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Living without a roof over your head isn't limited to our big cities.
"Homelessness is everywhere is this country," said Jean Hochron, director of the Office of Minority and Special Populations, Bureau of Primary Health Care, Health Resources and Services Administration. "That's a very difficult reality."
Since the late '80s, her government agency has worked to improve the overall well-being of this often-neglected population.
With 165 grantees across the United States, from urban to rural settings, HRSA's Health Care for the Homeless (HCH) program reached approximately 600,000 people in 2003. In 2004, Congress appropriated $140 million for HCH grants.
HCH programs provide care in a variety of ways, including:
- Primary health care and substance abuse services at locations accessible to homeless people
- Emergency care with referrals to hospitals for in-patient care services and/or other needed services
- Outreach services to assist difficult-to-reach homeless people in accessing care and provide assistance in establishing eligibility for entitlement programs and housing.
To increase access to services and resources for the homeless, HRSA encourages HCH grantees to develop or actively participate in local coalitions of health care providers and social service agencies.
People working with the homeless should have different expectations when compared with caring for the general population, Hochron said.
"It's difficult to see the kinds of outcomes we would of course want to see, which is somebody living on the streets in terrible conditions ultimately becoming housed, getting a job at IBM, and living happily ever after," she said. "Those are generally not the outcomes. Most of the success stories are smaller - people who for years would resist any kind of treatment have now become engaged in the health care system through the HCH program."
Mike Bederka is associate editor of ADVANCE. He can be reached at mbederka@merion.com.
To read more about respiratory issues in the homeless, read the cover story of the November print issue of ADVANCE for Managers of Respiratory Care.
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