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It's My Job: Heading Up Homeless Health: Seeb enjoys seeing patients beginning path to healthy lives

Kim Seeb is director of the homeless health program at Family HealthCare in Fargo. Kia Farhang / The Forum

Fargo - Kim Seeb spent a good chunk of Thursday morning canvassing homeless campsites and handing out surveys to the people she found.

As director of the homeless health program at Family HealthCare in Fargo, keeping in touch with the homeless is a big part of Seeb’s job.

The homeless clinic, open from 7:30 a.m. to 12:30 p.m., is separate from the main clinic at Family HealthCare, 301 NP Ave. in Fargo.

Seeb spends her afternoons as a case manager for her patients, trying to get them on track and into permanent housing.

What sort of case management do you do? All of us do some level of case management with our patients. When you’re trying to provide health care of any kind for a homeless individual, you kind of have to keep in mind what they’re going through when they leave here.

I always use diabetes as an example because we do serve a lot of diabetics. Managing a chronic disease like diabetes when you’re homeless is really, really difficult. You may not eat three meals a day when you’re supposed to take your medication. You’re busy figuring out where you’re going to eat, where you’re going to sleep.

Survival gets in the way of managing a chronic disease. So we do a lot of education.

Who is eligible for the care you provide? What it means to be eligible for this program is if you are homeless and your income is under 200 percent of poverty, you get enrolled in our access plan.

That means that when you come in to see a provider, your copay is $3. It’s not a free clinic. That’s part of our case management philosophy, that they need to be responsible for their health care.

If they’re paying a little bit towards their medications, they’re a lot more likely to not lose them.

We don’t turn anyone away if they can’t pay the copay, but we do remind them every time they come in.

We did take a look at the percentage of homeless patients who pay their copay. Now, I knew it wasn’t going to be zero.

But we were all very pleasantly surprised to learn that 45 percent of our homeless patients made some payment on their bill.

You’ve been director of this program for six years, and worked here previously before taking another job. What’s your focus now? Since I’ve been back, we’ve approached our program kind of as engagement – meet the patient where they are.

We don’t make them register, we don’t make them have to be a patient here to get hygiene products. We use those as engagement tools.

Four or five years ago, there was a gentleman in town who was new to all of us. He was drinking really heavily and he obviously had some mental health issues.

It was winter, and they were finding him passed out in snowdrifts. Everybody was really, really concerned about him, and he didn’t really engage with any service providers. He kind of kept to himself.

But he came into our clinic one day. He didn’t want to register, all he wanted was a pair of gloves. So we gave him a pair of gloves. And then he noticed that we had winter boots, so we gave him winter boots.

He started coming back on a pretty regular basis to let me know he was all right. And we did eventually get him into housing.

That, to me, is a really good example of what we’re trying to do. We don’t have to solve all their medical problems or their mental health problems or their substance abuse problems right away. We have to work with them where they’re at.

Do you think there’s enough attention paid to the issue of homelessness in the Fargo-Moorhead area? No. I think that the community pays attention to it when there’s a negative story or a negative situation.

If a homeless person commits a crime, it’s usually against another homeless person or it’s out of survival instincts. It’s something they feel they need to do.

I don’t think we put a positive emphasis on what we’ve done in the past six years, or the individuals that have been successful and those that still struggle and why they still struggle.