Joseph Calderon is a community health worker for the Transitions Clinic Network, a national network of 16 clinics across the U.S. that helps those newly released from prison who have chronic conditions establish relationships with primary care providers. Transitions Clinic programs are embedded in other practices; the goal is to help parolees make the difficult transition from prison—where they were passive players in health care—to the health care system “outside the wall.” Many parolees have multiple chronic conditions and behavioral health problems and distrust providers. Calderon, who spent 17 years in prison, serves as a bridge between parolees and clinicians.
I’m working with individuals who have no concept of taking care of themselves or their chronic conditions. Some have substance abuse problems. Others are homeless. For some of the homeless ones, thinking of a warm place to sleep and shower trumps medical care. Most of the people I work with have had a lot of bad experiences with the providers in the prison system—just as I did. Watching what happened there brought a lot of heartache and madness. I have never seen so many people die from things that could have been prevented.
Joseph Calderon (right), a community health worker for San Francisco’s Southeast Health Clinic, part of Transitions Clinic Network, with a client.
In my own case, I had a history of high blood pressure, a grandfather who died of a stroke, a father who died of a massive heart attack, and an uncle who died of stroke, so it was a real concern of mine. One night when I was in solitary confinement, I woke out of sleep with terrible chest pains. When I reported it in the morning, nothing was done for two to three weeks. And when I finally saw a doctor and described my history, he told me I was having muscle spasms and sent me back to the cell. I heard about Transitions at a mandatory parole meeting when one of their community health workers said the clinic could get me blood pressure medicine right away. That was my first experience with Transitions.
I’ve found a lot of recent parolees are unaware there’s help. Now that they are out, they don’t know how to get the care they need—or even that they need it. I understand that based on my own background. I grew up in the Mission District in San Francisco. A lot of my family didn’t really go to the doctor regularly. They went when they were sick and usually in a bad situation. Friends of mine went when they were beat up, shot, or stabbed. Based on that, and with my prison experiences with care, I didn’t really have the greatest view of what health care was going to look like on the outside or how I was going to take care of myself.
This is what I always tell guys I’m working with: In the communities we came from, we took better care of our cars than we did ourselves. Our cars got oil changes, tires rotated, you know, nice rims, music, but we didn’t go to the doctor for checkups or care.
My work with them is a lot of relationship-building, trust, and bonding. We are talking about men who have dealt with institutional discrimination. Many had no access to medical care prior to Obamacare. They are also dealing with cultural and social issues—the gangs, the madness, who to trust, the race issues. I’m able to listen to them and then when I tell them that I too was incarcerated—they know I understand the obstacles on both sides of the “fence.”
It’s my job to teach them how to make appointments, how to get medication. I advocate for them. Being able to call me relieves some of the stress of trying to navigate the system. I use those situations to empower that individual—not only doing it for them once or twice, but more importantly by showing them how it’s done.
Still there are some who doubt me. They ask why are you helping me? What are you getting out of it? I tell them I’m not getting paid $10 a head for helping them. I’m passionate about this job. I want a better world.
There’s one guy who comes to mind. He had trust issues and he didn’t do well in shelters. I worked with him to get him an SRO [single room occupancy housing], getting him off the street so he could try to address his other issues with substance abuse. Now he is sober. He understands the medical system, he’s working, and has housing. We want to see people integrated back into the community.
Showing them that they have some choices helps a lot. They have been in places where everything was done for them. They’re obligated to speak to parole officers and assigned doctors while in prison. Now they need to understand that they can choose their own doctor, their own therapist, and they’re there to help them and their interactions are completely confidential. That makes a big difference.
I really wish I could change society’s view of parolees and their potential. When it comes to hiring for these positions, I agree that books are great, degrees are great, resumes are great. I’m planning on getting a bachelor’s degree and maybe a master’s in psychology or social work. But there’s experience that can’t be taught. I came out of prison with that experience and passion. Yet in many situations we’re still not looked upon as being worthy enough to be part of the system. On the contrary, I think we have a lot to give back to society.