Brenda Merritt, MD, Project Renewal, 200 Varick St, 9th floor, New York, New York, NY 10014, (212) 620-0340 x393, RuchiM@ProjectRenewal.org and Hope Ferdowsian, MD, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave Levy Place Box 1043, New York, NY 10029.

In New York City diabetes prevalence has doubled in the past 8 years (NYC Department of Health and Mental Hygiene). Among New York City’s chronically homeless adults—most of whom additionally cope with substance abuse and mental illness—the challenge to identify and manage diabetes is greater than that of the general population. Project Renewal Inc., is a not-for-profit organization that provides New York’s chronically homeless population with outreach, primary care, mental health care, substance abuse treatment, employment services, and housing. One of Project Renewal’s primary care sites is a mobile medical van (MedVan) that provides care at 13 sites in Manhattan and Brooklyn.

This study examines how well Project Renewal MedVan providers complied with American Diabetic Association (ADA) Standards of Medical Care for Patients with Diabetes Mellitus 2003. Patients with diabetes were identified through billing records from July 2002 through June 2003. Indicators such as frequency of A1C measurement, foot and opthalmology exams, vaccinations, and blood pressure measurement were used. Healthcare for the Homeless guidelines were incorporated to ensure that needs specific to the homeless population were being met. The chart review determined the percentage of clients who were appropriately evaluated for A1C status, dyslipidemia, tobacco use, foot and opthalmologic pathology, and microalbuminuria. The study further examines effective interventions to improve service delivery and treatment adherence in the homeless population.

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