The long wait: Homeless and health services

Vincent Pelch of Nampa waits to see a physician at the Terry Reilly Health Services Caldwell clinic on Wednesday. Pelch is formerly homeless.

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© 2012 Idaho Press-Tribune

When people are faced with the choice of buying groceries or visiting the doctor, many will opt for food.

For the homeless, affording health care is even more daunting.

One option is Canyon County Community Clinic, which provides free care for those at 200 percent of the poverty level and without health insurance.

“I always get the question, ‘OK, I don’t have any money, how much will this cost me?’” said Lori Rose, the clinic’s volunteer coordinator and administrator. “And when we say it’ll be free, it’s like, ‘Whoa, you’re kidding.’ It’s hard to believe because they have tried, I think a lot of times, all the options out there and not been able to afford it or have been turned down.”

Several patients, having just lost their jobs or been released from prison, are homeless, she said.

Although the clinic has support from Terry Reilly Health Services — which offers services on a sliding scale for some patients — and West Valley Medical Center, its monthly $2,000 budget can only provide for 10-14 patients a week.

“We turn away people still every Wednesday because we don’t have room,” Rose said.

They’ll refer people to Terry Reilly, Humphrey’s Diabetes Center, the Department of Health and Welfare or sometimes local specialists who will volunteer time and resources.

Last year, Terry Reilly served 1,800 homeless adults and children in Nampa and Boise.

But the need is greater than the supply.

“There was not enough money to serve all of the homeless patients who came to us for help,” Executive Director Tim Brown said.

People might wait so long to get treatment they end up in the emergency room.

“They almost have to because the emergency room will be the place where they don’t just turn them away because they don’t have funds,” said Dr. John Pearce, the community clinic’s medical director and physician with West Valley Medical Group. “Depending on the hospital, they may actually qualify for their charity care, also. … If they qualify for their charity care it will likely get written off.”

But emergency room care is not as specific or long-term focused as clinic care, he said.

“They’re not going to adjust blood pressure medicine. If your sugars are to the moon, they’ll get your sugars under control, but they’re not going to go A through Z through what your nutrition should be, how do we balance your medicines, and so forth. It’s a different level of care, but it’s kind of the care of last resort.”

Rose would love to see more free clinics in Canyon County, she said.

“We are losing a lot of people who can’t afford the Terry Reillys of the world. And we, without funding and only open one night a week, there’s no way we can accommodate all of them.”

 

Idaho has mental health care shortage

Mental illness affects 20 percent of those who are homeless, according to the Boise Rescue Mission. But Idaho has a shortage of mental health care professionals, Brown said, and many people can’t afford it.

When people become depressed, they often don’t have energy to take care of themselves physically, Pearce said.

“If you get depression under good control, then they can start taking care of their diabetes and high blood pressure and so forth.”

The clinic refers patients with more severe depression and other mental illnesses to the Department of Health and Welfare.

The department’s Medicaid program paid for treatment for 2,347 people in Canyon County in 2010, said spokesman Tom Shanahan.

For homeless patients, the DHW Behavioral Health Division will try to help them find a place to live.

Boise Rescue Mission partners with Affinity Inc. to provide mental health care to those in need. In 2009, the program’s first year, 55 individuals and families received case management, 20 children attended group counseling and 39 people achieved stable medication management, the Rescue Mission’s website says.

The lack of mental health care stems from Idaho’s rural nature — it’s tough to support a clinic in sparsely populated areas.

Plus, when the population did boom in the mid-2000s, the number of new psychiatrists didn’t keep up, Idaho Medical Association Chief Executive Officer Susie Pouliot said in January.

Part of the solution, she said, is to fund more physician training programs in Idaho. But Idaho has to partner with neighboring universities because the state doesn’t have its own medical school.

 

Lack of transportation hinders medical visits

When Vincent Pelch was laid off in 2008, he found himself without a place to call home, bouncing from place to place, from city to city, throughout the Treasure Valley.

“That can make it very difficult ... trying to look into a place such as Boise for a job when you’re now suddenly in Nampa or Caldwell or Homedale,” said Pelch, 28.

Having just moved back to Canyon County from Portland, Ore., he found public transportation to be lacking.

“Coming back here I was like, where’s the buses? Where’s anything? I was very disappointed by that.”

To top it off, in early 2009 he was diagnosed with type 1 diabetes, which required monthly visits to the doctor at first.

“Things were starting to spiral out of control at that point,” said Pelch, who now visits the free clinic about four times a year.

“Transportation is a significant hindrance to many individuals ability to attend medical appointments,” Shanahan said. “Public transportation is sporadic in Canyon County.”

Valley Ride offers intercounty transportation, but usually doesn’t run past 8 p.m. or on holidays.

 

COMING THURSDAY

The Idaho Press-Tribune’s special report centers on transportation issues for homeless people.

 

For more on the Homeless, not Hopeless special report visit: idahopress.com/homeless

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