SHOW vans provide street-based care to unhoused New Yorkers, committee hears

At the June meeting of the Human Services Committee of Manhattan Community Board 2, Andy Cook, administrative director of the Street Health Outreach and Wellness program at NYC Health + Hospitals, described the SHOW vans and how they deliver primary care and social services to people living on the street.

SHOW — described by Cook as “street medicine” — uses adapted minibuses and roving teams to bring wound care, chronic-disease management, harm-reduction supplies and social-work support directly to people experiencing unsheltered homelessness. “We currently have 5 SHOW units across the city,” Cook said, noting the program is funded by the city and baselined to run six units.

Committee members pressed for operational details and local implications. Cook said each SHOW unit is affiliated with one Health + Hospitals facility that operates a primary‑care safety‑net clinic; Bellevue operates two SHOW units (one at Sara D. Roosevelt Park and one in East Harlem). Teams typically include a medical provider, nursing staff, a social worker, an addiction counselor, a community health worker and a clerk; when fully staffed, Cook said a unit is about seven staff members. Units operate regular ambulatory hours — he described them as “Monday through Friday, 9 to 5” — and are intentionally stationary so people without phones or internet know where to find services. “We're not gonna turn anyone away,” he said, and patients do not need ID or insurance to receive care.

Cook provided data on the program's scale and impact: over the last two years Health + Hospitals' staffed SHOW units completed “just over 30,000 street engagements, including about 3,000 medical or behavioral health encounters.” He said about 1,100 patients are active in the program at any given time. Cook also cited a system metric for continuity with primary care: “Street‑homeless patients engaged with SHOW have about a 24 percent rate of primary‑care engagement in the Health + Hospitals system, compared with about 9 percent for patients not engaged with SHOW,” which he presented as evidence that SHOW helps connect people to ongoing care.

On costs and capacity, Cook said the fully loaded operating cost for one SHOW unit is “about 1 and a half million dollars per year per show van to fully operate.” He told the committee the program is city‑funded and staffed units can be difficult to maintain: “When we are fully staffed, we would have about 7 staff members,” but staffing can vary across units and some are not always at full complement.

Committee members asked whether SHOW reduces emergency‑department use; Cook said reducing ER visits is an explicit goal and that SHOW‑engaged patients show higher primary‑care continuity, but added, “I don't have any data handy to demonstrate that to you.” He described referrals and warm handoffs to other city agencies and programs: SHOW social workers connect clients to HRA, other street‑outreach teams and specialty care as needed. The program also distributes harm‑reduction supplies and can activate EMS for psychiatric crises.

Members raised neighborhood concerns such as “spillover” and lines outside vans. Cook said SHOW teams are “busy, but not...disrupt[ive] to a neighborhood” and generally operate where the population already is, adding the program does both stationary services and proactive roving outreach.

Board members discussed whether to advocate for SHOW deployment in Community District 2 but were reminded that the program is city funded and the department is baselined to operate six units. The committee said it may consider a resolution in the fall to support capital or operating requests tied to Health + Hospitals' priorities.

As the committee wrapped up, several members asked the program to return later in the year for follow‑up once the board has had time to consider advocacy options.