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Coordinated Care By a Community That Goes Above and Beyond for Those Most In Need

Photo of Officers Conducting Outreach in Harvard Square

This is a story about “John.” If you have visited Harvard Square anytime over the last two decades, there is a good chance you have come across John. He is one of the more well-known, long-term unhoused Cambridge residents in the Harvard Square area. But you might not know where his story started and how the Cambridge Police Department, Harvard Square Business Association, Healthcare for the Homeless, and many other agencies have been coming together to support John over the years.

Originally from Africa, John studied medicine in Europe. He ultimately became a doctor. What led him to become unhoused in Boston and the Cambridge area going back to the 1980s is not clear, but mental health and immigration-related issues unfortunately were believed to have played a pivotal role. Around 2011, John made his way to the Harvard Square area, and, for the most part, he has been a fixture there living on the streets rather than in the city’s shelters.

According to Denise Jillson, Executive Director of the Harvard Square Business Association (HSBA), “John has been in the Square for years. Unlike some of the other unhoused individuals in the Square, he keeps to himself. It was difficult to get to know him, but he is someone we would always nod and say hello to. We did not want to make him feel uncomfortable.”

Elana Klein, a Licensed Independent Clinical Social Worker with the Cambridge Police Department’s Clinical Support Unit, began working closely with John a few years ago because of her work on the Multi-Disciplinary Outreach Team, which is an interdisciplinary team of providers from the City of Cambridge and non-profit agencies. Organized and founded by the Cambridge Police in 2015, the team delivers services (food, clothing and other basic needs, medical care, etc.) to unhoused residents and other vulnerable individuals throughout the city on a weekly basis.

Klein said, “There are many police officers who got to know John very well because he was always in the same spot in Harvard Square. A lot of them really grew to like and care about him. They would speak to him every day, multiple times a day and would often reach out to me if they had concerns about his well-being.”

One such officer is Frank Gutoski, who works primarily out of Central and Harvard Square.

“With John, he is a very intelligent individual, but prefers to be alone,” said Officer Gutoski. “We like to check on him at least twice a day and make sure he wakes up in the morning and is in good spirits. We also ensure he is OK at night and that he has all the resources he needs.”

“With me, I always make it a point when it’s inclement weather to check in on him,” Gutoski continued. “I give him a fair warning, make sure he knows there is a storm coming in, and make sure he knows it could be extremely cold. We always offer him resources, even though 99.9% of the time he will not accept resources. We offer them to him because he deserves it. He is one of our Cambridge residents that we have to look out for and take care of.”

John hasn’t always been unhoused. Due to the ongoing and persistent efforts of Cambridge Police Officers Helberg, Gutoski, Klein, and the rest of the Cambridge Multidisciplinary Outreach Team, a bed was secured at the state’s Department of Mental Health’s Safe Haven Program in Boston and they were able to convince John to move there in 2018. However, soon after the onset of the COVID-19 pandemic less than two years later, John left the residential program and once again was living on the streets in the Harvard Square area. Numerous efforts were made to help convince John to return to housing, but they were not successful and he remained living on the streets.

In December 2021, a service provider raised concerns that John appeared to be having difficulty walking and looked to be in a lot of pain.  Klein coordinated with the First Step Street Outreach program and Cambridge Police officers in Harvard Square in hopes of convincing John to go to a hospital and get evaluated, but he refused. Ultimately, Klein connected with Cambridge Healthcare for the Homeless and coordinated having a doctor conduct regular health check-ins on John through the First Step Street Outreach program.

By January 2022, New England’s extreme weather had settled in on Cambridge and new concerns about John’s safety and well-being were raised. Concerns included injuries from the weather, potential animal bites, and poor health from an infection in the area of the prosthetic for his lower leg. There had also been a significant change in his mood, including increased irritability, shouting at pedestrians walking by him, and refusing to engage with people he used to have good relationships with. After Jillson and Cambridge Police Superintendent Rob Lowe held a preliminary conversation about John, Cambridge Police Lieutenant Tony Bongiorno quickly convened a meeting with the Harvard Square Business Association along with providers from Pro EMS, the Cambridge Public Health Department, and Massachusetts Department of Mental Health to discuss an intervention plan for John. It wasn’t the first time various stakeholders convened to support John.

“We communicate with others and regularly come together as a team to develop plans,” said Officer Gutoski. “Over the years, we have come up with a few plans for John.”

The stakeholders at the meeting ultimately agreed that the difficult, yet best course of action would be to involuntarily send John to a Cambridge hospital for emergency medical and mental health screenings. This highly coordinated process involved ongoing communications with hospital staff and the police officers and staff who had longer-term positive relationships with John. For the next three weeks, John received medical care and was removed from the dangerously cold and stormy weather. However, he was discharged in February and John ultimately returned to Harvard Square. His prosthetic at this point was determined to be severely impaired and he was discharged in a wheelchair. Arrangements were ultimately made to have John reside at the CASPAR Emergency Services Center shelter on Albany Street in Cambridge, the first time he had ever knowingly stayed in a homeless shelter.

Over the next several months, John lived at the CASPAR Emergency Services Center shelter. With that stability, he was also in regular communication with the Department of Mental Health and CASPAR staff.  However, he desperately needed to get his prosthetic repaired in order to walk again and/or to have the option to live in a residence that was above a first floor or without an elevator.

Healthcare for the Homeless was able to find a clinic willing to provide free labor for the prosthetic replacement, but nearly $7,000 was needed in order to cover the parts for the prosthetic itself, as John’s health insurance did not cover any of the costs associated with the surgery. Lieutenant Bongiorno reached out to Jillson and the Harvard Square Business Association.

According to Jillson, the role the Harvard Square Business Association takes is not only caring for the Square’s “public space”, but also in caring for its people. The directive “to do the right thing” comes from the association’s leadership (officers, directors and members) and many of the Square’s property owners, who make an annual contribution to the HSBA’s Stewardship Fund. This fund provides the resources to make public space improvements like purchasing banners, flowers, holiday decorations, tables, chairs, and umbrellas. When there is a crisis like John’s, individual funders are also contacted and respond accordingly. In John’s case, there was a commitment from several benefactors to move forward to fund the expenses associated with the prosthesis within an hour.

By the summer of 2022, John was outfitted with a new prosthetic and the replacement was successfully completed.

By all accounts, John has been very happy with his prosthesis, is using it regularly, and even got a bicycle that he is able to ride now. While he has not expressed any interest in housing, he has been accepting food and clothing from the First Step street outreach team, and is able to care for himself and maintain better hygiene now that he has the means to be mobile.  The long-term goal remains for John to move into his own room via CASPAR’s Safe Haven program. Through police officers, staff, the city, and many partners, that collaborative goal is within reach thanks to an ongoing, relentless, compassionate, and collaborative approach that has been undertaken by many in the City of Cambridge for its most vulnerable residents like John.

Page was posted on 3/22/2023 4:48 PM
Page was last modified on 7/25/2023 1:23 AM
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