February 24, 2024: Exciting Update on Medical Respite from the State!

 

Health Care Authority Rulemaking Notice You are receiving this notice because you signed up to receive alerts for any rulemaking that occurs to one or more of the following rules. Preproposal - Statement of Inquiry (CR101) WAC 182-551-2230, Electronic visit verification (EVV) - System requirements To read the filing notice, see WSR 24-05-023 New Chapter 182-140, Mobile rapid response crisis team – Standards for endorsement  To read the filing notice, see WSR 24-05-041 WAC 182-527-2742, Estate recovery - Service-related limitations To read the filing notice, see WSR 24-05-076 Chapter 182-551, Alternative to Hospital Services, new subchapter IV  - Medical respite program To read the filing notice, see WSR 24-05-081 Proposed Rule Making - Public Hearings (CR102) HCA holds virtual public hearings. You must register in advance for this hearing. WAC 182-538-070, Payments, corrective action, and sanctions for managed care organizations (MCOs) To read the filing notice and view the proposed rules, see WSR 24-05-051 Rules pertaining to the 340B program WAC 182-530-1050, Definitions WAC 182-530-7000, Reimbursement WAC 182-530-7250, Reimbursement - Miscellaneous WAC 182-530-7300, Reimbursement - Requesting a change WAC 182-530-7900, Drugs purchased under the Public Health Services (PHS) Act WAC 182-530-8000, Reimbursement method - Actual acquisition cost (AAC) WAC 182-530-8100, Reimbursement - Maximum allowable cost (MAC) WAC 182-531-0050, Physician-related services definitions WAC 182-531-1200, Physician office medical supplies WAC 182-531-1450, Radiology physician-related services To read the filing notice and view the proposed rules, see WSR 24-05-054 Adding associates and community behavioral health support services provider facilities to eligible provider types and removing duplication WAC 182-502-0002, Eligible provider types WAC 182-531-1400, Psychiatric physician-related services and other professional mental health services To read the filing notice and view the proposed rules, see WSR 24-05-063 Permanent Adoption (CR103P) WAC 182-526-0210, Appeals requested by Intermediate care facilities for individuals with intellectual disabilities (ICF/IDD) To read the filing notice and view the permanent rules, see WSR 24-05-078 Expedited Rulemaking (CR105) WAC 182-543-5700, Medical equipment for clients in skilled nursing facilities To read the filing notice and view the proposed rules, see WSR 24-05-029

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February 2024: New Resource Family Promise of Pierce County

Staying connected and forming partnerships are crucial to Family Promise's mission. Feel free to share with others to experience what it can do:

https://familypromisepiercecounty.org/matrix

We encourage you to reach out to us in any way you feel 
comfortable:

•       Visit our website: https://familypromisepiercecounty.org
•       Follow us on social media: https://instagram.com/fppiercecounty/
•       Volunteer your time: https://familypromisepiercecounty.org/get-involved
•       Make a donation: https://familypromisepiercecounty.org/donate

Even if you cannot volunteer or donate at this time, simply spreading the 
word about Family Promise and our work can make a significant difference. 
Sharing our mission with your friends, family, and colleagues can help us 
reach more families in need.

Thank you again for your interest and support. We look forward to staying 
in touch and partnering with you to make a difference in the lives of 
families experiencing homelessness.

Steve Decker
CEO - Family Promise of Pierce County
253-444-4563 x391 (you can even send SMS text to our main number to reach 
me)
Calendar to connect: 

https://calendar.google.com/calendar/u/0/appointments/schedules/AcZssZ3UwEofeWp4YM9DzBzVXj52irYqyvYwCtG8oOMTv0_9fMYdyzsv5UiTYkgXgPtGCVWwJEllv8ND

2024: New Year-New Hope

 It is wonderful to start 2024 with great news! I wanted to include the newest resource that is literally at our finger tips! Family Promise of Pierce County has been officially formed through the efforts of a local pastor and her mighty staff and volunteers. 

In an effort to support families in our area experiencing housing insecurity and homelessness, please see the resource link, below:

Family Promise of Pierce County (https://www.familypromisepiercecounty.org/) has been born out of  Safe Parking efforts and the continued need for families experiencing homelessness or housing insecurity to secure resources to get themselves out of homelessness. There are many resources available for our neighbors in need and the caseworkers that help them.

Please take a look at this website and note that should you come across ANY person experiencing homelessness, this resource can be pivotal to bringing the necessary resources to the person in need.

Here is a link to an intake form that can be filled out and populates individualized resources to the person in need:

https://www.familypromisepiercecounty.org/intake

The intake has several different languages to give our English Language Learners  an ability to complete in their language. Once filled out, my understanding is resources will be populated to the resources available to the individual or family in need.

There's lots more coming. Let's hope more solutions will be born out of the continued efforts to combat homelessness.Together, we CAN help our neighbors in need.

