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APHA Scientific Session and Event Listing

James O'Connell, MD, Jill Roncarati, PA-C, and Stacy Swain, MPH. Boston Health Care for the Homeless Program, 729 Massachusetts Avenue, Boston, MA 02118, 617-414-7779, jroncarati@bhchp.org

PURPOSE: Housing first models have been utilized by several cities across the county, primarily to serve persons with chronic mental illness. No attempts have been made to house chronically homeless individuals living on the streets who suffer from the tri-morbidity of medical, psychiatric, and substance abuse.

METHODS: The multidisciplinary Street Team of the Boston Health Care for the Homeless Program (BHCHP) includes 2 internists, a physician assistant, 2 nurses, a psychiatrist and therapist. The team combs the streets of Boston day and night to offer direct medical and mental health care to these “rough sleepers.” A new housing first program has been implemented with a goal of housing 24 long-term “rough sleepers” directly from the streets. The BHCHP Street Team has worked with a housing partner to provide continuity of care through home visits. An evaluation of the program involves collecting demographics, documenting morbidity and mortality, and assessing health outcomes and utilization of emergency departments. A survey will be administered at baseline, 3 months, and six months to assess the effects of housing on health and well-being.

RESULTS: 8 persons have been housed sine October 2005, and 16 will be housed by July 2006. We will report on the housing stability and health outcomes.

CONCLUSIONS: This small pilot program will add to the growing body of literature that has attempted to assess the effects of housing on health. Our hypothesis is that safe housing will reduce morbidity and mortality, improve health outcomes, change health care utilization, and increase personal well-being.

Learning Objectives:

• Learn about the housing first model and why it is different form other hosuing models.
• Learn about the vulnerable sub-population of the homeless population, the rough sleepers
• Learn what Boston has discovered that works for housing people directly from the streets and how to help people who are housed stay in housing.

Keywords: Homelessness, Housing

Presenting author's disclosure statement:

Any relevant financial relationships? No