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San Francisco recorded \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">806 drug overdose deaths\u003c/a> in 2023 — more than in any other year on record. [pullquote size=\"medium\" align=\"right\" citation=\"Shireen McSpadden, executive director, Department of Homelessness and Supportive Housing\"]‘… It’s very hard to be in recovery when you’re around people who are not like-minded. We hope this new model will better support people in achieving their goals.’[/pullquote]“We all know it’s very hard to be in recovery when you’re around people who are not like-minded,” said Shireen McSpadden, executive director of the Department of Homelessness and Supportive Housing, at a press conference Thursday at Hotel North Beach, where the city’s new units will be located. “We hope this new model will better support people in achieving their goals.”\u003c/p>\n\u003cp>Sober living units will be prioritized for people experiencing homelessness who have completed drug treatment programs, as well as people who already live in any of the city’s existing 10,000-plus units of permanent supportive housing and are seeking a sober environment.\u003c/p>\n\u003cp>Residents will be required to meet with social workers on-site to develop “recovery prevention plans,” according to Richard Beal, a recovery advocate and director at the Tenderloin Housing Clinic, which the city contracts with to provide low-income housing. At Hotel North Beach, there will also be recovery-focused group meetings on-site and case workers to support residents in their recovery journey and other health and social needs.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Tenderloin Housing Clinic and the city’s Department of Homelessness and Supportive Housing will oversee the new program.\u003c/p>\n\u003cp>“We have so much work to do. We know,” Mayor London Breed said on Thursday. “But I think a project like this could be a game-changer and very transformative and exciting for so many people who deserve a second chance.”\u003c/p>\n\u003cp>Recovery advocates in the city have pushed for Breed to open more housing units for people seeking sober environments. Many people who are sober live in the city’s existing permanent supportive housing, but some say having a community dedicated to supporting their recovery journey could be beneficial. [pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]‘We have so much work to do … But I think a project like this could be a game-changer and very transformative and exciting for so many people who deserve a second chance.’[/pullquote]A recent survey of 450 Tenderloin Housing Clinic residents found that 71% said they would prefer to live in a sober hotel, according to Randy Shaw, director of the Tenderloin Housing Clinic, who shared the findings at Thursday’s press conference.\u003c/p>\n\u003cp>“We have had a lot of people tell us this is what they want,” McSpadden said.\u003c/p>\n\u003cp>But opening up an all-sober housing option within the city’s permanent supportive housing inventory hasn’t been easy.\u003c/p>\n\u003cp>Fair housing laws prevent local governments from mandating residents to be sober to access public housing — because that could discriminate against people who are in recovery and make it even harder to access shelter.\u003c/p>\n\u003cp>To get around state law barriers, the sober living program at Hotel North Beach will be paid through city dollars from the general fund, city officials said.\u003c/p>\n\u003cp>“I thank God that London Breed listened to the community, listened to the people, for having more transitional housing and helping people get to permanent housing,” said Cedric Akbar, a recovery advocate and executive director of Positive Directions Equals Changes. “One size does not fit all.”\u003c/p>\n\u003cp>San Francisco recently reopened 70 units of permanent supportive housing on \u003ca href=\"https://www.kqed.org/news/11970663/san-franciscos-hope-for-expanding-supportive-housing-treasure-island\">Treasure Island\u003c/a> for people in recovery who had just completed a residential drug treatment program. Residents, however, can’t stay there long term and must leave between six months to two years.\u003c/p>\n\u003cp>One resident at the Treasure Island site named Craig H. told KQED that having a like-minded community has supported his sobriety. But, he said it can be difficult to maintain sobriety after exiting transitional housing programs.\u003c/p>\n\u003cp>“San Francisco can help those of us that are getting ready to go back into the world. We need some housing,” Craig H. said. “We don’t need to be thrown back on 16th and Mission. We don’t need just SROs in the Tenderloin. We need a shot at it.”\u003c/p>\n\u003cp>At North Beach Hotel, the hope is to create more spaces for people who are at a stage of their recovery where a sober community could help.\u003c/p>\n\u003cp>Case managers and social workers at the hotel will also support residents if they relapse. [aside postID=news_11959733 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68436_230829-ODAwareness-26-BL-KQED-1020x680.jpg']If someone does relapse, Breed said, “Our goal is not to throw them out and put them on the streets, but to take them out of the environment and place them in another location that could provide more wraparound support services.”\u003c/p>\n\u003cp>Thursday’s press conference was interrupted by six residents and business owners who complained that they were not notified ahead of time of plans to open the sober living site in the neighborhood. The group chanted “no” as Breed walked up to speak and asked why they weren’t informed of the plans before the press conference.\u003c/p>\n\u003cp>McSpadden of HSH said that the city is following its normal process by identifying the site first and then inviting the community to provide feedback.\u003c/p>\n\u003cp>The purchase of the building has yet to be finalized, and the city has until March 7 to conduct outreach and community engagement about concerns and hopes for the site.\u003c/p>\n\u003cp>There will be a public meeting on Feb. 20 at the City College Chinatown campus to discuss the plans and gather local input.\u003c/p>\n\u003cp>“We know there have been some people who have not been directly outreached to, but we want to make that commitment today, that our goal is to sit down and have that conversation as we go through the process,” Breed said directly to critics at the press conference Thursday. “This is not about providing anything other than a safe living environment to be clean and sober and to contribute to the businesses and surrounding community.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"San Francisco city officials hope to offer a supportive living environment for low-income residents in recovery from addiction at this North Beach hotel.","status":"publish","parent":0,"modified":1707440447,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":1135},"headData":{"title":"San Francisco to Open First Permanent Supportive Housing for the Sober Community | KQED","description":"San Francisco city officials hope to offer a supportive living environment for low-income residents in recovery from addiction at this North Beach hotel.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco to Open First Permanent Supportive Housing for the Sober Community","datePublished":"2024-02-09T00:18:24.000Z","dateModified":"2024-02-09T01:00:47.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11975156/san-francisco-to-open-first-permanent-supportive-housing-for-the-sober-community","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco plans to open its first permanent supportive housing for residents who are sober and in recovery from drug or alcohol addiction, Mayor London Breed announced Thursday alongside recovery advocates.\u003c/p>\n\u003cp>The 149 units at 935 Kearny St. come as overdose deaths have continued to rise in San Francisco and across the West Coast. San Francisco recorded \u003ca href=\"https://www.kqed.org/news/11972898/2023-was-san-franciscos-deadliest-year-for-drug-overdoses-new-data-confirms\">806 drug overdose deaths\u003c/a> in 2023 — more than in any other year on record. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘… It’s very hard to be in recovery when you’re around people who are not like-minded. We hope this new model will better support people in achieving their goals.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Shireen McSpadden, executive director, Department of Homelessness and Supportive Housing","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“We all know it’s very hard to be in recovery when you’re around people who are not like-minded,” said Shireen McSpadden, executive director of the Department of Homelessness and Supportive Housing, at a press conference Thursday at Hotel North Beach, where the city’s new units will be located. “We hope this new model will better support people in achieving their goals.”\u003c/p>\n\u003cp>Sober living units will be prioritized for people experiencing homelessness who have completed drug treatment programs, as well as people who already live in any of the city’s existing 10,000-plus units of permanent supportive housing and are seeking a sober environment.\u003c/p>\n\u003cp>Residents will be required to meet with social workers on-site to develop “recovery prevention plans,” according to Richard Beal, a recovery advocate and director at the Tenderloin Housing Clinic, which the city contracts with to provide low-income housing. At Hotel North Beach, there will also be recovery-focused group meetings on-site and case workers to support residents in their recovery journey and other health and social needs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Tenderloin Housing Clinic and the city’s Department of Homelessness and Supportive Housing will oversee the new program.\u003c/p>\n\u003cp>“We have so much work to do. We know,” Mayor London Breed said on Thursday. “But I think a project like this could be a game-changer and very transformative and exciting for so many people who deserve a second chance.”\u003c/p>\n\u003cp>Recovery advocates in the city have pushed for Breed to open more housing units for people seeking sober environments. Many people who are sober live in the city’s existing permanent supportive housing, but some say having a community dedicated to supporting their recovery journey could be beneficial. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘We have so much work to do … But I think a project like this could be a game-changer and very transformative and exciting for so many people who deserve a second chance.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"San Francisco Mayor London Breed","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>A recent survey of 450 Tenderloin Housing Clinic residents found that 71% said they would prefer to live in a sober hotel, according to Randy Shaw, director of the Tenderloin Housing Clinic, who shared the findings at Thursday’s press conference.\u003c/p>\n\u003cp>“We have had a lot of people tell us this is what they want,” McSpadden said.\u003c/p>\n\u003cp>But opening up an all-sober housing option within the city’s permanent supportive housing inventory hasn’t been easy.\u003c/p>\n\u003cp>Fair housing laws prevent local governments from mandating residents to be sober to access public housing — because that could discriminate against people who are in recovery and make it even harder to access shelter.\u003c/p>\n\u003cp>To get around state law barriers, the sober living program at Hotel North Beach will be paid through city dollars from the general fund, city officials said.\u003c/p>\n\u003cp>“I thank God that London Breed listened to the community, listened to the people, for having more transitional housing and helping people get to permanent housing,” said Cedric Akbar, a recovery advocate and executive director of Positive Directions Equals Changes. “One size does not fit all.”\u003c/p>\n\u003cp>San Francisco recently reopened 70 units of permanent supportive housing on \u003ca href=\"https://www.kqed.org/news/11970663/san-franciscos-hope-for-expanding-supportive-housing-treasure-island\">Treasure Island\u003c/a> for people in recovery who had just completed a residential drug treatment program. Residents, however, can’t stay there long term and must leave between six months to two years.\u003c/p>\n\u003cp>One resident at the Treasure Island site named Craig H. told KQED that having a like-minded community has supported his sobriety. But, he said it can be difficult to maintain sobriety after exiting transitional housing programs.\u003c/p>\n\u003cp>“San Francisco can help those of us that are getting ready to go back into the world. We need some housing,” Craig H. said. “We don’t need to be thrown back on 16th and Mission. We don’t need just SROs in the Tenderloin. We need a shot at it.”\u003c/p>\n\u003cp>At North Beach Hotel, the hope is to create more spaces for people who are at a stage of their recovery where a sober community could help.\u003c/p>\n\u003cp>Case managers and social workers at the hotel will also support residents if they relapse. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11959733","hero":"https://ww2.kqed.org/app/uploads/sites/10/2023/08/RS68436_230829-ODAwareness-26-BL-KQED-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>If someone does relapse, Breed said, “Our goal is not to throw them out and put them on the streets, but to take them out of the environment and place them in another location that could provide more wraparound support services.”\u003c/p>\n\u003cp>Thursday’s press conference was interrupted by six residents and business owners who complained that they were not notified ahead of time of plans to open the sober living site in the neighborhood. The group chanted “no” as Breed walked up to speak and asked why they weren’t informed of the plans before the press conference.\u003c/p>\n\u003cp>McSpadden of HSH said that the city is following its normal process by identifying the site first and then inviting the community to provide feedback.\u003c/p>\n\u003cp>The purchase of the building has yet to be finalized, and the city has until March 7 to conduct outreach and community engagement about concerns and hopes for the site.\u003c/p>\n\u003cp>There will be a public meeting on Feb. 20 at the City College Chinatown campus to discuss the plans and gather local input.\u003c/p>\n\u003cp>“We know there have been some people who have not been directly outreached to, but we want to make that commitment today, that our goal is to sit down and have that conversation as we go through the process,” Breed said directly to critics at the press conference Thursday. “This is not about providing anything other than a safe living environment to be clean and sober and to contribute to the businesses and surrounding community.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11975156/san-francisco-to-open-first-permanent-supportive-housing-for-the-sober-community","authors":["11840"],"categories":["news_6266","news_8"],"tags":["news_21434","news_25968","news_25959","news_27626","news_4020","news_32277","news_1775","news_19960","news_29051","news_38"],"featImg":"news_11975179","label":"news"},"news_11974695":{"type":"posts","id":"news_11974695","meta":{"index":"posts_1591205157","site":"news","id":"11974695","score":null,"sort":[1707151787000]},"guestAuthors":[],"slug":"san-francisco-considers-a-measure-to-screen-welfare-recipients-for-addiction","title":"San Francisco Considers a Measure to Screen Welfare Recipients for Addiction","publishDate":1707151787,"format":"standard","headTitle":"San Francisco Considers a Measure to Screen Welfare Recipients for Addiction | KQED","labelTerm":{"site":"news"},"content":"\u003cp>The Democratic mayor of San Francisco is pushing a pair of controversial public safety proposals on the March 5 ballot, including one that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/domestic-general-news-3b2cac01584f4479b7b1da0bde1c8a88\">Mayor London Breed\u003c/a> also supports a ballot measure that would grant police more crime-fighting powers, such as using drones and surveillance cameras. In November, she’ll face cranky voters in a competitive reelection bid.\u003c/p>\n\u003cp>San Francisco is in a struggle to redefine itself after the pandemic left it in economic tatters and highlighted its \u003ca style=\"font-weight: var(--font-weight-reg)\" href=\"https://apnews.com/article/coronavirus-pandemic-sports-business-health-lifestyle-538efc664e9da0d2f0831f3f3ed9a4d7\">longstanding problems\u003c/a> with homelessness, drugs and property crime. Opponents say both ballot measures are wildly out of step with San Francisco’s support for privacy and civil liberties and will only hurt the marginalized communities the city prides itself on helping. [pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]‘They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive.’[/pullquote]But Breed, the first Black woman to lead San Francisco, said at a January campaign stop that residents from poorer, Black and immigrant neighborhoods are pleading for more police, and recovery advocates are demanding change as more than 800 people died of accidental overdose last year — a record fueled by the abundance of cheap and potent fentanyl.\u003c/p>\n\u003cp>“They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive,” Breed said at Footprint, an athletic apparel and shoe store that has been repeatedly burglarized.