Creating Common Wealth

They think often times that we wanna engage in spaces of public service, we think we wanna solve everything.

And in the public service sphere, there's this concept called the wicked problem, meaning that there's some things that we just won't be able to solve, definitely.

So for me, public service is about individuals, organizations and communities who are willing to give to address those problems.

So you can be in the private sector and still be committed to public service.

(jovial music) Harrisonburg, Virginia is a really old town.

It's also in the middle of nowhere basically.

it's in the middle of the Shenandoah Valley, which is absolutely beautiful place to live.

Very, very rural, agricultural, spread out not a real downtown center.

And then we have a lot of college students.

And so it's very much a college town and becoming more so.

It's kind of a mesh of those two cultures.

So you have a lot of the older ideas and a lot of new ideas that are kind of intermingling in Harrisonburg.

(calm music) If you don't purpose to look for it, you miss it, I think.

You see people on the streets.

You don't know if they're local homeless people or they're people that are just dropped off to collect money.

In the past year we've seen in the suitcase clinic, 300 homeless individuals.

So it's a fairly large population for a city the size of Harrisonburg.

And I think that number is growing every year.

Do you want just one stethoscope and blood pressure cuff or what do you want in your foot clinic?

What do you normally have?

Two would be great.

And 2009, the open door shelter was having a problem with the flu pandemic.

And so with all the influenza going around, they were trying to determine how to keep folks from getting sick and from passing it through the shelter to everyone.

So they called together a group of community health nurses and we sat down and tried to brainstorm ideas.

And we realized as a result of that, that there was no agency providing healthcare to these individuals.

So the homeless population basically had only one choice and that was to go to the emergency room.

But the hospital was not gonna be paid for the visit because they didn't have any money.

We started partnering with community agencies and trying to get different groups to come together.

And in 2011, we actually started offering the suitcase clinic services.

So the plan was to go into the shelters and provide acute care.

And to try to meet the needs of the individuals and keep them out of the emergency rooms.

And get them healthy enough that they could be working and that they could get into housing and remain housed.

And not end up back on the street because of having health issues that were taking whatever income they had.

(indistinct) Oh okay.

So I think this is a good thing to try.

It should help with the cramps too.

Yeah.

Okay.

Okay.

After it happens just take one.

Okay (indistinct).

No more than four a day?

No more than four a day.

But no more than four in a day.

Okay.

All right.

All right.

Holly, I understand that you're really tired.

And you're having nausea?

Okay.

And a lot of other pregnancies symptoms.

Okay.

And I'm not sleeping at night and I'm tired during the day.

Have you taken a pregnancy test?

Yes.

And it was positive.

Yes.

The diagnoses are very vast.

Diabetes, high blood pressure, schizophrenia, depression, anxiety, delusional.

And then the basic things, their teeth aren't clean.

They weren't able to take a shower for the last two weeks.

My thoracic disc has never been that big.

It's been hurting me for the last couple of months.

Thank you all for coming today for our September meeting of the suitcase clinic coalition.

We have a few things on our agenda to discuss.

Feel free to ask your questions or to join in at any time.

So we collaborate with every agency that will collaborate with us including the Harrisonburg Community Health Center.

We've worked with the free clinic in the past.

JMU, Eastern Mennonite University, the United Way.

All of the homeless shelters in Harrisonburg.

Lots of businesses support us which is awesome.

We all come together and we sat around a table where we make decisions about how we can help more people with the funding that we have.

And where we're gonna find more funding and those types of things.

However, we do have another option.

The health department will see 50 of our dental patients.

Oh fabulous.

(indisticnt) So I guess we'll start with that.

And it won't be 50 bombardment or anything.

(soft music) You kinda have to be different with each client because some of them might come in and be jovial and carry on.

Whereas you might have the real serious, I don't want to talk to you person.

So you kinda have to figure out how you're gonna react before you can treat them.

What can I do for you on this fine day?

I still got this persistent cough.

We can get medical records if they tell me they've been to the ER or they went to doctor so-and-so.

Sometimes we don't get a good history.

So we have to treat what we see and go from there until we can get medical records.

I used to drink.

Do you smoke?

