For the thousands of people experiencing homelessness in Austin, managing their health can pose unique challenges. But in 2019, a new mobile healthcare unit to “reach them where they are” hopes to improve health outcomes, especially for those with chronic illnesses, and mental health and substance abuse issues
In December, a collaboration among Dell Medical School at UT-Austin, CommUnityCare Health Centers, and Integral Care was awarded a five-year, $2.3 million grant from the Substance Abuse and Mental Health Services Administration, a program of the U.S. Department of Health and Human Service. The grant will allow the team to create a mobile, multidisciplinary team staffed by a primary care physician or nurse practitioner, a mental health care psychiatrist or nurse practitioner, a chemical dependency counselor, a nurse case manager, a mental health case manager, and a healthcare worker who’s shared some of the same experiences as the patients. The project aims to hit the streets in April 2019.
“We’re targeting some of the most vulnerable and hardest to reach,” said Tim Mercer, M.D., project director, faculty at Dell Medical School, and a primary care physician serving homeless patients for CommUnityCare, a federally qualified health center with 24 clinics that offers a safety net for uninsured and low-income patients.
“It’s not a foreign concept to us to see patients where they are,” said Mercer. Organizations that intersect healthcare and the homeless population like CommUnityCare, the ARCH downtown shelter, Integral Care, Austin-Travis County EMS, ECHO, and others have always worked together to provide care for this population, Mercer said. “We have a fairly extensive reach,” he said, which enables them to identify and locate those patients most in need.
But a mobile team that can provide holistic care without asking the patient to travel to appointments or make time for preventive care can eliminate many of the barriers homeless people face. “One of the principals of this care model is you meet people where they are, not just where they are living but also where they are in terms of readiness for treatment and willingness to engage in services,” said Mercer. “Consistency and frequency are key to maintaining trust.”
The team will treat patients in place and also see patients at a CommUnityCare clinic or one of Integral Care’s four mental and primary care clinics. Integral Care provides outreach and recovery services to people experiencing mental illness and substance use disorders, and it partners with the Austin Police Department and Austin-Travis County EMS as part of the Homelessness Outreach Street Team.
Dell Medical School’s Department of Population Health will collect data to measure the project’s success and help improve services, but Mercer says the project will also aim to further integrate medical care with mental health and substance abuse care. “They’re battling every day with health issues, not to mention their daily survival needs, and then we get frustrated when a patient misses an appointment. But it’s not their fault,” said Mercer. “So I hope this can be one step in the direction of providing them with more integrated services.”