NASHVILLE, Tenn. Linda Cundiff, RN, MSN has spent her career working to improve the health of underserved populations. As the Chief Operating Officer of Health Care Without Walls (HCWW), she works within an innovative model of free health care and support for homeless women and children in the Greater Boston area.
“Health Care Without Walls’ mission is compassionate care for women and families in need,” she told researchers and community advocates at the Meharry-Vanderbilt Alliance (MVA) on Friday, November 3, 2017. “To improve the lives of women who are homeless or marginally housed through quality healthcare, education and advocacy.”
‘Falling through the cracks’
HCWW was founded in 1999 on the premise that women experiencing poverty and homelessness were falling through the healthcare system and needed attention. Founder and President Roseanna H. Means, MD’s vision was to create a new model of care that would break down barriers for these women and families.
“Too many homeless women were falling through the cracks,” Cundiff said.
She described a “one size fits all” approach that proved ineffective. Mainstream medical care was unaware of the realities of homelessness, and rising costs of crisis care demanded innovative solutions.
HCWW provides what Cundiff called a “Gap Care” or “Bridge Care” approach. “We do it based on three pillars: community, conscience and cost savings,” she said.
That approach includes Core Services in numerous shelters throughout Boston and Bridges Programs for special groups. Core Services provides for adult women and families, while the Bridges Program provides for elders over 60 years old and prenatal/postpartum mothers.
Innovation through “Bridges”
“Bridges,” Cundiff noted, “is the innovative place we’ve gone.”
HCWW developed Bridges to Elders (BTE) and Bridges to Moms (BTM) in 2012. BTE is a community-based primary care and outreach partnership that serves elderly homeless women. It has realized documented health outcome improvements within the last three years. Participants saw an 86 percent drop in Emergency Department visits and a 77 percent drop in inpatient hospital stays.
In the BTM program, the HCWW team connects with women to offer aid in five key areas:
- Housing
- Transportation
- Personal safety
- Food security
- Community resources
Currently, there are 65 women within the program.
“BTM’s goals are increased access, fewer crises, fewer NICU days, better health for moms and babies, emphasis on care coordination and maternal bonding,” Cundiff explained.
Budget
HCWW’s $1.2 million budget is funded by 60 percent grant income and 48 percent donor income. More than 38 percent of donor income is from donations under $500.
Because grant funding is expected to decline over time, HCWW plans to increase individual donors and family foundations at all levels, especially small donors.
‘Outside the walls’
“Compassionate patient-centered care in the community is a long-term strategy that helps patients improve their lives and health,” Cundiff said.
“HCWW is proving that creative solutions to improving health and reducing costs must include what goes on in our clients’ lives outside the walls of health care institutions.”
Afterward, those who attended – representatives from the National Healthcare for Homeless Council, Room in the Inn, the St. Thomas Health Community Benefit and Metro Homelessness Commission– shared their programs serving vulnerable populations experiencing homelessness.
About the Meharry-Vanderbilt Alliance
Founded in 1999, the Alliance bridges the institutions of Meharry Medical College and Vanderbilt University Medical Center. Its mission is to enrich learning and advance clinical research in three primary areas -- community engagement, interprofessional education and research -- by developing and supporting mutually beneficial partnerships between Meharry Medical College, Vanderbilt University Medical Center and the communities they serve. Through community engagement, the Alliance serves a large community of stakeholders including surrounding universities and colleges, community organizations, faith-based outlets and community health centers. Its interprofessional education enhances students' interdisciplinary understanding and improves patient outcomes through integrated care. The research conducted provides access to experienced grant writers and materials supporting the grant application process and facilitates grant-writing workshops.
