Public Health Update

Street Medicine San Joaquin

Engaging and Addressing Medical and Social Needs

DOREATIA HART, BSN, RN, PHN • BARB ALBERSON, MPH • MAGGIE PARK, MD

Background

Street Medicine began in the 1980’s as a health discipline to address the alarming rate of unmet health care needs on the streets. Street Medicine is a whole person care approach that provides health and social services that specifically address the unique needs and circumstances of the unsheltered homeless community. These services are delivered directly to them in their own environment utilizing a highly skilled multidisciplinary team. Visiting people in their own environment facilitates necessary relationships and trust building for a highly vulnerable and socially marginalized population. This practice has been shown to decrease overutilization of local emergency rooms and addresses illnesses/infections before reaching advanced stages. Through assertive, coordinated, and collaborative enhanced care management, Street Medicine can be the beginning process in achieving higher levels of medical, mental health, and social care. (Street Medicine Institute, 2023)

Street Medicine San Joaquin

San Joaquin County Public Health Services’ Whole Person Care Program, in collaboration with San Joaquin Health Centers and Behavioral Health Services, will launch Street Medicine San Joaquin in Spring 2023. Street Medicine San Joaquin will provide direct care on the streets to meet homeless unhoused individuals where they are in their own environment and on their own terms. Street Medicine San Joaquin will utilize the SJ Health Medical Mobile Unit “Moby” to assist with addressing health care priorities as well as social conditions that have an impact on health. In collaboration with San Joaquin Health Centers, Public Health, and Behavioral Health, street services will include medical care (urgent/primary), enhanced care management, navigation of social and support services, rapid syphilis and HIV testing, initial syphilis treatment, TB testing (blood draw), and health education. The program will start providing services in Stockton and will do a landscape study to identify the highest need areas across the county. Several days before an event takes place, Community Health Outreach Workers (CHOWs) from Whole Person Care and SJ Health will visit the area to identify what needs to be addressed by the Street Medicine team.

While considering the whole person when evaluating the need for care, the Street Medicine San Joaquin team will consist of a Nurse Practitioner, Medical Interns, Registered Nurses, Public Health Nurses, Social Workers, and Outreach Workers. The team will engage clients on a weekly basis in their environment, to ensure they are linked to medical services and social support as well as assistance with Medi-Cal enrollment. The team will also focus on assisting the clients with maintaining care and linkage to support services such as housing & shelter resources, assistance with obtaining an ID, food stamps, transportation assistance options, mental health support resources, etc., providing education around daily living activities, medication adherence, and crisis management. Engaging with individuals this often should promote relationship building and trust which will ultimately open up opportunities to empower and address immediate needs.

In response to the alarming opiod crisis here in San Joaquin County, Street Medicine San Joaquin will also be distributing Naloxone and providing education on its use with the goal of decreasing opiod overdose and death among the unhoused homeless community. Naloxone is an FDA-approved medication that can save a person’s life when administered during an opioid overdose. For Naloxone to be effective during an opiod overdose, it must be in the right hands at the right time and administered within minutes of life-threatening symptoms such as stopped or slowed breathing. Street Medicine San Joaquin will encourage and offer addiction resources as well as distribute Naloxone kits as needed within the community to bolster San Joaquin County Public Health Services’ efforts to combat the opiod crisis.

Street Medicine San Joaquin’s mission is to care for the whole person…bringing immediate mental and health care to the people!