HEALTH CARE CENTER FOR THE HOMELESS INC
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Mission Statement
Health Care Center for the Homeless, Inc. (HCCH) is a 501(c)(3) non-profit organization founded by in 1993 by Dr. Rick Baxley to address the primary medical needs of homeless individuals living in downtown Orlando, Florida. HCCH began as the evening medical clinic at a local homeless shelter, initially staffed by volunteers. HCCH grew to add dental and behavioral health services, working out of multiple locations, and eventually moved to paid staff so we could provide our patients with consistent care. In 2001, we began providing health care services for low-income uninsured residents of Orlando. In 2006, HCCH opened Orange Blossom Family Health, allowing us to bring all of our programs and staff under one roof. HCCH currently provides health services for homeless and low-income housed but uninsured individuals living in Orange, Osceola, and Seminole Counties through our main site and three satellite locations.
About This Cause
Health Care Center for the Homeless (HCCH), through our sites known as Orange Blossom Family Health, has eight main program areas: primary and preventive medical care; oral health services; behavioral health and substance abuse counseling; vision services; an on-site pharmacy; mobile health services (medical and dental); a residential TB (tuberculosis) shelter; and street outreach - our HOPE Team (Homeless Outreach Partnership Effort). Patients come to our health centers after years of limited access to regular health care services. Their health care has been fragmented at best, which can aggravate chronic health issues such as diabetes or hypertension. Health situations such as these are manageable if diagnosed and addressed early on, but have become potentially life-threatening for our patients. They have typically turned to local emergency rooms for their primary medical care needs (and even their dental needs) and the result is a lack of the proper continuum of care needed to improve their health status and maintain proper overall health. The majority of our patients initially connect with us through our main health center’s medical or dental programs, but they are assessed for any additional needs we can address through the varied services we offer. HCCH is not a free clinic. Revenue from co-pays adds to our available resources and enables us to serve even more patients. For our patients who are uninsured, co-pays are calculated on a sliding fee scale based on household income. While we do request co-pays, we do not allow the inability to pay to be a barrier to care. In 2013, only about 23% of our patients had some form of health coverage such as Medicaid, Medicare, or similar managed plans. Reimbursement through these plans helps offset expenses and allows us to care for more patients, but the great majority of our patients receive their care at a very low cost or free. Through government grants and private support, HCCH absorbs the cost of this care. The main Orange Blossom Family Health location near downtown Orlando is a Federally Qualified Health Center (FQHC), recognized by the government for both the homeless and housed patients we provide care for. In 2013, we earned accreditation as a Level 2 Patient Centered Medical Home (PCMH), a program that addresses the on-going primary care health needs and access to care for patients such as ours. Through registries, information technology, and health information exchange, patients receive needed care in a culturally and linguistically appropriate environment. We provide a medical home setting for follow-up services and coordinate with the hospitals regarding specific health concerns. We have multi-lingual providers and staff to ensure clear communication with our patients. We continuously work to build relationships and partnerships in the community to help our patients find access to services beyond those we offer at our health centers. In 2013, we served 14,074 individual patients at our health center, resulting in 36,701 total encounters throughout all of our program areas. 80% of our patients were living at or below 100% of the Federal Poverty Guideline, or earning a little under $12,000 in pre-tax income per year. 36% of our patients were homeless and living at local shelters, in transitional housing, or on the streets. As a note, verified 2014 patient numbers are not available until our Uniform Data Systems (UDS) report is approved by the Federal Government. HCCH has three satellite clinic sites providing health care services in partnership with the following organizations: Community Food and Outreach Center on Michigan Street in Orlando/Orange County; Community Hope Center in Kissimmee/Osceola County; and Harvest Time International in Sanford/Seminole County. 