07-05-2025
It's supposed to bring medical care to the homeless. Why isn't it operational?
Nearly six months after being announced, the Tacoma-Pierce County Health Department's program to provide health care to those living unhoused in the region is still not up and running.
Some people are worried and wonder if the program will ever become what was promised.
In October 2024, the Tacoma-Pierce County Health Department (TPCHD) and the City of Tacoma announced the Street Medicine Pilot Program — funded by a $1 million grant from the Washington State Health Care Authority.
According to an Oct. 22 news release announcing the program, the street medicine teams would be composed of medical and behavioral health professionals, including a medical provider, a behavioral health professional and a community health worker.
'This program will bring crucial healthcare services directly to people living unsheltered,' the release stated. 'The program will deploy specially trained Street Medicine Teams to provide care to individuals living in encampments, tent cities, vehicles, and other unsheltered locations.'
During a Tacoma Pierce County Coalition to End Homelessness meeting on May 2, a representative from the department gave an update on the program.
Bianca Shell, program manager for the street medicine program, said the department is working on hiring staff for the team. She was hired in March.
Shell reported the program had hired two peer-support specialists, a homelessness liaison and a nurse with a behavioral health background. She said the department is in negotiations with a medical doctor and a nurse practitioner.
Shell said the program likely would not be fully staffed until September 2025.
She attributed the delay to an overall shortage in healthcare specialists following the pandemic and said the organization of Pierce County's street medicine team is different than in other places with similar programs.
Shell said in other places teams are organized and operated directly by healthcare providers, such as hospitals or clinics. Pierce County's is being facilitated by the health department, which typically does not administer health care.
'I don't know the exact reasons as to why not, but that puts us at a disadvantage. Because you have a health department who is trying to stand up this team when the health department historically has not done this kind of work,' Shell told members of the coalition. 'So that also accounts for some of the delay.'
By late June, Shell said she anticipates being able to deploy large vans in the community to distribute supplies and offer medical exams in some capacity. She said the program will have to form partnerships to be able to host the vans in parking lots and other areas with encampments.
To date, the program has distributed hygiene kits and opioid overdose-reversing medicine around the community. She estimated the program has helped distribute supplies to more than 500 people.
Sally Perkins is a local homeless advocate who does volunteer street outreach in Tacoma's Hilltop Neighborhood. During the May 2 meeting, Perkins expressed some of her frustrations with the rollout of the program.
'This is the first truthful presentation we have had on street medicine yet,' Perkins said following Shell's presentation. 'We've been gaslighted for months.'
Perkins said the timeline and progress of the program has been 'obfuscated' by both the City of Tacoma and TPCHD.
'Fast forward to May 2025. Still not up and running,' Perkins wrote to The News Tribune in an email. 'Handing out supplies is something that random volunteers like ME can do … for free.'
Perkins told The News Tribune she is concerned the street medicine team would not be what was promised — a program that brings health care 'directly' to those who need it.
She said she did not like the plan to park a street medicine van in one location and require those living unhoused to find it, which she said could be difficult for sick and mobility-impared individuals.
During the 2024 survey of those living unhoused in Pierce County, volunteers counted 2,661 people living unhoused in a single night. Of those surveyed, 25% reported having a chronic health condition, and 22% reported having a physical disability.
'This is not true street medicine and was not the intent of the original Legislative proviso, as I understand that proviso,' Perkins wrote to The News Tribune. 'And as far as I can see, there is no way for me, who is out talking to unsheltered people fairly regularly, to call this team directly and get them to show up when they are needed.'