\u003c/p>\n\u003cp>While Breed’s name isn’t on the presidential primary ballots going out now — San Francisco uses a method where residents rank mayoral candidates by preference a single time in November — the two measures she’s pushing are. They serve as an opening salvo for her reelection campaign as she faces off against fellow moderates who say her approach to the city’s problems has been weak.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Violent crimes are low in San Francisco, but the city has long struggled with quality-of-life crimes.\u003c/p>\n\u003cp>Breed said rates of retail theft and auto smash-ins have declined recently, thanks in large part to strategic operations by city police. Similarly, police have stepped up enforcement of drug laws, including by issuing citations to people using drugs in public as a way to disrupt the behavior and an opportunity to persuade the person cited to seek help.\u003c/p>\n\u003cp>But she said San Francisco needs to do more.\u003c/p>\n\u003cp>If approved by voters, Proposition F would offer another way to compel treatment by allowing the city to screen single adults on local welfare for substance abuse. People found to be abusing illegal drugs would be required to enroll in treatment if they want to receive cash assistance from the city, which maxes out at just over $700 a month. [aside label='More Stories on Public Health' tag='public-health']Opponents say coercion doesn’t work and homelessness may increase if the measure passes. Drug addicts are not criminals, they say, and there are not enough treatment beds and counseling services as it is.\u003c/p>\n\u003cp>A crackdown on drugs is reminiscent of the failed war on drugs that disproportionately harmed Black families, said Chris Ballard, co-executive director of Coleman Advocates, which pushes for improvements for Black and Latino youth in San Francisco.\u003c/p>\n\u003cp>“There are more ethical ways to address the issue aside from punitive measures, and that’s the proper way to take care of a community, to show true support,” he said.\u003c/p>\n\u003cp>Yet Trent Rhorer, executive director of the San Francisco Human Services Agency, which provides cash assistance and employment services to low-income residents without dependent children, said the current situation conflicts with the agency’s mission: to improve lives.\u003c/p>\n\u003cp>“To give someone who’s addicted to fentanyl $700 a month, I don’t think it helps improve their lives,” he said. “In fact, I think it does the opposite.”\u003c/p>\n\u003cp>Compelling treatment has become more acceptable in Democratic California, despite angst over the potential loss of civil liberties, as visible signs of homelessness and mental illness, fentanyl addiction, and unsafe street behavior surge.\u003c/p>\n\u003cp>Last year, several counties rolled out an alternative mental health court created by Democratic Gov. Gavin Newsom, former mayor of San Francisco, to fast-track people with untreated schizophrenia and related disorders into care, and in March, voters will take up a statewide mental health proposition, that some say will increase involuntary treatment.\u003c/p>\n\u003cp>Rhorer said the welfare program for single adults — which serves about 9,000 people per year — already asks applicants about substance abuse, with about 20% self-reporting an issue. A data check with the Department of Public Health revealed that almost one-third of recipients have been diagnosed with a substance use disorder, he said.\u003c/p>\n\u003cp>The ballot measure would replace that question with a more rigorous screening test that an addiction specialist would verify. If substance abuse is found, Rhorer said, the specialist and applicant would agree on treatment options that include residential care, a 12-step program, individual counseling and replacement medication. [pullquote size=\"medium\" align=\"right\" citation=\"Michael Hsu, store owner, Footprint USA\"]‘You’re sending the wrong message to these criminals.’[/pullquote]There is no requirement that the person be sober, only that they make good-faith efforts to attend their program, with the hope that “at one point a light bulb will go off,” Rhorer said.\u003c/p>\n\u003cp>The measure calls for the city to pay the rent of those accepted into the program for 30 days or longer to avoid eviction. About 30% of the people who fatally overdosed in 2023 were homeless, and more were living in subsidized city housing.\u003c/p>\n\u003cp>Besides authorizing drones, cameras and other modern technologies, Proposition E would reduce paperwork so police have more time to patrol. It would also allow police to pursue more suspects by vehicle, not just in cases of a violent felony or immediate threat to public safety — a policy store owner Michael Hsu learned of the hard way.\u003c/p>\n\u003cp>Hsu has had his Footprint store broken into multiple times since he took over in 2020, most recently on Jan. 1. Police arrived as the suspects were leaving but could not pursue them because no lives were at risk. Hsu, who lost about $20,000 in merchandise and damage, called that discouraging.\u003c/p>\n\u003cp>“You’re sending the wrong message to these criminals,” he said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"The Democratic mayor of San Francisco is pushing a March 5 ballot measure that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.","status":"publish","parent":0,"modified":1707162574,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":1132},"headData":{"title":"San Francisco Considers a Measure to Screen Welfare Recipients for Addiction | KQED","description":"The Democratic mayor of San Francisco is pushing a March 5 ballot measure that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco Considers a Measure to Screen Welfare Recipients for Addiction","datePublished":"2024-02-05T16:49:47.000Z","dateModified":"2024-02-05T19:49:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"sticky":false,"nprByline":"\u003ca href=\"https://apnews.com/\">Janie Har\u003c/a> \u003cbr> Associated Press","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","articleAge":"0","path":"/news/11974695/san-francisco-considers-a-measure-to-screen-welfare-recipients-for-addiction","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Democratic mayor of San Francisco is pushing a pair of controversial public safety proposals on the March 5 ballot, including one that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.\u003c/p>\n\u003cp>\u003ca href=\"https://apnews.com/domestic-general-news-3b2cac01584f4479b7b1da0bde1c8a88\">Mayor London Breed\u003c/a> also supports a ballot measure that would grant police more crime-fighting powers, such as using drones and surveillance cameras. In November, she’ll face cranky voters in a competitive reelection bid.\u003c/p>\n\u003cp>San Francisco is in a struggle to redefine itself after the pandemic left it in economic tatters and highlighted its \u003ca style=\"font-weight: var(--font-weight-reg)\" href=\"https://apnews.com/article/coronavirus-pandemic-sports-business-health-lifestyle-538efc664e9da0d2f0831f3f3ed9a4d7\">longstanding problems\u003c/a> with homelessness, drugs and property crime. Opponents say both ballot measures are wildly out of step with San Francisco’s support for privacy and civil liberties and will only hurt the marginalized communities the city prides itself on helping. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"San Francisco Mayor London Breed","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>But Breed, the first Black woman to lead San Francisco, said at a January campaign stop that residents from poorer, Black and immigrant neighborhoods are pleading for more police, and recovery advocates are demanding change as more than 800 people died of accidental overdose last year — a record fueled by the abundance of cheap and potent fentanyl.\u003c/p>\n\u003cp>“They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive,” Breed said at Footprint, an athletic apparel and shoe store that has been repeatedly burglarized.\u003c/p>\n\u003cp>While Breed’s name isn’t on the presidential primary ballots going out now — San Francisco uses a method where residents rank mayoral candidates by preference a single time in November — the two measures she’s pushing are. They serve as an opening salvo for her reelection campaign as she faces off against fellow moderates who say her approach to the city’s problems has been weak.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Violent crimes are low in San Francisco, but the city has long struggled with quality-of-life crimes.\u003c/p>\n\u003cp>Breed said rates of retail theft and auto smash-ins have declined recently, thanks in large part to strategic operations by city police. Similarly, police have stepped up enforcement of drug laws, including by issuing citations to people using drugs in public as a way to disrupt the behavior and an opportunity to persuade the person cited to seek help.\u003c/p>\n\u003cp>But she said San Francisco needs to do more.\u003c/p>\n\u003cp>If approved by voters, Proposition F would offer another way to compel treatment by allowing the city to screen single adults on local welfare for substance abuse. People found to be abusing illegal drugs would be required to enroll in treatment if they want to receive cash assistance from the city, which maxes out at just over $700 a month. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on Public Health ","tag":"public-health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Opponents say coercion doesn’t work and homelessness may increase if the measure passes. Drug addicts are not criminals, they say, and there are not enough treatment beds and counseling services as it is.\u003c/p>\n\u003cp>A crackdown on drugs is reminiscent of the failed war on drugs that disproportionately harmed Black families, said Chris Ballard, co-executive director of Coleman Advocates, which pushes for improvements for Black and Latino youth in San Francisco.\u003c/p>\n\u003cp>“There are more ethical ways to address the issue aside from punitive measures, and that’s the proper way to take care of a community, to show true support,” he said.\u003c/p>\n\u003cp>Yet Trent Rhorer, executive director of the San Francisco Human Services Agency, which provides cash assistance and employment services to low-income residents without dependent children, said the current situation conflicts with the agency’s mission: to improve lives.\u003c/p>\n\u003cp>“To give someone who’s addicted to fentanyl $700 a month, I don’t think it helps improve their lives,” he said. “In fact, I think it does the opposite.”\u003c/p>\n\u003cp>Compelling treatment has become more acceptable in Democratic California, despite angst over the potential loss of civil liberties, as visible signs of homelessness and mental illness, fentanyl addiction, and unsafe street behavior surge.\u003c/p>\n\u003cp>Last year, several counties rolled out an alternative mental health court created by Democratic Gov. Gavin Newsom, former mayor of San Francisco, to fast-track people with untreated schizophrenia and related disorders into care, and in March, voters will take up a statewide mental health proposition, that some say will increase involuntary treatment.\u003c/p>\n\u003cp>Rhorer said the welfare program for single adults — which serves about 9,000 people per year — already asks applicants about substance abuse, with about 20% self-reporting an issue. A data check with the Department of Public Health revealed that almost one-third of recipients have been diagnosed with a substance use disorder, he said.\u003c/p>\n\u003cp>The ballot measure would replace that question with a more rigorous screening test that an addiction specialist would verify. If substance abuse is found, Rhorer said, the specialist and applicant would agree on treatment options that include residential care, a 12-step program, individual counseling and replacement medication. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘You’re sending the wrong message to these criminals.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Michael Hsu, store owner, Footprint USA","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>There is no requirement that the person be sober, only that they make good-faith efforts to attend their program, with the hope that “at one point a light bulb will go off,” Rhorer said.\u003c/p>\n\u003cp>The measure calls for the city to pay the rent of those accepted into the program for 30 days or longer to avoid eviction. About 30% of the people who fatally overdosed in 2023 were homeless, and more were living in subsidized city housing.\u003c/p>\n\u003cp>Besides authorizing drones, cameras and other modern technologies, Proposition E would reduce paperwork so police have more time to patrol. It would also allow police to pursue more suspects by vehicle, not just in cases of a violent felony or immediate threat to public safety — a policy store owner Michael Hsu learned of the hard way.\u003c/p>\n\u003cp>Hsu has had his Footprint store broken into multiple times since he took over in 2020, most recently on Jan. 1. Police arrived as the suspects were leaving but could not pursue them because no lives were at risk. Hsu, who lost about $20,000 in merchandise and damage, called that discouraging.\u003c/p>\n\u003cp>“You’re sending the wrong message to these criminals,” he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11974695/san-francisco-considers-a-measure-to-screen-welfare-recipients-for-addiction","authors":["byline_news_11974695"],"categories":["news_457","news_8"],"tags":["news_21434","news_18538","news_27626","news_18543","news_19960","news_38","news_18176"],"featImg":"news_11974696","label":"news"},"news_11970663":{"type":"posts","id":"news_11970663","meta":{"index":"posts_1591205157","site":"news","id":"11970663","score":null,"sort":[1703246454000]},"guestAuthors":[],"slug":"san-franciscos-hope-for-expanding-supportive-housing-treasure-island","title":"San Francisco's Hope for Expanding Supportive Housing? Treasure Island","publishDate":1703246454,"format":"standard","headTitle":"San Francisco’s Hope for Expanding Supportive Housing? Treasure Island | KQED","labelTerm":{"site":"news"},"content":"\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. [pullquote size=\"medium\" align=\"right\" citation=\"De’andre Devereaux, resident of a HealthRight 360 program on Treasure Island\"]‘I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together. I finally got tired, and I haven’t looked back … this changed my life.’[/pullquote]“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. [pullquote size=\"medium\" align=\"right\" citation=\"William Pecknold Jr., resident of a HealthRight 360 program on Treasure Island\"]‘I don’t think it’s anyone else’s decision but the individual. I just know one thing for a fact. This place saved my life. It really did.’[/pullquote]“I don’t think it’s anyone else’s decision but the individual,” Pecknold said. “I just know one thing for a fact. This place saved my life. It really did.”\u003c/p>\n\u003cp>The residential step-down program is part of the city’s ongoing effort to increase the number of behavioral health care beds by 400, or 20% — a goal determined by the City’s \u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\">Behavioral Health Bed Optimization Report\u003c/a> released in 2020.\u003c/p>\n\u003cp>The site is part of a broader behavioral health program that collectively currently offers 128 beds across the island. The step-down facility is scheduled to be rebuilt by 2028 as part of a multistory building with health services and housing overseen by the Department of Public Health.\u003c/p>\n\u003cp>Still, the program is not running at full capacity yet due to a lack of trained staff. As of Thursday, 87 people were using the broader program’s 128 beds. At the Gateview site, in particular, it has just over half of the staff it needs and only 39 residents for its 70 beds so far, according to officials at HealthRight 360. [aside label='More Stories on Housing' tag='housing']San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. [pullquote size=\"medium\" align=\"right\" citation=\"Vitka Eisen, CEO, HealthRight 360\"]‘Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.’[/pullquote]Eisen has been through residential treatment and said she views the issue as a “both-and,” arguing that there is a need for housing where people exiting drug detoxification or inpatient programs can build community, find work and secure longer-term housing.\u003c/p>\n\u003cp>“If we can develop permanent housing and affordable housing for people, that is the most important thing to do. But these services are unique. When people are just leaving intensive residential treatment, they’re less likely to be isolated here,” said Vitka Eisen, CEO of HealthRight 360. “Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.”