Health care safety net for the homeless
The St. Bernadette Community Clinic is a health care safety net for the homeless and needy residents living in economically depressed neighborhoods of downtown Lafayette, La.
For 22 years, it has provided free primary and dental care to the homeless, those living in shelters, the poor and uninsured or underinsured who are sick or injured.
Most clients are homeless and suffer from substance abuse and mental health illness, says Bentley Senegal, Our Lady of Lourdes Regional Medical Center’s director of community services.
The hospital opened the clinic in 1995 to get care to people who otherwise would most likely go without receiving any medical attention until the need became so great that they end up in the hospital’s emergency department.
“Many actually sleep outside the door of St. Bernadette,” Senegal says. “Whatever has happened to them in their lives, they now find themselves at our doorsteps and we do what we can to help them.”
The number of homeless people seeking care at the clinic hasn’t changed much over the years, Senegal says. But substance abuse and mental health illness is a bigger problem these days.
“We are developing strategies and partnerships with other organizations in the community to try to get them the services they need,” he says.
The clinic provides non-emergency medical care to the homeless and poor, including cancer screening, mammograms, pap smears, wound care and treatments for infections. Dentists volunteer one day a week to extract bad teeth and arrange follow-up dental services so clients can get dentures. Those who need major dental work are placed on a long wait list – anywhere from six to nine months – before they can get treatment.
Senegal says the clinic’s services are part of a broader community collaboration to get its mostly homeless population the type of support that can help them get their lives back on track.
“When law enforcement picks up some of these people and brings them to our ED, many times it’s because they are suffering from a mental health issue or substance abuse or they are hungry or they are homeless and need shelter, but they don’t really need to be in the ED,” he says. “They are in the ED because of other issues, and we are trying to address those issues and get to the root of the problem.”
The clinic coordinates services in partnership with Catholic Services of Arcadania and with public health agencies and other community-based organizations to provide follow-up medical care, eye care referrals, community pharmacy referrals for medications, housing assistance and resources for other needs. “We are meeting a need and making a difference in the community,” Senegal says. “They know when they walk into the clinic they will get the care and support they need.”
The clinic logs about 3,200 medical visits and 550 dental visits a year. Five full-time staff members – two nurse practitioners, two nurses and a medical assistant – are assisted by volunteers to help fill the manpower gaps.
A retired nurse volunteers to conduct a monthly foot care clinic for patients “who may not have felt a human touch in a very long time,” says Jeigh Stipe, executive vice president of the Lourdes Foundation.
The clinic’s annual budget is about $500,000, with financial support coming from the foundation and fundraising activities.
Building trust with homeless clients takes time, says Stipe, “It usually will be several visits before they speak up. It takes a little time to build good relationships. And in time you will know that they do appreciate what is being done for them.”
When the Franciscan nuns opened the hospital in 1949, they were committed to providing the best possible hospital care, “but passionate about what was happening in the community,” Stipe says. “Go to them and they will come. That is the approach we have been charged with.”