Hundreds of Barrie, Ont. residents have received health care they might otherwise not have received thanks to a free clinic operating out of a local Anglican church.
Compassionate Care Without Barriers (CCWB) provides care to people who are poor, homeless or facing other barriers to receiving medical treatment. Located at Trinity Anglican Church, Barrie, the clinic books appointments every Monday morning from 8.a.m. to noon.
A two-person volunteer team runs CCWB. Registered nurse practitioner Brenda Brown provides medical care to patients. Jo-Anne Flood, former Catholic school board worker and current part-time municipal worker, handles the administrative side.
Patients receive care, referrals and drug prescriptions. Along with serving poor and homeless residents, the clinic offers care to people who may not have health cards such as refugees and international students.
Brown had treated more than 250 people at the free clinic, which opened in July 2023, when she and Flood spoke to the Anglican Journal May 23.
“The whole thing with Compassionate Care Without Barriers is removing all barriers to getting quality health care,” Flood says. “We don’t refuse anybody based on anything … Whatever can be done within the clinic is done for free.”
Flood and Brown had long discussed the idea of a free health clinic to respond to needs of poor and marginalized residents. Their plans brought them into contact with Trinity Anglican Church, which has a long history of providing outreach programs in Barrie’s downtown core.
From 1993 to 2014, Trinity hosted the David Busby Street Centre, a community non-profit that provided outreach, drop-in and shelter services for residents experiencing or facing the prospect of homelessness. After the onset of the COVID-19 pandemic, it formed a coalition of churches to provide free breakfasts.
Flood says she and Brown had dreamed of providing medical care for the community when they retired. “When we were looking around for a place, we loved what Trinity Anglican was doing in the community,” she says. “They’re just such a big part of the downtown core [with] the programs that they provide.”
Flood and Brown reached out to Canon Simon Bell, Trinity’s priest-in-charge, to describe their idea for CCWB. Bell immediately took to the idea and offered them the use of church space to host the clinic.
“There used to be a clinic in the downtown core … because we have a higher population of need,” Bell says. “Then the city shut it down and they moved it to the south end of the city, which is just completely inaccessible, to put it mildly.
“When Jo-Anne and Brenda came to chat to me, we went, ‘OK, this is great,’ because this is a need that had existed in the community.”
Many face barriers to treatment
A 2022 Simcoe County report prepared in collaboration with the Simcoe County Alliance to End Homelessness found a record 722 people in the county were experiencing homelessness. Half lived in Barrie.
“It is a significant number of [unhoused] people for a small town to have,” Bell says. “The added difficulty we have is that it’s not a single layered issue. It’s a multilayered issue. So [if] you may be homeless, you generally have a psychiatric care issue.”
Practical difficulties can prevent poor and homeless residents from accessing the treatment they need through the public health-care system.
Brown remembers a homeless patient with a wound on his shoulder who came into the clinic. He had gone to an emergency room and was given an appointment to see a surgeon. But after he returned to his tent, his paperwork got wet to the point of illegibility.
“He came back to see us and said, ‘I missed my appointment. I can’t go back. What do I do?’” Brown made a referral and spoke with the doctor’s office, who said he would have to go back to emergency, get another referral and go through the process again. Eventually they set up another appointment with the surgeon.
Brown describes the challenges patients like this homeless man, who did not have good communication skills, can face in an overburdened public health-care system.
“When he goes in there and he tries to represent himself as to what’s happening, if he doesn’t answer the questions that they want, they become frustrated, because they have so many patients in the waiting room and they just really need to know what they have to get at,” Brown says. “He’s already timid, he’s already traumatized, and he doesn’t know how to communicate, so that makes it worse.”
Theft is another problem for unhoused people trying to access care. The patient Brown was trying to help had left his property in the bush and was worried about it being stolen while he was away. Many of Barrie’s poor and homeless also face judgementalism when trying to access health care in settings outside the clinic.
Public health-care workers are very busy, Brown says. “They really want to help. They’re good people. That’s why they do what they do.” Yet difficulties in communication can lead to frustration, she adds.
“We have people coming in [to CCWB who] are terrified because they’re not always well received at the hospitals and the after-hours clinic,” Flood says. “There’s a stigma that goes with them. Their ailments get brushed under the rug because they’re an alcoholic or they use drugs.”
Brown says a common reaction she has seen to someone living on the street who comes in with a foot problem might be, “If you really cared, you’d be keeping that wound clean. If you really cared, you would be wearing a pair of shoes on those feet.”
By comparison, Flood says, “When they come to see us, there’s no judgement. If you have a sore foot, we’ll look after your sore foot and you get a hug at the same time.”
City backs down on bylaws attacking homeless
While Trinity Anglican Church has provided space for CCWB, Barrie city council has been accused of trying to put up more obstacles for the homeless.
In May 2023, city council passed a motion that directed staff to look into changing bylaws to ban people from distributing food, tents or tarps in public spaces or giving money to panhandlers on city streets, intersections and highway ramps. Councillors proposed bylaw amendments to enact these changes, sparking widespread outrage.