\u003c/p>\n\u003cp>\u003ci>Information on publicly available substance-use treatment in San Francisco and how to get care for yourself or a loved one can be found at \u003ca href=\"https://findtreatment-sf.org/\">findtreatment-sf.org\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Residents at San Francisco’s residential step-down treatment say housing makes all the difference in recovery. \r\n","status":"publish","parent":0,"modified":1703625640,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":1151},"headData":{"title":"San Francisco's Hope for Expanding Supportive Housing? Treasure Island | KQED","description":"Residents at San Francisco’s residential step-down treatment say housing makes all the difference in recovery. \r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco's Hope for Expanding Supportive Housing? Treasure Island","datePublished":"2023-12-22T12:00:54.000Z","dateModified":"2023-12-26T21:20:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"sticky":false,"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11970663/san-franciscos-hope-for-expanding-supportive-housing-treasure-island","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oakland native De’andre Devereaux is no stranger to Treasure Island, a former military base along the Bay Bridge, halfway between Oakland and San Francisco. Up until about a year ago, he was unhoused, and the 55-year-old would spend afternoons on the quiet island panhandling for food and cash.\u003c/p>\n\u003cp>Devereaux now lives on the island, but his life couldn’t look more different. After choosing to enter treatment for a substance-use disorder last winter, he’s now living at a 70-bed sober, supportive living community that opened on Treasure Island in April. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together. I finally got tired, and I haven’t looked back … this changed my life.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"De’andre Devereaux, resident of a HealthRight 360 program on Treasure Island","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“I’ve been in and out of rehabs since I was like 24 because I wasn’t ready to get my life together,” Devereaux told KQED at a holiday party for residents in the program in December. “I finally got tired and I haven’t looked back, and I’m happy for that because this changed my life.”\u003c/p>\n\u003cp>Residents can enter the step-down program after completing a separate rehabilitation program and live there between nine months and two years. They are also connected with recovery coaches who assist with job readiness and navigating public benefits and medications. Everyone in the program simultaneously participates in outpatient recovery services.\u003c/p>\n\u003cp>The program helped Devereaux line up a job as an in-home service provider for older people and those with disabilities — a job he said he loves.\u003c/p>\n\u003cp>“It feels good doing that, giving back,” he said as holiday music played and neighbors mingled at the facility on Gateview Avenue. The Department of Public Health and HealthRight 360 operates the community, a statewide health care nonprofit that provides substance-use treatment.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For most residents who spoke to KQED, having a safe place to call home and a supportive environment to help navigate the ups and downs of recovery has made the biggest difference in their journey with sobriety.\u003c/p>\n\u003cp>“The real thing is getting people off the streets and into a place where the fog can lift, you know? Because when you’re in a sober mind, and you finally do kick that drug, that’s a major thing,” said William Pecknold Jr., another resident. “I don’t know if everybody wants help, you know, but for those who do, this is where you can get it.”\u003c/p>\n\u003cfigure id=\"attachment_11970626\" class=\"wp-caption aligncenter\" style=\"max-width: 2000px\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11970626\" src=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg\" alt=\"A person wearing a hood stands beside a fence in a residential area.\" width=\"2000\" height=\"1333\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED.jpg 2000w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1536x1024.jpg 1536w, https://cdn.kqed.org/wp-content/uploads/sites/10/2023/12/231220-TIRECOVERY-11-BL-KQED-1920x1280.jpg 1920w\" sizes=\"(max-width: 2000px) 100vw, 2000px\">\u003cfigcaption class=\"wp-caption-text\">William Pecknold Jr. stands in the backyard of HealthRight 360’s Recovery Residence program. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>As an ironworker, Pecknold has helped build the literal framework for prominent Bay Area structures like 131 Fremont Street in San Francisco. However, he struggled with alcohol addiction and later turned to methamphetamine when he was unhoused.\u003c/p>\n\u003cp>He got sober during a stay in prison, then quickly entered drug treatment programs after his release last December. The experience sent him down a new path, but, he said, everyone’s journey looks different. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘I don’t think it’s anyone else’s decision but the individual. I just know one thing for a fact. This place saved my life. It really did.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"William Pecknold Jr., resident of a HealthRight 360 program on Treasure Island","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“I don’t think it’s anyone else’s decision but the individual,” Pecknold said. “I just know one thing for a fact. This place saved my life. It really did.”\u003c/p>\n\u003cp>The residential step-down program is part of the city’s ongoing effort to increase the number of behavioral health care beds by 400, or 20% — a goal determined by the City’s \u003ca href=\"https://www.sfdph.org/dph/files/MHR/SFDPH_Behavioral_Health_Bed_Optimization_Report_FINAL.pdf\">Behavioral Health Bed Optimization Report\u003c/a> released in 2020.\u003c/p>\n\u003cp>The site is part of a broader behavioral health program that collectively currently offers 128 beds across the island. The step-down facility is scheduled to be rebuilt by 2028 as part of a multistory building with health services and housing overseen by the Department of Public Health.\u003c/p>\n\u003cp>Still, the program is not running at full capacity yet due to a lack of trained staff. As of Thursday, 87 people were using the broader program’s 128 beds. At the Gateview site, in particular, it has just over half of the staff it needs and only 39 residents for its 70 beds so far, according to officials at HealthRight 360. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on Housing ","tag":"housing"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>San Francisco is set to open three more projects across the city next year as part of the \u003ca href=\"https://www.sf.gov/sites/default/files/2022-06/SFDPH%20Bed%20Expansion%20Dashboard%206.22.22%20Final.pdf.pdf\">bed expansion\u003c/a>. That includes a 30-bed care facility for people with mental health and substance-use issues, a 10-person mental health program for transitional-age youth, and a 16-bed urgent care facility.\u003c/p>\n\u003cp>But the city’s goal to add more beds is an ever-moving target. While more beds have been added, \u003ca href=\"https://missionlocal.org/2022/08/despite-rosy-press-board-and-cares-continue-to-go-quietly/\">other behavioral health facilities and beds across the city’s network have shuttered\u003c/a> as the overdose epidemic and housing crisis collide.\u003c/p>\n\u003cp>Residents in the step-down program are encouraged and supported to move out after a period of time. However, some housing and healthcare advocates argue that temporary programs can destabilize residents who have to move frequently from place to place. Many point to permanent supportive housing as the ultimate north star for making a dent in the housing and addiction crisis. \u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"‘Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.’","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Vitka Eisen, CEO, HealthRight 360","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Eisen has been through residential treatment and said she views the issue as a “both-and,” arguing that there is a need for housing where people exiting drug detoxification or inpatient programs can build community, find work and secure longer-term housing.\u003c/p>\n\u003cp>“If we can develop permanent housing and affordable housing for people, that is the most important thing to do. But these services are unique. When people are just leaving intensive residential treatment, they’re less likely to be isolated here,” said Vitka Eisen, CEO of HealthRight 360. “Our hope is that they can build their support in the earliest part of their recovery journey and their journey post-treatment.”\u003c/p>\n\u003cp>\u003ci>Information on publicly available substance-use treatment in San Francisco and how to get care for yourself or a loved one can be found at \u003ca href=\"https://findtreatment-sf.org/\">findtreatment-sf.org\u003c/a>.\u003c/i>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11970663/san-franciscos-hope-for-expanding-supportive-housing-treasure-island","authors":["11840"],"categories":["news_8"],"tags":["news_21434","news_28991","news_25968","news_25959","news_27626","news_18543","news_1775","news_25617","news_1279"],"featImg":"news_11970625","label":"news"},"news_11952285":{"type":"posts","id":"news_11952285","meta":{"index":"posts_1591205157","site":"news","id":"11952285","score":null,"sort":[1686132047000]},"guestAuthors":[],"slug":"from-the-vault-when-the-tenderloins-addiction-crisis-goes-viral","title":"The Ethics of Photographing Addiction in the Tenderloin","publishDate":1686132047,"format":"audio","headTitle":"The Ethics of Photographing Addiction in the Tenderloin | KQED","labelTerm":{},"content":"\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco’s Tenderloin neighborhood has been at the forefront of the opioid epidemic, amassing a reputation as a place of open air drug dealing, crime, and homelessness. Viral images and videos of open-air drug use have been seen around the world.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some argue publishing pictures and videos of people experiencing addiction is dehumanizing and has long-term effects that follow them for the rest of their lives. Others argue the images raise awareness and showcase the reality of San Francisco’s overdose epidemic. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/file/d/19yAIdEPxvSjitr007OHL9K7lu3SnOUS-/view?usp=share_link\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3352754299\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11934668/when-the-tenderloin-goes-viral\">\u003ci>\u003cspan style=\"font-weight: 400\">This episode originally aired on Dec. 9\u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":"Viral images and videos of open-air drug use have been seen around the world.","status":"publish","parent":0,"modified":1700689308,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":7,"wordCount":99},"headData":{"title":"The Ethics of Photographing Addiction in the Tenderloin | KQED","description":"Viral images and videos of open-air drug use have been seen around the world.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"The Ethics of Photographing Addiction in the Tenderloin","datePublished":"2023-06-07T10:00:47.000Z","dateModified":"2023-11-22T21:41:48.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"The Bay","sourceUrl":"https://www.kqed.org/podcasts/thebay","audioUrl":"https://www.podtrac.com/pts/redirect.mp3/chrt.fm/track/G6C7C3/traffic.megaphone.fm/KQINC3352754299.mp3?updated=1686009092","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11952285/from-the-vault-when-the-tenderloins-addiction-crisis-goes-viral","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-weight: 400\">San Francisco’s Tenderloin neighborhood has been at the forefront of the opioid epidemic, amassing a reputation as a place of open air drug dealing, crime, and homelessness. Viral images and videos of open-air drug use have been seen around the world.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Some argue publishing pictures and videos of people experiencing addiction is dehumanizing and has long-term effects that follow them for the rest of their lives. Others argue the images raise awareness and showcase the reality of San Francisco’s overdose epidemic. \u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/file/d/19yAIdEPxvSjitr007OHL9K7lu3SnOUS-/view?usp=share_link\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC3352754299\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>\u003ca href=\"https://www.kqed.org/news/11934668/when-the-tenderloin-goes-viral\">\u003ci>\u003cspan style=\"font-weight: 400\">This episode originally aired on Dec. 9\u003c/span>\u003c/i>\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11952285/from-the-vault-when-the-tenderloins-addiction-crisis-goes-viral","authors":["8654","11635","11649","11802"],"programs":["news_28779"],"categories":["news_8","news_33520"],"tags":["news_21434","news_22661","news_38","news_3181","news_22598"],"featImg":"news_11952295","label":"source_news_11952285"},"news_11945418":{"type":"posts","id":"news_11945418","meta":{"index":"posts_1591205157","site":"news","id":"11945418","score":null,"sort":[1680613242000]},"guestAuthors":[],"slug":"san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why","title":"San Francisco Has Doubled Participants of This Opioid Treatment. Here's Why","publishDate":1680613242,"format":"standard","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>The first time Alyssa Ibarra tried to get suboxone, a medication proven to treat opioid use disorder, she bought it from someone off the street.\u003c/p>\n\u003cp>After an ankle injury in 2014, she started using Vicodin and Percocet recreationally and later developed an addiction to opioids after experiencing postpartum depression.\u003c/p>\n\u003cp>“When I tried to stop, I remember just feeling really hopeless,” Ibarra said. “I didn't even think, ‘I'm having withdrawals.’ I just thought it was the postpartum.”\u003c/p>\n\u003cfigure id=\"attachment_11945552\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945552\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"A woman with blond hair and gold, hoop earrings wears a white blouse and tan zip-up hoodie. She is looking at her counselor who sits across from her with her back toward the camera.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Practitioner Paulette Walton (left) speaks with patient Alyssa Ibarra at the Outpatient Buprenorphine Induction Clinic (OBIC) at Community Behavioral Health Services in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, medications for opioid use disorder, like methadone, suboxone or buprenorphine, a generic form of suboxone, have been so tightly regulated that \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790432\">only about 27% of Americans with opioid use disorder have been able to access medication-assisted treatment\u003c/a>, according to a 2022 study by doctors at Rutgers and Columbia universities.\u003c/p>\n\u003cp>At the same time, \u003ca href=\"https://sf.gov/sites/default/files/2023-03/2023%2003_OCME%20Overdose%20Report.pdf\">overdose deaths have increased locally (PDF)\u003c/a> and across the U.S., \u003ca href=\"https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=More%20than%20106%2C000%20persons%20in,drugs%20from%201999%20to%202021.\">killing nearly 107,000 people nationally in 2021\u003c/a>, largely driven by synthetic opioids such as fentanyl, which is up to 100 times more powerful than morphine.\u003c/p>\n\u003cp>But local public health professionals and federal drug regulators are beginning to address the gap in access to medication-based treatment, so people like Ibarra can get the safe access they need faster.\u003c/p>\n\u003cfigure id=\"attachment_11945503\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945503\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"Two women wearing medical lanyards read over some files in a yellow folder together inside a medical clinic office.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Christine Soran (left) and Nurse Practitioner Paulette Walton work at OBIC on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When someone needs it in the moment, they need it in that moment. They can't wait months for an appointment,” said Dr. Christine Soran, medical director for \u003ca href=\"https://dsaam.org/obic/\">San Francisco’s public Outpatient Buprenorphine Induction Clinic\u003c/a>. “The city is putting resources behind it, and almost every medical provider I talk to is on board with this kind of treatment.”\u003c/p>\n\u003cp>In San Francisco, the number of people who receive buprenorphine has doubled since 2013, according to data from the Department of Public Health, with a 53% increase in the past five years. Ibarra is part of that group.\u003c/p>\n\u003cp>[aside label='More Stories on Health' tag='health']\u003c/p>\n\u003cp>The increase is largely driven by two changes: The \u003ca href=\"https://www.whitehouse.gov/ondcp/briefing-room/2023/01/25/white-house-hosts-event-to-mark-removal-of-barriers-to-addiction-treatment/\">federal government loosening its dispensing regulations\u003c/a>, and San Francisco public health officials seizing the opportunity to expand medication-assisted treatment services.\u003c/p>\n\u003cp>In December 2022, President Biden signed the bipartisan Consolidated Appropriations Act of 2023, which removed a federal requirement known as the X-waiver, which blocked some medical professionals from prescribing buprenorphine for opioid use disorder.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529309/#:~:text=As%20of%202020%2C%20less%20than,enforcement%20administration%2DX%20waiver%20courses.