Medical Respite Care for Fargo-Moorhead Homeless Population: A Needs Assessment
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Abstract
Homelessness continues to increase in the Fargo-Moorhead community, and little is known about the health needs of its chronically homeless population. An informal needs assessment completed in 2010 gathered feedback from several key informants with experience working with the homeless population. Informants cited a variety of unmet health needs and barriers to access of appropriate health care services, and the priority need voiced was for a medical respite program. The purpose of this project was to conduct a formal health needs assessment of the Fargo-Moorhead homeless population to describe and document health needs from consumers' and service providers' perspectives, assess current community resources, and involve stakeholders in program planning as appropriate. The specific need for a medical respite care program was also evaluated, based on informants' feedback in 2010. Data collection methods included written surveys and semi-structured interviews. Consumers' priority needs were to secure a source of income and housing. Many consumers reported untreated physical or mental conditions, but primary needs were dental care and means to afford health care. Most consumers reported lack of health insurance and transportation as barriers to health care access. Lack of trust and experiences of disrespectful care were also reported. Service providers recognized many of the same needs, but also reported needs for treatment of co-occurring physical or mental illness and chemical dependency. Appropriate levels of care were also a concern, and many service providers discussed the need for a lower level of supervised medical care for shelter residents and homeless persons discharged from hospital care. Service providers cited many of the same barriers that consumers reported, and recognized homeless persons' inability to prioritize care above basic needs or manage care while homeless. Homeless Health Services and Family HealthCare in Fargo, ND remain primary resources for health care, and many consumers reported receiving care at these clinics as a regular source of care. Service providers reported frequent collaboration with both clinics, among other supportive services. However, the need for a medical respite program in the community was established. Recommendations for program planning address this and other needs.