An Integrated Approach to Whole Person Care That is Transforming Homelessness

Providing healthcare for homeless patients presents some of the most challenging (and costly) conditions in medicine. Patients often have multiple concurrent conditions including a history of poorly managed chronic disease, substance abuse disorder, and behavioral health issues. All these challenges are compounded by the lack of stable housing which makes it difficult, if not impossible, for patients to own and use medical equipment, store and take prescribed medicine, eat a healthy diet, or get sufficient amounts of sleep.

Healthcare for the Homeless Programs

Healthcare for the Homeless programs tackle these challenges head-on, seeking to provide quality care and improved health outcomes in even the most difficult patient populations. More than 200 Healthcare for the Homeless programs operate in all 50 states, the District of Columbia, and Puerto Rico. Some of these federally funded programs are operated by Federally Qualified Health Centers and serve general, medically under-served populations in a given area. Other programs target services to specific, designated populations, such as homeless veterans. In 2012, these programs served over 835,000 patients nationwide.

In addition to basic primary and preventive health services, Healthcare for the Homeless programs must also offer:

  • Substance abuse treatment, either through a partnership or directly
  • Case management services
  • Services that enable people to use other Health Center services (such as patient outreach, transportation, and language translation services)
  • Patient education on obtaining and using health serviceshealthcare-for-the-homeless-puzzle-pieces

While mental health services are not a required component of Healthcare for the Homeless programs, services under federal programs require mental health services be provided directly or through partnerships with other providers.

Case Study Example: Colorado

The Colorado Coalition for the Homeless is a nonprofit organization which provides housing and integrated healthcare to homeless individuals and families in the state. The Coalition operates a Federally Qualified Health Center designated as a Healthcare for the Homeless program.

The Coalition practices a multi-disciplinary approach to delivering care — aggressive on-the-ground outreach is combined with integrated systems of primary care, mental healthcare, substance treatment services, dental care, vision care, case management, patient advocacy, and linkages to essential services such as housing, and other critical supports.

This integrated approach allows the Coalition to provide true whole-person care to the homeless populations it serves. For example — a patient comes into the center for one condition and during the visit other medical issues become apparent. Treatment for these additional concerns can often be provided on the spot by walking the patient to another provider located in the same facility.

To accomplish this vision of integrated care the Coalition, and similar Healthcare for the Homeless organizations across the country, focus on three key goals:

  • Achieve Practice Transformation – When primary care, behavioral health, and other providers are located in the same facility it is easier for patients to receive whole person care and for providers to collaborate on patient care plans
  • Enhance Provider Competencies — Medical providers tend to specialize in their area of medicine and be unfamiliar with other medical or behavioral health specialties. In addition, providers may need education on the impact of homelessness on health care and adjust their treatment recommendations to encompass the social determinants of health
  • Strengthen Organization Capacity — Improving the capacity of the facility to deliver high quality healthcare is a challenge that involves the entire organization, not just the front-line providers. All within the organization must be aligned to provide the support and structure necessary to deliver quality goals

Eccovia Solutions is a leading proponent of integrated care models which deliver whole person care. ClientTrack, our care coordination platform, simplifies the tasks required for provider collaboration, integrated care, and addressing the social determinants of health in a medical setting. Our customers include Healthcare for the Homeless and housing programs which seek to integrate housing solutions as part of a comprehensive medical care solution.

Blog Resource

https://aspe.hhs.gov/reports/primer-using-medicaid-people-experiencing-chronic-homelessness-and-tenants-permanent-17

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