Health centers provide care to all members of their communities, including those who may be experiencing homelessness. In addition to receiving grant support from the Community Health Center (CHC) program, some health centers located in areas with high numbers of homeless people may receive additional grants under the federal Health Care for the Homeless (HCH) Program to target care to homeless people. Some FQHCs receive only federal HCH grant support.
The Health Care for the Homeless (HCH) program was first authorized under the Stewart B. McKinney Homeless Assistance Act in 1987. Title VI of the McKinney Act added Section 340 to Public Health Service Act(PHS). The program was later re-authorized under section 330(h) of the PHS Act by the Health Centers Consolidation Act and today provides funding to health centers to provide comprehensive care to homeless populations while combating barriers to health care access.
The United States Department of Health and Human Services, Health Resources and Services Administration (HRSA) provides HCH grants to 298 health centers (2018). Together, these health centers as well as others serve more than 1million individuals experiencing homelessness, 86% of whom have incomes below the Federal Poverty Level and 34% of whom are uninsured. Services are offered at health center locations, through mobile vans, and at countless other locations such as soup kitchens, shelters, and community sites. The Healthcare for the Homeless support enables health centers to go where the patients are, a capability essential to improving access to health care among those who find themselves homeless. Services furnished by Healthcare for the Homeless grantees include:
• Extensive and coordinated outreach
• Screening for health conditions
• Primary health care including dental and behavioral health or chemical dependency services
• Referrals for specialty medical care not directly available through the health center, as well as referrals for legal assistance, housing and financial support programs
• Emergency services
• Case management
The programs emphasize integrated and multi-disciplinary care that is best suited to address the myriad health problems faced by those experiencing homelessness, that are typically exacerbated by their lack of permanent housing. The program’s great strength is the support it provides to health centers to coordinate “aggressive street outreach with integrated systems of primary care, mental health and substance abuse services, case management and client advocacy,” By addressing the wide-ranging needs of both the short-term and longer term homeless individuals and families, the Health Care for the Homeless program represents a vital resource for addressing the needs of the thousands of the Americans who experience homelessness every year.