Philadelphia, PA - Department of Human Services (DHS) Secretary Dr. Val Arkoosh today visited Project HOME to discuss a recent change in Medicaid that allows certain enrolled medical providers to meet with unhoused patients covered through Medicaid and provide care outside a clinical setting– a practice known as street medicine. DHS announced the initial Medicaid expansion in July 2023 and is now furthering the reach of street medicine programs by adding more eligible providers that can now render street medicine services through Medicaid. By allowing more specialties and providers to bill for services rendered during visits with people experiencing homelessness, DHS aims to increase access to care for Medicaid beneficiaries and improve health outcomes.
“All Pennsylvanians deserve access to high quality, compassionate health care that meets them where they are to provide support as they work through barriers to good health and a better quality of life,” said Secretary Arkoosh. “People experiencing homelessness can have complex needs and oftentimes limited access to medical providers outside of an emergency room setting. This expansion of eligible providers recognizes the value of street medicine practices and helps break down barriers to care by allowing more medical providers to treat people where they are.”
Effective October 1, 2023, DHS has expanded the types of providers eligible to practice and bill for street medicine in Medicaid to include dentists, federally qualified health centers, rural health clinics, Centers of Excellence for opioid use disorders, peer support services, family based mental health services, mental health crisis intervention services, mental health targeted case management, substance use disorder services, intensive behavioral health services, podiatrists, and tobacco cessation providers.
The initial option for providers to offer and bill Medicaid for street medicine services included Medicaid-enrolled physicians, certified nurse midwives, certified registered nurse practitioners, physician assistants, psychologists, and mobile mental health treatment providers. Pennsylvania was recently recognized as an early adopter of the use of street medicine.
Project HOME’s Epstein Street Medicine program provides point-of-contact medical care to individuals experiencing homelessness in Philadelphia, with a focus on those living outside.
Through holistic, person-centered, trauma-informed care delivered through a harm-reduction lens, the team aims to improve medical outcomes and enhance access to healthcare and support services. The Street Medicine team partners with Project HOME’s Street Outreach Team and provides medical services and establishes trusts with individuals experiencing homelessness where they live.
“As the name of our program suggests, so much of what we do begins, like Project HOME’s roots, on the street. Many people look at Kensington and they see hopelessness. The people we treat see that, and more importantly, they feel it. We don’t see hopelessness and I know the partners who helped to make Inn of Amazing Mercy a reality, don’t see hopelessness, either. We don’t see patients, we see people. We see people who need to know that they are not alone, and they are not forgotten,” said Kara Cohen, Project HOME’s Assistant Medical Director.
Investments in street medicine provide life-saving health care while also building trust within one of Pennsylvania’s most vulnerable populations. People experiencing homelessness in the United States die, on average, three decades earlier than their peers with housing most commonly due to preventable and treatable chronic medical conditions, such as diabetes, high blood pressure, asthma, and others. These visits provide a direct intervention with a high potential impact on health and wellbeing that will also divert people from costly visits to frequently overwhelmed emergency rooms. Services include but are not limited to primary care, vaccine administration, wound care, preventive services, counseling, medication-assisted treatment for opioid use disorder, and diagnostic services, rapid COVID-19 and flu testing, and more.
Additional resources for individuals experiencing homelessness available through DHS can be found through the Homeless Assistance Program, and more information about other assistance programs administered by DHS is available at www.dhs.pa.gov.
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