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Backpacks for the Homeless

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    Posted by: Jean-Marie, Union Hospital

    Date: July 09, 2015 10:57 AM

    Hi All,

    Recently, a staff member questioned me about their department’s initiative that provided backpacks for homeless patients. Homelessness is a very large issue in our community and we have several Community Benefit connections to serving the homeless.

    Now, not much information was given to me about the initiative apart from: designated patients received the backpacks. I would also like to clarify 2 things:
    1) I didn’t hear about this initiative until after it had occurred (it was approved by someone else, even though I am the Community Benefits Coordinator and all activities have to be discussed with me, especially if they contribute to a department goal)
    2) The March 1st event described in the email below is a separate event that was held in the community at a shelter

    Here is the staff’s email I received:

    I wanted to touch base with you about the backpacks for the homeless. I was told by my co-chair that somehow this doesn’t count for community service, when the patients we are giving them to live in the community. Why won’t this count for community service if the people we are giving them to live in the community? The homeless shelter that we served on March 1st was full of patients we have taken care of.

    Many people will not have fulfilled the community service requirement if this does not count.

    I want to count this initiative because it serves the homeless. However, I need to know if the backpacks are provided to patients only, does this conflict with the Community Benefit tenet of serving the community? And would it make a difference if the patient received the backpack at discharge?

    I guess I am trying to determine if serving homeless patients overturns the rule of not counting supports provided to patients only, since we would be preparing them for returning to their community, and thus working to keep them safe and healthy. ________________________________________________________________________________________________________________________________________________________________________________

    Response: David A. Rupprecht, St John Providence Community Health
    Date: July 09, 2015 1:19 PM
    Backpacks at discharge would not count.
    Backpacks to your community count.
    The recipients of the backpacks (in order to count for CB) do not need to be patients you have served.
    _________________________________________________________________________________________________________________________________________________________________________

    Response: Nancy Zuech Lim, STH

    Date: July 09, 2015 1:33 PM

    Jean-Marie,
    Question: What is in the backpack? Is it items to help with basic needs (food, shelter, transportation, safety, clothing, information to connect to social services) or is it PR and advertisements?
    Why was the program started?

    I am inclined to say it counts as CB if the contents address basic needs, because:
    • It addresses a Community Health Need – Homelessness
    • And seeks to improve the health of the community – through addressing basic needs, improving the ability of individual to adhere to medical care regimen by supporting basic needs that may compete with adherence med. Regimen. Addressing the homeless with chronic medical conditions.

    If this program was started as a patient relations activity to increase volume to the facility or to reduce re-admission rates then it is not CB.

    Those are my thoughts, nice that you have a community service requirement at your facility.
    Response: Pam Horlitz Lim, Mayo Clinic Health System

    Date: July 09, 2015 1:51 PM

    Programs for patients do not count,
    But…
    is there a way to expand the program and give the same back pack at multiple points of contact- maybe the food shelf, a free clinic, county social work and at discharge? __________________________________________________________________________________________________________________________________________________________________________
    Response: Lisa Bell, SSM Health Care of Wisconsin

    Date: July 09, 2015 1:52 PM

    I tend to agree with David that if they are provided at discharge regardless of what is inside they are still ultimately benefitting only your patients so would not count. If you were to provide the shelter with backpacks for the population at large then…first a great initiative!!!! And it would count

    I am really intrigued with the staff person’s comment about not fulfilling the community service requirement. Can you tell me more about that?__________________________________________________________________________________________________________________________________________________________________________ Response: Peter Morgan, Adventist Medical Center-Portland

    Date: July 09, 2015 5:42 PM

    Hi Jean-Marie,

    Since you did not mention any contents of the backpacks I will go on the assumption that they were empty.
    1. Your own patients- You mention that these are homeless patients so they probably qualified for financial assistance under your FAP. This would not eliminate the gift as a community benefit based solely on their patient status.
    2. Empty Backpack- this would address a social and physical determinate of health and not something that would address a community health improvement issue. I would capture the data under Schedule H Part II Line 1 or 9 (F1 or F9).
    3. Community service requirement- I have seen articles of late that some experts in the field of social determinates are pushing the Federal Government to require hospitals to take a more active role in addressing the issues of social determinates in their communities. I would feel comfortable in using this backpack work as fulfilling community service requirements. _______________________________________________________________________________________________________________________________________

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