Tom Chapman at the wheel of MCHC's Care-a-Van

March 19 - 26, 2006 is National Health Care for the Homeless Week. MCHC is proud of the crucial, community-supporting work it has undertaken to weave the safety net of services a little more tightly for the homeless.

Ensuring access to quality health services, caring for the most vulnerable in our communities: For the last 12 years, this mission has driven Mendocino Community Health Clinic, Inc. (MCHC). Once again, its mandate is propelling MCHC into new terrain.

Here, there and everywhere around the Ukiah area, Tom Chapman is driving the colorful MCHC Care-a-Van around town, ferrying folks to and from doctors’ appointments and supporting them as they try to make their lives work. A longtime Ukiah resident known to many Ukiahans by his British accent, his infectious good humor and his 10 years of service at Danny’s Vacuum shop, Tom now works as the Care-a-Van driver for MCHC.

MCHC pioneered Care-a-Van services after it became apparent that rising gas prices were causing yet more problems for patients already beset by illness. Suddenly, people began missing their appointments. Survey data shows that difficulty in getting transportation is one of the primary obstacles preventing individuals from obtaining healthcare services when needed. For many residents—the unemployed, the aged, the ill, the homeless and the hopeless—saving the money to get to their doctor has become an almost-insurmountable barrier to accessing care.

At the same time, it became apparent that MCHC’s established methods for outreach to the homeless could be made more effective. From a medical perspective, this is crucial because homelessness is almost always coupled with ill health. Lack of timely access to health care leads to increased medical costs when treatment is ultimately obtained. It also creates an increased burden on community services agencies, while increasing community exposure to threatening health conditions. Because the homeless often lack resources, one way or another, the community will pay these costs. MCHC believes that Care-a-Van services should increase health among the most challenged people in our community; it should also reduce costs to community services in the long term.

To protect our community from the economic and social side effects of untreated illness, MCHC recognized it was in a unique position to bring the homeless into the shelter of the safety net of care. Under the impetus to serve its mission, MCHC sought and received funding from Health Resources Services Administration (HRSA) to serve this vulnerable population.

According to Public Health’s 2005 Homeless Census and Survey, in the past year approximately 26% of the homeless said they use the local hospital emergency room as their primary source of care. Because of MCHC’s vital role in protecting our community from the burden of this costly care, Care-a-Van services are ensuring that those in the homeless population in need health services receive them appropriately. The Care-a-Van has become another crucial way that MCHC supports the overall economic health of our community while reaching out to the homeless by going where they gather—at Plowshares, at the Food Bank, at the Family Center.

(By the way, MCHC is also proud of the fact that the Public Health survey cited above also showed that almost 48% of the homeless go to their local health center for care. We can improve those numbers by using Care-a-Van service to capture the approximately 11% who never see a doctor. Experience tells us they need care.)

The Public Health study also showed that a little over 37% of the homeless have chronic health conditions that require medical monitoring and educational support. The professional who is most effective at delivering this type of care is a personal physician. MCHC’s environment of caring provides the ideal circumstances in which to accomplish both objectives. Additionally, MCHC staff connects those in need to the county’s safety net services, supporting them to become healthier and more hopeful about their ability to improve their lives.

That’s where Tom Chapman work is making such a significant impact. Weaving the safety net yet more tightly, Tom’s role as pilot of Care-a-Van’s homeless transportation services has provided groundbreaking access. He does much more than ferry the unfortunate to and from appointments; he’s become an expert on the helping those in need.

On a recent rainy day, a young mother came into the van without a coat. Tom knew that he could get her one from the Dorcas Society on Cherry Street. His work is transforming him into a helping friend to those in need. “I’ve lived in Ukiah a long time, but I never understood the difficult and daily challenges faced by so many people. The problem is a hidden one,” he says. “Every day, I meet people who are living under blankets because they can’t make the rent. I see young families who are isolated by poverty and hopelessness. Many of the people I meet feel despair, and I make sure that they know that, today, there’s someone who cares about them. That person is me.”