The Capital Case for Health Care for the Homeless
Building a future without homelessness . . .
The Capital Case for Health Care for the Homeless, Inc.
Five years ago, Gary was a statistic. Poor and homeless much of his life, you might have seen Gary on the street corner engaged in a fierce argument with the sky. Sporadic medical records listed a mental illness, alcoholism, high blood pressure, and brain damage from numerous blows to the head. Most residential programs deemed him “too sick” for housing. Just a one-year review of Gary’s case file suggests the price he and the rest of us paid for his years on the streets: he wound up in the emergency room 36 times (an average of three times per month) and was arrested on 24 occasions (twice each month) for loitering and related “public nuisance” crimes. Health Care for the Homeless knew that life could be different for Gary. After treating his health problems, we helped him qualify for disability assistance and rent an apartment, where he remains today. A one-year review of Gary’s file after his placement in housing yields surprising yet predictable results: zero arrests and only one trip to the emergency room when he was sent by a nurse from Health Care for the Homeless.
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Now is an exciting time in Baltimore. The unprecedented breadth of residential and business development presents clear signs of renewal following decades of population decline and urban decay. To aid in the City’s turnaround and to help address the seemingly intractable problems of poverty and homelessness, Baltimoreans like Gary know that Health Care for the Homeless – the only organization in Maryland providing health-related services, education, and advocacy to reduce the incidence and burdens of homelessness – has a proven record of going out on the streets to get people off the streets. Gary and the rest of our clients aren’t the only ones who recognize the importance of our work. In November of 2004, nearly 90% of Baltimore voters expressed their intent to heal and house their homeless neighbors by approving a $1,300,000 bond to build a new and larger facility for Health Care for the Homeless.
Health Care for the Homeless can serve a greater number of people. A recent study concluded that we can and should double the size of our facility to serve the number of people who need our help. The additional space will allow us to enhance the range of clinical services that homeless people need, including vision assessment, dental care, and other specialty services. We plan to increase the number of individuals served by 20% within the first two years of operation at our new location – with room to serve more than 10,000 people in the future (twice our current capacity) as operating resources permit.
A growing public-private partnership will make possible a new facility. Baltimore City is not alone in recognizing our capacity to reduce the enormous social burdens of homelessness. The Governor and the Maryland General Assembly have matched the City’s contribution, and a growing number of private foundations, corporations and individuals are providing support with the certain knowledge that Health Care for the Homeless can reduce the toll that homelessness, mental illness, addiction, and untreated medical problems take on the larger community.
We all believe in second chances. In the midst of Baltimore’s renaissance, the voters of Baltimore and the people of Maryland have invested in our ability to demonstrate that homelessness is not permanent. More than halfway toward our financial goal of $17,500,000 ($15,500,000 for construction and $2,000,000 for a maintenance endowment), we now seek additional partners to make homelessness a rare and brief experience for our most vulnerable friends and neighbors. We seek your financial support to raise the remaining resources necessary to provide a greater range of health services for the uninsured and to move more Baltimoreans from the streets back to the mainstream. 
Mission, Work & History
Health Care for the Homeless provides health-related services, education and advocacy to reduce the incidence and burdens of homelessness. In 2006, we delivered comprehensive medical care, mental health services, social services, addiction treatment and outreach to 5,734 different people over the course of more than 50,000 client visits – a small fraction of the 30,000 Baltimoreans thought to experience homelessness each year. Unfortunately, we had to turn away people who needed our help on more than 2,000 occasions simply because we lacked the space in which to serve them. Once in a larger facility, we are confident of our ability to leverage operating dollars to address this unmet need. In recent years, Health Care for the Homeless has declined the receipt of additional resources (due entirely to lack of space) from federal and state funders who are eager to help us assist a greater number of people.
