Clinica Msr. Oscar A. Romero

1. Clinica Msr. Oscar A. Romero Healthcare for the Homeless Program UCLA Honors 105- Client Program Evaluation Dr. Kathy O’Byrne, Dr. Neal Richman, Peggy Toy Jeric Huang | Pauline Matar | Rocio Mercado | Jacqueline Tak | Junyi Xie Anna Chen, PADRES Contra El Cáncer Maryann Situ, Clinica Romero

2. History of Clinica Romero • The Clinica Romero Pico Union site was founded in 1983. • Clinica Romero began as a program of El Rescate, an organization created as a resource center for Central Americans fleeing civil war in El Salvador. • Clinica Romero has been serving the healthcare needs of the homeless population in Pico Union since 1983.

3. History of Clinica Romero Northeast Site Clinica Romero Northeast: 2032 Marengo StreetLos Angeles, CA 90033 • After the closing of a major health facility in East Los Angeles, the responsibility of addressing the health needs of the community shifted to community clinics. • In response to the increasing need for healthcare services in Northeast Los Angeles, Clinica Romero opened its Morango Street site, taking on the responsibility of providing healthcare to the East Los Angeles population, including healthcare services for the homeless population

4. Organization Background • 150 staff members, 3 sites (2 clinical, 1 community center) • Services provided: - Medical - Dental - Health Education - Case Management - Substance Abuse - Mental Health - Community Organizing - Advocacy - Referral Services Eduardo A. Gonzalez, M.D.Executive Director

5. Healthcare for the Homeless: Program Objective To provide comprehensive health care and case management services to the homeless populations of East Los Angeles and Pico-Union.  Clinica Romero, Mission Statement

6. Recent Observations • Low 2006 first-quarter utilization for the Healthcare for the Homeless program • Changes in front-office staff and management • Shift in reporting responsibilities (billing supervisor  front office supervisor) • Limited outreach in the past few months

7. Research Question How can Clinica Romero achieve its goals for the homeless healthcare program serving Pico Union and East LA?  Reach at least 1,415 Homeless Clientele per year (People who come in to the clinic)  5,069 Homeless Encounters per year (Number of services used) *based on Northeast Valley Health Corporation contract-specific requirements

8. Possible sources of low utilization • Identification • Documentation • Information System • Change in Homeless Population

9. Research Methodology • Find out the homeless population demographics in East LA • Survey intake staff on intake protocol and training system • Assess intake information system • Interview nonprofit agencies that work with the homeless

10. Metro Service Planning Area (SPA 4)

11. Homeless Population: Gender CLINICA ROMERO 1,415 Homeless Clients per Year (Annual Projections) Men 52% Women 48% SPA-4 52,961 Number of People per Year (Annual Projections) Men 73% Women 24% Transgender/Decline to state 2% *Source: 2005 Greater Los Angeles Homeless Count- January 12, 2006 <www.lahsa.org>

12. Homeless Population: Ethnicity SPA-4 CLINICA ROMERO

13. Homeless Population: Age

14. Intake Staff Survey Results TRAINING • All respondents had not received NEVH training in the past 6 months INTAKE PROTOCOL • “do not follow it” • “needs improvement” INTAKE CHALLENGES • “drug or alcohol users, the way we approach them is different…” “We need…to have better communication with all the departments including all sites.”

15. Information System Assessment Methodology • Generated manual list of homeless clients and visits using superbills. • Generated electronic list through clinic reporting software, MedInformatix 3. Compared the two lists for accuracy of medical record numbers and date of birth. (September to November 2005)

16. Accuracy of MedInformatix Database Query

17. Interviews with Nonprofits Homeless Intake Procedures We strive to make the intake forms more readable for our clients so we do not overwhelm them and discourage them from using our services.” – Sondra Lender, Director of Chrysalis, Santa Monica Office Homelessness must be confirmed in writing by 3rd party -Mike Alvidrez, Executive Director, Skid Row Housing Trust Geographic or Demographic Shifts “There seems to be more persons who are Latino” - Nickolas Milfeld, Case Manager, LAMP (Los Angeles Men's Place)

18. Findings • Clinica Romero is serving a significant portion of Hispanic/ Latino population (85% of Clinica Romero clients are Hispanic/ Latino) • Clinica Romero offers translators in several languages (including Spanish) to make their services more accessible to the surrounding Hispanic/ Latino population • Clinica Romero has a great network of agencies and community resources that they make available to their clients

19. Recommendations • Increase outreach efforts to reach homeless population (i.e.- mobile clinic) • Provide regular training for intake staff to ensure an updated protocol is followed • Provide training to staff to ensure accurate reporting

20. Future Research • Continue research on the homeless demographic focusing specifically on the East Los Angeles and Pico Union communities that Clinica Romero serves • Observe the intake systems of other health clinics in the process of revising the Clinica Romero intake system • Determine the source of low accuracy homeless program queries generated by the computer information system

21. Thank You! It was a very humbling experience seeing all that Clinica Romero is doing for the community. We hope our recommendations will help more homeless people gain access to healthcare resources!