1. Outreach and Engagement (Chloe Gale, MSW Co-Director REACH Team chloegale@evergreentreatment.org Jen Mamary, MSW, LASW REACH Case Manager jenmamary@evergreentreatment.org)

2. Who are we? OUTREACH: -Encampment Outreach -Nurse and Mental Health Specialist CASE MANAGEMENT: - Sobering Case Managers –Women’s Program –Vet Program –Native American –IDU Case Mangement –Primarily Spanish Speaking OTHER: - Nurse (Jeff) - HEET –HHOT –REACH II –Drug Court –Mental Health Specialist

3. Who funds us? Health Care for the Homeless Network (Public Health-Seattle/King County) Housing and Urban Development MHCADS (Dept. of Community & Human Services United Way City of Seattle King County Veterans & Human Services Levy

4. Who are our clients? Chronically Homeless Chemically Addicted Vulnerable Adults Unconnected with other service providers High Utilizers of Medical and Social Services

6. What is our program goal Effectively engage with clients so that they may experience stabilization through methods such as housing, engagement in mental health programs, medical care, chemical dependency treatment, enrollment in benefits, etc. and creating close relationships

7. Let’s get down to the nitty gritty…

8. Clinical Approaches Harm Reduction Motivational Interviewing Client Centered Seeking Safety Groups and Activities—Camera Club

9. Referring Partners Harborview Emergency Services Jail Health Neighborhood Corrections Initiative (NCI) Program HCHN Medical Respite Metropolitan Improvement District Ambassadors Program Veterans Agencies Homeless Service Sites

10. Common barriers to services and housing Active Use Criminal History Mental Health Conditions (PTSD, Traumatic Brain Injury) Complicated Medical Conditions

11. Common issues cont… Medication adherence issues Belongings Vulnerability to assaults/injury Lack of adequate nutrition Running from DOC, yet wanting to comply

12. Yet more issues… Pregnant women may face little to no prenatal care and little to no education re: health issues Domestic violence (regardless of gender, age, race, or sexual orientation) Prostitution for resources (i.e. housing, food, clothing, drugs, etc.) Many clients lack education re: HIV/AIDS and/or other chronic diseases Discrimination, stigma, vulnerability…

13. Some days it just feels like you can never do enough…

14. So what CAN be done? Actively listen Support Meet the client where he/she is at Trust Remember there will be setbacks If possible, keep the door open to clients still actively using If possible, be flexible about clients who are late to appointments Set clear boundaries Follow through Have faith Use creativity to find a different angle with the more challenging cases (don’t give up!) Maintain a non-judgmental stance

15. Ok, we have a few sneaky tools up our sleeves… Engagement tools for REACH success:

16. Engagement tools: Bus tickets Paying for ID’s, metro passes, etc. McDonald’s, Coffee, Activity Housing (set-asides & vouchers) Shelter access Mobility of case managers

17. REACH Sobering Outcomes - 2007 ObjectiveActual Total Sobering Clients110134 Retain over 1 year6697 Engage new3031 Improve/Maintain Housing--102/134 (76%) Treatment33/110 (30%)104/134 (78%) Income Support66/110 (60%)99/134 (74%) Non-Urgent Health Care83/110 (75%)109/134 (81%)

18. So how do I make a referral to REACH??? Contact a case manager directly Contact a REACH supervisor –Chloe Gale 206-715-6483 –Kelley Craig 206-715-4103

19. Discussion