PA to Provide Health Care to the Homeless by Expanding Medicaid Coverage for “Street Medicine”

The Pennsylvania Department of Human Services announced a change in Medicaid, also known as Medical Assistance in Pennsylvania, that will allow certain enrolled medical providers to provide care outside a clinical setting to Medicaid beneficiaries who are experiencing homelessness – a practice known as street medicine. Street medicine uses physical and behavioral health services to address the unique needs and circumstances of people experiencing unsheltered homelessness that are delivered directly to them in their own lived environment.

“As a physician, I understand that people experiencing homelessness often have complex needs and face many barriers to health care,” said DHS Secretary Dr. Val Arkoosh. “At DHS, we are consistently working to improve access to care and to ensure that all Pennsylvanians receive high-quality and compassionate health care that can stabilize circumstances and help improve their overall quality of life. By creating a path for Medicaid to cover street medicine, we are making it easier for health care providers to meet people where they are, and to provide the care they need and deserve.”

Medical services are provided by health care professionals who are equipped with portable medical equipment and can be rendered to anyone covered by Medicaid who is experiencing homelessness. Services could include but are not limited to primary care, vaccine administration, wound care, preventive services, counseling, medication for the treatment of opioid use disorder (also referred to as medication assisted treatment), and diagnostic services, such as rapid blood screening for diabetes and high cholesterol, rapid COVID-19 and flu testing.

This change applies to Medicaid enrolled physicians, certified nurse midwives, certified registered nurse practitioners, physician assistants, psychologists, and mobile mental health treatment providers, who render services in the Medicaid Fee-for-Service or Managed Care delivery systems.

People experiencing homelessness in the United States die, on average, three decades earlier than their peers with housing, most commonly due to preventable and treatable chronic medical conditions. By allowing providers to bill for services rendered during visits with people experiencing homelessness, DHS aims to increase access to care for Medicaid beneficiaries and improve health outcomes.

Street medicine visits will provide low-cost, high-impact resources that will also divert people from costly visits to emergency rooms. Health care utilization costs for people experiencing homelessness are five times the national average, mainly due to an over reliance on the emergency room for routine medical care and increased hospitalization rates for illnesses presenting in advanced stages.