The Impact of Community Paramedicine on the Homeless Population

Community paramedicine can change the outlook of homelessness in your city. EMS departments interact with the homeless every day, making community paramedics uniquely poised to help.

This article will showcase two critical things: First, how community paramedics can help people struggling with homelessness. Second, how caring for the health of the homeless leads to safer conditions for the entire community. 

Mobile Integrated Healthcare-Community paramedicine (MIH-CP) is the Swiss army knife of healthcare. No matter the public health need, MIH-CP can extend a helping hand. We’ve featured articles on how MIH-CP impacts those who need primary care, patients with mental health struggles, and those suffering from drug abuse. 

We’ll see how community paramedicine can make a huge difference for a homeless patient.  

The Benefits of a Homeless Outreach Program  

Homelessness happens everywhere. No area is immune. Finding homes for people and providing care for those in difficult situations is essential for any community. 

But helping the homeless is not just a charitable contribution; this outreach has positive effects on the rest of society.

Here are several reasons why: 

  • Protecting the homeless improves public health. Public health is one living organism. If one part of the organism suffers, then everywhere else is also held back. Sadly, the homeless are among the most prominent group afflicted by infectious diseases. By protecting them, we further protect the community. 
  • Responding to homelessness creates a safer city. When citizens are cared for, everybody thrives. A healthy city is a growing city. When cities focus on reducing homelessness, everybody benefits. 
  • Reduction in substance abuse. If the demand for drugs goes down, the market will pull out. If communities can reduce the use of illicit substances, they will effectively reduce the number of drugs on their streets and in their schools. 

Community paramedics and ambulance companies are in a position to impact this chaotic area of society. Area studies have shown that the homeless are involved in more 911 ambulance calls than the general population

Since the homeless create a large slice of the patients treated by EMS, ambulance departments should plan to handle this issue effectively. 

Here are some problematic facts about ambulances and the homeless: 

  • The homeless use EMS often. 
  • The homeless are often repeat patients. 
  • The homeless create a different type of need. 

This creates a terrible cycle. 

The Cycle of Homelessness and Emergency Services 

Many EMS professionals feel that homeless patients fall into a negative cycle that is challenging to break. 

Here’s how the cycle works between EMS and the homeless: 

  1. The homeless patient has an ailment. They have no source of primary care, so they call an ambulance. 
  2. The ambulance transports them to the ER. The ambulance crew, often responding to a non-emergency, must transport the patient to the ER if the patient requests it (this is a standard rule in many areas), even if the patient has no serious illness. 
  3. The ER houses the patient for the night. The ER staff treats any glaring issues – though, sadly, many patients are just there for observance before they are discharged. Even if the physician implores follow-up care, homeless patients are often unable to follow through with outpatient care. 
  4. The patient is released. And the cycle continues. Some EMS departments will transport the same patient to the ER up to four times a day. 

How does a city break this cycle? 

That question is the cornerstone of this article. Community paramedics can play a role in pulling the homeless patient from this spiral.

How Community Paramedics Help Homeless Patients 

At the start of the COVID-19 pandemic, the issue of homelessness was brought to the forefront. But unfortunately, it’s easy for communities to forget that helping the homeless is more than just an act of kindness – it can directly impact public health. 

When the homeless go without care, it leaves debilitating infections unchecked. So a San Francisco community paramedic program began actively reaching the homeless. Their efforts not only helped those in need; they also prevented the emergency departments from becoming overrun.

Community paramedicine presents a safety net that screens the homeless for virulent disease and mitigates further transmission. 

