COMMUNITY HEALTH CENTERÕS OUTREACH PROGRAM TO HOMELESS POPULATION

Providing health care services to individuals who are homeless is a significant challenge for many localities, including Washington, DC, where the homeless population exceeds 15,000. Many among this population have special health care needs due to HIV/AIDS, mental illness, substance abuse, and serious physical health problems. Additionally, other barriers to care exist because of the transient nature of homelessness, lack of shelter, and no effective system for communication. To address the complex needs of this population, Unity Health Care, Inc., a federally qualified community health center in Washington, DC, operates Project Orion. Through mobile clinics, Unity Health Care uses highly skilled clinicians and outreach workers to deliver comprehensive services to vulnerable and hardto- reach populations living on city streets. Project Orion focuses on individuals who abuse substances and those who are most at risk for HIV. It has effectively provided services in familiar settings that engender safety and trust among this segment of the homeless population. This outreach program exemplifies some of the many benefits of cultural brokering for the patient/consumer

PHYSICIANS GAIN INSIGHT INTO HMONG HEALTH BELIEFS AND PRACTICES Physicians in Merced County, CA, are learning more about the healing practices of local Hmong shaman, to whom the community looks first for its health care needs. Shaman function as cultural brokers by increasing physiciansÕ understanding of Hmong health practices and healing ceremonies used for specific illnesses or conditions. Physicians are conducting interviews with practicing shaman to create a historical account of traditional practices. Through this program, coordinated by the Healthy House within a MATCH (Multidisciplinary Approach to Cross-Cultural Health) Coalition, a nonprofit community health organization, physicians have become more aware and understanding of the kinds of healing interventions their Hmong patients have sought before seeking the help of Western medicine.

Benefits to the Health Care Provider Health care providers will be able to elicit more in-depth information that will assist with accurate assessment, diagnosis, and treatment. Health care providers will be able to communicate diagnosis and interpret risks associated with different treatment options more effectively. Health care providers may be more effective in serving patients/consumers who have chronic diseases and conditions that may require a higher degree of self-management. Health care providers who communicate effectively with patients and consumers may experience a greater degree of satisfaction in their work, particularly when they see improved health status and outcomes. Health care providers can become more knowledgeable of and connected to the communities they serve.