The individuals in need here will have many comorbidities including psychosis, conditions associated with exposure like hypothermia and heat stroke, chronic pain, hunger, nutrition, uncontrolled diabetes, infectious diseases and many other chronic diseases like CHF, AMI, pneumonia, and COPD.
Recently the US Department of Health and Human Services published a document on the processes and benefits of using Medicaid programs to provide needed medical care to the types of homeless listed in the document (US Department of Health and Human Services, 2014).
Currently Medicaid is available in most states, but the homeless have little access to the benefits due to their unwillingness or inability to secure the benefit. Another issue with utilizing Medicaid is the individuals or clinics willingness to accept this benefit due to the limited reimbursement, usually about $0.10 per billed dollar.
As part of the solution being offered, The Future will provide a solution for enrolling eligible individuals in the Medicaid Program and then providing a clinic or designated facility to provide the care needed for the homeless. The homeless need a clinic in the same controlled environment as being discussed throughout this proposal. Part of the monies allocated for the homeless should cover the cost of staffing a clinic that would be able to care for the issues associated with being homeless, especially the need to manage psychosis, chronic medical conditions, and care associated with recreational drug abuse or alcohol abuse. This clinic will be staffed by one or more physicians, along with other allied health providers like NP’s and PA’s with the skills necessary to provide care for the homeless.
Due to the complexity of enrolling individuals in to health insurance programs, a designated individual will be hired with the job description of insurance enrollment specialist. This individual will enroll individual in all applicable insurance plans including Medicaid and Medicare.
Once these individuals have the insurance coverage they are eligible for, measures will be taken to ensure that the homeless seek care at the appropriate level, urgent care instead of emergency room and primary care physician, instead of emergency services for non-emergent conditions. By addressing this issue will alleviate the costs of providing charitable care to the individuals by many healthcare facilities. This part of the proposal would be of benefit to hospitals in areas with large homeless populations as the care provided may be done on a charitable basis.