Care Alliance Health Center

Geographic areas served: Cleveland, OH

Programs: Health care for the homeless: care alliance health center was established in 1985 as one of the original robert wood johnson foundation health care for the homeless projects in the nation and in 1993 became an independent nonprofit organization. Today, care alliance continues its focus on providing health care to those experiencing homelessness in the city of cleveland as a federally qualified health center receiving funding through the u. S. Department of health resources and services administration (hrsa). After more than thirty years of providing health care to the homeless population, care alliance has built a strong rapport with this population as well as developing tremendous respect as an integral member of the local delivery system of safety-net providers. The health care for the homeless program offers primary health care and supportive services at all three of care alliance's primary clinic locations as well as at outreach sites throughout the city where people who are homeless tend to congregate. Comprehensive dental and behavioral health services are provided at all of our main clinics. Individuals and families experiencing homelessness have unique health care needs. They are at high-risk of contracting or exacerbating serious health conditions as a result of prolonged exposure to severe weather and reduced access to health care. As a result, individuals are often treated at later stages of disease and have higher mortality and chronic morbidity than individuals with access to consistent health care. At our outreach clinics, we see many patients who have chronic illnesses and acute health issues. In an attempt to reach a greater number of homeless persons who may not be connected through safety net services, care alliance has established collaborative agreements with various locations throughout the community where homeless individuals tend to congregate so that they may provide medical and supportive care. These outreach locations include: 2100 lakeside men's shelter, norma herr women's shelter, city mission (crossroads and laura's home), metanoia, lorain avenue storefront, bishop cosgrove center, west side catholic center, and st. Malachi. Through our outreach program, care alliance is able to offer clinics throughout the city of cleveland where individuals experiencing homelessness may meet to obtain a meal, social services, a shower, or shelter. In 2015, care alliance launched a mobile clinic program to serve chronically homeless individuals living in permanent supportive housing. By providing these services in environments where these individuals are comfortable, our outreach staff are better able to engage patients into care with the long-term goal of bringing them into one of our primary clinics to obtain the full scope of comprehensive services needed to transition from homelessness into stable housing. Clients served = 4,489.

public housing primary care: recognizing the need to provide high quality and accessible care to a population vulnerable to health disparities, and in an effort to maintain our care relationships as our patients were housed, in 1998, care alliance applied for and received funding from hrsa to provide medical and dental care specifically to those living in and around public housing. Since that time, care alliance has operated two clinics within cuyahoga metropolitan housing authority (cmha) developments. These spaces have enabled the organization to provide its services in easily accessible locations to public housing residents and in a culturally sensitive manner. One facility is located on the near east side of the city inside the carl b. Stokes social services mall, and the other is on the near west side, located in riverview tower. After the recent renovation of our riverview tower clinic, both our riverview and stokes clinics offer primary medical and behavioral health services across the lifespan and comprehensive dental services to our patient population. In april 2015, care alliance opened the central neighborhood clinic to provide comprehensive primary medical, behavioral, and dental services to adults and children living in cleveland's central neighborhood, home to the highest concertation of public housing in northeast ohio. Clients served = 9,774.

hiv/aids: care alliance is committed to providing quality health care to underserved populations at risk for health disparities. As such, care alliance provides care to people living with hiv/aids (plwha) through ryan white part c and ryan white part a funding. Additional ryan white programming includes community-based and in-house hiv testing, counseling, linkage to care, and referrals to supportive services. In an effort to provide medical, dental and supportive services to plwha, our team works to maintain and develop strong relationships with hiv service providers in the cleveland area to ensure a continuum of care and non-duplication of services. While hiv testing and education is located at each of our four clinics, ryan white medical care is offered out of our downtown clinic on st. Clair. When an individual seen in the clinic or outreach location tests positive for the hiv virus, he or she is immediately linked to care. Individuals who test positive are introduced to our outreach worker for basic hiv education and discussion about the importance of consistent medical care and medication regimens. Patients who elect to maintain primary and hiv care at care alliance are enrolled in the ryan white program. Otherwise, individuals are connected to the most appropriate local provider of care to plwha. All new care alliance patients are seen by the ryan white care coordinator for an initial assessment to understand the need for supportive services. Ongoing supportive services include partner notification; medical evaluation and ongoing care; adherence education; medical case management and eligibility assistance; short-term mental health and short-term substance abuse counseling; specialized chronic illness care for ryan white patients with co-morbidities; oral health care services and referrals for oral surgery; and referrals for specialty medical care. Within the ryan white program, care alliance has established partnerships with many safety net agencies to offer outreach hiv testing and bridging services to at-risk, unaware or out-of-care populations. In 2016, these included the cuyahoga county corrections center, community-based correctional facility, west side catholic center, norma herr women's shelter, city mission, life exchange, stella maris, y-haven, nueva luz, and lgbt center. In care alliance's role as the primary care home for many of cleveland's underserved populations, the organization strives to ensure that patients stay in care, utilize all appropriate services, and comply with treatment regimens to maintain health and well-being. With this primary care mindset guiding all our services, we were able to retain 84% of our ryan white patients in care, a remarkable feat given our patient demographics. Clients served = 146.