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Providing Care to The Homeless in Shelters
We have been serving the homeless since 1969. Today, medical teams are present at 32 shelters, drop-in centers, SRO hotels, a hospital-based outpatient clinic in Manhattan, a drop-in center on Staten Island and a Women-in-Need Recovery Program in the Bronx. Our teams regularly give on-site medical care, outreach, screenings, case management, crisis intervention and long-term counseling. Our substance abuse counselors also provide health education. Since 2001, our designated hospitalist has served homeless clients through 700 hospitalizations.
The SRO/Homeless Program finds homeless people, brings them into relationships with practitioners and services, and develops and maintains relationships with other community services to ensure the needs of these people are met. Outreach is a key element in serving them. In 2005, we served approximately 9,800 patients through 58,000 visits at SRO/Homeless Program sites.
Women's Health Services for the Homeless
In 1996, through a Benita Blau Feurey grant and our own funds, St. Vincent's began its breast cancer education and early detection program for homeless women. Health care teams provide breast health education and information about breast self-examination, clinical breast exams, and mammography. In 2005, we served more than 1,600 women and enrolled approximately 600 of them into our breast health program.
Other Diseases and Education and Prevention Programs
The Homeless and Tuberculosis
Since 1979, tuberculosis has been recognized as a significant health problem among the residents of SRO hotels. We have followed screening and treatment protocols for this population since1982, and expanded TB treatment in 1994 to additional shelters and drop-in centers. Shelter services include directly observed therapy (since 1993) and directly observed therapy for latent TB infection (since 1995).
In May 1997, we developed a national TB investigation in four NYC homeless shelters to determine the safety and efficacy of ultraviolet light for air disinfection. The program has since expanded to sites in Birmingham, New Orleans and Houston. Since the 9/11 tragedy, the study of UV technology as a bioterrorism countermeasure has been conducted. Work is now underway to study what UV energy will be required to inactivate aerosolized smallpox virus and anthrax spores. Articles on TB transmission and St. Vincent's work with UV lighting are published in medical journals throughout the United States. To date, over 3,000 patients have tested positive for TB.
The Homeless and AIDS
In 1990, through a renewable grant from the NYS AIDS Institute, we established an HIV prevention program for the homeless. In 1991, the program received additional support through the USPH Award under the Ryan White Act for developing early strategies in HIV in the homeless population. Through these grants, an AIDS specialist offers education services at two specialized HIV housing sites.
The Homeless and Diabetes
Diabetes is prevalent among the homeless, especially among Latino men and women. As participants in the HRSA Diabetes Collaborative, St. Vincent's SRO/Homeless Program staff are developing ways to manage non-traditional treatment plans for homeless people with diabetes whose health care is episodic and inconsistent.
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