\">As of 2020, only 5% of U.S. physicians had approval to prescribe buprenorphine or suboxone\u003c/a>, according to a 2021 study conducted by emergency room physicians across the country and backed by the Foundation for Opioid Response Efforts, which funds research on solutions to the overdose crisis.\u003c/p>\n\u003cp>Under the X-waiver, the U.S. Drug Enforcement Agency required any clinician who wanted to prescribe buprenorphine to undergo certification training, unlike most non-addiction-related medication treatments where doctors can decide what works best for the patient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, more doctors, pharmacists and even first responders are able to prescribe buprenorphine to people who can benefit from it.\u003c/p>\n\u003cp>During the pandemic, the San Francisco Department of Public Health started delivering medications to people living in permanent supportive housing buildings and single-room occupancy hotels, where a large portion of the city’s overdose deaths have occurred.\u003c/p>\n\u003cp>Now, every Wednesday and Thursday, Damian Peterson, a psychiatric clinical pharmacist at the Department of Public Health, fills his backpack with patients’ prescriptions, plus the overdose reversal medicine Narcan, and other supplies that patients may request to help cut down on drug-use harms.\u003c/p>\n\u003cfigure id=\"attachment_11945500\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945500\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg\" alt=\"A black backpack is unzipped, revealing its contents inside, which includes hypodermic needles, medical supplies and opioid treatment medications.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Damian Peterson, a psychiatric clinical pharmacist with the San Francisco Department of Public Health, packs his backpack with harm-reduction supplies before making deliveries to SROs and permanent supportive housing in San Francisco on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peterson said he regularly visits 19 buildings, mostly in the Tenderloin and SoMa neighborhoods, and reaches about 70 clients.\u003c/p>\n\u003cp>On a recent Thursday, he took off by foot around 1 p.m. to deliver buprenorphine to Bryon Killilea, who lives in the Dudley building on 6th Street. The two have been meeting there about once a week for the past five months.\u003c/p>\n\u003cfigure id=\"attachment_11945502\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945502\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg\" alt=\"A man's hands hold a laminated flyer that reads, "Interested in Suboxone (Buprenorphine)? Text 628.233.0684."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Damian Peterson holds a sign about delivery of buprenorphine that is posted in an apartment building in San Francisco's SoMa neighborhood, on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Around here, the pharmacies are ridiculous,” Killilea said. He used fentanyl on and off for about 15 years, he said, and said the delivery program for buprenorphine was much easier than his experience with retail pharmacies.[pullquote size=\"medium\" align=\"right\" citation=\"Bryon Killilea, San Francisco resident and OBIC participant\"]'I'm just feeling more normal, not as antsy. I recommended it to a couple of my neighbors. I think this is a good thing.'[/pullquote]“They had a flyer out here and I came out and talked to them,” he said. “The hassles of going to places on BART, or needing to go every day, this sounded like a better option to have it delivered, and time-wise, it just worked out. And they were really nice.”\u003c/p>\n\u003cp>The time he’s gotten back has allowed him to spend more time with his 10-year-old son.\u003c/p>\n\u003cp>“I’m just feeling more normal, not as antsy,” Killilea said about how buprenorphine has helped him cut back on fentanyl. “I recommended it to a couple of my neighbors. I think this is a good thing.”\u003c/p>\n\u003cp>The U.S. is, in a way, now playing catchup with other countries that have made medication-assisted drug treatment widely accessible for decades.\u003c/p>\n\u003cfigure id=\"attachment_11945506\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945506\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"Buprenorphine and Naloxone orange tablets are measured on a blue surface inside a medical clinic. The bottle is white with black and orange letters.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Buprenorphine and Naloxone tablets at the Community Behavioral Health Services pharmacy in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/17915074/\">In France, all registered doctors have had the ability to prescribe buprenorphine since 1995\u003c/a>; the French government changed its dispensing policy after the heroin epidemic devastated the country in the '80s and '90s, and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/15204673/\">the policy change led to a 10-fold increase in patients being treated with buprenorphine\u003c/a>, according to one 2004 study analyzing the policy shift.\u003c/p>\n\u003cp>Within four years of opening up access to buprenorphine, opioid overdose rates in France declined 79%, the study found.[aside postID=news_11944267 hero='https://ww2.kqed.org/app/uploads/sites/10/2023/03/RS51826_068_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1020x680.jpg']San Francisco hopes to see similar success. But there are some major differences in the U.S. drug supply today from the time of the heroin epidemic here, in the 1980s and ’90s; the local illicit drug supply has become more dangerous with the introduction of fentanyl, which began ramping up in San Francisco around 2018.\u003c/p>\n\u003cp>Fentanyl is 50 times stronger than heroin and commonly used in medical settings for pain and after surgeries. Due to its unique chemical structure, it reaches opioid receptors in the brain faster than heroin or morphine. And its high potency makes it stick to fat molecules in the body longer than other opioids, which in turn can make it even more difficult to treat opioid withdrawal.\u003c/p>\n\u003cp>That means first responders and public health professionals will have to act more quickly when someone is ready for treatment.\u003c/p>\n\u003cp>Starting April 1, San Francisco Fire Department personnel began assessing people prior to taking them to the hospital, and administering buprenorphine after an overdose or if someone is experiencing withdrawal, and consents.[pullquote size=\"medium\" align=\"right\" citation=\"San Francisco Mayor London Breed\"]'Expanding access to life-saving medication is a critical part of our work to prevent overdoses.'[/pullquote]“Expanding access to life-saving medication is a critical part of our work to prevent overdoses,” Mayor London Breed said in a press release. “By giving our emergency responders the training and ability to deliver buprenorphine in the field, we can reach more people more quickly.”\u003c/p>\n\u003cp>While medication can address some of the physiological parts of opioid addiction, addressing other issues such as trauma, isolation and access to resources like food and housing are inextricably linked to recovery.\u003c/p>\n\u003cp>“Patients tend to be more successful if they feel like they have input on their recovery and what that looks like,” said Paulette Walton, a nurse practitioner at Outpatient Buprenorphine Induction Clinic (OBIC), shortly before meeting with a patient on a recent afternoon.\u003c/p>\n\u003cfigure id=\"attachment_11945507\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945507\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"One medical professional with a black blazer and blue blouse is sitting down as she speaks to a patient who sits across from her. The patient is wearing a white scarf and tan blouse as she smiles back at the medical professional inside the OBIC Clinic in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Practitioner Paulette Walton (left) speaks with patient Alyssa Ibarra at OBIC in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ibarra started coming to OBIC in the summer of 2021 after experiencing an addiction to Percocet, and briefly using heroin. For the last two years, she has regularly visited the clinic for her medication and counseling.\u003c/p>\n\u003cp>Ibarra said the stabilization this has led to has changed her life. She returned to work as a hairstylist and was promoted to manager. She’s parenting her young daughter. She’s dating again.[pullquote size=\"medium\" align=\"right\" citation=\"Alyssa Ibarra, San Francisco resident and OBIC participant\"]'They sit here and talk to me. They remember things about me. They say, 'I'm proud of you.' It's the support that I get here that I don't get at home.'[/pullquote]“They think rock bottom is literally losing everything,” Ibarra said. “But for me, rock bottom was just that the first thing I think about waking up now, just opening my eyes, I was reaching to grab my pills. And that was scary by itself.”\u003c/p>\n\u003cp>Ibarra’s recovery is ongoing. Currently, she’s thinking about changing her daily suboxone pill to a monthly, long-acting injectable. And she will continue to see her doctor at the clinic, where she said she’s found a care team that works for her.\u003c/p>\n\u003cp>“They sit here and talk to me. They remember things about me,” Ibarra said. “They say, ‘I'm proud of you.’ It's the support that I get here that I don't get at home.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"San Francisco doubles down on medication-assisted treatment for opioid addiction as the city faces an uptick in overdose deaths.","status":"publish","parent":0,"modified":1680647579,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":35,"wordCount":1709},"headData":{"title":"San Francisco Has Doubled Participants of This Opioid Treatment. Here's Why | KQED","description":"San Francisco doubles down on medication-assisted treatment for opioid addiction as the city faces an uptick in overdose deaths.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"San Francisco Has Doubled Participants of This Opioid Treatment. Here's Why","datePublished":"2023-04-04T13:00:42.000Z","dateModified":"2023-04-04T22:32:59.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first time Alyssa Ibarra tried to get suboxone, a medication proven to treat opioid use disorder, she bought it from someone off the street.\u003c/p>\n\u003cp>After an ankle injury in 2014, she started using Vicodin and Percocet recreationally and later developed an addiction to opioids after experiencing postpartum depression.\u003c/p>\n\u003cp>“When I tried to stop, I remember just feeling really hopeless,” Ibarra said. “I didn't even think, ‘I'm having withdrawals.’ I just thought it was the postpartum.”\u003c/p>\n\u003cfigure id=\"attachment_11945552\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945552\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"A woman with blond hair and gold, hoop earrings wears a white blouse and tan zip-up hoodie. She is looking at her counselor who sits across from her with her back toward the camera.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64058_020_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Practitioner Paulette Walton (left) speaks with patient Alyssa Ibarra at the Outpatient Buprenorphine Induction Clinic (OBIC) at Community Behavioral Health Services in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Until recently, medications for opioid use disorder, like methadone, suboxone or buprenorphine, a generic form of suboxone, have been so tightly regulated that \u003ca href=\"https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790432\">only about 27% of Americans with opioid use disorder have been able to access medication-assisted treatment\u003c/a>, according to a 2022 study by doctors at Rutgers and Columbia universities.\u003c/p>\n\u003cp>At the same time, \u003ca href=\"https://sf.gov/sites/default/files/2023-03/2023%2003_OCME%20Overdose%20Report.pdf\">overdose deaths have increased locally (PDF)\u003c/a> and across the U.S., \u003ca href=\"https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=More%20than%20106%2C000%20persons%20in,drugs%20from%201999%20to%202021.\">killing nearly 107,000 people nationally in 2021\u003c/a>, largely driven by synthetic opioids such as fentanyl, which is up to 100 times more powerful than morphine.\u003c/p>\n\u003cp>But local public health professionals and federal drug regulators are beginning to address the gap in access to medication-based treatment, so people like Ibarra can get the safe access they need faster.\u003c/p>\n\u003cfigure id=\"attachment_11945503\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945503\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"Two women wearing medical lanyards read over some files in a yellow folder together inside a medical clinic office.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64046_005_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Christine Soran (left) and Nurse Practitioner Paulette Walton work at OBIC on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“When someone needs it in the moment, they need it in that moment. They can't wait months for an appointment,” said Dr. Christine Soran, medical director for \u003ca href=\"https://dsaam.org/obic/\">San Francisco’s public Outpatient Buprenorphine Induction Clinic\u003c/a>. “The city is putting resources behind it, and almost every medical provider I talk to is on board with this kind of treatment.”\u003c/p>\n\u003cp>In San Francisco, the number of people who receive buprenorphine has doubled since 2013, according to data from the Department of Public Health, with a 53% increase in the past five years. Ibarra is part of that group.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"label":"More Stories on Health ","tag":"health"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The increase is largely driven by two changes: The \u003ca href=\"https://www.whitehouse.gov/ondcp/briefing-room/2023/01/25/white-house-hosts-event-to-mark-removal-of-barriers-to-addiction-treatment/\">federal government loosening its dispensing regulations\u003c/a>, and San Francisco public health officials seizing the opportunity to expand medication-assisted treatment services.\u003c/p>\n\u003cp>In December 2022, President Biden signed the bipartisan Consolidated Appropriations Act of 2023, which removed a federal requirement known as the X-waiver, which blocked some medical professionals from prescribing buprenorphine for opioid use disorder.\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8529309/#:~:text=As%20of%202020%2C%20less%20than,enforcement%20administration%2DX%20waiver%20courses.\">As of 2020, only 5% of U.S. physicians had approval to prescribe buprenorphine or suboxone\u003c/a>, according to a 2021 study conducted by emergency room physicians across the country and backed by the Foundation for Opioid Response Efforts, which funds research on solutions to the overdose crisis.\u003c/p>\n\u003cp>Under the X-waiver, the U.S. Drug Enforcement Agency required any clinician who wanted to prescribe buprenorphine to undergo certification training, unlike most non-addiction-related medication treatments where doctors can decide what works best for the patient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, more doctors, pharmacists and even first responders are able to prescribe buprenorphine to people who can benefit from it.\u003c/p>\n\u003cp>During the pandemic, the San Francisco Department of Public Health started delivering medications to people living in permanent supportive housing buildings and single-room occupancy hotels, where a large portion of the city’s overdose deaths have occurred.\u003c/p>\n\u003cp>Now, every Wednesday and Thursday, Damian Peterson, a psychiatric clinical pharmacist at the Department of Public Health, fills his backpack with patients’ prescriptions, plus the overdose reversal medicine Narcan, and other supplies that patients may request to help cut down on drug-use harms.\u003c/p>\n\u003cfigure id=\"attachment_11945500\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945500\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg\" alt=\"A black backpack is unzipped, revealing its contents inside, which includes hypodermic needles, medical supplies and opioid treatment medications.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63865_001_KQED_SOMABuprenorphineDelivery_03232023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Damian Peterson, a psychiatric clinical pharmacist with the San Francisco Department of Public Health, packs his backpack with harm-reduction supplies before making deliveries to SROs and permanent supportive housing in San Francisco on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Peterson said he regularly visits 19 buildings, mostly in the Tenderloin and SoMa neighborhoods, and reaches about 70 clients.\u003c/p>\n\u003cp>On a recent Thursday, he took off by foot around 1 p.m. to deliver buprenorphine to Bryon Killilea, who lives in the Dudley building on 6th Street. The two have been meeting there about once a week for the past five months.\u003c/p>\n\u003cfigure id=\"attachment_11945502\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945502\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg\" alt=\"A man's hands hold a laminated flyer that reads, "Interested in Suboxone (Buprenorphine)? Text 628.233.0684."