By Lee Egerstrom
The Hennepin County Healthcare for the Homeless program has taken over a drop-in clinic at the Anishinabe Wakiagun complex while Wakiagun uses the facilities as an overnight drop-in center for the homeless.
“It’s a blessing,” said Tom McElveen, chief operating officer for American Indian Community Development Corp. (AICDC), owner and operator of the Wakiagun housing complex at 1600 E. 19th St.
The collaboration combines health care and emergency homeless services for people in the south Minneapolis area around the Franklin Avenue corridor, he said.
Hennepin County health professionals began the drop-in clinic on Feb. 10. AICDC began operating the nightly drop-in center on Feb. 1.
By Feb. 25, 797 people had used the Wakiagun drop-in center to escape the cold, get some food, shower, and catch some sleep, said Sasina Samreth, AICDC administrative assistant who serves as coordinator of the center.
Among that group, 214 were repeat, homeless clients, she said. They included 144 who identified themselves as having tribal affiliations.
“We are not a shelter because we don’t have beds for the homeless,” she said. “We do have recliners so people come in, get warm, and do get some sleep.”
The overnight center is open from 7 p.m. to 7 a.m.
The Healthcare for the Homeless (HFH) medical clinic operates in the same Wakiagun basement space. It previously housed AICDC’s Kola Outreach Program.
Native groups worked with the county, city of Minneapolis and various nonprofit groups a year ago on Native homeless problems, homeless encampments, and resulting health and safety issues. The large homeless encampment got labeled “The Wall of Forgotten Natives” by advocates for the homeless.
The new shared arrangement at Wakiagun is an outgrowth of past collaborations.
Molly Dolan, a public health nurse with the county’s HFH clinics, said the clinic operates from 9 to 11:30 a.m. on Mondays and from 3 to 5 p.m. on Wednesdays. She is one of four medical professionals at the clinic.
Others are Rosemary Fister, a psychiatric nurse practitioner; Ellen Thompson, a medical provider; and John Lowe, a social worker and chemical health counselor.
Medical Clinic services include sick visits and check-ups for adults, blood pressure checks, care coordination, HIV screenings, pregnancy tests and birth control help, wound care and dressing changes, and medication refills.
These are critical services, Dolan said. HFC clinics can offer access to medications, rescue inhalers for people with asthma, and similar services that are often difficult to get by the homeless.
Mental health support services, also provided both days, include diagnostic assessments, chemical health assessments, brief therapy sessions, and paperwork assistance that include medical opinion and professional statement of need forms.
The Wednesday afternoon clinic offers buprenorphine treatment for people with drug addiction problems, especially for heroin and fentanyl. Buprenorphine, which is also known by the brand name Suboxone, helps people through periods of drug withdrawal and use, said Fister.
“It works by occupying the same receptors in the brain as heroin – receptors that impact pleasure and motivation,” she said. “This controls cravings for opioids, keeps people form going through withdrawal, and it does this safely.”
Indigenous people with substance use disorders especially have difficulty accessing care and resources they need to stay healthy, she said, “especially indigenous people.”
“I think of (health) disparities as a kind of oppression, a structural violence that is not acceptable. It is unacceptable that Native Minnesotans have one of the highest opioid overdose rates in the country,” Fister said.
Dolan, Fister and others refer to the clinics as “low barrier healthcare,” making it easier for people they refer to as both patients and clients to overcome barriers in accessing help. This can be a space, or geography problem, such as being homeless. It can also be paperwork and regulatory restrictions that make providing services difficult.
“Some of the barriers to getting care are structural and some are cultural,” Fister said in summing up barriers.
For instance, federal regulations put restrictions on doctors prescribing buprenorphine medications, “but not how many oxycodone prescriptions they can write,” she said. The latter is recognized as a common starting point for opioid addition.
The work of Hennepin County’s public health programs does fit with the ongoing work of AICDC and its Wakiagun housing complex.
AICDC is an outgrowth of an American Indian Task Force on Housing and Homelessness formed in 1991 by Native professionals working for federal, state, county and municipal governments and within the Native community.
Anishinabe Wakiagun (“The People’s Home” in Ojibwe) was opened in 1996 and has since been expanded to nearly 80 apartment units that offer long-term housing for people the complex staff recognize as “chronic inebriates.”
Residents must have 20 or more admissions to detox centers in the past three years, two or more attempts at chemical dependency treatment, and have been homeless the majority of the past two years, the home explains on its website.
It is not a shelter but rather a housing residency that works to bring stability to people’s lives. The average length of stay is 21 months. The longest stay was four and one-half years, Wakiagun states.
Regarding the initial mission of dealing with alcoholism, Wakiagun explains:
“The program goal is to minimize the negative consequences of the residents’ drinking patterns, while providing a stable, culturally appropriate living environment that encourages reduction in alcohol consumption.”
With that goal in mind, AICDC started its Kola (“Friend” in Lakota) Outreach Program in 1999 that has now passed the torch to Healthcare for the Homeless. The handoff came after Dr. Ken McMillan retired from Kola at the end of last year.
AICDC’s McElveen said fourth quarter 2019 data show Kola provided 325 people with services, or about 110 people per month. Among those services were an average of 33 medical consultations each month.
Past records from Kola clients show Hennepin County staff professionals who await them.
AICDC states on its website that the majority of Kola clients were males with an average age of 35, many suffer from depression or other mental illnesses along with chemical addictions, and many are distrustful of drop-in centers, shelters and medical clinics.
Many are military veterans.
With its healthcare and stable housing programs, AICDC estimates it actually saves Hennepin County taxpayers about $500,000 each year. One reason is that all Wakiagun residents have medical insurance coverage.
Beyond that, Wakiagun calculates that it reduces detox admissions by its residents by 85 percent, emergency room visits by 20 percent, and jail bookings by 23 percent.