New mobile healthcare unit aims to help homeless, ease ER burden

Austin

AUSTIN (KAXN) — A new federally-funded initiative aims to make it easier for thousands of homeless people in Travis County to receive healthcare while easing the burden on hospital emergency rooms.

The Dell Medical School at UT Austin, CommUnityCare Health Centers, and Integral Care announced Wednesday that they will be joining forces to run a mobile healthcare unit that aims to provide health care to homeless people by coming to them. Vulnerable women, people with chronic illnesses and serious mental illness and people with substance use issues will be the focus of this health care team.

The collaboration is being funded by a $2.3 million grant from the Substance Abuse and Mental Health Services Administration for a period of five years.

“Homeless Austinites living with multiple complex medical problems are among the most vulnerable and difficult to reach members of our community, but we believe that our innovative approach can work,” said Dell Med assistant professor and project director, Tim Mercer.

The mobile unit will comprise of a six-person team including a primary care physician or nurse practitioner, a mental health care psychiatrist or nurse practitioner, a licensed chemical dependency counselor, a nurse case manager, a qualified mental health professional case manager and a peer navigator.

“We are targeting folks who are chronically homeless, who have a chronic medical condition, have a serous mental illness and have a substance use disorder,” Mercer explained.

He added that there is a core group of around 300 individuals the mobile team will focus on who have all of those conditions. But the team can also help anyone who falls into each of those categories 

“We can care for patients under the bridge if they’re under the bridge or at a local agency or site if they’re comfortable there,” he explained. 

Mercer also works as a physician with CommUnity Care’s Healthcare for the Homeless team where he and his team members have learned to provide care just about anywhere. He said what is different about this program is that it brings a variety of health professionals together to one location so they can better serve people with a really complicated set of intertwined problems. 

The mobile team will need to rely on existing connections and databases to reach the homeless community, as many homeless individuals in Austin don’t have regular access to a phone, internet or even an ID. Mercer said that often the best bet can be following up with people at an appointed time and location. 

Along with providing health care, the team will also conduct research to determine the success rate of the program. “By incorporating research into this project, we will be able to understand if this approach to caring for our city’s homeless works and can pay for itself, by reducing hospital and ER visits, for example, and if it can be scaled and replicated to improve the health of communities across the nation,” said Dell Med professor William Tierney.

The grant will fund supplies, evaluations, and the mobile team of full and part time employees. Medical care and medications for patients will be covered by their insurance if they have any, or by Central Health’s Medical Access Program if they don’t have insurance. 

The 2017 Point-in-Time count from the Ending Community Homelessness Coalition (ECHO) found that 2,036 people in Austin are experiencing homelessness on any given night. 

According ECHO, the Homeless Management Information System numbers show that 61% of Austin’s homeless get healthcare through an emergency room or not at all. 

“It’s not that they’re choosing not to come into care, there’s many insurmountable barriers to care, from not having transportation, or competing with basic survival needs or just how dizzyingly complex our healthcare system is,” Mercer said. 

Greg McCormack, Executive Director of Front Steps, noted that many people are reticent to go to the CommUnity Care clinic inside the ARCH, especially if it’s far from where they’re staying. McCormack is hopeful this mobile health team will help people existing in homelessness to keep their health needs from going unaddressed. 

“I think it will improve the health of so many people who are existing in homelessness right now and will help engage them in services and hopefully not just attend their immediate needs, but also help to bring them in to trust that there is a system there to support them,” McCormack said. 

Paul Martinez is one of the many people experiencing homelessness in Austin, he has been on and off the streets for the past couple of years. 

“Being out here is very tough on your mental, especially tough on your physical as well,” he said.

Martinez experienced exhaustion from walking up and down the streets on one occasion when he got lost. That incident escalated when Martinez had an asthma attack and wound up in the hospital for three days. 

Prior to that, he was extremely nervous to go to community clinics and look for help.

“For me it’s just I don’t want to go in there, I don’t want to put myself in front of all these people and, you know, just me get judged or something like that” he said. 

But after the hospital trip, he pushed himself to go to the clinic inside the ARCH where he received a check up and an inhaler.  

Martinez said the clinic helped him to “breathe a sigh of relief”  

He also thinks the idea of having a mobile health team would be really helpful to others in his shoes. 

“There are people that are gonna need that, and I would use that for sure,” Martinez said. 

This mobile team is one effort among many Austin organizations and leaders have taken on in the past two years to address homelessness in the city. Austin’s referred to the overcrowding of the homeless population downtown and the increased drug activity there as a “health and public safety crisis” in 2017, and city leaders agreed, making homelessness a top priority for City Council. 

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