PENNSYLVANIA — Pennsylvania’s Department of Human Services (DHS) is taking a significant step forward in providing healthcare access to the homeless community. On Friday, October 20, 2023, Secretary Dr. Val Arkoosh visited Project HOME in Philadelphia to discuss an important change in Medicaid that enables additional medical providers to offer care to unhoused patients outside of a clinical setting, a practice known as street medicine.
This announcement comes after the initial expansion of Medicaid in July 2023, which allowed specific medical providers to administer on-the-spot healthcare services to homeless individuals covered by Medicaid. Now, the DHS is further expanding the reach of street medicine programs by adding more eligible providers that can render street medicine services through Medicaid.
By allowing more specialties and providers to bill for services rendered during visits with people experiencing homelessness, the DHS aims to increase access to care for Medicaid beneficiaries and improve health outcomes.
“Every Pennsylvanian deserves access to high-quality, compassionate healthcare that meets them where they are,” said Secretary Arkoosh. “This expansion allows more medical providers to treat people experiencing homelessness, breaking down barriers to care and recognizing the value of street medicine practices.”
Effective October 1, 2023, the DHS expanded the types of providers eligible to practice and bill for street medicine in Medicaid. The list now includes dentists, federally qualified health centers, rural health clinics, Centers of Excellence for opioid use disorders, peer support services, family-based mental health services, mental health crisis intervention services, mental health targeted case management, substance use disorder services, intensive behavioral health services, podiatrists, and tobacco cessation providers.
The initial option for providers to offer and bill Medicaid for street medicine services included Medicaid-enrolled physicians, certified nurse midwives, certified registered nurse practitioners, physician assistants, psychologists, and mobile mental health treatment providers. Pennsylvania continues to be recognized as an early adopter of the use of street medicine.
Project HOME’s Epstein Street Medicine program in Philadelphia provides point-of-contact medical care to individuals experiencing homelessness, with a focus on those living outside. The team aims to improve medical outcomes and enhance access to healthcare and support services through holistic, person-centered, trauma-informed care delivered through a harm-reduction lens.
“Many people look at Kensington and see hopelessness. The people we treat see that, and more importantly, they feel it. We don’t see patients; we see people. People who need to know that they are not alone, and they are not forgotten,” said Kara Cohen, Project HOME’s Assistant Medical Director.
Investments in street medicine provide life-saving healthcare while also building trust within one of Pennsylvania’s most vulnerable populations. Homeless individuals in the United States die, on average, three decades earlier than their housed peers, most commonly due to preventable and treatable chronic medical conditions, such as diabetes, high blood pressure, and asthma.
These visits provide a direct intervention with a high potential impact on health and well-being. They also divert people from costly visits to frequently overwhelmed emergency rooms. Services include primary care, vaccine administration, wound care, preventive services, counseling, medication-assisted treatment for opioid use disorder, diagnostic services, rapid COVID-19 and flu testing, and more.
Additional resources for individuals experiencing homelessness are available through the Homeless Assistance Program. More information about other assistance programs administered by DHS can be found at www.dhs.pa.gov.
This expansion of street medicine practices under Medicaid underscores the DHS’s commitment to improving healthcare access and outcomes for Pennsylvania’s homeless population, aiming to reduce health disparities and achieve better quality of life for all Pennsylvanians.
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