The Special Populations Health Centers Serve
by Lisa DiFalco
According to the HRSA, health centers have served over 1.1 million homeless individuals, more than 900,000 agricultural workers and dependents, and around 220,000 public housing residents. The numbers of these overlooked populations are significant.
- A national survey showed the average number of homeless people on a given night to be estimated at 1.6 million.
- Approximately one in every three migratory and seasonal agricultural workers has been served through a health center program funded by HRSA. The National Advisory Council on Migrant Health regularly provides consultations about and recommendations as to the health issues of this population.
- The HRSA has also been instrumental in funding accessible health centers for public housing residents, including minorities and the elderly.
Healthcare professionals may not be aware of the funding available to serve these populations, the special needs they present, and the resources that they can use to further their understanding and serve such specific populations. These special populations often overlap the insured and un-insured more commonly considered recipients of health services through health centers, and they may present with other needs to be addressed. Understand more about how health centers are supported in their efforts to serve the homeless, public housing residents and migratory farmworkers.
Heath Services for the Homeless
Homeless people can receive health services within their community. Federally Qualified Health Centers (FQHCs) receive support through various agencies. Some FQHCs located in areas with a large homeless population get grants from the federal Health Care for the Homeless (HCH) program. They can receive only this HCH grant or also get support from the CHC, or the Community Health Center program.
Initially authorized within the Stewart B. McKinney Homeless Assistance Act of 1987, the Health Care for the Homeless Program is in Title VI, Section 340. The HCH program was reauthorized in 1996 under the Health Centers Consolidation Act. What does the HCH program provide? HCH focuses on:
- Delivering a multi-pronged approach to the care of the homeless;
- Combining integrative systems of healthcare services, including primary care, substance abuse services and mental health services, with aggressive street outreach;
- Client advocacy;
- Case management; and
- Coordinating with other social service agencies and community health providers.
Homeless people are a vulnerable and often under-served population that presents with varied physical and mental health challenges. Assistance with medical care and use of community social services can help individuals receive desperately needed treatment and support.
Health Services for Public Housing Residents
The elderly and minorities are two groups that can benefit from public housing. The federal Public Housing Primary Care (PHPC) program was developed in the Disadvantage Minority Health Improvement Act of 1990. This program was reauthorized in 1996 in the Health Centers Consolidation Act. What does the PHPC program provide to public housing residents? In terms of healthcare services, such populations should have:
- More access to necessary comprehensive primary healthcare services in the form of disease prevention activities, primary healthcare services and health promotion; and
- Services provided either near or at their public housing development location.
Health centers are enabled to provide the basic primary healthcare services in locations convenient to those in public housing. Accessibility to basic necessary care helps populations get treatment that promotes a healthy lifestyle and long-term wellness.
Health Services for Farmworkers and Migrants
The population of seasonal and migratory farmworkers is substantial, with estimates of 3 to 5 million within the United States. A significant outlay of funds is provided to assist health centers in supporting this population. Approximately $150 million is administered by the federal Bureau of Primary Health Care to help 147 community health centers throughout Puerto Rico and 39 states.
Migrants can receive the services they need throughout the country. One tool used by clinicians to locate appropriate facilities is The National Health Centers Directory. Users of the directory only have to enter the state or search for clinics by zip code to find a Health Center for area migrant farmworkers. Additional resources to find a migrant or community health center include the websites of the National Center for Farmworker Health (NCFH) and the U.S. Health Resources and Services Administration (HRSA).
Health center staff can improve their understanding on federal policies that may impact farmworkers and dependents. Farmworker Justice offers technical assistance and training to staff at migrant health centers, working in partnership with legal services providers and community organizations. Farmworker Justice reviews and disseminates important policy developments about this population to the 165 migrant health centers in the country.
Growing Numbers of Special Populations
Health centers are working hard to provide the staff training and services necessary to help special populations. According to the CDC, one of the goals of Healthy People (HP) 2020 is to:
“Create social and physical environments that promote good health for all.”
Understanding the environment, current policy and social factors that affect special populations is necessary to effectively engage such populations in health centers. Case managers, health professionals and community service providers would do well to take it upon themselves to understand the diverse demographics and particular needs of the populations that they serve within their area. Education and resourcefulness on the part of health service providers can help them better serve those who are in dire need.