Chattanooga nonprofit Cempa Community Care has launched a new service to help homeless individuals get access to health care and treatment.
The Street Health Initiative came about as staff noticed trends in how the opioid epidemic considerably affects the homeless community, Chief Operating Officer Tonja Perkins said. The program is in its beginning stages as Cempa decides routes and territories to dive into.
"We have current patients that are currently unhoused that we see through our infectious disease clinic already, and we were looking at what it is that prevents them from getting to their appointments, what makes it difficult for them to stay on medication," Perkins said in a phone interview.
The nonprofit focuses on care and assistance for those affected by HIV, according to its website.
GROWING NEED
Kim Sargent is the director of behavioral health and program director for Cempa's prevention and harm department.
In a phone interview, she said nurses, therapists and harm reduction staff members will go to areas where they know there are large unhoused populations, likely traveling on a circuit.
"I'm hoping that we can bring folks into our primary care," Sargent said. "If we find positives, that we can get them treatment that they need."
The initiative's team consists of members who have lived with or work experience in assisting people who have substance use disorders, mental illnesses or are homeless, Perkins said. The team will meet people where they are, taking care of them from both a medical and testing standpoint, while building relationships.
"We know that unhoused people a lot of times see severe health inequities," she said. "They have a lot of trauma. They have a lot of lack of trust of health care entities, and so we're really trying to go to them in an effort to build and rebuild some of that trust system and provide them care there on the spot versus the challenges of getting them into the facility."
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Perkins said via email that Tennessee's level of opioid use outpaces the nation, with 45.5 overdose deaths per 100,000 people from 2011 to 2021, which is nearly double the nationwide rate of 24.7.
Additionally, she said people who suffer from substance use disorders are at high risk for health challenges, including HIV and hepatitis C, and face health care barriers due to stigma.
Infectious disease testing is the "wheelhouse" of Cempa, Perkins said, so staff will test homeless people for HIV and hepatitis C among other things before helping them get treatment.
Perkins said there are probably national HIV hot spots or pop-ups, and the problem is not unique to Tennessee.
"That can simply be because you've got a couple of people that don't know their status," she said. "They may spread it through drug use. They may spread it through sexual contact, so they're spreading it without knowing."
She said another effort in Cempa's Street Health initiative is to find people in the homeless community and get them on the appropriate medications to make their diseases "undetectable."
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Perkins said the team wants to look at individuals as a whole to see how to help.
"We know that there's needs out there, but right now, we really want to go out and see what is unique to the unhoused population in Chattanooga." she said. "What is it that they need in particular? Because every community is going to look a little different, and their needs are going to be a little bit different."
Once Cempa identifies needs through its initiative, staff will work with other partners that help the unhoused community, such as the Hamilton County Health Department, to deliver needs and services in the field.
GOALS
Perkins said one of the initiative's goals is to raise awareness around and broaden the community's knowledge of Cempa's services.
"We want to grow the number of people that we can help either to get into care, get into treatment, get into housing," she said. "We're kind of broadening our scope of practice."
Perkins said Cempa is "not giving up testing in other capacities" but simply sees a growing need concerning unhoused people and substance users.
"Change is inevitable for every organization," she said. "We want to be the most nimble of organizations and go where the need is, and so that's why we're bringing about changes and kind of taking on new initiatives because we see that there's need. We're not afraid to pivot."
Contact Leah Hunter at [email protected] or 423-757-6673.
U.S. Centers for Disease Control and Prevention / The HIV diagnosis rate per 100,000 people in Tennessee was 14.4 in 2022, according to a U.S. Centers for Disease Control and Prevention report.