Update: 6 Month Recap 2023

Some of you know I have been out of the loop for a few months. Thank you for persevering in the midst of some very difficult circumstances, grief and trauma. I wanted to circle back with you to let many of you know that there remains commitment to caring for our populations living in vulnerable states (ie, homeless). Many persons working in the government and private sector have continued to work hard to provide for our vulnerable neighbors. They deserve recognition even though most don't want it. I wanted to share some good news and resources that have come about due to the faithfulness and commitment of those of you who have prayed or worked directly alongside our homeless communities in need over many months and years: 

• January to June 2023: Twenty four nurses enrolled in the UWT BSN program were trained alongside homeless advocates, such as Paula & Lisa (Cornerstone Respite), Laureen (Elevate Health-Medical Respite Steering Committee), Janet (Medical Reserve Corps, Tacoma Pierce County Health Department), Gerald (Brotherhood Rise), Jay (Lived Experiences), Elliot (Greater Lakes) to research and provide evidence for the need for medical respite for homeless populations
•  Anton of Northwest Hospitality in Kitsap County has been helping train Olympic College Nurses in this area to care for homeless populations as well. 
•  Gerald of Brotherhood Rise in Tacoma is in the midst of providing a Tiny Home Village near St. Joseph's Hospital after receiving funds from a government grant 
• Duke of Tacoma Rescue Mission has been involved in moving forward on a Tiny Homes Village that appears to be getting closer to a reality: https://www.kiro7.com/news/local/plan-build-permanent-tiny-house-village-pierce-county-takes-another-step-forward/RKXEQYTCBJHVXO4A75UXZ7MD6Y/ 
•  Paula and business partner Lisa of Bridges of Hope have successfully provided care and advocacy for many homeless residents needing medical care through their Cornerstone Respite. Over $1000 and personal items from my husband was donated on behalf of my late-husband to this cause. 
•  Janet and Verna, Medical Reserve Corps nurses, along with Pacific Lutheran University nursing students have successfully been providing weekly foot care for nearly 10 months to the homeless residents of Tacoma Rescue Mission and Nativity House. 
•  There have been inclement weather listservs and weekly check-ins arranged by Tacoma Pierce County Health Department, Tacoma Pierce County Homeless Coalition and Lived Experience members where our neighbors living homeless have community members checking in on them and providing resources as needed. 
•  Numerous churches have stepped up to provide safe parking shelters for persons living vulnerable (not mentioning directly due to ensuring the vulnerable populations stay safe). More is needed, but there is action happening! 
•  There is a service provider involved in making a medical respite facility a reality-more to come-stay tuned! 
•  Please see the link for the new Homeless Outreach website from the Tacoma Pierce County Public Health Department-It is excellent. Jennie S. of Tacoma Pierce County Public Health Department and many others have been involved in creating the following website to help any of us in the community to help person living homeless-please review: 
•  New website for homeless service providers and advocates: 
• https://tpchd.org/healthy-people/provider-resources/homelessness-providers-toolkit/
• https://www.piercecountywa.gov/4118/Resources

Nov 29-Dec 2, 2022 Inclement Weather Meetings-Pierce County

An inclement weather group has been formed by a member of the Lived Experiences Coalition in partnership with many others in our community, such as many Pierce County employees trying to create sustainable solutions for our residents living unsheltered especially during this time of inclement weather.

Many may already be aware of these efforts. For those interested, please consider attending one of these scheduled meetings via zoom from 9-9:30 am the remainder of this week to learn what's needed and what's being done to meet the needs of our vulnerable neighbors. I'm including the invite in case you were unaware of these events and to continue to ask for prayer: 

Join Zoom Meeting Daily until Dec 2 from 9-9:30 am https://piercecountywa.zoom.us/j/95416584180 Meeting ID: 954 1658 4180 Dial by your location +1 253 205 0468 US 888 788 0099 US Toll-free Meeting ID: 954 1658 4180 Find your local number: https://piercecountywa.zoom.us/u/ab3ZhMWNFr

There are many in our community banding together to care for the most needy within our community and this is another attempt to organize efforts and materials to provide shelter and care for these persons experiencing homelessness, especially those without shelter. 

Keep in mind, there has been up to three times the need for shelter than we have available:

• https://www.piercecountywa.gov/7405/Homelessness-in-Pierce-County#:~:text=As%20of%20July%202022%2C%20there,in%20Pierce%20County%20experiencing%20homelessness. 
•  https://www.piercecountywa.gov/CivicSend/ViewMessage/message/19092 

If you have a need or something to share, please follow the link below to view what's needed and what has been donated to help: https://docs.google.com/spreadsheets/d/10Ec_bw5KKsFQidzRN7XkM6yea6vHzD0Yf0m5IfjgdpU/edit?usp=sharing 

Thank you for whatever you can provide, physically or spiritually. And thank you to those who continue to seek solutions.

November 15, 2022 Update

We welcome & encourage the following partners to our efforts to care and serve our unsheltered neighbors. Please offer prayers for these additional individuals and their organizations who daily serve our community's most vulnerable neighbors: Update from Kitsap County & NW Hospitality's Annual Fundraiser, held Nov. 4: 60+ fantastic supporters were able to join Anton and NW Hospitality for a fantastic party. Together, through all the planning and buildup, they raised $18,175.22 of their $25,000 goal and it’s not too late to donate to get us even closer! 

• Update from Pierce County: Ideal Option 
• https://my.idealoption.org/recovery-starts-here/?utm_source=G_S_B_WesternWA&campaignid=10097137430&adgroupid=101495901036&adid=522203714545&gclid=CjwKCAiA68ebBhB-EiwALVC-
• Rebekah has continued to search for and get women at risk off the street and into recovery. Sometimes she finds others in need: This week, please pray for a gentleman ("Mark") who was living in the area of 152nd & Pacific and was unable to walk due to swollen, wounded lower extremities. He was asked to "move" despite his health challenges and declined medical services at a healthcare facility as many frequently do. We have not been able to locate him since Wednesday, Nov. 9 and our hope is he reconsidered seeking services in a healthcare center and may be receiving care there now.
• Brotherhood RISE, located on 23rd & MLK in Tacoma, directed by Gerald Daniels. Brotherhood RISE serves the community of Hilltop through the provision of meals, services, and support. (https://www.risecenterofhilltop.org/). Another gentleman who has been chronically homeless, confined also to a wheelchair and weakening was discovered by Brotherhood RISE caseworkers and later transferred to a facility where shelter was provided; no "on street" care was provided because care was provided through another service provider. 
• Spanaway United Methodist (http://spanawayumc.com/) Pastor Samara Jenkins and husband Antwone serve our most vulnerable neighbors in the Spanaway and Parkland areas. We had a scare this week when Sheryl (of Comprehensive Life Resources) reached out to me and our Parkland Davita social worker, Shelby, when our homeless dialysis wheelchair-bound gentleman (Jorge) had "gone missing." We found him "alive and well" at Pastor' Samara's United Methodist church. He had been robbed again (which included his cell phone so no contact was able to be made with him), but was in good spirits and physically appeared to be improving as he reported his kidneys were "working again" (cannot confirm this, but it was great to hear he was feeling better and safe within the church's shelter). Additionally, we also learned that Pastor Samara has been able to provide shelter for 12 other individuals, 7 of whom were children in addition to Jorge within her church! 

