Q&A with Laura Garcia, CRNP 

After earning her Master of Science in Nursing from Johns Hopkins University in 2014, Laura Garcia quickly made the move to Health Care for the Homeless and never looked back. Starting as Family Nurse Practioner, Laura was promoted to Director of Adult Medicine in 2016. Over the last two years, Laura led our medical staff through the transition to telehealth and the launch of COVID screening, testing and vaccination clinics at our largest clinic site. In February 2021, she stepped into the Senior Medical Director position at Fallsway.

This August marked your seven-year anniversary at Health Care for the Homeless. What ignites your passion for this work, and what lessons have you learned along the way?

I always wanted to do public health. The Peace Corps really solidified my passion for prevention, because being in the hospital as a patient is really horrible. Watching people get preventable diseases such as dysentery and knowing that this was the result of a lack of access to relatively basic resources was difficult. I continue to be motivated by the idea that everyone deserves access to knowledge and resources to stay healthy. I was always more interested in serving vulnerable and underserved populations, and I knew that Health Care for the Homeless understood the complexity of what clients are facing each day.

One of the most important lessons I’ve learned is to slow down. It's a difficult skill to practice, but there have been so many times over the past seven years where I made an assumption about someone so I could get to the next client waiting outside. I’ve learned that I need to be patient in that space, slow down and listen. There is just so much I don't know about other people's lived experience. Being able to meet people where they are and experience that with them has been really key for me.

How is your new role distinct from your previous position as Director of Adult Medicine?

As Director of Adult Medicine, it was my responsibility to oversee primary care for adults at our Fallsway clinic; now that’s expanded to include pediatrics and psychiatric occupational therapy. Over the last four years, I worked closely with Dr. Iris Leviner, Director of Pediatrics & Family Medicine, to make sure that we were delivering good standard of care across our adult and pediatric services. Now, as Senior Medical Director, I’m overseeing those operations, too.

I also oversee our Medication Assisted Treatment (MAT) program, which is going through some exciting development right now. In April 2020 we had 64 clients enrolled in the MAT stabilization program; as of Sept 30, 2021 we have 185 clients enrolled. The program has evolved over the last year and half, which has allowed more clients to participate. We now have a walk-in model with a provider and two nurses staffed daily, which has drastically increased access, and that’s really encouraging. 

You oversaw the agency's safe transition to telehealth and COVID services during the pandemic. How did that change your approach to client care, and where do things stand now?

It took a highly communicative approach across the agency to implement changes during those early days of the pandemic. From a medical perspective, delivering telehealth services is very different from anything we do in the clinic, and that posed a real challenge, especially in the beginning. With telehealth, when someone says “I have this rash on my leg,” it’s often difficult to know if that is actually a rash or a very concerning infection. There became a serious risk-benefit analysis in determining what’s more life-threatening to clients, the condition or COVID-19.

Throughout the pandemic we have continued to have regular provider meetings, and that allows space for us to share and adapt our approach. We are all learning and re-learning together and that’s vastly improved our ability to adjust with changing safety guidelines. Every interaction with a client is worth a thousand words, and I’m grateful to be having those face-to-face meetings again.

How is racial equity and inclusion influencing your approach to this new role? What REI issues and opportunities are you looking to explore that will improve client care at Fallsway?

I am working on integrating an REI lens across all aspects of my position with respect to patient care and with staff. My first step is focusing at the beginning, with hiring practices, then transition to being intentional about creating a culture within the agency that actively supports and promotes an integrated racial equity approach. Secondly, we need to start discussing the impacts of race on patients’ health and wellbeing and start to think about how to change delivery of care. I believe the harm reduction model will be crucial in helping guide this process.

And is it true you speak advanced Berber? What inspired you to learn such a regional language?

During my time with the Peace Corps, I was a health volunteer in Morocco, though at that time I had no direct experience in health care. I did a number of things related to health education and project management, including health and leadership education programming for children and adults throughout my region. That’s also where I met my husband—he was a Peace Corps volunteer right up the road from me. That time dramatically transformed my life: it gave me my family and my career. 

What other hobbies or passions are filling up your free time these days?

I have a three-year-old, so there's a lot of Mickey Mouse Clubhouse—honestly, I never thought there would be quite so much Mickey Mouse in my life again! We are all trying to enjoy the outdoors as much as possible, hiking through Shenandoah National Park and visiting the playgrounds with my son. I try to balance my work time and still leave room to decompress with a good book.  

Be sure to congratulate Laura when you see her next, at Fallsway or out on the Shenandoah trails