Addressing issues in a homeless population: Partnerships for a just cause

Background and Issues: Homelessness is a complex problem for many communities throughout the country and one that has become particularly visible with the recent collapse of the housing industry. Collaboration between academia, a local health department, and two urban homeless shelters fills an existing gap in services for a community's most vulnerable citizens while providing undergraduate nursing students with hands-on experience in public health practice.

As a result of County budget reductions in recent years, provision of case management services to local homeless shelter residents was eliminated. Health department presence at the shelters was subsequently limited to communicable disease prevention. Shelter staff expressed their concern over this existing gap that created challenges for both staff and residents. This gap is now filled by undergraduate nursing students assigned to shelters for their public health clinical.

Description: Undergraduate nursing students in a public health nursing course conduct a community needs assessment to gather information about shelter residents' needs. Based on these findings, students coordinate with homeless shelter staff to provide case management. They also work on communication, advocacy, health education and other identified issues that may serve as potential barriers for residents in accessing health related and other community services. This experience requires that faculty serve as a primary bridge between shelters, the health department, and the university.

Lessons Learned: Successful partnerships are the result of mutually agreed upon goals and expectations. These need to be clearly identified at the beginning but may change over time. During a time of fiscal constraints and decreased staffing for community programs, partnerships at the local level may fill existing gaps.

Recommendations: This three-way partnership suggests that collaboration between academia, local public health, and homeless shelters is a promising approach to solving identified gaps in essential public health services. Data will be collected over time to determine the impact of these relationships.