These organizations know the personal stories of many who are living on our streets and I ask that you continue to pray for them and others serving now especially as our weather changes and it becomes cold and dark.  Pierce County officials are also combining efforts to alert advocates such as Rebeckah, Gerald, Samara, Antwon, and other case workers of inclement weather which increases the safety and health risks to our unsheltered neighbors. Through this organized, systematic approach AND your prayers, the three examples noted above have been able to have needs met in impossible circumstances. Please don't stop prayer intentions for all of those--known and unknown--on the street and for those committed to serve them as well. This work takes its toll and there are workers right now who need direct prayers for healthy minds and bodies to continue to serve. Please don't stop praying. God listens and responds!

November 2022 Update

Thank you for your continued prayers for our Medical Reserve Corps Nurses, outreach caseworkers from CLR & TRM in Pierce County, the HEART team and NW Hospitality in Kitsap County, as well as other 'unsung heroic volunteers' who continue to seek & search daily for our unsheltered neighbors, especially as the weather drastically changes to cold and wet conditions. 

The Pierce County Medical Respite Steering committee, led by Elevate Health, have announced the application for NOFA funds for anyone interested in being the owner or operator of a Medical Respite non-congregate shelter: Application and required attachments are due by 4:30 pm on November 18, 2022. All materials can be found on the Pierce County Human Services website at: https://www.co.pierce.wa.us/2779/Solicitations-and-Competitive-B. Additional solutions are being looked at outside our state. 

Brett Feldman, a Los Angeles practitioner, and his wife are making a difference in the provision of healthcare for homeless populations. Please review the following if interested in creative ways for sustainable solutions & pay attention to the degree of compassion that our unsheltered neighbors have for others as well in Brett's example that he provides in the following article: https://invisiblepeople.tv/street-medicine-bringing-healthcare-to-the-homeless-community/. 

Brett articulates much of what we all know intuitively is happening within our society as we struggle to meet the medical needs of this population. Thank you for continued prayers and work towards solutions. Data is continuing to be collected on individuals & situations related to medical needs within our unsheltered community in an effort to advocate for those who frequently don't have a voice.

October 2022 Updates

Many events have transpired in the past couple weeks and wanted to provide updates. Medical care and consultation are still being provided to our unsheltered neighbors. Education on the needs of our most vulnerable populations is being provided to community members in support of efforts being made to care for them. Foot care clinic continues every Thursday from 9-12 at the Tacoma Rescue Mission by the Medical Reserve Corps Nurses. Six unsheltered residents were served this week. Any nursing or medically-minded students can join MRC to help with providing medical or healthcare: http://piercecountymrc.org/. 

A 33-year old homeless female was bit by a stray dog and sustained deep muscular wounds in her lower extremity and hand which required assessment and cleansing.She received treatment for potential rabies, but could not get back to the hospital for her second round of injections. She appeared to be at risk of losing her hand due to impaired circulation. TRM outreach workers have been working very hard to find emergency housing for her and her male partner due to her inability to walk secondary to the injury sustained. They remain vigilant in following up on her weekly. TRM provided an excellent presentation to Tacoma Community College Human Services students on the many services and resources they provide to our vulnerable neighbors. 

GOOD NEWS: THERE ARE SOLUTIONS AVAILABLE I reached out to Brett Feldman, a PA-C and director of street outreach in LA. This medical director has been providing street outreach medical care since 2007 and this medical care has now been included as a medical benefit in MediCal medical insurance. See here for one of his webinars: https://nhchc.org/webinars/promoting-safety-in-street-outreach/

He has also provided a clinical tool for taking a history on an unsheltered homeless patient:

https://osf.io/ucve9/ 

I have invited Brett to present at a Medical Respite Steering Committee at a later date. He supports all our efforts and affirmed that this is how they started in LA and now they are able to connect and consult with many other providers in the healthcare community and even get reimbursed for services! 

 Tacoma Rescue Mission and Pierce County council members have vision on a new model that appears to be successful in Austin, Texas. I can vouch for this model first-hand because I visited Austin, Texas a year ago and walked the city, amazed at the lack of encampments and tents in such a big city. At the time, I was unaware of how a city that big could have little evidence of chronically homeless encampments anywhere. I found out why when I watched the following video: (https://thesubtimes.com/2022/10/18/a-community-of-hope-for-pierce-county/). 

If you notice in the video, mobile loaves and fishes (https://mlf.org/) appear to be part of this solution and I shared the work of MLF a few months back. It appears their efforts are effective which is GREAT TO SEE! There are other similar models that I have shared that work--the only barrier to solutions is a lack of faith that systems cannot be changed! 

Your prayers ARE working; please continue to keep our county officials, TRM and anyone else helping towards solutions in your prayers. They ARE WORKING! Thanks to all of you who are "unsung heroes" in the background--your efforts are NOT wasted and the LORD bless and keep you--He sees all you do--THANK YOU! Keep up the great work!!!

