
Boston Health Care for the Homeless Program receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.
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Across Boston, hundreds of people experiencing homelessness sleep on the streets, eschewing shelters. Known as “rough sleepers,” this unique sub-group of Boston’s homeless population faces extreme weather, violence, and trauma, putting them at increased risk of complex health problems and death.
In the winter of 1985, as hundreds of rough sleepers died on the street, the Commonwealth sent out an overnight van run by Pine Street Inn. Our founder, Dr. Jim O’Connell, joined twice a week to provide medical care–and in so doing, discovered and demonstrated the need for health care to be available outside the traditional clinic walls. This outreach approach was adopted by many BHCHP teams and providers offering HIV care, psychiatric care, harm reduction services, and more. And it birthed a particular team dedicated to walking the streets day and night to engage with folks and provide care: the BHCHP street team.
Over the decades, our street team has integrated to include medical, behavioral health, case management, and recovery care. Day and night, we search the streets of Boston to Identify and build relationships with rough sleepers, providing access to medical care in alleys, under bridges, on sidewalks, and wherever they may be. Ultimately, our goal is to foster lasting trust, taking care of people’s immediate medical needs and connecting them to our larger system of care, from from street to hospital to home.
Click here to read the latest newsletter piece on the Street Team.
The street team epitomizes BHCHP’s commitment to widening and guaranteeing access to high-quality health care. Rather than wait for patients to arrive at our clinics, the street team identifies potential patients living on the streets of Boston and brings care directly to them, day after day, week after week, and sometimes year after year. A patient’s ability to make it to a hospital or clinic is no longer a precursor to them receiving immediate medical care.
If and when a patient is interested in receiving ongoing follow-up care, BHCHP offers a number of supports, including transportation stipends, a system for walk-in appointments, and a specific clinic dedicated to rough sleepers. As or most importantly, though, are the relationships the street team forms with patients: It’s the trust built and compassion extended that makes patients feel comfortable receiving and pursuing more care, eliminating the barrier that mistrust in and judgment from the health care system so often places in between rough sleepers and wellbeing.
From wounds dressed under bridges to vaccines administered on park benches to portable ultrasounds conducted in an alley, our street team continues the lifesaving work that Dr. Jim O’Connell began in 1985, bringing medical and behavioral health care to thousands of rough sleepers across Boston.
Based out of Massachusetts General Hospital, the team includes two internists, a family physician, two psychiatrists, a physician assistant, two nurses, a case manager, and a recovery coach, all of whom conduct daytime street rounds four days per week. Twice a week, a provider from the team accompanies Pine Street Inn’s Overnight Van.
We also hold two weekly clinics at the hospital, dedicated to rough sleepers and their unique needs.
In addition to medical care and essentials, our street team aims to connect people with housing–work that includes following up with those who have left the streets and started new chapters. Since 2005, our team has made house calls to over 200 rough sleepers who transitioned to housing programs. Click here to watch a video called New Place New Problem about the difficulties patients faced when they make the transition from being homeless to being newly housed.
Our decades of work to bring medical care to Boston’s rough sleepers has inspired public health departments and clinicians nationwide, providing a model that has strengthened efforts across the country to connect these patients with long-term care and housing. Our street outreach program has been featured in medical journals such as Care Management Journal as well as books, including Rough Sleepers by Pulitzer Prize-winning author Tracy Kidder.
“I love seeing my patients in different settings, on the street, in clinic, in respite, in the hospital. I feel like by being able to see them in different contexts, you really grow a deeper understanding of them both clinically and as human beings.”
Dr. Katherine Koh, BHCHP psychiatrist
Boston Health Care for the Homeless Program receives HHS funding and has Federal PHS deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.