In 1984, the Robert Wood Johnson Foundation and Pew Charitable Trusts, together with the U.S. Conference of Mayors, established the National Healthcare for the Homeless Council. A group of New York City homeless service providers and advocates met to respond to the proposal to provide health and social services to homeless people.
But bringing services to homeless people was only the first step. Based on their experience, the planners knew that homeless people are often reluctant to accept care, having experienced repeated failures of the social service system, including educational, penal, mental health, and health care institutions, both prior to and during their homelessness. In fact, many homeless people - either fearful or skeptical - actively shun service providers.
Homeless people with little or no privacy may want to avoid the intimacy necessitated by health care services. Health professionals may ask histories and questions, the answers to which may be difficult or painful to recall. Some homeless people fear that health care professionals will be judgmental or even punitive. Mothers with substance use problems often want to avoid professionals who might report them for child abuse or neglect. Battered women may be embarrassed to confide in strangers. And some mentally ill people avoid all close contact as part of their illness.
Therefore it was clear that the health care professionals would have to be particularly sensitive to homeless people's reluctance to seek care and actively reach out to engage them and gain their trust. The team members would have to understand the unique and profound rejection experienced by homeless people. Homeless people are shunned; it is therefore not surprising that they find ways to isolate and protect themselves from the world, avoiding even those who may be trying to help. It was this barrier that the planners were most concerned about and most determined to overcome.
Experience over the last 25 years has proven the importance of delivery services on the homeless persons' own turf. The informality of the setting helps to break down barriers. Soup kitchen guests or shelter residents can observe a caring sensitive staff that comes regularly and dependably to places where homeless people congregate - places that many people shun and are not usually visited by professionals. Service providers are informal and friendly. Gradually it becomes easier for a homeless person to believe that these outreach workers want to be of assistance.
The Care for the Homeless staff includes intensive case managers, clinical social workers, substance use counselors, psychiatrists, health educators, a policy analyst, management information specialists, fiscal staff, supervisors and managers. The medical teams include doctors, nurse practitioners, physician assistants, social workers, medical assistants and health educators.
Care for the Homeless fights homelessness by delivering high-quality and client-centered healthcare, human services and shelter to homeless individuals and families, and by advocating for policies to ameliorate, prevent and end homelessness.
Care for the Homeless is committed to ending homelessness by providing direct services for homeless single adults and families, by conducting public education, research, and analysis of model programs and practices that create permanent housing opportunities, and by shaping policies to prevent future homelessness.