A mobile health van will expand its hours and cover more territory throughout the county. The homeless and the uninsured will have easier access to a primary care clinic. Service agencies will work with area hospitals to provide more counseling for addicts.
Those are among the expected results of a $625,000 federal grant awarded to Harford and Baltimore counties to help address health problems among the homeless.
The approach is to provide better care to the homeless populations in both jurisdictions before their illnesses reach critical stages and they land in a hospital emergency room, officials said.
The mobile clinic will begin providing services ranging from physicals to referrals for specialized treatment at up to six locations by the end of this month. An existing clinic at Harford Memorial Hospital in Havre de Grace will expand services.
The grant, which will be administered through Health Care for the Homeless, a Baltimore-based organization, is intended to help the counties meet health service demands in the rapidly changing suburbs.
"In the counties, a dramatic reduction in affordable housing is creating more homelessness," said Kevin Lindamood, vice president of Health Care for the Homeless. "People are being squeezed out of housing with nowhere to turn."
Homelessness puts people at risk of an array of illnesses and makes them less likely to seek help, he said.
Harford will use the funds, which became available this month, to establish more health programs for the homeless, provide additional treatment - particularly for acute illnesses - pay for specialized care, and broaden mental health and addictions services.
"In the city, services are concentrated, but in the counties, it is more difficult for the homeless to access help," Lindamood said.
Health Care for the Homeless provided services to 11,000 Marylanders last year, he said. The new effort in the two counties marks the largest expansion beyond Baltimore for Health Care for the Homeless services in nearly 20 years.
The grant will provide a boost to programs administered jointly by the Harford County Health Department and Upper Chesapeake Health, which operates hospitals in Bel Air and Havre de Grace.
"We will work with the hospital system to provide a primary care clinic through its mobile van several times a month at least six sites," said Pat Balducci, a clinical social worker who is supervisor of health services for the county Health Department.
The hospital system will be able to increase primary care services to the homeless, many of whom are patients at its clinic in Havre de Grace.
"Instead of the emergency room being a point of entry for the very ill homeless, the expanded outreach will help us identify more individuals and provide ongoing primary care," said Kathy Kraft, director of communications for Upper Chesapeake Health. "It will really help lay the groundwork for many programs."
The mobile clinic, donated by volunteer associations, will visit shelters in the county as well as locations where the homeless are known to gather. It will focus on the U.S. 40 corridor, which the more transient homeless frequent.
"We will visit every shelter and known location," said Beth Hendrix, deputy director of the county Department of Community Services.
The mobile service, along with a fixed site for a clinic, should decrease crowding in the hospital emergency rooms, which, until now, have been the only recourse for critically ill homeless patients, officials said.
"It will mean we can do thorough medical assessments," Balducci said. "Many homeless have serious health issues that have never been attended to."
Clinic staff are expected to see patients with a range of illnesses, including untreated diabetes, hypertension, heart disease, dermatological problems and communicable diseases, she said.
"They are in the elements and on foot, so there are significant feet problems, too," she said.
The grant will be divided equally between the counties and is renewable for the next two years if the counties meet benchmarks and standards, officials said. Harford is expected to treat no fewer than 200 patients this year and reach about 400 by 2009.
"We may serve even more," said Balducci. "This is an invisible population that includes veterans, women and children, and ex-convicts."
The most recent count of Harford's homeless, in January, showed the county's homeless population at 145, a 20 percent increase since 2005. In metropolitan areas such as Baltimore, the numbers counted typically are multiplied by 10 to give a more accurate measure.
"This not an exact science, and we know there are more than 145," said Elizabeth Meadows, community development coordinator of the county Department of Community Services. "But we do a thorough count and have a good idea of the numbers."
The county census also revealed that more people are opting for shelters or other housing programs instead of living on the streets, social services officials said.
Harford spends about $2 million annually on shelters, transitional housing and educational programs. County programs offer counseling and assist about 90 percent of clients in the transition from homelessness within two months, officials said.
"The grant will mean additional resources and strengthen our ability to administer them," Meadows said.
mary.gail.hare@baltsun.com