HCH In Seattle — the View from a Newcomer
By Laura Brennan, Senior Policy Manager
There is a multi-block radius in the heart of downtown Seattle packed with various organizations supporting individuals experiencing homelessness. I had the opportunity to visit a few of the HCH programs there recently. As someone relatively new to working on homelessness, what I saw was eye-opening, reflecting a profound sense of community and an urgent need to combat the policies that target unhoused individuals and complicate care. Here is my major takeaway and a few questions it raised:
The HCH programs downtown offer services designed to address the unique needs of individuals and ensure health care is accessible to all, regardless of ability to pay or past appointment history.
I met with primary care physicians who provide routine checkups, wound care, and management of chronic conditions, social workers and behavioral health providers who offer mental health care and treatment, and street medicine teams engaged with individuals on the ground, aiming to provide resources like food, water, and Narcan before offering up medical services.
Although the settings may vary, all the teams took similar approaches to service delivery, emphasizing compassion and nonjudgmental care to build relationships with consumers. It’s clear that with time and relationship building, consumers feel more comfortable opening up about the care they need, allowing providers to develop more comprehensive treatment plans. This ability to foster trust speaks volumes about the care and passion staff have for this work. Many of the providers I spoke to have worked in HCH programs for years, built relationships with consumers, and have a deep commitment to the work. This raised a few questions for me:
How are providers ensuring patient and staff safety while also building community?
With so many supportive services located within a few city blocks, individuals experiencing homelessness often congregate in these areas. Many are there to access services, but not all. This congregation of individuals has raised some safety concerns for the individuals accessing care as well as for staff. How do centers maintain an open-door policy that welcomes everyone while ensuring a safe environment for both staff and consumers?
This requires ongoing communication and collaboration among staff. In some clinics this looks like bathroom checks to prevent overdosing, having clear hours when resources are handed out, and in some cases security guards who also build relationships with the individuals who come in for treatment. Protocols that prioritize safety are essential but must strike a delicate balance to prevent making individuals accessing care from feeling unsafe or stigmatized.
What policy/advocacy steps can we take to make it easier for providers to get care to individuals in areas with frequent encampment sweeps and SODA laws?
Services provided by HCH programs are complicated by limited resources, affordable housing shortages, and policies that target unhoused individuals, like encampment sweeps and SODA (stay out of drug area) laws. The new SODA law in Seattle borders HCH programs and could hinder individuals’ ability to access care at those clinics. Encampment sweeps are really harmful and make it harder for individuals to attend clinic appointments and complicate efforts for providers who try to locate individuals with medical needs after the sweeps. In my role, I am looking forward to supporting local efforts to combat these laws and equip teams with advocacy tools and talking points to combat these harmful policies.
How can we engage providers in advocacy to prevent burnout?
The passion that drives many staff members into this field can also lead to burnout. As I mentioned, many of the staff I spoke to have been doing this work for years and remain passionate about it, but we need to prevent burnout and ensure that dedicated and qualified individuals remain in the field. Engaging clinicians in advocacy and policy change can be a great way to combat burnout, take back power, and push for needed solutions. We’ll be creating more materials in the coming months to support greater clinical engagement in policy and advocacy, and ensuring that HCH frontline providers have opportunities to tell their stories.