Baltimore’s homeless population is far from healthy. One-third suffers from chronic mental illness. Half have treatable drug addictions. One-fourth is "dually diagnosed" with both mental illness and addiction. Most are sick with problems like diabetes, hypertension, heart disease, and HIV/AIDS. All are poor, and three quarters have no health insurance. As a result, too many go without treatment, can’t work, and remain on the streets. Health Care for the Homeless is the only organization in Maryland specifically trying to get these vulnerable individuals off the streets by providing comprehensive health services without regard for ability to pay.
We remain a national model for the delivery of care to people experiencing homelessness. Established in 1985, Health Care for the Homeless is a nationally recognized model for the delivery of care to underserved populations. In 1988, we were incorporated as a nonprofit agency under sec. 501(c)3 of the IRS Code, and were awarded a Federal McKinney Program grant (under sec. 330h of the Public Health Service Act). Subsequently, we established a homeless children's project in collaboration with Mercy Medical Center, and homeless health care projects in Montgomery, Frederick, and Baltimore County. We operate the only State-Certified outpatient addiction treatment program (established in 1998) with a curriculum specifically designed to address the needs of people experiencing homelessness. Since September 2000, we have remained the sole independent Health Care for the Homeless project in the U.S. to be accredited by the Joint Commission for Accreditation of Healthcare Organizations (JCAHO), an external quality review organization whose standards ensure the delivery of effective and efficient care. The Federal Bureau of Primary Health Care has chosen us as one of seven “National Models that Work”, and the Federal Health Resources and Services Administration has named us among twelve national models of HIV services.
Health Care for the Homeless Board of Directors: HCH is led by an active and engaged volunteer Board of Directors. Members include people with the former experience of homelessness, representatives from the corporate and philanthropic communities (including attorneys, accountants, and developers), and individuals with backgrounds in the fields of medicine, dentistry, mental health, and addictions.
Health Care for the Homeless Staff: Our staff members represent a full range of clinical and professional disciplines including medicine, mental health, social work, addiction treatment, performance improvement, human resources, financial development, and public policy advocacy. In recognition of the organization’s experience and success, our staff have been asked to serve on and advise a range of public commissions and boards – including the Baltimore City Commission on Homelessness, the Maryland Medicaid Advisory Committee, the Governor’s Commission on Poverty, and the Maryland Interagency Council on Homelessness – and are frequently asked to speak about health and homelessness at Johns Hopkins University, the University of Maryland, and other educational institutions.
Rapid and continuous expansion: During our twenty two years of operation, we have grown from a staff of four serving 700 clients in 1985, to a staff of 110 diverse individuals serving more than 5,000 Baltimoreans (more than 11,000 people statewide) each year. This growth responds to the steady increase in the number of our neighbors experiencing homelessness – propelled by rising rates of poverty, an increase in the number of people without health insurance, a rapidly shrinking supply of affordable housing, and the declining value of the minimum wage. The U.S. Conference of Mayors measured a nine percent increase in the number of requests for homeless services between 2005 and 2006 in twenty-three cities surveyed (with nearly a quarter of all requests for emergency shelter unmet due to lack of space). The Maryland Department of Human Resources reports that in FY2005, the number of individuals sleeping in homeless shelters throughout the State was 34,771; people were turned away from shelter due to insufficient resources on 38,679 reported occasions. In Baltimore City, 12,507 people were sheltered while individuals were turned away on 19,047 reported occasions.
Fiscal responsibility: As we have faced the health-related consequences of homelessness over the past two decades, Health Care for the Homeless has remained a fiscally sound and well-managed mission-driven agency that has the organizational capacity necessary to effectively manage a capital project of this magnitude. Our annual operating budget of more than $8,000,000 originates from at least 40 different major funding sources – including the Federal Bureau of Primary Health Care and the Maryland Department of Health & Mental Hygiene – in addition to revenue from third-party billing and direct solicitation of more than 5,000 dedicated donors. We consistently receive unqualified annual financial audits, end each year without a deficit, and are audited annually by each of our major funders.