September 2022 Updates

Sept. 23, 2022 Saint Augustine writes in his Confessions, “You have made us for yourself, O Lord, and our hearts are restless until they rest in You.”

I’m restless as I hear of another unsheltered neighbor dying behind a Walmart only 1 day after discharge from an area hospital. 

Updates this week: 

• Kitsap county: 50 people displaced after an arsonist set fire to a motel in Bremerton: https://www.q13fox.com/news/many-seeking-medical-attention-after-bremerton-motel-fire Please continue to pray for the HEART director and his team as they try to relocate these individuals.
• Central/Downtown Pierce County: Medical Respite Nurses provided footcare yesterday to unsheltered residents at Tacoma Rescue Mission and identified one resident who averted going to the ER by referring him to Sea Mar for care. 
• East Pierce County: Cornerstone Hospice/Respite has recently opened up as a potential option for the unsheltered residents at the end of life. This facility is in Graham. Donations are appreciated. Inquiries? Send messages to andepaa12@msn.com. Note: Referrals need to come from a hospital or program that can compensate for care. 
• West Pierce Couny: Options for housing in east Pierce County can be sought out through Westwynd motel and apartments are located in Purdy. Monthly nightly and extended motel options are available and there are apartments, full housekeeping services. Frequently booked, but worth a try if you find someone desperate for housing. See below for information: www.westwyndmotelandapartments.com "Michelle" is the Office Manager, 253-857-4047 Prayers continue to be needed as there are many caring for the medical & shelter needs of our unsheltered neighbors. 
•  Sept. 29, 2022 Pierce County: Medical Reserve Corps Nurses have started a free clinic,serving the unsheltered within the encampments and Tacoma Rescue Shelter, providing assessments and foot care. In the two weeks that MRC nurses have been providing care, it is evident that the unsheltered residents are incredibly appreciative of nurses coming to them to care for them and this intervention has already been proactive in preventing hospitalizations and worsening conditions. Any nurse or student interested in helping can join as a MRC volunteer through this website: http://piercecountymrc.org/t

There is training, continuing education, and malpractice insurance available, but registering to be a MRC volunteer is the first step. Additional plans are in the works for a future wound care clinic at TRM, manned by Pacific Lutheran University nursing students and St. Joseph Hospital wound care clinic. 

Sixteen unsheltered persons were provided foot care in the past two weeks at the inaugural foot care clinic at TRM which will continue every Thursday from 9-11:30 am through December. We continue to hear of unsheltered residents losing housing after serious accidents hospitalize them, leaving them homeless and challenged to find a safe place to live while medically recuperating. 

An example: One 63 year old gentleman broke his back following a fall and was discharged (while still wheelchair-bound) when he lost his housing and became homeless for the first time in his life. Recently widowed, he had no support to advocate for him. He continues to wait for options and feels fortunate for the Tacoma Rescue Mission's men's shelter, but would like "just a room" to call his own. He has a little over $1200/month in income, but the housing market is competitive and case workers are inundated with requests. Could Westwynd apartments be an option for this gentleman?? Any suggestions can be provided here. TRM's women's shelter remains very well received as well: one young woman, awaiting housing, bragged about the kindness of the staff and the new bunk beds that can house up to 90 women at a time. Thank you again, TRM and all who daily continue to support our unhoused community! 

Kitsap County: The HEART team remains vigilant as elderly patients, some in their 70's and 80's,diagnosed with dementia and weakness requiring wheelchair assistance, risk being discharged to hotels and shelters post hospitalization. Continue to pray for the efforts of all the outreach workers in both counties as they lend support one person at a time in an overwhelming situation. As the fall nights become darker and colder, please continue to pray for protection and unity in our efforts to provide solutions and medical care to our unsheltered neighbors. Thank you again everyone! Keep up the great work and prayers most of all!

Housing Affordability & Sanctuary Cities

For your information: Wonder why housing is so challenging these days? https://www.pewresearch.org/fact-tank/2022/03/23/key-facts-about-housing-affordability-in-the-u-s/ What does being a "sanctuary city or state" mean? Washington State is a "sanctuary" state: https://ballotpedia.org/Sanctuary_jurisdiction_policies_by_state#Washington

September 2, 2022 Encampment Update (Pierce County)

Medical outreach continues despite the "official" end of the Medical Respite Steering Committee encampment assessment in July. Updates will continue to be provided as informational only and for the purpose of continued prayer for outreach workers and unsheltered individuals alike. Homeless outreach workers from Tacoma Rescue Mission (TRM), Medical Reserve Corps (MRC)/Tacoma Pierce County Public Health department (TPCHD), Pierce County Human Services (PCHS), Comprehensive Life Resources (CLR), Kitsap HEART team, Community Healthcare (CHC), Greater Lakes & others continue to reach out EVERY DAY as needed when needs arise among the residents living unsheltered in Pierce and Kitsap counties. KITSAP COUNTY: There has been no additional known need in Kitsap County. The Kitsap HEART team remains vigilant and responsive to the needs within their community, but if anyone in that area notices additional needs related to medical issues among persons living unsheltered, please post requests here. PIERCE COUNTY: Continued prayers needed for a woman of Hispanic descent who fracture her right ankle last week. She did not follow up with the Emergency Room as encouraged. It is a scary situation for those living unsheltered who do not speak English and are from outside the United States. Please keep this woman in your prayers for healing. Continue to also pray for the 60 year old wheelchair-dependent male with one leg who is on dialysis three times a week. (He was the person who received the electric wheelchair a couple weeks ago when his WC was stolen). I spoke with the dialysis center social worker who has been working with him today. Continue to pray for housing situation. Although he found a house to live in, with trusted roommates, the house is inconveniently located a greater distance away from his dialysis center which makes it more challenging for him to get to his appointments. A 65 year old male was seen today for lower wound infection from a formerly-fractured leg secondary to being hit by a motor vehicle. The infected wound was cleansed and wrapped with instructions to return to the area free standing MultiCare ER on Pacific Avenue nearest the encampment. He appears to need antibiotics at the very least. He is alert and oriented and able to ambulate with a walker and has several encampment neighbors who showed concern for him. TRM will be following up with him again next week. A second male reported a burn on his lower shin; manuka honey ointment was provided. Medical Reserve Corps Nurses are currently forming a medical street outreach group to continue to provide first aid as needed to our vulnerable neighbors living unsheltered. Thank you to all who continue to remain committed to providing compassionate medical care to those living unsheltered on the streets of Pierce & Kitsap counties.