Smoke?

I used to smoke, I quit that.

There are some individuals that we see that are so complicated.

Their medical diagnoses are like a train wreck.

My chest would hurt severely but it would be for a split second.

And I would actually black completely out everything would go dark.

It was like my heart would stop.

While you were exercising?

Yes.

It was like I had died and came back in just a matter of probably just a couple seconds.

And did everything look like it was gonna gray over before you fell?

Everything went solid black.

Black and then you fall.

Okay.

Is there a family history of any heart disease or stroke?

I would have no idea because I was adopted.

I do know that I had fetal alcohol syndrome.

Okay.

Right.

Okay.

Great I'll look at the other eye.

There's a couple of things I'd like to do.

We're gonna need to get some blood work.

Terry, we'll set you up with an appointment over at the community health center.

It'll be covered by Medicaid.

I would like to start you on a very mild blood pressure medicine.

And you're doing everything right in terms of not smoking, you're not using any substances that can affect your heart at this point.

Hopefully you're eating better.

In a situation where you don't have a place to go.

You don't have a place to sleep.

You don't have anything that you can really call your own space.

Having somebody actually exhibit that they want to hear you, that you're worth hearing.

It just makes such a difference for these individuals.

But not so much down here.

Okay.

Yeah, so it's really not the plantar fascia this time.

I think that you've irritated.

(soft piano music) About two years ago, I became homeless.

And lived in a tent for a while, lived at the homeless shelters I found out I was diabetic.

I had no health care at all.

The suitcase clinic, you know, they've got me doctor's appointments that were needed.

They've got me on medications.

They've just been there for support.

(soft piano music) Bill became integrated into the shelter locally and he was able to get to a point where they offered him a job.

Since bill had a job now, now he could get some housing.

And now Bill's really interested in taking care of his health because he wants to be able to maintain it so that he can continue working and still have a place to live.

And Bill's made some major steps that are really positive for him.

(jovial music) Homeless people are on their feet a lot.

They have constant exposure.

They have chronic foot conditions that affect the rest of their health.

And we can assess for things and immediately have them seen by the nurse practitioner or the physician's assistant on the spot.

And we can treat them.

Your feet are not in the best of shape.

They've had a bad life.

So if we can keep your feet healthy and keep you going, then it helps you to live and feel better.

(calm music) Sentara RMH is a 238 bed sole community hospital.

Our emergency department treats about 73,000 patients a year.

When you don't have access to a primary care provider, your only place to go for a preventative antibiotic for an infection is a place like the emergency department.

So that just adds to the numbers that we see for primary care that again, could be better managed elsewhere in the community.

With the suitcase clinic, a patient might talk to them about a kind of infection.

And so the provider can order an antibiotic at the suitcase clinic location.

And therefore what we do see, they are really helping their patients to manage their chronic conditions which means that the risk of complications that would elevate to needing emergency services are decreased.

But it'd be good idea to get the Medicaid paperwork going.

Do y'all have that here?

Who do I see about that?

Let's see (indistinct).

Last year, we saw 304 individual people.

In a year's time we saw them 1200 times.

We're saving the hospital, hundreds of thousands of dollars a year really by providing healthcare in the community and preventing ER visits.

And so once they get healthy, "Hey, I think I can go find a job now."

To me that is success.

Not only for the clinic but also for the person.

We would like to say that success for us would be to be out of business because nobody needed us anymore.

That would be the ultimate success for us.

(calm music) Creativity is I guess if I were to distill it all the way down, it's having the courage to be authentic.

If we understand that we're all unique and that we're all here to do something, then it's sad that we all live the same lives.

And so creativity again is one of those very basic things that is rooted in our authentic expression of ourselves in a safe place, hopefully that we call community or neighborhood.

And when that rings true, change happens.

That's innovation.

It moves us forward.

(jovial music) Cumberland County is a rural county in the central part of Virginia.

It is a farming community.

I like the scenery.

I enjoy my drive into work every morning.

There's lots of meadows with mist and there's cows.

They're usually spread out really sort of picturesquely across the field.

It's just really pretty.

There aren't any stoplights in our county.

