HOMES for the Houston homeless student run clinic celebrates 25th anniversary

Years ago, just after his wedding, David Wallace, clinical associate professor at the University of Houston College of Pharmacy, came to his new bride with a confession – he'd be busy every Sunday for the foreseeable future. There was a new student-managed collaborative clinic opening to serve Houston’s homeless, and he’d signed on to mentor the pharmacy students.  

Turns out, she was delighted. She’s a pharmacist, too.  

Now both the Wallaces and the Houston Outreach Medicine, Education and Social Services (HOMES) Clinic are marking their 25th anniversaries.  

And true to his word, Wallace has been at the clinic almost every Sunday.  

True partnerships 

The idea for the HOMES Clinic was hatched in 1999 by founder of Healthcare for the Homeless – Houston and then-Baylor College of Medicine physician David Buck, who is now associate dean of community health at the UH Tilman J. Fertitta Family College of Medicine. 

“The clinic is designed on three components that are considered essential to lifelong learning in underserved medicine: social, clinical and reflective practice,” Buck said. “This structure allows students to understand the power dynamics in medicine and what is needed to develop trust in a system that is deeply broken and limited.” 

In the clinic’s early days, along with the UH College of Pharmacy, the UH Graduate College of Social Work was deeply involved, and since then, the partnership has grown to include the Fertitta College of Medicine, Baylor College of Medicine, McGovern Medical School at UTHealth and UTHealth Houston School of Public Health. 

"The HOMES Clinic is a shining example of how interprofessional patient-centered care plays a critical role in improving the health of all communities, especially underserved populations," said UHCOP Dean F. Lamar Pritchard, noting that the clinic was recognized with the American Association of Colleges of Pharmacy Model Community Engagement Award in 2010. 

Since opening in January 2000, first at a location in midtown and later from its current location in downtown Houston (next door to the fittingly titled Beacon, a lifeline for individuals facing the hardships of homelessness) the HOMES clinic has helped train thousands of student volunteers and served over 5,000 patients. While the clinic itself is open Monday through Friday, run by Healthcare for the Homeless – Houston, on Sundays it is turned over to the students and their attending physicians and pharmacists.  

“Baylor College of Medicine students have rotated at the HOMES Clinic as part of their extracurricular activities for some time now, and I know they find it an exceptionally valuable experience,” said Jennifer G. Christner, M.D., and senior dean at BCM. 

No rest on Sundays 

On any given Sunday the student teams examine the patients first, present their findings to the supervising physician to develop a treatment plan and then to Wallace who determines what medications might be needed.  

One thing is certain – no two Sundays are ever the same.  

“We will see the gamut of things that can be seen in the housed population where you have diabetes or high blood pressure, COPD or asthma. We’ll also see people with different kinds of skin infections like cellulitis that is a little more acute. We also see patients with mental health concerns like depression, schizophrenia, bipolar disorder, and they may bring multiple conditions across this range of health challenges together,” said Wallace.  

It definitely keeps you on your toes, according to third year UH pharmacy student and HOMES Clinic student board member Annie Man.  

“It’s more like an emergency room or urgent care, you don't know what to expect but you make sure you have all the supplies, everything ready to treat them.” said Man.  

Plenty of supplies are available at the HOMES Clinic where they have screening tools that include HIV and COVID tests, urine analysis, blood glucose and A1C tests and colon cancer screenings - all for patients that just walk in the door. Also at the clinic, the immediate medical problem is not the only issue of focus. The staff discusses patients’ social situations, where they get their food and where to go if they need to get into stabilized housing. 

“We may not be able to provide all the services, but we can serve as a bridge back into healthcare for patients,” said Wallace. 

It’s a bridge many must walk 

As a city, Houston has much to be proud of regarding its population of homeless citizens. Ten years ago, the city faced one of the highest homelessness rates in the nation. Today, through relentless effort and compassion, the city has helped over 25,000 people find the stability of a home. 

Patients with that kind of vulnerability drew third year UH Pharmacy student Chad Johnson to return to the HOMES Clinic more times than required. (One such visit per student is a requirement in the UH College of Pharmacy at either HOMES Clinic or another federally qualified health care center.) 

“I could have been one and done, but I saw the challenge of it,” said Johnson. “Those experiencing homelessness have different types of vulnerabilities and they are trusting in students to provide care. I thought that was the noblest thing for students who are learning. We want to use our training to actually make a difference for people needing help.” 

As for Wallace, he said he gets a two-fer: Caring for Houstonians experiencing unstable housing and educating tomorrow’s compassionate providers. 

“It’s very fulfilling to provide a chance for our pharmacy students, early on in their education, to see what it’s like to be part of a healthcare team and how they can fit the need of the team in helping the patient,” said Wallace.  

Man says her experience at the HOMES Clinic is a lesson in trusting herself.  

“In school, we break everything down to organ systems, but real life is not like that. People come in, they have pain – and our mind starts racing - wondering what it could be. We have to remind ourselves that we know more than we know,” said Man. “We put in the effort, we studied all this time.  

It’s a reminder to be confident and trust ourselves.”