The program began making the twice-a-week stops on its North County route after the El Camino Healthcare District agreed last year to pitch in $1 million to bring the services to Mountain View and Sunnyvale. Hailing it as a success, the district's board voted in June to continue the stream of funding to the county-operated program through the 2018-19 year.
While the homeless can a tough population to reach, the mobile clinic managed to beat several of its goals, reportedly serving 267 people with primary and mental health care across 851 visits during the first year. The program also included dental care for 1,169 patients, holding more than 3,300 appointments ranging from routine checkups to extracting teeth, according to Barbara Avery, El Camino's community benefit director.
The mobile clinic is by far the largest recipient of the health care district's community benefit program, which provided 54 grants to agencies and nonprofits totaling $7.4 million for the 2018-19 year — and for good reason, Avery said. Rising homelessness and the housing crisis have increased the need for services targeted at a hard-to-reach transient population, and hospital officials at El Camino say the mobile health clinic helps with follow-up care.
"We're having a lot more homeless patients at the hospital, and we need support for when they're being discharged," Avery said. "This is one of the resources for ongoing medical care."
The rationale behind the program, which has been operating in South County cities for years, is that the health clinic needs to serve as a one-stop shop for primary care and mental health care, with a nearby dental clinic that takes referrals from the mobile clinic. Staffing for the van includes a physician, a nurse, a licensed vocational nurse, a psychiatrist, a psychologist and a social worker.
The clinic's Monday stop at the Sunnyvale shelter on Hamlin Court tends to keep everyone busy from the time they show up at 1 p.m. all the way to 9 p.m., according to Dr. Mudit Gilotra, medical director for the mobile clinic. Mental health treatment, therapy, social services, signing up for permanent housing — all of it falls under their purview, and it occasionally takes some triage to keep up with the demand.
The clinic's visits to Community Services Agency on Stierlin Road on Thursdays are a little shorter and tend to serve fewer people.
Gilotra said he believes that an integrated approach to homeless health care serves as a national model, and that physical and mental health shouldn't be treated as separate problems. The latest census conducted by Santa Clara County found that 38 percent of homeless people in the county had a psychiatric or emotional condition. Among the chronically homelessness, that figure jumps to 50 percent.
Mountain View's homeless population count has increased from 139 people in 2013 to 416 in 2017, according to the census data, nearly all of whom are deemed "unsheltered" and are living along creeks and in vehicles along city streets. This leads to some serious logistics problems in trying to reach a scattered and disconnected population. Avery said there was some uncertainty early on that the county could meet its ambitious goals.
"They weren't really sure they would get enough referrals or find enough people," she said.
Outreach efforts include scouring parking lots, shopping centers, creek trails and the Mountain View Library, and checking in with vehicle dwellers along Crisanto Avenue and Shoreline Boulevard near the Eagle Park area, Gilotra said. Clinic staffers are often met with some reluctance and uneasiness, he said, but repeat visits go a long way toward building trust.
"We don't do (the visits) every week but we do it a lot," he said. "On those repeat visits we can get them to talk, or we leave a flyer and they come to us willingly."
Data shared with El Camino Healthcare District shows that the strategy appears to be working. The vast majority of patients who visited the clinic, 80 percent, adhered to the behavioral health treatment plan they were given; nearly 75 percent of patients were screened for clinical depression; and 69 percent were screened for housing placement opportunities.
Gilotra said that having a range of services available at the same time allows the clinic to get a lot more done, helping clients avoiding making multiple visits to far-flung social services agencies, health care providers and mental health services. While some of the homeless people they work with have struggled with mental health disorders and chronic homelessness, he said many are able to rally and find more stable footing.
"When we first meet them we think 'there's no chance we are going to get this person in stable housing,'" Gilotra said. "Their life is in complete shambles, but with their motivation, we can get them a place of relative stability."
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