Healthcare and Medical Resources for the Homeless
According to the White House鈥檚 State of Homelessness in America report, over half a million people experience homelessness on a given night in the United States. 65% of this population resides in shelters and the remaining 35% oftentimes resort to the streets and other habitable locations such as parks, abandoned buildings, cars, alleyways, and more. Homelessness doesn鈥檛 affect one single demographic. In fact, an article published by Endhomelessness.org states that :听
372,417 individuals that experienced homelessness alone
180,413 homeless families
37,878 homeless veterans
36,361 homeless youth
88,640 people that experienced chronic homelessness聽
鈥 African Americans make up 40% of the homeless population, while Latinx populations make up 22% 鈥 both significantly higher compared to the other ethnicities such as Caucasian and Asian.听
The cause of homelessness varies with each case. The White House鈥檚 State of Homelessness in America report also mentions a few factors that contribute to an increased homeless population:
Overregulation of housing markets
Severe mental illness
Substance abuse problems
History of incarceration
Low incomes
Weak social connections
Those who are living on the streets often find themselves unable to afford adequate health care services, leaving them to suffer through any condition they may have without proper treatment, and possibly increasing the length of time in which they remain homeless. If, by any chance, they are able to seek out medical services, the chances they receive quality care are decreased due to medical facilities in the United States experiencing nursing shortages.听
Learn about the healthcare options available to those experiencing homelessness, and how you could pursue a medical career that puts in you line to help these individuals. It鈥檚 also incredibly important for healthcare workers to know the resources that can refer homeless patients to in order to help them get the help they need.
Shelter based clinics.
are programs that provide low-barrier health care to people living in shelter settings. One of the main issues with health care in shelters is the level of services they are able to offer; the smaller the facility, the smaller the health care quarters, the fewer services they may provide. Staff must be able to provide these services in an efficient way, rather than offering many services with low-quality outcomes. Other questions that may arise with clinical staff include:听
How do shelter policies affect people experiencing mental health challenges and behavioral issues?
What does the shelter do when there are health issues that arise for clients overnight, when clinic staff is not available?
How can shelter staff and the health care team work together to prevent people with health issues, including mental and behavioral health issues, from being evicted from the shelter?
How can shelter staff facilitate follow-up care for clients?聽
Certain health issues . These health issues include, but are not limited to:
Asthma
Hepatitis
Hunger and nutrition problems
Infestations
Seasonal flu
Trauma
Tuberculosis
Having a shelter-based clinic can help decrease these health concerns. Nurses and other healthcare positions are needed for shelter-based healthcare, and a degree can help you qualify for these kinds of positions.
Rescue missions.
Rescue missions such as the , dedicate their time serving around 66 million meals a year, providing over 20 million nights of shelter and housing, assisting around 45,000 people in finding employment, clothing over 750,000 people, and assisting over 17,000 homeless men and women with recovering from substance abuse. The AGRM is a rescue mission that relies on faith and whose members follow strict religious views. However, AGRM and other religious missions may not be accepted by those who do not have the same religious views.听
and oftentimes rely on donations from churches, individuals, foundations, businesses, and more.听
Nonsectarian programs.
operate similarly to religious rescue missions in the sense that they provide meals, housing, and recovery options for those who suffer from substance abuse. They are also privately funded and receive financial support from local businesses, charitable organizations, and foundations. However, they differ because they are not faith-based.听
Mobile healthcare services.
As homelessness increases, people are finding alternative ways to help in the form of mobile healthcare services.听
helps healthcare workers have access to those living on the streets by physically driving healthcare workers to those in need in vans or busses. They travel between communities with higher homeless populations and offer their services, significantly helping the homeless by evaluating and treating them depending on the diagnosis. The types of services they provided include:
Behavioral health care
Benefits assistance
Case management
Dental care
Immunizations
Lab tests
Medications
Primary care
Screenings
Triage
These mobile health units can often be found and accessed at:
Churches
Community health centers
Drop-in centers
Hospitals
Public health departments
Schools
Shelters
Social service agencies
Community health centers.
are health clinics that provide comprehensive family-oriented preventive and primary health services those who are homeless, and other underserved populations. They provide treatment including, but not limited to:
Acute medical examinations and treatment
Comprehensive physicals
Dental work
Hypertension
Immunizations
Laboratory work
Mental health counseling
Prenatal monitoring
Prescription drugs
Radiology services
Sexually transmitted diseases
Substance abuse treatment
Tuberculosis screenings
Well-child care
To fulfill the provisions of the Public Health Service Act (42 USC 254c), the centers must, either through staff and supporting resources, or through contracts or cooperative arrangements:听
Serve areas designated as medically underserved
Provide basic primary medical care services plus support and facilities appropriate for the target population
Have a governing board where the majority of the members are users of the centers鈥 services
Adjust the cost of services to the patient鈥檚 ability to pay聽
CHCs receive federal funding through the , an agency of the U.S. Department of Health and Human Services, that aims to improve health care for people who are geographically isolated, or economically/medically vulnerable. The CHC must comply with medical standards prior to receiving a grant, loan, or scholarship from the HRSA.听
Policy solutions providing medical care to the homeless.
