HOMELESSNESS IS A PROBLEM WITH MANY heads—cut one off, and another takes its place. Unaffordable housing, food insecurity, and insufficient access to healthcare are all major obstacles to those experiencing homelessness. But while there might not be a one-size-fits-all solution, there are still many ways to relieve the suffering of those without housing.
Take, for example, healthcare. It can be difficult enough for the average person to manage the high cost, fragmented care, and administrative complexity of the healthcare system. For someone experiencing homelessness, these barriers can become insurmountable. One organization that has made its mission to provide direct-in-community healthcare to unhoused adults and children is the UCLA Health Homeless Healthcare Collaborative. Operating in Downtown L.A., South and West Los Angeles, and North Hollywood, the HHC travels directly to people experiencing homelessness to provide access to much-needed help.
“We aim to provide people in the streets and shelters with the same high-quality care that UCLA Health is known for in its hospitals and clinics,” said Brian Zunner-Keating, RN, director of the UCLA Health Homeless Healthcare Collaborative. This care encompasses a range of treatments and support, including medical screenings, whole family primary care, psychiatric care and mental health services, and housing and social service referrals.
The Homeless Healthcare Collaborative is hardly the first group to provide healthcare to the unhoused. But it’s the unique focus on building trust and relationships with members of the unhoused community that enables it to efficiently address patients’ needs. “We try to keep in mind our trauma-informed approach and a lot of cultural humility as well,” says Zunner-Keating, “because unlike traditional healthcare settings, we as the healthcare providers are actually guests in our patients’ community.”
Stigma, discrimination, and cultural barriers have caused many unhoused individuals to lose trust in healthcare providers. In order to overcome that, the HHC partners with other organizations already familiar in communities with large numbers of unhoused people.
“Our community partnerships are one of the foundations of our program,” Zunner-Keating said. “We’ve also recently onboarded community health workers as part of our teams. They’re folks who have any mix of lived experience of homelessness themselves, or have had a lot of experience working with homeless services. They know the communities very well, and also know culturally very specific ways to approach and engage with folks.”
When it launched in January 2022, the HHC consisted of two specially equipped mobile health vans. Since then, a $25.3 million CalAIM grant and a $592,000 grant from a federal funding program have helped the HHC add four more vans and expand services to include specialty care and an enhanced care management program.
The results have been promising. In the first year of operation, the HHC completed over 9,000 patient encounters. Its efforts led to a 7% reduction in unhoused patients visiting the UCLA Health emergency departments, as well as a 32% reduction in repeat ED visits by high-risk patients seen by its team.
This not only reduces the strain on an already burdened healthcare system — a particular concern as COVID continues to exert its effect on the system — but also treats the problem at its root. Access to preventive care reduces the number of preventable ailments that so commonly spiral out of control and lead to serious illness and hospital- ization. If patients can address their issues early, the whole system benefits.
Improved healthcare will not solve every dimension of homelessness, but feeling better and living healthier represent fundamental steps toward regaining stability. As Los Angeles grapples with the issue, any evidence of progress is welcome.
