Health Care Center for the Homeless, Inc.

The Health Care Center for the Homeless (HCCH) is a 501(c)(3) founded in 1993 by Dr. Rick Baxley, a volunteer physician who saw the need to provide quality health care services to the homeless population in Orlando. HCCH initially shared a space at the Coalition for the Homeless, providing evening clinic hours one or two nights a week. In 1995,HCCH received a grant from the Robert Wood Johnson Foundation to provide primary health care to the homeless in Orange, Osceola, and Seminole counties. In 2002, HCCH was granted funding from the Health Resources and Services Administration (HRSA), Bureau of Primary Health Care to increase the center’s capacity and financially support the provision of primary and preventive health care services for the homeless. For many years, HCCH operated medical and oral health services out of three separate locations. In 2006, HCCH opened our clinic building, the Orange Blossom Family Health Center in Orlando, and doubled our capacity. HCCH is the sole provider of health care services for the homeless population in the tri-county area, taking a multi-disciplinary approach to delivering quality health care services. This approach merges aggressive street outreach with integrated systems of primary care, oral health, behavioral health and substance abuse counseling, case management, and advocacy. In 2007, HCCH received a $1.1 million grant from the Health Resources and Services Administration (HRSA), Bureau of Primary Health Care. This funding enabled us to increase our medical capacity and allowed us to create our HOPE Mobile Medical Unit. This 37 foot medical clinic on wheels is equipped with two exam rooms and a waiting area and is staffed by a physician assistant, a behavioral health counselor, and two medical assistants. This mobile unit is targeted at the homeless population in Orange, Osceola, and Seminole counties. 2008 saw the completion of our Phase II construction, adding four new medical exam rooms, medical and behavioral health offices, and a patient education and counseling center. The construction was funded by a Community Development Block Grant (CDBG) from the City of Orlando and private funds. Within the next year, we hope to begin our Phase III construction, focusing on a dental clinic expansion, which will add four additional dental operatories and relocate the administrative suite.

Services

Primary medical care is provided by a team of physicians, nurse practitioners, physician assistants, registered nurses, medical assistants, and student interns. Our goal is to create a medical home for our patients in an effort to prevent the inappropriate use of hospital emergency rooms. HCCH is providing healthier options in the management of chronic diseases. Through the Health Disparities Collaborative, a program designed to reduce disparities in health outcomes for poor, minority, and other underserved people, we use a Chronic Care Model. This is designed to empower the patient to take charge in managing their own health. HCCH also operates an in-house pharmacy and has a full-time Patient Assistance Program (PAP) Coordinator. The PAP program helps patients obtain free medication through various pharmaceutical companies. We were able to double our capacity with the opening of our clinic building, but the demand for our services continues to grow. As we provide primary care, we have an Orange County Referral Specialist who provides patients with referrals for secondary care.

Pediatric Care Poverty and homelessness do not discriminate based on age. The fastest growing homeless population is women with children. Domestic violence often affects innocent children and their health needs may be overlooked. At HCCH, our pediatric program provides services that include well child check-ups and immunizations. Our second mobile medical unit visits a local shelter to provide care for mothers and children. This outreach, along with other services provided at the Orange Blossom Family Health Center, is giving kids a healthier start in life.

Vision Services We offer eye exams and distribute glasses free of charge. Through a partnership with Lions Club International and LensCrafters, we are helping people see better and take care of the precious gift of sight. LensCrafters provides free screenings and glasses for 30 of our patients every Thanksgiving as part of Hometown Days. Our Vision Center is the only source of free optometric services for the homeless in Central Florida. We also screen patients for vision related issues that may result from diabetes and other chronic illnesses.

Dental Services Dental services at HCCH are provided by a team of dentists, hygienists, and dental assistants. Our range of services include emergency dental care, oral screenings, cleanings, restoration work, and referrals for surgery. In some cases, we are able to provide full or partial dentures aided in the process by our volunteer, Sister Jessica. We have also established a pediatric dental program that benefits both children and adults by providing oral health education. We believe good dental care not only gives someone a great smile, but also builds confidence. A nice smile can be essential in gaining employment in Florida's service driven economy.

Behavioral Health Services Our behavioral health services are provided by two licensed mental health counselors, a licensed clinical social worker, and a psychiatric nurse practitioner. This program is the only one in Orange County furnishing behavioral health services to the homeless. Our team of counselors provides mental health and substance abuse counseling, individual and group therapies, and referrals to detoxification and crisis centers. Our psychiatric nurse practitioner is able to prescribe and manage medication on an on-going basis for our homeless clients with chronic behavioral health issues. Our clinic is also an approved site for graduate level mental health interns and students. Our behavioral health team is empowering our clients to make better choices in gaining control of their lives. Health Care Center for the Homeless

The HOPE Team (Homeless Outreach Partnership Effort) Our outreach team is comprised of staff and volunteers working where the homeless live - on the streets and in the woods. The team provides basic needs such as food and clothing in an effort to build a rapport with clients who have an innate mistrust of people, eventually allowing staff to introduce clients to the services that HCCH can offer them. The team provides transportation for clients living in the woods to the clinic for health care appointments. The HOPE Team also assists homeless clients in obtaining identification cards, birth certificates, transitional housing, and referrals to behavioral health and substance abuse treatment programs. The team has also facilitated reconnecting individuals with their families.

Mobile Medical Program Building on the success of our HOPE Team, HCCH launched the HOPE Mobile Medical Unit (MMU) in May of 2008, funded through a Federal grant. Serving the community for almost a year now, this 37 foot unit is equipped with two exam rooms and is staffed by a medical provider, a behavioral health counselor, and two medical assistants. This unit provides medical and behavioral health services for the homeless in the tri-county area, visiting 18 community partner sites each month who also serve the homeless. In 2009, HCCH launched a second mobile medical unit through the generosity of the Senior Resource Alliance and Florida Hospital. This second unit will allow us to reach even further in the community to connect homeless individuals who are unable to come to our clinic location for medical services they desperately need. This program mirrors the Regional Commission on Homelessness approach for addressing the health care needs of homeless in the tri-county area.

The TB Shelter HCCH has the only residential facility for the homeless suffering from tuberculosis in the State of Florida. Our 10 bed residential shelter provides on-site supervised therapy for patients diagnosed with infectious tuberculosis. In operation since 1995, the shelter ensures patient safety and limits their contact with the community as a whole. Full recovery usually requires an average stay of six months and patients are monitored for their response to treatment. Twelve patients were served by this program in 2008, for a total of 1,272 bed nights. Patients are monitored for social and nutritional needs and are supplied with food partially funded by local churches.

Emergency Room Diversion Program The Health Care Center for the Homeless (HCCH) has a Health Navigator in the emergency room at Orlando Health. Many within the homeless population use the emergency room as their primary medical care provider. To reduce this improper use, the Health Navigator routes homeless individuals to our clinic, the Orange Blossom Family Health Center. Here, they can receive consistent medical care and are provided a medical home. Of the patients that kept their ER follow up appointments at the Orange Blossom Family Health Center, 68% did not return to the emergency room.

Linkages

HCCH has linkages to Heart of Florida United Way, Florida Hospital, Orlando Regional Healthcare, Orange County Health and Family Services, Primary Care Access Network (PCAN), and City of Orlando.

Statistics

Estimated homeless population: 8,800

Patients served: 6,020