The County Dept. of Public Health hopes that by combining helping hands with friendly faces, it can work to ensure health care for its homeless population.
The federally funded Health Care for the Homeless program aims to provide homeless persons with access to health services including primary care, emergency treatment, dental care, mental health care and substance abuse services.
Dana Gamble, the Public Health official who heads the program, said the goal of the program is to make sure that homeless people, especially those who are uninsured, can get what they need as opposed to what they can afford.
“We offer a lot of medical capabilities regardless of someone’s ability to pay,” he said.
To this end, the program’s definition of homeless is flexible, allowing RV dwellers and those in temporary living situations health care access under its auspices. There are also no age, residency or citizenship requirements. This sets it apart from programs like the county’s state-sponsored Medically Indigent Adults program, which covers uninsured Santa Barbara adults meeting certain conditions.
Key to the Health Care for the Homeless program are the Public Health nurses the county sends to work at various social service agencies, like shelters and other services for the homeless. Working directly with clients, the nurses can serve as the first line of medical defense by performing minor treatments, and they can also refer people for treatment to the county clinics or other facilities they contract with, like the Santa Barbara Neighborhood Clinics system. Though they cannot prescribe medicine, they function as an essential link between the homeless and health providers by serving as points of personal contact.
Lynelle Williams, director of the Santa Barbara Salvation Army Hospitality House, said the shelter’s clients often take advantage of the opportunity to talk to the county nurses both by making appointments and by just walking up to them.
“From my observation, they have a great rapport with the clients,” she said.
Gamble stressed the advantages of having the nurses as a regular presence around the shelters.
“Traditionally, homeless don’t have a lot of faith and trust in systems – government systems, health systems, etc.,” Gamble said. “[The public health nurse] becomes a familiar face, someone they can trust.”
But George, a 41-year-old homeless man in Isla Vista, says the paperwork, among other things, makes going to such agencies a hassle.
“There’s so much B.S. there. I don’t go to shelters,” he said.
Any homeless person should be able to walk into an affiliated clinic, like the I.V. Medical Clinic, and take advantage of the program, Gamble said. He also said that because the county only has a limited amount of money, the program could only apply to those ineligible for other forms of aid.
George said he ran into problems trying to find free dental care.
“They wouldn’t give it to me because I’m a veteran, so I can go to the [Veterans Affairs] hospital,” he said. “Well I go to the VA hospital and my teeth are bad. That’s what I need, dental work. The VA hospital doesn’t do dental work. … So I got craters in my teeth.”
Through a recently renewed federal grant from the Bureau of Primary Health Care, the Health Care for the Homeless program receives $225,000 annually to help provide homeless people with access to health care. After federal grant monies, the program costs the county an additional $400,000 a year. The funds go toward paying the clinics a set amount annually for agreeing to provide free treatment to homeless people, as well as other services like free transportation to the particular health care provider. The county provides bus tokens for the purpose, but the Dept. of Public Health also maintains a contract with Easy Lift Transportation, a nonprofit group, to fully meet transit needs.
“What we try to do is to make it as easy as possible for the disenfranchised in the community to access health services,” Gamble said.