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Changing the Path to Effective Health Care

Published on April 7, 2016

Launched in 2012, Health Guardians is an intensive and integrated care model that seeks to address and remove barriers to effective health care. Those barriers can be any mix of social, economic, or health-related issues. Health Guardians seeks out the most frequent emergency room users and works with them to map out a more effective care plan, often improving self-sufficiency along the way.

Health Guardians’ main focus is to find primary care for patients. Patient navigators travel one on one with patients to their appointments and help them map out their care. While working with Health Guardians, Ben Wortham found that this method of helping the poor with health care naturally lent itself to also housing the homeless. He experienced firsthand the difficulties of trying to monitor and deliver prescriptions to those living under bridges or on street corners. Wortham discovered, “Housing is the foundation of health care. You have to house them first for effective health care to really be possible.”

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Sacred Heart apartments on Canal Street

As part of Mayor Landrieu’s 2014 initiative to end veteran homelessness, Health Guardians partnered with UNITY of Greater New Orleans to open a permanent supportive housing facility. In December 2014, the Sacred Heart Apartments on Canal Street opened their doors with a single goal in mind: to keep the homeless housed.

Sacred Heart follows the Housing First Model, which is an approach to ending homelessness that seeks to find housing as soon as possible. Once housing is secured, other services such as health care, counseling, and case management are then provided as needed. The apartments are now home to 55 formerly homeless individuals, over half of whom are veterans. By providing housing to these formerly homeless veterans, Sacred Heart has played an important role in reaching the city’s goal of permanently ending veteran homelessness.

The staff at Sacred Heart, who refer to themselves as a team, consists of supervisor and case manager Ben Wortham; data specialist and case manager Tim Cullen; case managers Dorothy McKnight and Ray Davis; and intern Travers Kurr. Team members travel one on one with residents and advocate for them as they navigate life off the streets, most commonly dealing with health care and legal matters.

Sacred Heart Apartments

(L to R) Dorothy McKnight, Ben Wortham, Tim Cullen, Ray Davis

After being open for two years now, the end goal of keeping the homeless housed has not changed. Wortham commented that one of the biggest challenges the case managers face in meeting that goal is helping the residents adjust and simply learn to live inside. Many are used to sleeping on the hard ground under the interstate, not on a soft mattress in the quiet of a one-bedroom apartment.

The next big hurdle is forming relationships. Kurr stated, “You don’t end up living under a bridge because you’re good at relationships. You have a lot of broken parts here, and they’re constantly working to reconnect that frayed trust.”

The patience and tolerance of the case managers are essential in helping the residents build that trust over time and, in turn, start to seek the help they need. Davis shared, “All it takes is making the time and having the patience to sit and talk with them. You just have to meet them where they are.”

Now, the team at Sacred Heart has the residents focused on making goals of their own. The goals are different for everyone, but they’re important for each individual person. One resident’s goal was simply to go to bed by midnight every night. Weeks later, the team says he’s a new person and the entire culture of the apartments has changed just from that one person’s goal being met.

The 55 residents at Sacred Heart have made huge strides over the last year. All have accomplished at least one of their goals; all have health care; and all have made a personal connection with at least one of the team members. As for the future, the team is now moving towards helping the residents find jobs and become more involved, stable members of the community. They are also trying to integrate the principles of Health Guardians into the Housing First Model. The new model, which Wortham believes would be the first of its kind in New Orleans, would seek to find more effective health care for the poor by first housing the homeless.

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