\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS63877_015_KQED_SOMABuprenorphineDelivery_03232023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Damian Peterson holds a sign about delivery of buprenorphine that is posted in an apartment building in San Francisco's SoMa neighborhood, on March 23, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“Around here, the pharmacies are ridiculous,” Killilea said. He used fentanyl on and off for about 15 years, he said, and said the delivery program for buprenorphine was much easier than his experience with retail pharmacies.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'I'm just feeling more normal, not as antsy. I recommended it to a couple of my neighbors. I think this is a good thing.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Bryon Killilea, San Francisco resident and OBIC participant","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“They had a flyer out here and I came out and talked to them,” he said. “The hassles of going to places on BART, or needing to go every day, this sounded like a better option to have it delivered, and time-wise, it just worked out. And they were really nice.”\u003c/p>\n\u003cp>The time he’s gotten back has allowed him to spend more time with his 10-year-old son.\u003c/p>\n\u003cp>“I’m just feeling more normal, not as antsy,” Killilea said about how buprenorphine has helped him cut back on fentanyl. “I recommended it to a couple of my neighbors. I think this is a good thing.”\u003c/p>\n\u003cp>The U.S. is, in a way, now playing catchup with other countries that have made medication-assisted drug treatment widely accessible for decades.\u003c/p>\n\u003cfigure id=\"attachment_11945506\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945506\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"Buprenorphine and Naloxone orange tablets are measured on a blue surface inside a medical clinic. The bottle is white with black and orange letters.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64059_024_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Buprenorphine and Naloxone tablets at the Community Behavioral Health Services pharmacy in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/17915074/\">In France, all registered doctors have had the ability to prescribe buprenorphine since 1995\u003c/a>; the French government changed its dispensing policy after the heroin epidemic devastated the country in the '80s and '90s, and \u003ca href=\"https://pubmed.ncbi.nlm.nih.gov/15204673/\">the policy change led to a 10-fold increase in patients being treated with buprenorphine\u003c/a>, according to one 2004 study analyzing the policy shift.\u003c/p>\n\u003cp>Within four years of opening up access to buprenorphine, opioid overdose rates in France declined 79%, the study found.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11944267","hero":"https://ww2.kqed.org/app/uploads/sites/10/2023/03/RS51826_068_Oakland_HighlandHospitalBridgeProgram_10062021-qut-1020x680.jpg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>San Francisco hopes to see similar success. But there are some major differences in the U.S. drug supply today from the time of the heroin epidemic here, in the 1980s and ’90s; the local illicit drug supply has become more dangerous with the introduction of fentanyl, which began ramping up in San Francisco around 2018.\u003c/p>\n\u003cp>Fentanyl is 50 times stronger than heroin and commonly used in medical settings for pain and after surgeries. Due to its unique chemical structure, it reaches opioid receptors in the brain faster than heroin or morphine. And its high potency makes it stick to fat molecules in the body longer than other opioids, which in turn can make it even more difficult to treat opioid withdrawal.\u003c/p>\n\u003cp>That means first responders and public health professionals will have to act more quickly when someone is ready for treatment.\u003c/p>\n\u003cp>Starting April 1, San Francisco Fire Department personnel began assessing people prior to taking them to the hospital, and administering buprenorphine after an overdose or if someone is experiencing withdrawal, and consents.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'Expanding access to life-saving medication is a critical part of our work to prevent overdoses.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"San Francisco Mayor London Breed","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“Expanding access to life-saving medication is a critical part of our work to prevent overdoses,” Mayor London Breed said in a press release. “By giving our emergency responders the training and ability to deliver buprenorphine in the field, we can reach more people more quickly.”\u003c/p>\n\u003cp>While medication can address some of the physiological parts of opioid addiction, addressing other issues such as trauma, isolation and access to resources like food and housing are inextricably linked to recovery.\u003c/p>\n\u003cp>“Patients tend to be more successful if they feel like they have input on their recovery and what that looks like,” said Paulette Walton, a nurse practitioner at Outpatient Buprenorphine Induction Clinic (OBIC), shortly before meeting with a patient on a recent afternoon.\u003c/p>\n\u003cfigure id=\"attachment_11945507\" class=\"wp-caption aligncenter\" style=\"max-width: 1920px\">\u003cimg decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-11945507\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut.jpg\" alt=\"One medical professional with a black blazer and blue blouse is sitting down as she speaks to a patient who sits across from her. The patient is wearing a white scarf and tan blouse as she smiles back at the medical professional inside the OBIC Clinic in San Francisco.\" width=\"1920\" height=\"1280\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-800x533.jpg 800w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-1020x680.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/10/2023/04/RS64067_015_KQED_OBICBuprenorphineClinic_03292023-qut-1536x1024.jpg 1536w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">Nurse Practitioner Paulette Walton (left) speaks with patient Alyssa Ibarra at OBIC in San Francisco on March 29, 2023. \u003ccite>(Beth LaBerge/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Ibarra started coming to OBIC in the summer of 2021 after experiencing an addiction to Percocet, and briefly using heroin. For the last two years, she has regularly visited the clinic for her medication and counseling.\u003c/p>\n\u003cp>Ibarra said the stabilization this has led to has changed her life. She returned to work as a hairstylist and was promoted to manager. She’s parenting her young daughter. She’s dating again.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'They sit here and talk to me. They remember things about me. They say, 'I'm proud of you.' It's the support that I get here that I don't get at home.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Alyssa Ibarra, San Francisco resident and OBIC participant","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>“They think rock bottom is literally losing everything,” Ibarra said. “But for me, rock bottom was just that the first thing I think about waking up now, just opening my eyes, I was reaching to grab my pills. And that was scary by itself.”\u003c/p>\n\u003cp>Ibarra’s recovery is ongoing. Currently, she’s thinking about changing her daily suboxone pill to a monthly, long-acting injectable. And she will continue to see her doctor at the clinic, where she said she’s found a care team that works for her.\u003c/p>\n\u003cp>“They sit here and talk to me. They remember things about me,” Ibarra said. “They say, ‘I'm proud of you.’ It's the support that I get here that I don't get at home.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11945418/san-francisco-has-doubled-participants-of-this-opioid-treatment-heres-why","authors":["11840"],"categories":["news_457","news_8"],"tags":["news_21434","news_28991","news_23292","news_25968","news_25959","news_27626","news_25617","news_31709","news_22774","news_22661","news_29747","news_38"],"featImg":"news_11945501","label":"news"},"news_11943291":{"type":"posts","id":"news_11943291","meta":{"index":"posts_1591205157","site":"news","id":"11943291","score":null,"sort":[1678701641000]},"guestAuthors":[],"slug":"the-success-of-s-fs-mobile-opioid-clinics","title":"The Success of S.F’s Mobile Opioid Treatment Clinics","publishDate":1678701641,"format":"audio","headTitle":"The Success of S.F’s Mobile Opioid Treatment Clinics | KQED","labelTerm":{},"content":"\u003cp>San Francisco’s mobile opioid treatment clinics were set up as a way to address overcrowding at San Francisco General Hospital during the beginning of the COVID-19 pandemic. These vans distribute methadone, a medication used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>. And surprisingly, these temporary mobile clinics are drawing more patients than SF General’s indoor treatment clinics. Now, the people who run it want to find a way to keep them around.\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/file/d/1xbM4bouUiMJ34cSBPM29g1FzofZ5yCVV/view?usp=share_link\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Guest\u003c/strong>: \u003ca href=\"https://twitter.com/sydneyfjohnson\" target=\"_blank\" rel=\"noopener noreferrer\">Sydney Johnson,\u003c/a> KQED reporter\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC4114349077&artwork=false&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Links:\u003c/p>\n\u003cul>\n\u003cli class=\"routes-Site-routes-Post-components-Post-components-PostTitle-___PostTitle__title\">\u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\" target=\"_blank\" rel=\"noopener\">SF’s Mobile Clinics Made Opioid Treatment More Accessible During the Pandemic. But Will They Stay?\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/about/17653/help-make-the-bay-even-better\" target=\"_blank\" rel=\"noopener\">The Bay Survey\u003c/a>\u003c/li>\n\u003c/ul>\n\n","blocks":[],"excerpt":"San Francisco’s mobile opioid treatment clinics distribute methadone, a medication used to reduce withdrawal symptoms of fentanyl and heroine. Despite their success, their future remains uncertain. ","status":"publish","parent":0,"modified":1700682784,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":7,"wordCount":135},"headData":{"title":"The Success of S.F’s Mobile Opioid Treatment Clinics | KQED","description":"San Francisco’s mobile opioid treatment clinics distribute methadone, a medication used to reduce withdrawal symptoms of fentanyl and heroine. Despite their success, their future remains uncertain. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"The Success of S.F’s Mobile Opioid Treatment Clinics","datePublished":"2023-03-13T10:00:41.000Z","dateModified":"2023-11-22T19:53:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"The Bay","sourceUrl":"https://www.kqed.org/podcasts/thebay","audioUrl":"https://www.podtrac.com/pts/redirect.mp3/chrt.fm/track/A511B8/traffic.megaphone.fm/KQINC4114349077.mp3?updated=1678490768","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11943291/the-success-of-s-fs-mobile-opioid-clinics","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco’s mobile opioid treatment clinics were set up as a way to address overcrowding at San Francisco General Hospital during the beginning of the COVID-19 pandemic. These vans distribute methadone, a medication used to reduce withdrawal symptoms — while offering program patients snacks, water and canisters of naloxone, an overdose-reversal nasal spray.\u003c/p>\n\u003cp>In San Francisco alone, \u003ca href=\"https://sf.gov/resource/2020/ocme-accidental-overdose-reports\" target=\"_blank\" rel=\"noopener noreferrer\">nearly 2,000 people have died of drug overdoses since 2020\u003c/a>. And surprisingly, these temporary mobile clinics are drawing more patients than SF General’s indoor treatment clinics. Now, the people who run it want to find a way to keep them around.\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/file/d/1xbM4bouUiMJ34cSBPM29g1FzofZ5yCVV/view?usp=share_link\">\u003cem>Episode transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cp>\u003cstrong>Guest\u003c/strong>: \u003ca href=\"https://twitter.com/sydneyfjohnson\" target=\"_blank\" rel=\"noopener noreferrer\">Sydney Johnson,\u003c/a> KQED reporter\u003c/p>\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm/?e=KQINC4114349077&artwork=false&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Links:\u003c/p>\n\u003cul>\n\u003cli class=\"routes-Site-routes-Post-components-Post-components-PostTitle-___PostTitle__title\">\u003ca href=\"https://www.kqed.org/news/11941618/sfs-mobile-clinics-made-opioid-treatment-more-accessible-during-the-pandemic-but-will-they-stay\" target=\"_blank\" rel=\"noopener\">SF’s Mobile Clinics Made Opioid Treatment More Accessible During the Pandemic. But Will They Stay?\u003c/a>\u003c/li>\n\u003cli>\u003ca href=\"https://www.kqed.org/about/17653/help-make-the-bay-even-better\" target=\"_blank\" rel=\"noopener\">The Bay Survey\u003c/a>\u003c/li>\n\u003c/ul>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11943291/the-success-of-s-fs-mobile-opioid-clinics","authors":["8654","11840","11802","11649"],"programs":["news_28779"],"categories":["news_8","news_33520"],"tags":["news_21434","news_28991","news_25959","news_23051","news_22598"],"featImg":"news_11941683","label":"source_news_11943291"},"news_11934668":{"type":"posts","id":"news_11934668","meta":{"index":"posts_1591205157","site":"news","id":"11934668","score":null,"sort":[1670583649000]},"guestAuthors":[],"slug":"when-the-tenderloin-goes-viral","title":"When the Tenderloin's Addiction Crisis Goes Viral","publishDate":1670583649,"format":"audio","headTitle":"When the Tenderloin’s Addiction Crisis Goes Viral | KQED","labelTerm":{},"content":"\u003cp>San Francisco’s Tenderloin neighborhood has a reputation for drug addiction, poverty, and homelessness — all big problems that have not been solved by city and state leaders. But the neighborhood’s image is also shaped by disturbing pictures and videos of people taking drugs outside that go viral on social media.\u003c/p>\n\u003cp>These images, which circulate around the world, can evoke anger, fear, and frustration. They also shape opinion about what should be done and galvanize support for harsher, tougher crackdowns on drug dealing and drug use.\u003c/p>\n\u003cp>Some believe that sharing these photos on social media is necessary to document this ongoing problem. Others say they only show one side of drug addiction, and leave those photographed without agency in how their stories are used.\u003c/p>\n\u003cp>\u003cstrong>Guest\u003c/strong>: \u003ca href=\"https://twitter.com/HollyMcDede\" target=\"_blank\" rel=\"noopener noreferrer\">Holly J. McDede\u003c/a>, KQED reporter/producer\u003c/p>\n\u003cdiv class=\"card card--enclosed grey\">\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC1709992853&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/drive/folders/1Rh877knbawecxlCugjWIHSq3eTGDee1z\" target=\"_blank\" rel=\"noopener\">\u003cem>Read the transcript\u003c/em>\u003c/a>\u003c/p>\n\u003c/div>\n\u003cp dir=\"ltr\">\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\n\u003cp dir=\"ltr\" role=\"presentation\">\u003ca href=\"https://www.kqed.org/news/11910500/advocacy-or-exploitation-the-ethical-concerns-around-posting-images-of-poverty-and-addiction-in-the-tenderloin\">Advocacy or Exploitation? The Ethical Concerns Around Posting Images of Poverty and Addiction in the Tenderloin\u003c/a>\u003c/p>\n\u003c/li>\n\u003cli>\u003ca href=\"https://kqed.org/thebaysurvey\">\u003cstrong>Survey: \u003c/strong>\u003cb>Help Make The Bay Even Better\u003c/b>!\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1700682987,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":7,"wordCount":165},"headData":{"title":"When the Tenderloin's Addiction Crisis Goes Viral | KQED","description":"San Francisco's Tenderloin neighborhood has a reputation for drug addiction, poverty, and homelessness — all big problems that have not been solved by city and state leaders. But the neighborhood’s image is also shaped by disturbing pictures and videos of people taking drugs outside that go viral on social media. These images, which circulate around","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"When the Tenderloin's Addiction Crisis Goes Viral","datePublished":"2022-12-09T11:00:49.000Z","dateModified":"2023-11-22T19:56:27.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"source":"The Bay","sourceUrl":"https://www.kqed.org/podcasts/thebay","audioUrl":"https://www.podtrac.com/pts/redirect.mp3/traffic.megaphone.fm/KQINC1709992853.mp3","excludeFromSiteSearch":"Include","articleAge":"0","path":"/news/11934668/when-the-tenderloin-goes-viral","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>San Francisco’s Tenderloin neighborhood has a reputation for drug addiction, poverty, and homelessness — all big problems that have not been solved by city and state leaders. But the neighborhood’s image is also shaped by disturbing pictures and videos of people taking drugs outside that go viral on social media.\u003c/p>\n\u003cp>These images, which circulate around the world, can evoke anger, fear, and frustration. They also shape opinion about what should be done and galvanize support for harsher, tougher crackdowns on drug dealing and drug use.