PROGRAMS
Bringing Healthcare to the Unsheltered
Dr . John Garrett and Dr . Ti Hoang head up Dallas ’ first ever Street Medicine program .
ith approximately 3,700 people experiencing homelessness in Dallas , many face chronic medical and mental health challenges and rely on emergency departments ( EDs ) as their only source of care . Care for the unsheltered homeless constitutes more than 10 % ( 25 – 35 individuals daily ) of the patient visits in the Baylor University Medical Center ( BUMC ) ED .
“ Dallas has a pretty robust offering for getting people housed ,” said John Garrett , MD , chief of emergency medicine at BUMC . “ What we haven ’ t had in Dallas is anybody who ’ s tending to the medical needs of patients who are unsheltered .”
To address the needs of this vulnerable population , Dr . Garrett launched Dallas ’ first Street Medicine program , funded exclusively through philanthropy — reflecting Baylor Scott & White Health ’ s Mission to promote the well-being of all individuals . “ Many of our homeless patients return to the ED time and again because their chronic conditions go unmanaged . Without consistent care , they ’ re caught in a cycle that the Street Medicine program aims to break ,” Dr . Garrett said .
Street medicine , first introduced in the early 1990s , involves delivering healthcare to people experiencing homelessness in their own environments . Unlike clinics , shelters or health fairs , which require patients to travel to a specific location , street medicine brings care to patients .
Street medicine programs have been shown to decrease the need for ED visits by up to 70 % and decrease the number of inpatient admissions . By reducing reliance on emergency services , BUMC ’ s program empowers individuals by offering them a path toward improved health .
“ While data show these programs can benefit the healthcare system , that ’ s not the only reason we do this work ,” said Ti Hoang , DO , medical director of the Street Medicine program . “ We do this because it ’ s the right thing to do .”
Dr . Hoang completed her family medicine residency at BUMC and has experience working in similar programs in Houston and Fort Worth . Dr . Garrett recruited her to serve as medical director for BUMC ’ s program in 2024 . In only 45 days since the program ’ s launch , Dr . Hoang has cared for 80 patients . The goal is to reach at least 60 patients per month .
Patients can be referred to the program through BUMC ED physicians or care management teams , or through partner organizations . Dr . Hoang and a team of three to four others , such as paramedics and social workers , conduct follow-up visits via walking rounds , providing services such as urgent care , health screenings and physicals , wound care , minor procedures , medication counseling and mental health treatment .
Philanthropy ’ s role in helping the homeless
BUMC launched the Street Medicine program in 2024 with a grant from the Street Medicine Institute , and more funding is needed to sustain and grow the program .
25 – 35 Patients Daily …*
Care for the unsheltered homeless constitutes over 10 % ( 25 to 35 people daily ) of patient visits in the emergency department at Baylor University Medical Center .
* Source : BUMC ED Data
While success can be measured in terms of reduced ED visits and readmissions , a larger goal is to help people gain footing to overcome homelessness . Building trust with a healthcare provider is key . “ Part of this is not just waiting for the homeless to come to us when they ’ re really sick but being proactive so that we can keep them healthy ,” Dr . Garrett said . “ It ’ s a facet that we haven ’ t had in Dallas , and it ’ s exciting to see it happen .”
To learn more , please contact Amy Monday at Amy . Monday @ BSWHealth . org or 214.820.4771 .
THE COMPASS / BAYLOR SCOTT & WHITE FOUNDATION NEWS / WINTER 2024 3