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Kelly Bennett, MD Medical Director TTUHSC Free Clinic. Homelessness. Definition of Homelessness. Per federal government: “people who lack a fixed, regular, and adequate night time residence” A true residence cannot be administered in a group setting by a government agency or charity.
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Kelly Bennett, MD Medical Director TTUHSC Free Clinic Homelessness
Definition of Homelessness • Per federal government: • “people who lack a fixed, regular, and adequate night time residence” • A true residence cannot be administered in a group setting by a government agency or charity
Who is Homeless • Children < 18 are 40%; majority under age 40 • African Americans 40% • Caucasians 38% • Hispanics 20% • 40% of men are veterans • 1/3 have severe addictive disorders • 16% have severe mental health disorders • 1% of population will be homeless at some point during each year (3,000,000) • On any given day between 400,000 and 800,000 are homeless
What Causes Homelessness • Poverty: 12.5% of the US population is living in poverty (37,000,000) • Poverty: not enough money to pay for shelter, food, clothing, utilities, health care, etc. These people have to pick and choose what they can pay for. • Poverty increasing due to: • Increasing unemployment • Decreasing wages • Decreasing Public Assistance
Causes of Homelessness • Foreclosures are up 33% in last two years due to mortgage crisis • Lack of affordable low income housing: as unemployment rises and low income wages fall the rents have increased • Mental health problems/Addiction problems: these people cannot sustain employment • Domestic violence breaking up families • Lack of coordinated health care system
What Can Be Done • Think: • C contribute • A advocate • R reach out (volunteer) • E educate
Contribute • Things that can be contributed: • Clothes • Food • House hold goods • Computers • Cell phones • Cash donations to charity groups
Advocate • Join a coalition • Example: can become “friends” with salvation army on face book to be aware what help is needed • Follow local politics • Local city council has homeless committee with meetings open to the public • Involve the Media
Reach Out • Volunteer at a shelter (Salvation Army in Lubbock) • Help build shelters/houses (Habitat for Humanity in Lubbock) • Volunteer professional services: legal aid, dentistry, medical care, counseling, child care, construction
Educate • Educate yourself and others • http://www.nationalhomeless.org • http://www.endhomelessnes.org • Participate in 24 hour fast • Participate in a sleep out
Medical Needs of Homeless • Primary Care • Urgent/Emergency Care • Mental Health/Counseling • Dental Care • Substance Abuse Treatment • Of these the only “easy” care obtainable is a trip to the ER
What is the Problem • Primary Care/Urgent Care/ Non Crisis Mental Health • Cost of visits: not enough low cost clinics; funding still an issue; most are open during the day when people are supposed to be working, looking for work, etc. • Medicaid: currently for pregnant women, minors, elderly poor; plan in future to extend who is eligible; GOOD LUCK with states cutting benefits • Local indigent funding: example: Lubbock LCI; difficulty with process, proving you are poor
Problems continued • Counseling • Veterans can receive counseling at local VA resources • Covenant counseling in Downtown works on sliding scale • Mental Health Taskforce meets in Lubbock at the LP&L building every two months to coordinate local efforts
Problems continued • Dentistry • MUCH larger problem than people are aware of • Why? Dental insurance not often offered by employers; extensive dental work very expensive • CHCL resources overwhelmed • Twice in last year dentists have staged a large clinic for the underserved; Civic Center last year; this weekend at Abbeyville Dentistry • At Free Clinic we have dental clinic once a month
Problems continued • Substance Abuse Treatment • VERY expensive time intensive process • Even people with the BEST resources (money and insurance) often have difficulty finding treatment • Managed Care in Lubbock has indigent beds but that is sporadic • Dove Tree also has some indigent beds
Local Lubbock Efforts • Lubbock census in 2009 had approximately 700 homeless • 2010 count more difficult due to one temporary shelter (Carpenter’s church) having shut down causing more dispersal of homeless • Count was last week; awaiting official numbers • In 2010 due to increased number of people needing shelter City Council called for committee • Down town businesses and local public library want homeless situation examined
Lubbock Council on Homeless • Last week went to Amarillo to examine their procedures • Mini mall with “stores” that are different charitable organizations, day care, etc. • Examining another process in San Antonio • Supposed to have recommendations for city council by this fall
What can you do • Volunteer at local agencies • www.lubbockhospitality.com has list of local charitable agencies • Dial 211 to locate agencies to help people in need • Purchase local “Red Book” with information listed for local organizations