A Heal Well Kingston Presentation

About the Presentation

In March 2024 Heal Well welcomed Amelia Gelnett, Special Initiatives Manager at The Food Pantries of the Capital District who leads the New York State Food as Medicine Coalition initiative, to present on Food As Medicine.

The presentation slides are also available here: Heal Well Kingston March 2024 Presentation

About the Heal Well Focus Team

Heal Well facilitates and strengthens communication by engaging residents and organizations in activities to access healthy options. We bring together people working as health providers in Kingston to improve access to health facilities, increase knowledge of opportunities, develop healthy options, break down silos, and support needs assessment.

Our partners include social workers, health practitioners, doctors, non-profit and for-profit organizations, medical staff, yoga instructors, healers, government staff, and residents interested in health issues.

Visit https://livewellkingston.org/focus-teams/heal-well/ for more information.

Or contact Kristin Kessler at kkessler@kingston-ny.gov.

Mental illness affects more than 50 million Americans, with 1 in 4 Americans experiencing a mental health condition each year. But when we talk about mental health, it’s not just people experiencing a particular condition or illness; we all have mental health. Just like it’s important to take care of our bodies and physical health, it’s important to take care of our minds and mental health.

MENTAL HEALTH RESOURCES

In honor of Mental Health Awareness Month, the Heal Well focus group of Live Well Kingston is excited to host a virtual Together for Mental Health panel on Thursday, May 5th at 5:30pm. 

Checking this blog post before Thursday, May 5th at 5:30pm and want to join the Together for Mental Health panel? Click here to join the Zoom conversation, or watch the livestream at youtube.com/c/CityofKingstonNY. The recording will be made available on the City of Kingston’s Youtube page following the event.

During this panel, we will bring together a variety of experts in the field. And because we know that working on your mental health is not just a one-time thing, we have collected a few resources to share. 

Please note, these resources are up to date as of May 5th, 2022. Please be sure to reach out directly to each organization, company, or individual to confirm services offered.

WHAT DO YOU WANT OR NEED?

I want someone to talk to.

Ulster County Mobile Mental Health

(844) 277-4820

You can call between 10am-10pm, 7 days a week, to speak with someone.

Family of Woodstock’s 24/7 Call/Text Line

(845) 679-2485

Call or text their hotline anytime to receive help.

People USA

People USA has staff available 24/7/365 to support you. Check out their websites for hotlines for those going through a crisis, needing integrated peer services, peer advocacy support, and more.

I have been having thoughts about harming myself, or a loved one has been affected by suicide.

Suicide Prevention Hotline

(800) 273-8255

The Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals in the United States.

Now Matters Now

Now Matters Now is a collection of resources, videos, and stories to support people with suicidal thoughts. Their website also includes research based ways for managing the most painful moments of life. They teach Mindfulness, Mindfulness of Current Emotion, Opposite Action and Paced-breathing, skills that are part of Dialectical Behavior Therapy or DBT, proven to be helpful for people considering suicide.

A Different Cry

A Different Cry is a powerful video that explores the rising suicide rates among Black youth in America. Please exert caution for your own mental health as this can be a very emotional watch for some.

I want to see someone about my mental health.

Ulster County Mental Health Department

(845) 340-4110

They are able to help you find the right provider, connect you to supportive services such as care management and peer support, and help you navigate their system of care.

Access: Supports for Living

(888) 750-2266, Option 2 

368 Broadway Suite 205,  Kingston NY

Available 10am-6pm Mon-Fri in-person and 24/7 virtually, they can offer assistance in a variety of ways, supporting both individuals and families, from those with significant medical or behavioral issues, to others who live independently with minimal help.

Institute for Family Health

1 Family Practice Drive, Kingston, NY 12401

(845) 338-6400

The Institute for Family Health offers counseling and other services, including psychiatric care and medication, for children, adolescents, adults, and families.

I need addiction services.

Ulster County Family Advocate 

(845) 458-7455

This County service helps you navigate treatment options as well as providing overall guidance and support. 

Samadhi 

150 Sawkill Rd, Kingston, NY 12401

(845) 853-8148

The Samadhi Recovery Community Outreach Center  is a non-profit organization that offers recovery services and many free classes and groups to support recovery.

ORACLE (Opioid Response As County Law Enforcement) 

(888) 996-0940 

A rapid response team sponsored by the UC Sheriff’s Office. All calls are free and confidential and the Team consists of Peer Advocates, mental health professionals and rehabilitation specialists who are there to help you and your family, on your terms, without judgment or legal consequences.

Catholic Charities Centers of Treatment Innovation (COTI) 

(845) 281-8478

A team of peers and clinicians will support you and your family regardless of where you are at in the process of recovery.

I’m looking for community support.

Mental Health Association of Ulster County’s calendar lists many free classes and support groups.

NAMI Mid-Hudson

NAMI (National Alliance on Mental Illness) hosts a number of support groups, classes, and presentations.

I have many questions and just want everything in one place.

WellnessRecovery.org

Wellness Recovery is a listing of community resources available in and around Ulster County, NY. Maintained by the Mental Health Association in Ulster County, this resource provides a central place for you to find the next step on your recovery journey.

MHA also has a Mental Health Screening to help identify if you or someone you love is facing a mental health challenge.

I am looking for free or low cost wellness classes and services.

People’s Place Wellness Empowerment Center

17 St James St, Kingston, NY 12401

(845) 338-4030

Free workshops, such as Mindful Monday and Wellness Wednesday, Monday through Friday. Check out their calendar online for details.

Holistic Health Community 

(845) 867-7008

A group of practitioners who offer free holistic health care on the first Wednesday of the month at People’s Place and the third Tuesday of the month at the Marbletown Community Center. In addition, they offer a week of free virtual appointments, usually the last week of the month, in addition to a variety of group classes, both in person and virtual. To stay informed and sign up for these offerings, see their calendar and join their mailing list.

Live Well Kingston is one of a number of initiatives that is seeking to tie it all together; not just for better health outcomes, but to more efficiently support those outcomes with government dollars. According to a 2016 report from former Ulster County Comptroller Elliot Auerbach, the top four non-profits that received payments from Ulster County in 2015 dealt with health in some way: Gateway Community Industries, Mental Health Association of Ulster County, Family of Woodstock, and Ulster-Green ARC.

Those institutions, along with others like HealthAlliance of the Hudson Valley, the Cornell Cooperative Extension, the Institute of Family Health, and many more, are part of a new, county-wide initiative called Integrated Ulster.

Integrated Ulster seeks to create a universal approach for service providers to provide care that is:

• Welcoming
• Accessible
• Capable of being:
  • Person and Family-Centered
  • Recovery & Resiliency Oriented
  • Trauma Informed
  • Culturally Competent
  • Integrated

Katrina Huller Williams, LCSW-R, CASAC

The group is meeting regularly, and you can view their brochure here. We recently caught up with Katrina Huller Williams, LCSW-R, CASAC, who is serving as the group’s liaison, to learn more about how it all works.

1) What was the impetus to create Integrated Ulster?

