The Robert Wood Johnson Foundation has made two investments in large national programs directed at alleviating problems facing homeless people in America. The first, Health Care for the Homeless, attempted to increase the availability of health care services for homeless people. It became a model that was cited when the federal government passed the McKinney Act in 1987, providing federal dollars to improve access to health care for homeless people throughout the country.
After the Health Care for the Homeless program was completed, the Foundation funded a second program, this time focusing on homeless families. The Homeless Families Program was more ambitious than the first. It attempted to improve not only health care services for homeless families but also a range of other social services generally important to their well-being. The Foundation entered an active and productive partnership with the Federal Department of Housing and Urban Development, which made stable housing arrangements available to the families participating in the program. The premise of the program was that both housing and social services (including health care) were needed to get many homeless families back into stable and independent life circumstances.
The authors present findings from the formal evaluation of the program that the Foundation funded soon after the program was initiated. This chapter offers insights into the problems faced by homeless families as well as the obstacles faced by program managers trying to bring about system reform. The discussion also addresses the challenges involved in designing and implementing "enriched services" accompanying housing for the homeless.
- 1. Editors' Introduction
- 2. Reach Out
- 3. A Review of the National Access-to-Care Surveys
- 4. Improving the Health Care Workforce
- 5. Expertise Meets Politics
- 6. The Media and Change in Health Systems
- 7. Addressing the Problem of Medical Malpractice
- 8. Unexpected Returns
- 9. Developing Child Immunizations Registries
- 10. The Homeless Families Program
- 11. The National Health and Social Life Survey