Friday, November 16, 2012

New Facets

My last rotation of the year is Community Health, and it is unlike any other rotation. For one, no hospitals are involved. It's exactly what it says it is, serving the populations in the community! Second, a huge emphasis of community health is vulnerable populations. My clinical rotation is in Project H.O.P.E. which serves through the Colorado Coalition for the Homeless. I'm personally at The Samaritan House 2 days a week and then I do health screenings at Civic Center Apartments for their Housing First program.

It has been so amazing to and so privileging to get this opportunity. There are not very many people who are actually aware of the needs and what goes on in the homeless community. I feel that I have a more in-depth perspective working at Denver Health as that is a huge majority of the population that we provide services for. We are a safety net hospital providing care and resources for populations that otherwise wouldn't be able to access or utilize them. I also get the unique opportunity to see connections through Denver Health from the opposite end. It's really cool to see how we are connected to so many resources and how our facility is utilized. The liaisons between community case workers, coalitions, and the services at DH are just incredible.

On Wednesdays I am in the clinic. I have gotten to work one day, where the nurses that staff the clinic are basically volunteers who go through a program similar to Americorps for one year. They live in a community and give their time to the Coalition, serving its populations rotating through all of the clinics. On Thursdays, I spend my day in the kitchen, first serving lunch, then helping to prepare the evening meal, and serving the meal to its population.

Fridays are spent at Civic Center Apartments giving health screenings, which is really awesome, for those that it serves. The populations are comparable. One huge difference is a lot of those that we see at Civic Center Apartments are very much acutely ill in their mental illnesses and are actively fighting and/or under the influence of drugs/alcohol. In order to have a bed at Samaritan House, its residents enter into their 120 day program, where it is required that they remain clean and sober, advance through a series of levels in which they are actively pursuing employment (and usually must be employed after 30 days), and are required to participate in chores within the community of Samaritan House. Failure to meet any of these requirements can result in one being kicked out. They only serve meals to their own population, yet have an overflow area in which they allows 100 or so individuals off the streets to sleep in each night. That night is obviously quite longer than 100 people now that the weather is getting colder and those after the first 100 are turned away, to go find shelter elsewhere or hunker down on a street corner for the night. They also have a respite program that provides housing and care temporarily for those with medical needs. They usually only have 20 respite beds available. Both programs are run on a lottery system or happen by chance/luck for those that inquire at the right time. They house men, women, children, and families. They have separate men and women's dormitories, with the women's being much smaller than the men's. There is also a family dormitory where families can be housed together.

It is required that residents be out of the house most of the day, either working or searching for employment. There are exceptions for those working chores such as in the kitchen, etc or those who simply cannot be outside like those who are in respite care.

It's really quite amazing. And that is just a scratch of the surface of that facility. The Coalition also has several other homeless shelters and clinics available, owned and operated through the Archdioses of Denver. They also have many affordable senior living locations all over the metropolitan area. It's an amazing and extensive network that really offers a lot of services to the homeless community. And unfortunately, even with all that they do, they still only reach a small portion of the homeless community in Denver.

There are so many issues surrounding homeless, it's overwhelming to think of how to start repairing the system. It is a problem that encompasses financial hardships, mental health issues, the prison/jail systems, access to health care, community health, social work, government assistance programs, addiction, detox, etc. Really overwhelming when you start to think about it!

Anywho, that's where I'm at right now. Really exhausted, excited for this rotation, BUT even more excited to be done in three weeks :-) Just 3 more left to go. We can do it!!

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