Summary
"We are beginning to see the start of an impact from the economic crisis," says [John Shen]. "We are seeing people who are more mainstream who lost insurance, lost a job." In Novato, for instance, patients are showing up who have lost their coverage, a consequence of a lost job. The new patient population tends to be older, adds Shen, and that population deals with chronic illnesses that require more ongoing care than younger patients. The increase has not yet been documented statistically, says Shen, "but we see it with the patients coming through the door." The documentation of the anecdotal evidence will take a while. "We're compiling the data," he says.
"There are a ton of strategies you can use" to cope, says [Larry Meredith], "but what we're seeing is a lot of depressed, anxious people, much more suicidal ideation." The people showing up now seem to "have lost the competency they used in regular good times to be skilled, knowledgeable and participating members of the community." Self-help groups, Family Service Agency support and other provider strategies help this new at-risk population cope. "We have a trained therapist on staff, so that where there's a situation that needs attention, we can give an immediate 'warm handoff ' rather than just giving someone a phone number to call." That can make a difference when someone reaches the end of the line at an employment office. And that's not, adds Meredith, a mandated service. "That's something we've got to do to be helpful to the residents of the county - and to our staff." Fighting burnout in departments that provide support is a serious concern these days.Numbers tell part of the story. When the county finished counting the homeless population this year, the survey tallied an "unsheltered population" of 1,147 people and a "sheltered homeless population" of 623. The latter includes people who couch-surf or stay in temporary accommodations that could disappear quickly. The total of 1,770 homeless individuals in this year's count is just a oneday snapshot of the true homeless situation in Marin. Two years ago, when the last tally took place, 1,338 people were homeless in the one-day count. The numbers are higher this year partly because of a more rigorous survey method. Whatever method was used, it doesn't take into account the "precariously housed" population, people who have homes but because of uncertain circumstances can lose them in an instant. The homeless count this year determined that 3,028 people are riding the edge of homelessness - which means a total of 4,798 people in Marin are at risk.See the full content of this document
Extract
Clinical Decision
Across California the need for health and human services is increasing while revenue sources for provider programs declines. Marin hasn't escaped the trend.
A bright spot - if there is one in a generally somber picture - is the Marin Community Clinics, which will move its Novato facility to new and larger quarters at 1600 Novato Boulevard next week. The move, from the facility on Professional Center Drive, will accommodate more patients and services. In addition, the new facility will provide much easier access for patients. The old site is on a hill, and patient...See the full content of this document
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