A nonprofit has partnered with a for-profit managed care company to offer a broad range of services and track patients
“Anybody home?” physician assistant Teagan Flint asks outside a tent on F Street in downtown San Diego.
and trying to take a managed-care approach in terms of efficiency,” said Dr. Michael Hochman, who is based in Los Angeles County and leading the teams there and in other places as the program expands. “We’re thinking about an assigned panel of patients and applying that to street medicine.” ... physical conditions are under better control, that’s when the patient is better able to get a home.”
“We’ve had dozens of patients who have started on medications to help block or address substance abuse, and we’ve given them counseling,” Hochman said about the overall program, including patients in Los Angeles County. “Many have gotten enrolled in AA and Narcotics Anonymous. We’ve had close to 20 who have gone to rehab programs.
Hochman said Molina saw a need for a street medicine team in San Diego and provided a grant to start the local team. The company’s funding for the program came from the state’s new California Advancing and Innovating Medi-Cal, or CalAIM program, a transformation of Medi-Cal that is focused on homeless people and other at-risk groups. The program has a focus on prevention and requires plans to pay for care that is more accessible, proactive, transparent and culturally competent.
“I think it’s about kind of showing that they can deliver, and that’s true for all of the plans,” Simon said. About three-quarters of people on the street already are on Medi-Cal, and the San Diego team has almost 100 patients signed up with a goal of 400, Hochman said. Under state law, the only people not eligible for Medi-Cal are undocumented individuals ages 27 to 49.
While Goettsch began the process of enlisting McDaniel as a patient, another team member bandaged a leg wound on another person who had just walked up. Across the street, several people from encampments approached the white Healthcare in Action van with questions, and soon the vehicle was a sort of mobile MASH unit.
Hochman said street medicine teams that work out of the University of Southern California have about a 50 percent success rate of connecting with their patients after they are discharged from a hospital, and Healthcare in Action hopes to do better with the tracking devices. The teams also are making connections at hospitals so they can be alerted when a patient they are treating is hospitalized or discharged.
Hochman said many of the team’s clients have heart disease, about half have a serious mental illness and half have active substance abuse. Patients with mental issues are connected with a psychiatrist who speaks with them remotely, which Hochman said has proven to be the most effective method.