St. John's Street Wellness and Support (SWAS) - St. John's Community Health's (SJCH) Street Wellness and Support (SWAS) program will integrate comprehensive evidence-based SUD/COD treatment and related services for people experiencing homelessness (PEH) in South Los Angeles, California, as part of our existing Street Medicine Program. SWAS aims to improve the health, functioning and stability of PEH through team-based, peer-driven, recovery-oriented, trauma-informed assessment, treatment, harm reduction, case management, and recovery support. California. Population of focus is primarily Latino (55%) and Black (41%) with Whites, Asian Pacific Islanders, and American Indians/Alaskan Natives comprising the remaining 4%; 30% will be best served in Spanish or an indigenous Latin American language; 75% will be male and 25% female. Most clients (73%) will be aged 31-54, 21% aged 55+, and 16% young people 18-30. All will be living below the federal poverty level; 75 will have a history of involvement with the criminal justice system due in large part to the high prevalence of substance use and untreated mental health problems; 15% will be veterans; and 20% will be lesbian, gay or bisexual (LGB). South LA continues to endure disparities in behavioral healthcare access, use, and outcomes. PEH, especially those reentering their community after incarceration, face numerous obstacles to care and need help navigating the complex healthcare and housing systems in place meant to assist them. Such issues are compounded by SUD/COD, HIV, VH, and other chronic illnesses-and require integrated treatment solutions to address their needs. Yet low-barrier, culturally competent, trauma-informed behavioral health services in South LA are rare, even more so for PEH who may need prolonged support and trust-building before accepting services or treatment. Barriers like stigma, fear of law enforcement, and insufficient housing stock underscore the urgency of scaling supports. More investment in South LA is desperately needed to assist unsheltered PEH with SUD/COD to gain stability through treatment and supportive services. Expanding our existing SUD/COD and intensive case management services to support and advocate for PEH is critical to improving persistently poor treatment outcomes for South LA PEH. A total of 275 unduplicated PEH (75 in Year 1; 100 in each Years 2 and 3) will be provided with SUD/COD treatment, tobacco cessation, peer recovery support, and case management; and 1,375 (375 in Year 1; 500 each in Years 2 and 3) will be served via community engagement, harm reduction, and other health and wellness services that support SUD/COD recovery. Goals are to screen for, assess, treat, and provide follow-up care for SUD/COD for South LA PEH and to improve overall health and wellbeing, and enhance stability and functioning among SWAS participants. Objectives include: screening 800 PEH for SUD/COD including tobacco use; providing 275 clients 1 or more coordinated treatment (including Motivational Enhancement Therapy/MET and Medication for Opioid or Alcohol Use Disorders/MOUD or MAUD), peer recovery support, and/or case management services (30% to adhere to treatment, 25% to reduce substance use, 30% to improve mental wellness, and 15% to reduce tobacco use); 100% of those who screen for suicidal ideation will be further assess with a safety or treatment plan initiated as appropriate; and 50% of case managed clients will make progress on 1 or more goals.
