The best part of my job is working alongside smart, dedicated, and compassionate people who make a positive impact on the lives of people experiencing homelessness. People like Hannah Glover. She is a health navigator at the Elizabeth Gregory Home, a day shelter for women and female-identified people in the University District (U District) of Seattle. Located in one of the few remaining churches in the recently upzoned U District, Elizabeth Gregory Home is a true sanctuary for people surviving homelessness. (For a recent Seattle Times article on changes in homelessness in the U District and the roles of upzoning, see "How-and why-life for unsheltered youth on The Ave has shifted," by Brendan Kiley.)

Think about the last time you tried to access health care, like making an appointment with a primary care provider, or for updating your vaccinations. Was it easy? If it was easy, you likely are housed, have ready access to the internet, and have a job providing decent health insurance. And you likely already have established care with a provider covered by your insurance. People who are experiencing homelessness have a much harder time with access to health care due to lack of (or confusion over) health care insurance, transportation to/from health care, lower levels of health literacy, and competing basic needs like finding shelter, food, and safety. In addition, as described in my interview with Hannah Glover, too often, a major barrier to care for people experiencing homelessness is a previous bad experience with health care. Experiences like negative stereotyping, judgmentalism, and all the 'isms' you can think of. Having a skilled health navigator available to people in community spaces they trust is essential.

When I provide basic health care onsite at the Elizabeth Gregory Home, Hannah Glover makes my work much more efficient and effective. The nursing students I have with me benefit from her experience and insights. We need more excellent health navigators in community settings, not just within hospitals.

Tim Harris, founder and longtime director (1994-2020) of Real Change, Seattle's "street paper" anti-poverty newspaper, talked with me about his life and work in 2015. Real Change turns 30 this year, with the first issue published on August 20, 1994. My purpose with this Skid Road oral history project and podcast is to highlight and celebrate the visionary people in Seattle who have impacted the landscape locally in terms of housing and homelessness. Tim Harris is one of these visionary leaders.

In April, I interviewed Seattle-based housing advocate and consultant Ginger Segel. I know a lot about health policy, especially as it relates to care for people experiencing homelessness. I do not know as much about housing policy as I would like to, so I was eager to hear her stories and perspectives.

Segel first spoke of how, as a student at Columbia University in NYC, she witnessed the role of the university in displacing low-income people in the expanding area around the university. When she moved to Seattle in the 1980s, she got involved in tenant's union organizing and in Operation Homestead. Operation Homestead's mission was to counter the harmful effects of the closing of Single Room Occupancy Hotels (SROs) happening throughout the country. The activists occupied emptied-out buildings so that homeless and other low-income people could live there.

Segel then worked for the Low Income Housing Institute (LIHI) on establishing the consumer-led housing building, the Aloha Inn, now renamed The Inn and run by Catholic Community Services. Currently, LIHI is a major player in the Seattle-area (and beyond) efforts to provide more affordable housing to people experiencing or at risk of experiencing homelessness. Segal and other advocates helped form the state Housing Trust Fund, which, since its formation in 1986, has provided over $2 billion in capital financing to affordable housing projects throughout Washington State.

Now working as a consultant on affordable housing projects throughout the state, Segel has seen first-hand some of the drawbacks of Housing First and permanent supportive housing, including through the newly established Apple Health and Homes Initiative. I was involved tangentially in the formation of this initiative and testified in its favor (when it was House Bill #1866) before the House Health Care and Wellness Committee of the Washington State Legislature. The Apple Health and Homes Initiative pairs healthcare and housing resources for permanent supportive housing for vulnerable (and high-needs) individuals. Segel points out that we need to examine the benefits and pitfalls of Housing First closely. Communities she works with sometimes say that they are forced to take people they cannot handle and that creates safety issues for other residents and staff members.

Segel stated, "Another problem in the advocacy community is we have said we're going to solve this (homelessness) too many time but we never could solve it because the economic forces were always much stronger than our strategies."