Under the same roof: Medical and behavioral health services for people experiencing homelessness

For people experiencing homelessness in downtown Seattle, better access to medical and behavioral health services can be a life-saver.

Boren Clinic_0
New Neighborcare at Boren clinic located at 1930 Boren Avenue. (Image via neighborcare.org)

The new Neighborcare at Boren clinic offers those services under the same roof as the Dutch Shisler Sobering center – a safe place to sleep off the effects of intoxication. This new clinic reflects an ongoing effort to better integrate these crucial services in a place that is convenient and appropriate for the people who need them most. Since opening in November, the clinic has already served more than 100 people, averaging two visits per person.

“Accessing medical and behavioral health services can be challenging for anyone. This is especially true for people experiencing homelessness and the chaos brought on by drug and alcohol dependency,” said John Gilvar, program manager at Public Health – Seattle & King County’s Healthcare for the Homeless Network (HCHN). “Our goal is to establish a comprehensive, interdisciplinary health clinic that will focus on engaging patients in a regular primary care home.”

Gilvar’s team secured funding for the clinic, operated by NeighborCare Health, through a $650,000 federal grant from Health Resources and Services Administration (HRSA). The grant will help cover ongoing operating expenses. Additionally, the following partner organizations are working to secure capital funds that will cover the remodel of a 2,400 square-foot space into an enclosed clinic with exam rooms, a lab area, a meeting, room, bathrooms, and a reception area.

  • Community Psychiatric Clinic (owner of the facility, provides housing on the second floor)
  • Evergreen Treatment Services/REACH Program (provide chemical dependency services)
  • King County Department of Community and Human Services
  • NeighborCare Health (operate the clinic and provide medical and counseling services)
  • Pioneer Human Services (operator of the Sobering Center)

inside the clinic at borenDutch Shisler is an ideal location for a clinic because of its close proximity to day and night shelters, recovery centers, transitional housing, and other key providers. Collaborative care and case management will give this vulnerable population a better chance at managing illness and connecting with housing options – steps that may ultimately bring them closer to stability.

“In the morning, we’re definitely the first faces they see,” said Lina Letoe-Laki, patient services representative at NeighborCare. “We greet them, acknowledge them, and let them know that we see them as individuals and not as a homeless people. We ask them if they need anything, acknowledge that need, and try hard to meet it. We want to be the place they know they can go, no matter what.”

Not only is the care convenient to the more than 1,600 people the clinic expects to serve next year – it is delivered in ways tailored to people experiencing homelessness or drug and alcohol dependency. For instance, clinicians can prescribe medications in small amounts, since many patients don’t have access to proper storage or refrigeration. They also maximize comfort for patients enduring foot problems and other issues related to living outside.

Located at 1930 Boren Avenue, the clinic is currently open from 7 a.m.-10 a.m., Monday through Thursday, and from 7 a.m.-11 a.m. on Friday, with hopes of increasing those hours over time.  As the clinic expands hours and staffing, the team at the Boren Clinic intends to reach out to the community to make sure other neighboring service providers, including Mary’s Place, Urban Rest Stop, Recovery Café, and other transitional and permanent supportive housing providers, are familiar with their body of work.

Better integrating medical care with behavioral health and substance abuse treatment is a focus area for King County, with additional examples at Navos Health in Burien and the Meridian Center for Health in north Seattle.

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A writer, a public health practitioner, a social justice advocate, a rock climber, a musician, a river guide, and a food and fitness enthusiast.