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This blog is dedicated to distribute current information about the Coalition for the Homeless in Cleveland or poverty or the state of homelessness. Entries are written by board or staff of the Coalition. The opinions contained in this blog reflect the views of the author of the post. This blog features information on shelters, affordable housing, profiles, statistics, trends, and upcoming events relating to homelessness. We welcome comments, and will remove offensive or inappropriate messages. All postings are signed by the author.

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Jim Schlecht Event

Entries in health insurance (6)

Wednesday
Apr082015

The Importance of Healthcare for the Homeless

Mayor Jackson attends the new clinic ribbon cutting in March 2015. Photo by KenThe local health care for the homeless and public housing resident's Clinic under the Direction of Care Alliance had a ribbon cutting in March 2015.  This brings a free and low cost health care facility to the Central neighborhood. This will be a big boost to those at Cedar Extension Apartments and the new units being developed across from Tri-C.  Those lower income tenants at Arbor Park and the many others around Sterling Library have a health care home now.  Why is this so important for a community? And the other question this important in the era of the Affordable Care Act or Obamacare?

It is tremendous to have this expansion of health insurance in Ohio with the Medicaid expansion, but if the closest clinic is 60 blocks away there is still a hole.  Transportation is a huge barrier to maintain proper health care.  The elderly and fragile disabled populations served by these health clinics cannot travel long distances for health care.  They will if forced to, but will make better health choices if the clinic is convenient.  Those in need of healthcare will wait until things are serious before they see a doctor.  They will not want to wait in the emergency room for something that is not debilitating, but may walk over to the clinic to get it checked out. 

These Care Alliance clinics also have oral health care which is often overlooked, but can become serious.  It is often a sign of serious health issues or can start in the mouth and infection can spread to other parts of the body.  Oral health can make it difficult to process food, and can make it difficult to find stable employment.  This may mean that the individual is not taking in protein or able to eat healthy.  It may then spiral into an inability to get to sleep and the body begins to shut down.   It is a sad reality but with a glut of labor in the core city, employers often make the decision on whom to hire based on appearance.  The women without front teeth no matter how qualified is going to have a harder time getting a job.  We had a formerly homeless guy who regularly came to our office and refused to talk to groups of three or more.  Then he got healthcare last year with the ACA and all the rest of his teeth were taken out because of neglect and a gum disease.  After a couple of months, he was fitted for dentures so that he could digest food and now is regularly talking to larger and larger groups about his experiences. 

This facility has pediatrics care and a women's clinic as it opened on April 1, 2015.  We have had people who stay outside in need of care and would not go to the emergency room that received help from a Care Alliance doctor.  Outreach workers do find people living all over the city in places not fit for human habitation, and can stop into one of their clinics for help. Care Alliance offers a medical home to those displaced and wandering throughout the city.  This new clinic features a pharmacy as well.  It will only help to sign people up for health care insurance and maintain their eligibility.  This will be especially important if the State of Ohio keeps kicking people off the Medicaid Program, because they did not answer a long re-determination questionnaire. 

It is a beautiful facility which will help get homeless and low income people access to health care.  This will contribute to a healthier community. 

There is a nice article in the Plain Dealer today.

Brian Davis

Posts reflect the opinion of those who sign the entry.

Thursday
Nov202014

Articles in the News Around Homelessness

WEWS-TV 5 had a nice story on family homelessness and the overflow problems in Cleveland. We have had seven months of overflow shelter for families.  What month do we say this is no longer an overflow problem, but a lack of family bed problem.  We closed Continue Life earlier this year, and West Side Catholic reduced the number of transitional beds for family.  This is what happens when you cut back on beds available to families, you have to pay to transport and open up church basements for these emergencies.

The New York Times had a strange story about the feeding program.  I understand presenting a balanced story, but this is just strange.  The proponents of the law do not have any evidence or proof that feeding programs are "counterproductive."  It is one side saying that laws against feeding are morally bankrupt and lead to unnecessarily going to jail for purely innocent behavior while the other side is saying, "but we don't like to see poor people lining up to eat."

A positive story from Vox media about the decline in uninsured individuals in the Lesbian and Gay community.  Health insurance will also reduce homelessness in America when people aren't forced to decide between rent or medicine or food.  

The National Center on Family Homelessness has found that one in 30 children are homeless in America.  Since Ohio was right in the middle for the states around the national average, this would mean that 9,137 children were homeless in Cuyahoga County in 2013 and 88,323 were homeless in Ohio during the same time.   NCFH uses the Department of Education definition of homelessness which includes those sleeping in garages and friend's basements while they search for housing.  

Brian Davis

Posts reflect the opinion of those who sign the entry.

Monday
Jul282014

Housing is Healthcare!

This morning on Morning Edition there was a discussion about New York state's effort to use federal health care dollars for housing.  They specifically are petitioning the federal government to be able to use Medicaid dollars for housing.  The State's argument is that they already pay for housing in mental health facilities and nursing homes or the inability to discharge people to the streets so why not pay for safe places for people to recover from a serious health condition? WCPN also weighed in with a story about the value of expanded Medicaid to a family. I have seen attempts in Colorado and Boston to do innovative housing using health care dollars.  So, to answer the question posed on NPR, yes, housing is healthcare!