August 2022 Pierce County Encampment Update

Please note: formerly published blogs entitled "ARISE! of Pierce County 2017" (Prior to August 2022) has been updated to reflect the expanding communities being served. [Now known as "ARISE Pierce & Kitsap Counties of Washington State," this blog will continue to reflect the service being provided to our most vulberable neighbors in the neighboring counties of Pierce and Kitsap. The focus of this blog is to provide an outlet and record of advocacy and education on the needs of vulnerable neighbors in our midst and encouragement to those being served and providing service.] Even though encampment vist reports have slowed down a bit, there is still a lot going on--and some good news for a change! Read on: The 60 year old wheelchair-bound male diagnosed with kidney failure remains on dialysis three times a week. He was moved from a safe parking site (SPS) due to not having a vehicle, but remains living close by the SPS in a tent. Comprehensive Life Resources (CLR) continues to stay in touch with him in an effort to get him emergency housing. He was provided a donated wheelchair through New Hope after his wheelchair was stolen. Thank you to Paula (New Hope) for providing the donated WC! Tacoma Rescue Mission (TRM) outreach continues to be alert for medical needs within their outreach areas and has continued to notify me of these needs in the field. The elderly couple that was being followed a couple weeks ago are now off the streets! The gentleman broke his hip and is on hospice; his female companion is being cared for by her family. One of the males with lice was treated and TRM employees were able to get him a shower and haircut which was "one of the best days of his life" (per his perspective). Thank you, TRM workers! The female with the cats was able to get a friend to tow her vehicle to a safer location and it sounds as if she is living with a friend. The kittens and cats were alive the last time we checked in with her. Her male significant other remains incarcerated. Today there were two encampment visits where medical needs were identified: (1) One male with a large wound could not be found; (2) a female Hispanic woman appeared to have a broken or sprained leg and was advised to be evaluated at the hospital. Contact was made with MSW Keith at St. Joe's should she show up in the ER as she was advised. 15 & G encampment is rumored to be swept in the near future; neighbors report that the area remains unsafe which may be one of the reasons for the rumored sweep. There will always be an urgent need to continue to pray for our unsheltered neighbors. Encampments are not decreasing in size nor are they going away as we would hope. Advocacy continues through concerted efforts of many individuals and groups.

Weekly Encampment Update (Pierce County): July 28-29

Volunteers and caseworkers continue to circulate encampments and unsheltered individuals throughout Pierce County distributing water and various items as needed this week as the weather heated up.  Highlights include: Partnered with the Tacoma Rescue Mission this week. Several individuals were in need of medical care and consultation which included lice infestation, wounds, heat exhaustion, failure to thrive and coordinating efforts to get various individuals to medical clinics for evaluation and housing for those who were open to this option.Lice treatment kits were provided to two males with instructions on use. They may end up transporting to the ER as their investation may be full body.A lone female recently discharged from a healthcare setting was found nearby. She had been treated for a head laceration. Resources were provided as she declined services at the time of contact. She was alert and slightly confused, but able to make her own choices; she was encouraged to come to the TRM women's shelter.AMR ambulance successfully transported an elderly, frail female to Sea Mar Community Clinic after weeks of encouragement from street outreach workers. Her WC-bound husband declined services and left the encampment during a brief altercation with this same woman.Three males were roused from sleep when found to be at risk for potential heat stroke--all were grateful for the water, ice and cool rags provided to them as they had fallen asleep either in a car or on the hot pavement in a parking lot. Wound care provided for lower extremity cellulitis to one of them.Coordination efforts health & safety for a young male suffering from a brain injury. He was found wearing a helmet and a very heavy coat. He was showing signs of overheating and talking in a rapid stream of consciousness, but was able to take in hydration when offered. Paramedics were called for further assessment.A lone female in her mid 30's or 40's required assistance as she cared for 4 newly born kittens and 2 adult cats in her very hot, broken down car. Water, cool rags, battery-powered fans, snacks, cat food and gas were provided to her by volunteers outside of TRM. She was alert & oriented and had enough gas to move to a cooler location if she chose to do so. Declined safe parking, cooling center, or shelter as she was waiting for the return of her significant other.Several encamped residents in another camp were recently given notice to vacate the private wooded area where they were staying. One young woman required wound care for several infected, scabbed over wounds on her hands and legs. She was encouraged to go to a clinic, but had limited knowledge of resources to go to a clinic. Encourage her to come to the Tacoma Rescue Mission women's shelter. She had minimal clothes. Clothes were provided to her.Coordination efforts continued as the 60 year old WC bound male on dialysis remains unhoused in the Parkland/Spanaway area. His dialysis clinic was contacted and will be helping him with paperwork so he can hopefully get into housing soon. Comprehensive Life Resources has been a huge help with these efforts.Sadly, there were continued incidents of violence and losses this week. Shots were heard while at one of the encampments visited this week and police were notified. An encampment resident reported there were "7 violent deaths of friends he knew" in this same encampment this year alone. A driver in a different encampment was shot by the passenger in the same car. [The 34 year old, WC bound, incontinent female who we have been checking on could not be visited due to the perceived safety risks in the encampment where the driver was shot--it is unknown how she is at this time] It was reported that another encampment experienced the injury of a female trapped under a van and was hospitalized during an altercation that occured between two malesThe death of an ailing 40+ year old unhoused woman at the back of a church occurred a couple weeks ago after she reportedly lost housing 3 weeks prior to her death. Church workers had been caring for her as best they could prior to her experiencing a fall that led to her death.Kitsap County also had a homeless male who was in a wheelchair and was wearing a cervical collar, "wanting to die." Per HEART director: "He said that he 'broke his neck two months prior in a car accident.' He had left the hospital AMA and despite the pain wasn’t trying to go back to the hospital. His arm looked infected" and even when the HEART team got him to the hospital, he refused to enter and went to a cooling center instead.Many things to pray for when you review the happenings of this week. And this was only 1 day of many for our hard working street outreach workers and healthcare providers. Please pray for solutions, protection, and compassion as we reach out to others who are on our streets, vulnerable and at risk. Many are doing the work that needs to be done and everyone who is helping is making a difference. Processes continue to be refined and evaluated for improvement through this summer's data collection. Some resources that may be beneficial to review are included here;Washington State Legislature on Respite Care: https://app.leg.wa.gov/rcw/default.aspx?cite=74.41&full=trueTrauma Informed Care: https://nhchc.org/online-courses/trauma-informed-care-webinar-series/The importance of data collections:  https://nimrc-nhchc.talentlms.com/Stay safe out there and keep up the good work & especially the prayers!

