One Ohio Now Street vibes
a p r i l 15, 20 1 1
PG 7
APRIL 1 5 , 2 0 1 1
Prostitution: Crime or controversial career?
1
PG 11
ISSUE 197
ADVOCATING JUSTICE • BUILDING COMMUNIT Y
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Health Care For the Homeless Program is a Mobile Marvel The Cincinnati Health Network is in charge of the Health Care for the Homeless Program, and the medical van and the Elm Street Clinic are parts of the Health Care for the Homeless Program. The Cincinnati Health Department provides the medical staff, support team, laboratory and pharmaceutical services and other important aspects of the programs. The clinic opened on November 15, 2010. Carly Tamborski Contributing Writer
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n a cold, brisk afternoon, light snow falls from the sky onto downtown Cincinnati, prompting a steady flow of people to make the walk to the Drop Inn Center on 12th Street. Not only do these people hope to seek shelter from the weather, they know that it’s Wednesday: the medical van will be there today. Every Monday and Wednesday, the McMicken Health Collaborative’s medical van visits the Drop Inn Center at 2 p.m. to offer medical care to residents who can’t afford it themselves, and it doesn’t cost them a dime. When it’s not at the Drop Inn Center, the van also visits shelters, transitional housing and other area locations where the homeless congregate, as sometimes the homeless are reluctant to come to the Elm Street Clinic. On this particular afternoon, Stephanie Blackwell, a medical assistant, walks into the Drop Inn Center and across the open cafeteria to a small room, where she unlocks
Med Van. Vinit Murthy, Streetvibes Photographer a door. About 15 homeless people are sitting at tables surrounding the room, waiting patiently to sign up to see the doctor. Some rest their heads in their folded arms on the tables, looking too tired for words, while others energetically look around the room. Sometimes, people may wait for 2-3 hours to see the doctor on the medical van, who sees about 25-30 patients during one visit. Blackwell has worked with the collaborative for about six months, so she’s familiar with the procedures of the care system. “We basically provide medical care to the homeless, today for people that are in the Drop Inn Center.,” Blackwell said. “We can give injections, EKGs -- anything that we do in a doctor’s office we do in here on the van. We can do minor things like IUDs, incision and drainage, staple removals; we can do pap smears here. It’s like primary care for the homeless.” The van also provides pregnancy tests, blood draws, strep screens, urine analyses, blood sugar tests and HBA1c and INR tests. Patients needing radiology, referrals and
Med Van. The Mobile Marvel, providing care to those in need Vinit Murthy, Streetvibes Photographer other special tests are referred to University Hospital and given an order signed by a Health Care for the Homeless physician. While Blackwell’s coworker gets the van ready, she uses the small room to triage the patients. She passes around a sign in sheet and light paperwork for the patients, who are required to provide their name, social security number and contact information, if they have any. They are also required to sign a declaration of their homelessness. Blackwell takes their vital signs and asks what prompted the patient to seek help. She assesses the type of care they may need and then individually sends the patients outside to see the doctor on the van. There’s usually one doctor and two medical assistants -- like Blackwell -- present during the van’s operating hours. The vehicle has two exam rooms on either side of it, and in the middle, has a sink, file cabinets, supplies and patient files, truly making it a doctor’s office on wheels. To summarize the nuts and bolts of the operation, the Cincinnati Health Network is in charge of the Health Care for the Homeless Program, and the medical van and the Elm Street Clinic are parts of the Health Care for the Homeless Program. The Cincinnati Health Department provides the medical staff, support team, laboratory and pharmaceutical services and other important aspects of the programs. The clinic opened on November 15, 2010. According to the network’s 2009 data, the Health Care for the Homeless Program helped approximately 7,035 patients, and the van assisted 4,502 of those people. The program sees the types of patients one might expect to see in the underprivileged urban setting: primarily adult males and few children, with 69 percent of patients being males. Children living in poverty in Ohio qualify for other types of coverage that adults do not, which reflects why only about 6 percent of patients were under the age of 19. “The largest group of people we see are African American men, which I think is what you typically see in a shelter as well,” said Jackie Campbell, program manager for the Health Care for the Homeless Program. “Fifty-six percent of patients are African American men and 2 percent are Hispanic/Latino.” Campbell, who has a Master’s in public health, has been the program manager for about a year and a half but has always worked in non-profit healthcare. A van existed in the early 90s, but a revamped one was introduced in 2006. The Cincinnati Health Network purchased the van but leases it to the Cincinnati Health Department. The services offered on the van and in the clinic differ somewhat. The clinic offers dental, behavioral and primary care services, while the van mainly offers primary care. The van works with doctors and medical assistants, but the clinic has doctors, nurses, a nurse manager, a practice manager, a dental team, medical and dental students, volunteers and two mental health counselors, among other staff members. “With the clinic, we’re trying to provide a ‘medical home’ for homeless people instead of going to the ER every time where they’d see a different person,” Campbell said. While the services performed are at no cost to the patient, running the program (the clinic and van) is quite expensive and does require funding from multiple sources. Some support comes from federal funding and the American Recovery Act, as well as donations and grants. Even though the services are no cost to patients if a patient is homeless but has some sort of income, they may be asked to pay a small amount. “The cost of operating the van is fairly expensive,” Campbell said. “We have to pay doctors, pay for equipment, pay for medication. Less than 10 percent of our patients have any form of insurance to pay with.” See Health Care for the Homeless Pg. 4