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HomeMy WebLinkAboutMINUTES - 12162008 - C.93 TO: BOARD OF SUPERVISORS - Contra FROM: William Walker, M.D., Director o• :,;Is�,a 's Costa x.... .. a e �; Contra Costa Health Services _ � if'�,C�v, DATE: December 15, 2008 A-�ppp' county 11 SUBJECT: Health Care for the Homeless Project Update (I f? SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION(S): 1. ACCEPT the report from the Health Services Department regarding Health Care for the Homeless (HCH); and 2. RECOMMEND that staff report on an annual basis to the FHS 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/REASON(S) FOR RECOMMENDATION(S): The Health Care for the Homeless (HCH) Project has been operated by Contra Costa Health Services since 1990. The HCH Project provides health care services lto, the homelessss, CONTINUED ON ATTACHMENT:--YES SIGNATURE: C,�' OMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE 4 -MPPROVE OTHER SIGATURE(S): ACTION OF BOARD ON x-�r,I"�' a APPROVE AS RECOMMENDED 4HER VOTE OF SUPERVISORS / I HEREBY CERTIFY THAT THIS IS A TRUE 1( UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: P ATTESTED �IJ�1.��np,,,/�a- t�f DAVID TWA,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact Person:Andrea Dubrow CC: Hlth Svcs Contracts,50 Douglas,#320A Public Health Division,597 Center#200 GNo- D 5a-5 OC- BY: 'DEPUTY SUBJECT: REPORT FROM HEALTH CARE FOR THE HOMELESS PROJECT, HEALTH SERVICES DEPARTMENT population through mobile clinics, as well as through the CCHS integrated ambulatory system of care, and the Departments of Mental Health and Alcohol and Other Drugs. 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 mobile team is comprised of a Medical Director, Family Nurse Practitioners, Public Health Nurses and a Registered Nurse, Community Health Worker, Financial Counselor, Mental Health Specialist, and Substance Abuse Counselor. 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 three ambulatory care clinics, located throughout the County, designated specifically for homeless patients to help them transition from the mobile clinic setting into the ambulatory care system. HCH staff members are present at each of these clinics. During 2007, the CCHS saw 10,310 homeless patients who generated 74,625 visits. 2008 data will be available in March 2009. Expanded Medical Services Grant In June 2007, CCHS received a two-year$480,000 Federal grant to expand medical services to homeless patients. HCH acquired the CCHS Health-On-Wheels Van to expand mobile clinic operations throughout areas of need in Contra Costa and hired 1 FTE Nurse Practitioner and 1 FTE Registered Nurse, along with a Driver/Clerk. Our goal is to serve up to 1,700 additional homeless patients per year. Governance of Health Care for the Homeless Activities As this committee may recall, Contra Costa Health Services is a recipient of the Public Health Services Act Section 330(h) Health Care for the Homeless funds, and as such, it must meet governance requirements set forth by the Health Resources and Services Administration Bureau of Primary Health Care. The current governing body for HCH is the County Board of Supervisors, with input from the newly restructured Contra Costa Interagency Council on Homelessness (CCICH). This Council includes homeless consumers and other key stakeholders of the homeless community. In addition, a Homeless Consumer Advisory Board meets monthly with Health Care for the Homeless staff, a representative of the Council, and staff from the Contra Costa Health Services Office of Homeless Programs. This Consumer Board provides regular reports to the Council. Other activities to ensure consumer input into the Health Care for the Homeless program include focus groups and patient satisfaction surveys conducted on a regular basis. New Actions The following activities have occurred since the June 2008 briefing to the FHS committee on HCH activities: r Y SUBJECT: REPORT FROM HEALTHCARE FOR THE HOMELESS PROJECT, HEALTH SERVICES DEPARTMENT h v 1. Through the Expanded Medical Capacity funds, the former "Health On Wheels" Van has been refurbished and updated so that it now serves as a mobile clinic to homeless individuals, primarily in West County. 2. HCH staff participated in the 3rd annual Project Homeless Connect in Antioch in September 2008. 3. HCH added new mobile clinical service sites for homeless patients at: - St. Vincent de Paul, Pittsburg; - Outside of McDonald's restaurant, Concord (Clayton Road); - St. Mark's Church, Richmond. In addition, HCH expanded services at Love-A-Child in Bay Point by a longer clinic and with a higher level of medical provider, and began conducting outreach to clients at Loaves and Fishes in Antioch. 4. HCH, in collaboration with the County-Office of Homeless Programs, is nearing completion of a one-year grant from the Boston Scientific Foundation aimed at reducing health disparities in the homeless population. This funding provided training for staff from the HCH program, shelter staff, and homeless service providers from a range of community organizations. Topics included: Stages of Change, Motivational Interviewing, Providing Trauma-Informed Care, and Working with Homeless Clients to Set Self-Management Goals for Improved Health. Through this initiative, the HCH mobile clinic also began offering hemoglobin A1C testing to homeless patients. 5. The Contra Costa Interagency Council on Homelessness (CCICH), in partnership with the Consumer Advisory Board, County Office of Homeless Programs, and the HCH program has established working committees in the areas of: - Improving processes and outcomes for homeless patients being discharged from hospital into homelessness; - Identifying resources to improve dental health services for homeless adults; and -Designing a respite care program to provide a higher level of care for homeless patients residing in the shelters.