Women, and Black Women, have always been powering the movement to end the HIV epidemic, in Chicago and beyond. One of AFC’s most experienced and impactful leaders is Freddie Shufford, Vice President of Care. We sat down with Freddie during Women’s History month to ask questions about connecting women to care, and about her own experiences in her career and as a member of Senior Leadership at AFC. Freddie’s strengths in leadership and her ability to drive positive outcomes for her clients and staff may in part derive from her ability to deeply listen to and connect with clients, and then go a step farther, taking what she has learned from them and turning it into effective care practices. Freddie says she learns most from her clients. All of us can learn a lot from her.
AFC:
It’s Women’s History Month. From your experience, how can we prioritize Black and Latine women and girls in public health settings?
Freddie Shufford:
So, “prioritize.” That word brings to mind the idea of, “I'm putting the patient first.” I worked for 35 years at Cook County Hospital, which is a safety net hospital for individuals who can't afford to get health care anywhere else. So, they have a lot of experience taking care of people with different medical needs.
I would say that providers on all levels, whether you are a social worker or nurse or doctor, when you commit to work with a certain population, I believe you should come prepared. Educate yourself. Do some research. Immerse yourself in the cultural dynamics of the community you serve in order to get experience with and knowledge about the population that you're working with.
When you're engaging someone that may not look like you, or speak the same language as you, if you come in and can say something that sounds familiar and welcoming, that invites them to open up, and you can begin to build trust.
Cook County Hospital [where I worked previously] was an academic setting, so we did our best to try to educate practitioners about the patient population, and about some of the dynamics, some of the mistrust that was in the system already. So when a provider can come in and relate on a human level – for example, they could share a picture of their child from their wallet, to find a commonality with a patient who is a parent, and relate to their also being a family person. That could allow the patient to let their guard down. So educate yourself, become aware, learn cultural differences.
Also, another education point is your own conscious biases. You know, we all come with them. I have them. You have them. But we have to become aware. Just being aware may not change anything, but it is a first step, it could prompt you to lean toward this type of thinking – how am I helping my patient or client to trust me?
Some of the biases I've seen in the healthcare system around African Americans, Latinx people for example, is sometimes people speak to them as if they're not intelligent. What are the root reasons why a patient might not understand you? Are you being clear? Have you established trust? Are you asking questions that sound like questions, rather than statements? Or how about asking them to share how they're feeling, or to share with me your experience? We can begin to build trust by treating people with the baseline understanding that they understand and know their own body. When you walk in the room and think you know me better than me, that's a problem.
I'll give you a good example impacting women in the healthcare system, where we had to look at Pap smears. Those are regular, routine health standards, preventive measures that everyone should meet. And so we saw our people were not getting paps, and we were asking what is going on? Why are the providers not taking time to educate and prepare them for those pap smears?
So when we looked into it, we ended up making little female care kits, so patients could freshen up. They were a small thing to offer that let people maintain their dignity in these processes, because we might be treating sex workers, or people who may be homeless. They didn't get to take a hot shower like you did prior to your doctor's appointment. So they were declining these routine exams. They would say, “oh, maybe next week,” you know.
But we found that was one thing that a provider could do, is offer a hygiene kit so the patients could freshen up and feel prepared. By understanding our patient population, providers could be prepared for sensitive types of conversations and procedures, and offer solutions so people can get care.
So circling back to the word prioritize, I get back to educating yourself. Make yourself familiar. Understand your own biases. Immersing yourself in some cultural competencies and cultural humility, I think would prepare providers to be able to prioritize certain populations.
AFC:
What I'm hearing a little bit is that doctors, hospital administrators, have a lot of power that they can become advocates for these patients, but they need to lead the charge. Especially in an academic setting like you describe at Cook County, doctors and leaders there need to be saying, “I'm educating myself,” modeling that for their students.
Freddie Shufford:
Yes, yes. And you know what we see? Healthcare systems are very different when people come from different cultures and countries, and they also view providers differently. Patients can view them as the authorities, and because the doctors or providers have power, sometimes patients don't feel like they can really be themselves. For example, asking “Are you taking your medication? Did you miss a dose?” Is that a good way to ask the question, or would it be better to say, “How’s it going with you? Taking your medications? Are you having any side effects, or are you feeling any better?”
Providers can build trust by leading patients with connection, by relating to their experience, versus making a statement about it and not really engaging them in a conversation. Let’s treat the clients with the understanding that they want to live. It's their goal to live, but it’s not their goal to deal with the challenges of our health care system, so let’s help them get comfortable with the experience of getting care, to help them be better advocates for themselves, and help them find their voice.
