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Ensuring safety net health doors are open to all: Carolyn Downs Shelter Nursing Program

Bernie Creaven, a Community Health Nurse for over 15 years, understands how hard it is for families living in shelters to manage chronic disease, but when she witnessed the additional suffering her diabetic patients from the Republic of the Marshall Islands experienced, she "couldn’t leave it alone."
She learned how a lack of access to healthcare benefits was a main reason why these patients were struggling even more - some had their legs amputated because they couldn't afford medications and co-pays. They were afraid of losing the little they had.

Bernie did what all great community health nurses do—listen to patients and collaborate with community groups to change policies that prevent vulnerable people from living healthy lives.

She relentlessly raised awareness alongside the Children's Alliance, the Washington State Commission on Asian Pacific American Affairs, and many other individuals from the Marshall Islands.

Their efforts got the attention of Washington state Senator Rebecca Saldaña who ultimately sponsored the bill that will grant health insurance coverage to some Marshall Islanders.

Learn more about Bernie's efforts and the Marshallese community.

HCHN Nurse Bernie Creaven (left) and Sen. Rebecca Saldaña celebrate after a legislative victory.

HCHN Nurse Bernie Creaven (left) and Sen. Rebecca Saldaña celebrate after a legislative victory.

Christina Enriquez, Public Health nurse retiring after over 30 years of service

Christina Enriquez, Public Health nurse retiring after over 30 years of service

Many miles to support First Steps: Public Health's Parent Child Health Program

Transportation and cost are concerns for all newly expecting parents in rural areas. For those experiencing homelessness and housing instability, satellite clinics and home visits from Public Health nurses are crucial free services that help ensure every baby is born healthy and every parent is well-supported.

Christina Enriquez and Mary Tuncil are part of the Auburn Public Health Center team that operates Maternity Support/Women Infant & Children (WIC) satellite clinics every week in Enumclaw and on the Muckleshoot Tribal Reservation.

Their work begins with respect and understanding how homelessness in rural and tribal communities differs from more urban and suburban areas.

For Mary, supporting families in Enumclaw often means working across county lines to help families stay enrolled in health and social programs as they move back and forth between King and Pierce counties looking for housing and work.

For Christina, supporting families in Muckleshoot means working with the tribal government and elders to supplement the services the tribe directly provides for their members. Christina describes this as "repair work" that requires on-going relationship building, respect for sovereignty, and demonstration of trust.

Over 150 families experiencing homelessness and housing instability were served at our satellite clinics in King County's rural areas in 2017.

Flexibility and Focus:
HealthPoint's Shelter Nursing Program

The trust that we build out in the community is then the bridge into our clinic and to other community providers."
- Kim Hess

Kim Hess, Sonja Stendal, and Laura Aguilar deliver motivation, nursing care, and enroll clients in benefits at over 20 sites throughout King County.

Adapting to change is a skill this team has mastered over the past 15 years. Changes in the emergency shelter system have provided an opportunity for the team to build new relationships with the many day centers that have opened around the county.

Sonja Stendal meets with a guest to provide blood pressure screening at the KentHOPE Day Center

Sonja Stendal meets with a guest to provide blood pressure screening at the KentHOPE Day Center.

Day centers, like the KentHOPE Women and Children's Center, provide access to more guests and offer a trauma-informed environment where guests can approach the nurses as they choose.

These HealthPoint nurses have also developed a partnership with the Hepatitis Education Project. Project staff come to the day centers with the HealthPoint team and provide Hepatitis C screening while the nurses offer Hepatitis A and B immunizations. These new partnerships allow the team to deliver patient-centered care at new venues where they can serve as county-wide resources for health and communicable disease.

What keeps me coming back each day are the clients. Their thankfulness and knowing I've made a positive difference in their lives no matter how small."
- Sonja Stendal

Mobile Medical Program:
Seattle & South King County

Curbside consults to people living in cars and tents. Triage visits with tiny home village residents. Linkages to walk-in and scheduled care at partner clinics. These are three of the many creative ways our Mobile Medical team engaged over 1,400 people in 2017.

Outreach and relationship-building continue to be the keys to the program's reputation as a trusted source of high quality medical, dental, and behavioral health care. Faith-based organizations and community-based meal programs continue to be essential hosts and partners.

New sites reflect new strategies to address our local homelessness crisis. In Seattle, these include partnerships with the 24-hour Navigation Center and several sanctioned encampments. In South King County, new Day Centers in Auburn and Federal Way provide opportunities to engage individuals staying outdoors.

The Mobile Medical team also closely monitored trends and expanded availability of overdose prevention tools like Naloxone and immunizations and vaccines against communicable disease.

Follow where the Mobile Medical team travels:

The goal of outreach is to make a connection. I want someone to know I'm not walking around in a starched white coat, but a safe person.. that when someone is ready for help, they can get it."
- Dr. Shay Martinez, Mobile Medical Program

Connecting back to community:
Impact of the Mobile Medical Program

This is the first time in twenty years that I have addressed my health."

M.H. is a 56-year-old Veteran from South King County. Like many individuals who experience homelessness, giving back to the people that lent a helping hand is important to him.

He has been a trusted volunteer at New Hope Christian Fellowship, a Mobile Medical Program host site in Kent, for nearly a decade. He first stepped on the van for a flu vaccination and then later developed a connection to the Mobile Medical social worker, Sarah Reed.

Together, they began to navigate the healthcare system and address the common, but complex, health issues that build up after being disconnected from care and community.

Sarah and M.H. have worked together for over six years, during which time they focused on benefits enrollment, linkages to primary, dental, and vision care, coordination of emergency and specialty care, and much more.

Sarah continues to provide an equally important service: non-judgmental support and encouragement. This support is crucial as M.H. faces serious health challenges that are limiting his mobility - but not his ability to give back.

M.H., volunteer at the New Hope Christian Fellowship and Mobile Medical Program client

M.H., volunteer at the New Hope Christian Fellowship and Mobile Medical Program client