Weekly Encampment Update (Pierce County): July 18, 2022

Updates on the "Bridges of Peace" Medical Respite Program: 3 residents respiting with 2 more anticipated admits this week: One female resident required a trip to the ER for lymphedema and cellulitis of an upper arm wound that required care. Transport was provided by a MRC nurse. Another female resident was diagnosed with kidney failure after receiving chemotherapy for a diagnosis of cancer The third resident was a male diagnosed with HIV To date, there have been few, if any, healthcare system referrals to this program. The majority of referrals are coming directly from street caseworkers and treatment centers, making financial stability of this program a challenge. Keep in mind if "Bridges of Peace" was not in existence, these patients would be recuperating on the street. Any financial support would be greatly appreciated considering the need for medical respite in our homeless communities. We learned also of another male homeless resident who frequented an area ER who died of an overdose on Fentanyl soon after being discharged from the healthcare center. Three Pierce County encampments were visited this week. We're still seeing lots of untreated wounds, cellulitis, substance use disorders (SUD), and mental illnesses among most residents of encampments. Drug use and weapons are openly displayed. Central and downtown Tacoma appear to have the most active sites and caution is warranted when visiting these encampments. These encampment residents were seen this week & will require follow up: A debilitated, incontinent, wheelchair-bound 34 year old woman was assessed by Tacoma Fire Department a couple times this week and will remain on the radar weekly--she continues to decline medical services when offered, but hygiene items were left with her and she has an elderly couple close by, watching over her. They were instructed on s/s to report and when to call 911 should this young woman's condition deteriorate. A frightened 75 year old woman in the same encampment has been referred to a local women's & children's shelter. There were no other specific medical needs identified. We are on the lookout for a 15 year old homeless young woman who is addicted to heroin who continues to be dropped off at the 173rd & A street encampment in the Spanaway/Parkland area. There is some good news to report as efforts to reach unsheltered individuals have made some progress: The 85 year old with heart disease living in a broken down van in the Pacific & 34th encampment was moved to a Veteran's encampment where resources could be delivered to him more effectively; it sounds like he is connected with case workers. Thank you to all who were involved in this situation. The two young women we have been following from last week were relocated to Portland where caseworkers from Ideal Options connected them with resources, thanks to Rebekah from I.O. Jay, from Lived Experiences Coalition (LEC), identified a 60 year old gentleman who had some stitches that were in need of removal and these were removed today, preventing a potentially worse medical outcome later. A 61 year old wheelchair-bound gentleman who was missing a leg and living without a vehicle or tent was indentified in Spanaway/Parkland and interviewed by a MRC nurse. He will be followed until he gets services. Shiloh Baptist has a male shelter which is closed for two weeks due to COVID, but will be contacted to help shelter this gentleman. He is not open to Tacoma Rescue Mission or Nativity House at this time. More to follow as updates happen! Thanks to all who are involved with continuing to remember our unsheltered neighbors throughout Pierce County!

Medical Resources in Pierce County: 2022

• Refer to the following resources as needed to help unsheltered residents throughout Pierce County:

• Urgent Care: SeaMar 1307 S 11th St., Tacoma, WA 98405; 253.682.2180; also provides laundry service Community Health Care 1202 Martin Luther King Jr. Way, Tacoma, WA 98405; (253) 441-4742 Eastside CHC 1708 East 44th St, Tacoma, WA 98404; (253) 471-4553 
• Free Clinics: Neighborhood Clinic 1323 S Yakima Ave, Tacoma, WA 98405; Monday & Thursday 5pm – 8 pm Trinity Free Clinic 1615 6th Ave, Tacoma, WA 98405; Tuesday 5pm – 7 pm 
• Transportation: CLR PATH welfare check - 253-396-5065 TRM S&R (Davina) 253-383-1513 MOCT (mobile outreach crisis team) 253-798-4500 HEAL (Laurel) 253-231-0873 TFD Cares (Marisa) 253-534-8734 Van will stop/pick-up at six shelters every 60-75 minutes: Stability Site, Rescue Mission (Adams and S Tacoma), Nativity House, Beacon Youth, Salvation Army Monday thru Friday: 7:00 AM – 3:30 PM

