Hartford HealthCare's Neighborhood Health & Street Medicine team is expanding medical care for people experiencing homelessness across Connecticut, delivering treatment directly in shelters, encampments, and parks as extreme heat increases health risks for this population.
People without stable housing face elevated risk of heat-related illness and other medical complications during periods of extreme temperature, given limited access to shelter, hydration, and routine medical care. Now in its fifth year, the program has grown from a two-person, one-vehicle team into a 32-person operation across three teams serving Connecticut. Since launching in 2021, clinicians have completed more than 14,680 patient visits and made over 4,300 referrals. This fiscal year, the team has conducted 877 visits for patients managing advanced heart failure, end-stage cancer, high-risk pregnancies, and other serious conditions.
Kelly Toth, system director of Neighborhood Health & Street Medicine at Hartford HealthCare, said, "The needs we're seeing have changed dramatically. People experiencing homelessness are aging, they're sicker, and they're living with some of the most complex conditions we've seen, including advanced heart failure, end-stage cancer, high-risk pregnancies, and serious wounds. From the beginning, we knew we couldn't expect every patient to come into a hospital or clinic. We had to bring care to them, meet them where they are, and build the relationship first."
Clinicians provide portable ultrasounds, electrocardiograms (EKGs), bloodwork, wound care, vaccinations, chronic disease management, and medication support in the field. An inpatient Street Medicine consult service also coordinates medications, follow-up appointments, housing, and community support before discharge.
"The reality is that many people are discharged back to the street," said Dawn Filippa, RN, clinical, quality and safety manager for Neighborhood Health & Street Medicine at Hartford HealthCare. "If someone is medically ready to leave the hospital but has nowhere safe to recover, we try to meet them at the bedside before discharge, understand where they stay, what name they go by, where they get meals, and how we can find them again. That way, we can help with medications, follow-up appointments, and community connections instead of letting them fall through the cracks."
During summer months, clinicians treat dehydration, wound infections, insect bites, and heat-related illnesses while distributing water and cooling towels. In winter, the team responds to frostbite and other cold-weather injuries while connecting patients to shelters.
Toth added, "Trust doesn't happen in a single visit. Sometimes it starts with a granola bar, a bottle of water, and asking someone their name. It may take 10 visits before a person is ready to engage, but if we say we're going to show up, we show up. That consistency is what allows care to happen."
Street medicine models like this one have become an increasingly common approach among health systems seeking to reach patients who face barriers to traditional clinical settings. The program provides ongoing medical care, care coordination, and community connection for people experiencing homelessness throughout Connecticut, extending Hartford HealthCare's reach beyond hospitals and clinics to some of the state's most medically complex patients.