Integrated Ulster came out of work being done by the Conference of Local Mental Hygiene Directors’ Regional Planning Consortium to create a Co-Occurring System of Care that addresses the needs of people with both mental health and substance use disorders. We launched the project in November 2018, and it quickly became a much broader, more comprehensive initiative. The goal of Integrated Ulster is to create a system of care that is welcoming and effective in addressing the complex needs of all people in Ulster County. While the Ulster County Department of Health and Mental Health is the lead, our partners include a variety of organizations: from behavioral and physical health to social services and beyond. Our aim is to ease access to help by improving collaboration, communication and capability so we can better respond to residents’ needs. This will lend itself to an increase in overall wellness for residents of Ulster County.

2) How often is Integrated Ulster going to meet?

The Integrated Ulster steering committee meets monthly. Additionally, two subcommittees focused on Training and Interagency Communication meet monthly to move forward the goals of the larger group.

3) Are there any immediate changes that local patients should expect?

The central value of the project is for our partners to be welcoming and accessible to the public. With more than 40 agencies involved, the community can expect improvement in this area immediately. One of the first concrete accomplishments of Integrated Ulster was to create a Google doc listing the contact information of our 100+ members. The purpose was two-fold: make communication easier and instill a sense of accountability; it is our expectation that if you are part of this initiative you are accessible and responsive to the needs of the group and the community. We expect residents will feel this difference when they interact with our partners.

The purpose was two-fold: make communication easier and instill a sense of accountability

4) Are there any long-term changes that local patients should expect?

Through improved communication and collaboration, we expect residents will find it’s much easier to get the information, help and services they need. We want people to experience “warm hold ons”, where they are not just given another number to call but supported through the process of finding the right fit. We’re in the process of implementing a bi-annual orientation for staff which will be focused on our guiding principles: things like trauma-informed, person-centered, and recovery-oriented care. We aim to improve service providers’ ability to be welcoming and capable to responding to the complex needs of the individuals and families they serve. We will achieve this by providing cross-training opportunities, so providers can learn about systems outside their own to better handle the needs of their residents and link them to appropriate services. Through this effort, residents can expect increasingly caring and effective services as the initiative grows.

5) Are there any metrics or trackable goals that have been identified already?

Yes. Our initial goals include the contact list and staff orientation previously mentioned, as well as a weekly e-newsletter provided by UCDMH which is underway. Additionally, we are working with our partners one-on-one to assist them in become more welcoming, accessible and complex capable. Because all our partners are different, it’s important not to take a “one size fits all” approach but rather support each organization in reaching their unique goals. One tool we’re using is the COMPASS-EZ, which measures how welcoming and complex capable your organization is and gives you a measurable way to track improvements.

6) What are the biggest common issues that the member organizations are facing?

The call for mental health, substance use and other behavioral health services has increased significantly, and universal needs like stable housing has been much harder to come by in our community. Because our partners are public service organizations (non-profits, social service agencies, schools, etc.) limited resources coupled with increased demand for services seems to be the biggest common issue facing our members.

The call for mental health, substance use and other behavioral health services has increased significantly, and universal needs like stable housing has been much harder to come by in our community

7) Are there any hopeful signs or anecdotes of how health care delivery or patient management is getting better or easier in the area?

There is growing recognition in the public service system that health care can be best provided through an integrated, holistic approach. The connection between things like mental health, trauma and addiction and the brain are well researched, and the culture is slowly but surely moving to respond to this growing knowledge. Additionally, the response to the ACE study (which links adverse experiences in childhood to negative health outcomes in adulthood) is moving our system toward a trauma-informed model nationwide. Our aim is to be responsive to this movement and support our providers on a local level around these important changes.

Want to be part of the conversation around health and wellness in Kingston? Check out our Focus Teams: Heal Well, Play Well, Age Well, Travel Well and Eat Well, and sign up to receive the Live Well Kingston newsletter!

This film focuses on what happens over time to a person when they experience trauma and toxic stress during childhood. Researchers have found that traumatic events in a person’s life can cause long-term damage to their brains and their bodies. This can put a person at a higher risk for diseases and even cause a person to die sooner than someone who doesn’t experience trauma.

Trauma can happen to people of all ages, all skin colors, in all parts of our community. Nobody chooses to have this in their life. Families, doctors, schools, and mental health workers can learn to be more understanding of what can be done to help children heal from trauma and become strong and resilient.

A panel discussion will follow with trauma and resiliency experts: Beth Lewis-Jackson, Director of Special Ed for KCSD, Beatriz Vides, Founder of Crossnore School & Children’s Home, Dr. Marta Sanchez, a physician at the Institute for Family Health, Mary Beth Coons, founder of the Resilient Child Fund, and Esther, a peer advocate. Conversations will center on how to build resiliency in our community and schools.

Childcare for ages 5 and up will be available from 5:30-8:30 at the Everette Hodge Community Center Barn, 21 Franklin St., Kingston, when previously registered for at http://bit.ly/LiveWellKingston-Childcare or by calling (845) 334-3909. Light refreshments will be served. The organizers request that participants bring their own water bottles to reduce waste.

“This film introduces innovative programs that can significantly support children.” Says Emily Flynn, Director of Health and Wellness for the City of Kingston. “I hope our event will increase awareness of trauma and the connection to adverse health outcomes.”

This event is a collaboration of:

1. Heal Well
   • “Resilience” Film Screening: Heal Well is planning a screening of the film “Resilience, the biology of stress and the science of hope,” May 16^th, 6pm, at GW Elementary School Auditorium, with a panel discussion after. It is a film about childhood trauma and they will have resources in the room.
   • MiSN Community Baby Shower: The HAHV midwives and a maternal health coalition is working with Emily to host a community baby shower with community resources for women and children at the Hodge Community Center, June 9^th, 1-3pm.
   • Integrated Ulster: Ulster County is working on an initiative called Integrated Ulster that builds health coalitions and increases communications between agencies.
2. Play Well
   • Disc Golf Course and Clean Up: Play well helped do a park cleanup of the new Disc Golf course that has a grand opening April 27^th, 11am.
   • Chess Tables: Age Well and Play Well collaborated to apply for an AARP Community Challenge Grant for two chess tables, four benches, a shade structure and support for monthly chess meet-ups.
3. Eat Well
   • Laurie Mozian is no longer at HAHV. Katie Shehan-Lopez will still chair the team.
   • Conversations have been about how to communicate community about resources more. During the government shut-down multiple Eat Well member organizations sent out parallel press releases about food insecurity resources.
   • The Kingston Food Co-op will present at next Eat Well meeting, June 5^th, 10am.
4. Age Well
   • Cyber Seniors Program: moving toward installing another set of computers at the Stuyvesant Rupco building. Age Well is still having great success partnering high school students with the seniors for computer help.
   • Age Friendly Kingston: Age Well is considering applying to be an AARP Age-Friendly City. The County has been hosting focus groups about community services. Transportation and a senior center are still major concerns for this focus team.
5. Travel Well:
   • Bike Friendly Kingston: Kicking of Summer Slow Rides in May, will be every Thursday, 6pm at YMCA. The Tour De Kingston is June 23^rd. Bike Fest at Town of Ulster Library, June 8^th. Women’s Bike Fest was huge success. Read about what attendees had to say here. 
   • Complete Streets Advisory Council: Is creating a draft procedure of Traffic Control devices.
   • Greenline System: Kingston Point Rail Trail Phase 1 is under construction.
   • Bus Merger: The bus merger passed the Ulster County legislature and is going forward. UCAT is holding a public meeting, April 25^th, 5:30-7:30pm, at UCAT, 1 Danny Circle. Comments will be accepted no later than April 28^th. Buses will be free for 6 months.
   • 311: The City has launched the 311 system that can be used to report sidewalks that haven’t been cleared.

