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!