Weekly Encampment Report (Pierce County) July 7, 2022

This week has been eventful as usual. Prayers continue to be needed as we navigate the challenges of staying safe and continuing to assess the medical needs of our unsheltered neighbors which is extremely important as the encampments are increasing in numbers and health acuity is rising. Our encampment team has been joined by a peer counselor from Ideal Options. Encampment resident census has been fluctuating and increases in number of residents have been seen in a variety of sites: safety has begun to be more of a concern in the Pierce County sites and this has been noted from multiple sources: Encampment visits have revealed increased in violence, presence of weapons; Community Health Clinic's mobile medical unit has not been rounding on encampments due to safety concerns and Tacoma Fire Department sources agree that growing safety concerns make continuing to visit encampments a risk. This perception of risk was addressed by the Tacoma Pierce County Coalition to End Homelessness this week when concerns were brought to the Medical Reserve Nurses. Here's an overview of some of what was seen this week: Women were more prominent in one of the encampments that have been visited and there have been rumors of human trafficking within at least one of the encampments. Human trafficking is a reality and a concern as we have reports of pregnancies within the encampments and rising syphilis cases in Pierce County (per the Tacoma Health Department). A second woman reported moving 12 times in the past year and had been treated for cellulites in a hospital setting; she still showed signs of infection needing additional medical care. She was no longer in the encampment the following day. Status unknown at this time. An older gentleman who has been in a broken down van was slightly weaker this week. He reported a "resolved" cough" but his right foot was swollen and bruised after stubbing his toe this week. Nails were long and needed care. Learned that Tacoma Fire Department has a BLS medical transport van (known as the T49 service). This may be a resource that can be tapped into; 9-1-1 may need to be called first, but may be able to partner with TFD on this. Here's a resource that may be helpful for transport: TFD Cares and the phone # 253-534-8734. Noted different persons coming in and out of the camp; less approachable than previous visits and many who admitted to not being homeless, but were "just visiting." For those rounding on the encampments this next week, additional important information on new viral infection, Monkeypox (MPX) from the Tacoma Pierce County Public Health Department incudes the following: Re: Monkeypox (MPX). "MPX is a rare viral infection spread through skin to skin or droplet contact/ the current threat of transmission remains low in the US. Anyone with a new rash should see a medical provider (Sea Mar and CHC are good resources for unsheltered encampment residents: downtown, Sea Mar on 11th street and CHC at 11th/MLK). Report suspected cases to TPCHD at 253-649-1412." *Will post additional medical resources in a separate post* Nothing to report in Kitsap County this week. Will keep you posted. Thanks again to all who are actively working on solutions and praying for solutions.

June 30, 2022 Weekly Encampment Report (Pierce & Kitsap Counties)

Much happened this week, so a bit longer than usual.....Read on: Pierce County/Tacoma Over 100 unsheltered residents living in various encampments were visited by volunteer case workers and/or Medical Reserve Corps Nurses this week. More vehicles and tents appeared throughout Pierce County nearest two active Tacoma shelters, Tacoma Rescue Mission & Nativity House. Awaiting additional data from these areas. >Note: there are many more encampments scattered throughout the city and county, many of them underserved. This past week felt a bit more intense as Tacoma experienced two incidents of random, fatal shootings this week; one reported shooting death occurred within a homeless encampment in Tacoma. Some encampments openly display weapons, such as knives or guns. We have been warned by unsheltered residents to also not visit certain encampments due to safety issues. This is concerning due to the continued vulnerability of many living on the street. Additional incidents of violence include one young woman reporting an untreated "skull fracture" and another in a different encampment reporting "a broken wrist" after being "hit by a bat." Two women were reportedly pregnant and there are many more women than initially realized as many quietly remain in their tents, often "fearful" and vulnerable to such attacks as the ones reported this week. Most women will not talk to men and one woman openly accused a male caseworker of alleged, untrue violations. Trust is difficult to establish in these situations and having female nurses accompany the male caseworker has been appreciated by many women within the encampments. Mental illness and PTSD are frequent issues among those living on the street which occasionally cause persons to venture out on their own, away from group encampments, leaving them vulnerable in other ways. It was reported by an encampment resident that one young woman, recently discharged from a mental health facility "against her wishes, [was] forced out of " her chosen encampment by the encampment residents for unruly behavior and disturbance. As she was crossing a nearby street to leave, she was struck by two vehicles and killed instantly right outside the encampment. Among the usual cuts, scapes, wounds, substance use, aches and pains of being homeless, care provided to unsheltered residents included the following: Project Homeless Connect-June 24 (https://associatedministries.org/supportive-services/phcvolunteer/) Two unsheltered residents were recently discharged from the hospital to the street, one was ambulatory and one presented as significantly weak as he crawled into his tent*. 85 year old Veteran with CHF* remains in his broken-down vehicle, has lost significant amount of weight, converses, has some cognitive challenges; grandson took the second van that was able to be driven-unknown when he would return; there was outreach follow-up, but he has no phone so there was no way to follow up on the Veteran's resources he was told about; a caseworker from TPCHD to follow up with him, providing a community phone. *Interesting to note: Many unsheltered residents have medical insurance through DSHS, but medical follow up can be challenging due to the transient nature of living homeless, having a lack of knowledge of where to get help and knowing what symptoms require medical follow up, an inability to find reliable transportation, a fear of their tent/vehicle "homes" being claimed by others or removed by city or county workers. Missing appointments due to these reasons frequently labels these patients as "noncompliant" by our health systems staff who are also frequently understaffed and overworked, making follow up with these residents equally challenging. Resources Provided: A community outreach non-denominational Christain group, "Healing Hands of Hope," provided hot meals. Water and medical supplies were dispersed as weather heated up this week. Education was provided by Tacoma Pierce County Public Health Department on the syphilis outbreak that is occuring throughout Pierce County. Condoms distributed. 3 Narcan doses distributed. Ice pack and wrap provided to woman with hurt wrist. Incontinent pads and briefs provided to a man reportedly incontinent (was not present, left items in his tent. Kitsap County: UPDATE Last week's Kitsap County gentleman, "Mike," who was transported to an area hospital in critical condition, died two days later surrounded by family, according to Kitsap County HEART director. This was a victory in that he was found, agreed to transport to a medical facility, and died within a facility in the company of family. Sadly, many of our encampment residents are not as fortunate and die before they can get help. Hence, the purpose for supporting continued medical respite efforts for this population. New Hope Resource (see https://www.tnhrc.org/about) & Bridges for Peace, are two new resources designed to care for unsheltered residents to prevent illness and/or provide an opportunity for medical respite should unsheltered residents become ill or are discharged from a healthcare center in the Pierce County area (https://opengovus.com/washington-corporation/604410871). Continued support through prayers and other means are always welcome.

