Case Studies
All names have been changed to protect the identities of the clients.
Case Study 1 – High Utilizer
AJ is a frequent utilizer of 911 and called from various locations in the north end of Seattle. AJ has Alcohol Use Disorder, and often called 911 at the end of his day, hoping for a ride to the hospital, some sleep and a meal. One of the responding SFD units referred AJ to Health One, noting that he is living unsheltered. Case Manager Clayton reached out to UW Montlake ER and connected with a social worker there after AJ was discharged. The social worker shared that AJ often visited the library on UW campus and had breakfast at a church in Ballard.
Health One outreached AJ at the Ballard Library branch and had him sign a release of information so that his case could be staffed with other care teams. When completing the forms, the team noticed that AJ was having difficulty with memory recall. His case was staffed with multiple care teams, including the High Utilizer Group and the 1811 Housing Program (which includes an alcohol management program in-house). A social worker from UW Northwest also reached out to Ballard NeighborCare clinic (which serves the homeless population) and got him an appointment so he could obtain a doctor’s verification of disability. Health One visited the UW library several times, and with the assistance of the librarians, was able to locate him and transport him to his appointment. Later, Health One coordinated with 1811 to get the client set up for an intake.
Since then, AJ has been living at 1811. His 911 usage significantly decreased, going from 25 calls in 6 months to 2 calls in 4 months.
Case Study 2 – Cold Weather Outreach
An engine company responded to a 911 call for an individual with lower limb amputation who was outside in soaking wet clothes, in near-freezing temperatures. Concerned about his wellbeing, the firefighters called Health One.
Health One responded and found “Tex” huddling under a blanket in a torrential downpour. The Health One case manager and firefighters talked with Tex and found that he was interested in going somewhere to warm up and get some hot food. One firefighter arranged a ride for him in a wheelchair accessible Yellow Cab, while another prepared Tex some hot cocoa and got him some dry clothes. When the cab arrived, Health One assisted getting Tex into the cab. He was transported to a warming center, where he was able to get out of the cold, get warmed up, and change into dry clothes.
Case Study 3 – Recovery from Substance Use
Aid 25 called Health 99 on scene for a client, Stephanie, who was experiencing withdrawal from fentanyl. At the time, she was using upwards of 20 pills per day and had lost both her job and apartment.
Stephanie had family in Kent but did not feel comfortable contacting them. She told Health99 she was interested in getting treatment. The team offered that she would be able to get buprenorphine (Suboxone) that day, and she said she would be interested in that. Initially, the team contacted the Bupe Hotline to pick up at Harborview, but the client did not have insurance. Instead, Health One took Stephanie to the Harborview opioid treatment program, where she received assistance with getting benefits and medication and was scheduled to see a doctor the next day for buprenorphine. The following day, Health99 assisted Stephanie to her appointment and she received injectable Suboxone.
Health 99 tried to contact Stephanie a handful of times, either getting her voicemail or missing her in passing at the shelter she was staying at. Health 99 was able to check the hospital system and see that she was scheduled for a follow up injection appointment. The team tried again to contact her and Stephanie answered the call, stating she was doing much better, was working 2 jobs, and was going to get an apartment soon. She knew about the appointment and was planning to go.
Case Study 4 - A New Home
Health One received a referral and Vulnerable Adult Report from Aid 25 for a patient, Angelo, who lived in unsanitary conditions and appeared to be exhibiting self-neglect. The referral to Health One included a phone number for a sister who lived out of state and provided invaluable information on Angelo’s status throughout process.
An intake was completed by the team in the Angelo’s apartment. He was found to have no food, and no access to a toilet or shower facilities due to the toilet overflowing with excrement. A secondary visit by Health One involved assisting Angelo with removing 8 bags of garbage. Health One was informed that APS was in the process of assigning and investigator to Angelo’s case.
Health One provided a burner phone to Angelo, and building management was contacted to coordinate options for cleaning or rehousing. Health One discussed concerns around the unsanitary living conditions with Angelo and coordinated a warm hand-off to the Crisis Solutions Center. Due to the home conditions, Health One worked with CSC to allow for an extended stay.
Angelo was unable to verify income and financial sources. Further coordination with CSC indicated that Angelo would need higher level of care to thrive, and he was discharged home. Health One verified Veterans benefits and assisted Angelo with getting into transitional housing.
Angelo was taken to a doctor’s appointment , which confirmed cognitive impairment. Health One assisted Angelo with getting a COVID test, medication, setting up an intake appointment with an assisted living facility, and transport to the intake appointment. Upon acceptance, the team coordinated with the commissary to decontaminate and move his belongings into his new home.
In most recent visit, the client is thriving and expressed being happy, gaining a bit of weight, and getting a haircut.