Have any questions about these projects? Want to get involved? Email Emily!

Coordinated by Vincent Martello, over several meetings, the Task Force created a draft Action Plan consisting of three to five recommended measures that are designed to reach the ambitious goal. Some of the plan is  already underway and others are under active research and development. The review of the plan is being extended slightly due to the transition of leadership occurring in the County Executive’s office, but it is expected to be released sometime in May.

We caught up with Vin Martello, who is also the Director of Community Health Relations for the Ulster County Department of Health and Mental Health, to learn more about how the plan progressed.

How they got started

We have the medical examiner’s office here in the Ulster County Department of Health and Mental Health an our investigator is the first person on the scene if someone passes away. We were getting reports on a regular basis of opioid related fatalities. We talked with the County Executive, and suggested that we really need to re-examine our strategy with regards to opioid prevention and interventions. He was really supportive and told us to put together what we needed, and come up with a plan of action to reduce opioid fatalities by 50% within two years.

A three-pronged plan

It’s such a complex issue, so we had to put some kind of framework around it that would help wrap our minds around the enormity and complexity of it. We have to go beyond the war on drugs; even if you went out and arrested the top 1,000 drug dealers in New York, there would be another 1,000 tomorrow morning. There were three main prongs to our analysis.

Demand

If you add up all the resources and money used to market all manner of drugs in our society, it sends a pervasive message to our young people: “Whatever difficulties or challenges come their way, there’s a drug for that.” Advertising can have an affect on demand. I once knew someone that was involved in founding Partnership for a Drug Free America. He was a Madison Avenue ad executive, and he said he was using his talents to get people to do something less harmful.

You can see an example of the impact of advertising with the tobacco settlements. Youth smoking rates were on a continual upward curb. Once the settlements came out, billions of dollars flowed out to counter advertising in the schools, and you saw the curve of smoking rates descending rapidly down the other side.

Supply

Some ways to reduce supply include aggressive law enforcement interdiction, changing prescribing practices and pain management protocols, and facilitating unused medication take backs.

Treatment and Recovery

The third leg is improving treatment and recovery services. You get to the point where someone has been addicted to opioids or illegal drugs, it’s time to looks at all the programs and services that help people with recovery. We are reviewing where they are located, what is their methodology, and do people have easy access to it, or do they not.

A promising system with systemic barriers

We want to find where the system is broken here in Ulster County.

We have promising programs (many of which can be found on the Ulster Helps website), but also systemic barriers. The way our system of treatment was created is fragmented. You have a lot of different organizations that get funding from different sources, doing great work with committed staff, but they’re somewhat working in silos.

People are fine when they’re in the programs, but if they’re out of the programs or can’t get in at all, they can fall through the cracks. If someone is back on the street and they revert back to previous habits, their tolerance is low after completing a program, and an overdose occurs.

Learning from other communities

Our goal is to reduce opioid fatalities by 50% in Ulster County. Dayton, Ohio did it in a year’s time, and other communities have had similar results.

We’ve done a few road trips up to Albany County, where they’re doing tremendous work in their jail addressing opioid overdoses and recidivism. In Broome County, social workers are going out with first responders to do a “whole family” approach with outreach.

One of the things we learned in Albany is that jails are ground zero for opioid use disorders. That population has a very high level of drug use and addiction, and show up in the correctional system on a recurring basis. We’ve been working with the new county sheriff to put together an integrated and coordinated plan that will start the moment someone arrives. There is an evaluation process of in-house treatment that combines substance abuse treatment, physical wellness, behavioral health, health counseling and discharge planning, to make sure that when they get released, they’re going to have their necessary prescriptions.

Upon discharge, they’ll be handed off to a care coordinator who will be in contact with them for a minimum of ninety days out in the community, making sure they’re getting to their appointments and counseling sessions. That tends to be where people fall down. They get released from a program, and even if they did well in the program, it’s not enough.

Another area of focus is in emergency departments, where people show up with overdoses. Ellenville Regional Hospital has set up an emergency treatment system where they can provide suboxone for up to three days.

The patient then gets a warm handoff to a care coordinating agency, which is the Institute for Family Health.

Another thing we learned was the importance of reaching out proactively to people who are suffering from opioid use disorder.

As anyone will tell you who works in this area, you can’t get everyone. You have to keep on trying. When they send out care coordinators with emergency responders, they provide the family or friends with information packets, and the care coordinator reaches out again and again and again. They know that the patient might not call them back, but they also reach out and talk to friends and family members to talk about recovery and treatment programs. You have to be persistent and proactive in helping these individuals.

Opioid disorder: a chronic disease

We need to re-frame the Opioid crisis as a chronic disease, and it should be treated as such. If someone has heart disease or lung disease, there’s no stigma. Everyone gets it: you need treatment and recovery. It needs to be the same way with any substance abuse disorder.

Accessing treatment

People who have money are always going to have the option of exclusive, top of the line treatment programs that are out there. If you have Medicaid, you can get into some programs. If you’re at that threshold where you have some insurance but you have a huge deductible, or if you’re one of the 6% of people in Ulster County who don’t have any insurance at all, we can help. The state has tightened up the rules about denying coverage, and we have an advocate who is hired through Family Services of New York, and her job is to help families navigate through the maze of options.

Some providers also have capacity issues. There’s a big list of providers that provide suboxone and other medications, but many of them aren’t taking new patients, have waiting lists, or don’t take insurance, and many are no longer practicing. When you subtract for all of those factors, it’s really a small list.

An A to Z plan

We’re putting together an A to Z plan, mapping out a workflow and process step by step so that every player in the county understands what their roles and responsibilities are. That’s how we will close the gaps.

You can follow the progress of the Ulster County Opioid Prevention Task Force on the County website.

As always, if you like this article, please sign up to receive updates about Live Well Kingston, and learn more about our different working groups that are open for public participation: Age Well, Eat Well, Heal Well, Play Well and Travel Well.

1. Manage depression symptoms

Tabitha Sieloff, LCSW-R is a clinical social worker and owner of Mosaic Community Services in Midtown Kingston.

She says the colloquial “winter blues” manifests with symptoms that are similar to depression.

“People definitely have extra fatigue and difficulty engaging in the activities they would typically enjoy,” she said. “Hygiene can also become an issue. Showering, taking care of household chores. People who might have otherwise well-managed depression can have an increase in these symptoms in the wintertime.”

To start to bust out of the winter blues, she recommends three things:

• Take a Vitamin D supplement
• If you can’t get outside into the sunlight, use a sunlamp (which can cost around $50) to simulate the natural sun
• Exercise, ideally in the morning

“If you’re doing that trifecta in the morning, you can release endorphins that really help break through the depression,” she said. “If you just do one or two of those things, it’s not effective as doing all three.”