So sometimes people might have a tendency to just keep on driving through but we always have that they would have a reason to stop, to get near Cumberland a little bit more.

Most people live on farms or they have four or five or more acres of property.

There are just little pockets of homes that would be close together.

No subdivisions, no trailer parks, no big strip malls at all.

Cumberland community is very resourceful.

We lack business and industry.

We do not have a grocery store.

We have to really look outside the box and partner with other places to make sure everyone in the community has what they need.

I believe that Cumberland County public schools is the center of Cumberland.

On the map it actually is but we are pretty much the hub of the community.

(calm music) So you guys, now we're gonna call you wagis, you're welcome to WagiLab.

Here's our mascot, Wagi the dog.

And wagi stands for what a great idea.

And these next two weeks, we are gonna take every single idea, no matter how crazy it is.

And we're gonna be thinking about our community.

And how we might be able to make a difference because children have the best idea.

We thought that WagiLabs would be a wonderful program for Cumberland elementary.

And that it is a kid entrepreneurship program that is designed for our students to identify the needs that they see themselves within the community.

And then to work together, to be creative to come up with a solution to the problem that they have identified together.

(piano music) We take the kids out on a walk in the community to sort of point out all of the things that we have.

Who knows what this building is right here?

(indistinct) (piano music) And it sort of makes them start to think about what their community looks like.

So once they've sort of identified all of the great things that they see, then we flip it and you say, "Well, so what are we missing?

What don't we have?"

What do we need?

Anything that you think that is a need in your community, put it on the paper.

And you don't have to write it in the same direction.

You can write in your which way just as they come to your brain, just throw them on that paper.

I love it.

So a small YMCA.

(children chattering) That's a great idea.

Cause y'all need stuff to do as kids, right?

What else?

What else could we use?

Solar panels, yeah.

(calm music) The challenges in a small community like this are usually resources.

Unfortunately here, there's not a lot for the kids to do in the community.

There's no parks, no playgrounds, no basketball courts, tennis courts anything accessible to them.

My kids complain on a regular basis that there's nothing for them to do here in the community.

No activities, nothing really fun for them to do.

It's unfortunate that we end up usually having to go out of the area for any type of entertainment for ourselves.

Alright.

So we are about to create our community needs list.

Okay, so we're talking about something that we can see as a challenge or an obstacle in our community, right?

So you need to ask yourself, will it benefit the whole community in some way.

Who does it benefit, where, when, right.

We tell the kids Wagi the dog, our mascot says, "There's no bad ideas, every idea is good."

So we just encourage them just to throw everything up there and we'll see what sticks.

It's a collaborative effort.

Like they all are gonna own the idea.

When I say go, I want everyone to stand up.

I want you to take a look at that list, I want you to pick your favorite thing.

The thing that you most want to see happen in our community.

Okay, ready?

Go.

(jovial music) Third was a public pool, YMCA.

Second was the farmer's market.

The most votes was for entertainment.

You guys apparently feel strongly about having things to do in the community.

Would that be a true statement?

(jovial music) Our kids only see each other really school.

I mean, that's really it.

So I could see where they sort of were, looking for fun things to do.

If you live in a subdivision, right?

So you can ride your bike, right?

You can walk to someone else's house, you can do all those things.

But here in Cumberland, we're pretty spread out.

So you can't just walk to a neighbor's or a friend's house.

(jovial music) We're gonna go in the hallway, we're gonna brainstorm.

Whatever you might think of that you could create that would bring family, friends together for fun, in our community.

You're gonna put why it's good for us, how it gets kids out, how it brings the community together.

Then you're gonna go to the next idea, pick another poster.

We got more paper than y'all are gonna be able to use.

Got an idea?

What else could we do?

(calm music) So putt putt golf course showed up, local pool showed up, a smaller sort of YMCA community showed up and a greenway.

All really good solid ideas.

So then the students would come back with comments on those ideas and say, "Wow, putt putt's a really great idea, what if there was ice cream.

Or the pool is a really wonderful idea would there be swim lessons.

I think that putt putt kinda stuck.

Cause everybody likes putt putt.

They've probably done it at the beach.

So it's that activity that is awesome.

