Street Medicine Kalamazoo 2021 Impact Report

Street Medicine 2021 Impact Report: Our First Year on the Road

Kalamazoo

2021 SMKzoo Leadership Board Clinical Director Sravani Alluri, MD WMed Family Medicine Co-Founder Associate Director Nic Helmstetter, MD WMed Medicine-Pediatrics

A message from our directors...

We began our journey making house calls for the unhoused in January 2021 with nothing more than a doctor’s bag stocked with a few basic supplies, a backpack full of socks and hand warmers, and a desire to better understand our patients experiencing houselessness.

Over the last year we have taken care of more than 200 unhoused individuals.

With each new person we meet, we learn a bit more of the intricacies of providing care to a population that is highly mobile and focused, foremost, on daily survival.

This past year has been one of growth and maturation for our organization. From its inception to its expanded operations, including cooperation and partnerships with community programs and winning grants, we have positioned ourselves as a vital resource for individuals that remain largely excluded from the traditional healthcare system. We’ve faced challenges like the closure of the encampments and rose to meet them, creating a truly mobile model of care capable of taking care of a dispersed population and with the capacity to provide primary and urgent medical services just about anywhere. Bringing medical services to the streets, we have not only been successful at improving continuity of care, but at delivering that care with dignity and compassion, building a relationship of trust with this often stigmatized population.

This service is core to WMed’s mission, vision, and values. Looking forward to SMKzoo’s strategic plan in 2022, we are poised to enmesh ourselves deeper in our community with consistent clinics housed in our partners’ facilities frequented by our patients offering wraparound services. We are also applying for grants to fund a mobile clinic unit to widen the scope and improve the privacy of our practice, especially during times of inclement weather. We are in the beginning stages of elevating our street medicine research program: both descriptive and clinical. We will turn our focus inward to strengthen our commitment to education: building our medical school and residency training curriculum in street medicine in the form of formal lecture series, but also richer clinical experiences. We are committed to our learners forming the nucleus of our program.

Without them, our future isn’t as bright, nor the care of our community as secure.

- Sravani Alluri, MD & Nic Helmstetter, MD

Co-Founding Faculty Prashant Patel, DO Assoc. Dean for Health Equity & Community Affairs Cheryl Dickson, MD WMed Pediatrics Residents › Matthew Kennedy, DO PGY2 Psychiatry Fourth Year Students › Rachel Chang Co-Founder ›

Becca ReardonLochbaum Co-Founder

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Emma Swayze Co-Founder

Third Year Students › Tara Ballouz Co-Founder ›

Nirvan Shanker

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James Southard

Second Year Students › Ben Root

To serve the unhoused community in Kalamazoo by identifying current care gaps, providing primary and preventative health care, and training future physicians to thoughtfully interact with and advocate for the unhoused.

Mission

Vision

A longitudinal program that utilizes a biopsychosocial model of care to provide medical services to the Kalamazoo unhoused community.

Values

Community partnership and collaboration Patient-informed solutions Medical and behavioral harm reduction Equal access to quality healthcare regardless of housing

Our year on the road

By the numbers

1,323 hours spent by medical students, residents, and attending physicians volunteering with SMKzoo in the field

256 calls & texts made to the SMKzoo answering services, allowing unhoused patients to seek advice or request a visit with us

694

10,086

patient encounters in the field, ranging from wound care to chronic disease management

donations distributed to the unhoused community, including toiletries, first aid supplies, and over-thecounter medications

217

8

unique patients seen, including adults, children, and pregnant women

grant applications submitted, resulting in $72,000 of awarded grant monies

When?

Every Sunday, come rain or come shine!

Where?

Arcadia Creek Festival Place, located in Kalamazoo’s Central Business District & across the street from Kalamazoo Gospel Ministries.

Who? Medical students from every WMed class, alongside our community partner Food Not Bombs who provides a hot meal.

Street Rounds When?

2-3 times per week

Where?

All across Kalamazoo! If we can drive or walk there, we can see patients there.

Who? Rounding teams are made up of at least one attending physician and a group of residents and 4th year medical students.

