Improving Health Care Access to the Homeless Population Abstract
IMPROVING HEALTH CARE ACCESS TO THE HOMELESS POPULATION
ImprovingHealth Care Access to the Homeless Population
Homelessness is a global issue that prevails inmost countries. This is a group of people who live in the streets,shelters, and other places that are intended for human occupancy. Italso includes those temporarily living with friends and relatives,those who do not have a fixed and adequate nocturnal residence, aswell as those who are at risk of homelessness. In the future, therate of homelessness population is likely to rise. This issue facesall people regardless of their age, gender, marital status,ethnicity, or citizenship. For most, this situation is a singleshort-lived event while for other the state may last for a longerperiod or may occur in episodes. Unfortunately, despite this grouphaving the greatest needs for primary health care, they encounterbarriers accessing it. As a result, they are likely to become moreill and die at an early age, unlike the general population. This isbecause of stigmatization and prioritizing of other basic need suchas food before health care. This essay looks at the current healthsituation of the homeless people in the United States, as well asprovides an overview of several policies that may work efficiently inaddressing them. It also points out the key policy areas that needanalysis and resolution.
All people in the United States deserve toaccess high-quality, affordable, and comprehensive health care.However, delivery of health care to the homeless is challenging. Thecauses of homelessness and poor health include housing costs,insufficient incomes, unemployment, family instability, tragedies,among others. There is a great relationship between the two as onecan be the cause of the other. That is, homelessness causes poorhealth while poor health causes homelessness. In short, it is avicious cycle. In the United States, more than half a million peopleare homelessness. According to Migrants’ Rights Network (2013),clinical care reform can be a major strategy to end chronichomelessness. The topic is important because it enables healthstakeholders to develop strategies for improving the health outcomesof the homeless population (Skosireva, O’Campo&Zerger, 2014).The main policy areas that should be addressed in the research areenhancing health research, improving health access, and providinghealth insurance to the homeless. The main stakeholders in theresearch process are school administrators, homeless parents andchildren, the Department of Health agencies, and insurance serviceproviders (Lamb, 2014). Other stakeholders include academics(professors), physicians, social workers, nurses, researchers withbackgrounds in medicine, health, and public policy, as well aspreviously and currently spokespeople.
A right to health care is not indicated in thelaws of the United States. However, public opinion suggests that allpeople should access medical attention when required (Gaebel &Zielasek, 2015). The homeless individuals should be assisted toobtain affordable or federal managed insurance for example, Medicaid(McInnes& Fix, 2015). Access to health institutions should beimproved by developing transportation and communication systems inlow-income neighborhoods. The homeless population can communicatewith health staff through websites, emails, and social media (Hislop& Newlands, 2015). In the recent past, several studies have beenconducted to address the medical issues facing the homeless people.According to the US Department of Housing and Urban Development(HUD), more than half a million homeless Americans live in theshelters and on the streets. Research show that their rate ofhospitalization and the use of emergency department are higher whilethat of outpatient care is lower among compared to the generalpopulation. Despite their needs, it is a great challenge to accessappropriate health care services.
The current policy for the homeless is theAddiction, Mental Health, and Cognitive Care, which needs improvement(To, O`Brien & Hwang, 2015). It is implemented at the nationallevel, and it aims at enhancing the health outcomes of the homeless.It does not effectively improve the health care access to thehomeless population. It assumes everyone has a stable housing, whichin reality is not the case. As a result, it creates a seriouschallenge in the health care system. The medical services provided tothe homeless should be accessible and affordable. Health Care for theHomeless (HCH) is another current policy, which is a federal-fundedprogram and it offers homeless persons with primary health care. Thelocal community designs and controls it to provide comprehensive carethrough available health centers. It serves patients in the streets,shelters, and the transitional housing.
The policy should be modified by introducingaffordable insurance scheme and adopting technology that improveshealth care access (Keogh, Brien & Hoban, 2015). This way, therewill be changes in ways of serving vulnerable people experiencinghomelessness.
Therefore, an affordable insurance scheme is anexcellent intervention to deliver primary care to the homelesspeople. However, for this policy to be effective, it needs to addressall its obstacles. This includes providing care to the homelesspeople without valid health cards, providing care services thatovercome transportation and scheduling challenges, and providing carewithout medications or supplies need that are covered in the healthcare plans. Lastly, it should work toward changing the health careproviders’ perceptions so that they can be more understanding andtrustworthy as most homeless people have stigmatization feelings thathinder them from seeking health care. Lamb (2014) asserts thathomeless people face challenges while seeking treatment andpreventive care because they lack insurance coverage. In addition,they cannot engage health care providers. Lack of access leads themto seek medical attention when their condition has worsened, and itis an emergency case. According to National Health Care for theHomeless Council, the homeless population has a high rate ofuninsured people, unlike other groups (Lamb, 2014).
