Yomari Salvador-Rivera and Christine Nepple know where the cracks are in the healthcare system in Berks County, Pennsylvania. Their job -- in fact, their passion -- is working with the people who fall through those cracks.
They, along with core doctors and volunteers, are part of the Reading Hospital Street Medicine team, whose mission is to bring basic medical services to those experiencing or at risk of experiencing homelessness. Capital Blue Cross, through financial support, is helping them bridge that healthcare gap.
The program, which started in 2016, recorded 1,778 patient visits and 2,826 patient encounters counting telehealth visits at one of the program’s six partner sites.
“The work of these incredibly dedicated medical professionals is truly inspiring,” said Susan Hubley, Vice President of Corporate Social Responsibility at Capital Blue Cross. “They provide vital medical care with compassion to the most vulnerable members of our community.”
The street medicine team provides primary care services like physical exams, wound care, immunizations, screenings, medication management, and patient education. Collaborating with local nonprofit partners, they host health clinics that address a range of issues from addiction, diabetes, and foot care to mental health and vision problems.
Backpacks filled with basic medical necessities, the street medicine team visits various remote locations to meet with patients who are often living in tents, cars, under bridges, and in other mostly unsheltered areas.
It is vital to build trust between the homeless and the healthcare industry.
“Gaining trust of people who are already facing a stigma within healthcare is a challenge,” said Nepple, a certified registered nurse practitioner (CRNP) with 20 years of experience and the team’s clinical director. “We have to make contact with people multiple times. We start with just ‘hello’ and often a bag with food and a few supplies and a pamphlet.”
There are an estimated 650,000 people experiencing homelessness in America, according to the latest Department of Housing and Urban Development’s 2023 point-in-time count. That is a 12% increase from 2022.
The Reading Hospital Street Medicine team is part of a growing global phenomenon of street medicine programs that has spread to more than 140 cities in 27 countries across six continents, according to the Pittsburgh-based Street Medicine Institute.
By providing medical care in the community, these programs save lives and reduce costly over-reliance on hospital emergency rooms for basic care.
“There are a lot of people living paycheck to paycheck,” Nepple said, adding that many are a medical or car repair bill away from losing their home, their job, or worse. “People would be surprised to learn how close to homelessness a lot of people are."
Street medicine leads to positive outcomes — including a return home.
Such was the case with a 70-ish man and his 30-something son in Reading, according to Salvador-Rivera, the team’s program supervisor.
Not long after the man’s wife died, the father and son lost their home and the car they were forced to live in broke down, she said.
The two relied mainly on nonprofit safety net programs for some of life’s necessities, but access to healthcare was difficult. Those experiencing homelessness are at significantly greater risk of dying from preventable and treatable conditions, according to the U.S. Interagency Council on Homelessness.
More than bandages and medicine, the Reading Hospital Street Medicine team brings hope to those who often need it most.
With the team’s help, the father and son were able to access resources, food, and clothing, and now live independently in an apartment in Reading. Unable to work, they survive on the father’s retirement income.
“They started to regain their confidence and happiness,” Salvador-Rivera said. “They are a success story that inspires us every day.”
To learn more about the program, visit the Reading Hospital Foundation | Tower Health website.