The Dorothy Rider Pool Health Care Trust

LVHN Street Medicine Program Provides Health Care for the Homeless

You may be used to seeing homeless residents in large cities and urban areas  – standing on street corners, sleeping on church steps, or lined up at soup kitchens. But in the Lehigh Valley the homeless are often not as easy to spot. They are living in hidden camps, under bridges, and out of sight. It’s easy to assume that our region doesn’t have a homeless epidemic of its own to deal with, but that’s not the case at all.

“About a decade ago, DeSales University in Center Valley started a free clinic at the Allentown Rescue Mission for its Physician Assistant (P.A.) program in order to give the students hands-on experience,” explained Brett Feldman, P.A., Lehigh Valley Health Network (LVHN). “While we saw many homeless men there, we knew from what we were told that there were that many more men, and also women and children, living at camps around the region who would not come to the free clinic. So we decided to take the medical care to them one day a week.”

In early October 2012, Feldman and his wife Corinne, also a P.A., began working with Bob Rapp of Hope for Veterans who had developed a street guide of camp locations and other places the homeless would frequent, including bus shelters and Laundromats. Along with other medical volunteers, they would take free medications into the community and perform medical evaluations. Rapp would make introductions and ask homeless people to refer Brett and his team to others who they knew to be in need of medical assistance. Common issues include wound care, frostbite in winter months, Chronic Obstructive Pulmonary Disease (COPD), diabetes, and hypertension, among other illnesses.

“While the DeSales Physicians Assistant Program does not partner with Street Medicine in an official capacity, it functions as an immediate resource of medical support to the Street Medicine patients that otherwise would need to visit a primary care physician, which they often do not have access to, or the Emergency Department, when issues arise,” explained Jim Byrnes, CEO of The Allentown Rescue Mission.

“The access the Street Medicine patients have to the DeSales Free Clinic ensures excellent turnaround time and communication between Street Medicine, Mission staff, and the Clinic as its in-house location, which lends itself to better documentation and communication to the Street Medicine team that visits shelter guests at least once a week at the Mission,” Byrnes said.

Establishing Trust in Order to Provide Care

“It’s not easy for homeless people to trust others,” explained Feldman. “They have many reasons to distrust strangers. One of the things I am most proud of is the level of trust we’ve established over the years with these individuals. Getting referrals from our patients so that we can treat other homeless people in our community is the best feeling. It’s trust that has allowed us to serve 2,000 homeless patients in the past two years. This is critical because they are a segment of the population that can’t access the heath care systems like the rest of us can. Our Street Medicine team members might be the only people they know who aren’t homeless.”

“The LVHN Street Medicine Program is their primary source of care,” Feldman said. “We provide medications, take blood samples, treat them for their illnesses and diseases. We track our visits with them in the health network’s EPIC database. When additional testing is needed, the Street Medicine Clinical Coordinator will go along with them to the appointment to advocate for them. Any procedure or test costs not covered by Medicaid is often covered by philanthropic donations to the Street Medicine Program.”

“We’ve even started bringing along a laptop with Internet access and assisting them with signing up for Medicaid so they have health insurance,” Feldman said. “In many cases legal identification has been lost, so we’ve assisted them with acquiring that so they can apply for Medicaid.”

What’s Next for Street Medicine

Support from The Dorothy Rider Pool Health Care Trust and a grant from the Pennsylvania Department of Health has allowed Feldman to do this work full-time for the past three years, which allows him to focus his attention on his mission.

He has a five-year plan for the program that includes the development of a Respite Care site. It’s an in-between location where homeless individuals who have received medical procedures or surgeries can go to recoup once they are well enough to leave the hospital, but not yet strong enough to return to living on the street.

About a year ago, the Allentown Rescue Mission began a test pilot program to be the Respite Care site for Street Medicine’s discharged patients.

“The Rescue Mission sets aside four beds exclusively for Street Medicine patients enrolled in the Respite Care element of our transitional housing programming,” said Byrnes. “During their stay, guests receive basic case management support, free room and board, three free meals a day, and clothing as needed for the duration of their prescribed stay with us.”

The program will also need more health care practitioners to meet the community’s need in the coming years, including mental health providers. Fundraising efforts will continue to help make these goals a reality.

“If there is anything I’ve learned from doing this it’s that things can grow into something bigger than you think they will ever be, so don’t think small,” remarked Feldman.

International Street Medicine Symposium

Later this week Feldman will bring the 13th Annual International Street Medicine Symposium to the Lehigh Valley for the first time. During its three days at the Renaissance Allentown downtown, more than 450 medical professionals who are either already working with the homeless, or who are hoping to start a Street Medicine practice, will gather to share ideas, and learn from each other. “One-third of symposium attendees will come from the tri-state area, with another third coming from the rest of the country, and the remaining third coming from around the world.”

“Medical practitioners who are new to Street Medicine can attend a Street Medicine 101 seminar on how to get started and find funding for their program,” Feldman said. “There will also be a host city spotlight featuring me and other community representatives talking about our own program. Breakout sessions will cover topics like risk management, how to measure value, and sex trafficking. Speakers will come from around the world to present on topics from which everyone can learn.”

The Symposium is the world’s premier educational event dedicated to the health care of the unsheltered homeless populations. It will offer a slate of homeless health care experts from around the globe presenting clinical topics, innovations, research outcomes, and best practices relevant to Street Medicine.

Edward F. Meehan, MPH, Executive Director of The Dorothy Rider Pool Health Care Trust, noted, “The Pool Trust is proud to support the innovative work targeting the very complex issue of homelessness. The Trust looks forward to having the 13th Annual International Street Medicine Symposium in the Lehigh Valley, an event which will bring together leading experts in the field from around the world to enhance current efforts.”

Note: This article is one in a series of four dealing with homelessness in the Lehigh Valley. Please read our other articles on adult homelessness, children and youth homelessness, and the state of affordable housing in the Lehigh Valley.