Street Teams To Provide Health Care To Homeless San Diegans

Speaker 1: 00:00 People who are homeless, we'll now have a new resource for medical care on the streets today. Father Joe's villages is announcing its first street health program that meets people without a home directly where they are. Last year, 134 homeless people died in San Diego. That's up from 53 in 2010 Dr. Jeffrey Norris Medical Director of Father Joe's villages is joining us to talk about the program. Dr. Norris welcome. Thank you for having me. I really appreciate it and I'm happy to come talk about what we're doing. Absolutely. My understanding is that some of these medical teams have already been out on the streets working with the homeless. What kinds of health issues are you all seeing out there? So we see in those experiencing homelessness a lot of what you see in them, other populations, so diabetes, high blood pressure, uh, chronic obstructive pulmonary disease, so serious lung problems and, but we also see those issues in a much higher and much higher rates or what we call prevalence than in other communities and with much more severity. Speaker 1: 00:58 We also see a lot higher prevalence or rates of substance use disorders, alcohol use disorders, severe mental illness, um, and a lot of skin conditions, uh, staying, staying hygienic on the streets is difficult to say the least. And so people often end up with chronic wounds, uh, and various other skin ailments that are very important to treat to keep people healthy overall. And so what kind of treatment are you providing and how much are you able to do? So we right now are focused with our street health, uh, program on providing primary care in the streets to begin with. Um, our goal really is to meet people where they are and reach those folks that aren't consistently engaging with either outpatient healthcare services or social services. Uh, so these are individuals that have a serious health issues and generally just go to the hospital for their care end up in jail and prison, which is a not the way to provide consistent longterm care that's of high quality. Speaker 1: 01:59 Um, and it's also really expensive. So what we do right now is we go out and we try to find those folks and we meet them where we are to decrease barriers to care, uh, so that they can improve their health and also get better connected to the social service system and work on homelessness. That's really the ultimate goal here, is to not just address health, but address, uh, what's going on for them socially. So for now, right now, what we're focused on is primary care. And that's because, because this is a brand new program that's been here for about a month or uh, or so, and we've reached a couple dozen people. But the longterm vision is really to provide pretty comprehensive care, uh, via the streets. And that includes behavioral health, that includes psychiatry, that includes dental services longterm. Um, but the key is we have to get some money in some funding behind, uh, this program in order to make those other services happen. Speaker 1: 02:53 And Are you guys able to provide prescriptions, um, and preventative care? Absolutely. Absolutely. So if you talk to national experts in this area, uh, which is called street medicine and other cities, those experts argue that you can provide almost any service, uh, in the streets. I mean, there's some limitations obviously. Uh, you probably don't want to be doing gynecologic exams in the streets or you know, you can't do a colonoscopy in the street. Those sorts of things. There's some obvious limits, but in general, it really, you can provide pretty comprehensive care in the streets. The goal though is, is to engage with folks and get them to trust us and build rapport so that longterm, eventually they do come to a physical clinic. Do you engage in, in traditional healthcare services and are you guys going out every day? We're going out twice a week. Speaker 1: 03:40 Right now. We're going out on Mondays and Fridays. Um, and that's, uh, mostly due to funding limitations related to this program. We want to, uh, long term make this program a daily thing Monday through Friday, every day of the week. Do you ever encounter homeless people who just refuse medical treatment? Yeah, absolutely. There are folks who simply are not in a head space to engage with us. Whether that's because of lack of trust, bad experiences in the past, severe mental illness, substance or alcohol use disorders, um, or a mix of all of those things together. Um, and sometimes in those situations, even if we can't provide a true healthcare service, the goal is really to make a connection with the individual. And if that connection allows us to say, hey, we're going to be back out next week, would you be willing to talk to us next week? And if the answer is yes, then that's a win. Speaker 1: 04:32 In those situations. Is this all part of a, a new, larger regional approach to providing healthcare services to homeless individuals where they are? Absolutely. I see this as connecting to a variety of programs that are in various stages of implementation. Things like a health homes, which is a new case management program. Um, an effort to have a more streamlined approach to getting folks off the streets and into housing interventions in a variety of other programs. So this definitely fits in as part of a larger system of care. Um, rather than just an isolated siloed program by itself. And we saw vaccination foot teams out on the streets during the hepatitis a outbreak, which disproportionately affected homeless people. How is this program different from other programs that serve people on the streets? So I think the key here is we actually have clinicians who can prescribe medications, um, and do therapy for instance, or provide our goal longterm, as I stated, would be to get psychiatrists even out on the streets. Speaker 1: 05:31 Uh, that's the difference here is we're really delivering more comprehensive health care. This isn't just an outreach team going out and engaging with folks. It's true healthcare that that's what the difference here and similar programs have been used in other cities with large homeless populations for years. Why has it taken so long to implement this program here in San Diego? I think there's a variety of reasons for that. I think that certainly funding is one piece of it. Uh, there just hasn't been a consistent effort by any nonprofit agency or others to create a long term program. And then get the funding behind it to keep it going. Um, and then I think that the second piece of it is that over the last four or five years, San Diego is really, really owned homelessness as an issue. That is something we as a community have to take on. And so there's really a reflection on what services do we provide, where are the service gaps, and how can we do better? And so I think this is a part of this new wave of energy to, to own this issue and work on it more aggressively. I've been speaking with Dr. Jeffrey Norris, medical director of Father Joe's village is Dr. Norris. Thank you so much for joining us. Thank you. I appreciate it. Speaker 2: 06:42 [inaudible] Speaker 3: 06:47 [inaudible].