It鈥檚 important for medical workers to understand how policies and laws can help make healthcare more accessible to the homeless. The Affordable Care Act (ACA) was signed by President Barack Obama on March 23, 2010, and was created to expand affordable healthcare to all American citizens. The ACA also plays a role in preventing and putting an end to homelessness. The ACA benefits the homeless population in three ways:
It makes health insurance more accessible and affordable
It ensures coverage for behavioral health care, rehabilitative services, and tenancy support
It shifts the focus of health care delivery on outcomes and value 鈥 not procedures and volume
Health insurance for the homeless.
The ACA does have , but they have to meet specific requirements in order to be eligible. Medicaid and the Children鈥檚 Health Insurance Program (CHIP) are health insurance programs that are offered to low-income individuals and children. Eligibility for the programs are based on:听
Income level
Citizenship/eligible immigration status
State of residence
Those who aren鈥檛 eligible for even these resources often have to purchase coverage from the health insurance marketplace with financial assistance, or even settle for no medical insurance at all.听
How advocates can provide support to the homeless.
Advocating for and providing support to the homeless within your own community can be extremely effective. Healthcare workers who see the reality facing homeless people every day, and can be great advocates for volunteering and donations to help this population. Luckily, there are many ways to get involved, and healthcare workers can help be a voice for homeless people in their communities.听
Volunteering or donating.
There may hardly be a time when rescue centers and homeless shelters don鈥檛 need volunteers and donations. In fact, shelters may not have enough volunteers and struggle to keep up with the flow of traffic. Prospecting volunteers should still to see if there are any specific positions that need to be filled before others 鈥 as well as how to apply to become a volunteer. Some of the jobs might include:
Welcoming newcomers and showing them where to go
Organizing clothes/laundry
Handing out hygiene kits
Cooking
Cleaning
Security
Offering the residents different forms of entertainment聽
Nurse educators and advanced-practice nurses can be an extremely helpful resource when it comes to training the volunteers. They can educate the volunteers on the basics of nursing and first aid, which can be beneficial when working in an environment that is at high-risk for medical attention.听
When it comes to donations, homeless shelters are in need of:听
Non-expired food items
Personal care items (for men, women, and children)
Clothing items (for men, women, and children)
Linens
Toys and games
Feminine hygiene products
Your time
College and university programs.
Nurses and nurse educators can play an essential role in addressing the medical issues of the homeless, as well as educating both them and volunteers. Individuals who seek such a degree will position themselves right at the heart of the issue, by providing medical relief to homeless individuals first-hand. Those who enter programs such as Master鈥檚 of Health Leadership and Bachelor of Science in Nursing can use their degrees to help the homeless by either volunteering themselves or training other volunteers.听聽
Health leaders can help coordinate teams, manage institutions, and set standards for care in their community. RNs are the frontline caregivers who may work with or volunteer for direct patient care and clinical positions. Their duties may include providing screenings, helping those in need get referrals to an appropriate specialist, and more. RNs are vital in helping explain medical situations and care routes to all kinds of patients, including homeless patients.
Working at a shelter or clinic.
Volunteers aren鈥檛 the only ones that work in a shelter. Many healthcare degrees can help you be qualified to work in a shelter or clinic and give aid to people who need help. :
Shelter Directors: Oversee all of the home鈥檚 daily operations.
House Managers: Oversee the home鈥檚 daily operations if the director isn鈥檛 there.
Case Managers: Work one-on-one with residents 鈥 more specifically those who have struggled with domestic abuse, physical/mental illness, substance abuse, and more.
Counselors: Basic caretakers for residents. May even act as a driver when they need to go to an appointment, help with finding housing or health care, and more.听
Some shelters may even hire those who have a Bachelor鈥檚 of Science Degree in Health Service Coordination or Bachelor鈥檚 of Science Degree in Health Information Management (HIM) to assist them in health care administration. Implementing HIM services within a homeless shelter can help maintain residents鈥 records and confidentiality. Individuals in administrative roles such as these can help ensure that vulnerable populations are accessing the same standard and quality of care as what is offered in other medical settings i.e. hospitals and clinics.
