Family Practice
- Adult primary medical care
- Chronic disease care
- Prenatal care
- Family Planning
- Immunizations
- Lab Services
- Pharmaceutical Discounts
- Mobile healthcare for the Homeless
- Screenings for chronic diseases, cancer, diabetic retinopathy
- Coordinated referrals for specialty care and radiology
58% of our patients are adults
Health Care for the Homeless (HCH) is funded through San Mateo Medical Center. RFHC provides medical and dental care to the homeless as well as behavioral health services. Last year, we took care of 759 homeless (includes those in recovery programs). According to San Mateo County’s 2011 homeless count survey, unsheltered homeless living in vehicles and homeless encampments in East Palo Alto increased by 89% since the last count in 2009.
Chronic Disease Patients
In 2009, 47% of our patients (N=2,351) were diagnosed with diabetes, hypertension, asthma or heart disease; they made 10,191 medical visits. When compared to 2005 when 1,213 patients made 4,461 visits, this respresents an increase of 94% in the number of chronic disease patients and 128% more medical visits.
This increase is largely attributable to RFHC’s decision to address the high rates of chronic disease, particularly diabetes, in the service area through an integrated continuum of interventions to prevent and manage chronic conditions.
Early intervention is essential. Without early diagnosis, untreated out of control diabetes or hypertension can escalate to kidney damage or blindness with diabetes and stroke with hypertension.
Stroke and Heart Disease. We are participating in a Kaiser sponsored Phase project designed to reduce the risk of heart attacks and strokes. The study involves diabetics over 55 years of age who are given preventive treatment through medication and lifestyle change.
Living with Complex Chronic Conditions
- Pacific Islanders are at high risk for complex chronic conditions related to obesity, diabetes and hypertension. They represent only 9% of our patients, but comprised 19% of the diabetic patients and 19% of the hypertensive patients in 2009.
- In 2009 RFHC served 759 homeless patients living in shelters or treatment programs. Many homeless patients are living with complex mental health problems as well as addiction and chronic disease.
- 77% of African-Americans 65 years or older have hypertension and 31% of those with hypertension have diabetes (Source: UCLA, CHIS, 2007).
Dealing with complex Issues requires a multi-disciplinary approach
In addition to a chronic disease condition, many patients have to cope with economic hardship, cultural displacement and linguistic isolation. As a result, they may need a comprehensive array of services.
It takes a team: Our multi-disciplinary team approach involves bi-lingual Heath Navigators who are assigned to provide personal case management support, encouraging follow up with self-management goals and compliance with medical instructions.
If a patient is experiencing depression or some other mental health issues then a behavioral health counselor will be assigned.