Homeless people have a higher incidence than the general population for almost all health conditions, particularly hypertension, diabetes, HIV and sexually transmitted infections, and respiratory ailments, including asthma and bronchitis. Paramount to this increased incidence of health problems is the fact that the homeless lifestyle is typically characterized by factors outside the homeless person's control, such as where one lives, where one sleeps and what one eats. Additionally, homeless people cannot easily get health care and, because of their circumstances, health conditions are more difficult to treat.

An independent not-for-profit agency since 1993, today we contract with four licensed health facilities to provide health care and social services at 28 service sites. These health facilities are:

	Bedford Stuyvesant Family Health Center
	The Institute for Urban Family Health
	Montefiore Medical Center, and
	New York Hospital Medical Center of Queens

Since 1996, our teams have seen an average of more than 8,000 clients a year in almost 40,000 annual visits with our contracted medical providers.

Read about Care for the Homeless' Primary Care Effectiveness Review (PCER)

Primary care services
Interdisciplinary teams visit our service sites from one to five days a week and offer the following primary care services: physical examinations (including taking a complete medical history), episodic care and first aid, specimen collection for laboratory testing, dispensing of needed prescriptions, referrals to specialty care facilities, urine testing, HIV pre- and post test counseling, HIV testing, TB screening, medication compliance, psychiatric screening, and needed follow up visits. In addition to these on site services, our health care providers refer clients, when needed, to medical specialists in the community or to the contracted health facilities.

In these situations, difficulties often arise when clients are unaware of their enrollment in Medicaid managed care plans. Our providers work closely with clients, other providers and New York City Human Resource Administration to assure access to specialty care either by locating providers that accept a client's managed care plan or by disenrolling the client from managed care when clients feel that the managed care plan is not in their best interest.

Oral health services
Oral health problems are more prevalent among homeless people than the general population, and even more widespread among homeless children. While tooth decay is the most common chronic childhood disease and occurs disproportionately among the poor, homeless children fare far worse than housed children in poverty. One study revealed that untreated tooth decay in permanent teeth among homeless children in New England was 7.7 times the regional average. In general, then, lack of access to affordable dental care, lack of education and awareness of oral health present the greatest barriers to oral health care for low-income people.

By arranging dental care and providing oral health education, Care for the Homeless has begun delivering oral health services to homeless adults at three service sites: Bond Street Drop-in Center, Jackson Avenue Family Residence, and Bushwick Family Shelter. Our dental teams provide oral exams, cleanings, X-rays, fillings, extractions, dentures, sealants, night guards and referrals for any care that cannot be provided on site. Additionally, our dental health education sessions address the main content areas recommended by the Centers for Disease Control and Prevention and the American Dental Association.