Organization: Colorado Coalition for the Homeless | Denver, CO | Health Care for the Homeless Program – 330(h) and Public Housing and Primary Care Program – 330(i)
Contact: Heather Beck, Director of Outreach and Engagement Services | hbeck@coloradocoalition.org | http://www.coloradocoalition.org/
In Denver, Colorado, the homeless population is highly visible; many live on Denver’s streets, under bridges, and in alleys. For most, accessing health care and social support services is difficult and focusing on daily survival takes precedent. The Colorado Coalition for the Homeless (the Coalition) proactively engages patients to link them to information and social support services, as well as provides medical care through on-site treatment and a mobile medical unit. Despite the efforts of the Coalition’s Street Outreach Team, they found many people still faced challenges accessing medical care. In 2012, the Coalition began their Medical Outreach program to bring care directly to where patients live and spend time in response.
Each Wednesday morning, the Medical Outreach team drives to a location where there are known patients with acute needs. Then, they set out on foot, bringing the necessary supplies to provide basic medical care, including checking vitals and offering wound care. The team also provides behavioral services on the spot. Many patients served through Medical Outreach have existing relationships with Street Outreach staff. Street Outreach staff relay the needs of individual patients to Medical Outreach, and Medical Outreach providers leverage the established relationship with patients to administer much-needed medical care.
The Medical Outreach program is staffed by a medical provider, medical assistant, a member of the Street Outreach team, and a behavioral health navigator. Stout Street Health Center, the Coalition’s on-site treatment center, staffs medical providers for Medical Outreach and processes all patient lab work. The Medical Outreach program may also send a specialist, such as a psychiatrist, if they expect the support will be needed for specific patients. If possible, patients with behavioral or mental health needs are referred to access care at the health center. All Street Outreach staff are trained in trauma-informed care, motivational interviewing, and cultural competency in order to provide the most appropriate, sensitive, and individualized services along side.
The Coalition does not receive specific funding for the Medical Outreach program. The City and County of Denver fund the behavioral health navigators, but most of the support comes directly from the organization. The Coalition evaluates the Medical Outreach program by collecting data on what kind of care is accessed, how often care is accessed, and the number of follow-up appointments at the clinic.
Most patients served by the Medical Outreach program experience trauma, and it is important for Medical Outreach staff to work within this context in order to avoid further trauma. For programs hoping to establish a street medical outreach program, it is critical for staff to be flexible, take time to build relationships, and have the patience to sit down and talk to each patient about their immediate goals, including their health care. Without this foundation, all subsequent services cannot happen. According to Heather Beck, Director of Outreach and Engagement Services, “Every step of the way, we [outreach] walk alongside our client as a companion to help ease anxiety and fear and advocate on their behalf.”
HOP Tip: HOP’s Outreach Reference Manual Clinical Outreach chapter provides a practical framework and guidance on undertaking clinical outreach efforts. It explores the different facets of clinical outreach and how it can be planned and implemented. You can access the chapter through our website at www.outreach-partners.org.
This Innovative Outreach Practice was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U30CS09743, a National Training &Technical Assistance Cooperative Agreement, in the amount of $770,259. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.