Although it’s a little late for this winter, she recommends making a plan for managing the winter blues before next winter.

“I talk to people starting around September with their plan for winter,” she said. “It’s a lot easier to keep it going if you start it before winter hits.”

When to consider therapy

“I usually say that therapy is just one way for people to heal,” Sieloff says. “It’s not the only way. For many people it’s yoga, or religious activities, or reading a lot of self-help books. If your natural supports that are in place aren’t enough, and you’ve tried some things, then you should look out for additional help.”

“Therapy isn’t forever,” she added. “It can be a for a time period to get you through something difficult that your natural supports aren’t enough for. Then you can go on with your life.”

2. Go to free health events and support groups

We recently covered seven websites and organizations that promote and facilitate free health events and support groups in our community.

3. Stick to a sleep routine

“It’s impossible to overstate how important sleep is to good health,” says Dr. Barbara Chatr-Aryamontri, medical director of the Hartman Sleep Center at HealthAlliance Hospital: Mary’s Avenue Campus. “It affects our immune system, hormones, appetite, weight, thinking, energy, concentration, temper, mood — even life expectancy.”

To get good sleep, sticking to a sleep schedule is cited in many articles about beating the winter blues. Some tips for doing that include:

• Setting a consistent bedtime
• Make gradual adjustments to your sleep schedule
• See the morning light, by opening the curtains or having coffee on your porch
• Dim or turn off lights close to bedtime
• Avoid computers, tablets, cellphones and TV an hour before bedtime
• Try to not snooze your alarm
• Have dinner at the same time every night, two or three hours before bedtime

If you can’t stick to a sleep routine and have some form of insurance, it might be a good idea to consider a sleep study – “a noninvasive, overnight exam that lets doctors monitor you while you sleep to see what’s happening in your brain and body.”

“For this, you go to a sleep lab such as ours and sleep overnight at the center or in your own bed,” says Chatr-Aryamontri, who is board certified in pulmonology and sleep medicine.

While you sleep, an EEG monitors your sleep stages and cycles, which finds any sleep disruptions, eye and body movements, heart and breathing rates, and oxygen levels in your blood.

4. Go for a winter hike

Hiking is a popular activity in the Hudson Valley and Catskills in the summer and fall, and some of the more challenging and steep hikes can be inaccessible when there’s snow and slush on the ground. But according to Mike Todd, the creator of Hike the Hudson Valley, there are some advantages to going hiking during the winter.

“If you show up on a nice fall weekend at Mohonk Preserve or Sam’s Point, you can show up at 10:15 in the morning and not be able to get into the parking lot,” he said. “Winter is an easy time of year to find some solitude on the trails. The people who were packed in during the summer and fall are at home watching Netflix.”

Other benefits of winter hiking include not encountering snakes or mosquitoes, and a reduced risk of Lyme disease.

Todd recommends looking for hikes with gentle inclines, to remember that walking in the snow is more taxing than in normal conditions, and to consider additional gear like trekking poles and traction cleats for balance.

“For clothing, you definitely need a jacket, a backpack, and a bunch of layers,” he said. “At some point, you will get hotter and will want to stash your jacket somewhere. Wear thermal underwear under your hiking pants, and maybe a waterproof layer on top of that. It’s better to start off with too many layers than too few.”

Some of Todd’s picks for winter hikes near Kingston include:

• Undercliff/Overcliff trail at Mohonk Preserve
• Poet’s Walk
• Burger Hill
• High Banks Preserve
• Walkway Over the Hudson (the only hike that gets plowed)
• Falling Waters Preserve
• Mills Mansion
• Esopus Meadows

“Go hiking with somebody else when you can,” Todd concludes. “Especially this time of year, the stakes are a little higher if you get lost or slip and get hurt.”

5. Socialize

Five years ago, Kevin Godbey was retiring from IBM and looking for something fun and productive to do. Since then, he’s managed a site called Kingston Happenings, a constantly-updated guide to business and community events in the Kingston area.

The site has generated millions of pageviews, and is an important resource for people who are looking to beat the winter blues with socializing and new experiences.

“It’s sort of a bird’s-eye view of what’s going on in the community,” Godbey said.

The site includes nightlife and entertainment, a section for kids and families, health and fitness classes, and a community meeting calendar.

“A lot of people have different interest areas,” Godbey says. “If it’s music, there are a wide variety of music for a lot of venues, even alcohol free ones, if you’re skittish of the bar scene. If you’re into history, the Maritime Museum has talks and lectures all the time. There’s comedy, art, there’s a little bit of everything. We’ve got more yoga studios than you can shake a stick at. Just ask yourself what you’d like to do and you can find it.”

Godbey said that many local spaces allow for people to socialize at their own pace.

“Many local venues have made an effort to create space for lots of different people,” says Godbey. “You can hang in the corner and watch people go by, or you can mix and mingle. Either way, you can be comfortable.”

He adds that socializing locally can give people a more positive perspective on the world.

“You can be in proximity with people who are active and positive about what they’re doing,” he says. “It gives you a much better perspective than watching tv and hearing bad news and focusing on that. You can see lots of people trying to accomplish something, and talk to people about your commonalities or differences.”

Make healthy choices while you’re out and about

If you take one of Kingston Happenings’ recommendations and find yourself out at a local eatery or bar, you can still make a healthy choice for what to eat! Read our recent blog post on the topic.

The Mayo Clinic, for example, recently cited the following benefits:

• Feeling less lonely, isolated or judged
• Reducing distress, depression, anxiety or fatigue
• Talking openly and honestly about your feelings
• Improving skills to cope with challenges
• Staying motivated to manage chronic conditions or stick to treatment plans
• Gaining a sense of empowerment, control or hope
• Improving understanding of a disease and your own experience with it
• Getting practical feedback about treatment options
• Learning about health, economic or social resources

There are lots of free health support groups and educational events that you can participate in, right in Kingston! Here are seven organizations that are holding them:

(NOTE: Even if you see an event on an organization’s calendar, please call before attending the first time to confirm that the event is happening and that it is free.)

1. HealthAlliance of the Hudson Valley

HealthAlliance of the Hudson Valley, which is part of the Westchester Medical Center Health Network, has a big footprint in Kingston, with two hospitals and a Diabetes Education Center on Albany Avenue.

They have a very active schedule of free healthcare events that you can attend, which are all listed in the Classes and Events section of their website.

Some highlights include the Seniors Health and Wellness Breakfast Club (held at the Hudson Valley Mall every month), a monthly Diabetes Education Seminar, a Multiple Sclerosis Support Group, and an Ostomy Support Group.

2. Hudson Valley LGBTQ Center

The Center is based on Wall Street in Kingston, and lots of invaluable free services that are either directly related to health or adjacent. They have a great calendar of events here.

Some upcoming meetings include free HIV/STI testing, morning meditation, and a caregivers support group.

3. Ulster County Library Association

The Ulster County Library Association counts 21 libraries; in the scope of this article, we have the Town of Esopus Library, The Kingston Library, and the Town of Ulster Library.
All three of them have community calendars that often include free health events and support groups.

