Just a quickie but today was a good one. I think I've finally finding some services to share with people over at TC3!
I have now located free vision care (eye exams and glasses), free dental care, including dentures, and free prenatal care. It may have taken calling at least 20 different so-called 'low-income dental clinics' but free dentures exists. The resource manual is coming along quite nicely and I should be able to bring it over to TC3 within the next week.
More coming soon detailing the next step of the project!
Wednesday, June 29, 2011
Tuesday, June 28, 2011
18 Interviews Down
Hi Blog Readers,
This is an entry of disparate thoughts:
1. First of all, many thanks to everyone who's shared their encouragement and interest in my project. Your praise for the blog and support for the challenges that this summer's work proposes has been enormously appreciated. And if you have ideas, thoughts, etc. please don't hesitate to leave me a comment note.
2. I've now completed 18 interviews with women at TC3. Each story has been so very different and yet, the frustrations with the limits and failures of health care provisions continue to resonate. In addition to the often-mentioned vision and dental care barriers, mental health care needs continue to arise. Not only is there limited access for diagnoses and support but the costs of filling prescriptions often seem to feel insurmountable. I'm going to move into the next stage of the project shortly so stay tuned for details!
3. For each of these 18 interviews, I've sat at the Tully's coffee shop directly across the street. The staff have been fantastic and most patrons seem to have no idea what's going on- it's just me scribbling furiously to catch every word the woman sitting across from me says. However, earlier this week, there was an older man sitting, drinking his coffee and working on a crossword puzzle, who kept giving me the dirtiest looks. I don't know what it was about- I was sitting with a woman who looked more 'homeless' than some of the others I've interviewed. I do believe the majority of these women would 'pass' and those of us with sustainable incomes would never guess them to be tent city residents. I just smiled back at him, despite his continued glares. Eventually he got up and left, not without shooting me one last glare. I hope my interviewee didn't notice.
Today, though, after completing one particular interview, the interviewee and I chatted a bit about what it's like for her to live in a tent city. She had already shared how she believes her interactions with medical care providers to be different because of her housing and lack of insurance coverage. She then stated that when she had stayed at a Tent City 4 location previously, she had been part of a panel of residents who spoke with community members at a new tent city location. She stated that a woman in the audience of this panel stood up and asked the tent city residents if they would be using the park a few blocks away. One panelist responded, "Well, yes, it's a public park and people in the tent city do like parks."
The audience member then probed further and said, "Well, what are we supposed to do with our children?" My interviewee shared that she had been holding the mic at this point, and had no idea what to say, so she responded, "I'm not really sure what you mean."
The woman, rather than catching onto the idea that her question might have been offensive, just repeated it verbatim. "What are we supposed to do with our children?"
Dumbfounded that someone would speak with such presumption and prejudice, the panelists were all silent. Finally, one non-tent city resident who was also speaking on the panel, vouching for the community's credibility, shared, "Well, some tent city residents have children and have raised children so I assume they'd be happy to meet your kids."
The woman I was interviewing shared this story with grace and with sadness. But not with any hint of anger or frustration or anger. In fact, she admitted that before she ended up in a tent city, she had dismissed homeless people, and probably would have shared some concerns similar to this particular accuser.
This is an entry of disparate thoughts:
1. First of all, many thanks to everyone who's shared their encouragement and interest in my project. Your praise for the blog and support for the challenges that this summer's work proposes has been enormously appreciated. And if you have ideas, thoughts, etc. please don't hesitate to leave me a comment note.
2. I've now completed 18 interviews with women at TC3. Each story has been so very different and yet, the frustrations with the limits and failures of health care provisions continue to resonate. In addition to the often-mentioned vision and dental care barriers, mental health care needs continue to arise. Not only is there limited access for diagnoses and support but the costs of filling prescriptions often seem to feel insurmountable. I'm going to move into the next stage of the project shortly so stay tuned for details!3. For each of these 18 interviews, I've sat at the Tully's coffee shop directly across the street. The staff have been fantastic and most patrons seem to have no idea what's going on- it's just me scribbling furiously to catch every word the woman sitting across from me says. However, earlier this week, there was an older man sitting, drinking his coffee and working on a crossword puzzle, who kept giving me the dirtiest looks. I don't know what it was about- I was sitting with a woman who looked more 'homeless' than some of the others I've interviewed. I do believe the majority of these women would 'pass' and those of us with sustainable incomes would never guess them to be tent city residents. I just smiled back at him, despite his continued glares. Eventually he got up and left, not without shooting me one last glare. I hope my interviewee didn't notice.