Healthcare resources for populations affected by homelessness.
Assistance programs for homeless LGBTQ youth.
compared to their heterosexual or cisgendered youth counterparts 鈥 which often is a result of a lack of tolerance from their parents or guardians. In fact, .听
Thankfully, programs have been created to help those who have had to experience these hardships. The (SAMHSA) have created programs such as:
Youth on Fire
Drop-In Center at Tulane University
All of which were created for a variety of reasons that include but aren鈥檛 limited to:
Creating a culture of respect
Supporting opportunities for safe and non-judgmental dialogues
Viewing the experiences of LGBTQ+ youth through a trauma-informed perspective
Providing safe spaces for transgender youth to develop positive self-images
Assistance programs for homeless substance abusers.
Substance abuse, aside from the obvious medical side effects, can also lead to homelessness in individuals who are suffering from the disease. However, not all hope is lost if you are one who is suffering from both; there are programs available for those who are both homeless and are affected by substance abuse. It鈥檚 important to reach out to your homeless shelter coordinator to see what options are available within the home. Some might have a counselor on-site, while others may not.听
The SAMHSA states in an that 鈥渉omeless people with both substance disorders and mental illness experience additional obstacles to recovery, such as the increased risk for violence and victimization and frequent cycling between the streets, jails and emergency rooms. Unfortunately, these people are often unable to find treatment facilities that will help them.鈥
It can be difficult to find a single program that is available nationwide. This is why it鈥檚 important to research in your area.听
Assistance programs for homeless people with mental illness.
SAMHSA created the to aid those transitioning from homelessness into a new home with safe and stable housing, allowing them to recover from both substance use disorders and mental health issues. A recent evaluation of SAMHSA鈥檚 PATH program 鈥 examining 2010-2012 data 鈥 showed that 鈥渢he program achieved its intended outcomes and expanded its reach, providing services to approximately 200,000 people each year, and was highly regarded by the people it served.鈥
Psychiatric and mental health nurses, two of the fields that need nurses the most, can volunteer their time to help aid those transitioning from homelessness to help them overcome any mental and psychiatric hardships that may come along, such as:
Stressors from moving (applying for housing, finding furniture, etc.)
Getting used to paying bills/forming a routine
Applying for jobs
Anxiety
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Assistance programs for homeless veterans.
Medical professionals often work with veterans in mental or physical health capacity. Medical professionals are key in helping veterans navigate civilian life after they鈥檝e served, and are an important element in decreasing homelessness in veterans. As of January 1st, 2019, there were 鈥 this is a 2.1% decrease since 2018. Veterans may find themselves without a home for various reasons:
Inability to find affordable housing after returning from combat
Economic hardships
Traumatic brain injuries
Post-traumatic stress syndrome (PTSD)
The Department of Veteran鈥檚 Affairs offers a variety of :听
Domiciliary Residential Rehabilitation and Treatment Programs
Homeless Grant and Per Diem Program
Substance Use Residential Rehabilitation Treatment Program
Post-Traumatic Stress Disorder (PTSD) Residential Rehabilitation and Treatment Program
Compensated Work Therapy/Transitional Residence Programs
In order to be eligible for any of the veteran鈥檚 assistance programs listed above, an individual must be enrolled in the VA health care system 鈥 or qualify based on one of the exceptions in the law. Individuals can view the to view more program requirements.
Assistance programs homeless youth and students.
Medical professionals are needed to help fight homelessness in all ages, from children to adults. According to a report from the National Center for Homeless Education, during the 2017-2018 school year. Other statistics include:
16 states experienced growth in their homeless student populations of 10% or more during the three-year period covered in this report聽聽
Funding for the Education for Homeless Children and Youth (EHCY) program increased by almost $12 million between fiscal years 2015 and 2017
Over the three-year period, the number of students in unsheltered situations at the time they were first identified increased by 137%聽
Children aren鈥檛 able to control their financial status, which can make it particularly hard for them to understand why they don鈥檛 have a home. Fortunately, there are for students and youth to utilize to help them adjust to and :
Homelessness is an increasingly difficult problem in the United States and around the world. There are many resources for those experiencing homelessness, but there is always an increased need for volunteers and employees who can help make a difference. A degree in healthcare could be your crucial first step in working to help fight homelessness in your community. RNs, educators, shelter managers, organization leaders, and more are all needed to help continue the programs that are there to help those who are facing homelessness. If you feel the call to this unique career path, get started on your degree today so you can start helping others as soon as possible.