Here’s how MIH-CP can help the homeless:

  • Walk up care. Preventative care is delivered directly to the patient. Community paramedics take an active role in treating patients on the street. A city can use community paramedicine to remove the transportation variable, ensuring that help is delivered to the homeless. 
  • Alternative destinations. One of the significant benefits of a community paramedic program is the possibility of transporting a patient to an alternative destination. Alternate destinations are helpful for homeless patients, as many of them can be treated somewhere other than the emergency department. In addition, homeless patients often concurrently have a substance addiction or mental health struggle, so transporting them to treatment facilities can prove helpful. 
  • Follow-up on patients. It’s challenging for a stationary primary care provider to follow up on a homeless patient. Essentially, doctors are left hoping the patient shows up for their appointment. However, transportation is often a burden for homeless patients. A community paramedic can go directly to these people. Often, paramedics in the field know where certain homeless people live within a city, giving them a distinct advantage in administering care. 
  • They build a relationship. A community paramedic program in Minnesota reached out directly to homeless patients to help slow the spread of COVID infections. One of the keys they mention is the community paramedic’s ability to build relationships with the patients. Many homeless people lack the relational safety net usually provided by friends and family – building trust with MIH-CP professionals can make all the difference. 

Now, let’s look at the mechanics of initiating a homeless outreach program.

Steps to Starting an MIH-CP Homeless Outreach Program

If you’re looking to start a community paramedic program, the first step is assessing the needs in your jurisdiction. It’s crucial to ensure that orchestrating a homeless outreach program is a good use of resources. 

However, once you’ve established that homelessness is a pressing problem in your area, follow the steps below. 

Several key steps to reaching the homeless population with MIH-CP: 

  1. Build partnerships to treat the homeless 
  2. Plan alternative destinations.
  3. Focus on super-utilizers. 

Now, let’s explore these steps in more detail. 

1. Build Partnerships within the Community 

Organizations need to band together to deliver the best possible care to the homeless. 

Here are several potential partners: 

  • Law enforcement. Like EMS, Law enforcement officers interact with the homeless every day. If departments could coordinate responses with community paramedics, it would reduce their workload and improve patient outcomes. 
  • Hospitals. The hospital is the center of healthcare. A partnership with community paramedics helps them work proactively. In many areas, community paramedic programs have been shown to reduce hospital readmissions rates
  • Community centers. Libraries, churches, the YMCA – these are all groups with a vested interest in caring for the homeless. 

When you partner with local groups, you create a powerful force for good. However, you need to keep these bonds secure. 

Here are several ways to stay connected to the community: 

  • Use a platform that works. Julota helps groups communicate even if they use different platforms. For example, many EMS departments use a different system than the hospital or the emergency department. Julota removes this wall, allowing communities to safely share information with other professionals.
  • Focus on the issues that matter. Give all partners a seat at the table. For example, some members might be worried about drug abuse; some may be concerned with primary care. By being open, everyone wins. 

Not only are companies helping the lives of the homeless in their community, but they’re nurturing a healthier population – an area that can grow. 

2. Plan Alternative Destinations for Homeless Patients 

Alternative destinations can prove helpful for the homeless population. 

Here are several alternative destination options: 

  • Primary care offices
  • Substance detox center 
  • Community mental health 
  • Urgent care 
  • Local shelters 

All homeless patients flooding to the emergency department are counterproductive regardless of sickness or illness. Instead, the goal should be to get these patients where they need to go. 

3. Focus on Super-Utilizers in the Homeless Population

Certain homeless patients will use the EMS system more than others, like any population. While these patients can create frustration, they are probably the ones who need the most care. 

Some super-utilizers (often known as frequent flyers) activate the 911 system at surprising rates, like this patient who called 911 400 times over 18 months. 

If community paramedic programs focus on solving the super-utilizers core problems, they will take a giant step toward improving the efficiency of local healthcare. 

Key Takeaway

Mobile integrated healthcare is on the cutting edge. In the last twenty years, community paramedicine has helped shift the landscape from one that is reactive to one that is proactive. 

Julota has developed software that gives organizations a secret weapon to fight for better public health. 

Unlike a traditional ePCR, which only takes a snapshot of the patient profile, Julota allows health providers to build a long-term care report – one that shows the patient’s complete history. This model gives professionals the whole picture they need when providing care. 
Contact Julota’s team of professionals to see how you help the homeless in your community.