When Joe Hickey became executive director of St. Patrick’s Center in 2011, he established a day shelter to provide showers, laundry, telephone access and meals for homeless residents in Wilmington’s poverty-stricken east side – the poorest zip code in the state of Delaware. Soon, more than 200 mostly homeless people were seeking respite at the center every day.

“I quickly realized that there were a very large number of people coming here and with them came a whole host of problems that we were not equipped to deal with,” he says.

For help, he turned to Christiana Care Health System’s neighboring Wilmington Hospital and its community outreach program.

“Joe said he didn’t think anyone else had the skill sets to do it,” recalls Linda Brittingham, Christiana Care’s director of social work. “He said, ‘Linda you are going to fix it.'”

Christiana CareUnder the health system’s “Medical Homes Without Walls” outreach, three social workers began providing assistance with issues related to health care, insurance, mental health and substance abuse. A nurse visits several times each month to take blood pressure screenings and do wellness checks. Christiana Care volunteers also regularly prepare bagged lunches for the center’s homeless clients.

“We tease out the problems,” Brittingham says. “We get people a medical family and then we work with them on their other issues. We get to know the whole person and their needs.”

Hickey says the center’s clients “face hunger and extreme poverty every day. We are their support system.”

He says Christiana Care’s social workers help the center’s clients take care of their immediate needs. “They get them into detox or rehab or help them with transportation so they can see a doctor,” he says.

The focus on getting the homeless the most appropriate care in the most appropriate setting has eased pressure on the hospital’s emergency department (ED). Homeless residents were arriving in the ED seeking help. But Brittingham says most didn’t need emergency medical care – they needed assistance with shelter, food and clothing – but police had nowhere else to take them.

The health system worked with area homeless organizations and social service agencies to ramp up support for the homeless, and worked through the center to get them the services they needed.

Since 2013, the number of people using the ED for non-urgent medical reasons dropped 83%, according to Christiana Care. At the same time, there was a 40% increase in the number of homeless who were off the streets and in city shelters.

Both Brittingham and Hickey hope the hospital can build on the social work initiative by providing on-site medical care at the center.

“They have been fantastic,” Hickey says of Christiana Care’s social workers. “They have gone above and beyond what I expected in providing expert service to the people who come here with issues like substance abuse, mental health, lack of transportation, neglect and physical abuse. They are part of our family.”   

Christiana Care