The MediCal program that provides health insurance to one in three Californians, 15 million, now includes social services focused on the health of people at risk of becoming homeless or already homeless.
During the video conference: How MediCal is providing health care to homeless Californiansorganized by Ethnic Media Services, Health workers, community providers, and officials from the California Department of Health Care Services shared how MediCal will help Californians experiencing homelessness and housing instability.
The MediCal Transformation
Glenn Tsang, homelessness and housing policy advisor for the California Department of Health Care Services, said MediCal’s transformation has played a crucial role in meeting the health needs of those at risk of homelessness.
“We’re talking about bringing services to our members and meeting them where they are in their lives, whether it’s a shelter or a camp; and we do it through community networks that best understand their needs and have created a relationship of trust.”
Tsang said Enhanced Care Management Community Supports are a new beneficiary launched in 2022 to offer connection to emergency shelters, transitional housing, and improve medical and behavioral health care.
“Our homeless population has inadequate access to shelters, lack of food and care.”
She added that communities of color are disproportionately impacted by homelessness in California and nationally.
“So improved care is a critical tool for achieving racial health equity.”
Community Supports
He stated that homeless people frequently receive health care in the emergency room, hence housing services have been available under Community Supports, some of them specific for the homeless population.
“This is a housing transition navigation service that provides assistance with housing searches, applications and communicating with landlords.”
They also advise them so that they have support with financial assistance to cover deposits and other barriers to obtaining a housing unit; and offer housing options for homeless people who are discharged from a hospital and need a stable environment for recovery.
Transition income
He clarified that they are not covered by Medicare, but they have made a request to their federal partners at the Centers for Medicare and Medicaid Services to cover six months of rent for members who are making very critical and impactful transitions from settings such as hospitals, jails, prisons and emergency rooms.
He added that people between the ages of 26 and 40 who, as of January of this year, qualify to receive full MediCal, regardless of their immigration status, are eligible for Enhanced Care Management (ECM), the new benefit that offers services to members with complex needs that make it difficult to improve their health, such as homelessness.
Amber Middleton, director of the HOPE program at the Shasta Community Health Center in upstate, revealed that they have been providing health care to the homeless population for 20 years.
“Our program has a mobile medical component that is known to homeless people; and we have a street medicine program, through which we served 651 people in 2023. Since 2020, we have operated a medical relief program that when it became a community support service, we transitioned funding; and then we also operate a clinic at our local homeless shelter.”
He stressed that ECM’s entire focus is to go to the population, not wait for things to get very bad for them to seek services.
“Those who work in health care for the homeless will understand that sometimes things as basic as a walker, a wheelchair, or access to oxygen are denied to them solely based on their housing status.”
He showed that a health care administration coordinator works alongside the patient to care, advocate and break down systematic barriers.
street medicine
Brian Zunner-Keating, director of the UCLA Homeless Healthcare Collaborative, said since they were created they have provided more than 9,000 clinical assessments to nearly 5,000 people.
“Our program brings doctors, nurses, social workers and psychiatrists directly to the homeless population in our community who need medical care.”
He said they depend on allied organizations and also employ community health workers who are the bridge to the community.
“These are the individuals who help us find people on the streets who need care. And then we bring our teams of medical professionals, medical supplies, case managers and even prescription medications directly to people suffering on the streets.”
In particular, he said this is helpful for those who cannot attend a clinic for various reasons.
“As you might expect, not everyone is willing to accept our care right away. “We rely on the community health workers who are part of our team to help us make that connection.”
She noted that her community health workers are people who have some kind of lived experience related to homelessness or perhaps substance abuse in their family or mental illness in their family, or people who come from and grew up in the neighborhoods they serve. that serve.
“If they are not ready to accept our services, the best thing we can do is say hello and give them a warm smile, and we will always offer them water maybe some snack and hygiene kit. After a few weeks, they may begin to talk about their needs. “Usually we can’t just walk up to someone and say, ‘Do you need to see a doctor?'”
