Ventura County faces the highest rate (28%) of chronic homelessness among the general homeless population of all California counties, exceeding the national average. People who are homeless frequently have multiple, overlapping complex physical and mental health needs. Simultaneously, they face many practical barriers accessing services and obtaining needed care -- potentially resulting in delayed care, poor outcomes, and higher costs in health care and multiple public services and systems.
For example, a brief analysis of conditions and service patterns among the homeless population showed that 40% had multiple overlapping chronic conditions and co-occurring mental health and 24% had substance use disorders. Fifty six percent had eight or more physical health encounters with the public health care system and 28% had eight or more behavioral health encounters with the behavioral health care system. Forty nine percent were treated in both systems and nearly 50% had no preventive health visits on record.
To address these challenges, Ventura County Health Care Agency worked closely with the community to develop “One Stop” mobile care unitspods. This initiative was developed through consultations with multiple stakeholders, including cities, law enforcement, county agencies and community service providers recognizing that lack of hygiene and basic medical care represented a barrier to housing and other critical services. The program aims to address multiple needs directly in the field where homeless individuals live and congregate rather than waiting for them to seek health care through formal settings.
Mobile “One Stop” outreach and service events, which include medical, behavioral health, and social services such as meals and employment information, are co-located onsite along a mobile shower unit funded and staffed by the Whole Person Care pilot. The mobile shower units engage hard-to-reach, chronic homeless populations and provide a low barrier entry point into services that promote stability. An alcohol and drug treatment specialist counsels and links participants with detox, rehabilitation, medication assisted treatment, and intensive outpatient services. A public health department communicable disease specialist provides on-the-spot testing, counseling, needle exchange, and naloxone overdose prevention kits. Several community organizations offer case management, including needs assessment and enrollment into job training and sober- and transitional-living services. Community volunteers also provide meals, clothing, hygiene supplies, and haircuts.
Since the pilot launched in late December 2017, more than 1,235 clients have been served. All clients have been assessed for housing eligibility and 18 have been successfully housed thus far. Mobile shower services are emerging as a strategy for communities addressing the pressing challenges of homelessness. Some hygiene events provide access to a range of additional supportive services, but few, if any, provide direct access to County-sponsored health, mental health, and social services all in one location. A new pilot "backpack-medicine" with family medical residents at the Health Care for the Homeless clinic is further extending primary care services into the surrounding homeless encampments, serving as many as 150 homeless persons.