The New Hope Clinic provides medical, dental, nutrition, addiction treatment, counseling, outreach and case management for people living with HIV/AIDS in Yakima and throughout central Washington. Program director Debra Nelson remembers how New Hope began.

The History

"We started out with humble beginnings. In 1989, people with AIDS were coming home to Yakima to die. Unfortunately there was a tremendous healthcare provider shortage, and most people were receiving care in the emergency rooms. A core group of healthcare providers realized from the beginning that if we didn't all work together, we would continue to give fragmented care to those with the most need. After much consideration, a volunteer outpatient clinic was started that same year."

"In 1993, we were getting bigger and needing more resources -- office space, exam rooms and money to hire a part-time coordinator. We decided to go to Yakima Valley Farm Workers Clinic [YVFWC]. Today we operate at almost all of the YVFWC sites. Our main clinic is in Yakima, but we also see patients in Toppenish, Grandview, Walla Walla, and Hermiston, Oregon."

The People

"We now have a part-time medical director (Neil Barg, M.D.) who is an infectious disease specialist, five full- and part-time public health nurses, an outreach worker, chemical dependency specialist, and a dental case manager. The public health nurses see patients between clinics, provide teaching and health monitoring activities."

"We saw 135 patients last year. About 20% are women, 60% are Caucasian, and 35% are Hispanic. They live mostly in rural areas; about 25% are seasonal farm workers. Our clients' most pressing need is probably dental care. We also see seasonal farm workers who have a whole cadre of different kinds of needs. They need after-hours clinics; many need a lot of help negotiating the system. Just getting here is difficult. We see patients who travel over 100 miles to get services. Unless they are in Yakima, there are no bus services."

"We still see gay white men as the biggest category. Heterosexual women, however, are rising quickly. We are really seeing a rising number of Hispanic women. The need for bilingual services is quite intense. Usually we find monolingual people quite late in the disease and they need so much time and care to get their immune systems back. We have moved from a case management model to a primary care model. We use public health nurses exclusively. We find that they are in the best position to coordinate really complex care."