Imagine breaking your leg and going to the hospital to have it set while sleeping in a shelter.  The hospital will release you with a cast and then try to get bed rest to recover from the broken bone.  It is not easy and it is unlikely that you will be able to keep the leg up while you recover.  You have to go get food and most shelters make you leave from 8 a.m. to 3 p.m.  How do you recover from a fever in a shelter or even surgery?   Behavioral health issues are just as big of a problem for those without housing because they cannot find a place to recover.   There is the problem of repeated trips to the most expensive part of the health care continuum with emergency room care.  There is repeat visits because homelessness and bed rest are mutually exclusive.  There is the issue of sleep deprivation in the homeless community which then causes other health issues.  There is an inability to get consistent care for chronic health conditions because of an inability to secure quality health insurance (before 2014).  

Housing is a game changer for people with long term health issues.  If you have a solid bed to go back to and get a good night sleep it will change your life.  Housing takes a great deal of stress and pressure off a person.  Housing allows a person to take their medication on a consistent schedule without their pills being stolen.  You can take care of personal hygiene in housing that is difficult while living in a shelter, and you can make meetings with health care professionals.   Those in housing have regular sleep and can take care of their dietary needs.  Housing is critical to have effective health outcomes.  We know that those who spend a period of time living on the streets do reduce their lifespan.  It is obvious that Housing is a Health care issue. 

Brian Davis

Posts reflect the opinion of those who sign the entry

Friday
May022014

Award Winners at Care Alliance

John Corlett and Brian Davis both received awards from Care Alliance at the Annual Meeting last week.  Francis Afram-Gyening (on left) presents the award to John Corlett (middle holding award) for all his work locally to expand health insurance for low income people in Cleveland.  John is an executive at MetroHealth and he put in place MetroHealth Care Plus in preparation for Medicaid Expansion.   This policy has allowed nearly 40,000 people locally to finally have health insurance.    Cuyahoga County is a far better community because of John Corlett and we are way ahead in signing people up for Medicaid when compared to the other counties in Ohio.  This will have huge ramifications in saving money for the hospitals indigent care budgets and the health clinics. 

The Care Alliance Board also gave an award to Brian Davis Community Organizer for the Northeast Ohio Coalition for the Homeless.  Afram-Gyening and outreach worker, Jim Schlecht, presented the award to Davis for his years of service to the homeless community in Cleveland.  Afram-Gyening cited his long history with NEOCH going back 20 years including a time when Davis led a protest outside of the previous incarnation of Care Alliance called Healthcare for the Homeless.  Afram-Gyening also made the crowd aware of the work of Davis in keeping people safe over this past winter.  

Just a few numbers from the Care Alliance Annual Report:

  • 10,643 patients served.
  • 59% of the clients were experiencing homelessness and half had a chronic health condition.
  • 68% had no health insurance.
  • 94% live in extreme poverty.
  • 663 patients received dentures, partials or other restorative dental care.
  • 2,473 received behavioral health services.

This number of 68% having no health insurance in 2013 is significant.  Previously this number hovered around 80%.  Thanks to MetroHealth this number is going down in our community, and it will continue to decrease with Medicaid expansion.  This is going to have huge implications for the community with a healthier society and improved outcomes.  

Thursday
Jan232014

Don't Get Sick in Texas if You Are Poor!

The second most populous state in the union is not a good place to get sick if you are poor.  Texas has 17.9% of their population living below poverty and the state leaders have decided not to extend health coverage to poor people. That is 4.5 million people who do not have an ability to afford health care coverage.  They are too poor to afford health care through the Affordable Health Care Act, and will not have the ability to have 100% of their coverage paid by the federal government.  Some of those living in poverty are children or elderly and so already have health coverage.  Some are disabled or have health care coverage at a job that pays below the poverty rate, but none of the 4.5 million will be able to obtain Medicaid. 

Florida, a state run by a health care executive, has also made the decision to forgo millions in federal dollars and the ability to improve the health care of probably somewhere around 1.6 million people of the 3.2 million people in Florida living in poverty.  Pennsylvania, Georgia, Michigan, Virginia and North Carolina are also making the purely political decision to punish their citizens for electing democrats to federal offices.   There are 25.39 million people in the United States who are currently living below the poverty level in the United States and have picked the wrong state to live in. 

Will people in Nashville see that their neighbors in Louisville, Kentucky are doing a lot better because they have health care?  Will the residents of St. Louis, Missouri move across the mighty river to Illinois in order to get health care coverage?   Never before have people followed government benefits when living in poverty, but will they for health coverage?  Will a Dad with a disabled wife working at Hobby Lobby making minimum wage in Oklahoma City move his family to Little Rock to gain health coverage?   Will the 54 year old chronically unemployed woman in Concord, NH move across the border to Vermont so that at least her health care will be taken care of? 

We have posted a summary of the population of the states that are not going to expand Medicaid with the number of people living in poverty in those states.  We will keep those numbers updates as more and more states come off the list after seeing the errors of their ways.

Brian Davis

Posts reflect the opinion of those who sign the entry