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Fading Out: Aging and Beyond RSS feed

Street Medicine: Health care for the homeless

State of Homelessness (map, National Alliance to End Homelessness) Click on your state to view detailed information on homeless statistics, bed inventory, and system capacity. Read the report, including Key Facts

 

Key Findings from the Point-in-Time Counts (Fact Sheet: 2023 Annual Homelessness Assessment Report, U.S. Dept. of Housing and Urban Development, 12-1-23)

   "At a point in time at the end of January 2023, 653,104 people – or about 20 of every 10,000 people in the United States – experienced homelessness across the United States. This is the highest number of people counted and reported as experiencing homelessness on a single night since reporting began in 2007. Unlike in the past where a single population drove the change, this year’s increases were across all populations. While the upward trend in unsheltered homelessness began several years ago, these increases were exacerbated in recent years as the COVID-19 pandemic, an opioid epidemic, and a nationwide affordable housing crisis conspired to make attaining and maintaining housing increasingly difficult for many low-income households. Increases in sheltered homelessness, particularly increases among families, reflect recent contextual issues such as the expiration of pandemic-era eviction moratoria and income protections, expansion of shelter capacity based on new pandemic-related resources and the easing of pandemic-related restrictions on shelter capacity."


Why it’s so hard to end homelessness in America (Alvin Powell, Harvard Gazette, 1-24-24) Experts cite complexity of problem, which is rooted in poverty, lack of affordable housing but includes medical, psychiatric, substance-use issues.


Which States Have The Best Homelessness Assistance Programs (Nick VinZant, QuoteWizard, Insurance News)
"Key findings in 2021:
~Colorado ranked the top state in the nation for housing assistance from 2018 to 2019.
~Connecticut saw a 23.6% decline in homelessness from 2018 to 2019.
~In 2019, it was estimated that nearly 568,000 were experiencing homelessness.
~As of November 2020, 10.74 million Americans are unemployed.
~Mississippi, Louisiana and Alabama all had the lowest counts of total homeless per 10K in 2019.
~New York, Hawaii and California have the most homeless per 10K."


Housing crisis is the 'canary in the coal mine' (Eleanor Black, Newsroom, New Zealand, 4-21-21)New Zealand needs to change its approach to housing completely, and treat it as a public right, like health and education, says property developer Mark Todd. Sitting with a coffee at Mt Albert’s Taco Loco, he gestures towards Ockham’s Modal building across the road – 32 thoughtfully-designed rental apartments on just 680 square metres, with a shared residents’ lounge and balcony, indoor bike storage, easy access to public transport, efficient hot water system and a music room.

 

Homelessness Statistics (National Alliance to End Homelessness)
National Coalition for the Homeless
Healthcare for the Homeless Suitcase Clinic (Facebook page)
---Suitcase Clinic, James Madison University (Harrisonburg, Virginia 22807)
---Homelessness is a Healthcare Issue: New Medical Group Will Treat Southern California Homeless Seniors


NEXT: Next Generation Military and Veterans Healthcare Systems (America Conference Institute press release, 2023) 

    ‘This is street medicine wrapped in the framework of managed care’     "With the population of unhoused individuals in California soaring to more than 161,000, SCAN Group, whose holdings include SCAN Health Plan, one of the nation’s largest not-for-profit Medicare Advantage plans, is launching Healthcare in Action, a new medical group that will provide healthcare and other services to individuals experiencing homelessness."
Homeless encampment cleanups do little to change numbers of people on the street, study finds (Doug Smith,LA Times, 7-24-24) Homeless encampment cleanups including Mayor Karen Bass’ Inside Safe program that moves people into motels and hotels have no long-term effect on the number of people living on the streets, a new study by RAND Center on Housing and Homelessness has found
Supreme Court rules cities may enforce laws against homeless encampments (David G. Savage, LA Times, 6-28-24) The Supreme Court ruled Friday that cities in California and the West may enforce laws restricting homeless encampments on sidewalks and other public property. In a 6-3 decision, the justices disagreed with the 9th Circuit Court in San Francisco and ruled that it is not “cruel and unusual” punishment for city officials to forbid homeless people from sleeping on the streets or in parks.
---Will the Grants Pass ruling on homelessness spur smaller cities to shoo people into L.A.? (David Zahniser and Doug Smith, LA Times, 7-7-24) When the U.S. Supreme Court issued its landmark ruling on anti-camping laws last month, Pasadena Mayor Victor Gordo was one of the local political leaders who welcomed it. The high court concluded that laws penalizing homeless people for sleeping or pitching tents in public spaces do not constitute cruel and unusual punishment. That means cities can clear homeless encampments from parks, sidewalks and other areas even when they lack sufficient shelter beds.
“Hollywood 2.0” An innovative treatment team approach combining outpatient and intensive field services, in partnership with the community that center around an individual’s needs. "It starts with connection and ends with a neighbor living a safer, more meaningful life.

A California Medical Group Treats Only Homeless Patients — And Makes Money Doing It (Angela Hart, KFF Health News and Orange County Register, 7-19-24) Doctors, nurses, and social workers are fanning out on the streets of Los Angeles to provide health care and social services to homeless people — foot soldiers of a new business model taking root in communities around California.
   Their strategy: Build trust with homeless people to deliver medicine wherever they are — and make money doing it.
   They distribute GPS devices so they can track their homeless patients. They stock their street kits with glass pipes used to smoke meth, crack, or fentanyl. They keep company credit cards on hand in case a patient needs emergency food or water, or an Uber ride to the doctor.
   Healthcare in Action and SCAN’s Medicare Advantage insurance plan generate revenue by serving homeless patients in multiple ways:
---Both are tapping into billions of dollars in Medicaid money that states and the federal government are spending to treat homeless people in the field and to provide new social services like housing and food assistance.
---For instance, Healthcare in Action has received $3.8 million from Newsom’s $12 billion Medicaid initiative called CalAIM, which allows it to hire social workers, doctors, and providers for street medicine teams, according to the state.
---It also contracts with health insurers, including L.A. Care and Molina Healthcare in Southern California, to identify housing for homeless patients, negotiate with landlords, and provide financial help such as covering security deposits.
---Healthcare in Action collects charitable donations from some hospitals and insurers, including CalOptima in Orange County and its own Medicare Advantage plan, SCAN Health Plan.
---Healthcare in Action partners with cities and hospitals to provide treatment and services. In 2022, it kicked off a contract with Cedars-Sinai to care for patients milling outside the hospital.
---It also enrolls eligible homeless patients into SCAN Health Plan because many low-income, older people qualify for both Medicaid and Medicare coverage. The plan had revenue of $4.9 billion in 2023, up from $3.5 billion in 2021. "#1 in Member Satisfaction among Medicare Advantage Plans in California"


United States Interagency Council on Homelessness
Geriatrics and Extended Care (Veterans Administration)
---Community Resources, Geriatrics and Extended Care (Veterans Administration's useful links).

 

More to come, I'm sure. -- Pat McNees

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