“Health care for the homeless” was the first mission of Heartland Health Outreach when it began in 1984 with a mobile health care team that made outreach visits to shelters and soup kitchens. “As we worked, we identified people with illnesses such as HIV, serious mental illness, diabetes, and hypertension. The traditional medical system was not serving them, and for chronic conditions, we knew they needed regular care,” says Heidi Nelson, the executive director of Heartland Health Outreach (HHO), the health care arm of Heartland Alliance for Human Needs and Human Rights www.heartlandalliance.org. The hard life associated with homelessness worsens health issues, and yet 70 percent of homeless individuals have no health insurance. The answer to this need for care was Heartland Health Center – Uptown.
When Heartland Health Center - Uptown opened in 1994, it served both patients experiencing homelessness and local residents in the moderate-to-low income community, including the uninsured, unemployed, refugees and immigrants. Over the years, the health center added dental services at a shared site in Edgewater, and expanded homeless medical outreach services to cover many of Chicago’s suburbs.
“Over the last five years especially, we have significantly expanded our services, our staff, and the number of people we serve,” Nelson says.The hard life associated with homelessness worsens health issues, and yet 70 percent of homeless individuals have no health insurance.The waiting area is more spacious and now contains private cubicles for confidential intake interviews.
“We served 8,500 homeless individuals a year in 2005, and we expect to see 14,000 in 2010.”
Since opening in 1994, the site has been central to the mission of Heartland Alliance for Human Needs and Human Rights; providing affordable health care for those with no other options. In recognition of its 25th anniversary, the Uptown health center has completed renovations which combine fresh new surroundings with increased capacity to accommodate oral health services as well as additional medical exam rooms.
The stylish new reception area, for example, is reflective of that of a private clinic, giving the men, women, and children who come to the health center at 1015 West Lawrence Avenue the same respect and dignity as patients who don’t live in shelters, supportive housing, or on the street. The waiting area is more spacious and now contains private cubicles for confidential intake interviews. It exemplifies the belief of Heartland Alliance that health care is a human right and that all individuals deserve to be treated with dignity and respect.
With the facility’s reorganization and additional equipment, it now provides primary medical care, mental health services, and—for the first time at the Uptown health center—dental care. The center’s increased capacity enables offering dental services to children who are experiencing homelessness, services which are supported by a grant from the US Department of Health & Human Services.
Heartland Health Center – Uptown has three physicians, seven nurse practitioners, and a dentist, with capacity to also incorporate the training of dental students.
Outreach
Heartland Health Outreach’s core model of service delivery integrates primary health care and social services through a multi-disciplinary outreach team approach. In addition to offering health services on-site at its Uptown Health Center, health services are also delivered at outreach sites, including emergency shelters, transitional and interim housing facilities, domestic violence shelters, drop-in day centers, single room occupancies, meal program sites, under bridges, on the streets, and anywhere that people experiencing homelessness may be staying throughout the Chicago metropolitan area.Heartland Health Outreach’s core model of service delivery integrates primary health care and social services through a multi-disciplinary outreach team approach.
The multi-disciplinary team is comprised of a primary health care provider, medical assistant, benefits and entitlement specialist, and a case manager who can assist with housing referrals, employment assistance, meals, and other social service needs for program participants. HHO subcontracts with four federally qualified health centers in order to extend the same range of health services to the south and west sides of Chicago, south suburban Cook, DuPage, and Lake Counties. Combined with its subcontractors, HHO’s program provides health care at over 100 outreach sites in its scope of service.
Consumer Informed Care
Members of Heartland Health Outreach’s Health Care for the Homeless Consumer Advisory Board (HCH CAB) are also members of the National Health Care for the Homeless Consumer Advisory Board (NCAB): http://www.nhchc.org/advisory.html. Heartland’s HCH CAB is made up of individuals who are either currently experiencing homelessness or who have formerly experienced homelessness and who have received services from Heartland Health Outreach's Health Care for the Homeless program.
The HCH CAB participates in program governance by providing input and feedback to the Heartland Health Outreach Board of Directors on the quality and variety of services being delivered. The group serves as a collaborative voice on national issues pertaining to health care and homelessness. The NCAB is a standing committee of the National Health Care for the Homeless Council, and the elected Chairperson of NCAB sits on the National Council’s Board of Directors.
Advocates for Change
With health care reform a hot topic in Washington these days, Heartland Alliance has also expanded its advocacy. Heartland has established a set of core principles that protect the poor and disenfranchised, starting with the idea that health care is a human right, and are working with advocates and elected officials to measure any new legislation against those principles.
“The services that we have been providing for 25 years—and our experience with the real-world impact of health care policies—inform our advocacy,” Nelson says. “We want to ensure that the people we work with have a voice as decisions are made.”
