title: A primary care-public health partnership addressing homelessness, serious mental illness, and health disparities.
abstract: BACKGROUND
  People with histories of homelessness and serious mental illness experience profound health disparities. Housing First is an evidenced-based practice that is working to end homelessness for these individuals through a combination of permanent housing and community-based supports.
  
  
  METHODS
  The Jefferson Department of Family and Community Medicine and a Housing First agency, Pathways to Housing-PA, has formed a partnership to address multiple levels of health care needs for this group. We present a preliminary program evaluation of this partnership using the framework of the patient-centered medical home and the "10 Essential Public Health Services."
  
  
  RESULTS
  Preliminary program evaluation results suggest that this partnership is evolving to function as an integrated person-centered health home and an effective local public health monitoring system.
  
  
  CONCLUSIONS
  The Pathways to Housing-PA/Jefferson Department of Family and Community Medicine partnership represents a community of solution, and multiple measures provide preliminary evidence that this model is feasible and can address the "grand challenges" of integrated community health services.
authors: Department of Family and Community Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA; Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA. lara.weinstein@jefferson.edu
authors: Lara Carson
authors: LC
authors: Weinstein
authors: Marianna D
authors: MD
authors: Lanoue
authors: James D
authors: JD
authors: Plumb
authors: Hannah
authors: H
authors: King
authors: Brianna
authors: B
authors: Stein
authors: Sam
authors: S
authors: Tsemberis
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology / Q000534:rehabilitation; D015897:Comorbidity; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research / Q000458:organization & administration; D054625:Healthcare Disparities / Q000458:organization & administration*; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000458:organization & administration*; D010414:Pennsylvania; D011314:Preventive Health Services / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D011618:Psychotic Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D011635:Public Health Administration; D062486:Public Health Surveillance; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012947:Social Work / Q000458:organization & administration*; D017664:Uncompensated Care
keywords: Community Medicine; Delivery of Health Care; Homeless Persons; Mental Health; Public Health