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Some of California鈥檚 most prized rivers, bays, beaches and streams are contaminated with levels of fecal bacteria that exceed state limits, threatening human health. While aging sewage infrastructure is largely to blame, homeless encampments are also a probable source of contamination.
"Street medicine" programs seek out people living in back alleys and under highways. It鈥檚 a public health approach designed to build trust and eventually connect homeless patients to other services.
Denver is considering adopting a new 911 alternative used in Eugene, Ore., that allows mental health and medical professionals, not police officers, to respond to some emergency calls, saving money and de-escalating situations with mentally ill people.
Hospital systems now invest in housing to help some of their most frequent patients. This allows them to safely discharge patients who otherwise would have no place to go, freeing up beds for sicker patients and saving the hospitals money.
A large public hospital in Los Angeles gets over 1,000 unidentified patients a year. Most are quickly identified, but some require considerable gumshoe work 鈥 a task that can be complicated by medical privacy laws.
Deaths of homeless people in Los Angeles County have jumped 76% in the past five years, outpacing the growth of the homeless population, according to a Kaiser Health News analysis of the coroner鈥檚 data. Experts say drug and alcohol abuse are significant factors.
California hospitals must comply with a new state law that requires them to try to find a safe place for homeless patients upon discharge. But hospitals say doing so isn鈥檛 as easy as calling a shelter and securing a cot.
Homeless patients accounted for about 100,000 visits to California hospitals in 2017, marking a 28% increase from just two years earlier. Health officials attribute the surge to the overall rise in California鈥檚 homeless numbers and the large proportion of people living on the streets with mental illness.
Outbreaks of infectious diseases such as typhus and hepatitis A are resurging in California and around the country, particularly among homeless populations. Public health officials warn that such diseases could spread broadly.
The dialysis industry raised nearly $111 million in a successful bid to defeat the measure, which also was opposed by hospitals and doctors. The union that sponsored the measure collected about one-sixth that amount.
New programs, known as ACOs, reward hospitals and physician groups that hold down costs by keeping enrollees healthy. The health care providers are asked to address social issues 鈥 such as homelessness, lack of transportation and poor nutrition 鈥 that can cause and exacerbate health problems.
They say it will help reduce unnecessary ER visits and ensure better follow-up care. It鈥檚 also good P.R., and helps them meet their obligations to provide benefits to the community in exchange for significant tax breaks.
A Medicaid-funded effort in San Antonio seeks to test vulnerable populations for latent TB infections.
California lawmakers consider a bill to use state money to help homeless Medi-Cal patients pay rent 鈥 shifting their focus from sheer survival to wellness. The move could save taxpayers millions, advocates say.
A Seattle program pioneers palliative care that reaches dying patients on streets and in shelters.
Pilot projects are being launched in 18 counties to reduce ER visits among Medi-Cal's most costly patients.
HHS awarded $156 million to 420 health centers around the country in the first grants ever specifically geared to dental care.
Using run-down motels to care for and temporarily house homeless people recently discharged from the hospital helps stabilize them inexpensively, preventing unnecessary and costly returns to ERs and hospitals.
A small group of advocates and entrepreneurs is using mobile phones and digital scales to make a difference in the health of poor people, too.
A pioneering program in southern California provides ongoing care and housing to homeless people who are 鈥渟uper-utilizers鈥 of hospital emergency rooms. The effort is reducing ER visits and saving a lot of money.
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