Pinellas County Health Program Evaluation Services

Pinellas County is seeking proposals from qualified evaluation firms to assess the County’s indigent healthcare needs and the system to address them, and to conduct a comprehensive evaluation of the benefits, rationale, and potential impacts of the County’s investment in indigent health care services. The evaluation shall address community and patient-level burdens while considering the most effective services and approach to serving uninsured/underinsured residents. Pinellas County’s Human Services Department administers the Pinellas County Health Program and the Healthcare for the Homeless Program which are two distinct programs that each provide a holistic access to healthcare services, including primary care, specialty care, mental health care, substance use treatment, dental care, vision services, and pharmacy benefits. As the County continues to be good stewards of taxpayer dollars, we want to ensure that this program is evaluated to determine if this is a good investment of public funds.

This evaluation will address three primary areas including 1) access to comprehensive primary care and supportive services, including gaps and challenges to access, for medically indigent Pinellas County residents under 300%, 200% and 100% of the Federal Poverty Level, 2) effectiveness and operational efficiency of services provided; and 3) a review of the County’s investment, financial performance of the program, and funding opportunities/options. The evaluation shall be written to provide county leadership with objective data and actionable recommendations to inform future service delivery strategies, funding decisions, and policy recommendations.

Pinellas County, through the Human Services Department, administers enrollment in and operates two health programs with similar services but different eligibility requirements. The Pinellas County Health Program (PCHP) and the Health Care for the Homeless (HCH) program provide primary medical services, including the treatment of illness or injury, preventive care, education, prescription coverage and referrals for lab work, specialty care, dental assistance, mental and behavioral health care, and substance use treatment. The Florida Department of Health in Pinellas County is contracted to perform all clinical operations including the provision of primary care staffing and subcontracting for specialty care services including mental and behavioral health care and substance use services.

Pinellas County Health Program

The Pinellas County Health Program is considered an indigent health care program administered by the County. All Pinellas County residents who qualify may apply for the health program and may be eligible for one year of enrollment with renewals upon recertification of eligibility criteria. To qualify for services, the resident must be a U.S. citizen or non-sponsored legal resident, a Pinellas County resident, an adult between the ages of 18 and 64, be uninsured and unable to pay for needed medical care, be ineligible for Medicaid, Medicare, or other public assistance programs, and meet federal income guidelines at or below 100% of the federal poverty level (FPL).

Enrolled clients are provided health care services through one of five patient-centered medical homes (PCMH) throughout the County. The medical homes are within the Florida Department of Health locations including the Tarpon Springs Health Department, Clearwater Health Department, Mid-County Health Department, Pinellas Park Health Department, and St. Petersburg Health Department.

In Fiscal Year 2024, the PCHP had 2,743 unique active patients with 1,828 (67%) patients receiving primary medical care during the year. The number of active clients has declined significantly from FY 2020 (pre-Covid) where the County had 5,356 active clients and 3,206 (60%) clients with a medical encounter. The PCHP is solely funded through County general revenue funds (approximately $10 million annually).

Health Care for the Homeless Program

The Health Care for the Homeless Program is a Federally Qualified Health Center (FQHC) and receives federal funds from the U.S. Department of Health & Human Services, Health Resources and Services Administration. The program is run out of two sites, the Bayside Health Clinic and a Mobile Medical Unit. Unhoused patients are also served through a Street Medicine Program that brings medical care to individuals living in the street, encampments, and throughout the county. The program primarily serves unhoused individuals and those at-risk of homelessness in Pinellas County regardless of income, insurance status, or ability to pay.

In 2024, the County celebrated the completion of a 2,000 sq. ft expansion to the Bayside Health Clinic (total 5500 sq ft). The project created four new exam rooms, an additional dental operatory for a total of three dental chairs, four new offices dedicated to behavioral health integration for on-site mental health and substance use services, a conference room, and improved professional office spaces for clinic care coordination staff, and storage. The clinic sees approximately two-thirds of all program patients.

The County has had a Mobile Medical Unit for almost 30 years. It travels countywide to shelters, drop-in centers, substance use treatment facilities, and other sites where unhoused people frequent. In 2024, the County acquired a new 45’ vehicle featuring two private exam rooms, a private counseling room, a lab draw/ counseling area, an intake area and more. In Calendar Year 2024, the Mobile Medical Unit saw 812 clients with 1,417 patient visits at the five locations visited by the van.

The program also operates a Street Medicine Program, bringing health care to unsheltered individuals who may be reluctant to access health care at traditional brick and mortar facilities. The Street Medicine Team is also there to promote health education and engagement amongst unsheltered individuals and provide referrals to the HCH program, and to enable access to routine and comprehensive health care. The Street Medicine team served 456 patients in 2024 with wound care, vaccines, preventive care, medications and chronic disease management. The team travels throughout the County to areas where unhoused individuals are each week providing care, case management and support in a streamlined mobile van environment.

More recently, the County has been funded and is in the procurement phase for a third mobile vehicle to further access to critical care services. We anticipate this vehicle providing an additional access point to expand primary care and behavioral health services where and when needed within the community.

In total, the Health Care for the Homeless Program served 2,311 unique patients in Calendar Year 2024.  The program saw a 31.2% increase in substance use patients served, 13.3% increase in mental health patients served, and a 1.8% increase in dental patients served. With the new vehicles and expanded building being tremendous program assets to enhance access, the County anticipates their profound impact on the lives of those we serve in accordance with the County’s mission to provide high-quality healthcare that is accessible to everyone, regardless of their background or circumstance. The Health Care for the Homeless program is partially funded with federal funds (approximately $2 million) and County general revenue (approximately $7 million).