\u003c/p>\n\u003cp>Some believe that sharing these photos on social media is necessary to document this ongoing problem. Others say they only show one side of drug addiction, and leave those photographed without agency in how their stories are used.\u003c/p>\n\u003cp>\u003cstrong>Guest\u003c/strong>: \u003ca href=\"https://twitter.com/HollyMcDede\" target=\"_blank\" rel=\"noopener noreferrer\">Holly J. McDede\u003c/a>, KQED reporter/producer\u003c/p>\n\u003cdiv class=\"card card--enclosed grey\">\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC1709992853&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/drive/folders/1Rh877knbawecxlCugjWIHSq3eTGDee1z\" target=\"_blank\" rel=\"noopener\">\u003cem>Read the transcript\u003c/em>\u003c/a>\u003c/p>\n\u003c/div>\n\u003cp dir=\"ltr\">\u003cstrong>Links:\u003c/strong>\u003c/p>\n\u003cul>\n\u003cli>\n\u003cp dir=\"ltr\" role=\"presentation\">\u003ca href=\"https://www.kqed.org/news/11910500/advocacy-or-exploitation-the-ethical-concerns-around-posting-images-of-poverty-and-addiction-in-the-tenderloin\">Advocacy or Exploitation? The Ethical Concerns Around Posting Images of Poverty and Addiction in the Tenderloin\u003c/a>\u003c/p>\n\u003c/li>\n\u003cli>\u003ca href=\"https://kqed.org/thebaysurvey\">\u003cstrong>Survey: \u003c/strong>\u003cb>Help Make The Bay Even Better\u003c/b>!\u003c/a>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11934668/when-the-tenderloin-goes-viral","authors":["8654","11635","11802","11649"],"programs":["news_28779"],"categories":["news_8","news_33520"],"tags":["news_21434","news_2587","news_1089","news_3181","news_22598"],"featImg":"news_11911802","label":"source_news_11934668"},"news_11934623":{"type":"posts","id":"news_11934623","meta":{"index":"posts_1591205157","site":"news","id":"11934623","score":null,"sort":[1670553306000]},"guestAuthors":[],"slug":"how-street-medicine-teams-are-tackling-the-unhoused-health-care-crisis","title":"How Street Medicine Teams Are Tackling the Unhoused Health Care Crisis","publishDate":1670553306,"format":"standard","headTitle":"KQED News","labelTerm":{"site":"news"},"content":"\u003cp>Living on the streets of California is a deadly affair. The\u003ca href=\"https://www.researchgate.net/profile/David-Turbow/publication/336130686_Principal_Component_Analysis_of_Morbidity_and_Mortality_among_the_United_States_Homeless_Population_A_Systematic_Review_and_Meta-Analysis/links/5d913ac9299bf10cff1a0b50/Principal-Component-Analysis-of-Morbidity-and-Mortality-among-the-United-States-Homeless-Population-A-Systematic-Review-and-Meta-Analysis.pdf\"> life expectancy of an unsheltered person is 50\u003c/a>, according to national estimates, nearly 30 years less than that of the average Californian. As \u003ca href=\"https://calmatters.org/housing/2022/10/california-homeless-crisis-latinos/\">homelessness spirals out of control\u003c/a> throughout the state, so too do \u003ca href=\"https://www.nytimes.com/2022/04/18/us/homeless-deaths-los-angeles.html\">deaths on the street\u003c/a>, but it’s those whose lives are the most fragile who are least likely to get medical care.\u003c/p>\n\u003cp>[pullquote size=\"medium\" align=\"right\" citation=\"Brett Feldman, physician assistant\"]'They have Medi-Cal. They're eligible for all these benefits, but they can't access these benefits.'[/pullquote]Now, the state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness. Through a series of incentives and regulatory changes, the Health Care Services Department is encouraging Medi-Cal insurers to fund and partner with organizations that bring primary care into encampments.\u003c/p>\n\u003cp>They’re known as street medicine teams. There are at least 25 in California.\u003c/p>\n\u003cp>“Oh, crap. This is where she was, and they just swept that,” said Brett Feldman on a Friday morning in November, looking at a green tent, crumpled and abandoned on Skid Row in Los Angeles. Feldman, a physician assistant, is searching for a female patient in her 40s with severe and unmanaged asthma. She cycles predictably in and out of the hospital, and Feldman knows she’s due for another hospitalization soon.\u003c/p>\n\u003cfigure id=\"attachment_11934632\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM.png\">\u003cimg class=\"size-medium wp-image-11934632\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-800x526.png\" alt=\"A man wearing a black t-shirt and gray pants leans over to look at a tent on the street.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-1020x670.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-1536x1009.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM.png 1540w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Brett Feldman asks a man in his encampment if he has seen a patient along Skid Row in Los Angeles on Nov. 18, 2022. The patient was likely pushed out of the area as the Los Angeles sanitation department cleared the unhoused to clean the street near Skid Row. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The road is streaked with water from a cleaning truck, and sanitation workers in fluorescent vests sweep up debris. Parking enforcement and police cruisers line the section of road where a homeless encampment once stood. Nearly 5,000 people live in the half-mile block infamous for the hypervisibility it affords the state’s unrelenting homelessness crisis.[aside postID=\"news_11932895,news_11927968\" label=\"Related Posts\"]Burdened by disproportionate rates of \u003ca href=\"https://escholarship.org/uc/item/44c5j3qz\">substance use disorders, mental health disorders and chronic disease\u003c/a>, people experiencing homelessness are some of the state’s neediest patients, but few receive anything more than emergency services. Barriers like lack of transportation and cumbersome insurance rules keep most from getting regular health care. Instead, they drift through the emergency room during a crisis, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">racking up high costs to the system (PDF)\u003c/a> and deteriorating physically in the interim.\u003c/p>\n\u003cp>Delivering health care this way is costly and not particularly effective for the patient or the system. \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">More than half of the state’s $133 billion Medi-Cal budget is spent on the top 5% of high-needs users (PDF)\u003c/a>, according to the California Department of Health Care Services.\u003c/p>\n\u003cp>“Where we have been falling short, especially with this population, is their reality is so different from ours that we haven’t been building reality-based systems for them,” Feldman said. “They have Medi-Cal. They’re eligible for all these benefits, but they can’t access these benefits.”\u003c/p>\n\u003cp>The state’s efforts to bridge the gap between eligibility and access is supported in part through \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">CalAIM\u003c/a>, a multiyear plan to revamp the state’s lower-income health insurance program. Grants to hire staff or invest in billing or data collection software offer some stability to teams that have historically been volunteer- or charity-operated. The department also issued a rule change in November \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2022/APL22-023.pdf\">allowing street medicine teams to tap into and manage unhoused patients’ Medi-Cal benefits (PDF)\u003c/a>, meaning providers can be reimbursed for their work.\u003c/p>\n\u003cp>“One of our core principles of CalAIM is breaking down the walls of health care and meeting people where they are,” said Jacey Cooper, director of the state’s Medi-Cal program. “We really feel like street medicine helps us do that.”\u003c/p>\n\u003ch2>What is street medicine?\u003c/h2>\n\u003cp>Several months ago, Feldman’s Skid Row patient suffered a brain injury from lack of oxygen during an asthma attack. She’s now confined to a wheelchair and reliant on a friend for basic needs like finding food and using the toilet.\u003c/p>\n\u003cp>Newer asthma medications might be able to help end her hospitalization cycle, but until recently only her assigned primary care doctor, whom she has never seen, was allowed to refer her to a specialist for assessment under Byzantine Medi-Cal rules. Feldman had been trying to get her a primary care appointment for more than a year, to no avail.\u003c/p>\n\u003cp>Under the new rules, however, Feldman could have referred the asthmatic patient directly to the lung specialist she needed or gotten prior authorization for the medication since it was recommended during a hospital stay. Instead, without adequate medical care to address her condition, her life has been irrevocably altered.\u003c/p>\n\u003cp>Statistically, she’ll be lucky to live longer than a few more years.\u003c/p>\n\u003cp>“She used to be a staple down here. She knew everybody,” Feldman said. “Now, she can’t walk, is confined to her tent. She’s lonely because she’s used to being part of the Skid Row community. She had a very full life despite being unhoused.”\u003c/p>\n\u003cp>Feldman, co-founder and director of the street medicine program at the University of Southern California’s Keck School of Medicine, said the goal of street medicine is to give some autonomy back to people who usually have very little power left in their lives.\u003c/p>\n\u003cfigure id=\"attachment_11934633\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM.png\">\u003cimg class=\"size-medium wp-image-11934633\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-800x515.png\" alt=\"A man wearing a black t-shirt uses a stethoscope on a woman's arm in a tent.\" width=\"800\" height=\"515\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-800x515.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-1020x657.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-160x103.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-1536x989.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM.png 1538w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Brett Feldman checks Carla Bolen’s blood pressure while she sits in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park on Nov. 18, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Each day he and a team of providers scour the county streets diagnosing chronic and acute conditions, treating mental illness and substance use, delivering medicine, drawing blood for tests and following up with patients who request a visit. Community health workers hand out food and hygiene supplies and help them navigate hurdles as they try to obtain housing and social services.\u003c/p>\n\u003cp>“We know that people who are experiencing homelessness have higher mortality, have higher ER utilization, have higher length of stay when they get admitted,” Cooper said. “We really see this as part of a comprehensive approach to ensuring that we have a true continuum of care for people experiencing homelessness.”\u003c/p>\n\u003cp>The traditional health care system thrives off efficiency: The more patients move through an office, the more the provider gets paid, resulting in brief appointments and little sympathy for circumstances that make patients late. But that setup doesn’t work for unsheltered people who run the risk of getting their belongings stolen if they leave their camp — or who would rather find something to eat than take care of what may seem like a minor malady.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB369\">Less than 30% of unhoused people with Medi-Cal have ever seen their primary care provider\u003c/a>, according to a state legislative analysis of a street medicine bill vetoed by Gov. Gavin Newsom in 2021. The measure passed the Legislature with broad support but was opposed by the state Health Care Services Department for potential duplication of services. In the \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/AB-369-1082021.pdf\">veto (PDF)\u003c/a>, Newsom directed the department to work with street medicine teams to fill any gaps left by CalAIM; one such gap was adjusting billing codes that prevented street medicine reimbursement.\u003c/p>\n\u003cp>“When you’re focused on those very basic needs, like food, safety, shelter, how are you then able to focus on, you know, managing your diabetes or your blood pressure or some of these risk factors that can lead to more serious downstream effects?” said Dr. Kyle Patton, medical director of the street medicine program at Shasta Community Health Center in Redding.\u003c/p>\n\u003cp>On a Monday in September, Patton and Anna Cummings, a case worker, trekked through a wooded area on the north edge of town to meet Amber Schmitt, 47, a patient with an infected leg. The ground is muddy from a storm the night before. Schmitt is paying a friend $700 a month to stay in his apartment, but hidden among the trees and rolling hills is her abandoned encampment, along with dozens of others. Schmitt gets $1,000 a month from Social Security, but it’s not enough to afford a security deposit or rent in the area, she said.\u003c/p>\n\u003cfigure id=\"attachment_11934634\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM.png\">\u003cimg class=\"size-medium wp-image-11934634\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-800x531.png\" alt=\"A man wearing a dark shirt, sunglasses and jeans looks down at an object in his hands while a woman wearing a black hooded sweatshirt and pants has her bandaged right leg propped up on the trunk of a car.\" width=\"800\" height=\"531\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-800x531.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-1020x677.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-160x106.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-1536x1020.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM.png 1542w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Kyle Patton prescribes Amber Schmitt with medication to treat the wound on her leg in the back of his truck on Sept. 19, 2022. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The gash on Schmitt’s right shin is mottled and inflamed. She said she scraped it on a fallen branch. Patton cleaned and dressed it for her previously, but she had no choice but to reuse bandages after running out. Now she can barely walk from the pain.\u003c/p>\n\u003cp>“This is a silver-based dressing, which will kill bacteria in wounds,” Patton tells Schmitt after rinsing the area with a saline wash. “We’ll get you some more dressing, too. And then you’ve got some skin breakdown and maceration between your toes. I don’t like the look of that.”\u003c/p>\n\u003cp>He gives her a fungal cream and a bottle of antibiotics. Schmitt is a leukemia survivor and has had a hip replacement on the same injured leg. Her medical history makes her prone to infections and poor circulation in her extremities, Patton said.\u003c/p>\n\u003cp>“There’s people that would maybe make the argument that … they have health insurance here in California, they should just utilize the system as-is. The reality is because of certain factors within the context of their homelessness, they’re not able to do that,” Patton said.\u003c/p>\n\u003cp>Although they qualify for comprehensive health coverage under Medi-Cal, the program wasn’t necessarily designed with unhoused people in mind. For example, Medi-Cal will pay for transportation to and from a doctor’s appointment, but it requires the patient to provide a fixed address and give several week’s notice to the driver, something most people experiencing homelessness aren’t able to arrange.\u003c/p>\n\u003ch2 id=\"h-link-between-homelessness-and-health\">Link between homelessness and health\u003c/h2>\n\u003cp>Health data on unhoused people is sparse, with no state agency and only a handful of counties tracking the information, but it’s clear that most of their deaths are preventable.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.achch.org/uploads/7/2/5/4/72547769/2018-2020_ac_homeless_mortality_report_final_4.11.2022.pdf\">Alameda (PDF) \u003c/a>and \u003ca href=\"https://nhchc.org/wp-content/uploads/2022/10/Mortality-in-PEH-Marin-Co-10-22.pdf\">Marin (PDF)\u003c/a> counties, half result from acute or chronic health conditions like cardiovascular disease, cancer or respiratory failure. In Orange County, these make up a quarter of deaths among the unhoused. In Los Angeles County, heart disease is the second-leading cause of death among people experiencing homelessness, second only to overdoses.\u003c/p>\n\u003cp>Even overdose deaths are considered preventable — yet in San Francisco, overdoses cause 82% of deaths among the unsheltered.\u003c/p>\n\u003cp>“We commonly see conditions that you would see in a typical population, but they’re just not addressed. So, out-of-control high blood pressure, uncontrolled diabetes … also substance use in terms of opioids, we see a whole lot more than in the general population,” said Dr. Absalon Galat, medical director for LA County’s Department of Health Services’ Housing for Health division.\u003c/p>\n\u003cp>Galat’s team started its foray into street medicine in an effort to dole out COVID-19 vaccines, but team members quickly found they needed to do more. The county used COVID-19 relief funds to purchase mobile clinics, and CalAIM funding has helped them hire 60 staff members.\u003c/p>\n\u003cfigure id=\"attachment_11934635\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM.png\">\u003cimg class=\"size-medium wp-image-11934635\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-800x526.png\" alt=\"A man with a black Raiders hat and gray shirt sits down in a medical facility.