Working together to deliver mobile physical-behavioral health integration for the people experiencing chronic homelessness

Thursday, June 2, 2016: 2:30 PM-4:00 PM
Broadway I (Hilton Portland)
Mental health illness comorbidity limits the efficacy of the standard primary care delivery system. Robert Wood Johnson Foundation shows that comorbid physical and mental health illnesses yield lower socioeconomic status, increased health costs, and decreased length and quality of life. Permanent supportive housing is a proven approach to ending homelessness and promoting health. Chronic homelessness in Cuyahoga County has decreased 73% since Housing First opened its first building in 2006. In 2015, FrontLine Service (a community mental health agency), Care Alliance Health Center (an FQHC), and Enterprise Community Partners collaborated to launch an integrated delivery system for individuals living in Housing First permanent supportive housing in Cleveland, Ohio. This innovative care delivery program includes a fully-equipped primary care Mobile Clinic, equipped for real-time wireless Electronic Medical Record (EMR) access. Our integrated primary care and mental health team is comprised of primary care and psychiatric providers, RN care manager, outreach navigator, administrative support staff, and case management. Through working together with partners and HCH clients, the Mobile Clinic program enables the delivery of whole-person care at the doorstep of Cleveland's most medically-vulnerable residents, individuals who were otherwise difficult to reach, and does so in an effort to improve outcomes and the quality of care. Throughout our program implementation, we have addressed several challenges, which we can now help other organizations navigate: Engaging HCH clients to determine what services they need and how best to design, deliver, and promote those services through mobile health care program; Overcoming the differences between the primary care and behavioral health philosophies and delivery models; Administering care in a public setting in a way that is mindful of confidentiality and HIPAA compliance; Adapting to post-implementation operational adjustments; and Determining effective on-site patient workflow between two organizations.
Dan Meges, MD (Medical Director Emeritus, Care Alliance Health Center)
Cynthia Vrabel, MD (Medical Director, FrontLine Service)
Dave Buck, MD, MPH (Professor - Baylor College of Medicine, Healthcare for the Homeless - Houston, Baylor College of Medicine)
Mark Sperber, MA, LPC-S, LCDC, LMFT-Asssociate (Behavioral Health Consultant, Healthcare for the Homeless - Houston)
Joseph Benson, NCAB Member (Community Health Worker, Health Care for the Homeless Houston)
Dr. Katherine Fox Nagel (Chief Administrative Officer, Care Alliance Health Center)
Andrew Berger (Nurse Practitioner, Care Alliance Health Center)
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