Today, though, after completing one particular interview, the interviewee and I chatted a bit about what it's like for her to live in a tent city. She had already shared how she believes her interactions with medical care providers to be different because of her housing and lack of insurance coverage. She then stated that when she had stayed at a Tent City 4 location previously, she had been part of a panel of residents who spoke with community members at a new tent city location. She stated that a woman in the audience of this panel stood up and asked the tent city residents if they would be using the park a few blocks away. One panelist responded, "Well, yes, it's a public park and people in the tent city do like parks."
The audience member then probed further and said, "Well, what are we supposed to do with our children?" My interviewee shared that she had been holding the mic at this point, and had no idea what to say, so she responded, "I'm not really sure what you mean."
The woman, rather than catching onto the idea that her question might have been offensive, just repeated it verbatim. "What are we supposed to do with our children?"
Dumbfounded that someone would speak with such presumption and prejudice, the panelists were all silent. Finally, one non-tent city resident who was also speaking on the panel, vouching for the community's credibility, shared, "Well, some tent city residents have children and have raised children so I assume they'd be happy to meet your kids."
The woman I was interviewing shared this story with grace and with sadness. But not with any hint of anger or frustration or anger. In fact, she admitted that before she ended up in a tent city, she had dismissed homeless people, and probably would have shared some concerns similar to this particular accuser.
Sunday, June 26, 2011
So timely!
I just came across this article in today's NYT. The Obama administration is launching a 'secret shopper' survey to find out how long it takes to receive care as a new patient trying to make an appointment with a doctor. They're tracking discrepancies between the access to care for someone on Medicaid versus holding private insurance. The results should be pretty interesting.
Friday, June 24, 2011
Trudging Through the System
I know, I know, I just posted, but there's some serious frustrations that I think need to be expressed. It's hard for me to talk with folks who need services and not do anything to try to help them find them. I've set about trying to compile some referrals that will be provided to TC3 so that they have an up-to-date resource. Don't worry, it won't be shared until my TC3 interviews are complete on Monday so as to retain my methodological credibility.
As someone with access to a cell phone, a desk phone with unlimited minutes, and 24 hour/day internet, I cannot even begin to imagine the frustrations TC3 folks feel in trying to find resources for medical care. Again, it becomes ever more obvious why someone would choose the ER over a phone-transferring run around. Moreover, TC3 folks are limited to three minutes on the camp phone so any time spent on hold eats up alloted minutes.
Here's my prime example trying to find pre-natal care:
1. Call Medicaid. Wait on hold for 15 minutes. Robot voice says I have at least another 30 minutes of wait time. Give up on this referral option.
2. Call Planned Parenthood for a referral idea instead. They offer free birth control and yearly exams (Hooray!) but suggest I call Medicaid. I share that it puts me on hold for an hour.
3. I search on the Department of Health website for referral numbers. I call a Downtown Seattle clinic which says they have a home visiting nurse and explain the situation and needs. They say I need to speak with WIC.
4. This clinic transfers me to Kent County WIC HQ. I've now left Seattle services behind for some reason.
5. I tell Kent County WIC person what I'm looking for. She asks for address, wonders why I'm calling Kent, and then tells me phone number for a clinic-based WIC office near TC3.
6. I call the suggested number for this clinic WIC office, only to find a recording telling me that the number has been changed.
7. I call the new number and hear a voicemail message saying that the WIC office isn't open on Fridays.
8. More than 30 minutes since beginning this process, I leave a voicemail at the local WIC office. Hopefully they'll call me back on Monday.
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As someone with access to a cell phone, a desk phone with unlimited minutes, and 24 hour/day internet, I cannot even begin to imagine the frustrations TC3 folks feel in trying to find resources for medical care. Again, it becomes ever more obvious why someone would choose the ER over a phone-transferring run around. Moreover, TC3 folks are limited to three minutes on the camp phone so any time spent on hold eats up alloted minutes.
Here's my prime example trying to find pre-natal care:
1. Call Medicaid. Wait on hold for 15 minutes. Robot voice says I have at least another 30 minutes of wait time. Give up on this referral option.
2. Call Planned Parenthood for a referral idea instead. They offer free birth control and yearly exams (Hooray!) but suggest I call Medicaid. I share that it puts me on hold for an hour.
3. I search on the Department of Health website for referral numbers. I call a Downtown Seattle clinic which says they have a home visiting nurse and explain the situation and needs. They say I need to speak with WIC.
4. This clinic transfers me to Kent County WIC HQ. I've now left Seattle services behind for some reason.
5. I tell Kent County WIC person what I'm looking for. She asks for address, wonders why I'm calling Kent, and then tells me phone number for a clinic-based WIC office near TC3.
6. I call the suggested number for this clinic WIC office, only to find a recording telling me that the number has been changed.