The policy should include three primary caremodels to fulfill the primary health care needs of the homelesspopulation. They include mobile outreach service, fixed outreachsite, and targeted standard facility/clinic site. The clinic site hassimilar characteristics to any other family physicians office anddeals with immediate care for acute illness, health education, andscreening. To meet the homeless patients’ needs, they should belocated near their shelters, as well as have daytime and eveningworking hours. Such model would integrate homeless individuals intothe health care system, as well as provide them with care. Fixedoutreach site is similar to targeted standard facility in its focusareas. However, it is more accessible to the homeless people wouldotherwise not reach out for care. They are normally situated withinthe homeless shelters, transitional housing settings, and communitydrop-in centers. Finally, the mobile outreach service seems the mostaccommodating to patients because it operates at sites near them. Itoffers services such as diagnosis, education, prevention, screening,and referrals to other agencies, which are provided by nursepractitioners. Sadly, the model faces challenges such as lack ofsufficient equipment and space. This modification will certainly bebeneficial to those in desperately need health care. It will breakdown obstacles that homeless people experience in accessing care asthose who cannot get off the street will now get the treatment theyneed. However, such health policy reformation concrete support forcontinuity of care is necessary. Winetrobe et. al., (2015), assertsthat health insurance coverage plays a vital role in the vulnerablepopulation. On the other hand, the service providers should assistthe homeless people with insurance applications and connect them withhealth care sources.
Secondly, adopting technology that improveshealth care access is necessary to solving health issues of homelesspopulation. Lamb (2014) says that homeless persons have access totechnology, which can have health benefits. This is throughdeveloping programs that link them to the health care through theInternet. Innovative technology enables health professionals whoserve homeless community to offer better health care by providingaccurate and current information. They also help doctors to monitorthe health of their patients, as well as encourage healthierbehaviors. Studies show mobile phone technologies enhancescommunication between health care providers and vulnerablepopulations. During the patient encounter, it fosters greaterunderstanding and engagement, which results in adequate care andbetter outcomes. Technology enables health practitioners to spendmore time interacting with patients, which is more critical whiletreating vulnerable population.
KeyIssues to Consider
The main barrier to proper implementation ofthe policy is limited stakeholder participation (Winetrobe, Rice,Rhoades & Milburn, 2015). All interested parties should beinvolved in the decision-making process for example, formulation ofhealth strategies (Migrants’ Rights Network, 2013). Thestakeholders must ensure that all homeless individuals have equalaccess to health services. Health resource, for instance, healthstaff, finances, and medical supplies should be provided to benefitthe homeless population (DeWorsop, Mecca & Maiaroto, 2016).
In addition, it is important to acknowledge theextreme differences between the homeless and non-homeless individualsaccessing primary care. Indeed, there are many people homeless peoplefacing financial and non-financial barriers that prevent them fromaccessing health care despite their burden of illness. Winetrobe et.al., (2015) states that the success of policy implementation in ahealthcare system depends on the commitment of the providers.Consumers, providers, and policymakers share a positive outcome.Consumers hold policy makers and providers accountable for making andimplementing the policies. Policymakers develop policies whileproviders endorse changes in practice. They need to appreciate,support, value and act on policy entitlement.
I recommend the adoption of a universal andaffordable health insurance program for the homeless people in theUnited States. Besides, emphasis should be put education on healthand financial literacy, basics of health insurance, and how to accesscare efficiently. This will create awareness, as well as help thevulnerable population to make informed decisions on suitable plansfor their needs. This will ensure they ensure better health andreduce the risk of homelessness. The rationale for selecting thepolicy is based on providing affordable health care to all homelesspersons. The possible outcome of policy implementation is improvedpatient access and quality of life among the homeless population, inaddition to experienced, empowered, engaged and well-supported staff.Evidence indicates that existing system fails patients fromvulnerable groups including homeless individuals. Therefore,implementing effective interventions outlined in this essay willenable the homeless to live a longer and fulfilling life like anyother person. It will provide primary health care, emergency care,substance abuse services, dental care, and mental health treatment. Ahealth insurance system is likely to reduce homelessness, easesuffering of those on the streets, as well as reduce futurehomelessness episodes.
DeWorsop,D., Mecca, M. &Maiaroto, M. (2016).“Screening Program toIdentify Needs Due to Geriatric Syndromes (SPRING): A NewPerspective on Healthcare for Homeless Adults.”TheAmerican Journal of Geriatric Psychiatry,24(3), S77-S79.
Gaebel,W., &Zielasek, J. (2015). “Homeless and mentally ill–a mentalhealthcare challenge for Europe.”ActaPsychiatricaScandinavica,131(4), 236-238.
Hislop,J., & Newlands, C. (2015). “Evaluation of a specialistphysiotherapy service for homeless people.”Physiotherapy,101, e574.
Keogh,C., Brien, K. and Hoban, A. (2015). “Health and use of healthservices of people who are homeless and at risk of homelessness whoreceive free primary health care in Dublin.” BMChealth services research, 15(1), 58.
Lamb,V. (2014).Improving access to health care for homeless people.Retrieved from http://journals.rcni.com/doi/pdfplus/10.7748/ns.29.6.45.e9140
McInnes,D. &Fix, G.(2015). “Preliminary needs assessment of mobiletechnology use for healthcare among homeless veterans.”PeerJ,3, e1096.
Migrants’Rights Network (2013).Migrant Accessto Health Services Consultation.London: Migrants’ Rights Network.
Skosireva, A., O’Campo, P. &Zerger, S.(2014). “Different faces of discrimination: perceiveddiscrimination among homeless adults with mental illness inhealthcare settings.”BMC healthservices research, 14(1), 376.
To, M., O`Brien, K. & Hwang, S. (2015).“Healthcare utilization, legal incidents, and victimizationfollowing traumatic brain injury in homeless and vulnerably housedindividuals: a prospective cohort study.”TheJournal of head trauma rehabilitation,30(4), 270-276.
Winetrobe, H., Rice, E., Rhoades, H., &Milburn,N. (2015). “Health insurance coverage and healthcare utilizationamong homeless young adults in Venice, CA.”Journalof Public Health, fdv001.
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