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-1020x671.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM.png 1058w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Isaac Pierce gets a checkup in the Los Angeles County Department of Health Services' mobile clinic parked in Whittier Narrows Park on Nov. 17, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, the county’s \u003ca href=\"https://www.latimes.com/california/story/2022-10-13/la-county-mobile-medical-clinic\">fleet of mobile clinics,\u003c/a> complete with fully outfitted exam rooms, began visiting areas where services are sparse. Smaller teams of clinicians and case workers roam encampments to follow up with patients, treat minor issues and bring patients to the mobile clinic. There’s some disagreement among street medicine providers about whether mobile clinics remove enough barriers because they still require patients to travel to a set location, but Galat said his goal is to improve access, whether it’s by wheel or foot.\u003c/p>\n\u003cp>“People are dying every day,” Galat said. “So we have to try with what we know best in the medical field right now to limit people who are dying.”\u003c/p>\n\u003cfigure id=\"attachment_11934636\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM.png\">\u003cimg class=\"size-medium wp-image-11934636\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-800x526.png\" alt=\"A light blue medical truck with several photos of people and a medical logo on the side with a ramp and stairs leading inside.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-1020x670.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM.png 1056w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Los Angeles County Department of Health Services' mobile clinic parked in Whittier Narrows Park to see unhoused patients on Nov. 17, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The connection between homelessness and health is inextricable, said Dr. Michelle Schneidermann, director of the People-Centered Care team at the California Health Care Foundation, a statewide health policy think tank.\u003c/p>\n\u003cp>“Either one can lead to the other. A catastrophic health incident or a series of conditions can lead to someone not being able to work, leading to poverty,” Schneidermann said. “We see this all the time, health conditions precipitating homelessness, and the other way around.”\u003c/p>\n\u003cp>Take Danny Doran, 56, who visited LA County’s mobile clinic at Whittier Narrows Park on a recent Thursday to pick up insulin. He spent his career as a plumber and owned a home in Bishop. Three years ago he fell into a diabetic coma and was hospitalized for months. A friend Doran trusted to pay his bills while he was hospitalized emptied his bank account and disappeared — Doran has been unhoused ever since. Several weeks ago he was beaten and robbed by another unhoused man, who left him with a fracture in his skull and a tremor in his hands.\u003c/p>\n\u003cp>“I guess I’m a little bit naive,” Doran said. “We’re all humans and we’re prone to mistakes, you know? So I hate for anyone to have their money stolen like mine was and end up like me on the streets.”\u003c/p>\n\u003cp>At the mobile clinic, Doran said the doctor on staff agreed to be his primary care physician. His previous primary care doctor stopped accepting Medi-Cal insurance, and Doran hasn’t had regular access to insulin ever since.\u003c/p>\n\u003cp>“The doc here, she truly has compassion for her patients. I’m glad our paths crossed,” Doran said.\u003c/p>\n\u003cfigure id=\"attachment_11934637\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM.png\">\u003cimg class=\"size-medium wp-image-11934637\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-800x523.png\" alt=\"A man wearing black hat, camouflage scarf and black jacket outside near a truck with a medical logo.\" width=\"800\" height=\"523\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-800x523.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-1020x666.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-1536x1003.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM.png 1546w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Unhoused patient Danny Doran sits in the waiting area for the mobile clinic parked in Whittier Narrows Park on Nov. 17, 2022. Doran is being checked after being assaulted near his encampment just a few days before. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Schneidermann, who is overseeing a study on street medicine programs across California, said CalAIM, which also pays for housing services, is an opportunity for the state to address its most pernicious problem.\u003c/p>\n\u003cp>“Until we can end our crisis of homelessness … we have to find a way to deliver care for people on the streets,” Schneidermann said.\u003c/p>\n\u003ch2>New programs popping up\u003c/h2>\n\u003cp>Prior to CalAIM and the Health Care Services Department’s rule changes, street medicine programs operated outside of traditional health care, funded by philanthropies or the rare health organization willing to lose money. Now, the department’s changes offer some hope for stability, Feldman said.\u003c/p>\n\u003cp>Noting that these programs were birthed out of the pandemic, Feldman said they “might not exist in a few years if they’re not supported, but they have all these patients that rely on them.”\u003c/p>\n\u003cp>A year ago only 25 programs existed across the state, primarily concentrated in urban areas, Feldman said. But ever since CalAIM launched at the beginning of 2022, he’s run into more organizations looking to begin services. CalAIM requires Medi-Cal insurers to coordinate patients’ physical, behavioral, dental and developmental care as well as social services — something many street medicine teams already do. The goal is to make the “system hustle behind the scenes rather than making the patient hustle,” California Health Care Foundations’ Schneidermann said.\u003c/p>\n\u003cp>One such program is run by Anthony Menacho in Sacramento. Unlike USC, Shasta Community Health or LA County’s teams that are staffed full-time, Menacho’s street medicine band is composed entirely of volunteers. They visit six camps every other weekend.\u003c/p>\n\u003cp>The work was funded initially by a $100,000 grant from Health Net, the largest Medi-Cal provider in the state, but Menacho, who trained as a physician assistant with Feldman at USC, wants to be able to do the work full-time and hire more clinicians. He’s working to secure money through CalAIM and the Department of Health Care Services.\u003c/p>\n\u003cp>“We don’t have the academic resources or people behind us to be able to put in a department or infrastructure on the drop of the dime,” Menacho said. “We run on grants, but that’s not true sustainability. We can’t do it ourselves. It has to be a coordinated effort and I think that’s what CalAIM is trying to do.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"Unhoused people often have sporadic or no access to health care, resulting in costly, chronic conditions. A new statewide effort encourages Medi-Cal insurers to partner with street teams to improve care.","status":"publish","parent":0,"modified":1670614182,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":49,"wordCount":2895},"headData":{"title":"How Street Medicine Teams Are Tackling the Unhoused Health Care Crisis | KQED","description":"Unhoused people often have sporadic or no access to health care, resulting in costly, chronic conditions. A new statewide effort encourages Medi-Cal insurers to partner with street teams to improve care.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"NewsArticle","headline":"How Street Medicine Teams Are Tackling the Unhoused Health Care Crisis","datePublished":"2022-12-09T02:35:06.000Z","dateModified":"2022-12-09T19:29:42.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png","isAccessibleForFree":"Y","publisher":{"@type":"NewsMediaOrganization","@id":"https://www.kqed.org/#organization","name":"KQED","url":"https://www.kqed.org","logo":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}}},"nprByline":"Kristen Hwang","excludeFromSiteSearch":"Include","showOnAuthorArchivePages":"No","path":"/news/11934623/how-street-medicine-teams-are-tackling-the-unhoused-health-care-crisis","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Living on the streets of California is a deadly affair. The\u003ca href=\"https://www.researchgate.net/profile/David-Turbow/publication/336130686_Principal_Component_Analysis_of_Morbidity_and_Mortality_among_the_United_States_Homeless_Population_A_Systematic_Review_and_Meta-Analysis/links/5d913ac9299bf10cff1a0b50/Principal-Component-Analysis-of-Morbidity-and-Mortality-among-the-United-States-Homeless-Population-A-Systematic-Review-and-Meta-Analysis.pdf\"> life expectancy of an unsheltered person is 50\u003c/a>, according to national estimates, nearly 30 years less than that of the average Californian. As \u003ca href=\"https://calmatters.org/housing/2022/10/california-homeless-crisis-latinos/\">homelessness spirals out of control\u003c/a> throughout the state, so too do \u003ca href=\"https://www.nytimes.com/2022/04/18/us/homeless-deaths-los-angeles.html\">deaths on the street\u003c/a>, but it’s those whose lives are the most fragile who are least likely to get medical care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"'They have Medi-Cal. They're eligible for all these benefits, but they can't access these benefits.'","name":"pullquote","attributes":{"named":{"size":"medium","align":"right","citation":"Brett Feldman, physician assistant","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Now, the state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness. Through a series of incentives and regulatory changes, the Health Care Services Department is encouraging Medi-Cal insurers to fund and partner with organizations that bring primary care into encampments.\u003c/p>\n\u003cp>They’re known as street medicine teams. There are at least 25 in California.\u003c/p>\n\u003cp>“Oh, crap. This is where she was, and they just swept that,” said Brett Feldman on a Friday morning in November, looking at a green tent, crumpled and abandoned on Skid Row in Los Angeles. Feldman, a physician assistant, is searching for a female patient in her 40s with severe and unmanaged asthma. She cycles predictably in and out of the hospital, and Feldman knows she’s due for another hospitalization soon.\u003c/p>\n\u003cfigure id=\"attachment_11934632\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM.png\">\u003cimg class=\"size-medium wp-image-11934632\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-800x526.png\" alt=\"A man wearing a black t-shirt and gray pants leans over to look at a tent on the street.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-1020x670.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM-1536x1009.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.25-PM.png 1540w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Brett Feldman asks a man in his encampment if he has seen a patient along Skid Row in Los Angeles on Nov. 18, 2022. The patient was likely pushed out of the area as the Los Angeles sanitation department cleared the unhoused to clean the street near Skid Row. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The road is streaked with water from a cleaning truck, and sanitation workers in fluorescent vests sweep up debris. Parking enforcement and police cruisers line the section of road where a homeless encampment once stood. Nearly 5,000 people live in the half-mile block infamous for the hypervisibility it affords the state’s unrelenting homelessness crisis.\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"aside","attributes":{"named":{"postid":"news_11932895,news_11927968","label":"Related Posts "},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>Burdened by disproportionate rates of \u003ca href=\"https://escholarship.org/uc/item/44c5j3qz\">substance use disorders, mental health disorders and chronic disease\u003c/a>, people experiencing homelessness are some of the state’s neediest patients, but few receive anything more than emergency services. Barriers like lack of transportation and cumbersome insurance rules keep most from getting regular health care. Instead, they drift through the emergency room during a crisis, \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">racking up high costs to the system (PDF)\u003c/a> and deteriorating physically in the interim.\u003c/p>\n\u003cp>Delivering health care this way is costly and not particularly effective for the patient or the system. \u003ca href=\"https://www.dhcs.ca.gov/CalAIM/Documents/CalAIM-ECM-a11y.pdf\">More than half of the state’s $133 billion Medi-Cal budget is spent on the top 5% of high-needs users (PDF)\u003c/a>, according to the California Department of Health Care Services.\u003c/p>\n\u003cp>“Where we have been falling short, especially with this population, is their reality is so different from ours that we haven’t been building reality-based systems for them,” Feldman said. “They have Medi-Cal. They’re eligible for all these benefits, but they can’t access these benefits.”\u003c/p>\n\u003cp>The state’s efforts to bridge the gap between eligibility and access is supported in part through \u003ca href=\"https://calmatters.org/health/2022/02/california-medi-cal-reform/\">CalAIM\u003c/a>, a multiyear plan to revamp the state’s lower-income health insurance program. Grants to hire staff or invest in billing or data collection software offer some stability to teams that have historically been volunteer- or charity-operated. The department also issued a rule change in November \u003ca href=\"https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2022/APL22-023.pdf\">allowing street medicine teams to tap into and manage unhoused patients’ Medi-Cal benefits (PDF)\u003c/a>, meaning providers can be reimbursed for their work.\u003c/p>\n\u003cp>“One of our core principles of CalAIM is breaking down the walls of health care and meeting people where they are,” said Jacey Cooper, director of the state’s Medi-Cal program. “We really feel like street medicine helps us do that.”\u003c/p>\n\u003ch2>What is street medicine?\u003c/h2>\n\u003cp>Several months ago, Feldman’s Skid Row patient suffered a brain injury from lack of oxygen during an asthma attack. She’s now confined to a wheelchair and reliant on a friend for basic needs like finding food and using the toilet.\u003c/p>\n\u003cp>Newer asthma medications might be able to help end her hospitalization cycle, but until recently only her assigned primary care doctor, whom she has never seen, was allowed to refer her to a specialist for assessment under Byzantine Medi-Cal rules. Feldman had been trying to get her a primary care appointment for more than a year, to no avail.\u003c/p>\n\u003cp>Under the new rules, however, Feldman could have referred the asthmatic patient directly to the lung specialist she needed or gotten prior authorization for the medication since it was recommended during a hospital stay. Instead, without adequate medical care to address her condition, her life has been irrevocably altered.\u003c/p>\n\u003cp>Statistically, she’ll be lucky to live longer than a few more years.\u003c/p>\n\u003cp>“She used to be a staple down here. She knew everybody,” Feldman said. “Now, she can’t walk, is confined to her tent. She’s lonely because she’s used to being part of the Skid Row community. She had a very full life despite being unhoused.”\u003c/p>\n\u003cp>Feldman, co-founder and director of the street medicine program at the University of Southern California’s Keck School of Medicine, said the goal of street medicine is to give some autonomy back to people who usually have very little power left in their lives.\u003c/p>\n\u003cfigure id=\"attachment_11934633\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM.png\">\u003cimg class=\"size-medium wp-image-11934633\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-800x515.png\" alt=\"A man wearing a black t-shirt uses a stethoscope on a woman's arm in a tent.\" width=\"800\" height=\"515\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-800x515.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-1020x657.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-160x103.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM-1536x989.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.35-PM.png 1538w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Physician assistant Brett Feldman checks Carla Bolen’s blood pressure while she sits in her encampment at the Figueroa St. Viaduct above Highway 110 in Elysian Valley Park on Nov. 18, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Each day he and a team of providers scour the county streets diagnosing chronic and acute conditions, treating mental illness and substance use, delivering medicine, drawing blood for tests and following up with patients who request a visit. Community health workers hand out food and hygiene supplies and help them navigate hurdles as they try to obtain housing and social services.\u003c/p>\n\u003cp>“We know that people who are experiencing homelessness have higher mortality, have higher ER utilization, have higher length of stay when they get admitted,” Cooper said. “We really see this as part of a comprehensive approach to ensuring that we have a true continuum of care for people experiencing homelessness.”