Two advocacy organizations, the Canadian Drug Policy Coalition and Pivot Legal Society, sent the proposed bylaw amendments to the United Nations rapporteurs on the right to adequate housing and extreme poverty. City council backed down and voted to refer the bylaws back to staff for review, though the motion is still in effect.
The congregation at Trinity also opposed the amendments, which would have severely impacted their community outreach from CCWB to their free breakfast program.
“All the projects that we do would’ve been impacted profoundly by those bylaws,” Bell said. “We strongly opposed them at a series of meetings with the mayor just to indicate how ridiculous that concept actually is.
“Our last resort was to say to him, ‘Go ahead. Put the bylaw in place and I’ll tell you what I’m going to do tomorrow morning. I’m going to take an 85-year-old parishioner, put a sandwich in her hand and get her to stand in front of Trinity and give it away, and I want you to come and arrest her.’”
“When I mentioned that on Sunday morning, I had so many volunteers,” he adds. “The grandmas just said, ‘I’ll go and do that.’ Most of those programs are run by people who have just retired and who might be in their eighties. Our breakfast program is all staffed by pensioners, basically. That’s the reality of it. The politics of that for the city is pretty embarrassing, to put it mildly, because that is the reality of who really cares.”
Church support essential for clinic
Since the controversy over the bylaw amendments, CCWB has continued to offer its services to the community.
Many parishes across Canada have parish nurses, who integrate faith and health by providing pastoral care and prayers as well as health advocacy, counselling and education.
Bell says numerous parishes in the Anglican diocese of Toronto have had a parish nurse at one time or another.
Nurse practitioner-led clinics operating out of churches, on the other hand, are more rare. Similar services to CCWB, Bell says, have been offered in Toronto at All Saints and Church of the Redeemer through their outreach programs.
Deb Belowitz, a parish nurse at St. Mark’s Anglican Church in Brantford, Ont., recalls a clinic at St. James Cathedral in Toronto where a parish nurse worked. However, she says the position was essentially “administrative” and notes that unlike nurse practitioners, “a parish nurse by definition cannot provide physical care at all.”
Neither Flood nor Brown were aware of similar clinics providing physical care run out of churches. Any nurse practitioner-led clinics Flood knew of were led by a physician or team of physicians who bill the Ontario Health Insurance Program (OHIP) and pay their staff salaries, whereas nurse practitioners are unable to bill OHIP for their services.
While CCWB has no real funding, Flood says the clinic has received donations; one local company, for example, gave them medical equipment worth $4,000 for free. The clinic is also looking into other funding options. She says the physical space provided by Trinity has helped make the clinic’s operations possible.
“Through the generosity of Trinity Anglican Church and the space they’ve provided us for free, we have been able to volunteer our time and Brenda’s skill,” Flood says. “If we had to pay rent and/or utilities we would not be able to do what we do.”
Brown concurs. “Trinity has provided a unique opportunity to dispense basic health care services to individuals who find themselves homeless, marginalized, or as refugees,” she says. “The clinic space at Trinity allows us to provide privacy to our patients and hopefully some dignity at a minimal cost.” She says she hopes that they might be able to hire another nurse practitioner or a social worker if the clinic is able to secure funding.
The clinic may soon expand its services beyond Monday mornings. “I’m hoping Brenda will retire at the end of August and then we’ll be able to offer more hours,” Flood says. “Right now we’re confined by what hours she can work.
“If we can open it up, I am hoping we can have almost an open house and really advertise the service and bring more awareness to it starting in the fall,” she adds.
‘We are here to love everybody’
For Bell, Trinity’s support for CCWB reflects the call to love everyone that is central to Christian ministry.
Initially after the clinic’s establishment, Bell says, some local people were fearful about CCWB, confusing it with an unrelated initiative in Barrie to provide a safe-supply site. Brown says the clinic has provided medications for hypertension, diabetes, chronic obstructive pulmonary disease and asthma, as well antibiotics for infections, but it does not prescribe opioids or benzodiazepines. If psychiatric medication is requested, CCWB first sends patients to a psychiatrist for assessment and orders the needed blood work.
“There’s a big debate about narcotic use and user centres and drop-ins,” Bell says.
“Folk seem all too willing to stoke fear through disinformation when it comes to addressing the needs of vulnerable people in our community and it is generally politically charged,” he adds. “But it was very easy to resolve through me addressing it in the services on Sundays and following up with folk in person.”
“There’s a synergy of values between Trinity and Compassionate Care because we’ve been trying to do the same thing … At the end of the day, that’s also saying we are here to love everybody,” Bell says. “We have a particular community of need who we touch base with every day, but we are here to love everybody.”
In a recent service, Bell compared grace—God’s benevolence to humanity—to dropping a pebble in a pond, which causes ripples to emanate outward.
“I think Compassionate Care does that because it’s not just Jo-Anne and Brenda, but the people who receive that grace from them and compassion from them, [who] themselves become another ripple in somebody else’s life of compassionate care…
“I think it changes the nature of the broader community in which we work and live in that it said, ‘They can be compassionate. Why can’t we? They can be gracious. Why can’t we?’ That theological conversation in the city is really important.”
CCWB appointments can be made by email at [email protected] or by calling 705-417-2763.
