1. WARM HAND OFF: INTEGRATING SYRINGE EXCHANGE, TREATMENT AND PRIMARY CARE National Harm Reduction Conference 2012 Haven Wheelock, Syringe Exchange Coordinator Katie Kirkman, RISE Case Manager Eowyn Rieke, Medical Doctor

2. Our Mission Helping homeless youth and other marginalized people move towards improved health and self- sufficiency.

3. Injection Drug Users Health Service Syringe Exchange (FY2011-2012) 3,676 different people 34,860 visits 487,704 needles returned HIV/Hep C Testing Harm Reduction Counseling Community Referrals Hours: Main Street: Monday-Friday 12-5pm Clackamas Service Center: Thursday 2-5pm

4. C LINIC & H EALTH S ERVICES Services Primary Medical Care: We are the medical home for over 5000 patients, available to every youth in the Homeless Youth Continuum Psychiatric Mental Health Chronic Disease management Acupuncture/Chinese Medicine, Chiropractic, Therapeutic Massage Pharmacy Tattoo Removal Populations we Serve Homeless any age 30 any housing status With special services for: Non-English speaking Injection drug users Transgender Mentally ill Substance users Insured or Uninsured

5. M EDICAL O UTREACH Two medical vans equipped with 2 and 3 exam rooms, a laboratory, and an electronic medical records system. We go to Clackamas and Multnomah Counties.

6. Street RISE Reaching Independence through Self-Empowerment Services: homeless youth age 17-25 Outreach Recovery Oriented Activities 7 Days a Week Substance Use & Mental Health Treatment Case Management Education and Employment Supports Life Skills Training Integrated Primary Medical Care Access to Permanent Supportive Housing

7. Things we use to help keep our folks moving toward improved health Tools to Integration

8. IDU HS and Medical Clinic Referrals are made in the exchange for same day appointments in the clinic Warm Hand offs are welcome as needed Appointment reminders can be left at the exchange for harder to engage clients IDU HS staff attends patient briefs as necessary to support client and staff Face to face discussions of relevant medical issues Educating fellow staff on IDU related issues

9. Does It Work? Approximately 21% of Syringe Exchange clients (~800 people) report having been seen at our medical clinic in the past 2 years Last year we referred 350 clients to be seen by doctors

10. Medical Clinic and RISE Coordinated Care Staff Relationships Warm Hand Offs Attending Visits Integrated EMR Patient notes Flags Email

11. New Alert / Flag

12. How Does It Work? STATS HERE PLEASE????

13. How we do it Strategies

14. Basic Human Respect for People Gender identity Treating the Whole Person Unconditional Positive Regard Casual Interactions Staff Clients Clear and Open Expectations

15. WARM HAND OFF: INTEGRATING SYRINGE EXCHANGE, TREATMENT AND PRIMARY CARE IS FUN!!!