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HomeMy WebLinkAboutMINUTES - 02042014 - C.65RECOMMENDATION(S): 1. ACCEPT the annual report from the Health Services Department regarding Health Care for the Homeless; and 2. RECOMMEND that staff continue to report on an annual basis to the Family and Human Services Committee regarding progress and status of the Project, with an additional report to the full board, annually. FISCAL IMPACT: No impact. The HCH Project is funded through a Public Health Services Act Section 330(h) grant from the Health Resources Services Administration. BACKGROUND: Since 1990, the Health Care for the Homeless (HCH) Project has provided health care services to the homeless population through mobile clinics, as well as through the CCHS integrated ambulatory system of care, and the Behavioral Health departments. Primary health care services provided by the HCH Mobile Team include routine physical assessments, basic treatment of primary health problems such as minor wounds and skin conditions, respiratory problems, TB screening, acute communicable disease screening, and coordination and referrals for follow up treatment of identified health care needs. A significant portion of the homeless patients seen in the mobile clinics have chronic diseases, including asthma, hypertension, diabetes, and mental health/substance abuse issues. The HCH mobile team is comprised of a Medical Director, Family Nurse Practitioners, Registered Nurses, Community Health Workers, Mental Health Specialist, Substance Abuse Counselor, Consumer Liaison and Certified Enrollment Counselors. APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 02/04/2014 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Candace Andersen, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: Rachael Birch, 925-313-6167 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: February 4, 2014 David Twa, County Administrator and Clerk of the Board of Supervisors By: June McHuen, Deputy cc: C. 65 To:Board of Supervisors From:William Walker, M.D., Health Services Director Date:February 4, 2014 Contra Costa County Subject:Health Care for the Homeless Project Update Homeless patients who receive care on one of the mobile clinics are referred into one of the CCHS ambulatory care health centers for primary and specialty care, into County mental health and substance abuse services and to Contra Costa Regional Medical Center for emergency, inpatient hospital, outpatient surgeries, laboratory and radiology. There are currently four ambulatory care clinics, located in San Pablo, Antioch and Concord, designated specifically for homeless patients to help them transition from the mobile clinic setting into the ambulatory care system. HCH mobile team members staff each of these clinics. During 2012, CCHS treated 16,947 homeless patients who generated 111,944 visits. This is an increase from 2011, when CCHS saw 16,487 homeless patients who generated 104,910 visits. The increase is likely due in part to the declined economy which places further demand on the safety-net system, including CCHS, partly due to the increase in the capacity of CCHS clinics and partly due to the increase in Medi-cal eligible clients through Health Care Reform. Data for 201 will be available in late Spring 2014, and will be presented to the Family & Human Services committee. BACKGROUND: (CONT'D) New Actions The following activities have occurred since the last briefing to the Board of Supervisors on HCH activities: Homeless Respite Care and Shelter Clinic The HCH Project continues to provide all medical and nursing care at the Philip Dorn Respite Center and continues to operate the licensed Respite clinic. The clinic serves homeless individuals staying at the Concord shelter and Respite, as well as all clients who meet the homeless criteria. Open four days (20 hours) per week, the clinic includes an RN, FNP and Community Health Worker. The Respite clinic recently added a half-time Psychiatrist who works with the HCH providers to address behavioral health concerns among the clinic and Respite center patients. Pro-Bono Dental Health Services for Homeless Clients The Homeless Consumer Advisory Board and HCH launched a partnership with a small group of private dental providers who provide services free of charge to homeless individuals who do not qualify for dental coverage through other programs. The Advisory Board has been a strong advocate about the need for this free service given a lack of affordable dental services, and we are very pleased that a pilot program will address some of this unmet need. A seventh client will soon begin receiving services from Dr. Alijanian, DDS, of Walnut Creek. Dental services are essential to regaining employment and exiting homeless. AB 109 Program The HCH Project recently began providing medical services to the AB 109 Program parolees through referrals from the Program’s forensic team. This forensic team ensures that parolees have access to Behavioral, Health, Medical and Social services by linking them to County services. Reentry Program for Individuals Exiting Incarceration The HCH Project continues to provide staff at the PACT (Probation and Community Together) monthly meetings, providing parolees with assistance in entering our health care system. New Clinics The HCH Team received a New Access Point HRSA grant to provide an integrated team of providers at the newly opened Concord Health Center 2 (CHC2) building. The grant funded a Psychiatrist, a Substance Abuse Counselor, a Mental Health Counselor, 2 Community Health Workers and a Public Health Nurse, who were added to the current clinical staff profile of the Ambulatory clinic. CHC2 provides mental health and substance abuse counseling, screening, home visiting and linkage services to patients. Homeless patients seen at this clinic have access to all services with reduced wait time to receive appointments. CHC2 opened in August 2013. New Staff Members The HCH team received an Outreach and Enrollment HRSA grant in October 2013 to hire and train two staff members to be Certified Enrollment Counselors through Covered California. Staff conduct in-reach and outreach to our homeless and at risk population, helping clients with their Medi-Cal or Covered California applications or connecting them to the County’s EHSD department for assistance. HCH also added a Consumer Liaison to our team in 2013. This position works directly with the Consumer Advisory Board and with homeless consumers to identify and address health needs in the community. Summary 2014 is proving to be an exciting and busy time of adjustment and growth for the HCH program as CCHS sees an influx of newly eligible clients. We expect that our next report will have significant updates on the milestones achieved for these new projects, while we also work hard to sustain the ongoing work of the mobile clinic team and homeless ambulatory care clinics. CONSEQUENCE OF NEGATIVE ACTION: The Board of Supervisors and the public will not have current information on program efforts. CHILDREN'S IMPACT STATEMENT: Not applicable.