Some upcoming examples: Stress Reduction Through Meditation and Yoga at the Library.

4. Healthy Ulster County

Healthy Ulster County is a coalition of community partners led by the Ulster County Department of Health. They have a wealth of free health events and workshops on their calendar that are accessible by people in Kingston.

Some upcoming examples: a weekly Mall Walk led by the Office for the Aging, and a conference at the Best Western Plus on eating disorders.

5. MHA Ulster

The Mental Health Association in Ulster County has been operating as a local advocacy agency for over 50 years. Their calendar is chock-full of free support groups and classes for the community.

Some examples: a weekly coed yoga class, Men’s Anger Management, and interpersonal skill building workshops.

6. Healthcare is a Human Right/RUPCO

Every month, Healthcare is a Human Right runs a free/low-cost alternative modalities clinic at RUPCO’s Lace Mill in Midtown Kingston. It’s on the second Thursday from 4 to 7 p.m.

7. Other Places to Look

• Chronogram events calendar
• Hudson Valley One events calendar
• Kingston Happenings events calendar
• Health Quest event calendar

And finally, if you enjoyed this article and are looking for more ways to get involved in health in the Kingston community, learn more about Live Well Kingston and come to a meeting of one of our five focus groups: Age Well, Eat Well, Travel Well, Play Well or Heal Well!

Each focus group convenes people from all walks of life and organizations, with the shared goal of developing, implementing and supporting policy, systems and environmental change for the topic at hand.

It’s called The Grace Project, and it’s driven by Charise Isis, who has lived and worked in Kingston for the last twelve years as a commercial photographer. On October 1st, the Today Show will air a segment on the effort. The project has also attracted the attention of the Huffington Post, WebMD, Refinery29, Cosmopolitan, Daily Mail, Bustle, Elite Daily and many more.

Working from her studio on Broadway in Kingston, she’s collaborated with a number of local healthcare organizations, including Breast Cancer Options and HealthAlliance of the Hudson Valley’s Oncology Support Program.

The origins of the project are kind of a coincidence, Charise says.

Primarily a boudoir and pinup photographer, Charise says that women often leave her studio having had transformational experiences, with a better view of their body and sexuality.

“About ten years ago, a man called to book a session for his wife,” she says. “He hadn’t told his wife that he was contacting me, which was odd, but then he called back and his wife had agreed to do it. This beautiful, vivacious 62-year old woman showed up at my studio, and she had all of these hatboxes and hangers with her.”

She had a confession to make: she was a 12-year breast cancer survivor, and she needed all of the clothing because she felt mutilated.

“She said her husband wanted her to feel the way boudoir women feel after leaving the studio,” she said. “I thought it was a beautiful gesture.”

As the session went on, the woman became more and more comfortable; uncovering her non-mastectomied breast and eventually her mastectomied breast.

“She said, ‘OK, I’m doing this,” Charise says. “I saw someone letting go of 12 years of shame from their body. It was one of the most powerful photographic moments I’d had up to that moment.”

Two weeks later, by happenstance, another woman who was undergoing treatment for breast cancer contacted Charise for a session. At that time, she started looking around on the Internet for other examples of mastectomy photos.

“There were all brutal photos of women’s torsos from the top of the neck to below the belly, with harsh medical lighting,” she says. “There needed to be faces. I wanted to show the beauty and courage that still existed in these women. I started putting it out there into the world, and as of now, I’ve photographed over 400 women, and a few men too.”

Charise’s goal is to photograph 800 subjects, representing the number of people who get a diagnosis of breast cancer every day. Funded by individual donations (via fiscal sponsor NY Foundation for the Arts), she travels throughout the United States for shoots with both individuals and groups, while showing her work in a variety of venues.

Hope Nemiroff, the Executive Director of Breast Cancer Options, says Charise has photographed women at the organization’s retreats for women with metastatic breast cancer at the Omega Institute.

“I came to Omega one day, and there were women on the deck without their shirts on for the retreat, getting pictures taken,” Hope says. “It was really interesting she could walk into a room and do that. Normally, people get very embarrassed. She made them not feel different, which is great. She’s done remarkable work with these women, and she’s one of the few who’s doing it for them… the metastatic population often gets overlooked.”

“It was early on in the project, the women at the retreat were at Stage 4,” Charise says. “When you’re Stage 4, you’re terminal. It really informed a lot of the way that I went forward with the project. The first woman I lost from the project was from the retreat. We had a really profound photoshoot and connection.”

Charise says she’s become an advocate for women with Stage 4 cancer.

“That’s the cancer that kills,” she says. “We all know breast cancer is out there, but I want there to be more money put toward research on Stage 4.”

About The Grace Project

You can learn more about The Grace Project at their website or by following them on Facebook and Instagram.

About Breast Cancer Options

Breast Cancer Options focuses on providing services for people who “fall through the cracks.” They have an active mailing list and calendar that focus on things that often do not come up in doctor’s visits, and facilitate survivor-led support groups as well as a camp for children of people with breast cancer. They’re holding a fund-raiser on Sunday, November 4 at Keegan Ales titled “Psychic and Healing Fair,” where 50% of the proceeds from readings and healings will be donated to them.

About the Oncology Support Program

OSP was founded in 1994 and operates across the street from the Mary’s Avenue Campus of HealthAlliance Hospital. It serves anyone who has experienced or living with cancer of any sort, with services ranging from arts and wellness classes, education, workshops and discussion groups.

Before you go on GoFundMe, check in with Kingston’s community of healthcare non-profits. For no charge, you can call or walk in, and see someone who specializes in helping un or underinsured people qualify for different programs or forms of assistance, or get referred to someone who does.

They may also be able to assist you in other ways that will help you get and stay healthy; finding more affordable housing, a better job, childcare, transportation and even groceries. They’re even handy at referring people to healthcare providers who work on a “sliding scale” based on your income.

The eight organizations interviewed below are just a sampling of all of the organizations that do some work in this arena: the Maternal Infant Services Network, Mental Health Association of Ulster County, Healthcare is a Human Right, the ARC of Ulster Greene, Hudson Valley Mental Health, Ulster County’s Veteran Services Agency, and the O+ Festival are also active.

Below you can read a little about the organizations and specialists who can help you afford healthcare; their common experiences, challenges and successes.

1. RCAL

Name: Debbie Denise, Benefits Advisor

Mission: RCAL helps anyone with a disability to achieve independence and integration in society to allow them to live as independently as possible, and to be a part of the world.

How RCAL helps:

I see about 25 people a week. At least 10 of them are seeking some form of Medicaid. People cannot afford health insurance these days. A broken leg will send you to bankruptcy court. Medical expenses are through the roof, especially for the elderly who are on a fixed income.

Medicare has very poor home health aide benefits for our patient population. Generally, if they’re coming out of a hospital situation, they might be able stay in their homes if they had a little bit of help. They’ve reached that point where they can’t lug laundry or swing a mop, but they could live in their home with some help.

The cost depends on the level of aid, on the level of $13 an hour and up, and part of my job is to help them navigate that. We don’t offer the home health aide, but I help them navigate the system, so when they come out on the other end, they have all the things they need.