What?

By car and on foot, our team makes contact with the unhoused. Once we meet, we can offer medical assistance similar to what is offered in any primary care clinic.

EKGs, point-of-care ultrasound, a cadre of point-of-care tests allow us to assess our patients, and of course, nothing beats a good physical exam! Then, we are able to prescribe or dispense medications or provide counseling on site.

How? Personnel are recruited by protected clinical time for our attendings, integration into resident training blocks, and medical student volunteering; our supplies are purchased through grants and donations.

What?

Volunteers spend time in the community, providing toiletries and other basic supplies to our unhoused neighbors. Our tent stocks deodorant, shampoo, soap, condoms, menstrual products, oral care supplies, first aid kits, over-the-counter medications, and much more! Most importantly, we get to know those we’re serving and use their input to inform our purchasing and projects.

How? We have received many in-kind donations from pharmacies and businesses around Kalamazoo, as well as fiscal donations from individuals. WMed Office of Health Equity and Community Affairs has also purchased supplies. Our goal is to have Arcadia Park activities completely donation driven by 2023.

Arcadia Park

Our team participates in community events to both spread the word about SMKzoo and develop partnerships with organizations in the area who work with similar populations as we do. As part of our mission of training future physicians to deliver sensitive, accessible healthcare we also host educational events for medical students, residents, faculty, and staff.

Street Medicine Answering Service What?

Patients, community partners, and consultants can reach our team by calling or texting our Street Medicine Kalamazoo number. Team members are available to respond to patient concerns, schedule visits, or discuss care within 24 hours of inital contact. The answering service also allows us to locate patients and coordinate meetups. We also receive referrals from local advocates and partners on this number, allowing us to reach new patients in need.

Who? The answering service is staffed by upperlevel medical students, residents, and attending physicians.

Where?

This portion of our work can be done from anywhere: the office, at home, or while on street rounds.

Events Attended & Hosted in 2021 include: ›

“Street Medicine Kalamazoo: Our Mission & Goals,” Student Interest Group Presentation

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“Global to Local: Venturing to Meet the Needs of the Unhoused of Kalamazoo,” WMed Global Health Grand Rounds

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Southwest Michigan First Chamber Connect Meeting

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Kalamazoo’s Annual Wellness & Recovery Fair

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Narcan Training with COPE Network

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“The Wisdom of Trauma” Film Screening & Discussion

Community Engagment & Education

Student & Resident Spotlight What drew you to this group initially?

I think a shared frustration that begins to ferment in medical students as we progress through school is that while we can learn so much and do so much, this institution remains largely inaccessible to so many people. SMKzoo was appealing to me because it brings clinical work to where it’s needed most-- outside the clinic. When medicine is withheld on the basis of factors like housing or insurance, SMKzoo is an opportunity to help treat people like human beings, and do the work we all came to medical school to do.

Nirvan Shanker, Class of 2023

What skills have you gained from working with SMKzoo?

Learning and practicing street medicine has let me hone my ability to create a therapeutic alliance with just about anyone. Our patients feel heard and form very kindred relationships with us, so we’re able to come up with creative solutions for them that meet their goals and are realistic for them. Going into OB/GYN, that ability is a huge advantage.

Becca Reardon-Lochbaum, Class of 2022

How do you see SMKzoo fitting into your general medical education?

I think that Street Medicine can fit into medical education seamlessly; every person who sees a doctor needs some kind of help, and SMKzoo is really just an effort to better understand (and apply an understanding of) needs unique to an especially vulnerable population. There is so

much that can be done both qualitatively and quantitatively to better comprehend and address those needs, and medical students can and should be in the business of seizing those means of learning, no matter what population they hope to one day serve.

James Southard, Class of 2023

What has surprised you the most working with this community?

The lasting relationships I’ve made with members of the community have been eye-opening.

Everybody has a story to share and is so willing to open up to SMKzoo members, allowing me to develop a deeper understanding of the needs of the unhoused and appreciate how tight-knit Kalamazoo really is.

