The rapidly growing field of street medicine

The rapidly growing field of street medicine—the practice of providing medical care to homeless people living on the streets—is getting a boost in California with the addition of a new player: a medical group dedicated exclusively to working with the homeless.

And it really does make a profit.

Sachin Jainwho worked on federal Medicaid policy during his time in the Obama administration, helped lead Southern California Street Medicine Group it's called Healthcare in action in 2021 — and makes no secret of his desire to receive new money from the state and federal governments for treatment and housing for the homeless.

“Health care problems cause homelessness, but they are also exacerbated by homelessness,” Jain told me. “And health care dollars are huge.”

Across the country, Jain and street medicine doctors and nurses who have long worked on the fringes of the health care system and earned little income are becoming integral players in the Biden administration's policies. effort to eliminate the consequences of homelessness.

No longer relying on sporadic funding and charitable donations, many street medicine operations use billions of dollars in Medicaid to provide social services, from helping patients find an apartment to paying utility bills. Since October, the federal government has also increased compensation for service providers providing local assistance to homeless people.

“We are entering the world of insurance and now we have the right to compensation,” he said. Jim Withersa longtime Pittsburgh street medicine purveyor who helped start the movement. “We're legit!”

But Withers is wary of trying to make money from treating the homeless.

“I’m really worried about the corporatization of street medicine and capitalism encroaching on what we’re building,” he said. “Taking care of people under the bridges and on the streets doesn’t always fit the economics of our health care system. The spirit of the street medicine movement is one of social justice, but the streets don’t belong to anyone.”

California is the ideal laboratory for this new world of Medicaid-funded social services.. This home for more people living on streets and sidewalks, in vehicles, or along waterways than any other state. It is also home to more street medicine providers than anywhere else: 64 from approximately 150 Street medicine organizations all over the country are here.

Healthcare in Action employs doctors, nurses and social workers who provide a wide range of health services, including basic wound care, medication administration and antipsychotic injections.

His street medicine teams work in 17 California communities and incomes are growing rapidly, reaching $15.4 million in 2023 compared to 2 million dollars in 2021. It makes money from Medicaid and charitable contributions, among other sources. It also contracts with hospitals, health insurance companies, and municipalities to provide services.

Jane says Healthcare in Action is tackling the problem of disease on the streets and saving the health system money by keeping homeless people with costly illnesses out of hospitals and prisons.

His street medicine teams also work to provide people with food, drug treatment and, in some cases, housing.

But much of the teams' time and energy goes into building trust. It can take time to convince people to agree to medical care or housing, for that matter.

“One of the problems in public health is that we dehumanize people who experience homelessness,” Jain said. “We think they are not worthy of the same graces that we all have.”


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