By Laura L. Acosta
Before sunrise on a brisk Monday in April, dozens of individuals experiencing homelessness lined up outside the Opportunity Center for the Homeless in downtown El Paso to see a health care provider.
For some like Oscar Salas, this would be the first time they received medical attention in years.
“My dad was a doctor in the Army and my mom worked at a hospital,” said Salas, who waited patiently for results from his blood work. “When we were sick, we would always get a shot.”
But after Salas fell on hard times, finding affordable health care was almost as difficult as finding a place to sleep at night.
Lately, the 62-year-old found himself feeling more anxious than usual. His inability to get help further exacerbated his anxiety, but hope was on the horizon.
In April 2016, The University of Texas at El Paso organized the first of four H.O.P.E. (Health Opportunity Prevention Education) Health and Job Readiness Fairs at the Opportunity Center to improve health care access and address unemployment among individuals who have experienced homelessness.
This one-of-a-kind partnership has enabled students from UTEP’s College of Health Sciences, School of Nursing and School of Pharmacy to gain real-world experience while giving back to the community.
“The H.O.P.E. Project clinics help our students to get real life experiences where students are engaged in the analysis of and problem solving for community-based problems involving those experiencing homelessness,” said Eva Moya, Ph.D., a UTEP College of Health Sciences associate dean and social work associate professor. “And it's also the right thing to do. We have the talent, we have the skills, we have the partnerships, and it's a perfect way for us to serve our community using a collaboration approach and strengthening our partnerships with the community and the public health sector.”
Throughout the year, more than 100 health sciences, nursing and pharmacy students worked together and applied the skills they learned in the classroom to take care of 632 of El Paso’s displaced and unemployed individuals.
“Volunteering is in our blood,” said Mario Herrera, who took Salas’ blood pressure and checked his feet for ulcers and sensory neuropathy, a condition that often causes weakness, numbness and pain, usually in the hands and feet. Herrera graduated from UTEP in 2016. “As nursing students, we just want to help people. When opportunities arise to help those in need, we're first to volunteer.”
According to the Point-in-Time (PIT) count, about 1,100 people were homeless on the night of Jan. 21, 2016 in El Paso. Out of this group, 516 were people in families and 581 of them were single adults. The United States Department of Housing and Urban Development requires the annual PIT count of sheltered and unsheltered homeless persons to be taken on a single night during January.
Since opening its doors in 1994, the Opportunity Center has provided meals, beds, transportation, substance abuse counseling, and medical and employment services to 350 individuals a day.
Its founder, Ray Tullius, a UTEP graduate, understands better than most that homeless persons have an overwhelming need for support services, from medical care to job training, to help them get their lives back on track.
A serious illness ended Tullius’ career in construction and farming. Unable to work, Tullius ended up homeless and living in shelters. He was 40 years old and staying in a friend’s basement when he returned to UTEP to get a bachelor’s degree in social work.
“I saw many people that I could relate to who would never leave homelessness without some support, so I began developing different options for them,” Tullius said.
In 2014, Tullius and UTEP’s Department of Social Work established a learning partnership that enabled graduate social work students to help homeless persons reintegrate into the community. Students in the macro-level social work class initially brought up the idea of organizing a community intervention project on health screenings and rehabilitation services for the residents of the Opportunity Center.
But the H.O.P.E. Projectcame to fruition about two years later after faculty members from the College of Health Sciences, School of Nursing and School of Pharmacy were visiting the Opportunity Center as part of the UTEP Provost’s Community Engagement Faculty Tours.
“It is important for students and faculty from health sciences, nursing and pharmacy to learn from each other while also learning the scope of practice of the different professions,” said Guillermina Solis, Ph.D., assistant professor in the School of Nursing. “In providing service to the homeless population, students become connected intellectually and emotionally, and they begin to see and understand the difficult living situations which impact health.”
At 6 a.m. on April 11, 2016, participants filed into the Opportunity Center’s Women’s Resource Center for the first H.O.P.E. Health Fair. Many hoped to get preliminary diagnoses on diseases such as diabetes that might otherwise go unnoticed. Nearly 200 participants attended the two-day fair.
Students in the clinical laboratory science program pricked Ervin Smiley’s finger to test his blood sugar and cholesterol levels. They also tested for anemia and other conditions.
