Health Care for the Homeless is a federally qualified health center in Baltimore. Across multiple clinic sites (downtown, West Baltimore, Baltimore County) and a mobile clinic, they provide comprehensive health services to more than 10,000 people without stable housing each year.
Their mission: to end homelessness through racially equitable health care, housing, and advocacy in partnership with those of us who have experienced it.
With this mission in mind, it is no surprise to find around a dozen Johns Hopkins school of Nursing alumnae among their medical staff.
We caught up with three JHSON alumnae – Elizabeth Goldberg CRNP-PMH, Tyler Cornell CRNP, and Nicole Maffia CRNP – who work at Health Care for the Homeless, each in different capacities.
What is your role with Health Care for the Homeless?
“I’m a psychiatric nurse practitioner. I’m part of the Department of Psychiatry, which is made-up of three psychiatrists and myself. We meet with patients and come up with a treatment plan that usually includes psychiatric medications. We follow up and see how they’re doing on the meds and determine whether we need to make any changes overtime.”
I really wanted to get more involved in working with the pediatric Latino community on a regular basis. And Health Care for the Homeless was willing to hire a pediatrics only provider. I’m the only pediatrics only provider on staff. Everyone else is either adult or family. So I think my role there is unique for that reason and it fits well because our pediatric clinic is about 90% Spanish speaking.”
“My focus is with infectious diseases and substance use disorder. I work with adult patients also get support from their case managers. That’s so important; otherwise, how can I sit in an exam room and try to help somebody with their physical health if they’re not having their basic needs met or they have other barriers to get to the clinic or to get to specialty appointments or to pick up their medications?”
What challenges are you currently addressing?
“We saw a lot of clinics shut down during the pandemic, especially clinics that were meeting the needs of recently immigrated clients. We’ve kept our doors open and we’ve seen an influx in the number of patients seeking care. There’s a shortage of primary care providers for patients with insurance and without insurance. As people are trying to access care, I think that just in general primary care is getting overwhelmed by the number of the people who need care. We need more services meeting people’s needs in different communities around Baltimore.”
“Most clients seeking care at our pediatric and family medicine clinic are uninsured. A lot of times we’re trying to delicately balance the need to help the patient with their current problem and connect them with care in the community without it costing them thousands of dollars.”
“I’ve had many patients come back to me after two or three years of not seeing them. There could be any number of reasons why they disappear. During that time I worry about their welfare. How are they doing? Are they still getting meds? There’s also the possibility that they passed away because, unfortunately, people experiencing homelessness have a shorter life expectancy than housed people.”
How do you feel/see the impact of your work on the community?
“Patients can come to me and they know that I’ll understand them. Some patients have young kids who have really been through it. Being able to to help them, even in a small way, is very meaningful on a micro level. Those micro issues make a bigger impact on the community. One child in school means then that the mom can work, buy groceries, pay her rent, and maybe get into a more stable housing environment. So it’s kind of like a snowball effect; one small step can create big change.”
“I see patients who get a lot better on their medicine and stay stable, especially if they were in and out of hospitals when I first met them.
“I think that people recognize they’re getting really high quality care at Health Care for the Homeless. Coming here does not mean that they are being treated less, which is what they might feel in other parts of their lives. People who are treated with dignity and respect see themselves as valuable humans and will carry that forward. It definitely makes an impact to feel heard and to feel like somebody actually cares.”
How has Hopkins prepared you for working through these challenges?
“I had a very good experience in both the BSN and the MSN MPH programs. I think that Hopkins sets students up with really good preceptors and clinical experiences. The level of course work you’re expected to be competent in is high so students leave with a good breadth of knowledge and feel capable when they get into the real world.”
“Hopkins teaches you to look at the whole patient and the community – where they come from and the other factors that influence their life. For children, environmental factors are very relevant. I see a lot of families who have been through traumatic immigration experiences. A big part of what I do is talk to them and look at their whole experience.”
What would you like people to know about Homelessness in Baltimore?
“I want people to be aware that a lot of the people we serve are not street homeless. They might doubling up with friends or family. Many are working, but a lot of jobs out there just don’t pay enough to be able to have housing, and food, and transportation, and clothing. Wages just don’t add up to be able to afford basic needs. People that you might walk past in any given day could very well be homeless and you wouldn’t have any idea.”
“People walk through our doors coming from a lot of different places. They would not have chosen this path, so our job is to meet the patient where they are. I start every appointment asking, ‘What’s most important to you that we talk about today?'”
Health Care for the Homeless is a vital resource for those in the community who are experiencing unstable living conditions.
Join the team by applying for an open position! Or learn more about Health Care for the Homeless and their efforts at www.hchmd.org.