7. I call the new number and hear a voicemail message saying that the WIC office isn't open on Fridays.
8. More than 30 minutes since beginning this process, I leave a voicemail at the local WIC office. Hopefully they'll call me back on Monday.
I'd be ready to head over to the ER just about now too.
Some Emerging Patterns
I've now had the opportunity to interview ten women who currently live at Tent City 3. All have been incredibly kind and open, which is especially noteworthy since they're speaking with a stranger about personal health needs. And while each person's story differs- how they've ended up in TC3 and what their personal health care needs are- there have been some emerging patterns.
To maintain confidentiality, I don't want to share any of the personal stories for fear of such an experience being tied to one of the ten women but I can share some general themes that aren't necessarily surprising but are wholeheartedly saddening.
1. No income means waiting for months: While there are numerous clinics that provide sliding scale fees, often going as low as $15 for a visit, this amount, if you're someone without SSI, Medicaid or GA-U, and you have an annual income of $0, the nominal $15 co-pay is too much. There are a handful of clinics that will not refuse treatment regardless of one's ability to pay, or they use Charity Care funding, bringing a bill down to nothing. But, these are the clinics where you frequently encounter a waiting list for new clients or a several month waiting period for an appointment.When faced with these two challenges, I can imagine why it's often far more appealing to head straight to the ER, where you couldn't be refused treatment.
This is not meant, in any way, to disparage the work being done at each of Seattle's clinics for the low-income. Rather, this work sounds tremendous and should be replicated. Rather, I believe that such an occurance further clarifies the barriers the homeless face and how dire the need actually is.
2. The ER provides primary care: I remember talking to voters throughout the 2007-2008 campaign cycle, trying to get folks onboard with a vague plan for universal healthcare as proposed by then Senator Obama. For those ardently opposed, the talking points would always involve the token, "Because we don't have coverage for all Americans right now, folks are using hospital emergency rooms as their primary care resources, and you, as a tax payer, are footing the bill."
I assumed this to be true- the Talking Points Masters wouldn't lie- but with 10 interviews now accomplished, there hasn't been a single woman who hasn't mentioned the ER as her resource when faced with illness. Most avoid any kind of health care due to lack of insurance or income, but when they have some type of ailment that they believe needs treating, some type of ailment that I would definitely pop into my regular doctor for, they take a bus ride over to one of the area's hospitals. They simply have no other option and they haven't had access to enough preventative care to prevent such a need in the first place.
3. Walgreens Glasses: There is a desperate need for vision care yet no one seems to have been able to find it for little to no cost. Instead, many women shared that they've just purchased $1 reading glasses at Walgreens, which may help slightly but do very little to conquer the constant headaches or need to squint.
4. Dentures: There's a dental van that comes to TC3 about once a month and is able to pull out people's problem teeth or complete fillings as needed. It's a great service but it leaves folks in the lurch for other much-needed dental care. More specifically, I continued to hear about dentures; there's several women in their mid-40s and 50s who wear dentures and need repairs. But no one seems to offer denture work for low income individuals.
It might have been the cycle of Indigo Girls songs on my Ipod this morning that put me in a more frustrated-than-usual by social inequities and injustices mood, but the unmet needs just don't seem like what folks should have to encounter in the United States in 2011. There's a lot of great services in existence, and noble attempts at alleviating suffering and limiting the reach of poverty, but I can't help but grow more and more frustrated about the continuing political debate regarding PPACA funding. No, the ACA isn't a panacea but it's surely a start. Those holding up the legislation's enactment with cost concerns should really have to go and speak to these women. They should have to tell them personally, "I'm sorry you can't chew your food because of an infected absess in your mouth but we just can't afford to help you."
To maintain confidentiality, I don't want to share any of the personal stories for fear of such an experience being tied to one of the ten women but I can share some general themes that aren't necessarily surprising but are wholeheartedly saddening.
1. No income means waiting for months: While there are numerous clinics that provide sliding scale fees, often going as low as $15 for a visit, this amount, if you're someone without SSI, Medicaid or GA-U, and you have an annual income of $0, the nominal $15 co-pay is too much. There are a handful of clinics that will not refuse treatment regardless of one's ability to pay, or they use Charity Care funding, bringing a bill down to nothing. But, these are the clinics where you frequently encounter a waiting list for new clients or a several month waiting period for an appointment.When faced with these two challenges, I can imagine why it's often far more appealing to head straight to the ER, where you couldn't be refused treatment.
This is not meant, in any way, to disparage the work being done at each of Seattle's clinics for the low-income. Rather, this work sounds tremendous and should be replicated. Rather, I believe that such an occurance further clarifies the barriers the homeless face and how dire the need actually is.
