Learn how a newspaper article in December 2011 led to a collaborative effort to address healthcare barriers faced by the homeless in Oakland County. Through assessment, identification of needs, and community engagement, the initiative aims to connect resources and improve health outcomes for individuals experiencing homelessness.
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Looked at data Nurse-On-Call Reports Oakland Schools Data Point in Time Count
What do we do? Send in a Public Health Nurse! Assessment of client health needs Identify needs/gaps for partners Share resources
ER & Homelessness Findings Unknown healthcare resources Difficulty accessing services No preventive care Overuse of ERs Limited follow-up care
Next Steps Work together! Connect with local resources Create a network of services Engage community partners
Creation of the Collaboration 20 individuals & 14 agencies Case studies Addressed barriers & gaps Beneficial networking Need for future meetings
Identifying Barriers & Gaps Client Barriers Provider Barriers Stable housing Uncompensated care No identification Red tape Zero/limited income Limited funds Lack of ongoing medical care Unaware of other resources
Where do we begin? Asking important questions: Where we want to go? What do we want to accomplish?
Vision Mission Improving the health and well-being of persons experiencing homelessness in Oakland County Connecting community and health care organizations to coordinate resources for persons experiencing homelessness
Hospital Discharge Taskforce Improve communication Create a resource directory Follow-up care Better outcomes for everyone
Care Coordinator Works with clients in hospital or ER Connects clients to resources including housing Assists with problem solving Works with Hospital Discharge Task Force
Recuperative Care Getting more for less! Time Period Number of ED Visits Number of Hospital Admissions Total Days in Hospital Estimate ED Admission Costs Estimated Hospital Costs Minimum Cost of Care Case #1 6 7 6 57 $3,500 $115,140 $118,640 months Case #2 12 17 17 170 $8,500 $343,400 $351,900 months Case #3 1 1 1 5 $500 $10,100 $10,600 month
Identification Taskforce Barriers to obtaining identification Partnering with official agencies Educating providers
Networking Networking is essential! Keeps group engaged Make it part of the agenda
Networking: Participant Feedback 5 Those attending HHC meetings have consistently gained knowledge about the services and resources available in Oakland County for persons experiencing homelessness. 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Before After After Before
Success Stories & Community Benefits Connecting individuals to housing and services Individualized plan of care Utilizing client strengths Problem solving Support System
Sharing Resources Cooling centers & heat safety information Warming centers & cold weather safety information Medical equipment & supplies Infant supplies Disease prevention resources Hosting MI-Bridges training
Recognizing the Effort 2013 National Association of Counties (NACo) Achievement Award 2014 National Association of County and City Health Officials (NACCHO) Model Practice Award Recognition in the 2014 and 2015 Oakland County State of the County Address
