L.A. Care invests $4M in street medicine to expand unhoused's access to care

L.A. Care Health Plan is investing $4.05 million in a street medicine initiative to expand access to care for unsheltered people.

Nine organizations offering street medicine services will each receive up to $500,000 from the health plan. The goal of the program is to beef up street medicine teams serving Los Angeles as well as help ensure people without stable housing do not drop off Medi-Cal amid Medicaid redeterminations. 

Among other services that will be provided through this initiative are enhanced care management, preventive screenings, vaccinations, screenings for severe mental illness and connections to housing and social services.

The funding comes from California’s Housing and Homelessness Incentive Program, a voluntary program for Medi-Cal managed care plans to make improvements in this area.

“L.A. Care’s Street Medicine Initiative will increase the number of street team members and services offered to the most vulnerable people in our communities, many of whom are L.A. Care members,” John Baackes, L.A. Care CEO, said in a press release. “A secondary purpose of this initiative is to assist people experiencing homelessness with their Medi-Cal applications. The last thing we want is for people to needlessly lose health coverage simply because there was no address to send their renewal packet.”

The nine organizations being awarded funding are: 

  • Department of Health Services, Los Angeles County
  • Healthcare in Action
  • JWCH Institute Inc.
  • Los Angeles Christian Health Centers
  • Northeast Valley Health Corporation
  • St. John’s Community Health
  • Special Service for Groups Inc.
  • The Children’s Clinic
  • Venice Family Clinic

Street medicine and housing initiatives live under L.A. Care Plan’s Community Health Department, also home to teams tackling social services and behavioral health. The latest initiative is relatively new for the plan, as is street medicine itself, Sameer Amin, M.D., chief medical officer of L.A. Care, told Fierce Healthcare. 

“Oftentimes when people lose their housing they’re no longer connected … to the clinic they were going to before,” Amin said. “Sometimes you have to bring the care to them.” 

“Street medicine as a concept is relatively simple,” Amin continued, “but operationally it’s actually very difficult.”

The teams need to coordinate not only among themselves but also with brick-and-mortar clinics at which unsheltered people may already be getting care. Street teams also need to consider the various resources they might need to serve different people, like vaccination or screening equipment for the elderly or children. They need to have a referral network in place, whether for social services or specialists, and they need to figure out how to share health information for purposes like billing, medication management and more.

On top of all that, it is crucial to keep the population enrolled in their health plan so they don’t get cut off from lifesaving health services. A significant number of the unhoused in the county are on the state Medicaid plan.

“You don’t want to layer disruption upon disruption upon disruption,” Amin said. 

L.A. Care—which serves more than 2.9 million members in Los Angeles County—is currently working with the state, street medicine providers and brick-and-mortar clinics to build out street medicine infrastructure in the county. The plan is also coordinating with other payers in the county to ensure efforts are not being duplicated, Amin said.

“This is a significant healthcare issue,” Amin said. “It’s incumbent upon us as a healthcare community to help them maintain their health as they're going through this.”