Tuesday, October 13, 2009

Homelessness and Healthcare

An important population to consider when looking at the health care system is the homeless. For whichever reason a person is homeless, regardless of their mental stability, economic status, or education health care is a basic need for everyone, and as a country we are excluding many people from our current health care laws.
There are many faults to the current health care system, and many reasons why populations, like the homeless, are not taken into account. But, on a positive note, let's take a look at a hopeful article about a homeless health care facility right here in Boston. The article is taken from the Health Reference Center Academic Infotrac. The site is below the article.

Jean Yawkey Place in Boston is operated by the Boston Health Care for the Homeless Program (BHCHP), founded in 1985 by Jim O'Connell, MD, to provide behavioral and primary healthcare to people who are homeless. Although the building originally housed the city's morgue, a pathology lab, and a ambulance garage, Jean Yawkey Place offers centralized and dignified surroundings for Boston's homeless population.

The 4-story, 77,000-square-foot building was constructed in 1933. The renovation, designed by Steffian Bradley Architects, began in December 2006 and took approximately 18 months. The projects total cost was $42 million. The Yawkey Foundation contributed $5 million.

Jean Yawkey Place provides people who are homeless access to a broad range of healthcare services, including behavioral healthcare, under one roof. It houses a primary care clinic with 14 exam rooms, a dental clinic with 5 operatories, outpatient mental health services, family services, a pharmacy, BHCHP's research department, program and administrative offices, and 104 beds for respite care.

"The behavioral health services are integrated within the [primary care] clinic and offered within the exam rooms on an as-needed basis" explains Teresa Wilson, AIA, a principal at Steffian Bradley Architects. "This model of care allows for full flexibility in the use of each exam room ... rather than sending the patient to a different area for behavioral health services "

The main entrance opens into the lobby of the Cary W. Akins Pavilion, which features large bay windows to create a sense of spaciousness and to bring in more light. The dental clinic and pharmacy are located directly off the lobby, as is a large conference room with sliding doors. The lobby uses woods, a light color palette, and a low ceiling to create a warm and pleasant atmosphere. The primary care clinic and other services on the first floor serve walk-ins and those with appointments.

A separate historic lobby serves as a staff entrance and as a gathering place for fund-raisers. Original wood detailing was preserved, and the lobby's original colors were reproduced. Windows added along an exterior wall for extra light were designed and placed to keep with the building's original style.

The second floor contains the activity room, staff and client dining rooms, administrative offices, and a large solarium constructed on the original building's roof. The solarium provides clients with a sun-lighted indoor place to relax and socialize, or they can step out onto the deck to gather at tables and benches, The deck has a green screen of ivy that obscures a fence. Stephen W. Van Ness, AIA, principal-in-charge at Steffian Bradley Architects, notes that the solarium "was really meant to be the heart and soul of the facility itself. ... The idea was to bring as much natural light into that space as possible," Jean Yawkey Place's third and fourth floors, named the Barbara Mclnnis House, include the same services as those provided on the first floor. They also are provided on these upper floors to ease traffic and to ensure those using the respite beds on these floors receive optimum care. The third and fourth floors use natural materials and neutral colors, The corridor's flooring has bold patterns, and varied ceiling heights reduce the perception of the hallways' length.

Each respite room has four-to six-bed arrangements and each floor has an isolation room. Each room has a recessed "front door" with a wall light and personalized tackboard to provide a sense of home, as well as shared bathrooms, a TV for each roommate, and large windows.

YAWKEY PLACE Boston, Massachusetts

what are people's thoughts about a facility like this? Would we be helping the homeless population by creating more of these places?

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