I think the way we work with clients, the way we view them and engage with them, the way we view their lived experience, can really teach us. I've learned the most from our clients. You know, they taught me how to treat them. If you listen to them they will teach you. They are the best teachers.
AFC:
That’s a beautiful statement. And I feel like just from having worked with you a short time, that I can tell how much you center the clients and and the people you're caring for in your work. So I thought our readers might be interested to know, can you briefly explain your professional background and how you came to AFC?
Freddie Shufford:
So I am a social worker by training. I've worked in a number of settings, but my lifelong goal was to work in a healthcare setting. I just love health care. Maybe it goes back to when at the age of five I broke my arm. That was my first experience with the doctor. And actually, I went to the County Hospital because we lived right in that area. I had to get a cast, and it was sort of cool to have a cast. And the health care environment just seemed very caring.
When I finished college, I did some child welfare work. I worked with developmentally delayed children. I worked at a school and I worked at the county hospital. And working at County reminded me of when I was younger getting care, and of my own vulnerabilities. I find that when people are sick, they are at times more open, because they're very vulnerable. And we have all felt that way to a degree, and I feel like I can connect with the patients on that and develop trust. So my early experiences I think sort of shaped me to deal with individuals who were vulnerable, who were having some major life changes, who needed support, who needed encouragement.
And also, working at the county I could work with people who looked like me. These could be people from my own community, from my own church. I was working in an environment where patients could see me walk through the room and they could feel like, oh, wow, she could be somebody I know! That was really a good feeling for me, to be the one there to educate them, to give them the tools they needed once they left my care to go out and do what was best for their health.
Eventually I had an HIV patient that came into the hospital. He was undocumented, and stayed in the hospital for one year because I couldn't find a nursing home to take him. I couldn't because he was undocumented and he had no family here. That was my introduction to HIV, my client not having any resources. HIV was new to everyone, and that experience sort of…it pulled me in.
I don't know if you've heard of Bryan Stevenson, who wrote Just Mercy. Bryan Stevenson said something in the book that gave me words to put on my experience: that being in proximity with individuals can sometimes help you develop your own passions and gifts.
So I felt like that's what happened when I worked in that healthcare environment. It sparked something in me to really want to get in and advocate and support people. While I was at the hospital working with people with HIV, I met people at the AIDS Foundation. So my work then became parallel with the AIDS Foundation’s work, and I became a case manager. I would come to the AIDS Foundation for meetings. I was on the Governance Committee, chaired that for a few years. So, I had a relationship with AFC long before the opportunity presented for me to come here to work. That opportunity presented in January 2023 when I was really looking to shift in my space at the County. There was an opening for this role, so I told myself, just throw your hat in the ring. It would be such a great opportunity! And, sometimes things just sync up in your life, where your life situations and opportunities intersect.
It turned out they agreed, this could be a good match. So it was very organic. I felt it was a natural transition, I felt the team was so open. And, some of the faces were familiar. Some of them I had known for years. So, me coming to AFC was almost like a welcome home kind of thing.
AFC:
Could you describe, at AFC what areas of work do you manage?
Freddie Shufford:
The Vice President of Care oversees the case managers, who take responsibility for collaborating with patients to build a care plan to meet their needs. Those case managers are key to helping individuals get connected to medical care, and to other resources like housing, food, transportation, medication adherence, and insurance education and enrollment.
Also, I oversee the benefits specialists. These are individuals that help with enrollment into benefit plans. This has become such a complicated thing for people these days, to stay on top of all the different insurance plans. Benefits specialists also help get our clients covered through the AIDS Drug Assistance Program, where individuals can get their medications, which is particularly important.
I also oversee staff who connect clients with the Department of Rehab Services, which is through the state and serves those individuals who find themselves homebound and need services to come into their home. This is called the DRS Program, and there is a process where you can get a personal assistant and that could be a family member or close friend to come into the home to help you.
I also oversee our 340B program, which is the pharmacy reimbursement program, and collaborate with other individuals like Cynthia Tucker and Brandi Calvert who oversee clients leaving the corrections and justice systems and those who need housing.
AFC:
Since you started at AFC, what impressions do you have of AFC as both a workplace and as a connector to care?
Freddie Shufford:
So as a workplace I have reached six months being here, after working closely with AFC from the outside. But now from the inside looking out, I can say AFC definitely cultivates some of the best professionals, the best individuals to come into this workspace and give their all. My staff is working at the highest level of their skill set, to lift people up with support and encouragement.
Some of the individuals we work with, both clients and staff, have had multiple life traumas, so I feel like working with my team at the AIDS Foundation, I have to play the role of a supporter and advocate for my staff. I need to be someone that's there to help my team develop themselves professionally to be able to face their daily tasks, to pick up the phone and not know what they're gonna hear from a client on the other end.
