How two sisters from Ecuador became Westchester executives

It’s more than simply a feeling of compassion that Andrea Ruggiero and Grace Battaglia share for the young immigrant children they see filling the waiting rooms at Open Door Medical Centers.

It’s a sense of déjà vu.

Open Door Family Medical Centers provides primary care, dental care, integrated behavioral health services, clinical nutrition, wellness programs and chronic disease management every year to nearly 57,000 children and adults who might not otherwise have access to health care. Many of these families are Spanish speaking from Central and South America.

Flash back to the early 1990s. This is when eight-year Andrea and five-year-old Grace Beltran, pretty dark-eyed sisters who recently arrived with their parents from Ecuador, were first introduced to Open Door in Ossining for their checkups and sick visits. Speaking little English, they lived with their parents and assorted relatives in a tiny walkup apartment above a bicycle shop in Chappaqua. Their parents had chosen this affluent town because they wanted to give their girls the best chance at a quality education and a better life.

“They really made it a priority that we lived in a town with one of the best school districts, even though there were challenges because the rent may have been higher and the family had to share a bedroom,” says Grace, who today is Director of Marketing at Open Door.

“I think it was challenging in that our friends had more, but we were never really made to feel that we were different,” says Andrea, now Vice President, Community Health for Open Door. “We always felt included. The community was always kind to us.”

They were the only Spanish-speaking children in their school, taking ESL classes with one other student, a Japanese boy. It was at this time that their parents started a housecleaning service. During the summers and after school the girls would occasionally help out – Grace remembers helping her parents clean the spacious home of a classmate. Their parents bartered cleaning services for their own English lessons with the school’s ESL teacher, bringing home children’s workbooks that their daughters would pour over with them. In the summers, with their friends at summer camp and their parents at work, the girls spent most days at the library where they read books and took advantage of the air conditioning.

“You can’t allow these things to define you,” says Grace. “You are defined by how you handle those circumstances rather than the circumstances themselves. We knew that one day we would have the opportunities that everyone else had. We were always of that mindset.”

Open Door became a constant in their lives, even when they moved several years later to a bigger apartment in Armonk. They grew attached to their Open Door pediatrician Dr. Romulo Guzman, who worked in the Ossining site. Later, as teenagers, when their father started to show signs of a form of muscular dystrophy that would eventually leave him unable to work, the girls served as his interpreters when he visited his Open Door physicians.

“Grace and I always had each other for support, we always had each other at the end of the day,” says Andrea, who is a little more reserved than her ebullient sister. “We never really felt alone. I don’t know what we would have done without the other.”

After graduating high school, Andrea attended Manhattanville College in Purchase, commuting from home as “Our dad never really wanted us to go far away. We were not allowed to sleep out of the house.” She always had a strong sense of giving something back to others. Graduating with a degree in psychology, she got her first full-time job in a place that was familiar to her – at Open Door, working as an HIV case manager.

“This was 2004, and I absolutely fell in love with that program and the work that was being done at Open Door,” she says. “A lot of the work I did was around care coordination. It was about providing wrap around services to patients who needed the extra support. Whether it was through patient advocacy or case management, it was about making sure patients had everything they needed to have a better chance at success with in their health care needs”

This meant exploring her patients’ housing issues. Helping them afford their co-pays. Looking at food insecurity. In short, she was responsible for putting in place the support systems that would allow patients to focus on their health.

Not everyone in her family was happy with her career choice. “My father was furious with my degree; he had always wanted me to be a lawyer,” she recalls. “He said, ‘What are you doing to do with that degree? You are never going to make any money.’”

This did not seem to be an issue with her sister. After choosing not to attend NYU at the 11th hour – and leaving school weighed down with student debt – Grace too received a scholarship to enter Manhattanville College. She majored in finance, graduating with a near perfect GPA, and a lucrative job offer from a financial lender to work in marketing.

“The job required a lot of traveling – it was very isolating and I found finance to be very dry,” says Grace. “It just wasn’t fulfilling to me. I needed more.”

Several months later at Andrea’s wedding she met Lindsay Farrell, Open Door’s president and CEO.

“Obviously I knew about Open Door. I told her what I was doing and that I needed a change,” says Grace. “Lindsay said, ‘You need to be at Open Door.’ I was 21, and I figured if there was ever a time to make a change it was now.”

Shortly thereafter, Grace accepted a job as a paid intern for four months at Open Door – taking a significant pay cut. In this role, Grace was responsible for conducting community outreach. She recalls the first program she ran, which involved educating new mothers on caring for their babies.

“It was then that I realized how happy I was working with vulnerable families; it added a whole new meaning to my life,” she says. “I absolutely loved doing this and it made so much sense to make this into a career.”

Andrea was not surprised that her sister joined her, believing it was only a matter of time. “I knew how happy I was working here and how unhappy she was working in the for-profit sector,” says Andrea. “It felt very natural and it was obviously great to have my sister in the same environment as I was working in. We never missed a beat.”

The Beltran sisters are not the only Open Door employees to first experience the organization as young immigrants. Dr. Carmen Tamayo, now the medical director of Open Door’s Mount Kisco facility, was eight when she and her younger sister, Margarita, an outreach coordinator, became patients when their family first migrated from Colombia, fleeing civil war, chaos and corruption. Years later, while studying for her medical boards and applying to residency programs – she would eventually complete a family medicine residency in a program partnered by Open Door and Phelps Hospital – she credits Open Door for helping her mother find the proper treatment and manage the expenses in her successful fight against non-Hodgkin’s lymphoma.

A Different Organization Today

The Beltran sisters realize the Open Door they work in today is very different from the one they saw as little girls coming in for physicals and sick visits. “Our patients get comprehensive care,” says Andrea. “They might come in for sick visit, but leave with appointments to WIC (the state’s Women, Infants Children program), or optometry, or our licensed clinical social workers. People sometimes think it’s just a place to go get a flu shot or a physical. The number of services provided in these buildings is unbelievable. ”

Founded as a free clinic in 1972, Open Door’s mission of building healthier communities through accessible, equitable, culturally competent health care has led to site and service expansions. Today, the organization operates centers in Brewster, Mamaroneck, Mount Kisco, Ossining, Port Chester, and Sleepy Hollow, in addition to seven school-based health centers in the Port Chester and Ossining school districts, a mobile dental van in Mount Kisco, and a new dental practice in Saugerties.

Andrea, now 36, and Grace, 33, who have been with Open Door for 15 and 13 years, respectively, are married – Andrea to an attorney, Grace to an executive in a family real estate company – and each is the mother of two young children. Interestingly enough, the sisters who once lived in small apartments with their parents in Chappaqua and Armonk, live with their families in homes they own in these two towns.

“Those who work at Open Door are all dedicated to helping educate and empower our patients to take care of their health, assuring a more equitable healthcare system for all of us,” says Farrell, who has been president/CEO of Open Door since 1998. “Having experienced Open Door as both young immigrants who were patients and now as senior executives who help develop our programs and policies, Andrea and Grace, like Dr. Tamayo and Margarita, have the added perspective of witnessing the value of our work from both sides of the equation.”