CalOptima Health:
Notice of Interest Opportunity for
Street Medicine Expansion
CalOptima Health is accepting letters of interest from Orange County cities to expand its Street Medicine Program.
Application Deadline - November 8, 2023, 5 p.m. (PST)
Background
CalOptima Health's mission is to serve member health with excellence and dignity, respecting the value and needs of each person. In line with that mission, CalOptima Health has made a commitment to address the health of our unsheltered members through our partnership-driven Street Medicine Program. Street medicine includes health and social services specifically developed to meet the unique needs and circumstances of unsheltered individuals. The fundamental approach of street medicine is to engage people experiencing homelessness where they are and on their own terms in order to maximally reduce or eliminate barriers to care and follow-through services. Working in collaboration with various county, city and community organizations, CalOptima Health's Street Medicine Program's ultimate goal is to improve the overall health and housing status of the unsheltered individuals served.
CalOptima Health's Street Medicine Program Values and
Philosophies
CalOptima Health's Street Medicine Program is a critical piece of a larger, comprehensive approach to caring for our members living on the street and on their journey home. In addition to being able to provide important preventive services, urgent care and social services, this program fosters the relationship building that is key to helping a person into a permanent home.
CalOptima Health's Street Medicine Program relies on three integrated components to achieve those health and housing outcomes: (1) Outreach and engagement, (2) coordinated medical care that meets people where they are, and (3) comprehensive Enhanced Care Management (ECM) and Community Supports.
The Street Medicine Program has a set of core values and philosophies that are recognized as best practices and, as research has demonstrated, drives the program toward success. First is the practice of trauma-informed care, which includes the principles of safety, choice, collaboration, trustworthiness and empowerment. In practice, this entails meeting individuals where they are both literally and figuratively. Street medicine providers meet individuals in their identified home while showing the individual unconditional positive regard. The Street Medicine Program follows the philosophy of rapport first and care second, meaning the relationship the provider develops with those they serve is the foremost priority. Only once rapport is established can there be meaningful physical care. Similarly, the person must come first in street medicine, and being person-centered is a core philosophy of the program.
In addition to the above, utilizing a canvassing approach is crucial to street medicine. It goes hand in hand with meeting members where they are and takes some of the work, coordination and stress off the individual, as they do not have to navigate to a brick-and-mortar location. The street medicine providers canvas an identified geographical location to both enroll new individuals and provide comprehensive medical and social care, including ECM and Community Supports.
By ensuring the above philosophies and values are at the heart of the CalOptima Health Street Medicine Program, we are confident all selected street medicine providers can effectively treat the whole person and move them towards achieving the goals of the program.
Description of CalOptima Health's Street Medicine Program The foundation of CalOptima Health's Street Medicine Program is two collaborative care teams, a coordination care team and a medical care team, that provide integrated outreach, engagement and comprehensive service provision. Collectively these teams engage in a canvassing-based approach to identify unsheltered members in the field and connect them to necessary preventive, urgent and primary care services. The coordination care team members are primarily responsible for identifying eligible members who agree to participate in the program and then providing services such as ECM, housing navigation (and additional housing-related Community Supports as applicable), routine face-to-face visits to address various medical needs and scheduling appointments with the medical care team. The medical care team is responsible for primary medical care including, but not limited to, ongoing medical care, ordering and reading labs, prescribing medications, and referrals to specialists and urgent care as needed. The medical care team offers all enrolled patients the opportunity to have the street medicine providers serve as their primary care provider (PCP). Together, these teams are designed to serve a caseload of up to 200 unsheltered members.
To ensure proper care and support for patients enrolled in the program, service provision standards have been established. For the medical care team, there is to be a minimum of one patient encounter with every person enrolled in the program every 45 days, with encounters varying depending on the acuity of medical needs. For the care coordination team, there is to be a minimum of one patient encounter with every person enrolled in the program per week.
Services are more frequently provided based on each patient's specific needs.