But it's not something they get to do all the time.

So wouldn't it be great if it was here in the community, they'd go do it.

I really commend them on thinking about what is something our families could do together for entertainment.

Because well they say families that play together, stay together, right?

(laughs) So you listen, listen, you've got a suggestion of a putt putt.

Okay.

But you're gonna have to develop the idea and sell it.

And you can't just say, "Everybody will do it."

I'm not gonna invest.

I'm not gonna be interested in your idea if you just tell me, "Well everybody will like it."

I want who, I want what, I want why, I won't when, all of it.

So it's important once the children sort of define what their idea is going to be and they're beginning to sort of gel the solution, that you act immediately.

And give them exposure to anybody that you can think of or reach out to, to give them context to their idea.

And they can brainstorm with these other people and think about things that they probably as little kids wouldn't know.

But they need to hear and talk about to sort of get them thinking about how they think outside the box to solve some of those problems.

All right.

So you guys thinking of doing an 18 hole putt putt course?

Yes.

Okay, so you're thinking 18 different holes that could have a different theme, based on who sponsors it.

Okay, cool.

So with these sponsors, how would we know how much money we would ask each sponsor for in order to fund the project?

So you're gonna have to pay for people to do the labor, right?

To build it.

Unless you guys are building this all yourself.

You're probably gonna need some help, right?

And we need gear.

You need gear, you need equipment.

What about marketing?

Are you gonna advertise?

YouTube.

(laughing) On YouTube okay.

Facebook.

Are you gonna create your own YouTube channel?

Yes.

Can we have a putt putt course without land?

No.

No.

Right, we gotta have a place.

So this is how we do our search to find lands, to find active lands in Cumberland.

And a building lot so you can build something on it.

And there are 17 matches.

We have one piece of land that's right here on Anderson Highway.

And it is almost 10 acres for 125,000.

Good road frontage on route 60, located across the street from Cumberland County High School.

And within walking distance of Cumberland Courthouse.

I think that's a great location.

(upbeat sound) WagiLabs provides a new mindset that there's not an end and there's not one way to a solution.

That the best ideas continue to grow.

And they're created when there's a team that has built them together.

(upbeat sound) So can you tell me how you're gonna do this now?

Show me what you're doing.

(upbeat sound) They all had their own ideas about the hole, so it seemed a natural progression that they each could design a hole.

And they could build a model of it.

They decided that the golf course ought to be themed.

And they got to brainstorm it.

Then out of that came, each of the holes could be business themed.

So they each sort of created their own prototype.

You hit the ball, keep going goes the fire truck with water pushes it out here.

My business I'm doing is a library .

This is like a ramp where edges slide up.

You have to go past the cats and your ball will hit the arm balls and they'll move.

Its gonna have a ramp cause I have my doors, I got them right down.

So I'm gonna have this pull up and down.

(children chattering) (calm music) We're WagiLab kids.

Our mascot is Wagi, a dog that is on a mission to do good things.

Wagi stands for what a great idea.

Now our ideas were too crazy.

We wanted lots.

Wagi taught us to accept, don't judge and build on the ideas of others.

Our goal is to find ways here in Cumberland to bring family, kids, other orientations together to have fun.

We want to invite you here to learn about our ideas and to give feedback.

So today was their mini copytalk for proposing their business opportunities.

You can see this hole is for Cumberland Volunteer Fire Department.

You can see the sponsor sign at the end or beginning of the hole.

I think they wanted to see if people thought it was a good idea.

I think they wanted some feedback that, "Yeah, you're on the right track.

Yeah, we as the grownups in the community kind of feel the same way that you feel."

Bear Creek Lake State Park brings in a lot of people from all over Virginia and the country and even Europe.

And we could say, "Hey, if you want something to do, go on down to this golf course."

So I think it's a wonderful idea.

And I really don't think there would be a problem with setting up a small library there.

Great idea.

You guys did a great job.

Many of our students come from a home where they really don't have all of the things that larger communities have.

It's good for them to have that opportunity and think about how can I maybe fix some of the problems that I see.

And help some of my community members or my neighbors get to a better place.

(jovial music) (jovial music)