I help them navigate Medicaid either through something called spousal refusal or a pooled trust to make it more affordable, or through something called the Nursing Home Transition and Diversion (NHTD) Medicaid Waiver. The waiver allows Medicaid to pay for the home health aide. Once they get the NHTD waiver in place, they can hire through an agency, or they can go through a client-directed service. It allows them to hire a neighbor, friend, hungry college student, to be their aide. That person would have to attend a three or four hour class to be eligible.

How do people find you?

It’s a mix of referrals within RCAL, or people on the street, referrals from other agencies, I get them from all over. Up until recently, Medicaid was barred from telling clients about the Medicaid pool trust for example, but recently Congress changed the rules so they can.

What are pooled trusts?

Pooled trusts allow anyone with a disability and seniors to get Medicaid without any cost. I deal with two pooled trusts. SCS in New Jersey, and the other is CDR in Rochester. They send people to me, and trained me to do each of those applications.

(From SCS website): … a supplemental needs trust established by Senior Community Services, Inc., a non for profit charitable organization pursuant to federal and state law. The sole purpose of the trust is to permit disabled individuals to shelter their monthly excess income (calculated by Medicaid to be spent down) by depositing the excess funds into the trust, in order to become or maintain full eligibility for governmental benefits.

Success stories:

I’ve actually had a number of successes come back, because I’ve gotten them into pooled trusts, and they’re allowed to keep use of their income, and they were allowed to stay in their homes because they got home health aides. Their lives are so much better now. That’s a very rewarding feeling.

How is your job funded?

There are a number of funding streams… my dominant funder is actually the Department of Education. My primary job is to help people navigate Social Security benefits. I help them get on SSI, SSDI, help them maintain their benefits, and help them return to work, which is a very cool thing. Sometimes my involvement is just helping people fill out the application, which can be daunting for someone with limited capacity.

Final thoughts:

If you look at the Medicare system, and what it provides and what if offers, it’s supposed to be healthcare for the elderly, but so much of what the elderly need is not part of what’s offered.

People want to stay in their homes. People don’t want to go to facilities, they don’t want to go to nursing homes. They want to be at home. I speak to many sons, daughters, uncles, brothers. You cannot have someone in your home who has level three dementia and go off to work. You can’t leave them home alone for eight hours. You’re going to come back and find out they walked to Saugerties and had no idea where they were. There have to be aides. Aides are very much in demand.

2. Ulster County Office for the Aging

Name: Gloria Ferraro, Senior Aging Services Aide/NY Connects

Mission: NY Connects is a locally based “No Wrong Door” system that provides one stop access to free, objective, comprehensive information and assistance for people of all ages needing long term services and supports. The program links individuals of all ages to long term services and supports regardless of payment source; whether it be private pay, public or a combination of both.

How Gloria helps:

NY Connects can work with anyone who needs information on long term services and supports. We offer information and assistance for children or adults with disabilities, older adults, family members and caregivers, friends or neighbors, Veterans and even professionals who need direction helping someone remain healthy and independent. NY Connects can help find care and support to remain independent. Our staff helps you understand care options, find transportation, caregiving supports, understanding Medicare, and applying for Medicaid and other benefits.

How people can use NY Connects:

NY Connects can be accessed by telephone at (800) 342-9871/ locally (845)334-5037 or online at the NY Connects Resource Directory at www.nyconnects.ny.gov.

We have a “no wrong door” policy that comes from the state.  You can find the answer for the services you need with one stop. They didn’t want people to be passed around from agency to agency.

I also get calls from a discharge planners. Someone might call from Vassar Hospital, with a patient in Ulster County, who’s going to need groceries. Or a call from a daughter in California who’s caring for a mom in Ulster County.

Success stories?

We’ve had some really cool, wonderful things happen. That’s the most satisfying thing. Someone had a student loan debt, and their social security was being garnished. Being able to get that remediated for them was great. I’ve even helped people get out of timeshares, although that’s not typical NY connect stuff.

Final thoughts:

I deal with these organizations with a daily basis, and they’re all phenomenal. We want to help people thrive, age in place, be in their home, live the same life everyone else wants to live. I see the efforts of all these agencies. We all kind of do the same thing, but the population isn’t receiving the same thing at the same time. One agency could be going to gateway for one issue, and seeing ARC or Mental Health for something completely different. We all are pretty specialized.

3. Family Services

Name: Carol Sutcliffe, Ulster County Family Advocate

Mission (From website): Our mission is to help families and individuals help themselves through direct services, collaboration, and advocacy.

(Carol): Family Services has many programs. Primarily we’re in Poughkeepsie, but there is an Ulster County presence.

How Carol helps:

I’ve been in my specific position for almost 2 years. It’s a position that is funded by the Ulster County Legislature. There was a task force a couple of years ago to try to address the opioid issues in the county, to help people get treatment.

It’s a one person deal, and my role is to help people with drug and alcohol issues, help them get into treatment, help them navigate the treatment system, help them if they have difficulty with insurance coverage. I also help families when they’re concerned that their loved ones have addiction issues.

How people can connect with Family Services:

Occasionally, we’ll get someone off the street. We’re located on Aaron Court in Kingston. The phone number is advertised often on the radio by the county and on ulsterhelps.org. Half of the calls are people who would like to get into treatment themselves, and the other half is the family members, mainly mothers, who are concerned about their loved ones using.

Helping with insurance:

Generally, I hear from people who have Medicaid insurance. But frequently, I’ll get a call from someone who wants to get into treatment and has no insurance. There are treatment centers who will take someone without insurance while they’re there, they’ll get them insurance. That’s one way to go. There are also insurance navigators out there. I often refer people to the Maternal Infant Services Network.

They actually have navigators in different places in Ulster County during the week who will sit with them and get them insurance on the spot. If it’s an emergency, we can send them somewhere that’ll help them get insurance right away.

Changes in the law:

Quite honestly, I think the insurance advocacy part of this job is not as big as it was thought to be. The reason for that is that in January of 2017, laws went into effect in NYS which basically ensure that someone can get treatment for at least 14 days without the insurance company getting in the way or doing reviews, for any drug and alcohol treatment that is deemed medically necessary. I haven’t run into insurance companies not wanting to cover things. It’s not as big a part of my job as I thought it would be in the beginning.

Final thoughts:

People contact me and want to get their loved one into rehab, but it’s a voluntary thing. A lot of times they’ll be struggling because their loved one doesn’t want to go. A big part of my job is working with people in that situation.

4. HealthAlliance of the Hudson Valley

Name: Maria Elena Ferrer-Harrington, Director of Community Engagement

Maria Elena on HealthAlliance’s Mission:

The mission of HealthAlliance is “to provide the highest-quality healthcare service to all people in our communities.” Those are the words. But in actuality, we do more than that — because healthcare, to us, is more than just helping someone with a medical need.

We at HealthAlliance are working within the hospital and collaboratively with community partners — individuals, agencies, faith groups, schools and other local organizations — to help make that happen. We’re working with them to address issues affecting the well-being of people in the communities we serve.

