Vulnerable Population Health Policy Proposal

Kyla Hoag

NURS-FPX6026: Biopsychosocial Concepts for Advanced Nursing Practice 2

Capella University

Kathryn Sheppard

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Need for Policy

The homeless is an example of a vulnerable population and they face an assortment of

healthcare challenges, both physical and mental. The homeless population is susceptible to many

physical health related problems such as chronic pain, impaired mobility, impaired hearing or

vision, and obesity. “Chronic pain is thought to be common among homeless people, in part due

to frequent injuries and the high prevalence of concurrent health conditions” (Hwang et. al.,

2011, p. 1). For many people with chronic pain, common pain relief methods are ineffective, and

opioids are used an alternative. It is easy for this population to end up addicted to opioids and

other substances because of chronic pain. Homelessness causes a lack of stability, which can lead

to drug addiction. The homeless population often self-medicates with street drugs, and they use

substances to numb the pain and stressors that comes with living on the street. “According to the

National Coalition for the Homeless, substance abuse is more prevalent in people who are

homeless than in those who are not” (Mosel, 2022). It can be challenging for homeless people to

stop using substances because they have smaller support networks. They also typically do not

have easy access to traditional recovery programs, detox centers, and rehab programs. It is then

crucial to look for a solution that will allow the homeless population to effectively manage their

chronic health conditions such as pain or mental health issues, and to most importantly get them

into a safe environment, where they do not have access to substances to continue feeding their


Proposed Policy

The proposed policy I will be discussing is an interdisciplinary pain rehabilitation

program. The interdisciplinary approach to institutional and community problems occurs when

members of different disciplines work inter-dependently (as opposed to the term “multi-

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disciplinary,” which describes members of different disciplines who function independently”

(Hamel, 2001, p. 58). An interdisciplinary program is necessary for this population because they

face a variety of issues that make traditional drug rehabilitation programs less efficient. An

interdisciplinary program addresses the contributors to chronic pain which include behavioral,

psychological, and physical aspects. “To effectively serve the homeless population, rehab

programs must do at least three things: provide services that address the needs for employment,

income, and housing; offer access to affordable interventions; and provide long-term care,

treatment, and support” (Smith, 2020). The most effective rehab programs for the homeless

population understand that substance abuse cannot be managed without addressing the needs of

the person as a whole.

Interprofessional Approach

Effective rehab programs for the homeless population should provide patient-centered

services that are multidisciplinary, meaning competent enough to treat various conditions and

coordinate further services. Chronic pain is important to get under control, but most importantly,

the homeless population’s primary concern that needs to be addressed is housing. Substance

abuse often correlates directly with homelessness, therefore, the sooner the patient can find

stable housing, their chances of falling into addiction are drastically reduced. For treatment to be

effective, the homeless must have a stable living situation. Once basic needs are met, problems

with addicted can be focused on. An interprofessional team should be established to help develop

this type of patient’s plan of care. This team should include: a primary care provider, a pain

specialist, nurses, a mental health professional such as a therapist or psychiatrist, and social

services. There needs to be coordination between inpatient and outpatient social services as this

population is ready to transition into the community again.

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Individuals experiencing homelessness face unusual challenges in accessing healthcare.

These challenges include lack of transportation, loss of housing, financial hardships, lack of

insurance, and negative encounters within the health care system. There are many aspects of

being homeless that can cause a person to struggle with drug addiction. However, traditional

rehab programs hardly work for the homeless as they face a wide range of problems, including

mental, behavioral, and physical. I am proposing an interdisciplinary pain rehabilitation program

to help these patients lessen drug use, increase psychological functioning, promote healthy

behaviors, and have a safe place to call home, temporarily.

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Hamel, Pauline. (2001). Interdisciplinary perspectives, service learning, and advocacy:

A nontraditional approach to geriatric rehabilitation. Topics in Geriatric Rehabilitation.


Hwang S., Wilkins E., Chambers C., Estrabillo E., Berends J., MacDonald A. (2011). Chronic

pain among homeless persons: Characteristics, treatment, and barriers to management.

BMC Fam Pract. 12(73), 2-9.

Mosel, S. (2022). Substance abuse & homelessness: statistics & rehab treatment. American

Addictions Center. Retrieved from


Smith, Johnelle. (2020). Drug And alcohol rehab programs for homeless individuals. Addiction

Resources. Retrieved from


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