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Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers

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Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Community health centers provide co-located medical, behavioral, and case management services to meet the unique and complex needs of the underserved, including homeless individuals. Multivariate analysis of staffing patterns in health centers serving high homeless caseloads highlights above-average behavioral and case management staffing, regardless of Health Care for the Homeless funding status. Rural health centers and those in the South had lower behavioral health and enabling services staffing. Implications include the need to monitor disparities, link health centers with available technical assistance, and emphasize integrating co-located behavioral health, enabling, and medical services through grant oversight mechanisms.

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Notes

  1. This paper uses data from community health centers that receive grant funding under Section 330 of the Public Health Services Act through the Bureau of Primary Care at the Health Resources and Services Administration (HRSA) of the United States Department of Health and Human Services. Other facilities sometimes use the term ‘health center,’ but this analysis is limited to health centers that are funded through HRSA.

  2. Section (r)(2)(b) of Section 330 of the Public Health Service Act (42 USCS § 254b) freezes the proportion of funding to each of the special populations at the proportion in 2001, or 8.7 % of total health center program funding. Authorizing Legislation of the Health Center Program, Available at: http://bphc.hrsa.gov/policiesregulations/legislation/index.html.

  3. In 2010, 246 Section 330 grantees received HCH funding. Three-quarters of the 1.1 million homeless health center patients in 2012 were served by HCH grantees, while over a quarter of a million homeless patients were served by health centers that did not receive HCH funding. Health Resources and Services Administration, Department of Health and Human Services. 2012 Uniform Data System, HCH grantee summary data. Available at: http://bphc.hrsa.gov/uds/datacenter.aspx?fd=ho&year=2012.

  4. Department of Health and Human Services. Strategic Action Plan on Homelessness. March 2007. Available at: http://www.hhs.gov/homeless/research/endhomelessness.html.

  5. Health Resources and Services Administration. Authorizing Legislation of the Health Center Program Section 330 of the Public Health Service Act (42 USCS § 254b) [Internet]. Available from: http://bphc.hrsa.gov/policiesregulations/legislation/authorizing330.pdf.

  6. Health Resources and Services Administration, ACA Mental Health Service Expansion-Behavioral Health Integration Supplemental Funding Opportunity Announcement (HRSA-14-110). Available at: http://www.hrsa.gov/grants/apply/assistance/bhi/.

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Authors and Affiliations

  1. Division of Behavioral Health and Intellectual Disabilities Policy, Office of Disability, Aging, and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, United States Department of Health and Human Services, 200 Independence Ave, SW, Office # 424E.24, Washington, DC, 20201, USA

    Emily B. Jones

  2. Department of Health Policy and Management, The Milken Institute School of Public Health and Health Services, The George Washington University, 2141 K St NW, Washington, DC, 20037, USA

    Emily B. Jones, Julia Zur & Sara Rosenbaum

Authors
  1. Emily B. Jones
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  2. Julia Zur
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  3. Sara Rosenbaum
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Correspondence to Emily B. Jones.

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This work represents the views of the authors, not of the U.S. Department of Health and Human Services.

Appendix

Appendix

See Table 5.

Table 5 Receipt of Health Care for the Homeless funding and homeless caseload, 2012
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Jones, E.B., Zur, J. & Rosenbaum, S. Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers. Adm Policy Ment Health 44, 492–500 (2017). https://doi.org/10.1007/s10488-015-0674-5

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  • DOI: https://doi.org/10.1007/s10488-015-0674-5

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