October 19, 2023 Global Gals
Attendees: Alexis, Andrea, Janice, Julie, Krista, Lisa, Megan, Sharon, Susan
Influential woman: Isabelle Allende, Chilean author. Born 1943. First novel published at age 40 in 1982.
Speaker: Lisa Silvestro, Nurse Practitioner
Nursing school in Boston. First job in San Diego was with wealthy people coming to La Jolla for detox providing concierge medicine. She prefers street medicine to clinical setting.
Community Home Reduction Team: Family Health Centers of San Diego started in January 2022. It’s a City and County collaboration grant program funded for five years. Large amount of money in addiction medicine from federal government due to Purdue Pharmaceutical payout.
FQHC: Federally Qualified Health Center
Substance use disorder and homeless are the requirements for the program. (SEE ATTACHED PPT) Shelter located at 3220 Sports Arena Blvd and run by Alpha Project. Family Health Center handles care coordination. 44 beds and focus on Midway area and East Village. No requirement of when the person has to leave the shelter. Counseling groups and substance abuse groups available for patients.
What does Lisa say to a homeless person? She focuses on building a relationship, she engages person in conversation. She gives out Narcan.
Safe Haven, run by Episcopal Community Services, is next step for patients who want help. 18 month program, 22 beds. Some patients have a job.
A lot of data collection. Weekly reports. First year goal: 100 patients. Result: 350 patients. Family Health Centers can follow the person through to getting housed, can follow for 90 days. Goal to connect to brick & mortor clinic.
Most patients age 35-60. Special shelters for younger than 25. Many patients suffer from chronic homelessness.
Harm reduction example: patient isn’t going to stop using drugs so teach to not reuse needles.
Fentanyl test strip. Used to test the drug (meth, heroin, marijuana) for fentanyl. Some patients want Fentanyl for the high.
Xylazine test strips. Newer drug. Known as Tranq. Vet tranquilizer.
Health Care In Action – Lisa works with them 2 days a week. Scan Health medicare program started HCIA (Long Beach). Street medicine. Medical van is the primary care clinic. Ability to supply injectable psych medications. Lisa really likes street medicine. Public health issue. Trying to keep people out of the ER. Offers patients a lanyard with tracking. Can be nimble because of small organization size.
One safe camping site off Pershing. Tents, bathrooms, showers.
Since the new San Diego city ordinance. Observes the homeless people are getting harassed. They have to move their stuff. Ticketing by police.
How does Lisa take care of herself? She doesn’t know. She finds survivor stories that inspire her.
Lisa took care of four people over an 8 hour period. HCIA required to take care of people around Petco Park and at safe sleeping camping spots. Other vans coming in from Father Joe’s and Family Health Centers. Van programs competing for funding from MediCal. Managed care provider gets money when assigned a patient. Medical relies on managed care plans to collect data.
Street medicine collaborative with Physicians Assistants new in California.
Soboxone is a drug for opioid addiction.
Book: The Least of Us – True Tales of America and Hope in the Time of Fentanyl and Meth by Sam Quinones (2021).
Call or text Lisa if you want to visit a shelter. Thank you Lisa for sharing your stories and being an empathetic, caring person. We need more like you in this world!