I can support my staff by being confident that if they listen and are compassionate, they will be able to help their clients work through whatever their situations are. I believe the passion that people bring to their work is evident in that, at AFC, you can see people going above and beyond.
Also, I believe it's our responsibility to help people build self-sufficiency, empowering them to better understand their resources. So we say to our clients, if there’s an employment program coming up, or a training on some skills you could build, “Why not go and take that class? Why not enroll in that?” We need our clients to be able to take care of themselves in the event some programs or services go away. “Let’s move you towards something more sustainable.”
AFC:
I imagine that has to be an empowering experience for your clients as well to be involved with such a comprehensive view of the services that they're navigating with you. Like earlier, you described clients and caseworkers as working in a collaboration or a partnership, not just a top-down, checking-items-off-a-list kind of relationship.
Freddie Shufford:
Yes. It’s a collaboration. I don't know if we realize that we may be role models for clients, too. We’ve seen individuals go back to school, and then come back into the field, sometimes as patient navigators, peer navigators, and case managers.
So many people with lived experience come back and give back because they had someone that sat with them and was patient enough to understand.
And it, like I said earlier about Bryan Stevenson: that close proximity can ignite a spark there for them to say, “This might be something I want to do with my life.”
AFC:
I see a parallel there with your early experience in a medical setting, thinking, “I like this. I feel welcomed here. Maybe I want to work in a medical setting.” Kind of like seeing an opening, or having an experience that opens a door, from receiving kindness and openness. Those kinds of relationships pay dividends for people in the future in unseen ways.
Freddie Shufford:
Yes. Definitely.
AFC:
So, what successes are you and the care team having and what challenges are you facing?
Freddie Shufford:
I would say we are seeing major successes with viral suppression. We help our clients understand what viral suppression means, how that impacts their life, and the quality of their life. Our case managers, housing navigators, all those that provide client-facing services are really prioritizing this.
And because housing is health, and if our prioritizing your support services, and connecting you to housing, is helping you stay connected to your medical provider, we know that will help our clients achieve viral suppression. Understanding that if you are undetectable, then you cannot pass the virus on – that understanding is critical.
A lot of times HIV would not be number one on the client's list when they first met with me. They were concerned about the basic needs and life, right? And if they had children and they were parents, then taking care of their children was at the top of the list. But I was there because I think their HIV is important, too. So I help navigate those basic priorities with them so that they can be a good mom, have a safe place to live, and take care of their health. The Ryan White wrap around services provides space for our clients to prioritize their physical and mental health.
Challenges we see are probably systemic things, like for example the state has a database that can almost drive the way you interface with the client, instead of best practices doing the driving. Now of course, many things in those systems are good. Having face to face contact between case manager and client, that's ideal. Seeing your doctor, that's great. Getting your labs twice a year, all those are great and important standards.
However, our clients don't fit into neat packages like that. We all know that data is good, everybody wants data to support programs - but not everything in this type of relationship is a data point, right? If I'm sitting with you, listening to you, being empathetic, that can’t translate into a data point, but, it’s those things that build trust. So it’s valuable, but hard to quantify.
So I would say a challenge for the team then becomes, if it can’t count in the system, are we valuing all of the work they do? And as a leader I think, “Let's redefine what makes your work successful.” So we're exploring that, how to lift up those qualitative things, those quality of life things that our case workers do, that may not be recorded.
AFC:
So, what else do you have planned for the future, and what brings you hope and motivation in in working towards those future goals?
Freddie Shufford:
I felt like my first year at AFC, I would want to do some exploring, making sure I'm listening to the staff, listening to other collaborators and partners. And then look at, possibly, is it time to restructure the way we deliver care? Is the model that we have today, the model that we need to get us to where we wanna be, which is to zero? Can the model be reshaped or redesigned to meet the most needs of the most individuals within our city and within our state? So I would say, I’m exploring a redesign, a makeover.
I’m exploring how we can diversify funding and, really looking at priority populations, perhaps secure funds to do pilot programs to see if we can better serve our priority populations through new service models. Could a new service model help us eliminate barriers to create better outcomes? And making sure we invite people with lived experience into these discussions.
So I get excited about thinking, how can we be more innovative to serve our clients? And I believe that's something that will keep me excited. And I’m looking forward to growing and developing my team, all of us looking into the future and trying to pull that closer, helping people value their journey while we do the work. We don’t always need to be looking for the destination, but finding the value in all of these small day-to-day things that add up into big successes for our clients.
