A new public health professional at Cottage Health is providing medical care for homeless patients as part of a collaborative community program.
The health care system recently hired Julia Petras as the new community nurse in the Population Health department, and her role includes assisting the homeless who need medical assistance to connect with primary care providers. The Population Health initiative at Cottage Health helps people before they have a health emergency, with a goal of individuals staying healthier and less likely to hospitalization.
Petras helps Santa Barbara’s most vulnerable community members who are living on the streets and who tend to end up in the hospital emergency department as a last resort measure.
“I’ve kind of had to evolve and shape my role because it is new, and no one has been in it before,” she said. “It’s still very much evolving.”
Petras began her role with Cottage Health in mid-February, about a month before COVID-19 officially hit Santa Barbara County. The first confirmed case of novel coronavirus in the county was announced in mid-March.
She has served as a nurse for eight years and earned a bachelor of science degree in nursing from the University of Vermont in 2013.
“I went to nursing school with the intention of going into a public health field,” Petras said. “I thought nursing was a good avenue into the public health field.”
She brings experience in home-care and community nursing, and she dabbled in acute cardiology, among other positions.
Petras served in Bangladesh during the Rohingya refugee crisis and assisted with the emergency response through Medical Teams International, a humanitarian relief non-profit focused on providing life-saving medical care for people in crisis.
“I’ve always had a travel bug,” Petras said. “I’ve always had this deep drive to help the most vulnerable, and the population that always fascinated me was refugees.”
Petras received a diploma in tropical nursing, and in December 2019, she earned a master’s in international public health from the Liverpool School of Tropical Medicine in England.
While getting a master’s degree, she spent time conducting a household survey for maternal and child health of refugee communities in Uganda.
The Santa Barbara-based community nurse role at Cottage Health sparked her interest after serving internationally for some time.
She actively looked for a job in public health and searched for a position that matched her skills.
“I felt like I wanted to serve my local community, and have experience working domestically in a public health sector,” Petras said. “When I saw this posting, I thought it was interesting because you are working for a hospital, but you are working in public health, and I thought that was neat because not many hospitals have a Population Health Department.”
Her new role working to improve the health of people experiencing homelessness is relevant to her interests and experiences.
“Even though it is my first job exclusively working with the homeless population,” Petras said. “I definitely have worked with the homeless in various settings in the past.
“I saw a link between refugee populations that I’ve worked with in the past and the homeless population,” she continued. “Some of the needs of the populations are similar, and there are some stark differences as well…I thought my skill set and experience would well serve the homeless population.”
The homeless clients Petras see through the Santa Barbara Connect Home program are derived from a so-called top 50 list, which includes the highest utilizers of emergency services, like hospital emergency departments, medical transportation and others, Petras said.
She also follows graduates of the Cottage Recuperative Care Program.
In partnership with PATH Santa Barbara and Cottage Health, the program is designed for homeless individuals who are medically vulnerable and who need a place to recuperate after a medical event or hospitalization.
Petras has taken on a critical role during a global public health emergency.
Both client groups and programs that Petras sees are among the most vulnerable to COVID-19, given their underlying chronic health conditions, age and homelessness status, she explained.
She visits clients at their new homes at the Housing Authority of the city of Santa Barbara properties, as well as the PATH Santa Barbara shelter, Santa Barbara County’s non-congregate shelter for housing people during the crisis, and motels, where City Net is sheltering their clients most vulnerable to COVID-19.
Coronavirus measures meant to slow the spread of the virus have created new opportunities for client visits.
The virtual visits have become an opportunity to more easily connect homeless clients to their medical homes for the management of their chronic conditions, Petras said.
Those visits, in turn, decrease unnecessary emergency department volume that can overburden the hospital system, “which is especially problematic during a pandemic,” Petras said.
The virtual visits allow a provider to see the environment the client is living in during the session. This can give a provider a better picture of the patient and needs that may have been missed in a traditional office visit, Petras said.
The virtual visits also eliminate a transportation barrier, Petras added.
Substance abuse and in particular, alcohol and methamphetamine use, are big problems in the area’s homeless population, as well as vision issues and chronic conditions.
“Our cottage outreach team is actively engaging clients in substance abuse program referrals during this COVID-19 time,” Petras said. “We are happy to see those services available for our clients at this time especially.”