Health Care for the Homeless (HCH)

1. Health Care for the Homeless (HCH) Housing is health care Margaret Flanagan, lgsw Disability and case management coordinator

2. Who we are Over 200 HCH projects nationwide Recognized model that specializes in serving those experiencing homelessness Established in Baltimore in 1985 as one of the pilot sites HCH provides comprehensive and integrated services offering pediatric and adult medical care, mental health services, case management, addiction treatment, dental care, vision, HIV services, outreach, and supportive housing

3. Locations in Maryland • Baltimore City – free-standing clinic, provides funding to four smaller projects in: • Frederick County • Baltimore County • Montgomery County • Harford County • Saw over 10,000 individuals last year across all sites; 80% in Baltimore

4. Who we serve (2011 data)

5. Our Mission Health Care for the Homeless works to prevent and end homelessness for vulnerable individuals and families by providing quality, integrated health care and promoting access to affordable housing and sustainable incomes through direct service, advocacy, and community engagement.

6. How HCH is structured Teams setup by discipline Work across teams to provide comprehensive care Working towards integrated, patient-centered teams Goal is to provide high quality care to as many individuals

7. Case management occurs across teams • Case management within HCH is diverse • Centers around the belief that housing is health care and the best way to serve individuals who are homeless is to work to end homelessness • Provides ongoing support to: • Manage chronic health conditions • Obtain benefits and income • Obtain and maintain housing • Education on resources • Connection or referrals to other programs

8. Case Management at HCH • Medical providers offer education about health management and disease prevention including Asthma, Diabetes maintenance and prevention, Hypertension, and HIV counseling, testing, and referral services • Homelessness is hazardous to one’s health • Higher incidents of chronic health conditions such as high blood pressure, Hep C, diabetes, and hypertension • How to manage health when living on the streets or in shelter

9. Case Management at HCH • Mental health providers offer counseling, crisis intervention and ongoing support to clients • Hard to focus on therapy without basic needs met • Benefits assistance for the most vulnerable • Groups to provide education and ongoing support • Addictions providers assist with compliance with treatment through harm reduction model • Phase groups • Individual plans • Meet the client where they are in recovery process

10. Case Management team • Case Management team assists medical, mental health, and addictions teams with short and long-term tasks to prevent and end homelessness • Application supports • Assistance obtaining identification • Referrals to employment programs • Applying for housing options • Connection to services within HCH • Mail services for clients who lack permanent address

11. Specialty programs at HCH The Adherence Program promotes the effective treatment of chronic diseases by encouraging healthy living practices and educating clients about disease management and HIV transmission prevention The Connect Projectprovides housing placement, home visits, and intensive case management to end or prevent the homelessness of people living with HIV/AIDS and other co-occurring health problems The Convalescent Care Programprovides recuperative care, case management, and nursing assistance for individuals who are too ill to recover in traditional shelters or on the streets

12. Case Management in and out of the home • Supportive housing • Housing first model • Provide supportive services in the home to help maintain housing • Counseling on energy usage, cooking, relationships with neighbors • Outreach engages people into services where they are • Works to connect vulnerable individuals to care in the clinic • Relationship building and meeting needs based on what the CLIENT identifies

13. Summary Health care for the Homeless provides comprehensive and integrated care to individuals experiencing homelessness Focus on preventing and managing chronic health conditions, accessing income and other benefits, and obtaining and maintaining homelessness In accord with direct service, also focus on advocacy in order to promote awareness and involvement in external environment