Fourth Street Clinic is a unique service in Utah, as there is no other health care provider that provides the breadth of integrated, on-site services that are accessible, affordable and targeted to homeless Utahns. Homelessness is often the result of a downward spiral that begins with a person's health problem and escalates into unemployment, financial, and housing problems. Without homes people experience illnesses and injuries at three to six times the rates of housed individuals and die an average of 30 years earlier. Fourth Street Clinic works to break this cycle regardless of ability to pay. Health insurance is accepted, but not required and because all patients fall below 200% of poverty, the Fourth Street Clinic sliding fee scale doesn't assess charges for services.

Fourth Street Clinic's funding strategy is 1) maximize outreach and enrollment strategies to remove barriers and encourage patients to participate in Medicaid, and 2) continue to diversify private in-kind funding partnerships and work to maintain these relationships for years to come, and 3) research and apply for funding from private granting agencies, and 4) establish a deferred giving program for our current donors. FOURTH STREET CLINIC 2020 PRIORITIES Integrated Behavioral Health Care Continue to fully Integrated Behavioral Health Care throughout the clinic and into our Nurse Care Management sites. By doing this Fourth Street Clinic will increase access to high-quality integrated behavioral health services, including prevention or treatment of mental health conditions and/or substance use disorders, including opioid use disorder. Trauma Informed Care Training & Implementation A 2019 Fourth Street Clinic priority was to train staff and community partners on Trauma Informed Care (TIC). TIC is an evidenced based organizational structure and treatment framework that involves understanding, recognizing, and responding to the effects of all types of trauma. TIC emphasizes physical, psychological and emotional safety for consumers and providers, and helps survivors rebuild a sense of control and empowerment. For 2020, Fourth Street Clinic is planning an extensive renovation of our waiting room that will be more patient care focused and welcoming to embrace the TIC principles.

Fourth Street Clinic has long-term and sustainable fundraising plan that has successfully grown clinic operations. Fourth Street Clinic also has 32 years of experience building long-term community partners based on Memorandums of Understandings and a strong credentialing process to expand (not duplicate) services and operationalize community and medical volunteers.

2019 OUTCOME REPORT ? Patients by Race (top 2): Caucasian (69%), Black/African American (9%) ? Patients by Ethnicity: Hispanic/Latino (20%) ? 18 years of age and under: 4% / 65 years of age or older: 4% ? Female: 38% ? 15% self-report as LGBTQ+, unknown or chose not disclose ? Insurance status: Uninsured: 49%; Medicaid: 43%; Medicare: 7%; Private: 1% ? Patients best served in a language other than English: 9% ? Patients with an income less than 100% of Federal Poverty Level (FPL): 87% ? Homeless: 92% ? 11,927 medical encounters were completed, a 19% increase from 2018. ? A 17% increase of patients receiving cervical cancer screening. ? 6,687 Enabling Services were completed, a 27% increase from 2018. ? 11 specialty medical clinics were offered including: dermatology, ENT, gastroenterology, hepatology, gynecology, neurology, rheumatology ophthalmology & optometry, audiology, and podiatry. ? 1,626 visits were completed in the dental clinic for numerous procedures, including extractions, fillings, and periodontal treatments. ? 4,874 Behavioral Health visits were completed – a 31% increase from 2018.

Fourth Street Clinic is more than a safety net to homeless persons, it is a lifeline. Only with your support can we continue to provide needed and critical health care to those men and women and families that are experiencing homelessness. There are NO other health care services available that focus solely on homeless patients in Salt Lake County. We are fortunate to be in a community that recognizes the important work being done and are willing to support with a financial contributions. Fourth Street Clinic depends on our staff, board, volunteers, donors, in-kind gifts and more to provide quality comprehensive care to patients. Each year more patients come through the door which means an increased need to rely on the generosity of individuals, foundations, corporations, and institutions for funding.