Haven for Hope (H4H) is San Antonio’s largest homeless shelter and has an average of 1,400 people on campus daily. The campus holds the distinction of being the number one address for 9-1-1 calls to originate within the City of San Antonio with an estimated 1,800 transports of H4H clients to downtown hospital emergency rooms occurred from April 2015 to March 2016. These 9-1-1 calls were steady from month to month and remained a concern for ambulance over-utilization for the City of San Antonio.
Leadership from STCC, H4H, San Antonio Fire Department’s Mobile Integrated Healthcare (MIH) Team, and the CentroMed, San Antonio’s Federally Qualified Health Center, came together to create this necessary intervention. These players developed a collaborative model to address patients’ needs during the evening and overnight hours when healthcare resources are limited on the H4H campus. Their collaboration led to the Haven for Hope Acute Care Station. The Acute Care Station is staffed with an assigned MIH paramedic overnight, 7 days a week. The primary goal of the MIH paramedic is to respond to 9-1-1 calls that originate from the campus and work with the patient and H4H staff to navigate the patient to the appropriate place for care. Options for the patient could include treatment and release on scene by the MIH paramedic, referral to the CentroMed clinic on the H4H campus, or to be transported via ambulance to an emergency room should the patient require this level of immediate care.
Throughout the night, MIH works with all patients they come in contact with, hands them off to a H4H Patient Navigator who will then connect them to the CentroMed clinic first thing in the morning where the patient will be seen. This ensures continuity of care and significantly decreases the potential for no-shows to the follow up appointments. The end goal is that H4H staff and CentroMed will continue to engage these patients to provide a consistent medical home.