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Engagement and retention in treatment of an urban homeless population

Laura M. Gillis, MS, RN, Baltimore Homeless Services, Inc., 210 Guilford Avenue, Baltimore, MD 21202, 410 545-3409, laura.gillis@baltimorecity.gov, Jerry T. Lawler, PhD, Office of Substance Abuse Studies, University of Maryland School of Pharmacy, 515 West Lombard Street, Baltimore, MD 21201, and Anthony C. Tommasello, PhD, Office of Substance Abuse Studies, Univeristy of Maryland School of Pharmacy, 515 West Lombard Street, Baltimore, MD 21201.

Efforts to engage an urban homeless population into treatment have always proved difficult, and long-term follow-up is essential for evaluation of interventions (Mowbray, et al 1998). Retention in treatment and follow-up rates has varied and different researchers propose a variety of predictive variables suggestive of less attrition.

Most studies of homeless persons treat dropout as something caused by fixed client characteristics rather than an organizationís engagement strategies and tracking methods. Health Care for the Homeless (HCH), a Federally Qualified Health Center serving a disenfranchised homeless population in an urban setting, conducted a targeted outreach program from March 1997 through August 2000. Follow-up for re-interview and engagement in services was remarkably successful, given the characteristics of this population. Of the 172 clients registered for the study, 64% were interviewed at a 6-month follow-up and 90.1% at a 12- month follow-up. Of the 110 clients enrolled for HCH services, 86.7% were contacted at the 12-month follow-up. Over 93% received at least one service from the organization.

This paper describes the engagement strategies used to keep homeless HIV+ clients with substance use disorders in treatment as well as the staff training program and service delivery methods undertaken to conduct this specialized outreach. We also describe creative and useful tracking methods. These include providing incentives to family members to help locate clients, integrating tracking into the client registration process and finding clients through the managed care eligibility system.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Interventions, Evaluations and Research Issues and Findings Among Homeless Populations

The 132nd Annual Meeting (November 6-10, 2004) of APHA