The URL can be used to link to this page

Home My WebLink Aboutstatus-of-primary-care-access-for-homeless-in-alameda-county-october-2024 Primary Care Access October 2024 The Status of Primary Care Access for People Experiencing Homelessness in Alameda County Background In 2023, Alameda County Health, Health Care for the Homeless (ACHCH) and Public Health Community Assessment, Planning, and Evaluation (CAPE) collaborated on a project to gain insight into the experiences of People Experiencing Homeless in accessing and receiving health care services in Alameda County. The ﬁndings, obtained through a series of focus group, conducted at homeless shelters, encampments and drop-in centers across the county, demonstrate the complex needs of an underserved population, who face multiple barriers accessing care, and often distrust a medical system that has caused and compounded traumatic harm. Purpose As a follow-up to the focus group ﬁndings, in mid-2024, ACHCH followed up with Federally Qualiﬁed Health Centers (FQHCs) and Community Health Centers (see appendix A) to assess the current state of access to primary care across the community clinic network in Alameda County. This work happened through calls to clinic appointment lines, with ACHCH staff posing as a prospective patient. Staff called 13 FQHC’s/Community Health Clinic organizations that provide care at 36 locations in Alameda County. Each organization was asked the following questions, and provided response across all their clinic sites: 1) Are they accepting new patients for primary care? 2) What is the wait-time for new patients? 3) For existing patients, how long does it take to get an appointment with their PCP? Findings While the signiﬁcant expansion of Medi-Cal over the last several years has resulted in coverage for nearly all PEH, system barriers continue to make access to primary care challenging. LifeLong (with the exception of Trust) and Tiburcio Vasquez reported to ACHCH that they are not accepting new patients at any of their clinic sites, and AHS Highland Wellness (the largest AHS ambulatory care site) is also closed to new patients. The exceptions are Bay Area Community Health (Fremont), Davis Street Primary Care Clinic (San Leandro) and AXIS Community Health (Livermore and Pleasanton), and LifeLong Trust Clinic (Oakland) - all who are currently accepting new patients. The average wait-time for new patients to get an appointment with a primary care provider is three months. For existing patients, the wait-time to get an appointment with their primary care provider can range from one and a half weeks to one month. Primary Care Access October 2024 The current lack of primary care access exacerbates the profound health outcomes demonstrated in the Alameda County Homeless Mortality Report ﬁndings that the age-adjusted mortality rate for people experiencing homelessness in Alameda County in 2022 was 5.4 times that of the general population. (Alameda County Homeless Mortality - ALAMEDA COUNTY HEALTH CARE FOR THE HOMELESS (achch.org). Without access, people delay care and/or inappropriately use expensive emergency services. This further compounds the challenges PEH face of system navigation, consistency of care, bias and discrimination, lack of trust in service providers and quality issues/inferior services as reﬂected in the Focus Group Study ﬁndings. Best Practices and Opportunity Drop-in has been used as a method of intervention to address the issue of health care access. Patients are able to show up at a clinic location and receive care without scheduling an appointment. This approach enables health clinics to reduce or eliminate delays in patient care and enhances continuity of care. This model has only been successfully implemented at several clinic locations; however, they only exist in Oakland currently. LifeLong is scheduled to open a TRUST clinic in Berkeley in 2025. -Roots Community Health Clinic has adopted the Open Access model with their “Welcome Wednesdays”, an open campus for the unhoused members of their community. Every Wednesday from 1pm-3pm, unhoused people can receive medical services including blood pressure checks and glucose checks as well as wrap-around services such as health education, navigation & care management, referrals, vaccinations, hygiene kits, beneﬁts enrollment, employment services, food pantries, showers and linkages to other resources. -LifeLong TRUST Clinic is a primary care clinic in Downtown Oakland with robust integrated behavioral health, substance use, gender affirming care and HIV care for homeless patients, as well as health education and housing support services. The clinic has drop-in hours for new and existing patients Monday-Friday at 8:30 am or 1pm. -LifeLong Howard Daniel Clinic is a primary clinic in Oakland that has drop-in hours for existing patients Monday and Wednesday 1-2pm. Primary Care Access October 2024 Appendix A: List of FQHCs and Community Clinics Contacted - Alameda Health System (2) - Asian Heath Services (1) - AXIS Community Health (3 locations) - Bay Area Community Health (6 locations) - Baywell Health (Formerly West Oakland Health Center) (2) - Davis Street Primary Care Clinic (1 Location) - James A. Watson Wellness Center (no response) - La Clinica: (3 locations) - LifeLong Medical Health Center (4) - Native American Health Center (1) - Order of Malta Clinic of Northern California - Roots Community Health Clinic (2 Locations) - Tiburcio Vasquez Health Center (10 Location) Primary Care Access October 2024 Appendix B: Q&A Details by FQHCs and Community Clinics Contacted 1) Are they accepting new patients for primary care? 2) What is the wait-time for new patients? 3) For existing patients, how long does it take to get an appointment with their PCP? Alameda Health System: Q1 All sites accepting new patients but Highland and Eastmont, they are not accepting new patients until January 2025 Q2 Eastmont: Waitlist -but unclear on wait time Q3 Eastmont: Depends on providers and their individual schedules Asian Health Services: Q1 Yes, regardless of the patient's insurance coverage. Q2 If it's not urgent, it can take three months. If it's urgent, make an effort to gather people together with you in the next two weeks. There are a few limited same-day appointments that are reserved month, two months, or three months. The schedule is determined by the PCP's assessment of patient needs. Telehealth appointments are available for existing patients, but they are usually AXIS Community Health: Q1 Yes Q2 3 months Q3 2-3 weeks Bay Area Community Health: Q1 Yes Q2 No wait time Q3 5-7 days Baywell Health (Formerly West Oakland Health Center) Q1 Yes Q2 New patient appointments are not available until mid-Jan Q3 On average, it takes six to eight weeks. Davis Street Primary Care Clinic: Q1 Yes: All new patients are screened by eligibility worker Q2 No response Primary Care Access October 2024 James A. Watson Health Center: Q1 No response Q2 No response Q3 No response La Clinica: Q1 Fuente Wellness Center (San Leandro youth & young adults ages 11-24): Yes Fruitvale: No response San Antonio: Yes Fruitvale: No response San Antonio: 6- 8 weeks Fruitvale: No response San Antonio: It depends on the patient's needs. The provider will assess the need. LifeLong Medical Health Centers: Q1 Clinics in Berkeley and Oakland are only accepting Alameda Alliance members assigned to them prior to 1/1/24. They do not have capacity to take new patients, and there is no waitlist at this time. The exception to this is the Trust Health Center, which has capacity to take new patients. All clinics do have capacity to enroll Medicare patients enrolled in the following plans: Brown & Toland, Alta Bates, Aetna, Scan Health Care, AARP Medicare Complete, Alignment Health Plan, Native American Health Center: Q1 They are accepting new patients. Appointments, a month out. Q2 No Wait list Q3 A in person appointment is a month out. Telecare appointment is one week out. Order of Malta Clinic of Northern California Q1 Accepting new patients who are not covered by health insurance Q2 The ﬁrst appointment is scheduled for two to three weeks out. Q3 About two weeks Primary Care Access October 2024 Roots Community Health Clinic: Q1 Yes Q2 Two -three weeks Q3 It takes two to four weeks. The average is approximately three weeks. Tiburcio Vasquez Health Center: Q1 Not Accepting new patients Q2 NA Q3 NA