274841 Lessons from the streets: Health disparities among Boston's rough sleepers

Tuesday, October 30, 2012 : 3:10 PM - 3:30 PM

James O'Connell III, MD , Boston Health Care for the Homeless Program, Boston Health Care for the Homeless Program, Boston, MA
The Boston Health Care for the Homeless Program (BHCHP) began delivering medical care to persons living on the streets in 1986 in a partnership with Pine Street Inn (PSI). A BHCHP physician joined PSI's overnight rescue van two nights each week to serve those living under bridges, down back alleys, on park benches and in downtown doorways. After a number of deaths on the streets, BHCHP created a multidisciplinary street team to expand services to this elusive sub-group of the homeless population. This session will explore the challenges faced by this street team, emphasizing an integrated medical and behavioral approach that brings clinicians directly to the streets at night and during the day. Efforts to assure that this team remains integral to the mainstream of Boston's academic medical centers will be highlighted, especially given the high utilization of emergency rooms and hospitals by rough sleepers. Finally, the effects of low threshold housing programs available to chronic rough sleepers will be discussed, including the importance of house calls to these individuals once placed in supportive housing.

Learning Areas:
Provision of health care to the public

Learning Objectives:
Explain the core components of a multi-professional medical and behavioral health team designed to overcome obstacles to care for chronic rough sleepers through direct care on the streets that is integrated within the mainstream health services of Boston.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been engaged in the fulltime medical care of homeless individuals for the past 27 years, and have overseen the implementation and development of the Boston Health Care for the Homeless Program, a service delivery model that integrates care in over 70 shelters with hospital care at Boston Medical Center and Massachusetts General Hospital.
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.