Practicing Street Medicine

It’s easy not to see the needs of our community. The pristine parks and the million-dollar homes on the lakes create a pastoral view of Coeur d’Alene. But there are people who struggle to find adequate health care, do not have enough to eat or cannot find affordable housing.

Heritage Health’s Homeless Outreach program addresses the needs of Coeur d’Alene’s homeless population every week from their mobile clinic. Gar Mickelson, the clinic’s program coordinator, says the city’s homeless population is in the vicinity between 400 and 500. And those are only the numbers that fall under the city’s definition of homeless. Mickelson thinks the range could be as high as 700 if individuals staying at someone’s home were included. The Coeur d’Alene School District alone counts around 400 to 500 homeless students. In addition, at least between 60 and 80 individuals “sleep rough” each night, meaning that they have no other choice but to sleep outside.

“There’s a lack of education and awareness as to the exact nature of homelessness in our community,” Mickelson said. “Some say we don’t have a problem, but there is.”

There are several barriers to alleviating homelessness in Coeur d’Alene. One is that there is a prejudice associated with being homeless. City and law enforcement officials are also often reticent to help when solutions, such as a managed encampment, successful in other cities such as Seattle, have been proposed. However, advocates, including local faith-based organizations, have been blocked by city ordinances, Mickelson explained.

“There’s a stigma that these people are losers and that they are there by choice because of addiction. We try to bring some voice for the homeless here,” he said. There’s also an inherent belief that St. Vincent de Paul’s services suffice. While they have warming centers for when the weather drops below 28 degrees Fahrenheit in the winter, Mickelson noted that there is much worse weather occurring asides from the colder temperatures even in the spring. He called for more long-term housing rather than temporary shelters. “Our goal is to get them housing,” he said.

“The list of barriers for homeless or impoverished people is huge. Going to an appointment, getting food - if you don’t have access to a car or fuel - that’s where our other team comes in,” said Physician Assistant, T.J. Byrne, referring to the outreach portion of the clinic.

Heritage Health’s Homeless Outreach program is funded by a grant from the National Health Care for the Homeless Council. Mickelson and his team travel around the city, parking the Heritage Health bus at various locations, including food banks and churches around the Coeur d’Alene region.

“We try to help everyone who is at risk for health issues - who doesn’t have access to healthcare,” Byrne said.

Outreach includes social services to help with job searches or helping to resolve whatever problem they may have. He says they see between 60 and 80 individuals, including uninsured individuals, for healthcare and around 200 individual encounters for social services.

“Outreach is anything we do outside of the clinic such as giving someone a ride for employment or reaching out however we can,” Mickelson said. “People come or we encounter (them on the street) to help them find a resource. We call it case management and have an ongoing relationship with them whether it’s finding a job or transporting them to an appointment.”

Mickelson, Byrne and Two Feathers, the case manager for the clinic, walk the trails around the areas looking for or following leads to homeless encampments to provide what Mickelson called, “street medicine.” When they meet with someone experiencing homelessness, they offer an emergency packet of toiletries and water and also might offer tents and sleeping bags or simply check in with them.

Byrne explained that they also follow leads to reclusive residents or those who are homebound who may need care. “We’re always trying to make healthcare more accessible,” he said. They also give individuals gift cards to McDonald’s in exchange for filling out a survey in an attempt to track the elusive homeless population.

The packets distributed are donated by caring individuals to Heritage Health. Supplies needed include: socks, gloves, scarves, gum, nail clippers, deodorant, cup of noodles, disposable razors, batteries (AAA or AA), protein bars, granola bars, hand warmers and juice boxes. Supplies can be dropped off at Heritage Health, 1090 West Park Place in Coeur d’Alene. They are also in need of volunteers.

Mickelson recommends researching and learning more about homelessness as a way to support social justice. He often speaks to groups about his experience and relationship with homeless individuals.

“Sometimes if (people) hear the stories, they can understand why people are homeless. There’s a lack of understanding – people don’t understand so they avoid it,” he said. While it’s difficult to summarize his decades of experience and understanding of homelessness, “We choose not to despair but remain hopeful – we come to love these people.”

Byrne said, “Intolerance and ignoring is not the right way - I don’t know the answer … people need shelter first and access to other services.”

For more information on how you can help Heritage Health treat Coeur d’Alene’s homeless community, visit myheritagehealth.org or call 208.215.1007/ 208.215.1009.

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