Provides harm reduction services and wrap-around support for people accessing syringe exchange. Offers one-to-one exchange of clean syringe equipment, along with health education, wound care, and naloxone for overdose prevention. Includes Hepatitis C and HIV screening with referral for care, family planning services such as birth control counseling, contraception (Depo-Provera), emergency contraception, and pregnancy testing. Also helps with Medicaid enrollment and provides referrals for primary care, dental care, substance use disorder treatment, medication-assisted treatment, and other community services.

Harm Reduction Program offered by Cowlitz Family Health Center at Grade Street Campus

Provides harm reduction services and wrap-around support for people accessing syringe exchange.

Programs that distribute Narcan or other similar substances that block the effects of opiates such as heroin, morphine, codeine, OxyContin, methadone, fentanyl and Vicodin but cannot themselves be used to get a person high. Opiate antidotes can be used to reverse the effects of an opiate overdose including restoring breathing that has stopped or slowed down, and may be distributed to opiate users to reduce the number of deaths that occur from opiate overdose.

Opioid Antidote Distribution

Programs that administer tests which identify individuals who have been exposed to hepatitis A, B or C by detecting the presence of associated antigens, antibodies or genetic material (DNA). Hepatitis is an inflammation of the liver caused by a variety of agents including viral infection (hepatitis A virus, hepatitis B virus, hepatitis C virus and delta agents), bacterial invasion and physical and chemical agents. Hepatitis A and delta agent hepatitis are spread primarily from person to person via the fecal-oral route, but may occur by contact with water or food contaminated by the virus. Hepatitis B and C are spread by blood and serum-derived fluids and by direct contact with body fluids. Depending on the type of hepatitis involved, screening may be particularly recommended for persons who have traveled or worked in countries with high rates of infection, sexually active homosexual men, injecting and non-injecting illegal drug users, persons who work with infected primates in a laboratory setting, persons with chronic liver disease, persons with clotting disorders, blood bank and dialysis workers, dental hygienists, and other members of health care teams who come into contact with blood, body fluids or body tissue.

Hepatitis Testing

Programs that provide a comprehensive overview of available birth control methods including information about fertility cycles, natural family planning, contraception and sterilization, and help people evaluate their options and select the method that bests suits their needs.

Birth Control Counseling

Programs that provide sterile injection supplies and equipment to help prevent the transmission of HIV/AIDS, hepatitis B and C, and other blood borne infectious diseases; and prevent other health complications such as vein damage and infections. Items distributed may include new sterile needles with syringes, needle tips, syringes, acidifiers, alcohol swabs, chlorine disinfectant tablets, filters, stericups or cookers, saline, sterile water vials, sharps disposal containers, and tourniquets.  Also included are supplies for safe hormone injection for trans, gender diverse and two-spirited individuals who face unique barriers and inequitable access to gender-affirming health care services. Programs may offer supplies free of charge, in exchange for used ones; or sell new supplies.

Needle Exchange and Injection Supplies

Programs that offer HIV tests which are used to identify individuals who have been infected with the Human Immunodeficiency Virus (HIV) and are at risk for developing AIDS (acquired immune deficiency syndrome) or which are used to measure progression of the disease in people known to be infected. The most common HIV screening test is the enzyme immunoassay (EIA) which most frequently uses peripheral blood drawn from the arm or a finger as a sample, but can also be conducted using serum, oral fluids or urine. Repeatedly reactive EIA tests are confirmed using the Western blot or the immunofluorescence assay (IFA). The most common test that is used to measure disease progression is the PCR (polymeraise chain reaction) or viral load test. Many programs that provide HIV testing also provide pre-testing and post-test counseling which includes information about AIDS/HIV, reducing risks for HIV transmission, emotional support to help the individual deal with the testing process and test results, and information about and referral to other AIDS-related services.

HIV Testing

Programs that prescribe and/or supply temporary devices for preventing pregnancy which may include oral contraceptives (birth control pills), hormonal injections (Depo-Provera), intrauterine devices (IUDs), the patch, the sponge, cervical caps, condoms, foam, the vaginal ring and diaphragms.

Contraception

Programs that provide specialized treatment services for individuals who have chronic skin wounds such as pressure sores or ulcerations associated with diabetes and peripheral vascular disease that have resisted other forms of treatment.

Wound Clinics

Programs that utilize laboratory procedures to determine whether an individual is pregnant or which provide access to devices for establishing pregnancy that people can use at home.

