The effects of clinic and staff attitudes about people experiencing homelessness

The topic of changing attitudes of medical care professionals towards people experiencing homelessness has been studied in the context of teaching primary care residents during their rotations to be more culturally competent. There have also been papers directed at people experiencing homelessness feelings of acceptance in their own primary care. The Health Resources &Services Administration, HIV/AIDS Bureau through its Special Programs for National Significance funded a national initiative with the goal of building a medical home for HIV+ homeless/unstably housed populations. Nine sites across the US have participated in initiative. Each of these sites have their own culture, challenges and expertise. Some of them were experts in HIV care while others care for a population of homeless or people who are unstably housed providing primary care. For those sites that were unfamiliar with serving the homeless/unstably housed population the presence of this new staff and it's initiatives were able to elicit changes in attitude and understanding among existing clinicians and clinic staff. At the multisite level, the Evaluation Technical Assistance Center (ETAC: Boston University School of Public Health, Boston Health Care For The Homeless) supported all sites to become more culturally competent. Examples of formal support included courses on trauma informed care, Supervisor training to support front line staff, monthly webinars for patient navigator focusing on how to work with people experiencing homelessness with multiple co-morbidities. Three of these participating sites will explain their unique situations and how they were able to improve staff cultural competency so as to enhance the building of a medical home.