2. The ER provides primary care: I remember talking to voters throughout the 2007-2008 campaign cycle, trying to get folks onboard with a vague plan for universal healthcare as proposed by then Senator Obama. For those ardently opposed, the talking points would always involve the token, "Because we don't have coverage for all Americans right now, folks are using hospital emergency rooms as their primary care resources, and you, as a tax payer, are footing the bill."
I assumed this to be true- the Talking Points Masters wouldn't lie- but with 10 interviews now accomplished, there hasn't been a single woman who hasn't mentioned the ER as her resource when faced with illness. Most avoid any kind of health care due to lack of insurance or income, but when they have some type of ailment that they believe needs treating, some type of ailment that I would definitely pop into my regular doctor for, they take a bus ride over to one of the area's hospitals. They simply have no other option and they haven't had access to enough preventative care to prevent such a need in the first place.
3. Walgreens Glasses: There is a desperate need for vision care yet no one seems to have been able to find it for little to no cost. Instead, many women shared that they've just purchased $1 reading glasses at Walgreens, which may help slightly but do very little to conquer the constant headaches or need to squint.
4. Dentures: There's a dental van that comes to TC3 about once a month and is able to pull out people's problem teeth or complete fillings as needed. It's a great service but it leaves folks in the lurch for other much-needed dental care. More specifically, I continued to hear about dentures; there's several women in their mid-40s and 50s who wear dentures and need repairs. But no one seems to offer denture work for low income individuals.
 |
| Thanks Congressman Ryan but your budget proposal is just going to result in more preventable visits to the ER |
Tuesday, June 21, 2011
First interviews begin today
I'll be heading over to TC3 this afternoon to begin speaking with female residents. In preliminary conversations with a few women last Thursday, I'm heading into these interviews with a hypothesis that the services for health care needs exist, by and large, but there's a disconnect in making sure those services are accessible and that patients know of them. One woman shared, "I'm 44 and I've never had a mammogram. I know there are places that have sliding scale fees but even $28 is too much for me to pay."
Another resident shared that she hasn't had a pap smear in several years and knows she's due for one but just doesn't know where to go. I also met a woman who's pregnant and another who was recently diagnosed with cancer. I'm not sure what prenatal care and treatment options exist and are being accessed for these residents but I'm hopeful that if they're not currently what they need, we can identify the shortfalls.
I was honored to present these brief conversations and the project at-large to the Seattle Women's Commission at their June meeting last night. In addition to being asked some incredibly thoughtful questions and hearing some helpful brainstorms about directions the project could take, the Commissioners shared the work each of their sub-committees have accomplished. One committee is working to see how current city sex education programs can include education about prostitution. As the Commission's 2011 Work Plan explains,
Additionally, while the idea of paid sick leave seems like a pretty solid 'no-brainer' to me, the majority of cities in the nation don't mandate any policy like this from their employers. While Connecticut just passed state-wide legislation mandating paid sick leave, Seattle is following in the footsteps of San Francisco and looking at it on a city-level. The Seattle City Council is considering a plan that would mandate paid sick leave for all workers, regardless of the size of the business. The Women's Commission has been at the forefront of the effort, speaking with individual council members to help convey the need. It would pretty monumental to be here when such a bill passes. Check out more details from this morning's story!
Another resident shared that she hasn't had a pap smear in several years and knows she's due for one but just doesn't know where to go. I also met a woman who's pregnant and another who was recently diagnosed with cancer. I'm not sure what prenatal care and treatment options exist and are being accessed for these residents but I'm hopeful that if they're not currently what they need, we can identify the shortfalls.
I was honored to present these brief conversations and the project at-large to the Seattle Women's Commission at their June meeting last night. In addition to being asked some incredibly thoughtful questions and hearing some helpful brainstorms about directions the project could take, the Commissioners shared the work each of their sub-committees have accomplished. One committee is working to see how current city sex education programs can include education about prostitution. As the Commission's 2011 Work Plan explains,
- It is estimated that between 300 and 500 underage girls are prostituted in King County. SWC will promote education of sexual exploitation/youth prostitution issue to educators and parents. It will also research Seattle School District's violence prevention curriculum and advocate for inclusion of teen dating violence and prostituted youth education for middle and high school students. SWC also seeks to explore building stronger connection between Youth & Families Initiative and youth prostitution issue.
- Additionally, SWC will analyze areas of influence in legislative arena and make policy recommendations; advocate for changing law around arresting underage girls for prostitution.
Friday, June 17, 2011
Completely Unrelated...
Nothing to do with TC3 but today, while out asking for gift card donations to local drugstores to help incentivize interview participation, I saw not one, but two different people with ferrets on leashes. Seattle loves ferrets?
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