By Alvin Tran
Alameda County has new plans in store for its homeless population – it intends to open an integrated medical clinic in downtown Oakland.
The TRUST Clinic is one of the county's newest projects and involves the collaboration of several agencies including Alameda County’s Health Care for the Homeless Program, Social Services Agency and Behavioral Health Services.
But unlike other clinics in Alameda County, TRUST will be one of just two which will offer integrated health services, including primary care, behavioral health, case management with housing assistance, and medical-legal partnerships.
“This clinic is a very innovative idea. It’s not something that’s being done in very many places,” said Dr. Michael Boroff, a clinical psychologist who will be working at the clinic. “It embraces the integrated health care ... with medical and mental health and all of these different aspects of services combining and working together as a team.”
“I’d be hard-pressed to identify the population who needs these services more than the homeless population that we’re going to be serving,” Boroff added. And that population is large -- more than 4,000 people in 2011, according to a report by EveryOne Home, an advocacy group.
Wendy Georges, the TRUST Clinic Manager, said many homeless people deal with a variety of health and behavioral problems. Homeless individuals might have mental illness and substance abuse issues, they may have difficulty keeping track of their medical appointments, and might struggle in social settings.
The TRUST Clinic is intended to be a place where people can get a variety of services for up to 24 months. The hope is that during this time, patients will achieve financial and housing stability and be prepared to transition to other permanent clinics in Oakland.
“What we’re hoping to do in the TRUST Clinic is to address all of those problems across a spectrum -- stabilize their health, stabilize their mental health, offer effective substance abuse and interventions for addiction, provide legal advocacy to people so that they can successfully transition off of (General Assistance), get on to insurance which will then increase their access to medical care, mental health care,” Georges explained.
While many homeless individuals are current recipients of General Assistance, also known as welfare, Georges said that many of them are still unable to obtain adequate health services. TRUST will help enroll individuals in other areas of assistance.
“If they get on to Social Security, Supplemental Security Income -- SSI -- or SSDI, they'll have access, automatic access, then to Medi-Cal and, in some instances, to Medicare,” Georges said.
But when more people become insured, there will be other challenges to face.
According to Georges, more than 56,000 people in Alameda County will become eligible for health insurance once President Obama's Affordable Care Act takes full effect in California.
“The demand outweighs the supply,” Georges said, adding that the current community clinic system in Alameda County will continue to be overburdened with patients from the safety net population –- a population in need which lacks health insurance.
This is where the TRUST Clinic comes into play. Georges describes the clinic as the “safety net for the safety net.”
“By redirecting the homeless population to the TRUST Clinic we relieve the burden on our community health network and enhance an already inadequate safety net system in Alameda County,” Georges explained later in an email. “Our clients/patients already have difficulties gaining access to the system and fitting in even when they do. We are establishing the (clinic) with just such clients/patients in mind, so truly to function as a safety net for the safety net.”
While the bricks and mortar clinic opens in 2013, Alameda’s homeless population does not have to wait until then to begin receiving the TRUST Clinic’s integrated health services. Starting Tuesday staff members of the clinic, including a nurse practitioner and a clinical psychologist, began offering part-time, interim mental health services at two locations in Oakland.
“We’re going to start with mental health and we’re going to begin this building up process, get our mechanisms in place,” Georges said. “It’s a little bit of a practice run for a ramp up to full scale services."