- Street medicine is a growing program and thanks to funding changes there are now more than 50 street med teams across the state, including several here locally.
- While these changes are small victories, those leading the charge worry that funding is still not sustainable to provide their patients with care for years.
- Video shows Dr. Matthew Beare and Clinica Sierra Vista Street Medicine team helping patients along the riverbed.
In the nine months since we first met Dr. Matthew Beare and the Clinica Sierra Vista Street Medicine team, they’ve grown to five teams locally and that’s just the start of the advancements for this program.
John has been a patient of Dr. Beare for two to three years now. He’s also been homeless during that time.
“It’s been hard, with getting kicked out and trying to take care," he said. "They got me into housing [but] my dog, he’s a little high-strung."
The street medicine team had helped John get into affordable housing, but he said his dog had an incident with another tenant, and rather than lose his pet, John lost his housing.
Dr. Beare and his team check in with John and their other patients along the riverbed every Thursday, not only proving medical care but food, clothes, hygiene kits and even more. While their team has been working for years now, the last nine months have been significant with street medicine as a program has caught the attention of legislators in the state and nationwide.
“What we were seeing before is that street medicine was usually started by some, you know, ragtag band of Robin Hood type, you know, medical providers who just saw this immense suffering on the street and had to do something," said Brett Feldman, director of USC’s Street Medicine Program.
Feldman first got involved in Pennsylvania in 2007 and has been instrumental in growing the program across California, including Bakersfield’s. When he first began working with Dr. Beare’s team, they were working solely on Clinica’s dime.
“They couldn't bill medical even though the majority of their patients were insured," Feldman said.
In 2021, legislators worked to pass a bill that would have helped reimburse street medicine teams but instead Governor Gavin Newsom sent the bill to DHCS to establish a system for street medicine providers to bill public and private insurers.
“For the patients who rely on it to survive. It's really a recognition for their to their right to life," said Feldman.
John said when he first met the street med team, he was on medication that involved taking several pills a day. He said Dr. Beare was able to prescribe him new medication that involved taking only a single pill.
"It’s probably a lot better on my kidneys," he said.
By allowing the providers to bill medical and medicaid of their services, Feldman said this opens opportunities for teams to expand and create more flexibility and consistency for their patients.
“That translates to other things, too. You know, they know someone's gonna check on their housing for them. You know, so often we meet people who have housing vouchers they didn't even know about, or they had vouchers that have expired," he said.
Feldman said in 2022 they conducted a survey across the state that showed there were 26 street medicine programs. They checked again this last summer and found there are now more that 50, with another two dozen in development. While these changes are a small victory for street med teams across the state, there’s still hurdles moving forward.
“Street medicine appears to be more costly, because you can't see as many patients because, I mean, simply there's it's complicated, but very simply, we have to go and find them. So that takes more time, but the rates are the same," Feldman said. "It has to be determined if we can sustain our programs on the current medical rates.”
Now, they’re working with Manage Medi-Cal to find more ways to continue to provide the healthcare services and stability for thousands of patients, including john.
“They provide a lot of stuff," he said. "Like I look forward to coming and drinking coffee in the morning and all the stuff they give you.”
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