When homeless encampments are torn down, what happens to health care?

In early May, large yellow bulldozers toppled over mounds of desert earth. Trees were uprooted. Shacks that once were homes were now splintered. Sand billowed into the hot air. Just a short drive away from where the well-known Coachella Music Festival is hosted, an encampment in the city of Coachella had been evicted the day prior and 60 people were left without a place to live. The California Department of Transportation was now cleaning up the encampment’s remnants and making sure there was no “home” anyone would want to come back to.

Fast-forward a few months. The individuals are displaced throughout the desert of the Coachella Valley. Either their county-funded motel vouchers ran out, their affordable housing opportunities fell through or they were still waiting to receive an update from their case manager. A handful of residents were given keys to long-term affordable housing, though it was about a 45-minute drive from the encampment they once called home and the food pantries, shelters and homeless services that had been a short walk away.

The residents also no longer had the mobile health care units that used the encampment as a home base, where health care workers had spent years developing relationships with encampment residents. As the encampment collapsed, the access to specialized mobile health care disappeared in an area of the desert where health care already is lacking.

Anecdotally, mobile health workers have said their contact with encampment residents dropped after the evictions. Mobile health care providers in the Coachella area said they now don’t know where to find their patients and often spend time circling the community trying to track them down, though many of their patients have hidden their tents out of sight due to fear of being evicted again. The loss of this specialized patient experience, tailored to an underserved population, is an overlooked impact of encampment displacements across the state.

As encampment evictions are becoming more common across California, I want to see if this trend is prevalent statewide. I am working to find data that will prove or disprove this anecdotal hypothesis. I am seeking data from mobile health care units and county health departments throughout the state to see if there was a dip in outreach service following encampment evictions.

But as I’ve tried to access such data, I have found it is quite challenging to obtain. The way that organizations keep track of their outreach is not always reliable or consistent.

Many of these organizations have both brick-and-mortar locations and mobile units, and data from both are typically lumped together as one. In addition, the data these organizations typically pull for their own reports are unduplicated counts, which means even if a patient uses their services 10 times, that patient will still only count as one data point.

For my 2018 Data Fellowship project, we want duplicated returning patient numbers and we want that just for the mobile units. We want the data to show how those patient relationships have been built over time and how those same patients were served month after month prior to their displacements, because that consistency is where the outreach impact is made. Because of this complexity, we have been told it will take many billable hours for these organizations to run the data reports.

I am very patient, though, and I believe the data to be a worthy source that could influence policy decisions related to how cities handle homeless encampments.

In general, homeless people don’t seek health care themselves or even recognize when they are in serious need. Mobile health units build relationships over months until patients trust them enough to accept care. Workers know that any change — especially being displaced — could derail that work. My reporting aims to show how a policy decision to clear encampments has led to a disruption in these health care services. By bringing awareness to the public and policymakers, we hope the state rethinks its method of encampment removals, and its impact on access to health care.

That health care is often crucial. Did you know that one of the most overlooked killers for the homeless are things like skin abscesses that burst? It’s right up there with drug overdoses and heat-related deaths in the desert, but its arguably more preventable when the proper health care services are in place. I plan to explore that theme, too.