Published by: Jane Hooker on 8/12/2010 9:40:41 AM
In an article titled The Boston Health Care for the Homeless Program: A Public Health Framework in the recent American Journal of Public Health (August 2010), Dr. Jim O’Connell and the research team for the Boston Health Care for the Homeless Program provide a historical accounting of their work for the past 25 years. The introduction serves as a motivating call to action to address the needs of the nation’s homeless population and describes how they and their community partners have closed what seems to be an ever increasing gap between those that have and those that have not. Dr. O’Connell describes a journey where team members increased their knowledge about the vulnerable population they serve and subsequently identify new strategies to provide the care needed by the population.
Using the three core public health functions - assessment, policy development and assurance - and the 10 corresponding essential public health services, this team was able to stay true to their mission and identify real time, specific care needs for the individuals served as well as provide the needed services. Some of the issues identified were short term while others identified problems that led to program development.
An example of urgent but short term issue was the identification of an epidemic of non-HIV-tuberculosis that required specialized outreach to deliver 18 months of medications to control the epidemic. A long term need was identified for a comprehensive dental program that began as a part-time dentist working in two shelters and now provides care in several areas and includes a 5-operatory clinic with 3 dentists.
The Boston Health Care for the Homeless Program has proven to be innovative in the provision of care to this group of vulnerable patients. Examples include:
- a comprehensive electronic medical record
- provision of care to their clients at race tracks for horses
- the expansion of health insurance with a success rate that confirms that approximately 75% of BHCHP patients manage to keep crucial benefits without interruption (with the exclusion of those individuals who cannot produce required documentation)
- and the expansion of the concept of “street medicine” that has been included in local training programs for physicians, nurses, dentists and social workers
Throughout the article, process and outcome measures were provided validating the success of the program.
This Team should be very proud of the things they have accomplished and the positive impact they have had on the individuals they serve.