181107 Comprehensive health assessment team for the homeless

Wednesday, October 29, 2008: 12:50 PM

Eric G. Handler, MD, MPH, FAAP , Deputy Agency Director/Public Health Officer, Orange County Health Care Agency, Santa Ana, CA
Karen D. Munoz, MSN, PHN, RN , Public Health Community Nursing, Health Care Agency/County of Orange, Santa Ana, CA
Paul Leon, BSN, PHN, RN , Public Health Community Nursing, Health Care Agency/County of Orange, Santa Ana, CA
Kerry Moriarty Homsy, MSN/MPH (c), PHN , County of San Diego, San Diego, CA
The homeless population of Orange County is substantially increasing. The large majority of the Orange County homeless consists of working families with young children and employed individuals unable to afford housing, food, and daily living expenses. It is estimated that 70% of the homeless families are headed by low income, single parents. Throughout Orange County there are concerned stakeholders who have recognized the effects of homelessness on the most vulnerable of our community. Yet, there is confusion as to how to address their concerns and their desire to offer meaningful assistance. Orange County Health Care Agency, realized the importance of this problem and the effect it has on the community. As a result, the Comprehensive Health Assessment Team for the Homeless (CHAT-H) was created to provide a multidisciplinary approach to serving this vulnerable community. The team consists of a Public Health Nurse (PHN), a behavioral health nurse, a benefits specialist (social worker), and student volunteers (nursing and medical students). The team works together to meet the complex needs of this population in areas in which they congregate. The PHN targets all levels of practice in order to create a comprehensive approach to addressing the issue of homelessness. The behavioral health nurse performs behavioral health assessments of individuals and refers for further care as needed. The benefits specialist assists the population in accessing eligible services, such as Medi-Cal and Calworks. In addition, the PHN and behavioral health nurse will be teaching parenting classes. The program will be evaluated using collected qualitative information describing the experiences of the recipients receiving the services. Further evaluation on the effectiveness of the program will be based on whether the clients receive medical services, are able to access care, and evaluations from the parenting classes. The formation of this new program is in direct response to the growing needs facing the homeless in Orange County and to address the rising concern among the whole community. A multidisciplinary assessment team was envisioned and created to provide a holistic approach to serving the needs of this unique population.

Learning Objectives:
1. List three characteristics that place the homeless at higher risk for developing poor health outcomes compared to the rest of the population. 2. Discuss four factors that need to be addressed when targeting interventions for the homeless population. 3. Describe the importance of utilizing the ecological framework to guide interventions at all levels of practice in order to elicit lasting change for this population.

Keywords: Homeless, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: The CHAT-H Team described and the activities associated with it are the responsibility of the program that I supervise, Public Health Community Nursing of the Health Care Agency of the County of Orange, California. I have been involved in the creation, implementation and the evaluation of the program.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.