The Health Care for the Homeless Capital Campaign
A detailed Board-approved plan guides our campaign. The need for a new facility to end the homelessness of a greater number of people was reaffirmed in our 2005 Five-Year Strategic Plan. Led by a team of Board members with extensive experience in property development, organizational consulting, real estate law, and financial management, our capital plan guides us to assess and purchase new property in 2007, break ground in early 2008, and move into a state-of-the-art facility fourteen to eighteen months later. With the partnership of committed individuals in the corporate, public and private sectors, this achievable goal will measurably benefit the people of Baltimore within three short years.
A specific property has been identified. The City of Baltimore has agreed to convey to HCH a property at the southeast corner of the Fallsway and Hillen Street in downtown Baltimore. Situated along major routes of public transportation, this location is accessible to our current and potential clients and is within walking distance of other services that homeless people need, such as shelters, soup kitchens, and hospital care. Currently a parking lot, the site would permit a building “footprint” of approximately 18,000 square feet, sufficient to accommodate a 45,000 square foot facility.
A larger facility will enhance our work to end homelessness. Health Care for the Homeless knows how to structure multidisciplinary clinical resources to promote access to care for homeless people. In addition to ensuring that we can serve a greater number of individuals, our preliminary design plans would:
- Promote improved access to care through the incorporation of a covered waiting area for those who gather before operating hours as well as separate waiting rooms for women and people with mental illness;
- Allow for state-of-the-art health care practice through updated examination rooms, larger group treatment facilities, and an electronic health records system designed to improve quality and continuity of care;
- Facilitate the delivery of new clinical services such as dental care, vision assessment, on-site specialty medical services, new supportive treatment groups, and an enhanced art therapy program.
Strong political and financial support: In 2003, a structural assessment revealed that expansion is simply not feasible from our current 111 Park Avenue location. Since that time, the City of Baltimore and the State of Maryland each has invested substantial time, financial resources, and political capital to secure new property for Health Care for the Homeless. Baltimore voters approved by 90% a $1,300,000 capital bond and the City’s Office of Homeless Services has committed $250,000. This serves as a local match for $3,700,000 in capital funds in the approved FY2005 and FY2006 State budgets. Elected officials are assisting HCH with a $1,000,000 request for federal capital funds. Led by a $2,000,000 contribution from the Harry & Jeanette Weinberg Foundation, the philanthropic community (including the France-Merrick Foundation; the Rouse Company Foundation; the Alvin and Fanny B. Thalheimer Foundation; Mary Catherine Bunting; The Maryland Hospital Association; Jeff Jacobson and Erickson Retirement Communities; Willard Hackerman; the Abell Foundation; the Cavanaugh Financial Group Charitable Foundation; the Morris Goldseker Foundation of Maryland, MedStar Health, and others) is highly supportive of the project. Public and private receipts and pledges to date total approximately $10,700,000 toward our goal of $17,500,000 ($15,500,000 for building construction and $2,000,000 for a maintenance endowment) to end the homelessness of vulnerable Marylanders.
You can help us prove that homelessness is not permanent. Over the past two decades, Health Care for the Homeless has learned that homelessness is not permanent – that ending homelessness is possible when the appropriate resources and skills are brought to bear. As indicated by the vast majority of Baltimore voters, there is no better time to invest in the future of our most vulnerable friends and neighbors than in the midst of the City’s social, financial, and residential resurgence.
By supporting a new building for Health Care for the Homeless, you’re not merely purchasing bricks, beams and examination tables. Instead, you’re ensuring that all boats are lifted by Baltimore’s rising economic tide. Your generous gifts to the Health Care for the Homeless capital campaign are expressions of your belief in second chances and investments in Baltimore’s greatest capital – our human potential.
The Health Care for the Homeless capital campaign seeks gifts and pledges over a three- to five-year period. All gifts are tax-deductible to the extent allowed by law. Pledges, donations of cash, securities, and planned gifts are gratefully accepted. In addition, the campaign offers many commemorative gift and naming opportunities to honor our donors or our donors’ families, friends, or business associates.
For additional information, please contact:
Jeff Singer, President & CEO
Health Care for the Homeless, Inc.
421 The Fallsway, Baltimore, MD 21202
410-837-5533
jsinger@hchmd.org