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Published on Friday, April 14, 2017

Delivering better service through a "triage" approach

Reception Area, Virginia Public Health and Human ServicesProviding a triage approach to assist people coming to Public Health and Human Services for help isn't new in St. Louis County. It's already proved successful in Ely, Hibbing and more recently Duluth. But now, with remodeling to create a central reception area in the Northland Office Building, triage services are being offered in Virginia, as well.


The approach is about much more than just a new space. It's also involved staff training. But the result is better service for our citizens. This past week, a small event was held for agency partners and staff to highlight the new approach. Shown in the photo is Kelly Sather, Adult Mental Health Supervisor, talking about the history of the triage approach. Representatives from Range Mental Health and AEOA, as well as and County staff, are among those looking on.


Natalie Smolich, triage financial worker, says she assists approximately 10 people a day through phone calls, walk ins or email. She's also conducted 113 intake interviews


Natalie describes her role:


"I serve as a liaison between St. Louis County Public Health and Human Services & Bois Forte employees to expedite questions and concerns on cases, usually regarding status of application, rides to appointments, and health insurance.  The triage phone number and email address is a central point of contact rather than having to figure out which team to call.


Often I am able to answer questions they have immediately but if I don’t have the answer they are looking for I will look into it for them and give them a call back.  This cuts down on call transfers and hold times making it a smoother process for case managers and employees of Bois Forte to get information to our clients.


As a triage team, we will be attending the quarterly collaborative meetings with Bois Forte to enhance our relationship with tribal representatives as well as streamline the process for clients."


Meanwhile, Social Worker Laura Summers shared this example illustrating the heartbreaking complexity of the situations faced by people seeking help from the County, and how the Triage approach helps us better serve them.


"In January 2017, about a month after the Triage team was in place, Supervisor Barb Hilde alerted me there was a young woman with a baby in the hallway sitting on the floor.  This young lady appeared to be upset and had been sitting there for quite some time.  I approached the young lady, introduced myself, and offered her assistance.  The young lady agreed she needed some assistance with some paperwork and I invited her into an interview room in the office with her baby.  The young woman had a significant injury to her right eye and a more minor injury to her left eye.  The baby, who was 11 months old was asleep in the stroller.  I observed the baby, and the baby appeared to look well.

I assisted the young lady with her paperwork and when we completed that, I inquired about her injuries.  The young lady stated she was hit by a patient at work who was in distress and provided me with a detailed series of events that led to the injury.  The young lady also needed assistance with financial assistance, so I consulted with the Triage FAD worker, Natalie.  I also took this opportunity to check if there were any cases opened, and found that there was a report made that this young lady was the victim of domestic violence by her baby’s father, and she was currently working with Advocates for Family Peace.  The young lady opened up a bit and told me she is currently homeless, so I assisted her with calling the common entry point of 211 and stayed with her during this process.  There was a bit of confusion with 211, and I assisted the young lady in getting an interview scheduled with a homeless outreach worker to begin that process.  While she was on the phone with 211, the young lady disclosed she was working with Advocates for Family Peace and they were putting her and her baby up at a local hotel, but that was only for a few days.  When the call finished, I again asked her about her injuries, but she did not waiver on being injured at work.  The young lady did tell me that her boyfriend, who is the father of her baby, had previously abused her.  She spoke of him being arrested and after that, she and her baby moved out of state- but then she agreed to move back to Minnesota when the boyfriend stated he was making changes.  The young lady spoke of her abusive childhood, how she was in foster care, how her parents have struggled with chemical dependency issues, and how she has a general distrust of county social workers due to negative things that have happened in her life.  The young lady told me she was “hanging out” in our building because she did not have transportation at that time and that a friend dropped off her and the baby around 9am that day on their way to work and she was coming back at 3pm to pick them up when she completed work.  I was able to obtain a few bus passes for her so her and the baby would be able to get around.  Natalie was able to provide the young lady with her and the baby’s insurance information as the baby was in need of immunizations and care- but she did not have the insurance cards as they were at the boyfriend’s house.  After they left, I contacted child protection to see if the case was assigned.

The next day, I spoke with the assigned child protection worker, Mickey Longrie.  There has been a child protection history.  I agreed to coordinate with the young lady the need for Mickey to meet with her about child safety.

I brainstormed with Jessie (RTH- Triage Community Partner) and Natalie about options for this young lady and her baby.  Justin (AEOA Triage Partner) had an opening in a supportive living environment for a two bedroom.  Jessie contacted him and learned it was still available. I obtained the young woman’s phone number and called her with this possibility. She was very happy and agreed to call Justin. I told the young lady we have the application here for her to fill out when she can get here.


I met with the young lady and assisted her with the housing application.  I informed her about the child protection report, which upset her greatly.  Assured her that she is not in any trouble and that the focus is child safety- and that she is doing all the right things by working hard to keep her baby safe.  The young lady met with RMHC Community Partner Nettie to complete the homeless outreach worker paperwork, which is a necessary component for housing.  During this time, the young lady opened up to Nettie about the domestic violence.

There were multiple barriers for the young lady and her baby to move into supportive living environment- financial, prior rental history, and emergency issues.  Natalie and Justin were able to assist the young lady greatly in resolving the issues.  During this time, the young lady was sleeping in her car while her baby stayed with her mother.  The young lady does not get along with her mother’s boyfriend, so she was not welcome in the home, but that her baby was, and that the baby was safe there.  The young lady was worried with all the barriers that she would not get into supportive housing- and if she did not get in, she was planning on returning to the abusive relationship with her baby, which no one wanted.  The safety of both the baby and the young lady were paramount.  The young lady was struggling with child care issues as the baby’s father was the child care provider prior to her leaving the abusive situation.  The young lady works and also was attending school- so child care is essential.  Natalie was able to contact the day care center and assisted the young lady with the necessary forms and paperwork so safe child care was available the next day so the young lady did not lose her job, and the baby did not have to be cared for in a volatile situation.

The young lady and her baby were able to move into supportive housing- providing them both with safety and stability free from violence.  The supportive programming provided in the housing continues to provide a safety net for the baby and her mother.  This young lady and her baby went from being in a violent home life, with little hope, and a very real possibility of returning to this unsafe situation, to secure housing, day care and food assistance in a very short eight days due to everyone in Triage stepping in to remove and resolve barriers.  The baby was safe throughout this process, and the mom and her baby continue to remain safe and supported."


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Author: Dana Kazel

Categories: St. Louis County Spotlight



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Dana Kazel 
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