Since 1988, Street Outreach Services (SOS), a program developed by the San Francisco Community Clinic Consortium (SFCCC), has been meeting the healthcare needs of San Francisco's unhoused community, while a companion program, Veterinary Street Outreach Services (VSOS), provides veterinary care for pets. In 2023, SOS announced the opening of a new pop-up clinic to serve the residents of 33 Gough Street, a collective of 70 tiny homes providing shelter for the city's homeless.

Medical professionals volunteering for the SOS program typically travel in a well-equipped Medical van between homeless camps, overpasses, and shelters throughout the city. Many of the patients are transient or reluctant to seek follow-up services. These medical teams often need help to track their patients or ensure compliance with prescribed medications. A centralized pop-up clinic within a community encourages residents to seek long-term treatment, not just emergency care.

“The success of the tiny home village partnership speaks to the power of collaboration to address critical community health issues like homelessness,” says SFC CEO Johanna Liu.

“SFCCC is a convener: whether we're bringing our 12 member health centers together or coordinating with other community-based organizations to serve our SOS clients, our role is to provide leadership and foster innovation based on over forty years of experience as local safety net experts serving San Francisco's most vulnerable residents.”

Pop-up Medical Clinics Part of a Larger Mission

The recent addition of a mobile medical facility is only the latest development in a pilot program co-sponsored by homeless community advocate Dignity Moves, Tipping Point Community, The Department of Homelessness and Supportive Housing, Urban Alchemy, and Home First Services. Together, these non-profit organizations and city departments are addressing the needs of San Francisco's unhoused community.

The tiny home village at 33 Gough Street is designed to provide qualified applicants with affordable, basic housing while they transition from the streets to more permanent addresses.

As envisioned, the existing tiny home community already contains a range of vital services and retail outlets. Each unit includes a bed, desk, climate controls, and a secured door. Other communal facilities, such as showers, bathrooms, and laundry, are on-site. Residents also have access to a computer lab, a community garden, and a satellite office for caseworkers. The community currently has 70 private spaces available to rent.

The tiny home village's unique setup represents a new care delivery model for the SOS team.

“Compared to other SOS sites, it's more like doing old-fashioned home visits,” shares SOS Community Health Worker Trevor Wong. “It's easier to find people and follow up with them than if they're living in a tent and always moving around.” Another SOS provider points out that because a number of organizations are delivering other on-site services, it makes it easier for SOS staff to coordinate additional services for residents.

NIMBY, Construction Costs, and Political Climate on the Project

The pilot program's original greenlighting has been challenged in recent years. Concerned residents in the area surrounding 33 Gough Street have expressed concerns over property values, crime rates, and other issues commonly associated with public housing projects. Many of these concerns have been addressed by the project's developers and city officials, and the project has actually beaten its proposed 2025 opening date.

However, the city itself has also taken action to halt the project in the past due to excessive per-unit costs. While similar housing projects have reported per-unit construction costs of $10,000, developers of the 33 Gough Street project reported per-unit costs closer to $100,000. The original budget for the entire program was $7 million, which would have necessitated additional funding from private and public sources.

Homelessness as a political issue has also affected programs such as the 33 Gough Street Project. The city of San Francisco took action against unsanctioned homeless camps, many of which are located on public property. These sweeps, although considered legal actions, were allegedly not followed up with efforts to relocate the displaced homeless population.

This prompted several homeless advocacy groups, including the Coalition on Homelessness, to file lawsuits against the city in 2022. A federal judge has paused these lawsuits while the Supreme Court considers a similar case in Oregon.

The Upside of Pop-up Medical Clinics

Brick-and-mortar medical clinics providing free or reduced-cost care for indigent patients is not a new concept. However, these facilities are located at fixed points in larger cities where public transportation may not be viable. Limited operational hours and minimal staffing also mean longer wait times and minimal follow-up care. 

A regularly scheduled mobile medical clinic allows residents with transportation or mobility challenges to receive treatment and undergo testing in their own neighborhood. The clinic's staff have the opportunity to develop long-term relationships with their patients, making it possible to chart progress or adjust medical prescriptions. Treatable conditions often left unchecked by indigent patients can now be addressed before they become life-threatening. 

Large-scale temporary homeless projects such as 33 Gough Street may or may not gain traction in other cities facing similar housing and poverty issues. Still, the project does demonstrate the benefits of a mobile medical service in an often underserved community.

This article was produced by Media Decision and syndicated by Wealth of Geeks.