Kelly Bennett, MD Medical Director TTUHSC Free Clinic

Definition of Homelessness  Per federal government:  “people who lack a fixed, regular, and adequate night time residence”  A true residence cannot be administered in a group setting by a government agency or charity

Who is Homeless  Children < 18 are 40%; majority under age 40  African Americans 40%  Caucasians 38%  Hispanics 20%  40% of men are veterans  1/3 have severe addictive disorders  16% have severe mental health disorders  1% of population will be homeless at some point during each year (3,000,000)  On any given day between 400,000 and 800,000 are homeless

What Causes Homelessness  Poverty: 12.5% of the US population is living in poverty (37,000,000)  Poverty: not enough money to pay for shelter, food, clothing, utilities, health care, etc. These people have to pick and choose what they can pay for.  Poverty increasing due to:  Increasing unemployment  Decreasing wages  Decreasing Public Assistance

Causes of Homelessness  Foreclosures are up 33% in last two years due to mortgage crisis  Lack of affordable low income housing: as unemployment rises and low income wages fall the rents have increased  Mental health problems/Addiction problems: these people cannot sustain employment  Domestic violence breaking up families  Lack of coordinated health care system

What Can Be Done  Think:  Ccontribute  Aadvocate  Rreach out (volunteer)  Eeducate

Contribute  Things that can be contributed:  Clothes  Food  House hold goods  Computers  Cell phones  Cash donations to charity groups

Advocate  Join a coalition  Example: can become “friends” with salvation army on face book to be aware what help is needed  Follow local politics  Local city council has homeless committee with meetings open to the public  Involve the Media

Reach Out  Volunteer at a shelter (Salvation Army in Lubbock)  Help build shelters/houses (Habitat for Humanity in Lubbock)  Volunteer professional services: legal aid, dentistry, medical care, counseling, child care, construction

Educate  Educate yourself and others    Participate in 24 hour fast  Participate in a sleep out

Medical Needs of Homeless  Primary Care  Urgent/Emergency Care  Mental Health/Counseling  Dental Care  Substance Abuse Treatment  Of these the only “easy” care obtainable is a trip to the ER

What is the Problem  Primary Care/Urgent Care/ Non Crisis Mental Health  Cost of visits: not enough low cost clinics; funding still an issue; most are open during the day when people are supposed to be working, looking for work, etc.  Medicaid: currently for pregnant women, minors, elderly poor; plan in future to extend who is eligible; GOOD LUCK with states cutting benefits  Local indigent funding: example: Lubbock LCI; difficulty with process, proving you are poor

Problems continued  Counseling  Veterans can receive counseling at local VA resources  Covenant counseling in Downtown works on sliding scale  Mental Health Taskforce meets in Lubbock at the LP&L building every two months to coordinate local efforts

Problems continued  Dentistry  MUCH larger problem than people are aware of  Why? Dental insurance not often offered by employers; extensive dental work very expensive  CHCL resources overwhelmed  Twice in last year dentists have staged a large clinic for the underserved; Civic Center last year; this weekend at Abbeyville Dentistry  At Free Clinic we have dental clinic once a month

Problems continued  Substance Abuse Treatment  VERY expensive time intensive process  Even people with the BEST resources (money and insurance) often have difficulty finding treatment  Managed Care in Lubbock has indigent beds but that is sporadic  Dove Tree also has some indigent beds

Local Lubbock Efforts  Lubbock census in 2009 had approximately 700 homeless  2010 count more difficult due to one temporary shelter (Carpenter’s church) having shut down causing more dispersal of homeless  Count was last week; awaiting official numbers  In 2010 due to increased number of people needing shelter City Council called for committee  Down town businesses and local public library want homeless situation examined

Lubbock Council on Homeless  Last week went to Amarillo to examine their procedures  Mini mall with “stores” that are different charitable organizations, day care, etc.  Examining another process in San Antonio  Supposed to have recommendations for city council by this fall

What can you do  Volunteer at local agencies  has list of local charitable agencies  Dial 211 to locate agencies to help people in need  Purchase local “Red Book” with information listed for local organizations