Pregnancy Testing

Programs that link people who are in need of drug and/or alcohol use disorder services with appropriate resources.

Substance Use Disorder Referrals

Programs mandated by the Affordable Care Act (ACA) that help individuals who want to purchase insurance, and small businesses that need to provide health insurance for their employees, understand the qualified private health plans that are available within the marketplace and guide them through the enrollment process. The navigator conducts public education activities to raise awareness about the marketplace; distributes fair, accurate and impartial information concerning enrollment including information that acknowledges other health programs such as Medicaid and the Children’s Health Insurance Program (CHIP), and the availability of premium tax credits and cost-sharing reductions; provides referrals for consumers with a grievance, question or complaint; and offers information that is culturally and linguistically appropriate to meet the needs of the population served by the marketplace. Navigators are trained to offer expertise on each health insurance plan with the objective of empowering individuals to make informed choices and to facilitate selection of a qualified health plan; and either have or can easily establish relationships with the target population.

Navigator Programs

Programs that prescribe and/or supply birth control pills which are taken within 72-120 hours of having sexual intercourse to prevent an unintended pregnancy. Emergency contraception may be provided in the form of Plan B (2 pills), a large dose of regular birth control pills (two or four pills twice during a 12 hour period) or through insertion of a copper IUD.

Emergency Contraception

Provides the following healthcare services to drug users, focusing on issues that occur as a result of injecting drugs. 
- Abscess treatment and care
- Vein care consultation
- HIV/hepatitis testing and counseling 
- Hepatitis A & B vaccinations 
- TB screening
- Treatment for colds and upper respiratory infections 
- Harm reduction education
- Narcan
Offers counseling and case management as well as referrals to drug treatment and other health and social services. 
Connects users to Buprenorphine and Methadone treatment.

Injection Drug User Medical Clinic offered by Public Health - Seattle & King County at Robert Clewis Center

Provides abscess treatment and care, vein care consultation, HIV/hepatitis testing and counseling, Hepatitis A & B vaccinations and TB screening to injection drug users. Can connect them to Buprenorphine treatment. Narcan available.

Programs that identify individuals who have contracted tuberculosis by administering chest x-rays; the Mantoux test, the von Pirquet test or the Vollmer patch test, all of which determine the presence of a tuberculosis infection based on a local inflammatory reaction to a sample of the bacillus which has been injected or rubbed into the skin; or other screening tools.

Tuberculosis Screening

Medication assisted treatment (MAT) programs that use buprenorphin to help people with an opioid use disorder abstain from or reduce their use of opioids (usually heroin or painkillers such as oxycondin or morphine). Buprenorphine produces a weaker version of effects (including euphoria and respiratory depression) that are associated with full drugs such as heroin and methadone. The effects increase with each dose until at moderate doses they level off, lowering the risk of misuse, dependency and side effects. Treatment occurs in three phases: a medically monitored start-up phase when the patient is in early stages of withdrawal; a stabilization phase after a patient has discontinued or greatly reduced their misuse of the problem drug, no longer has cravings, and experiences few, if any, side effects; and a maintenance phase when a patient is doing well on a steady dose of buprenorphine. The length of time of the maintenance phase is tailored to each patient and could be indefinite. Once an individual is stabilized, an alternative approach would be to go into a medically supervised withdrawal, which makes the transition from a physically dependent state smoother. People then can engage in further rehabilitation—with or without MAT—to prevent a possible relapse. Ideal candidates for opioid dependency treatment with buprenorphine have an opioid use disorder diagnosis, are willing to follow safety precautions for the treatment, have been cleared of any health conflicts with using the drug and have reviewed other treatment options before agreeing to buprenorphine treatment.

Buprenorphine Based MAT Programs

Programs that provide counseling services for individuals at risk for contracting or transmitting the HIV virus with the objective of supporting their ability to make behavior changes that will reduce their risk of acquiring or transmitting HIV. Counseling involves a personal risk assessment, development of a personalized action plan and the decision to seek an HIV test. Individuals who have a history of injection drug use, unprotected intercourse or sexual contact, sexual activity at a young age, multiple sex partners, sexually transmitted infection, and/or sex trade work are considered to be at high or increased risk and are targets for prevention counseling.

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Harm Reduction Program offered by Cowlitz Family Health Center at Grade Street Campus

Injection Drug User Medical Clinic offered by Public Health - Seattle & King County at Robert Clewis Center