For the doctors and nurses who care for Orange County's homeless and uninsured, moving around is the key to making health care accessible for those who can't afford it.
Mobility also has helped them realize that many of their assumptions about health care aren't always right.
"The places that we went all throughout Orange County weren't the places I expected us to go," said family physician Dr. Michael Provenghi, a Kaiser Permanente family physician who has helped organize physicians for mobile health clinics. "Most of our visits were to places in south Orange County where you wouldn't expect to find homeless."
Provenghi, who grew up in Cypress and still lives there, worked with county doctors and nurses using borrowed motor homes to visit parks, parking lots and other sites in Laguna Niguel, Capistrano Beach, Santa Ana and other places where patients could gather for treatment.
The project was part of the work of the nonprofit Illumination Foundation. It's the brain child of county public health nurse Paul Leon, who says he recognized the need for health care for homeless families and single adults after a visit several years ago to the Santa Ana armory.
County armories are used in winter to shelter those with nowhere else to go. At the time of Leon's first visit, families with children stayed there although since then they've been moved to a program that sends them instead to motels.
Altogether, 500,000 Orange County residents are known to lack health insurance, said Leon, and the figure may be much higher.
The Illumination Foundation has a budget of $3.37 million for 2011, with most of the money coming from Orange County's 19 hospitals. The foundation finds housing for the homeless for two weeks after they are released from local hospitals so they can recover from surgeries and other treatment and not go straight back onto the streets.
The hospitals pick up the housing costs because, in the long run, officials said, it is less expensive than having recovering patients wind up back in the hospital with infections or other problems associated with their recovery. Orange County and local cities contribute about $640,000 to the annual budget for health care and some housing costs, according to the foundation.
While Provenghi still works with residents in Kaiser's family physician program and other volunteer doctors, Leon left his county job to create the Illumination Foundation.
It began three years ago with the motor home mobile clinic where Provenghi served and now is focused on using donated indoor space around the county so that those waiting for care can be inside and doctors and nurses have somewhat larger and more private spaces to work.
On Tuesday, the Illumination Foundation was set up inside the Community Court building in Santa Ana, in three small offices not far from where special court cases are heard and adjacent to another service that tries to help the unemployed find work.
Dr. Clayton Chau, associate medical director of the county's Mental Health Agency, worked out of one office while Dr. Thomas Kang, from Kaiser, saw general health patients in a second room.
Yellow and black fliers announcing the date and location of the clinic had been posted in areas like county service centers where homeless and uninsured patients might see them. Appointments were required to ensure those who came were able to see a doctor.
It's like this every week. Only the location changes.
So far, the foundation has been able to find two indoor sites in Santa Ana, at Isaiah House and the Community Court offices, one in Anaheim at the county Family Resource Center and it is seeking space in south county.
Schizophrenia and bi-polar conditions are the two most common mental afflictions of the homeless, said Leon, while hypertension, diabetes, and congestive heart failure are the primary adult illnesses.
Among families given emergency housing, statistics gathered by the Illumination Foundation showed that 57 percent of the adults had difficulty functioning due to mental health problems while 36 percent reported a history of drug and alcohol abuse.
Children in families needing shelter suffer from "mostly anxiety disorders" from being homeless, said Leon.
"The unique thing about our program is we're mobile," said Leon. "We can move around and set up anywhere. If we're not seeing these people, they're not going to get seen."
-- TRACY WOOD