Healthcare for the Homeless

This program focuses on the delivery of Health Care that effectively integrates Primary Care, Mental Health Care, Substance Abuse Treatment and Intensive Case Management services focusing on the unique needs and circumstances of Tarrant County residents experiencing homelessness.

History:  

In 2007, Commissioner Roy Charles Brooks established a Blue Ribbon Task Force on Health Care for the Homeless. The Commissioner brought together partners from the Fort Worth/Arlington/Tarrant County Continuum of Care, the City of Fort Worth’s Directions Home Plan, and stakeholders from every major care provider and challenged them to develop a plan for the effective delivery of care to the homeless.

Goal:  A Plan for the Delivery of Health Care that effectively integrates Primary Care, Mental Health Care, Substance Abuse Treatment and Intensive Case Management services focusing on the unique needs and circumstances of Tarrant County residents experiencing homelessness.

A well coordinated and centralized system of care will greatly improve the health outcomes for the most vulnerable persons in our community as well as save money by reducing emergency and urgent care.  Developing further innovations and planning will position Tarrant County to take full advantage of emerging federal resources.

Results:  Since the publication in 2008 of the “A Plan for the Delivery of Health Care to the Homeless Plan” by the Center for Community Health at the UNT Health Science Center, many gaps identified in the plan have been addressed.  Implementation of these new processes and programs have greatly improved health service delivery and care for persons experiencing homelessness. Highlights of these improvements include:

• MedStar EMS Community Health Program through the new Advanced Practice Paramedics (APP) has reduced 9-1-1 calls to emergency shelters and is connecting patients to non-emergency preventative care saving thousands in emergency department costs.
• Creation of a non-emergency MedStar telephone number to provide 24/7 access to EMS to reduce unnecessary Priority 1 calls without jeopardizing emergency response.
• JPS Health Network Cypress Clinic opened in the heart of the emergency shelter area serving 3,200 patients per year.
• JPS Health Network Medical Navigator directly serves emergency sheltered homeless with medical case management.
• JPS Health Network expanded collaborations with homeless service providers to enroll uninsured homeless into the JPS Connection Homeless program.
• Cross training between JPS Health Network, MedStar, Tarrant County Public Health staff and the Tarrant County Homeless Coalition and homeless service provider case managers enhanced knowledge and coordination of care.
• Cook Children’s Hospital Homeless Initiative provides medical care and a medical home for all homeless children living in emergency shelters. Primary care is provided through a medical home at Miller, McCart, or Arlington Neighborhood clinics to 699 children through 1,619 patient encounters, including 522 well child visits and 967 sick child visits plus combined visits.
• UNTHSC/TCOM Medical Students provide biweekly health screenings at the Day Resource Center for the Homeless serving approximately 40 patients a month.
• Improvements in the TB Screening of the homeless residing in emergency shelters resulted in a significant reduction in the incidence of active TB screening over 150 persons per month and integrated the process with maintaining accurate client data in the Homeless Management Information System (HMIS).
• Responder collaborations  were strengthed between the Catholic Charities SOS Team, MHMR PATH Team and MedStar APP serving the unsheltered homeless.
• The creation of the TCHC Direct Client Services Fund, through the United Way and the City of Fort Worth Directions Home Program, provides cash assistance for health care needs, co-pays and prescriptions not covered by existing programs or insurance.
• Creation of the TCHC JPS Homeless Dental Program provides critical dental care and dentures -- serving 67 patients in the first year.

New Developments:  In June 2012, Commissioner Brooks reconvened the original Blue Ribbon Task Force along with new members to discuss current programs and initiatives and identify next steps for the Healthcare for the Homeless Plan.  

The Task Force examined each component of Emergency, Primary, Mental Health, and Substance Abuse Treatment care to develop a highly detailed needs analysis. The Task Force examined best practices nationally and engaged technical assistance from the Health Care for the Homeless National Council to pursue a Health Care for the Homeless project for Tarrant County.

In August, 2013, The Fort Worth Foundation and JPS Health Network teamed up to build and run an adult medical clinic and social services complex near the East Lancaster Avenue.