A Primary Care–Public Health Partnership Addressing Homelessness, Serious Mental Illness, and Health Disparities

Background: People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports. Methods: The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the “10 Essential Public Health Services.” Results: Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system. Conclusion: The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the “grand challenges” of integrated community health services.

[1]  Leiyu Shi,et al.  Primary care and public health activities in select US health centers: documenting successes, barriers, and lessons learned. , 2012, American journal of public health.

[2]  L. Weinstein,et al.  Community-based partnerships for improving chronic disease management. , 2012, Primary care.

[3]  Quyen Ngo-Metzger,et al.  Primary care and public health activities in select U.S. health centers: documenting successes, barriers, and lessons learned. , 2012, American journal of preventive medicine.

[4]  K. Griswold.  Communities of Solution: The Folsom Report Revisited , 2012, The Annals of Family Medicine.

[5]  Jason Matejkowski,et al.  Moving From Street to Home: Health Status of Entrants to a Housing First Program , 2011, Journal of primary care & community health.

[6]  S. Bartels,et al.  Health Care for Patients with Serious Mental Illness: Family Medicine's Role , 2009, The Journal of the American Board of Family Medicine.

[7]  A. Kilbourne,et al.  Primary care of patients with serious mental illness: your chance to make a difference. , 2008, The Journal of family practice.

[8]  Sam Tsemberis,et al.  Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. , 2004, American journal of public health.

[9]  American Osteopathic.  Joint principles of the Patient-Centered Medical Home. , 2008, Delaware medical journal.

[10]  J. O’Connell,et al.  Premature Mortality in Homeless Populations : A Review of the Literature , 2005 .