Tara Ballouz, Class of 2023

What is the key to SMKzoo’s success thusfar?

The key to SMKzoo’s success so far is that we provide primary care that embraces our patients and adapts to their needs. We partner with community members and patients to eliminate barriers by providing flexible scheduling, visiting patients where they live, and bringing medications, ultrasound, and laboratory tests out into the streets where are patients are.

Ben Root, Class of 2024

What is the greatest challenge in this work?

Maintaining patient follow up. We actively seek out members of the unhoused community by visiting communal spaces, pairing with services

our patients frequent, or setting up a time and place to meet with people individually. Many members face difficulty maintaining a cellphone due to frequent moving, unstable finances, theft, etc. Our group works hard to stay in touch with them and make sure we do not lose people to follow up because of communication.

Emma Swayze, Class of 2022

What is the greatest lesson you take away from working with SMKzoo?

It truly takes “all hands on deck” by the community to ensure that organizations like ours have the opportunity to sustainably provide the best care to unhoused community members. I am continually humbled by all the effort, support and passion of the Kalamazoo community to step up to the challenge of assisting those who truly need it.

Rachel Chang, Class of 2022

What impact do you see SMKzoo making in the community?

I feel that the biggest impact that SMZoo has made is the relationships that we’ve been able to form with the members of our unhoused community. Homelessness is more than just not having a place to live.

Persons who are unhoused have complex needs, and SMKzoo provides opportunities to get to know these folks and appreciate that there is no typical profile for a person experiencing homelessness. Whether they’ve experienced domestic violence or sexual assault, are dealing with mental illness, unemployment, eviction, etc., we stay engaged with them, communicate respect, and try to show them that they still have value. While we may not be able to fix their circumstances, we can meet

them where they are to provide them with high-quality, compassionate healthcare and connections to social services. Beyond this impact on Kalamazoo’s unhoused community, SMKzoo is helping to create more well-rounded clinicians, who treat patients — both housed and unhoused — with respect and with consideration of their full biopsychosocial spectrum of needs.

Matthew Kennedy, WMed Psychiatry PGY2

In memoriam...

December 21st is Homeless Persons’ Memorial Day, marking both the first day of winter and the longest night of the year.

The crude death rate of the unhoused comunity is fourfold that of the general population and their life expectancy has been shown to be up to 20 years shorter.

We remember... our neighbors near and far who were lost this past year to an ailment that doctors alone cannot remedy, the disease that is homelessness.

To our partners & supporters

United Way of Battle Creek and Kalamazoo Region

Kalamazoo Community Foundation

Michigan State Medical Society Foundation

Kalamazoo Harm Reduction

OptiMed Pharmacy

Bronson Methodist Hospital

The Family Health Center

Kalamazoo Food Not Bombs

Integrated Services of Kalamazoo (ISK)

Ministry with Community

Community Outreach Prevention & Education (COPE) Network

To our donors Anonymous Dr. Marie Arnaout Dr. Teresa Bailey Ray & Alex Bayer Jane Boersma Signe Burchim Dr. Maria Demma Cabral Pattie Curtis Ethan Curie Dr. Ross Driscoll Elizabeth Farner Stacy Fasching

Dr. Alice Franks & Rod North Don & Liz Franks Dr. Ankita Gautam Dr. Lisa Graves Becky & Jeff Green Pete Hanner Ann Harris Dr. Saraswati Keeni Sose Klein Cindy & Steve Lochbaum Rod Malcom & Wendy Van Peenan Matthew Matheney

Dr. Daniel Mattox Lorri Mease Leia Monk Michael Navarro Nick Nizzardini Leanna Oertel Vasavi Paidpally Karina Pantoja Lisa Pellman Anne Reardon Gavin Reardon Kathryn Reardon Maggie Rothney

The Rowland Family Jean Shelton Linne Shimanek Dr. Paula Termuhlen Karen Tulik Dr. Holly Turula Mel & Bo Van Peenan The Vollbrecht Family Linda Zhou Arlene & Scott Zipp Oshtemo Pharmacy PERIOD Optimed Pharmacy