Medical outreach extended to Modesto’s homeless
A street medicine team that helps homeless people like Dana Chavez of Modesto is funded through December and beyond.
Golden Valley Health Centers began the medical outreach a year ago through a $157,000 grant from Sutter Health. Launched in May 2018, the one-year pilot program took basic health care to the homeless in Modesto, Turlock, Patterson and Los Banos.
Sutter has extended the funding and hopes to continue with its participation in future years, as part of a trend of taking health care out of office settings to where people need it the most, said Kelly Brenk, community health manager for Sutter Health. It partners with Golden Valley Health Centers in the program.
Tuesday, Chavez received care at Modesto’s outdoor emergency shelter from Golden Valley nurse Hortensia Maldonado. Chavez, who suffers from diabetes, has open sores on a swollen left leg infected with cellulitis.
“She does a good job with my wraps,” Chavez said. “I can’t change them all the time.”
In the first year of the program, the team consisting of a medical van, nurse and outreach staff found that many homeless need treatment for infected sores and wounds, said Lise Talbott, director of clinical education and outreach for Golden Valley.
While living outdoors, they get sores on their feet from walking around or accidentally cut their hands, and it’s difficult to keep the wounds clean. “We had expected to do more chronic disease management,” Talbott pointed out.
The minivan will soon offer HIV testing, and Golden Valley is looking into providing pregnancy tests, after receiving a number of requests for that service, Talbott said.
In the first year, the street team made about 3,000 contacts with the homeless and performed 470 health assessments. The program is part of a $56 million investment made by Sacramento-based Sutter in charity care for the underserved, unreimbursed Medi-Cal costs and other community benefits, including $1.1 million for community partnerships that improve lives in Stanislaus County.
Maldonado leads the street team to homeless camps, checking blood pressure and glucose levels for adults. The outreach team encourages people to make appointments and get established with health care providers at clinics.
“It’s not hard to set up appointments, but it’s much harder to get them to keep appointments,” Maldonado said. To reduce the number of no-shows, she’s starting to use a calendar to write down dates and remind patients to keep appointments, she said.
“We really are trying to assess people and see if they need medical treatment right away,” Talbott said.
Maldonado worked for a nursing home before taking the homeless outreach job with Golden Valley. She drove her own car to encampments before the minivan was purchased last year. There was no prior training and Maldonado set up most of what the program does.
She finds that blood sugars are higher among the homeless, possibly because of high-carbohydrate food served in shelters.
In the winter, the van brings socks, blankets and hygiene kits to homeless camps. “We just try to do things to help people heal and feel better,” Talbott said.
Stanislaus County public health has taken measures to prevent contagious diseases in homeless camps. In October, county health services dispensed 113 flu shots and 105 hepatitis vaccinations at events at Beard Brook Park and in Turlock. Starting in February, hundreds of people moved from the Beard Brook tent city to the outdoor emergency shelter under the Ninth Street Bridge.
Counties in Southern California were struck with hepatitis A outbreaks in homeless populations in the past two years. Stanislaus County has not seen an increase in hepatitis A cases, and health officials are trying to keep it that way.
Besides hepatitis A, people who are homeless are more vulnerable to influenza, strep throat, sexually transmitted diseases and tuberculosis.
Health teams that work with the homeless always expect to see hepatitis C, a viral disease of the liver that may be linked to injection drug use, Brenk of Sutter said.
Chavez said she was sick and living in her vehicle at Beard Brook Park when she first met Maldonado. Chavez had come out of the hospital to discover that she had lost her rental dwelling. She rapped on her car window when she saw the nurse walk up.
Chavez, who sat in a wheelchair Tuesday, said outreach workers were trying to get her into housing. It’s what Maldonado most likes to hear from the homeless people on her rounds.
“People say they just got placed in housing and just need to see a primary care doctor,” Maldonado said. “They move out of the tents with their luggage and bikes. They stabilize their lives.”