Dr. William Mercer (right), who leads Project Hope, asked at a health department meeting last week for the board to consider allowing the program to separate from the county health department. (Wheeling-Ohio County Health Department photo)
Leadership at Project Hope, a street medicine initiative operated out of the Wheeling-Ohio County Health Department, has asked the health department’s board to consider allowing the program to separate from the government agency.
Dr. William Mercer, who leads Project Hope, made the ask at a health department meeting last week. He said the needs for the program — which provides medical care and connections to services for homeless residents in the area — have outgrown what it can offer under health department operation.
“The main thing is there is just much more to do in the area, so we still want to be partners with the health department, but we feel we need to be under a bigger entity,” Mercer said in an interview with West Virginia Watch. “Because the need is so great, we’ve outgrown the health department. We’ve done great work there, we’ve flourished, but we just need to be under a bigger umbrella that can fulfill all of our [community’s] needs.”
Project Hope as it currently stands is almost completely volunteer run. All funds for the program come through donations to the health department. While that’s been enough to keep the program operating in its current form, Mercer said there isn’t enough flexibility to adequately meet the needs of the program’s current clients and other potential clients. He wants the option to hire full time, paid staff and offer different kinds of services that he says are desperately needed for patients, but that are hard to deploy as an arm of a government agency.
“Sometimes, under state regulations [for how local governments can spend money on public health initiatives], we have trouble utilizing some of the donations we receive and putting them toward services we know are needed,” Mercer said. “The reality is that there are greater needs right now than what we’re able to meet.”
But Mercer’s request to the county’s board of health is a complicated one. At last week’s meeting, the board of health agreed to look into the logistics of ceding the program over to another nonprofit or organization.
Howard Gamble, the administrator for the Wheeling-Ohio County Health Department, said the technical aspects of separating a program that was formed and is funded through the health department are great. All the equipment used by the program — from beds for patients to the large mobile unit used to bring services directly to people on the streets — are owned by the health department.
“County health departments typically do not have this as a routine problem,” Gamble said. “We don’t have policies or procedures for it. It’s not as if there’s a turnkey that exists to hand the program and all its assets over to someone else.”
Gamble said the health department is proud of the work done by Project Hope. At this point, he said, the bigger question for him is why not keep it operating through the health department?
“We always have people that think, ‘This would be so much better if it were run by X, Y or Z organization,’” Gamble said. “But I ask, why not the county health department? We’ve run it all these years, it’s been successful, it treats people, it meets the county’s needs, it has so many volunteers, it works well with other programs. Why do we think another agency or organization would do better?”
The landscape for meeting and assisting Ohio County’s homeless population is changing, though, Mercer said. An ordinance passed earlier this year that bans “camping” on public property has allowed those who are homeless few options for where to stay. With only one location available where they won’t be fined for violating the rule, some people who are homeless have been forced to share spaces with known abusers.
When the exempted site moved, however, outreach teams lost contact with several clients and patients.
“I’m not sure where these people went,” Mercer said. “It’s hard to track them down and those are people who we know needed these services.”
Overall, the exempted camping site has “worked out a little better” than Mercer thought it would. People who could use the services from Project Hope are in one place. It’s easier now to bring the mobile unit and provide treatment on site.
In other areas, though, Mercer would like to see services expand. Not everyone in the region who could benefit from Project Hope’s outreach is necessarily homeless. There are high rise, often low-income apartment buildings where residents go without medical treatment despite high need, Mercer said.
If it were possible to run Project Hope under another organization, the program could consider billing for services, as many of these people are covered by Medicare or Medicaid. That would ensure long term sustainability for the program instead of continuing to rely on community donations. And while the program currently employs two full time staff, having a non-governmental operator could allow it to offer more competitive wages for new as well as existing positions.
But Gamble believes that the services being offered by Project Hope right now are adequate. There’s nothing stopping another organization from replicating them or starting up their own, similar services to fill other gaps in care for the community.
“It happens every once in a while that someone looks at another organization and says, ‘they do this so well.’ That might be true, that might not be true. But at this point, we’re satisfied with the successes of the program,” Gamble said. “If someone else wants to do this, there’s nothing stopping them. They may need to get some startup work like we did, but they can do it. We don’t have a trademark on this kind of outreach program. It can be replicated anywhere, used anywhere and the whole concept can be shared.”
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