2015 will bring a fourth satellite site in East Orange County at the Samaritan Resource Center. All of the current satellite locations offer primary medical care and behavioral health services. There is the potential to also provide dental services within the Seminole County site, with plans to begin these services at some point in 2015. With these satellite sites, HCCH is able to reach people further out in the community in need of health services who find it more difficult to travel to our main location. MEDICAL PROGRAM - Primary and preventive medical care was the original focus of our organization. The initial goal was to reduce the improper use of local hospital emergency rooms for non-emergent care needs by providing an affordable primary care resource on an on-going basis. Our staff of paid providers and medical professionals allows for a greater continuum of care and increases the comfort level for our patients by affording them a familiar provider to work with over time. HCCH uses the Chronic Care Model, a program designed to reduce disparities in health outcomes for poor, minority, and other underserved populations. Providers create treatment plans to address health issues, with patient compliance being a major factor. We educate our patients in managing their own health, especially those suffering from chronic health issues such as diabetes or hypertension. HCCH offers some smaller services within our medical program: a free screening mammography program for our female patients here and free rapid HIV testing. PHARMACY - Our on-site pharmacy provides low cost medications for our patients as prescribed by their health care professional here. This makes obtaining a prescription more convenient for our patients who lack regular transportation. For those who qualify, we have our Patient Assistance Program (PAP) which helps access crucial medications available through the major pharmaceutical companies either at a very low cost or for free. This program is for our very low income patients who have no form of health coverage. VISION SERVICES - Addressing eye health issues promptly is crucial since damage can often be irreversible. Through the vision program at our main site, we are able to provide our patients with eyeglasses, eye health education, and screenings for vision related concerns that could result from chronic health issues such as diabetes. We partner with Lions Club International and local eyeglass retailers to fulfill specific prescription needs. TB SHELTER - In 2013 (most recent numbers available), Florida ranked fourth in the nation for the occurrence of infectious tuberculosis. HCCH manages the only residential shelter in Central Florida for homeless individuals suffering from infectious tuberculosis. The Orange County Health Department conducts on-site therapy, with full recovery taking an average of six months. Patients are encouraged to stay at this 10 bed facility until they regain their health while HCCH provides primary medical care and addresses social and nutritional needs. ORAL HEALTH SERVICES - Dental services were added in 1995 to address the extensive tooth decay encountered in our medical patients. Our oral health services include emergency dental care, oral screenings, cleanings, restoration work, oral health education, dentures, and referrals for surgery. We have an established pediatric dental program and for patients who are missing teeth, we are able to provide dentures at a lower cost. In some cases we are able to provide dentures at no charge for homeless patients who qualify for our Denture Sponsorship Program, which is funded through private donations and grants. BEHAVIORAL HEALTH AND SUBSTANCE ABUSE COUNSELING - Our behavioral health team currently consists of a Licensed Mental Health Counselor, Licensed Clinical Social Workers, and an Advanced Registered Nurse Practitioner who prescribes and manages medications. Through individual and group therapies, we help address mental health and substance abuse issue and on-going medication management is provided for patients suffering from chronic behavioral health issues. Individualized treatment plans are created, helping our patients to make better life choices and to improve their interaction with society as a whole. MOBILE HEALTH SERVICES - HCCH has a mobile medical unit featuring two exam rooms taking care to homeless individuals who may find it more difficult to get to our health center locations. Staffed by an Advanced Registered Nurse Practitioner (ARNP) and two Medical Assistants, this unit provides primary medical care and partners with local agencies who also serve the homeless population in the tri-county area. Currently visiting over a dozen different sites each month, the unit does visit some locations multiple times due to higher patient volume. Our three chair mobile dental unit partners with Title 1 schools in Osceola and Seminole Counties to place sealants on the first four permanent molars for second grade students. Title 1 schools have a 50% or higher enrollment in the free or reduced lunch program, with our MDU program focused on the schools with enrollment 70% or higher. The sealant program prevents early decay and unnecessary tooth loss, with services provided right on school campuses once parental approval is received. There is no charge to the family for the services provided through our sealant program. HOPE TEAM (HOMELESS OUTREACH PARTNERSHIP EFFORT) - Our outreach team goes to where their homeless clients live...on the streets and in the woods of Central Florida. Building rapport and trust with their clients, the HOPE Team is able to encourage them to connect with the services HCCH can provide. HOPE Team clients are given special priority for appointments due to their harsh living conditions and the Team can provide transportation to and from the health centers as needed to ensure their clients keep their appointments. The ultimate goal of the HOPE Team is to help their clients exit homelessness and obtain stable housing and they are actively engaged in the Housing First model that Orlando is moving towards. The HOPE Team also assists their clients in accessing mainstream benefits such as food stamps.