Today, Wednesday, August 15th, is National Health Care for the Homeless (HCH) Day, a time when the country and health centers focus on the importance and contributions of HCH programs. Now, as much as ever, it is important that they know our story. The story of how the HCH program has grown is impressive. In response to the growing number of people without homes, the HCH program has grown from 19 programs in 1985 to 300 HCH programs across the country, with at least one in every state, Washington, D.C., and Puerto Rico. In 2016, HCH programs provided services to 934,174 people experiencing homelessness.
But much more impressive and important to the country and mainstream health system is HOW we provide services. By serving the most vulnerable and marginalized, we model how care should be delivered to everyone. There are many examples, but I’ll just highlight three here: addressing behavioral health needs, addressing social determinants of health, and delivering care in disasters.
The opioid epidemic is taking lives and crippling communities in all parts of the country, and the mainstream health system knows they need to integrate behavioral health with primary care, but is trying to figure out HOW to do it. HCH programs are leaders in this. For more than 30 years, HCH programs have provided mental health and substance use disorder services along with primary care. According to 2016 UDS data, a physician in an HCH program was 6-10 times more likely to employ Medication-Assisted Treatment than physicians in regular health centers.
HCH programs have always addressed the social service needs of their patients. Outreach to meet people where they were (physically and psychically) has always been—and remains—a staple of HCH programs. We have succeeded in building relationships that allow us to know the person’s needs beyond the medical ones—and to address them, including linking them to appropriate housing. Medical respite was created out of the impetus to treat more than a person’s immediate medical needs, and out of the realization that if a person was cleared to be discharged from a hospital but did not have a suitable place to become stabilized, their health would deteriorate.
Natural and man-made disasters are becoming increasingly common, and the health system is ramping up to provide care to disaster victims. They will have to serve people who have no place to go, who are traumatized, and who show up for care without identification, prescriptions, or an accessible medical history. HCH programs do this every day and are often called upon to be a leading part in the response to disasters.
Today, we celebrate HCH Day, with more than a touch of bittersweetness. We wish that there were no people experiencing homelessness in the richest country on earth, but we are glad that we can be there to help our neighbors. We also are aware that in serving the marginalized, we have uncovered lessons that are applicable to how care should be delivered to everyone. We’ve a story to tell to the nation—and it’s up to us to tell them our good news. Let your community and your local and federal officials know about the great and vital work you do.