Portland program steers homeless patients to primary care

PORTLAND – Karri Gilliam said she makes friends easily.

But few friendships she has made are as valued as the one with Shawna Holloway.

"We hit it right off. We walked into a room and started talking, and she has been helping me ever since," Gilliam said last week.

Homeless and facing a biopsy for four lumps on her breast, Gilliam, 43, is one of 27 patients Holloway helps obtain primary medical care and counseling for mental health and substance abuse through a collaboration between Maine Medical Center and the Preble Street Resource Center.

"It brings a smile to my face to see someone happy with the care they are getting and know they feel supported," Holloway said.

Homeless HealthPartners began in February as a two-year project, program coordinator Malia Haddock said. The program is funded through MaineHealth CarePartners.

"It started as a community conversation around how can we best get the clients connected to primary care in the community," Haddock said.

Patient referrals can come from Preble Street or Maine Medical Center, or even as Holloway walks through the courtyard outside the resource center. As of last week, there were 50 more referrals waiting to be processed.

At present, Holloway is the sole case manager helping patients, but Haddock said another will be added and both will carry about 30 cases.

Ideally, the program will assist people for about three months, getting them connected to health-care providers and services, and whatever financial assistance they may be eligible to receive.

Realistically, the time frame will be longer for some referrals, given the depth of services the patients need.

"The reality of working with this population is there are any number of barriers that are in place," Holloway said. "The reality is we will be working with patients longer than that, if need be."

Quick to laughter and not easily deterred, Gilliam lost a kidney as an infant and has lived on her own since she was 13. While warned at the Portland Community Health Center about the lumps, she said she did not act on them until her pain grew too severe to ignore.

Even then, she said, Holloway not only visited doctors with her, but helped explain what they were saying in terms she could more easily understand.

"She helped me keep my head up. I was not so much thinking bad thoughts, but didn’t know what to expect," Gilliam said.

Preble Street coordinator Bill Burns said giving patients a clearer picture of what they face is invaluable.

"Sometimes they are not treated well in some health-care settings" he said. "They also may think they don’t deserve health care."

The program is also designed to reduce reliance on emergency care when primary care is more suitable.

"If you are relying only on the (hospital) emergency department, you are getting fragmented care, perhaps when something becomes a crisis," Haddock said.

Case managers will track and compile data on the program, which will help determine what larger system issues need to be addressed.

Holloway said her role is to help build trust between providers and patients.

"Some people haven’t gone to the doctor because there is some underlying fear, so this can ease their anxiety a bit," she said.

Gilliam said it was more than "a bit."

"If I needed her there, she’d be there. If I needed help, she said call her," she said. "She stepped right in, it’s been perfect."