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River City Medical Group (RCMG) is a “progressive Independent Physician Association (IPA) uniquely dedicated to serving the Medi-Cal population” and they contract with over 1,600 network physicians who serve approximately 600 provider and clinic locations throughout the greater Sacramento area.

“We are owned and operated by practicing physicians and our Board of Directors is made up of practicing doctors,” Janice Milligan, Vice President of Community Relations & Program Development at River City Medical Group, said.

According to Amanda Gray, Marketing & Communications at River City Medical Group, “we have dedicated and experienced associates who handle claims, conduct training, and provide resource development for provider offices. The goal is to help our doctors focus on providing health care.”

As the only exclusively Medi-Cal medical group in the area, RCMG serves over 180,000 Medi-Cal members through their contracts with four of the participating Sacramento GMC health plans – Aetna, Anthem Blue Cross, Health Net and Molina.

“The reason the doctors came together was they recognized that in Sacramento there were large communities of people who were having difficulty accessing culturally competent care,” Milligan said.

From this stemmed RCMG’s mission, which is “to recognize and meet the needs of our diverse cultural and socio-economic communities while treating our members with compassion and respect. We strive to provide quality health care, using our resources responsibly to benefit our patients,” Gray said.

RCMG stands out as one of the largest Medi-Cal IPAs in Northern California and they work closely with their Sacramento network, including Peachtree, One Community Health, SNAHC, Wellspace, HALO, Sacramento Family Medical Centers, Whole Health Community Clinic, and Elica Health Centers.

“Our Medical Directors and nurses work with Sutter Hospitals, Dignity Health (Mercy), UC Davis, Kaiser Permanente, Adventist, and many of the Bay Area hospitals to coordinate the myriad of healthcare services our patients need,” Gray said. “As an integral part of the Sacramento community, RCMG works collaboratively with many community-based organizations who share our passion to bring healthcare resources to underserved communities.”

This kind of collaboration is what sparked a relationship between River City Medical Group and Joshua’s House.

“RCMG coordinates hospice services for our members experiencing terminal illness and we recognize that Joshua’s House is a much-needed resource in our community. Our doctors see patients who are terminally ill and for those patients who are experiencing homelessness many hospice programs have not been practical. Joshua’s House will fulfill the true definition of hospice for these patients,” Gray said.

“In Sacramento and in every community in California, we have a long way to go when it comes to helping people who are homeless participate in their care by mitigating so many of the social barriers and behavioral health barriers,” Milligan said. “I can’t imagine anything that’s more rewarding than bringing together all of these resources for doctors to help their patients who have a tough time participating in their healthcare.”

CBS13 Sacramento broadcasted this story about Joshua’s House on February 21. Special thanks to reporter Angela Musallam and to John Gay for his interview.

With a mission to transform lives and a vision to set the standard as a place that provides quality care in a supportive community, One Community Health is succeeding as a leader for health care services in Sacramento.

The clinic originally started in 1989 as the Center for AIDS Research, Education and Services (CARES) in an apartment with one provider and one nurse, but in 2015 it became a Federally Qualified Health Center (FQHC). Today, One Community Health provides a full range of services for Sacramento County, including medical and dental care, substance abuse treatment, nutrition education, and mental health services.

“We provide all these services in a single location, so we are able to reach out and pull more people in who have a need,” One Community Health CEO Christy Ward said. “It’s really wonderful when you hear some of these individuals’ stories and hear about the impact that even small things have on them as an individual.”

Ward joined the clinic in May 2016 after leaving her position as the Chief Executive Officer at the Multnomah County Health Department in her long-time home of Portland, Oregon. Although she had never been to Sacramento, she recognized what One Community Health was providing for the community.

“At all levels of the organization, in the clinic as well as the board of directors, everyone wants to give back to the community and they want to grow and provide services for more people,” Ward said.

For One Community Health, that sometimes means going beyond addressing just the medical concerns.

“We want to achieve the best health possible for each individual person,” Ward said. “We’re thinking of the social determinants of health, like food and security, housing, safety, and those types of things. We try to take each person and identify their barriers and help to sort through those as well as we’re able to.”

Ward believes the best way to help the community is to make sure people know One Community Health is there for them.

“We will always see somebody regardless of ability to pay. We’re here and we’re always going to be here,” Ward said.

One Community Health has seen many recent expansions to help them achieve their goal of always being there for as many people as possible. In December, they opened a new clinic in the Arden Arcade area. On Jan. 22, they expanded their clinic in Midtown from 17 medical exam rooms to 42 rooms and three dental chairs to nine chairs. They also added a full-time podiatrist, a full-time chiropractor, and women’s health experts and have a goal for 2018 to hire more staff and providers and add acupuncture and other specialties.

Ward also serves on the Board of Directors for HCRI, Inc./Joshua’s House.
Marlene vonFriederich-Fitzwater is opening a hospice for homeless people in memory of her grandson called Joshua’s House.

Her grandson was homeless.

“I originally became aware of the fact that people with cancer, heart disease, and AIDS and any number of serious illnesses had to nowhere to go,” vonFriederich-Fitzwater said. “In 2014 I had a 34-year-old grandson that I was very very close to who struggled with homelessness and drug addiction and died in Nebraska that was it.”

She met with homeless people to figure out what she wanted to incorporate the Joshua’s House.