CalOptima Health's Commitment
While CalOptima Health serves as the lead of our Street Medicine Program, we believe that a partnership-driven, collaborative effort between CalOptima Health and city personnel leads to the most effective and sustainable outcomes for our members living on the street.
In support of this partnership, CalOptima Health is committed to:
1. Delivering compassionate and dignified medical and social care to its unsheltered members to reduce barriers to quality medical and social care and improve the health outcomes of unsheltered individuals.
2. Collaborating with the selected cities to ensure seamless integration of its Street Medicine Program with consideration of the cities' broader endeavors to address homelessness.
3. Proactively engaging with the selected cities in the planning process and maintaining transparent communication throughout.
4. Inviting the selected cities to provide feedback on the top two provider proposals for their
5. Financially supporting the startup and launch of a street medicine team designed to serve a caseload of 200 unsheltered members.
6. Scheduling and chairing regular steering committee meetings and inviting all relevant stakeholders.
7. Closely supervising the providers to ensure the effective realization of the program's goals and objectives.
8. Providing routine outcome data to the cities based on the goals of CalOptima Health's Street Medicine Program.
9. Allocating space for the street medicine providers and the van on CalOptima Health property.
10. Remaining receptive to feedback from the cities pertaining to its Street Medicine Program.
City's Commitment
In support of this partnership, the selected city commits to:
1. Collaborating with CalOptima Health to welcome street medicine services within the city's jurisdiction, thereby supporting the compassionate and dignified treatment of its unsheltered residents in order to foster a sense of belonging within the community and improve their health outcomes.
2. Attesting their 2022 Point-in-Time Count showed a minimum of 200 sheltered and/or unsheltered individuals OR, alternatively, providing data proving such.
3. Formally recognizing CalOptima Health as the program lead and acting in support of CalOptima Health's Street Medicine Program framework.
4. Providing feedback in selecting a street medicine provider.
5. Collaborating with the provider CalOptima Health selects for service provision.
6. Sharing data on unhoused city residents with CalOptima Health, as appropriate or needed.
7. Actively participating in the planning and implementation of the Street Medicine Program by attending the Street Medicine Steering Committee meetings.
8. Ensuring that law enforcement and fire personnel actively engage in the collaborative efforts needed to effectively run the Street Medicine Program.
9. Allowing CalOptima Health's Street Medicine Program to serve all zip codes within the city's jurisdiction.
10. Assisting in locating properties within the city's jurisdiction that can serve as street nedicine support centers in Phase Il of CalOptima Health's Street Medicine Program
1. Supporting the Street Medicine Program launch in their city no sooner than April 202 Evaluation Criteria
Criterion Maximum Basis for Assigning Points
Points
1. CalOptima Health core City's demonstrated commitment to value alignment, including trauma-informed, inclusive, person- commitment to treat centered programs and those that align with individuals with dignity harm-reduction principles.
and respect 20
2. Comprehensive, existing City must demonstrate experience and efforts and strategies to commitment to addressing the
address homelessness 15 homelessness crisis.
Existing partnerships and City must describe existing partnerships community involvement that will positively contribute to the Street 15 Medicine Program.
4. Uploaded letter of interest Application portal includes a letter of 5 interest that must be signed by the city
manager.
5. All attestations complete Application portal includes attestations that 5 must be made regarding the Street
Medicine Program.
Total Earnable Points 60
Timeline
Activity Date
Oct. 6, 2023, at 9 a.m.
pplication deadlin Nov. 8, 2023, at 5 p.m.
nternal revier Nov. 9-22, 2023
CalOptima Health Board of Directors Dec. 7, 2023
Meeting
Documents and Portal Access
The letter of interest template, a series of qualitative questions, as well as the required city attestations will be made available on the following portal:
https://webportalapp.com/sp/streetmedicine
Questions about this opportunity? Contact Nicole Garcia, Director, Medi-Cal and CalAIM, at [email protected].