Teams

Laine Goettsch, lead peer navigator with Healthcare in Action, steps out of the mobile health clinic van near a homeless encampment on F Street in downtown San ...

Patients with mental issues are connected with a psychiatrist who speaks with them remotely, which Hochman said has proven to be the most effective method. “How I deal with the job is, I’m going to try my best to help that one person, because I was that one person. After spending two and a half years homeless in Los Angeles’ skid row, the 27-year-old has overcome his addictions and is helping others find their own path to recovery. A few yards away, a sign tied to a fence served as a reminder of the dangers of life on the street. Across the street, several people from encampments approached the white Healthcare in Action van with questions, and soon the vehicle was a sort of mobile MASH unit. The teams bill managed care companies and receive a monthly rate for the group of patients they are seeing. Hochman said the state Department of Health Care Services does not make the rates public because they vary from plan to plan based on geography and other factors. The teams also are making connections at hospitals so they can be alerted when a patient they are treating is hospitalized or discharged. By creating a reliable funding source through Medi-Cal, which provides health care coverage for low-income California residents, and a managed health care provider such as Molina Healthcare of California, the Healthcare in Action model can fund larger teams that work up to seven days a week, with a physician on call after hours. The company’s funding for the program came from the state’s new California Advancing and Innovating Medi-Cal, or CalAIM program, a transformation of Medi-Cal that is focused on homeless people and other at-risk groups. “The follow-up is really where we start to make progress and get their medical conditions under control,” Hochman said. “We’re thinking about an assigned panel of patients and applying that to street medicine.”