Board Reviews Medical Care Practices for Empowerment Center

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Scott Hesch waiting to speak to the Empowerment Center Oversight Advisory Board on January 13, 2016. Hesch is currently unemployed and homeless. He said he needs a hernia operation before he can return to work but that his limited medical coverage will not cover the cost of the operation. Photo by Jennifer Tinter.
Scott Hesch waiting to speak to the Empowerment Center Oversight Advisory Board on January 13. Hesch is currently unemployed and homeless. He said he needs a hernia operation before he can return to work but that his limited medical coverage will not cover the cost of the operation. (Jennifer Tintner/WUFT News)

Scott Hesch called 911 to pick him up from Dignity Village when he couldn’t stop throwing up from gastrointestinal bleeding.

His call was one of 601 calls made to emergency medical services from the Empowerment Center from October 2014 to November 2015. The Empowerment Center encompasses Grace Marketplace homeless shelter and Dignity Village homeless campsite in Gainesville.

“I would’ve taken the bus to the hospital if I could have,” said Hosch, a Dignity Village resident.

Hesch, who has called Dignity Village home since it opened in 2014, said he took the bus back and forth to the hospital three times before realizing how serious the situation was. 

The Empowerment Center Oversight Advisory Board is now reviewing best practices for handling medical care at Grace Marketplace and Dignity Village.

Gainesville Fire Rescue (GFR) and Alachua County Fire Rescue (ACFR) presented their cost of providing emergency medical services for the Empowerment Center to the board on Wednesday. GFR reported its total cost was $222,608 and ACFR reported its cost was $261,038.

“The total cost is not an actual expense, but what is considered the value of the response,” explained JoAnne Rice, GFR Deputy Chief.

The value is calculated by an independent company. ACFR was able to collect $59,362 from Medicare/Medicaid but had a write down of $58,772 Medicare/Medicaid, which will not be paid. There is a remaining $141,000 in costs which will likely not be collected because the majority of the people treated were uninsured and homeless.

Many of the complaints called in were for incidents that could have been treated without the patient being taken to a hospital by ambulance if there was professional medical help on site. By having paramedics and the mobile health clinic at the Empowerment Center each one day a week, the advisory board hopes to cut some of the costs on the city and county.
Many of the complaints called in were for incidents that could have been treated without the patient being taken to a hospital by ambulance if there was professional medical help on site. By having paramedics and the mobile health clinic at the Empowerment Center each one day a week, the advisory board hopes to cut some of the costs on the city and county. Graph courtesy of Empowerment Center Oversight Advisory Board.

In September, GFR began a community paramedics program to dispatch two paramedics to Dignity Village on Mondays. They provide follow up services from the Mobile Outreach Clinic on Fridays.

“If we have an early intervention we hope to stem those calls,” said Rice. “The majority of incidents the paramedics are treating are infections.”

Those two paramedics cost GFR $4,838 for services provided from September to December.

Rice said GFR is analyzing the data, but believe it is too soon to tell if the paramedics are making a significant difference.

“A small number of people account for a disproportionate number of calls,” said Jon DeCarmine, Grace Marketplace Operations Director. “I could probably name the 20 people who account for 50 percent of those services.”

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Hesch said he tried to stay in the dorms at Grace Marketplace during his recovery but was unable to because he would not have been able to stay in his room during the day. At the time, people could only be in the dorms from 7 p.m. to 7 a.m., but they now have 24/7 access, according to DeCarmine. 

Hesch stayed at St. Francis House for 12 days after leaving the hospital for respite care. He then returned to Dignity Village.

“I don’t go out of my way to look for help and people don’t go out of their way to help me, so I’m stuck in between a rock and a hard place,” said Hesch.

There are currently 44 people staying in the dorms in Grace Marketplace, and 55 people are staying in the outdoor shelter, which has a wait list of five to 10 people per day, according to DeCarmine. He said they are able to accommodate about three to five of those people.

There were 158 people staying in Dignity Village as of Jan. 8, according to Assistant City Manager Fred Murry.

“To some extent, you were probably providing these medical services to the individuals before but not in as an efficient rate,” said Alachua County Commissioner Mike Byerly, a member of the center Oversight Advisory Board.

Harold Theus, ACFR Deputy Chief, agreed with him. “There’s no way to pinpoint if there’s been a shift in homeless services now that they are concentrated at Dignity Village,” Theus said.

At the Jan. 13 meeting, the board discussed looking into new methods for expanding medical services, such as adding more paramedics and creating a medical clinic for Grace Marketplace.

“I’m 56 years old, and I’ve given up,” said Hesch. “Sadly, there’s a lot of men like me who’ve just given up.”

About Jennifer Tintner

Jennifer is a reporter who can be contacted by calling 352-392-6397 or emailing news@wuft.org.

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