October 3, 2023 – Congresswoman Lori Chavez-DeRemer: Column – Expanding street medicine to address the homelessness crisis
One of the worst failures of Measure 110 has been its ability to support the treatment of individuals suffering from addiction. Since the measure weakened law enforcement’s ability to penalize the trafficking, possession, and use of addictive illicit drugs, substance abuse has exploded. Unfortunately, Oregon continues to rank near the bottom nationally in addiction treatment.
While I agree with the majority of Oregonians who support a complete repeal of Measure 110, it’s clear we need to take action now to mitigate the fallout – particularly as it relates to the homelessness crisis. Federal data shows Oregon’s homeless population is growing at one of the fastest rates in the nation, as the crisis also continues to rise across the United States at a record-setting rate.
Too many people have fallen victim to a vicious cycle of substance abuse, mental illness, and poverty. Last year, approximately one in three homeless individuals in Oregon had either a substance use or mental health disorder. Despite making it easier to access and use dangerous drugs, the state has failed to follow through on providing adequate, accessible health care services to treat some of the most vulnerable people in our society.
While I recognize the importance of expanding affordable housing as one way to tackle the homelessness crisis, I believe this other critical component – treating addiction and mental illness – has been largely ignored for too long. As I explored ways to tackle this part of the crisis, my team and I began partnering with community organizations and street medicine professionals to write new legislation.
Our goal was to figure out the most effective way to expand substance abuse and mental health treatment, also referred to as dual diagnosis treatment, to the homeless. Ideally, expanding health care services to these individuals would help them transition into safe and stable housing. After months of hard work, we officially introduced the bipartisan DIRECT Care for the Homeless Act.
The new proposal requires the U.S. Department of Health and Human Services (HHS) to create a four-year pilot program to expand street medicine services for the unsheltered homeless. It would specifically apply to cities or counties with 150 unsheltered homeless individuals per 100,000 residents, which is determined by U.S. Department of Housing and Urban Development (HUD) data. Street medicine providers, who would be reimbursed by HHS, provide dual diagnosis treatment directly to those who need it, wherever they are. By streamlining access to this needed treatment, the DIRECT Care for the Homeless Act would help close the current health care gap.
To incentivize workers to practice street medicine, this legislation includes a provision allowing medical students pursuing the field to take an interest-free pause on their student loan payments. Additionally, it expands Public Service Loan Forgiveness eligibility to community service officers, who can help improve public safety. Finally, I strongly believe in transparency and accountability for new government programs. If signed into law, this bill requires the Government Accountability Office (GAO) to publish a study analyzing the pilot program’s effectiveness.
In the coming months, I’ll continue working to build a strong, bipartisan coalition of support for this much-needed legislation. Oregonians frequently tell me the homelessness crisis is one of their top concerns. I’ll continue bringing these concerns to the policymaking tables in D.C. by taking a unique approach to address this crisis.
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