Recently, we asked 100 homeless people at a feeding project in downtown Tucson, Arizona a simple question: "Would our healthcare system rather serve a housed person or a homeless person?"

 

100 out of 100 homeless people surveyed -- after they stopped laughing -- answered "housed."

 

We're sure this sobering fact comes as no surprise to you as well. However, the consequences of this perceived bias are unfortunate and dramatic:

     • Because of how the homeless are treated by the healthcare system, they wait until they are very, very sick before they seek help.

     • Because they wait so long, there is one, logical place to go when they finally go for care: our already overcrowded emergency departments.

     • Because the homeless have a dramatically higher rate of traumatic injuries (frequently from assault), they often need a higher level of care than a housed patient.

     • And because homeless persons have a much poorer health status than the housed population, they spend multiple nights in intensive and critical care units at a rate far exceeding the rate of the housed population.

 

This is a community health care emergency: a community health care emergency that is threatening the very existence of many hospitals.

 

One possible (and admittedly partial) solution? Street-based medical volunteers — RNs coupled with an EMR/EMT — overseen by a team of compassionate volunteer MDs. The goal? To develop relationships with the homeless on the street which allow early assessment, early referral, and -- consequently -- early care of their medical problems.

 

We call these volunteers CCHS: Certified Community Health Specialists