Though they gained positive insight about Del Norte County, Colleen Machado and Shelby Bodenstab say they have learned accessing food, fresh water, child care, medical care and other necessities isn't easy for many living in Klamath, Gasquet and Smith River.

Machado and Bodenstab, employees with the Del Norte County Public Health Branch, have been tasked with gathering input from residents for the agency's first Community Health Assessment. And though the assessment will focus on the whole county, Bodenstab says she and Machado especially want to hear from those outside Crescent City.

Bodenstab and Machado held a meeting in Smith River on Wednesday, hoping to hear from families in the Latino community especially, but no one showed. The Public Health Branch will hold another health assessment meeting Friday in Klamath.

"We are at the very least offering them the opportunity to make their voices heard, which doesn't happen very often," said Bodenstab, a public health nurse.

Bodenstab said she and Machado, the agency's immunization coordinator, learned that Gasquet, Klamath, Smith River and Del Norte's other outlying communities don't receive many direct services from the county Department of Health and Human Services. The Public Health Branch has more freedom to provide services to those areas, conducting home visits and holding flu shot clinics, but Bodenstab says the more she and Machado hear from residents, the more they realize "how much is lacking."

"One of the things we heard in Gasquet was 'you guys are the only direct service we get out here,'" Bodenstab said, referring to a flu shot clinic the Public Health Branch held in that community. "They were very grateful. It's one tiny thing we do once a year and they were overwhelmingly grateful for it and we're like 'we were out here in the fall.' 'Yeah,' (they say), 'but you came.'"

The Public Health Branch is still in the process of collecting data to formulate its Community Health Assessment. The meeting in Smith River was among the agency's second round of public meetings, according to Bodenstab.

Putting together a Community Health Assessment is necessary for the Del Norte County Department of Health and Human Services to be accredited through the Public Health Accreditation board. Once the data has been collected and the Community Health Assessment has been released, the Public Health Branch will create a Community Health Improvement Plan.

According to Machado, being accredited sets the standard for how the local Public Health Branch delivers services and engages with the community. Between eight and 10 counties in California are accredited, she said.

Bodenstab added that it would probably be difficult to get funding soon if DHHS isn't accredited.

"We owe it to our community to be able to organize community health, make sure everyone's getting what they need," she said.

Drawing on notes taken at the first Smith River meeting on March 13, Bodenstab said residents mentioned the redwood trees, ocean, parks, climate and weather as positives. Smith River is ideal for gardening and residents liked that there was a year-round program through the local elementary school.

Latino residents appreciated True North Organizing Network's role in helping them advocate for themselves, saying they needed more assistance in that realm. They also appreciated the K8 structure at Smith River School that enables their children to stay together until they go on to high school, Bodenstab said.

The Crescent City Farmers Market was another positive among Smith River residents, as well as those in Klamath and Gasquet, though they wished there was a farmers market closer to home, Bodenstab said. Though Gasquet has a farmers market, Bodenstab said residents wanted a larger market.

Bodenstab noted that another strength for the Smith River area was the Tolowa Dee-ni' Nation, which offers workshops and has an elder nutrition program. United Indian Health Services also operates a medical clinic in Smith River, though it's only available to tribal members and their households, Bodenstab said.

For much of Del Norte's Latino community, medical services are lacking. Most go to Open Door Clinic in Crescent City where there's a sliding fee scale and the language barrier is lessened, Bodenstab said. She noted that for the Latino and Hmong population in Del Norte County finding a medical provider who can speak their language is a huge barrier to accessing medical care.

"In public health we're just starting to understand how big the barrier there is," Bodenstab said. "We're finally at that point we can acknowledge it and say this is a huge gap for services."

Bodenstab, who works with mothers and families, said this is especially true for those needing prenatal care. She said the Public Health Branch is working on creating a poster that informs expectant mothers in Spanish, Hmong and English where to go to get that care.

A lack of medical insurance and a lack of privacy are other challenges the Latino population faces, Bodenstab said.

"People say we will pay for insurance, but you have to have a Social Security number and so we can't pay for insurance, but we're willing," Bodenstab said. "We know how much, how important it is...."

Because there is only one clinic with Spanish translation, there is a significant lack of confidentiality, Bodenstab said. Bodenstab said one woman told her and Machado that she had gone into the clinic and when she got home her mother knew that she had gone and why she was receiving care.

"And she's like 'my gosh I didn't want my mom to know,'" Bodenstab said. "One of the things mentioned is when people went from public insurance and they were able to get into private insurance, they immediately switched providers because there would immediately be confidentiality even if there was still a language barrier."

Though they had their concerns, Bodenstab said residents who attended the March 13 meeting in Smith River also had suggestions for improving health. One of which was to use Smith River School's gym for yoga or Zumba classes. The other was for neighbors in Smith River to reach out to each other.

Residents also suggested educating health care providers about confidentiality laws and having True North incorporate more trainings for the Latino population on self-advocacy in a medical environment.

"One of the really cool things I liked was let's have specific hours for translators being available at clinics so people here can plan their appointments, perhaps in clusters, and go together," Bodenstab said, adding that the Latino population generally doesn't use the public transit system. "They can ride share together and there's people that speak their language."

People can still provide input on the Community Health Assessment by visiting https://tinyurl.com/HealthyDelNorte. According to Machado, the Public Health Branch will accept data from the public through the beginning of May.

The meeting in Klamath will be held from 3-5 p.m. Friday at Redwood Hotel and Casino. Refreshments and childcare will be provided. To RSVP, visit dnCHAk.eventbrite.com or call (707) 464-0861.

Reach Jessica Cejnar at jcejnar@triplicate.com

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