June 22, 2022 Weekly Encampment Report (Pierce & Kitsap Counties)

Over 80 homeless encampment residents were seen by 4 Pierce County Medical Reserve Nurses and 2 Tacoma Pierce County Public Health case workers in two Tacoma-area shelters this week on June 22; 1 gentleman was seen on an emergency basis in Kitsap county on June 23 per a referral by Kitsap County HEART director. There are many more encampments, but waiting on others to get back to record data related to medical needs of others living unsheltered in Pierce County. Pierce County: Between the encampments on Pacific & 35th and 15th & G, there was an increase from approximately 54 to 80 in one week. Pierce County caseworkers report sweeps occurred this week which may account for the increase in the two encampments we visited on June 22. Concern for this weekend is the rise in temperatures. Water was dispersed as was information on s/s heatstroke and ways to keep cool while living unsheltered. The Tacoma Pierce County Coalition and the City of Tacoma are anticipating needs of unsheltered residents, but concern is it won't be enough. Consider keeping water in your car as you move about this weekend in case you see a need among our homeless neighbors. Kitsap County: In Kitsap county, an unfortunate gentleman who suffered from morbid obesity has been living in his car for about a year and had been incapicitated and very ill. He was monitored for a couple days before being transported to St. Michael's Hospital in Silverdale. Waiting to hear what the plan is for him as he was in critical condition when he was transported. Common medical conditions seen this week included acute and chronic coughs, illnesses such as strokes, congestive heart failure and diabetes, wounds, addictions, muscle and bone pain, weakness requiring wheelchair assistance. Ages seen this week were from 18 years to an 85 year old Veteran who chose to stay in an encampment with his grandson.

June 17, 2022 Weekly Encampment Report (Pierce & Kitsap Counties-Resources)

The past couple of weeks have been busy as we are collecting data in an effort to advocate for medical care for unsheltered individuals living in Pierce and Kitsap county. We visited over 100 persons living unsheltered in only 4 encampments in Tacoma alone, surviving in tents or cars, with a variety of medical conditions. There are many more encampments that were not visited that we hope to receive data from as case workers visit throughout the summer. Examples of medical conditions include: broken bones, amputated limbs, wheel chair bound individuals, open wounds, liver and kidney disease, strokes, congestive heart failure, diabetes and COPD; rape, IV drug use, and mental illness with no consistent medical follow up despite the community clinics in the area. Everyone working in the medical and social fields are working hard; there just isn't enough help or ease for the unsheltered residents. The age range of the unsheltered residents spanned from twenties to late 60's and they had no true habitable shelter. Male and females, all different races remain together, surviving in inhumane conditions. It's bad enough that they are sick, but they have literally NO PLACE TO RECUPERATE. Although there is a medical respite shelter (Nativity House in Tacoma), it is very limited compared to the demand for medical care. The residents we saw were not in an emergent need, but clearly needed more care than has been available to help them heal and be treated with the dignity and worth that they need. In case this information becomes discouraging, I would like to encourage the viewing of a new movie release, "The Letters" which highlights the life and mission of Mother Theresa of Calcutta. Here is a link to the trailer: https://www.youtube.com/watch?v=m0zDwMQ9Oak Another on her life's work: https://www.youtube.com/watch?v=FjasTcmDpF0 https://missionariesofcharity.org/

May 21, 2022 Weekly Encampment Report (Kitsap County)

Veteran's Park encampments were dispersed approximately 2 weeks ago by the Homeless Encampment Action Response and Transition (HEART) Team and weekly visits by NW Hospitality director, a Lived Experience Coalition member and others continue to ensure there are not any individuals left behind. The Kitsap County HEART Director, along with KC officials, have been working diligently to ensure unsheltered residents find housing options beyond the temporary 29-day hotel stays. Three unsheltered residents remain in Veteran's Park; most unsheltered residents were relocated to hotels throughout the Kitsap County area by the HEART team; many were able to keep their cats which was an initial concern to some of the encampment residents. According to HEART director many were grateful for the chance to have shelter, but it is temporary as permanent solutions are always being sought out. No medical needs or supplies were dispersed this week. NW Hospitality director, Lived Experience Coalition member & others will continue to circulate the park weekly. Please see the following link regarding the medical issues that occurs in homeless encampments: https://www.pchomeless.org/MeetingMinutes/Details?id=619