Doctors Without Walls Santa Barbara Street Medicine

Doctors Without Walls-Santa Barbara Street Medicine (DWW) has been providing medical assistance to the underserved populations in Santa Barbara County for 16 years. DWW programs address the timely treatment of the medical needs of Santa Barbara County's most vulnerable populations, the working poor and homeless. Our volunteer teams screen, diagnose, record and treat the diseases and illnesses of our clients, in the early stages, so that medical problems do not become acute. DWW conducts medical van weekly daytime street outreach missions (5) and backpack-based walking evening street medicine outreach missions (2). DWW has reopened the weekly Women's Free Homeless Clinic (WFHC) in partnership with Transition House (2 Fridays) and Rescue Mission (1 Friday). Immediately following the Friday clinic, the WFHC conducts medical van outreach. In addition, DWW supports 3 outdoor Neighborhood Navigation Center clinics. All of this creates an environment where our clients trust DWW to assist them in achieving health equity and for increasing the quality of a healthy life. Our volunteer Street Medicine, Women's Clinic and Street Outreach teams are comprised of physicians, scribes, pack logistics, pharmacy, vitals, social services, outreach and peacekeeper professionals. Because street medicine can only provide limited services, empowering clients to utilize local resources is crucial to improving their health and quality of life. However, clients are often unable to use these local resources due to logistical and psychological barriers. DWW helps clients overcome these barriers. When needed services are beyond those provided by street medicine, DWW develops a care plan and helps clients navigate the healthcare system by accompanying and introducing clients to local medical homes, specialists, or other needed resources. DWW programs address the timely treatment of the medical needs of Santa Barbara County's most vulnerable populations, the working poor and homeless. DWW Place-based clinics are always on the same day at the same time giving our clients a sense of security in knowing there is a health care location where they can find the services they need. All of this creates an environment where our clients trust DWW to assist them in achieving health equity and for increasing the quality of a healthy life.

Our Companion Care teams provide services to our clients in developing care plans and helping clients navigate the healthcare system by accompanying and introducing clients to local medical homes, specialists, or other needed resources. During COVID19, DWW continued to provide medical services to the most vulnerable populations in Santa Barbara County by practicing street medicine in encampments, abandoned buildings, freeway onramps and offramps and wherever they are. Our Companion Care teams provided education and medical services to reduce the spread of the pandemic while still providing the best medical care possible for unsheltered populations. In March 2021, DWW began vaccinating our unsheltered and marginally sheltered homeless populations against COVID19. In 2021 DWW vaccinated 67% of Santa Barbara County's homeless population. During the DWW Outreach and Companion Care missions, volunteers note the physical observations of a client's well-being, including conversations. If a client needs behavioral health services, DWW either refers or contacts, depending on the client's level of trust, our partner, BeWell. The stress of being homeless often triggers mental illnesses and exacerbates existing mental health problems. Our priority is to use our close relationships with these vulnerable individuals to treat low acuity illness, and if chronic illness exists, to use our Companion Care teams to liaison them into a medical home where they can receive optimal management and treatment.

The mission of the Women's Free Homeless Clinic (WFHC) is to provide a safe, trusting, female-only environment in which the unsheltered or marginally sheltered women of Santa Barbara can access medical and mental health care and referrals to community resources. This is achieved by a research-based integrative approach that addresses their basic human needs, while supporting health and further growth. The integrative approach incorporates the following guidelines: meeting immediate physical needs; building trusting relationships; coordinating care with other potential service areas for the individual and addressing behavioral issues as they pertain to the physical health of the individual. WFHC clients will see a clinician for medical needs, receive acupuncture, assistance with applying for housing, insurance, or school, they will be able to do laundry, take showers, attend mental health groups with a mental health specialist, attend self-defense classes, as well as yoga.

In January 2022 DWW Board of Directors and current Program Leadership met to discuss the outcomes of COVID19, including how we should move forward with the success we had experienced. We looked at the data, at the current trends of State and Local Government, our relationships with our Partners and other social and community factors such as food scarcity and housing availability. At this meeting DWW made the decision to enhance our current street medicine model by delivering more efficient, comprehensive, and inclusive medicine. DWW decided to adopt point-of-care testing, defined as medical diagnostic testing at or near the point of care that is, at the time and place of patient care. DWW currently tests for Diabetes, uses Portable Ultrasound and EKG in order to better diagnose a client's medical problem.DWW Leadership decided to adopt the Enhanced Care Management (ECM) model to produce the best results for continuum of care. The goal of an ECM benefit is to provide a whole-person approach to care that addresses the clinical and non-clinical needs of high-need beneficiaries. ECM is a collaborative and interdisciplinary approach to providing intensive and comprehensive care management services.