Homeless Outreach Program Expansion

Program Description

The I.M. Sulzbacher Center for the Homeless, Inc. is the largest homeless service provider in Jacksonville, FL. Sulzbacher provides emergency shelter, meals, case management, supportive housing programs, primary health and dental care, behavioral health services, and outreach to homeless men, women, and children. Sulzbacher began the HOPE (Homeless Outreach Project Expansion) project in 2000, conducting street outreach to the homeless in the city. HOPE consists of two teams working from mobile vehicles. Offering medical outreach to homeless persons living on the street, the HOPE Teams made thousands of contacts last year. HOPE builds trust and rapport with clients by providing bag lunches, clothes, water, blankets. With one team serving the communities of Jacksonville Beach, Neptune Beach, and Atlantic Beach and another downtown Jacksonville, they provide psychiatric outreach and medical services on the street, to the most at-risk members of our community. As many street homeless persons have mental illness, the Sulzbacher psychiatrist rides with the HOPE Team every week, providing care to those most in need. Further, once clients have determined they are ready to enter shelter, the HOPE Teams facilitate entry into shelter, case management, and other support services necessary to help them regain their independence and self-sufficiency.

Creativity

HOPE began with an inquiry from the City of Jacksonville, whose leaders knew Sulzbacher had an outstanding program for helping homeless persons regain their independence through comprehensive case management and health services. Sulzbacher is an agency that embraces collaboration. The City of Jacksonville and HRSA are funding partners. HRSA also allows Sulzbacher to be a Federally-Qualified Health Center (FQHC), which enables us to provide the highest quality health care. The Jacksonville Sheriff’s Office is a partner in referring clients to HOPE, resulting in fewer arrests of homeless persons for “lifestyle” crimes. Sulzbacher partners with local universities to be a teaching site. Dental and psychiatric students from the University of Florida and nursing students from the University of North Florida rotate through the Sulzbacher Clinics. The psychiatric and nursing students ride along with the HOPE Teams, not only receiving unparalleled learning experiences, but also participating as extra hands working with clients.

Leadership

Providing outreach services with a medical/psychiatric component for 17 years provides a wealth of experience that other agencies could draw from. The HRSA Health Center program oversees almost 1,400 Federally Qualified Health Clinic (FQHC) sites across the country which deliver comprehensive, high-quality primary health care services. Many would be qualified to host a program like HOPE. HRSA encourages outreach to patients who would not otherwise receive care. Other homeless shelters, even if they are not FQHCs, could partner with an FQHC to provide this model of service. Program design and results are disseminated by the President/CEO, Health Resources Administrator, and other Sulzbacher leadership during press releases and in direct meetings. Staff travel to HRSA and other health-related conferences and discuss health center functionality and services , to include HOPE, with other medical/ social service professionals. Results are reported directly to HRSA and the City of Jacksonville in regular grant reports.

Sustainability

The City of Jacksonville provided the funding for the downtown Jacksonville HOPE team in 2000, and has been a consistent and enthusiastic partner since that time. Funding from the City of Jacksonville pays for the two full-time outreach personnel, supplies, vehicle fuel and maintenance, and part of the medical/behavioral health salaries. The City has been very willing to provide long-term funding of this program. In 2006, Sulzbacher expanded to a second HOPE Team to service the communities of Jacksonville Beach, Neptune Beach, and Jacksonville Beach (also Duval County). This second team was initially funded by a grant from Bank of America, and has been funded by that time by funding from the Health Resources & Services Administration (HRSA). This is long-term funding as part of a larger on-going grant for Sulzbacher health services. Continuing operating cost are covered; when additional needs arise, the Center seeks new grants or major donors.

Replicability

Crucial to duplicating this program is a willingness to collaborate. Social service agencies are beginning to see the value in collaborating in order to achieve the best possible outcomes for clients, but there is still a long way to go. Buy-in from local government/community and law enforcement is vital. Often the homeless are looked down upon. Some communities have the philosophy that the homeless are just a problem, and should be transported elsewhere, rather than treated with dignity and compassion. Partnership with universities for students is a good way to expand program capacity, and to also educate future generations of medical professionals, not only about medicine and treating the body, but also about compassion. With a modest grant or other source of income, this program could be easily replicated in almost any urban area – rural would be a challenge due to sparse population and wide distribution of clients.

Results/Outcomes

The ultimate goal of the HOPE program is to improve the quality of life and health for homeless persons living in Duval County, Florida. In 2017, the downtown HOPE team made 2,278 total contacts with 1,132 new clients. 702 received health assessments and direct medical and psychiatric care. This team also brought 190 individuals into shelter and case management services. Also in 2017, the Beaches HOPE team made 1,677 total contacts with 106 new clients. 471 received health assessments and direct medical and psychiatric care. This team also brought 42 individuals into shelter and case management services. Together, both teams provided a total of 3,955 street outreach contacts to 1,238 unique clients. 1,173 received health assessments and medical/psychiatric care, and 232 individuals came into shelter. This program provides direct care for clients/patients who, due to mental health issues, fear, distrust, or disenfranchisement would most likely die alone on the street.