he hadn't followed through on. With RIA’s help, he was able to establish a primary care provider and get his medications. Once his legs were no longer seriously swollen, he was able to focus on the other areas of his life that needed attention.
Residents in Action's homeless shelter.
"RIA not only helped these people. It helped the community because you don't have folks just out there in the streets," Carter says. "From the health insurance perspective, you don't have the higher costs from people getting care at the ER just to be warm or have somewhere to stay that night."

Stoudamire Wellness Hub: Local and organically grown

At 4401 Connor St. in Detroit, the Stoudamire building's climate resilience hub houses the Eastside Community Network (ECN) office and its Stoudamire Wellness Hub.
Stoudamire Wellness Hub.
Here, holistic wellness activities help members, who join for $20 or less a year, to live healthier lives. Partners in the Wellness Hub include Henry Ford Health, the Metro Detroit Restorative Justice Network, Trinity Health, the University of Michigan, and Wayne State University, which regularly sends out its Wayne Health Mobile Unit to provide members with free health services.  

"People who visit the Wayne Health Mobile Unit aren't people who had an appointment," says Nayomi Cawthorne, director of Stoudamire Wellness Hub. "It's more like, ‘OK, I came out of my class — I'm not feeling so great. Oh, the Mobile Unit is here. Let me go in. I'm going to go see how they can help me.’"
Nayomi Cawthorne at Stoudamire Wellness Hub.
Cawthorne says these drop-in appointments make health care access easier. People do not have to wait on hold to schedule appointments, make sure they have insurance coverage, or get a referral — steps that can lead many to avoid health care altogether.

In a community where hypertension and diabetes are rampant, health screenings for anyone who walks in can make a lifesaving difference. Rapid HIV and hepatitis C screening, along with a sterile syringe program, also help reduce health risks. A social determinants of health evaluation helps people connect with other needed resources. And Cawthorne is also working on bringing a mobile pharmacy to the Wellness Hub.
Stoudamire Wellness Hub.
The Henry Ford Health Detroit Institute of Ophthalmology also offers diabetic retinopathy screening. People can schedule an appointment, but spaces are always left open for drop-ins.

"We've had people who, through this preventative screening, now know that they have early signs of diabetic retinopathy and have been able to connect to the necessary resources to help them," Cawthorne says. "That's been really impactful for us to see how access really does change people's lives."

Another partner, Cognosante, helps members enroll in health insurance plans. Again on a drop-in basis, residents can assess their options for Medicaid, Medicare, and Marketplace health insurance coverage.

"We know the statistics. We know that these types of health interventions are useful. But it is a totally different thing to see the impact of relationship building over two years, the power of creative health-related partnerships and interventions," Cawthorne says. "What I'm learning is that healing is actually a far more spontaneous experience in reality, far more organic than prescriptive — that spontaneity and creating opportunities and access in places where there wasn’t any before. That's the piece where I'm seeing it evolve and take on its own life."

Packard Health Clinic at West Willow: Large system, small footprint, big benefits

Opened in July 2023, the Packard Health Clinic at West Willow provides health care access for people living in Ypsilanti Township's West Willow neighborhood and beyond. Rebecca Fleming, Packard Health director of community health initiatives, describes the West Willow neighborhood as a very isolated, underserved area with no full-service grocery stores or pharmacies. Three-quarters of its residents are African American. These factors made West Willow a logical place for Packard, a nonprofit community health center with multiple locations serving Washtenaw County, to establish a neighborhood clinic.

"Everyone deserves health care. That's our mission," Fleming says. "We are here to serve those who may not have the resources or accessibility to these services. We're here to fill that void."
Rebecca Fleming.
New patients who might have to wait several months to get established with a traditional primary care provider can meet with one at the clinic in a matter of days.

"The accessibility is really key," Fleming says. "The clinic is going well. It's growing. Services are growing. We ensure that wrap-around care when someone comes to us, and we do that all on site. Point-of-care testing, treating [urinary tract infections], upper respiratory things — all are part of our service scope."

Fleming manages the clinic’s daily operations, including staffing, managing supplies, scheduling to attend neighborhood organization meetings, and talking to community members. The clinic’s main focus right now is ensuring community engagement.

In addition to the church, another partner in the clinic is the University of Michigan (U-M) School of Nursing.

"The School of Nursing provides the nurse practitioner who's out there actually seeing the clients," Fleming says. "They and U-M in general have worked a lot in the West Willow neighborhood for several years. So they've really built that relationship, the rapport with the community, which is essential."

West Willow clinicians also help many patients with chronic disease management, medication refills and education, aging issues, women's health services, and new babies.

"Just after birth, they're able to establish care, which is really great," Fleming says.

In its first nine months of operation, the clinic scheduled 256 appointments — about seven appointments per week. About a third of the people seen are new patients to Packard Health, many of them middle-aged adults seeking primary care.

"We're really happy that we can offer that access," Fleming says. "We do see a fair amount of patients who are already established with Packard but may have an acute issue. That's perfect for this clinic to help with, like, ‘Hey, my other doctor can't see me today. But I have this need.’ And that's exactly why we're here."

Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at Estelle.Slootmaker@gmail.com or www.constellations.biz.

Stoudamire Wellness Hub photos by Steve Koss. Packard Health Clinic at West Willow photos by Doug Coombe. Residents in Action photos courtesy of Residents in Action.