Kelly Bennett, MD
Medical Director
TTUHSC Free Clinic
HOMELESSNESS
Definition of Homelessness
 Per federal government:
 “people who lack a fixed, regular, and
adequate night time residence”
 A true residence cannot be administered in a
group setting by a government agency or
charity
Who is Homeless








Children < 18 are 40%; majority under age 40
African Americans 40%
Caucasians 38%
Hispanics 20%
40% of men are veterans
1/3 have severe addictive disorders
16% have severe mental health disorders
1% of population will be homeless at some point
during each year (3,000,000)
 On any given day between 400,000 and 800,000
are homeless
What Causes Homelessness
 Poverty: 12.5% of the US population is living in
poverty (37,000,000)
 Poverty: not enough money to pay for shelter,
food, clothing, utilities, health care, etc. These
people have to pick and choose what they can
pay for.
 Poverty increasing due to:
 Increasing unemployment
 Decreasing wages
 Decreasing Public Assistance
Causes of Homelessness
 Foreclosures are up 33% in last two years due




to mortgage crisis
Lack of affordable low income housing: as
unemployment rises and low income wages
fall the rents have increased
Mental health problems/Addiction problems:
these people cannot sustain employment
Domestic violence breaking up families
Lack of coordinated health care system
What Can Be Done
 Think:
 C
 A
 R
 E
contribute
advocate
reach out (volunteer)
educate
Contribute
 Things that can be contributed:
 Clothes
 Food
 House hold goods
 Computers
 Cell phones
 Cash donations to charity groups
Advocate
 Join a coalition
 Example: can become “friends” with salvation
army on face book to be aware what help is
needed
 Follow local politics
 Local city council has homeless committee with
meetings open to the public
 Involve the Media
Reach Out
 Volunteer at a shelter (Salvation Army in
Lubbock)
 Help build shelters/houses (Habitat for
Humanity in Lubbock)
 Volunteer professional services: legal aid,
dentistry, medical care, counseling, child
care, construction
Educate
 Educate yourself and others
 http://www.nationalhomeless.org
 http://www.endhomelessnes.org
 Participate in 24 hour fast
 Participate in a sleep out
Medical Needs of Homeless
 Primary Care
 Urgent/Emergency Care
 Mental Health/Counseling
 Dental Care
 Substance Abuse Treatment
 Of these the only “easy” care obtainable is a
trip to the ER
What is the Problem
 Primary Care/Urgent Care/ Non Crisis Mental
Health
 Cost of visits: not enough low cost clinics;
funding still an issue; most are open during the
day when people are supposed to be working,
looking for work, etc.
 Medicaid: currently for pregnant women,
minors, elderly poor; plan in future to extend
who is eligible; GOOD LUCK with states cutting
benefits
 Local indigent funding: example: Lubbock LCI;
difficulty with process, proving you are poor
Problems continued
 Counseling
 Veterans can receive counseling at local VA
resources
 Covenant counseling in Downtown works on
sliding scale
 Mental Health Taskforce meets in Lubbock at
the LP&L building every two months to
coordinate local efforts
Problems continued
 Dentistry
 MUCH larger problem than people are aware of
 Why? Dental insurance not often offered by
employers; extensive dental work very expensive
 CHCL resources overwhelmed
 Twice in last year dentists have staged a large
clinic for the underserved; Civic Center last year;
this weekend at Abbeyville Dentistry
 At Free Clinic we have dental clinic once a month
Problems continued
 Substance Abuse Treatment
 VERY expensive time intensive process
 Even people with the BEST resources (money
and insurance) often have difficulty finding
treatment
 Managed Care in Lubbock has indigent beds
but that is sporadic
 Dove Tree also has some indigent beds
Local Lubbock Efforts
 Lubbock census in 2009 had approximately 700
homeless
 2010 count more difficult due to one temporary
shelter (Carpenter’s church) having shut down
causing more dispersal of homeless
 Count was last week; awaiting official numbers
 In 2010 due to increased number of people
needing shelter City Council called for
committee
 Down town businesses and local public library
want homeless situation examined
Lubbock Council on Homeless
 Last week went to Amarillo to examine their
procedures
 Mini mall with “stores” that are different
charitable organizations, day care, etc.
 Examining another process in San Antonio
 Supposed to have recommendations for city
council by this fall
What can you do
 Volunteer at local agencies
 www.lubbockhospitality.com has list of local
charitable agencies
 Dial 211 to locate agencies to help people in need
 Purchase local “Red Book” with information listed
for local organizations