A Tacoma program intended to provide healthcare services and resources to the unhoused is operational after a slow start, but the program is still months away from full capacity.
In October 2024, the Tacoma-Pierce County Health Department (TPCHD) and the City of Tacoma announced the Street Medicine Pilot Program — funded by a $1 million grant from the Washington State Health Care Authority.
According to an Oct. 22 news release announcing the program, the street-medicine teams would be composed of medical and behavioral health professionals, including a medical provider, a behavioral health professional and a community health worker.
“This program will bring crucial healthcare services directly to people living unsheltered,” the release stated. “The program will deploy specially trained Street Medicine Teams to provide care to individuals living in encampments, tent cities, vehicles, and other unsheltered locations.”
In May, program manager Bianca Shell told members of the Tacoma Pierce County Coalition to End Homelessness the program was still working to hire staff for the team.
At that time, the department reported the program, which promised to bring wrap-around clinical healthcare, behavioral health, and chronic condition treatment services directly to those experiencing homelessness, had distributed supplies primarily.
During the Tacoma City Council’s Community Vitality and Safety Committee meeting on July 10, the city and the health department gave an update on program operations.
Chantell Harmon Reed, director of public health for TPCHD, attributed some of the delays to full implementation of the street-medicine program to the “bureaucratic process” related to contracting.
Harmon Reed told the committee the program had launched a “full deployment” as of May 26. She described the “full deployment” as a cargo van full of supplies to distribute and a converted sprinter van serving as a medical-exam area.
“Leading into the May 26 date was also a process of gathering information,” she told the committee. “You have to build trust; you have to build name recognition; you have to build face recognition.”
Harmon Reed said the “full deployment” would be operational once a week until September as the street-medicine team tries to understand how it will regularly operate. By September, the street medicine team plans to do three “full deployments” a week before expanding to four a week after October.
“We have to figure out what makes sense for us in making sure that the services are appropriate, and our policies are appropriate, and we can have a true understanding of where do we go all across the city,” she said.
Harmon Reed said because of the nomadic nature of the unhoused population, it takes “strategy” to best serve them.
While the two vehicles are deployed once a week, a cargo van with a registered nurse and an outreach worker are operational two additional days a week to provide follow-up care.
Harmon Reed told the committee the street-medicine team aims to offer wound care, foot care, testing for sexually transmitted infections, HIV and Hep C, as well as treatment and referrals for opioid-use disorder and mental health.
Supplies the team has distributed and will distribute include food, hygiene kits, clothing, sleeping bags, sunscreen and bus passes for individuals to travel to treatment.
According to data shared by the program, the team made outreach contacts with roughly 80 people in April and May before contacting nearly 140 people in June.
Since April, the street-medicine team’s mobile nurse care has treated 30 wounds, six infections and made 18 referrals to primary care.
Since the program started, the team has reportedly served or supplied more than 760 people — with more than 530 hygiene kits and nearly 350 Naloxone kits distributed.
Harmon Reed said the program is developing relationships with partners to host clinic pop-ups in parking lots as well as service providers they can refer clients to.
Caleb Carbone is the homeless strategy, systems and services manager with the City of Tacoma’s Neighborhood and Community Services Department. Carbone told the committee the city is looking to secure additional funding from the state to be able to sustain and expand the street-medicine program.
Sally Perkins is a local homeless advocate who does volunteer street outreach in Tacoma’s Hilltop Neighborhood. Earlier this year, Perkins expressed frustrations with the slow roll-out of the program.
On July 10, Perkins provided public comment to the Community Vitality and Safety Committee, expressing some recommendations to the street-medicine team. Perkin’s suggested, among other things, that outreach workers should be able to call the team directly to get it to come to respond to a medically challenged homeless person as soon as possible.
“All of us already hand out supplies, volunteer street medics can do basic first aid,” she said. “It’s the more complicated situations that we need street medicine for, especially when the homeless person who is ill does not want us to call 911.”
In June, a panel of homeless-service providers in Pierce County sounded the alarm on the need for healthcare among those living unhoused.
On June 3, Jake Nau, the homeless outreach manager for St. Vincent DePaul, told Pierce County Council members at least 50% of the unhoused people he meets are either over 55 years of age or are experiencing a physical or mental disability they either were living with before becoming unhoused or have incurred through their experience living on the streets.
During the 2024 survey of those living unhoused in Pierce County, volunteers counted 2,661 people living unhoused in a single night. Of those surveyed, 25% reported having a chronic health condition, and 22% reported having a physical disability.
According to the U.S. Interagency Council on Homelessness (USICH), people who experience homelessness have an average life expectancy of around 50, almost 20 years lower than people who are housed. The Center for Disease Control states that people experiencing homelessness are at a greater risk of infectious and chronic illness, poor mental health and substance abuse.
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