“I’m getting old so I have to see how the body is holding up,” Smiley joked. The 56-year-old worked in the Opportunity Center’s Safe Haven facility, which houses single men and women with mental disabilities.
UTEP clinical faculty members reviewed test results. Participants with results outside the normal range were referred to San Vicente Family Health Center for follow-up care.
“Working with the homeless is not what I expected,” said Alexandra Garcia, who graduated from the clinical laboratory sciences program in 2016. “I think it made us more compassionate because you hear some of their stories, but you don't feel bad for them. You feel good because you helped. I feel like I made a difference in their lives.”
In the Opportunity Center’s emergency shelter, pharmacy students worked alongside Walgreens and McCrory’s pharmacists to administer more than 60 flu shots. Social work graduate students like Krizia Mendez and community mental health providers screened 125 adults for depression and anxiety.
Mendez was facilitating a study on mental health and homeless individuals at the Opportunity Center. Participants responded to a patient health questionnaire, which was used to detect depression and anxiety. Those who scored moderate to severe were referred to San Vicente Family Health Center for treatment.
“We get to interact and hear their stories and see what they’re going through every day,” said Mendez, who also took the macro-level social work class taught at the Opportunity Center. She graduated in May 2016. “We see the difference that we’re making.”
UTEP also collaborated with 11 community partners to offer basic health care screenings, vouchers for women’s wellness exams, substance abuse prevention and tobacco cessation.
The El Paso Department of Public Health tested 140 individuals for syphilis and HIV and 21 individuals for Hepatitis C. The department also screened 145 adults for tuberculosis: 111 were negative; 25 were positive; and nine needed to be retested.
In September 2016, UTEP organized a second H.O.P.E. Health Fair at the center. Sixteen community organizations and 92 volunteers served 153 individuals. A third health fair in April 2017 served 187 individuals .
“It’s complicated to get these health and human services when you’re uninsured or underinsured, especially if you’re also having to deal with other issues like being home free or not having a regular place to live,” Moya explained. “We have a wealth of resources in this community, and if we can come together through partnerships, more of these services could be provided on a more regular basis and persons in need would be served in a more effective fashion. The broad and complex nature of the public health needs that surround home-free populations demand communication, coordination and collaboration of interdisciplinary efforts, joint actions and careful follow-up to prioritize and address health and mental health needs.”
Prompted by the success of the H.O.P.E. Health Fair, UTEP’s Master of Rehabilitation Counseling (MRC) program collaborated with 11 community partners to host the first H.O.P.E. Employment Clinic at the Opportunity Center in summer 2016.
Ninety-three individuals participated in a job clinic day on July 28, the first of three phases to help individuals experiencing homelessness find sustainable employment.
“When it comes to employment, there are a lot of barriers that individuals who are homeless experience, like not having an ID card,” explained Kristin Kosyluk, Ph.D., assistant professor in UTEP’s MRC program. “It’s important to address those barriers, but it’s also really important, especially from a rehabilitation counseling standpoint, to recognize that people also have strengths and interests that can be used to help them develop training and employment goals.”
During the project’s first phase, participants focused on identifying barriers to employment, such as limited skills or work experience or a lack of transportation, and how to overcome them. In the second phase, participants worked with MRC students to identify skills, strengths and goals related to employment, learned how to search for jobs, created a resume and practiced interviewing skills.
The final phase involved two job fairs organized by Workforce Solutions Borderplex and the H.O.P.E. employment clinic.
“This initiative reflects a need within our community, and counters the opinion that all homeless are job ready,” said John Martin, fund development director at the Opportunity Center. “We as a community need to be in a position to assist and support federal initiatives to end homelessness … They want to work – they need the skills and resources to do so. The community needs to be engaged in this effort.”
The clinic also provided a valuable community-engaged service learning opportunity for 22 MRC students who applied much of what they learned in the classroom to help homeless individuals move toward job readiness.
“The most important thing that I learned about working with the homeless is that each individual has a personal story that explains their current state of homelessness,” said Donald T. Andrus, a graduate student and research assistant in the MRC program. “But despite their homeless status, they remain optimistic about their futures and independent living goals.”