HCH Frequently Asked Questions
Q: What kind of direct services do you provide?
A: HCH operates a multidisciplinary outpatient health care clinic in Baltimore delivering comprehensive pediatric, adult, and geriatric medical care, mental health services, social work and case management, addiction treatment, dental care, HIV services, outreach, prison reentry services, supportive housing, and access to education and employment. We also fund similar services in the City of Frederick and Montgomery, Harford, and Baltimore Counties. HCH is not a shelter or soup kitchen, but we do help individuals access these resources.
Q: How do you define homelessness?
A: HCH uses the Department of Health & Human Services’ interpretation of the federal definition of homelessness, which in short defines a homeless person as “an individual who lacks a fixed, regular, and adequate nighttime residence.” This includes those living on the streets, in shelters, emergency hotels, transitional housing, or temporarily “doubled up” with friends, relatives, or neighbors. Once an individual is stably housed, HCH continues to provide services for up to a year before helping the person transition to another health care provider in the community.
Q: What is the profile of the typical HCH client?
A: In our work over the past two decades, we’ve come to realize that there’s no such thing as a “typical client.” People experience homelessness for a range of reasons and come from many backgrounds. Statewide, 62% of our clients identify as black/African American, 22% as white/Caucasian, 11% as Hispanic/Latino, and 1% as Asian. 80% are between the ages of 25 and 64. Most have incomes below 100% of federal poverty guidelines.
Q: Do homeless individuals have common health problems?
A: In general, people without homes suffer the same range of health problems as those in the larger population, but at significantly higher rates. HCH clients experience high rates of addiction (50%), mental illness (34%), “dual diagnosis” (25%), and a wide range of acute and chronic illnesses including hypertension, diabetes, and HIV. Due primarily to health problems and restricted access to care, people experiencing homelessness are three-to-four times more likely than their housed counterparts to die prematurely.
Q: What is your approach to ending homelessness?
A: HCH views homelessness as a symptom of the larger problems of poverty, restricted access to health care, and the lack of affordable housing. By integrating direct service and advocacy, HCH works to end homelessness on individual and societal levels. We deliver the comprehensive services our clients need now while also promoting the broader public policies necessary to make homelessness rare and brief.
Q: What is “Housing First?” HCH has been a local pioneer in the “housing first” philosophy – rapidly re-housing our clients as quickly as possible and providing the supportive services people need to remain off the streets. Following a small pilot project in 2005, 85% of participants still are housed. We see a similar retention rates in a range of new programs employing this “housing first” approach.
Q: What is your approach to individuals with addiction?
A: Many individuals experiencing homelessness suffer from drug addiction and alcohol abuse. Endeavoring to “start where the client is,” HCH uses a “harm reduction” approach focused upon reducing the harmful aspects of addiction rather than outright prohibition. Abstinence is not a prerequisite for entry into our addiction treatment program or any other HCH service.
Q: Is there a fee to use your services? Are your clients insured?
A: HCH never refuses care based upon inability to pay. As reflected on our fee schedule, there is no charge for individuals and families with incomes at or below 150% of federal poverty guidelines. Approximately 75% of HCH clients lack comprehensive health insurance.
Q: How large is your budget? How are you funded?
A: HCH has a diversified organizational budget of more than $10 million that derives from more than 40 major funding sources and hundreds of important smaller contributions. Approximately half our budget originates from federal, state, and local public sources (including the federal Department of Health and Human Services, the Maryland Department of Health and Mental Hygiene, and Baltimore Homeless Services). Third party billing accounts for approximately one-third of the budget. The rest comes from corporations, foundations, and individuals.
Q: How many people do you see?
A: In Baltimore, HCH provides services to between 150- 200 individuals each day. Annually we serve more than 6,000 individuals during more than 54,000 patient visits. Statewide, HCH serves nearly 12,000 people each year during more than 74,000 patient visits at clinic sites in Baltimore City, Frederick, and Montgomery, Harford, and Baltimore Counties.
Q: How do your clients find out about HCH? A: HCH goes out on the street to get people off the street. Some HCH clients learn about our services from outreach workers who engage them in the community and bring them back to the clinic. Some hear about us from other clients who have received assistance. Others are referred by staff from area soup kitchens, shelters, and outreach programs.
Q: Are services provided by paid staff or through volunteers?
A: HCH employs approximately 120 highly-qualified professionals at its Baltimore headquarters to deliver services and further the mission of the organization. Dedicated HCH volunteers lend their expertise to help us raise funds, deliver specialty health care services, provide Spanish language translation, complete public policy projects, and assist with other needs.
Q: How do you advocate to end homelessness? A: HCH works on local, state, and national levels toward public policies that make homelessness increasingly rare and brief. Our annual advocacy agenda promotes expanded access to comprehensive health care, affordable housing, sufficient disability assistance, and jobs with livable wages. HCH staff frequently work with policy makers on issues of homelessness and health and serve on a variety of task forces, commissions, and coalitions.