The sudden end of the Street Nursing Program leaves more questions than answers

About two weeks ago, the Street

Nursing Program at Adventist Health/ Rideout Hospital in Marysville was abruptly stopped, leaving some of our most vulnerable individuals in the dark and at risk of even more hardship.

The program, whether the public was fully aware or not, was a valuable resource to not only the homeless community but the hospital in which it served – to some degree, it lessened the burden placed on its emergency room.

According to a 2022 report from Adventist Health/rideout, the street program was “successfully able to increase the number of individuals seen by tele-medicine out in the field and in turn reduce the number of individuals sent to the emergency room for treatment.”

Made up of four hospital employees, the team was known to go directly to those in need and help the unhoused.

Its original mission, according to Adventist Health/rideout President Chris Champlin, was more akin to mobile health centers that typically show up at coordinated entry points such as the Life Building Center in Marysville and others that regularly serve the homeless population. Those mobile clinics offer basic care and counseling opportunities.

But over time, the people who were part of the street team saw more value in going directly to where the suffering was actually taking place. While mobile health clinics definitely serve their purpose, the team believed that going “above and beyond,” as Champlin put it, was the most effective use of their time.

“Our nurses may have been doing what they considered above and beyond, but the program is designed to deliver critical care to the homeless,” Champlin told the Appeal shortly after the decision to end the Street Nursing Program. “The nursing program is intended to deliver care. When we look at what we should be doing and what this evolved into, there’s a discrepancy.”

The hospital’s reasoning for ending the program is that it was redundant, in that there were similar services already available through other health clinics and the like. With medical costs soaring nationwide, the Street Nursing Program appeared to be viewed as an extra expense Adventist Health/rideout just couldn’t afford.

As a result, on April 12, the four members of the team were let go. Without notice, according to those involved, and without the ability to inform their clients – the people whose trust they rightly earned – that they would no longer be able to help them. Their phones and all Adventist Health/rideout property had to immediately be returned, leaving the dedicated team with no way to communicate with the people they had cared so much for.

Hospital officials have claimed that the phones have been on and monitored since April 12.

One previously unhoused woman, who said the Street Nursing Program helped her in finding permanent housing, described what the loss of the team could mean for those still living on the streets or along the river bottoms.

“It’s gonna be a lot of homeless that die,” Gina Jones said on April 15 in reaction to news that the program was canceled. “I was one of them. I just laid there, you give up hope, you have no hope. And then she came there and gave me hope, just gave me hope and encouragement to get my surgery and know that everything will be OK. I would have died down there at the river bottom, I know it. … It was bad down there, but she made sure I kept my hope. … I’m housed because someone cared and that’s hard to find when you’re homeless. … They cared enough that where I wanted to care about myself and do better. … I couldn’t survive out there anymore, it was too rough.”

Champlin, in speaking with the Appeal after the decision was made to end the program, repeatedly stressed that the program was not necessarily ending, but instead was transitioning to what are called FQHCS (Federally Qualified Health Centers). He was confident after speaking with officials at clinics such as Ampla Health, Peach Tree Health, and Harmony Health, that the work the four had done would continue in a similar capacity.

The good news is, that eventually became a reality. This week, Harmony Health stepped up and chose to hire three of the four team members. However, when they will be able to go out into the field again and continue their work still remains to be seen.

Therein lies the problem.

We commend Champlin and the hospital for wanting to continue the program and we understand the financial strain the program caused the hospital – even though some grant money was used for some of its operations.

At issue, however, is how the hospital handled the situation and how in that handling, it left a large portion of the homeless population, and even local law enforcement, in the dark. According to people with the team, they had no prior notice the program was ending. They had no way of communicating to their clients that they would no longer be able to help them. They had no way to properly transition such a complex and personal program that, in their mind, had grown to be the most effective way in helping the unhoused.

“We went into work, we knew we had a follow-up HR (Human Resources) appointment at 9 a.m. We thought it was to follow-up with another issue that we had talked to HR about,” Aundrea Caracciola, a nurse that was part of the Street Nursing Program, told the Appeal days after her firing. “We came into work thinking we were working. Went to the meeting and they told us that effective immediately our program no longer existed, and that we were to go to our

offices and clear out our things and leave.”

Surely Adventist Health/ Rideout and others knew well before April 12 that the program would be cut. Surely there were budget meetings, brainstorming sessions, and discussions about what effect the closing of the program would have not only on the people directly involved, but the community as a whole.

According to Adventist, its stated “values” are at odds with how the situation was ultimately handled. Here are those values:

– Be love: Love matters. Treat yourself with love and care so that you are free to love and care for others. Be trustworthy, forgive freely and find common ground.

– Be a force for good: Be courageous. Take action. Whether it is through your position or your passion, work to impact your community for the better.

– Be a mission owner: Own your role, find your talent and know that your contribution is mission critical. Ask yourself, “How do I inspire health, wholeness and hope?”

– Be welcoming: Recognize all people are created equal and embrace them in hospitality as you

would a cherished friend.

– Be curious: Seek to understand how things work and why. Innovate and be open to new ideas and approaches. Own your mistakes and learn from them.

Again, we understand the challenges hospitals such as Adventist Health/ Rideout face. Stories of rural hospital closings have been in the news for the past few years.

The monumental task of functioning in the American healthcare system is not to be taken lightly.

But in situations like these, compassion and understanding seemed to have been pushed to the side because the money just wasn’t there. The hospital couldn’t recover the costs of the program and because of that, abruptly left the hopeless without hope.

Moving forward, we hope that entities such as Adventist Health/ Rideout fully understand the impact the closing of programs such as the street nursing team have on all of us. Project Hope is on the horizon – an effort to fill the gap in coverage that is hurting our community. In that effort, we ask that Adventist Health/rideout learn from past mistakes and live up to their own values.