Photo Courtesy of Pensacola News Journal
Jerry Pullen sat on an examining table in the newly opened health clinic at the Waterfront Rescue Mission the other day, while nurse practitioner Daniel Mines listened to his heart beat through a stethoscope.
Pullen — a short, muscular man with calm, bright eyes and a kind voice — has lived on and off the streets for more than a decade. When asked what put him there, he points to a drinking problem. Pullen has lived at the mission now for a little more than a year and, in that time, his life has changed.
“I’m moving forward,” he said. “I ain’t had a drink in over a year.”
Earlier this month, Mines performed surgery on Pullen’s toe. It was a minor operation, one Pullen probably would have foregone before Mines arrived on the scene last month. The clinic that Mines oversees — funded through a grant from the federal Health Resources and Services Administration and operated by Escambia Community Clinics, Inc.— provides free health care to area residents who, like Pullen, have no place to live.
Mines said the clinic had been serving eight or nine patients per day since opening on Feb. 28 but that the goal was to provide 6,600 consultations within the first year of operation.
“We’ve been trying to get the word out,” Mines said, “but its kind of hard with the population that we’re serving.” When word does get out, however, it shouldn’t be hard to meet the goal.
In 2013, 945 people were identified as homeless in Escambia and Santa Rosa counties, according to the U.S. Department of Housing and Urban Development’s annual Point in Time Survey. Of these, 182 were considered “seriously mentally ill.” A further 156 had chronic substance abuse problems, according to the survey.
When asked their primary source of medical care, the majority of these individuals responded with “emergency room.” Those results concerned Chandra Smiley, who sits on the board of directors for the EscaRosa Coalition on the Homeless, along with Bob Rogers, vice president of ministry programs for the mission. Smiley is also director of clinical services for Escambia Community Clinics.
Smiley said the survey data had inspired her and others to find a solution. Relying on emergency rooms for health care is harmful not only to the individual patients, but to society as a whole, she said.
“The emergency room is your most expensive care setting next to actually being inpatient,” he said. This reality — combined with the fact that the homeless are seldom equipped to pay the exorbitant medical bills resulting from a visit to the ER — mean those costs often get absorbed by the system and passed on to other consumers.
Beyond this, an emergency room is a poor substitute for regular medical attention.
“Going to the emergency room, only addresses what’s going wrong with you right now,” Mines said. “They’re doing episodic care, whereas we’re going to try to provide the whole continuum of care — from acute care to preventative services, to primary care, so that we can take care of all their health care needs. So that they don’t get sick. So that they don’t have to go to the emergency room.”
The clinic — open from 7:30 a.m. to 4 p.m. Monday through Friday — provides everything from treatment of the common cold, to biopsies, prostate cancer screenings and minor surgery. Smiley said her organization planned to subcontract with Baptist Health Care’s Lakeview Center to provide mental health counseling at the clinic by the beginning of April.
Those services will complement Waterfront’s existing programs. The organization opened a new and expanded campus in 2012. The new facility — located on Herman Street, in West Pensacola — includes 10 respite care beds, to house homeless patients who have been discharged from area hospitals but have nowhere else to recover. Until the clinic opened, these residents did not have access to onsite medical care.
“They didn’t have any medical support,” Smiley said, “but, now that we’re on the campus, they have it.”
By providing long-term and preventative care, Mines said, Escambia Community Clinics and its partners hope to identify and remedy the health problems that, if left untreated, could lead to more emergency room visits.
Rogers said this was vital in helping those he served achieve the stability needed to rebuild their lives.
Pullen is a case in point. If it hadn’t been for that minor surgery, Mines said, his injury could have gotten infected and, if left untreated, could have resulted in more serious health problems — one more barrier to Pullen’s efforts to rebuild his life.
Instead, Pullen is working part time at the clinic, mopping floors and wiping down counters, and also at the mission’s day resource center, where he passes out food and clothing.
Pullen said he hopes to save up enough money to move to Chesapeake, Va., and reunite with his son and grandchildren.
“I’m taking it one day at a time,” he said, “but that’s what I pray for — to live near them again.”