While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
Position: Associate Executive Director, Michigan Veterans' Foundation
I could not thank Mr. Chatman in any kind of words or material things. I can only pray to God that he blesses this man for what he has done for me. From the time he walked in the door in the morning...he was working on my problems. Problems that I didn't know where to start at or attempt to even solve because of my addiction, were being wiped away. The most important part was that he has shown me how to live.—Resident of the Detroit Veterans Center Transitional Housing Program
Mr. Chatman will always be in my heart and mind. He taught me to love myself and others. He gave me a chance when no one else would. When I was thinking about suicide he took me by the hand and walked me back to life. Mr. Chatman is a Vietnam vet. He has seen and done a lot of things in his life. I think this is why he has so much love for his fellow man. I think God put all of us on this Earth for a reason, and his is to go out of his way to help others. He is a hard-working man, and they don't come any better.—Resident of the Detroit Veterans Center Transitional Housing Program
Born in 1952, Tyrone Chatman grew up poor, on Detroit's blighted East Side. Around him, drugs, crime, mental illness, alcoholism, homelessness, and all the other devastating effects of poverty were endemic. Mr. Chatman's father lived and died as an alcoholic, and the family often had no heat during Michigan's long winters. Tyrone wore threadbare hand-me-down clothes and frequently went to bed hungry. Someday, he promised himself, he would do what he could to help others escape that lifestyle, and build a better life for themselves and their families.
Tyrone sustained himself in those days with odd jobs, working hard as a paperboy starting at age 9. By the time he was 14, he was a door-to-door salesman, peddling household products, greeting cards, oven mitts, ironing board covers—anything useful around the house. "I was a pretty darn good door-to-door salesman," he recalls with a laugh. The skills he developed were useful back then—earning him the respect and admiration of other children as well as pocket money to help himself and his family. And those same skills were to become essential to him later in life, when he entered the human services arena, and had to pound the pavement for scarce funding. "I'd tell these captivating, profound stories," he remembers, "with the hope that it would bring out that human side in people, and make them want to help me out in my mission."
In 1970, at age seventeen, Mr. Chatman enlisted in the US Army. After a one-year tour in Germany, which he remembers as an exhilarating look at life outside the ghetto, he was sent to Vietnam, where he served as a military advisor. As he recalls it, he was really a "combat social worker." As part of the Army's "Pacification Initiative," he would go into villages, and try to win over the often hostile civilian population by getting them things they needed. Mr. Chatman enjoyed the work, was decorated three times, and returned from Vietnam with a deep, lasting appreciation of the contributions of America's veterans.
Home from the war, he spent 1972 and 1973 drifting, then found work on the assembly lines of Michigan's automobile industry. But when the oil shock of 1979 and the subsequent recession hit, the last hired were the first fired, and Mr. Chatman found himself without a job. Taking advantage of government funds for trade readjustment, he enrolled in Highland Park Community College, where he studied social work. He conducted his internship at the Neighborhood Services Organization (NSO), a 24-hour walk-in center for substance abusers, located in Cass Corridor, Detroit's skid row. He stayed on when the internship was over, and when the center's director left two years later, Mr. Chatman found himself, at the age of 35, in charge of the whole operation.
NSO's clients were poor, mostly homeless, and suffering from problems ranging from alcoholism and drug addiction to mental illness. The walk-in center, Detroit's only such facility, provided help for these people, allowing them to survive on a day-to-day basis, and to access detoxification and treatment. NSO was a safe haven for street people in an extremely dangerous part of the inner city.
Under Mr. Chatman's direction, NSO soon began to expand its activities. As he puts it, "Instead of being one of those directors who was okay with being in the office and managing the facility, I began to reach out into the community, to explore other things that perhaps we could be doing." To support these new ventures, Mr. Chatman aggressively pursued funding opportunities through government and private agencies, and gained some access to federal and state surpluses. By 1994, NSO was providing crisis intervention and referral services; individual and group counseling; emergency food, clothing, and shelter; showers and laundry facilities; transportation; case management; General Education Diploma (GED) classes; employment placement; basic medical care; AIDS information; and other support services. In 1993, Mr. Chatman instituted a 20-bed rest and recuperation room for homeless hospital discharges, and in 1997, a sub-acute alcohol detoxification service for the indigent with full medical staffing, a first aid station for street people who had injured themselves, and a hot lunch program that served 300 people per day. By 1998, the center was serving 100,000 people annually. During his 15-year tenure at NSO, its budget rose from less than $200,000 to more than $1.5 million.
Mr. Chatman also concentrated his efforts on NSO staff development. He created a 10-week Institute on Substance Abuse Studies, in which NSO staff and interested individuals in the community were trained in anger management, self-defense, and when to seek help. The course stressed the use of intellect over emotion in serving an often violent, sometimes out-of-control population. Over a 15-year period, the course trained more than 1,500 people. In addition, NSO conducted a National Acupuncture Detoxification Association training, in which participants were certified to use acupuncture as an adjunct to substance abuse treatment. In recruiting staff, Mr. Chatman often used recovering former clients of NSO. As one of them put it, "If I had not been hired at the time that I was, I probably would be dead or in prison, that is a fact. Had I not been given an opportunity, one more chance at life, on life's terms, there would be no story for me to share."
While at NSO, Mr. Chatman also became an advocate for services for the disenfranchised of Detroit. He was appointed to the mayor's Homeless Task Force, which helped Detroit develop its Seamless Continuum of Care Collaborative, comprised of approximately 15 service providers (including NSO), to serve the homeless in a more comprehensive manner. Largely due to Mr. Chatman's efforts, Detroit became the first collaborative of this kind to receive funding from the federal Department of Housing and Urban Development.