How Maria Elena helps:

I direct the hospital’s community engagement efforts. Community engagement is different from community outreach. Community outreach is basically something done “for” the community, like participating in a health fair, where we’re the center of gravity, saying that we want to help and that we offer these particular services.

But community engagement is different. It’s not done “for” the community. It’s done “with” the community. It’s based on building relationships to address an issue. The partners we work with are equal in the relationship, and they all value the community-engagement process. These relationships are not something that you might call a “one-off,” happening only one time, or even something that happens for only a short period. They’re based on building long-term relationships to address community needs, often the root causes of those needs.

Helping patients without insurance:

HealthAlliance provides healthcare for anyone regardless of their insurance status or ability to pay. We also have a longstanding policy to help patients in need of financial assistance, regardless of their age, gender, race, national origin, socioeconomic or immigrant status, sexual orientation or religious affiliation. The amount of assistance depends on your situation. And we really work with you and support you to make it work because we understand the difficulties with healthcare costs.

Depending on your situation, our support includes helping you get health insurance you didn’t know you qualified for or didn’t ever apply for. This can include Medicaid, Parental Care Assistance Program, HIV Special Needs Plans — even Special Supplemental Nutrition Program for Women, Infants, and Children, known as WIC, which is not insurance but provides free, healthy foods for pregnant or breastfeeding women and children under the age of 5.

We also have something called “charity care.” We’re not a bank, but we provide charity care for patients treated in our emergency department or for any other medically necessary services if they don’t have insurance or can’t afford their insurance copays. Charity care is based on eligibility, and we make the decision after the patient completes a charity care application. The charity-care assistance ranges from discounted hospital services to free hospital services.

You can find out more about financial assistance on the HealthAlliance website, hahv.org, or by calling its Patient Accounting Department at 845-334-2743.

(How to read this table: If you have a bill from HealthAlliance, and you’re in a household of two that makes $32,000 a year, you may qualify to have your bill reduced by 80%).

What about people not calling ambulances in an emergency because of financial reasons?

We are very aware that this is a real concern for the community. Unfortunately, we at HealthAlliance don’t have our own ambulance company in Kingston. Those are owned and operated by separate companies. What we can do at HealthAlliance is work with you to help you understand your bill and maybe encourage you to contact the ambulance provider to see what can be done. Remember that if you are eligible for Medicaid, Medicaid would pay any medical bill you have, including the ambulance, for as many as three months before you enrolled on it. Also, if you have a mental health emergency you can call the Mobile Mental Health ambulance, which is completely free for residents of Ulster County.

Do affordability issues come up for “multi-visit patients?”

(Note: Hudson Valley One recently covered HAHV’s new Emergency Department Care Navigation program to help multi-visit patients who suffer from a mix of “homelessness, mental illness and substance abuse.”)

Multi-visit patients — who we used to call “high utilizers” — do cost the hospital money because they come to our emergency department so often and may not be able to pay. But rather than the money, we focus on their needs — or, perhaps, to say it better, their unmet needs. Why do they come here so often?

We try to understand the underlying social and behavioral reasons why they come so frequently and work with them and our community partners — that’s one of the places where community engagement comes in — to find the most appropriate solutions so the patients can improve their living conditions and quality of life. Doing this and this alone has been shown to improve people’s health.

What are some of the other agencies or coalitions working with HealthAlliance to treat our population?

We’re a small community, so everybody knows everybody. We are part of different coalitions, and we foster connections every month. We work closely with The Institute for Family Health, Family of Woodstock, Catholic Charities, RUPCO, Planned Parenthood, even Fidelis Care, the insurance company, just to mention a few.

Biggest successes?

I have to say I have many satisfactions. But I guess my biggest success is the progress we’ve made in establishing the community-engagement relationships. This is a new concept, having a hospital work with other groups to solve community needs. Hospitals used to be places that you simply went to if you were very sick. Now we’re truly engaging with the community. The collective thinking is always better than the thinking of just one entity.

5. The Institute for Family Health

Name: Courtney Beaupre, Director of Care Management Upstate

Their mission (from website:

The mission of the Institute for Family Health is to improve access to high quality, patient-centered primary health care targeted to the needs of medically underserved communities.

How Courtney helps:

I’m the regional director of our care management programs for upstate (our Hudson Valley sites). I oversee our benefits programs, our care navigation for adults and children, and the maternal-infant community health collaboration in Poughkeepsie, where we do patient navigation for women and children. I oversee the sites we have in Ellenville, Kingston, New Paltz, Hyde Park, and Poughkeepsie.

Helping patients afford health care:

The Institute is a federally-qualified health center. We don’t turn anybody away regardless of their ability to pay. We will take anyone who needs healthcare, behavioral health, dental care, and make sure they have access to that. We have a variety of benefit programs including a sliding scale program, financial hardship and a 340B pharmacy discount program.

Sliding scale:

Whether someone has insurance or not, they can come in and apply for the sliding scale fee. It’s based on the federal poverty guidelines. The eligibility is based on income and household size, which allows us to know where they fit on the sliding scale fee.

For those who are above 200% of the federal poverty guidelines, they would be charged 100%, but maybe they still can’t afford it, then they can still apply for financial hardship.

If they make $30,000 for one person, that’s 200% over the guidelines. They can still apply for a financial hardship. They have to say they pay X amount for rent, they have these other expenses, and they can’t afford any extra to pay for an appointment. Everything has to have supporting documentation. They have to have documents about what their income is, what their expenses are, they have to have receipts of their expenses such as a home health aide, etc.

Once we’re able to see they truly have financial hardship, that gets processed through our finance department. They’re able to either put them on a nominal fee to pay, or they can help make a payment plan that’s easy for them to be able to pay in installments. Even if someone does the sliding scale, we still work with people.

Regardless of anything, anyone can come here. We want to try to get them into the programs, make sure they can get insurance, or at least have access to healthcare.

Navigating the health exchange:

If you find yourself without insurance, it can be difficult to navigate the health exchange. I’ve worked in care mangagement and made phone calls, and I’ve been on the phone for an hour with people, insurance navigators through the state. The nice thing about our enrollment specialists here is they have a direct line in. They can go directly into the state sites instead of just calling on the phone.

Collaborating with other agencies in Ulster County:

We’re so lucky in Ulster, because we have so many providers and services that are able to help people at that point of contact. There just seems to be more services than other places.

We work together with a lot of the different places. We’re always busy… in Kingston, we see between 10-15 people per day for one navigator.

How people can come in and get help:

We’ve gained the reputation of providing these services.

We will serve anyone even if they’ve never been here before. We make sure they get what they need, and refer them to outside agencies and resources.

6. Always There Home Care

Name: Susan Koppenhaver, Chief Executive Officer

Mission (from website): To assist residents of all ages in the Mid-Hudson Valley to regain and/or maintain optimum health, to remain at home and to prevent premature or recurring institutionalization by providing home care, healthcare and individual quality of life services.

How Always There helps:

Home care agencies have always sort of been partly a case manager too. We’re sometimes the only professional people that can get to somebody’s house. Our people try to get a sense of what’s going on in a patient’s house; we ask about their medications, and we have the opportunity to help them with the non-medical part of their care. We provide trained clinicians to help patients and clients get back on their feet, or stay in their homes as long as possible.