\u003c/p>\n\u003cp>The traditional health care system thrives off efficiency: The more patients move through an office, the more the provider gets paid, resulting in brief appointments and little sympathy for circumstances that make patients late. But that setup doesn’t work for unsheltered people who run the risk of getting their belongings stolen if they leave their camp — or who would rather find something to eat than take care of what may seem like a minor malady.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=202120220AB369\">Less than 30% of unhoused people with Medi-Cal have ever seen their primary care provider\u003c/a>, according to a state legislative analysis of a street medicine bill vetoed by Gov. Gavin Newsom in 2021. The measure passed the Legislature with broad support but was opposed by the state Health Care Services Department for potential duplication of services. In the \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2021/10/AB-369-1082021.pdf\">veto (PDF)\u003c/a>, Newsom directed the department to work with street medicine teams to fill any gaps left by CalAIM; one such gap was adjusting billing codes that prevented street medicine reimbursement.\u003c/p>\n\u003cp>“When you’re focused on those very basic needs, like food, safety, shelter, how are you then able to focus on, you know, managing your diabetes or your blood pressure or some of these risk factors that can lead to more serious downstream effects?” said Dr. Kyle Patton, medical director of the street medicine program at Shasta Community Health Center in Redding.\u003c/p>\n\u003cp>On a Monday in September, Patton and Anna Cummings, a case worker, trekked through a wooded area on the north edge of town to meet Amber Schmitt, 47, a patient with an infected leg. The ground is muddy from a storm the night before. Schmitt is paying a friend $700 a month to stay in his apartment, but hidden among the trees and rolling hills is her abandoned encampment, along with dozens of others. Schmitt gets $1,000 a month from Social Security, but it’s not enough to afford a security deposit or rent in the area, she said.\u003c/p>\n\u003cfigure id=\"attachment_11934634\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM.png\">\u003cimg class=\"size-medium wp-image-11934634\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-800x531.png\" alt=\"A man wearing a dark shirt, sunglasses and jeans looks down at an object in his hands while a woman wearing a black hooded sweatshirt and pants has her bandaged right leg propped up on the trunk of a car.\" width=\"800\" height=\"531\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-800x531.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-1020x677.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-160x106.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM-1536x1020.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.44-PM.png 1542w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Kyle Patton prescribes Amber Schmitt with medication to treat the wound on her leg in the back of his truck on Sept. 19, 2022. \u003ccite>(Larry Valenzuela/CalMatters/CatchLight Local)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The gash on Schmitt’s right shin is mottled and inflamed. She said she scraped it on a fallen branch. Patton cleaned and dressed it for her previously, but she had no choice but to reuse bandages after running out. Now she can barely walk from the pain.\u003c/p>\n\u003cp>“This is a silver-based dressing, which will kill bacteria in wounds,” Patton tells Schmitt after rinsing the area with a saline wash. “We’ll get you some more dressing, too. And then you’ve got some skin breakdown and maceration between your toes. I don’t like the look of that.”\u003c/p>\n\u003cp>He gives her a fungal cream and a bottle of antibiotics. Schmitt is a leukemia survivor and has had a hip replacement on the same injured leg. Her medical history makes her prone to infections and poor circulation in her extremities, Patton said.\u003c/p>\n\u003cp>“There’s people that would maybe make the argument that … they have health insurance here in California, they should just utilize the system as-is. The reality is because of certain factors within the context of their homelessness, they’re not able to do that,” Patton said.\u003c/p>\n\u003cp>Although they qualify for comprehensive health coverage under Medi-Cal, the program wasn’t necessarily designed with unhoused people in mind. For example, Medi-Cal will pay for transportation to and from a doctor’s appointment, but it requires the patient to provide a fixed address and give several week’s notice to the driver, something most people experiencing homelessness aren’t able to arrange.\u003c/p>\n\u003ch2 id=\"h-link-between-homelessness-and-health\">Link between homelessness and health\u003c/h2>\n\u003cp>Health data on unhoused people is sparse, with no state agency and only a handful of counties tracking the information, but it’s clear that most of their deaths are preventable.\u003c/p>\n\u003cp>In \u003ca href=\"https://www.achch.org/uploads/7/2/5/4/72547769/2018-2020_ac_homeless_mortality_report_final_4.11.2022.pdf\">Alameda (PDF) \u003c/a>and \u003ca href=\"https://nhchc.org/wp-content/uploads/2022/10/Mortality-in-PEH-Marin-Co-10-22.pdf\">Marin (PDF)\u003c/a> counties, half result from acute or chronic health conditions like cardiovascular disease, cancer or respiratory failure. In Orange County, these make up a quarter of deaths among the unhoused. In Los Angeles County, heart disease is the second-leading cause of death among people experiencing homelessness, second only to overdoses.\u003c/p>\n\u003cp>Even overdose deaths are considered preventable — yet in San Francisco, overdoses cause 82% of deaths among the unsheltered.\u003c/p>\n\u003cp>“We commonly see conditions that you would see in a typical population, but they’re just not addressed. So, out-of-control high blood pressure, uncontrolled diabetes … also substance use in terms of opioids, we see a whole lot more than in the general population,” said Dr. Absalon Galat, medical director for LA County’s Department of Health Services’ Housing for Health division.\u003c/p>\n\u003cp>Galat’s team started its foray into street medicine in an effort to dole out COVID-19 vaccines, but team members quickly found they needed to do more. The county used COVID-19 relief funds to purchase mobile clinics, and CalAIM funding has helped them hire 60 staff members.\u003c/p>\n\u003cfigure id=\"attachment_11934635\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM.png\">\u003cimg class=\"size-medium wp-image-11934635\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-800x526.png\" alt=\"A man with a black Raiders hat and gray shirt sits down in a medical facility.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-1020x671.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.54-PM.png 1058w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Isaac Pierce gets a checkup in the Los Angeles County Department of Health Services' mobile clinic parked in Whittier Narrows Park on Nov. 17, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>In September, the county’s \u003ca href=\"https://www.latimes.com/california/story/2022-10-13/la-county-mobile-medical-clinic\">fleet of mobile clinics,\u003c/a> complete with fully outfitted exam rooms, began visiting areas where services are sparse. Smaller teams of clinicians and case workers roam encampments to follow up with patients, treat minor issues and bring patients to the mobile clinic. There’s some disagreement among street medicine providers about whether mobile clinics remove enough barriers because they still require patients to travel to a set location, but Galat said his goal is to improve access, whether it’s by wheel or foot.\u003c/p>\n\u003cp>“People are dying every day,” Galat said. “So we have to try with what we know best in the medical field right now to limit people who are dying.”\u003c/p>\n\u003cfigure id=\"attachment_11934636\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM.png\">\u003cimg class=\"size-medium wp-image-11934636\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-800x526.png\" alt=\"A light blue medical truck with several photos of people and a medical logo on the side with a ramp and stairs leading inside.\" width=\"800\" height=\"526\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-800x526.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-1020x670.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.24.59-PM.png 1056w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Los Angeles County Department of Health Services' mobile clinic parked in Whittier Narrows Park to see unhoused patients on Nov. 17, 2022. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>The connection between homelessness and health is inextricable, said Dr. Michelle Schneidermann, director of the People-Centered Care team at the California Health Care Foundation, a statewide health policy think tank.\u003c/p>\n\u003cp>“Either one can lead to the other. A catastrophic health incident or a series of conditions can lead to someone not being able to work, leading to poverty,” Schneidermann said. “We see this all the time, health conditions precipitating homelessness, and the other way around.”\u003c/p>\n\u003cp>Take Danny Doran, 56, who visited LA County’s mobile clinic at Whittier Narrows Park on a recent Thursday to pick up insulin. He spent his career as a plumber and owned a home in Bishop. Three years ago he fell into a diabetic coma and was hospitalized for months. A friend Doran trusted to pay his bills while he was hospitalized emptied his bank account and disappeared — Doran has been unhoused ever since. Several weeks ago he was beaten and robbed by another unhoused man, who left him with a fracture in his skull and a tremor in his hands.\u003c/p>\n\u003cp>“I guess I’m a little bit naive,” Doran said. “We’re all humans and we’re prone to mistakes, you know? So I hate for anyone to have their money stolen like mine was and end up like me on the streets.”\u003c/p>\n\u003cp>At the mobile clinic, Doran said the doctor on staff agreed to be his primary care physician. His previous primary care doctor stopped accepting Medi-Cal insurance, and Doran hasn’t had regular access to insulin ever since.\u003c/p>\n\u003cp>“The doc here, she truly has compassion for her patients. I’m glad our paths crossed,” Doran said.\u003c/p>\n\u003cfigure id=\"attachment_11934637\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003ca href=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM.png\">\u003cimg class=\"size-medium wp-image-11934637\" src=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-800x523.png\" alt=\"A man wearing black hat, camouflage scarf and black jacket outside near a truck with a medical logo.\" width=\"800\" height=\"523\" srcset=\"https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-800x523.png 800w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-1020x666.png 1020w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-160x105.png 160w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM-1536x1003.png 1536w, https://ww2.kqed.org/app/uploads/sites/10/2022/12/Screen-Shot-2022-12-08-at-12.25.07-PM.png 1546w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Unhoused patient Danny Doran sits in the waiting area for the mobile clinic parked in Whittier Narrows Park on Nov. 17, 2022. Doran is being checked after being assaulted near his encampment just a few days before. \u003ccite>(Larry Valenzuela/CalMatters)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Schneidermann, who is overseeing a study on street medicine programs across California, said CalAIM, which also pays for housing services, is an opportunity for the state to address its most pernicious problem.\u003c/p>\n\u003cp>“Until we can end our crisis of homelessness … we have to find a way to deliver care for people on the streets,” Schneidermann said.\u003c/p>\n\u003ch2>New programs popping up\u003c/h2>\n\u003cp>Prior to CalAIM and the Health Care Services Department’s rule changes, street medicine programs operated outside of traditional health care, funded by philanthropies or the rare health organization willing to lose money. Now, the department’s changes offer some hope for stability, Feldman said.\u003c/p>\n\u003cp>Noting that these programs were birthed out of the pandemic, Feldman said they “might not exist in a few years if they’re not supported, but they have all these patients that rely on them.”\u003c/p>\n\u003cp>A year ago only 25 programs existed across the state, primarily concentrated in urban areas, Feldman said. But ever since CalAIM launched at the beginning of 2022, he’s run into more organizations looking to begin services. CalAIM requires Medi-Cal insurers to coordinate patients’ physical, behavioral, dental and developmental care as well as social services — something many street medicine teams already do. The goal is to make the “system hustle behind the scenes rather than making the patient hustle,” California Health Care Foundations’ Schneidermann said.\u003c/p>\n\u003cp>One such program is run by Anthony Menacho in Sacramento. Unlike USC, Shasta Community Health or LA County’s teams that are staffed full-time, Menacho’s street medicine band is composed entirely of volunteers. They visit six camps every other weekend.\u003c/p>\n\u003cp>The work was funded initially by a $100,000 grant from Health Net, the largest Medi-Cal provider in the state, but Menacho, who trained as a physician assistant with Feldman at USC, wants to be able to do the work full-time and hire more clinicians. He’s working to secure money through CalAIM and the Department of Health Care Services.\u003c/p>\n\u003cp>“We don’t have the academic resources or people behind us to be able to put in a department or infrastructure on the drop of the dime,” Menacho said. “We run on grants, but that’s not true sustainability. We can’t do it ourselves. It has to be a coordinated effort and I think that’s what CalAIM is trying to do.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/news/11934623/how-street-medicine-teams-are-tackling-the-unhoused-health-care-crisis","authors":["byline_news_11934623"],"categories":["news_8"],"tags":["news_21434","news_32132","news_683","news_32130","news_32131","news_29607"],"featImg":"news_11934631","label":"news"},"news_11924123":{"type":"posts","id":"news_11924123","meta":{"index":"posts_1591205157","site":"news","id":"11924123","score":null,"sort":[1661940031000]},"guestAuthors":[],"slug":"how-safe-injection-sites-can-help-address-our-addiction-crisis","title":"How Safe Injection Sites Can Help Address Our Addiction Crisis","publishDate":1661940031,"format":"audio","headTitle":"How Safe Injection Sites Can Help Address Our Addiction Crisis | KQED","labelTerm":{},"content":"\u003cp>Gov. Gavin Newsom vetoed a bill that would have allowed a trial run of safe injection sites in San Francisco, Oakland, and Los Angeles. These sites, where people can use illicit drugs under supervision, would have been the first legal ones in the state.\u003c/p>\n\u003cp>But the idea isn’t new. Safe injection sites have been used as a harm reduction tool for decades in Canada, Australia, and in parts of Europe. They exist in other parts of the United States — two have opened in New York City, and Rhode Island has approved them statewide. So, why don’t we have them in California yet?\u003c/p>\n\u003cp>\u003cb>Guest: \u003c/b>\u003cspan style=\"font-weight: 400\">\u003ca href=\"https://twitter.com/lesleywmcclurg\">Lesley McClurg\u003c/a>, KQED health correspondent\u003c/span>\u003c/p>\n\u003cp>\u003ca href=\"https://drive.google.com/file/d/183Y_GSFT22ThitdSaUOlXmFR0XJZ5yTW/view\" target=\"_blank\" rel=\"noopener noreferrer\">\u003cem>Read the Transcript\u003c/em>\u003c/a>\u003c/p>\n\u003cdiv class=\"card card--enclosed grey\">\n\u003cdiv class=\"card card--enclosed grey\">\n\u003cp id=\"embed-code\" class=\"inconsolata\">\n\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" frameborder=\"0\" height=\"200\" scrolling=\"no\" src=\"https://playlist.megaphone.fm?e=KQINC6177765272&light=true\" width=\"100%\" class=\"iframe-class\">\u003c/iframe>\n\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1700690369,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":6,"wordCount":118},"headData":{"title":"How Safe Injection Sites Can Help Address Our Addiction Crisis | KQED","description":"Gov. Gavin Newsom vetoed a bill that would have allowed a trial run of safe injection sites in San Francisco, Oakland, and Los Angeles. These sites, where people can use illicit drugs under supervision, would have been the first legal ones in the state. But the idea isn’t new. 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Gavin Newsom vetoed a bill that would have allowed a trial run of safe injection sites in San Francisco, Oakland, and Los Angeles. These sites, where people can use illicit drugs under supervision, would have been the first legal ones in the state.\u003c/p>\n\u003cp>But the idea isn’t new. Safe injection sites have been used as a harm reduction tool for decades in Canada, Australia, and in parts of Europe. They exist in other parts of the United States — two have opened in New York City, and Rhode Island has approved them statewide. 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