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Homelessness inevitably causes serious health problems. Illnesses that are closely associated with poverty - tuberculosis, AIDS, malnutrition, severe dental problems - devastate the homeless population.

Health problems that exist quietly at other income levels - alcoholism, mental illnesses, diabetes, hypertension, physical disabilities - are prominent on the streets. Human beings without shelter fall prey to parasites, frostbite, infections and violence.

National Health Care for the Homeless Council

About homelessness and its impact in King County

On any given night in Seattle and King County, almost 12,000 people are experiencing homelessness, according to All Home's most recent Count Us In report. Poor health is both a cause and a consequence of homelessness. For a person living on the streets, in shelter, or otherwise without their own safe place to call home, the chronic instability and frequent chaos of daily life creates enormous barriers to health care access. People experiencing homelessness often have trouble making and keeping medical appointments due to competing priorities in their lives-such as getting a shelter bed for the night. They often have no place to rest and recuperate, or to store medications. Too often the absence of stable, safe, and appropriate housing conspires with uncontrolled chronic illness to create a downward spiral of crisis after crisis from which recovery is extremely challenging. As a population, people experiencing homelessness have a high prevalence of infectious diseases, mental illness, and co-occurring addiction disorders. For all of these reasons homelessness is a critical public health concern.

To learn more about homelessness and health, visit the National Health Care for the Homeless Council and the King County Homelessness Assistance & Continuum of Care Planning.

Overview of the Health Care for the Homeless Network (HCHN)

HCHN collaborates with nine community-based partner agencies in serving homeless adults, families, and youth/young adults. These agencies send care providers to over 60 locations throughout King County. Our flexible model allows these providers to meet people where they are, both geographically and in terms of their readiness for appointment-based services. Service sites include shelters, day centers, transitional housing programs, meal programs, and clinics. Many services are provided on the streets by outreach teams. Interdisciplinary, interagency care teams integrate a broad range of medical, mental health, substance abuse, case management, and health access services. Stand-alone services such as dental care are also provided at some clinic sites.

HCHN’s work is designed to align with the All Home Continuum of Care plan to make homelessness rare, brief, and one time. Our services also align with Public Health – Seattle and King County goals by promoting health among a particularly vulnerable population and by helping prevent the spread of disease. In addition to direct patient care, HCHN provides training and consultation services for homeless agencies to assist them in establishing appropriate health and safety protocols designed to protect both staff and clients by, for example, preventing the spread of communicable diseases that can occur when people live or sleep in close proximity to others.

HCHN is part of a national movement initiated in the 1980s and first spread throughout the country through a 19-city demonstration of the Robert Wood Johnson Foundation and the Pew Charitable Trust. HCHN was part of the original 19-city cohort. In 1987, federal grant support was established for HCHN through the Stewart B. McKinney Homeless Assistance Act. Today, we are one of over 180 Health Care for the Homeless projects nationwide.

Our community advisory body: The Health Care for the Homeless Planning Council

The Health Care for the Homeless Planning Council provides strategic direction and community guidance to Public Health-Seattle King County in effectively addressing the health needs of people experiencing homelessness. The Planning Council membership allows for continuous input from a broad range of experts, including people who are currently and formerly homeless, housing and shelter providers, funders, and representatives of government agencies providing behavioral health and other services to the homeless.

Our values

Adopted by the Seattle-King County HCHN Planning Council:

  • Access to high quality care for people experiencing homelessness
  • Holistic approaches to care that integrate physical and oral health, mental health, addiction services, supportive housing, and social supports
  • Improved health status and the prevention of disease among homeless people
  • Flexible, respectful service models that are tailored to the needs of homeless people and work to link them to appropriate services and housing
  • Diversity and the effort to eliminate racial and ethnic bias in our work and in access to health care
  • Effective relationships with organizations and systems with whom we partner
  • A community-based governance structure for HCHN that is ethical and open
  • Program staff who are committed to leadership development, customer service, and quality assurance
  • Putting ourselves out of business by advocating for the social justice that will eliminate the need for our program

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Community partner agencies and services

Health Care for the Homeless Network programs and services are provided through contracts with the following organizations. Staff work in interagency, multidisciplinary teams to serve homeless sites:

  • Federal Way Day Center, Kent Family Center, shelters, day centers, street outreach and transitional and permanent supportive housing sites in South King County
  • Shelter-based services for families in central Seattle (YWCA Downtown, East Cherry, and South Myrtle locations)
  • Homeless Youth Clinic (in partnership with University of Washington)
  • REACH case management program for chronic public inebriates at the Dutch Shisler Sobering Center
  • Outreach and case management conducted on the streets and at regular and other sites in Seattle including The Markham Building, Ballard Homeless clinic, ETS Methadone clinic, Dutch Shisler Sobering Center, and Navos Public Health Center
  • Redmond Youth Services Center, shelters, day centers, transitional and permanent supportive housing sites and street outreach in East King County and other areas
  • Pioneer Square Clinic:
    • Shelter-based services for single adults at St. Martin de Porres, Peter’s Place, Markham Building, DESC Main Shelter, Compass
    • Hygiene Center, Compass Cascade, Chief Seattle Club and Angeline’s Day Center
    • Robert Clewis Center Clinic (co-located with Needle Exchange)
    • Medical Respite Program - for people too sick to be on the streets, but not sick enough to need hospitalization, beds at Edward Thomas House
    • Third Avenue Clinic at YWCA Opportunity Place

  • Boren Homeless Clinic at Dutch Shisler Sobering Center
  • Shelter-based services outside Seattle including Avondale Park, Burien Hospitality House, Domestic Abuse Women’s Network, Lifewire, Hopelink-Kenmore, Hopelink Place, Katherine’s House (Catholic Community Services), Kent Hope Day Center, Reach Center of Hope, The Sophia Way, The Landing (Valley Cities Counseling & Consultation), Titusville Station, The Landing (Friends of Youth)
  • Nursing Services at Permanent Supportive Housing (PSH) operated by Valley Cities Counseling and Consultation
  • 45th Street Youth Clinic
  • Housing Health Outreach Team – Nursing services at 13 Downtown Seattle Permanent Supportive Housing (PSH) buildings: Canaday House, Humphrey House, Kerner-Scott House, Lewiston, Morrison, Noel House, Ozanam, Plymouth on Stewart, Rose of Lima, Scargo, Simons, Westlake and Wintonia.
  • Ballard Homeless Clinic at Nyer Urness Permanent Supportive Housing
  • Medical services at Country Doctor Youth Clinic
  • Health Care Access Project - Advocates work with homeless families to help them access health care insurance and many other services. Services provided at Hammond House, Elizabeth Gregory Home, Jubilee Women’s Center, Mary’s Place Downtown and North, Hope Place (UGM), YWCA Downtown and Willow sites.

Funding

HCHN receives support from the following organizations:

  • City of Seattle
  • King County
  • Private foundations and individual donors
  • United States Department of Health & Human Services, Health Resources and Services Administration, Bureau of Primary Health Care
  • United Way of King County