Mr. Chatman was also a member of the Detroit City Council President's Shelter Ordinance and Licensing Task Force, charged with identifying locations where homeless persons establish makeshift shelters, as well as helping develop more comprehensive licensing standards for the city's established shelters. He served on the State of Michigan Target Cities Advisory Committee, helping ease access to treatment for substance abusers, creating jail-based treatment programs, and incorporating case management services into treatment. Additionally, Mr. Chatman helped bring attention to the dangerous over-saturation of alcohol billboard advertising in Detroit, and was instrumental in developing the "Denounce the 40-Ounce" campaign, which brought counter-advertising against the sale of 40-ounce alcoholic drinks. He served on the Boards of the Homeless Action Network, the Michigan Veterans' Foundation, the Churches Intervention Ecumenical Ministries, and the Cass United Methodist Church Non-Profit Housing Corporation.
At the same time, Mr. Chatman provided assistance to a number of other homeless service providers. By 1998, he had become Detroit's most visible advocate for the homeless. However, in that year, a shift in personnel and policy at the city agency funding the NSO led to frictions between Mr. Chatman and his supervisors. The week before Thanksgiving, when on paper NSO operating funds had become technically depleted, Mr. Chatman was asked to shut down the center and find referrals for all NSO clients on short notice. Mr. Chatman and his staff silently refused, and the NSO center remained open through Thanksgiving. In the meantime, a client alerted the city council president, who intervened to contravene the closing order. Mr. Chatman, however, began to consider leaving NSO. Ironically, it was just at that time that Mr. Chatman was nominated for the Robert Wood Johnson Community Health Leadership Award for his work at NSO. A site visit by Community Health Leadership Program (CHLP) staff confirmed that Mr. Chatman was an ideal candidate for the award, but when he told them he was considering leaving his post because of the lack of support from the sponsoring agency, they decided to defer his candidacy, and re-invite his nomination if he remained in the same field.
In May of 1998, Mr. Chatman left NSO, and took on the associate executive directorship of the Detroit Veterans' Center (DVC), on whose board he had long served. DVC's mission was to fill the gaps in the current service delivery system for veterans, operate a transitional living facility, coordinate services within the existing Seamless Continuum of Care Collaborative, and act as an advocate on behalf of disenfranchised veterans. It was, in short, an ideal posting for Mr. Chatman, who now had 18 years experience serving the homeless, and an even longer commitment to helping America's vets, many of whom had experienced great difficulties readjusting to society after returning from Vietnam.
At this time, DVC had just built a new facility, but had not begun to operate it. Bringing some key staffers with him from NSO, Mr. Chatman helped get the center up and running. He also acquired the lot next door, which by 2001 had become a new Career Initiative Center, to help veterans reintegrate into the workforce. Upon assuming his new job, Mr. Chatman immediately began lobbying other human services providers to provide on-site support services such as health care, substance abuse intervention, legal assistance, benefit and entitlement assistance, and vocational training. DVC currently offers paid labor to local businesses, which often results in job training and job placement opportunities. Its new facility offers transitional housing and support services to 104 homeless male and female veterans, as well as on-site support services for veterans who are not homeless. The center also provides space for 12-step treatment programs for alcohol and substance abuse.
In 1999, Mr. Chatman's nomination for the Robert Wood Johnson Community Health Leadership Award was successfully resubmitted. He was thrilled to receive the award, which carried with it a $100,000 stipend. He determined to use the money to complete construction of the Career Initiative Center building, then bring Detroit Health Care for the Homeless on board as a rent-paying tenant. Mr. Chatman projects that within a year of the building's opening, DVC will recoup the award money plus an additional $60,000 in rent.
Beyond the financial assistance, the Community Health Leadership Award provided Mr. Chatman with a host of other benefits. It burnished his reputation, resulting in other awards, such as the Spirit of Detroit Award and the John J. Gunther HUD Best Practices Award. A wave of media attention also resulted, along with increased access to state and federal legislators. This, in turn, resulted in an increased ability to attract further funding. "People want to give funds to folk who have a proven track record, or who seem successful," Mr. Chatman points out. "If you're successful, people want to grab hold of your coattails and enjoy the ride. And I let them do it! We always get funded. Always. I've not had one grant proposal turned down since the award."
Another benefit of CHLP attention has been the opportunity to network with other winners of the award. Mr. Chatman has already been on the first of three annual retreats he will be attending with other Leaders. "At one point," he says, "I started to feel like, 'Why am I here? Look at what these folks are doing!' But as we began to interact and to bond, someone commented that it's almost like being amongst angels. People who are doing God's work, and who do it with no strings attached...'cause it needed to be done."
Mr. Chatman is bursting with new projects and plans for the future. DVC recently opened a memorial garden, "Dedicated to All Those Who Served." The garden's plantings consist entirely of donated or found items, such as roses found growing in an abandoned building, and bricks and wrought iron picked out of the garbage. At the garden's dedication, Mr. Chatman's new DVC choir had their first performance. The group is now planning performances at Detroit's VA Medical Center. On a grander scale, he would like to expand and replicate the DVC's services elsewhere in Michigan. Under a new grant from the state Department of Labor, Mr. Chatman will be beginning new career initiatives for veterans, including training them as computer network technicians, software specialists, and computer repairpersons. He hopes to run this training (and others for landscape maintenance and janitorial services) as a nonprofit business through DVC. Training in these areas was underway as of fall 2000.
To Tyrone Chatman, leadership means genuinely caring about the well being of others. "I don't consider myself special, or better than anyone else," he says. "But if it's within my capability to make life better for someone, then I'm going to do it."
While the need to address disparities in care is well known, few strategies for reducing disparities have been studied systematically.
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