CalOptima Health’s street medicine program, where unhoused people get health care services right where they are, this month expanded and began serving Costa Mesa’s homeless population.
CalOptima, which runs the county’s health insurance programs that serve low-income people and the elderly, is partnering with Celebrating Life Community Health Center, which will administer the program out of a van staffed by medical personnel and packed with supplies.
“We know through health research that exists that preventive medicine is very important,” said Kelly Bruno-Nelson, the executive director of Medi-Cal/CalAIM for CalOptima. “The unhoused that are on the street are not receiving that type of preventive care.”
The goal is to get medical care to unhoused people where they are — health care workers will utilize the van to meet patients on the street — and take care of emergent needs that arise. CLCHC has an office in Costa Mesa that can provide more specialty care if needed, said CEO Sergey Sergeyev.
The hope is to eventually have 150 unhoused people enrolled and receiving regular medical care. And the program, which soft-launched on Aug. 12, also aims to provide case management and support to get people into permanent housing.
“Housing is health,” Bruno-Nelson said. “We can get people healthier on the street, but we can’t get them ultimately healthy unless we get them housed.”
Trust is a key element for the program to get unhoused people willing to receive medical care and other services. Alec Bradbury, a nurse practitioner who is a part of the Costa Mesa street medicine team, said they build that trust by listening to patients and having an open and accepting attitude.
“A lot of them won’t trust you right off the bat, and that’s OK,” Bradbury said. “But you still show face every once in a while. Slowly but surely a lot of these patients will warm up to you.”
Bradbury said many unhoused patients have likely been turned away from the medical system before based on their appearance or substance use. So, they’ve never been the chance to talk about who they are or express their needs, Bradbury said.
Bruno-Nelson said being unhoused in and of itself is traumatic, but many living on the streets have experienced other types of traumas.
“I can’t express how important (trust) is to the program,” Bruno-Nelson said. “If we just send a bunch of doctors out on the street in a van, we wouldn’t need to provide transportation because no one would get in it, because there would be no trust.”
Already, Bradbury said, the team has enrolled 28 people and given some physical exams. Several people who they’ve treated haven’t seen a medical professional in years or even decades, Bradbury said.
The street medicine team is staffed by a medical director, a licensed vocational nurse, a nurse practitioner, a social worker and three peer navigators. More peer navigators will be hired as the program enrolls more patients.
The van carries medical supplies for wound care. It has naloxone, an antidote for opioid overdoes, and fentanyl test strips to hand out to people who might need them.
Sergeyev said from his experience, the most common ailments they’ll treat include hypertension, diabetes, substance use disorder and sexually transmitted diseases.
“None of those, even a wound quite honestly, can be eradicated with one visit,” Bruno-Nelson said. “So they need ongoing care. They need a primary care physician that’s seeing somebody ongoing in order to make a difference with those diagnoses.”
The program is modeled for people to see a physician once a month and a peer navigator every two weeks, Bruno-Nelson said.
Costa Mesa is the second city in the county to get street medicine. CalOptima in April 2023 began the program in Garden Grove.
Bruno-Nelson said Garden Grove has 170 people enrolled in its street medicine program and to date has housed 15 people.
One advantage for Costa Mesa, Bruno-Nelson said, is the city already has a shelter in place. In Garden Grove, CalOptima bought a hotel and is in the process of making it a shelter.
The street medicine program is funded for 18 months in Costa Mesa. Once it’s enrolled enough people, it will be sustainable for CLCHC to run permanently since it can bill Medi-Cal for its services.
Street medicine is still expanding, too. On Sept. 3 it will soft launch in Anaheim.
Bruno-Nelson said many cities have contacted CalOptima expressing “tremendous interest” in having street medicine in their city.
Expansion will be up to CalOptima’s board of directors, but Bruno-Nelson said she predicts the health agency could consider approving expansion to more cities by the end of the year.
Sergeyev said street medicine has been proven to work.
“We are here to make a difference in the community,” Sergeyev said.
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