Tacoma committee hears update on state-funded street medicine pilot for people experiencing homelessness

Tacoma officials told the Community Vitality and Safety Committee on July 10 that a state-funded pilot providing medical care to people living outdoors has moved from planning into regular outreach, and they outlined service types, early encounter counts and a timeline for expanding deployments.

The city accepted a $1,000,000 grant from the Washington State Health Care Authority for a pilot through June 30, 2025, Caleb Carbone, homeless strategy systems and service program manager with the City of Tacoma’s Neighborhood and Community Services, told the committee. "The city accepted a grant for $1,000,000 through June thirtieth of 2025 from Washington State's Health Care Authority to pilot a program to provide street medicine services to support residents who are in encampments in the city of Tacoma," Carbone said.

Why it matters: Committee members and providers said street medicine can reduce emergency-room visits and 911 calls for medically fragile people who do not seek clinic care. Jan Runbeck, RN, supervisor of the Yakima Avenue Health-for-All pilot (housed at Nativity House and administered by Vallejo Vocations), cited a recent Challenge Seattle report and said its statewide emergency-department counts underline the scale of unmet need: "there are now about 900,000 visits to Washington state emergency departments made by those who are unhoused every year at a cost of over $1,150,000,000 per year," she said.

What the program does: Chantelle Harmon Reid, director of the Tacoma-Pierce County Health Department, described a multidisciplinary team that includes community health workers or peer navigators, behavioral-health specialists, a registered nurse and a physician or nurse practitioner. The teams provide wound and foot care, testing and treatment referrals for infectious disease (including hepatitis C and HIV screening), opioid-use-disorder treatment referrals and basic harm-reduction supplies such as naloxone. Harmon Reid said the program also distributes hygiene kits, clothing and bus passes and connects people to specialty and primary care when possible.

Deployment and staffing: Harmon Reid said the health department began full deployment on May 26, 2025. A contracted nurse employed by Comprehensive Life Resources (CLR) began mobile-nurse visits earlier in April; that mobile nurse and an outreach peer navigator currently run weekly clinics focused on wound and foot care. Carbone said a physician and an advanced practice nurse are deployed on separate days and the city and health department are working to increase clinical days. Committee members were told the program aims to expand clinical deployments to at least three days per week by September and to increase to more days by October, with the longer-term goal of fielding two teams operating in separate parts of the city.

Early service numbers: Presenters said the program has distributed hygiene supplies and other items and recorded dozens of clinical encounters since initial deployments. Numbers presented by Harmon Reid and Jan Runbeck included about 536 sleeping bags/blankets distributed, 347 naloxone kits, roughly 760 people served during outreach, and 21 physician- or nurse-practitioner medical visits in the reported period; the mobile nurse documented multiple wound-care encounters and repeat visits for follow-up. Harmon Reid also said about 20% of people reached had access to a phone. Presenters attributed variability in follow-up and some gaps in recorded medication completion to staffing changes and the transient nature of the population.

Funding and sustainability: Committee members pressed for clarity about long-term funding. Carbone and Harmon Reid said the current award is state funding through the Health Care Authority and that the state expects to provide additional support to established programs, but the amount and duration were not finalized. Harmon Reid said the health department has begun establishing billing processes—"super bills" and charge codes—to pursue Medicaid and other reimbursement where feasible, and city staff said the City Manager could be asked to prioritize the program in future budget cycles. Councilmember Scott asked whether the county might match city funds; Carbone said he had asked the county to consider a match.

Coordination with other providers: Presenters described ongoing coordination with local outreach teams (including the HEAL team, Brotherhood Rise and other shelter and respite partners) and sought co-location opportunities such as parking lots and safe-car sites. Harmon Reid and Jan Runbeck described ride-alongs and referral pathways between outreach teams, the mobile clinic, local federally qualified health centers and hospitals.

Public comment and community perspective: Sally Perkins, a District 3 resident, told the committee she welcomed the briefing but criticized the timing of public notice and earlier outreach. "The street medicine effort first funded in 2024 has been a long time getting started," Perkins said, and asked the city to prioritize direct response and clinical care for medically challenged people who do not want 911 called. Presenters said they had used the health department’s own resources while contracts were finalized and emphasized trust-building with people living outdoors.

Next steps and limitations: Presenters said they are developing heat maps to target hot spots, refining policies and seeking partner sites for more stable clinical space. They emphasized the program is a pilot with limits: initial funding runs through June 30, 2025, and expansion depends on continued state support, county or city funding decisions and successful billing for reimbursable clinical services. No formal committee decision or ordinance was taken at the July 10 meeting; the session was a briefing and Q&A.

Committee members thanked providers and asked staff to return with updates on deployment schedules, billing progress and outcomes data.