“I did the focus groups,” vonFriederich-Fitzwater said. “Five different focus groups and interviewed 120 one-on-one just about what they thought their needs would be.”

The hospice will open next year in 2018. There will be between 16 to 20 bedrooms. It will allow people to bring pets and there will be art and music therapy available.

“They designed it with water walls and greenery walls and indoor gardens to bring nature in,” vonFriederich-Fitzwater said. “It’s essentially like a board and care. The local hospitals have signed on to deliver hospice care to the people they discharge here and then we provide everything else. The meals, the clothes, the support, the companionship.”

She’s been working on this project since her grandson passed away several years ago.

“I really feel like he’s guiding me and opening doors and connecting me to the right people,” vonFriederich-Fitzwater said. “I would hope he would be happy and pleased which I think he would but I really hope he would be.”

Joshua’s House to become one homeless hospice facility on West Coast

A retired Sacramento doctor is creating a hospice center for the terminally ill experiencing homelessness.

Joshua’s House will be next to Loaves and Fishes in the River District.

Marlene Von Friederichs-Fitzwater is in the process of completing the sale of the industrial lot and will convert it into a homeless hospice center.
Marlene Von Friederichs-Fitzwater

“Everybody should have that opportunity to die with respect, dignity and love,” she said. “These are people with heart disease, cancer, AIDS — whatever serious terminal illness — that otherwise would be on the street, and die on the street.”

Fitzwater is a retired professor with UC Davis School of Medicine, a professor emeritus at Sacramento State and the founder of the nonprofit Health Communication Research Institute.

The Sacramento facility is named after her 34-year-old grandson who died in 2014 while homeless in Nebraska.

“When he was clean and sober, we would talk a lot about what his purpose was in life. He wanted to help those he saw on the street who were sick, dying and had no one to care for them,” she explained. “So this is in his memory. It’s a tribute to his compassion and his love for others. This is something I feel very much guided by him.”

Courtesy photo Joshua

Joshua’s House will be among just a handful in the country offering this type of end-of-life care — and is the first in the West Coast.

“It really struck me when I was at UC Davis working in the cancer center and learning some of the people we were treating were homeless,” she explained. “They can be treated at a local hospital, but we don’t have enough MediCal beds, we don’t have 24-hour shelters, we don’t have places where hospice care could be provided.”

Fitzwater said doctors have agreed to discharge terminally ill patients, and then provide hospice care at Joshua’s House to their patients.

Marlene Von Friederichs-Fitzwater

“The hospital certainly doesn’t want to discharge people back on the street,” she said. “We’re not a nursing facility. We’re not a medical facility. It’s more like a room and board.”

The center will initially have 16 to 20 beds, a chapel, library, music and art therapy, as well as reunification services for those wanting to mend ties with family.

“I one-on-one interviewed about 130 people who were homeless, and the big issue for them is a fear of dying on the street alone,” she said. “They already feel invisible and forgotten, and then to think about their life ending on the street. It’s a fear they all share.”

Marlene Von Friederichs-Fitzwater

Residents will also be able to keep their pets if possible.

“They want to bring nature in so they don’t feel like they are in a box. They don’t want to be reminded they are poor,” she explained. “We are trying to create a beautiful, loving, open space where they will feel safe — but also loved and respected.”

Joshua’s House is scheduled to open in Fall 2018.

We had a very successful United Way Day of Caring on Saturday, September 23 on 1500 North C Street. We gave out more than 500 bottles of water, 100 pair of special Bombas socks, 250 personal item gift bags and containers to homeless individuals for keeping their belongings dry and safe. More than 30 volunteers also picked up a lot of trash and made a “dump run” to take trash to the dump! We have some photos and there’s an article in the newsletter on the first page about the event.

Thank you to Inside Publications for including Joshua’s House in your September edition. We are excited about the opportunity to bring hospice care to the terminally ill homeless community in Sacramento.
If you’d like more information or if you’d like to get involved, just let us know.

WHAT: United Way’s Day of Caring

Day of Caring brings together business leaders, community members,
campaign coordinators, nonprofit partners and volunteers across the
region to work on service projects that will make an impact. Volunteer
teams range in size from 10 – 200 and come out to tackle meaningful
projects that address community needs.
This toolkit provides emails and social media posts to help promote Day
of Caring, solicit volunteers and to garner general awareness of Day of
Caring and its activities.

WHEN: Saturday, September 23. Start promoting today!
WHO: Volunteers, corporate partners, general public

WHERE: Kick off the day on Saturday morning Sept. 23 at 8:30 a.m. at Cal Expo with
volunteer projects hosted throughout Amador, El Dorado, Placer,
Sacramento and Yolo counties.

WHY: Day of Caring. Volunteers are ready to participate in collaborative projects
that create positive change, build community gardens, paint walls, read to
kids, stuff envelopes, build picnic tables, put together supplies, plant trees
and more. This is your chance to show first hand the great work your
organization does and garner some attention and support from potential
donors and media.

For more information visit: Day of Caring 

Homeless people suffer illnesses and accidents at a rate far higher than the rest of the population. This is not only another of their challenges — it can be a contributing factor in putting them into homelessness in the first place. This photo story was taken in Gainesville, Fla., for an Advanced Photojournalism class at the University of Florida.