Health Care for the Homeless - Summary of Program Partners
The Cincinnati Health Network, through the effective use of partner resources, provides comprehensive, integrated medical, dental, mental health, substance abuse services, and supportive services including respite care. In a continuing effort to meet the ever changing and growing needs of those experiencing homelessness, CHN partners with experienced providers to improve the overall health status of homeless individuals living in the service area.
University of Cincinnati Physicians Company physicians provide primary care and psychiatry services at the Healthcare for the Homeless Program clinics, on the Mobile Medical Van, seasonally at the River Downs Racetrack and as back up for the physician at the Center for Respite Care. Furthermore, a UCPC provider serves as the Medical Director for the Health Care for the Homeless Program. Additionally, the Medical providers of the UCPC are instrumental in expanding training opportunities for residents and medical students within the Health Care for the Homeless Program.
The Cincinnati Health Network contracts with the Cincinnati Health Department (CHD) to provide comprehensive dental care, including preventive and restorative dental services to CHN’s patients in the Health Care for the Homeless program. The CHD also assists with the operation of the Mobile Medical Van by providing maintenance, storage and the driver for the vehicle. In addition, the CHD makes laboratory services available to CHN patients, under its contract with Labcorps and pharmaceutical supplies as our ship to pharmacy for the 340B Drug program.
Ongoing Referral Agreement
The Cincinnati Health Department (CHD) agrees to accept referrals from the Cincinnati Health Network (CHN) for patients that present with a need for high risk pregnancy care. Under this agreement, the CHD provides comprehensive obstetrical care including prenatal care, labor and delivery services, and postpartum care. Due to the multiple challenges of homelessness, all CHN patients who are pregnant are referred for care at the Cincinnati Health Department’s Elm Street Clinic.
The Center for Respite Care (CRC) is a 14-bed 24-hour facility for homeless people who are either too sick for a shelter or have been recently discharged from a hospital and need a safe place for recuperation. Patients receive basic short-term medical and nursing care as well as social services while they recover from illnesses. Under this contract, the Cincinnati Health Network provides 8-10 hours per week of physician services to CRC and provides funding for nursing services.
The Cincinnati Health Network contracts with Greater Cincinnati Behavioral Health (GCB) to provide 3 Counselors to deliver integrated behavioral health services at the Cincinnati Health Network’s clinic locations. Services include diagnostic assessment, triage and referral services, development of a treatment plan and individual or group counseling. The services are closely coordinated with CHN provided medical services in an integrated model of care.
The Shelterhouse Group
The Shelterhouse for Men houses a certified Substance Abuse Treatment program for homeless adults. The program includes referral for medically monitored detox when needed, individual and group counseling, education on chemical dependency and addiction, community service, job training and a focus on housing and self sufficiency. The Cincinnati Health Network contracts with the Shelterhouse to conduct substance abuse assessments and deliver treatment services including group and individual counseling to homeless individuals in need of such services.
Under this partership, the Freestore Foodbank (FSFB) provides Payee Services to serve as representative payees for disabled homeless individuals. Other Enabling Services, including but not limited to assistance with transportation, resources for food, shelter, housing, clothing, birth certificates and identification, food stamps and other benefits enrollment assistance are provided to people experiencing homelessness. In addition, the Certified Application Counselors at the Freestore Foodbank provide outreach and enrollment services into Medicaid or other insurance coverage plans related to the Affordable Care Act. FSFB staff provide all the above services daily at the Freestore Foodbank facility, at CHN Clinic sites and other locations where homeless individuals reside or congregate.
Through an on-going Memorandum of Agreement, the University of Cincinnati Medical Center (UCMC) provides inpatient hospital care; ambulatory services; diagnostic and imaging services; podiatry services; and emergency medical and psychiatric services for adult males and females of the Cincinnati Health Network’s Health Care for the Homeless Program on a referral basis.
Ryan White Part C HIV/AIDS -Summary of Program Partners
The Cincinnati Health Network as the local grantee for the Ryan White Part C program provides administrative oversight for the operation of the program; offers HIV counseling and testing at its HCH sites; provides access and linkage to care; and leads the Quality Management Team of the local Greater Cincinnati HIV Collaborative. Our contractual relationships with the partners listed below, have been in place for 21-27 years and have resulted in a commitment to high quality, community-based care for low-income and underserved residents of this service area.
The Cincinnati Health Network contracts with the UCMC IDC to provide early intervention and comprehensive primary HIV care to individuals living with HIV/AIDS throughout our tristate 15 county service area. The physician and non-physician medical staff are employed to provide on-going primary HIV care, behavioral health counseling and supportive services to approximately 2000 patients annually; whom receive RW services. Providers of the IDC are the primary clinical educators for HIV/AIDS issues in the region, actively participate in the Quality Management Team, and work closely with the Consumer Advisory Board to ensure consumer involvement in service delivery.
The HIV Early Intervention Program (EIP) is located in the Emergency Department at UCMC. The Cincinnati Health Network contracts with the UCEIP to provide HIV testing, prevention and linkage to care. The EIP has been particularly useful in reaching patients who have substance abuse problems, psychiatric illness, experiencing homelessness, high rates of STDs, and incarceration histories. The EIP offers HIV counseling and testing services to both walk-ins and registered patients not yet diagnosed with HIV on a 24 hour basis.
The Northern Kentucky Independent District Health Department provides case management along with counseling and testing services in four Northern Kentucky counties and was a founding member of the Greater Cincinnati HIV/AIDS Collaborative. Currently, the Cincinnati Health Network contracts with the Department to provide medical case management services with a focus on linkage to care to people living with HIV in Campbell, Kenton, Boone and Grant counties of Northern Kentucky. Case management and other service delivery programs are coordinated through collaboration with the case-management network.
Other Collaborative Partners:
Caracole operates a variety of housing opportunities for PLWH from a Shelter Plus Care program to rapid re-housing and permanent supportive housing opportunities. Caracole is also a RW Part B provider, offering medical case management and other supportive services to over 1500 individuals annually. Over the last year, Caracole has taken over the state funded HIV testing program originally operated by Planned Parenthood. This organization also operates a 340B pharmacy for 153 PLWH receiving their case management services.
A RW Part F program, the local performance site of MATEC program provides training, technical assistance and capacity building support to local clinical providers interested in HIV care.
Operates 5 FQHCs throughout the City of Cincinnati and provides STI screening and limited HIV testing. Patients with positive test results care referred to RW Part C program for care.
This county Health Department provides HIV and TB testing and provides efficient and accurate data reporting on HIV incidence and prevalence.
Provides outreach and faith based prevention counseling, Evidence-Based Interventions and HIV Counseling/Testing/Referral.
The CCHB operates the Early Prevention Intervention Program and provides prevention, outreach and group and individual support for MSM particularly for African American men.