Friday, May 27, 2011

Health Care for Homeless People

Photo by Cheryl Jones of the NEOCH Photo Project

Healthcare Initiative at NEOCH

The staff at the coalition advocate for quality and comprehensive healthcare for all people as a key component to ending homelessness and keeping people housed. This includes behaviorial health issues such as addiction and mental health problems. The cost of out of pocket healthcare can quickly bankrupt a financially comfortable family as well as a family living in poverty. It is a given that routine and preventative medical appointment is necessary throughout life in order to fulfill the most basic needs, and typically more complicated and expensive medical needs are sought as a person ages. The effects of the economic recession have caused greater numbers of people to seek out programs that provide free and reduced medical care.

NEOCH has been researching healthcare among people experiencing homelessness the last few years. In 2008 staff surveyed 300 homeless people and published a report called Heading For The Emergency Room: Ohio s Inability To Care For Its Poor, which outlined the finding of the surveys. The survey highlighted the fact that emergency rooms serve as the only place that poor people living in Cuyahoga County can find comprehensive health care. The 2008 study showed that preventative and maintenance care are often left unattended. For example, the majority of those surveyed had not been to a dentist in three years. It is the hope of NEOCH staff that we can raise funds to hire a Homeless Healthcare Advocate to serve the people of Greater Cleveland, below is a list of the project(s) the advocate would work on.
  • Review Entry/ Discharge policy for nursing homes
  • Review and solidify an alliance with direct health care organizations to develop common intake procedures.
  • Review the coordination of services to discharge protocol between and within the different health care organizations especially those responsible for providing health care to homeless individuals
  • Survey and meet with shelter director to learn about their interaction with the local hospital. This will include following up to see if both the local hospitals and shelters are adhering to the agreement that the County organized a couple of years ago to manage discharges into the shelters.
  • With the development of the new health care law, develop recommendations in collaboration with Care Alliance to improve access and discharge and intake methods.
  • Create steering committee to carry out recommendations on how to best serve homeless people locally.
  • Review other similar program and highlight two of those that could be used as a model for Cleveland to improve access and long term health care outcomes.
  • Provide a point person (health care individual advocate) for those experiencing homelessness who can advise a person experiencing homelessness about the services in the community.
Currently in the community there are only 8 to 10 respite beds available (that can only accommodate men) at a transitional facility. They can reside at this facility for up to four months. Shelter, especially the local emergency shelter, are not designed to help a person recovering from illness. Emergency shelters do not allow persons to stay in the shelter during the day, and those living in non emergency shelter are often not able to be in their sleeping quarters during the day. There is also the fact that shelter residents have no one to assist them with personal care issues or to monitor medication or to provide appropriate dietary needs. Care Alliance does a good job with medical clinics at some of the larger shelters and a doctor and nurse do regularly visit nearly every shelter in the community. But there is only the one facility that is specifically designed for respite care to those recovering from a health care crisis and do not have a home of their own.

There are many wonderful organizations that provide free or by donation healthcare to those experiencing homelessness in the greater Cleveland area, undoubtedly these programs save lives and lesson the health burdens of poor and homeless people. Unfortunately, there is a large demand for all health care services including treatment, counseling, dental, and rehabilitation. In order to be a healthy productive person, regular healthcare screenings are required. This is especially true for homeless people who face inclement weather, excessive time on the feet, poor nurturing, sleep deprivation, poor hygiene, self medication issues, or a lack of mental health services. It is exciting that in the near future poor and homeless people will have the majority of their preventative care fully covered by Medicaid and additional assistance with prescription coverage. While poor and homeless people will still face large barriers to healthcare, healthcare reform will offer many needed services and hopefully be a stepping stone for more comprehensive coverage that includes addiction services, mental health and reproductive health services to all fragile population.

by Holly Lyon
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1 comment:

Mark said...

Homeless is often airbrushed out of the traditional media and living in a tent should be by choice.

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