We try to get them hooked up with the Office for the Aging, who can help them with a Medicare issue, or a transportation issue. We end up working with people like RCAL, or people who will do home renovations for people with mobility or disability issues. They might say they don’t have enough food, so we get them hooked up with someone like Gateway to deliver bags of food, through Meals on Wheels. That’s part of the networking that we do in the community.

We’re also involved in DSRIP (NYS’ Delivery Reform Incentive Payment Program to redesign Medicaid); we hired and placed a care coordinator who works full-time in Dr. Paul Llobet’s office, and he does case management, making sure people are signed up for everything, putting people in touch.

How people can get help from Always There Homecare:

If we walk into a home, we’re asking about your medications. If you say, “I’m on this this and this, and the doctor told me to get on this other medication at the hospital, but I can’t always make it to the bus, or I don’t have a car, or my daughter is supposed to get it, etc,” we’ll help figure out a solution.

We went ahead three years ago and put together a resource directory of anything in the county that can possibly help someone. We give it to all of our nurses. If you need something that we can’t help with, we’ll at least have a contact number.

Final thoughts:

This is a very collaborative county.

7. Gateway Community Industries

Name: Sophie Halpern, PROS Clinical Director

Mission (from website): Gateway Community Industries, Inc. assists people in choosing, acquiring, using, and maintaining the skills and supports necessary to achieve success and satisfaction in their lives. We accomplish this through integrated vocational, therapeutic, residential, and business services.

How Gateway helps:

We serve a Medicaid population with a small, carved-out pocket of the population that is private pay, that comes to us on a sliding scale basis. Those are the individuals honestly that have the most difficulty. The population that I serve is seriously mentally ill. There are some services for those individuals if they are of a Medicaid cross-section. The people that come to us who are in need of those services, but who do not have Medicaid have a much more difficult time.

They are unable to pay for the service, even the sliding scale. We support people in a range of different financial situations in being able to not only connect with entitlements or benefits that exist in relation to insurance, but also in signing up for insurance itself. We do help to coordinate that part of the process in making sure that person has access to healthcare services based on their enrollment in health insurance. It really is kind of situational, but as social workers, we are aware of community resources to help the ends meet in terms of eligibility for certain programs and filling in the gaps when somebody is not eligible for something but has the need. We piece it together the best we can when we work with people.

Finding community resources:

If someone comes in without coverage, we would certainly do some informal linkage and referral to other resources in the community during our intake process. When somebody already is enrolled in our program, we absolutely play that role of being an informal case manager to support people.

We often are coordinating with Healthalliance and with the case managers around the community, like the Mental Health Association of Ulster, People Inc., Hudson Valley Community Services, Family of Woodstock. There are a handful of coordination agencies within the community.

What help is needed beyond insurance?

Our population often needs some form of cash assistance, rental assistance or supportive housing placements. It all contributes to someone’s health, wellness and stability. I can think of two cases right now where we’re working on helping to connect to different entitlements through social services. Two of them actually are cash assistance, which translates to rental assistance. One of them is homeless currently, one is living in a pretty seedy halfway house, and we’re trying to help both of them find housing stability through fostering the connection to the different services that they’re entitled to.

Our staff has been working really hard to try to get them connected to those services, because it’s the primary thing they need to get to have some form of income to qualify for other services that they could really benefit from. We’re working really closely to figure that out with them right now. They’ve already found an increased level of stability, even in just having the conversations and starting the process of obtaining those benefits. It really instills hope in someone that there’s a possibility for change if that tangible resource is available.

Final thoughts:

We’re helping them with the skills we take for granted, but they’re all paramount for helping yourself in this world. They can’t organize, they can’t plan it out, they can’t initiate the task. That’s something that many of the folks that we hope lack.

8. Family of Woodstock

Names: Michael Berg, Executive Director and Salvador Altamirano-Segura

Mission (from website): The goal of Family’s programs is to assist people to achieve self-sufficiency and self-respect.

How they help:

Michael: We have a golden paragraph. It’s a summary of all the services provided in Kingston.

Sal: I supervise Adult case management services, which has various components. We help individuals on parole coming out of prison, they have a long-term case management program, which is subsidized housing for families and singles. We have a health home program, which has case management and care coordination through the health home. We also provide case management to the homeless, and mental health case management.

We can help individuals who are not being covered by Medicare or anything else. Anybody that walks through the door.

We will do an assessment, and if the person is seeking medical care, we will see if they qualify for insurance. If they believe they do, they refer them to a care navigator, who is paid by the state. Their only job is to sign people up for health insurance. We can help them in many situations. If they have no income, it’s pretty easy, but if they have some limited income, it can become more complicated than that.

How often does health care affordability become an issue?

Sal: It’s not that often for us, to be honest. Sometimes it’s difficult, when someone doesn’t have insurance, or if they’re undocumented, you can get insurance. If you’re pregnant, you can get insurance related to anything about the pregnancy. You can get Medicaid to treat a life-threatening situation.

What are some of the factors connected to people affording health care?

Michael: One of the things that I believe is special is that we address the presenting problem. We do not limit what people can ask for. We certainly refer to every other agency in our county.

Sal: Our view as an agency is that everything is connected. If an individual comes to us because they don’t have food on the table, it might not be a food problem. Everything is connected. Not having food might also have to do with healthcare, or a physical disability. It might even have to do with trauma they experienced as children.

Michael: The way the system is moving now, it’s considering the social determinants of health. Housing is becoming part of the healthcare. Your doctor might ask, is your housing unstable? If you don’t have food, or you’re homeless, or you’re having problems with your children, your doctor might be the person you end up talk to. For our clients, we might be their only resource.

What’s an example of addressing health without directly providing health care?

Michael: We started providing food for kids at the Hodge Center. We were giving kids snack. We literally could not feed them enough. We made a decision to go to full five course dinner that we serve to every kid at the Hodge Center in the afternoon, sometimes that’s 80 kids.

Because school breakfast and lunch is so important, we started doing breakfast and lunch in the summer. They we were doing it for the Boys and Girls Club, the Read and Write Center, the Center for Creative Education, the Kingston Library, the African American Library on the Rondout. This summer, we’re going to give out 10,000 meals.

We have to present a full package where people can select what they need. That’s really our strength. We make plenty of referrals, but we do the most that we can do.

Where does your funding come from?

Michael: There are two ways you can run an agency: you can look at what money is available and build your agency around it, or you can start providing services and shift as you identify what people need, while seeking money and training. We’re putting ourselves out there and letting people say what they need. We have governmental contracts, and we fund-raise a lot.

Sal: Funding sources have become really outcome based. On the one hand they’re saying you need to address every single thing, but they also want to narrow down to what can you demonstrate you achieved.

Michael: I don’t want to run the agency based on what money I have. The way we have to present ourselves is asking, “What do you need?” That identifies areas that we have to work toward.

Final thoughts:

Michael: It’s interesting… we have grown, but we’ve tried to be really consistent in the values we instill in the programs. We may have specialized services, but we’re always available. Anybody can show up and get help.