Unhoused people face many challenges surrounding receiving medical care in traditional health settings, such as high costs, stigma and discrimination. They often receive no follow up care, making receiving all necessary services difficult. The Berkeley Free Clinic (BFC) and the City of Berkeley both strive to provide accessible medical care to Berkeley’s unhoused population to help them work around these challenges.
The Berkeley Free Clinic is a volunteer-run public health clinic offering free health services to anyone who wants them. While COVID-19 has limited BFC’s capacity to offer acute care, the clinic has still been crucial in providing other accessible health services to Berkeley’s unhoused population during the pandemic. Acute care is treatment for non-common and treatable medical concerns such as coughs, colds, and rashes.
Like many volunteer organizations, BFC was impacted by the COVID-19 and clinics closed when the first shelter in place order was released.
“We didn’t feel like we knew enough about COVID-19 to be able to stay open safely,” said BFC registered nurse Finn Black.
The number of volunteers for BFC dropped significantly during the time BFC was closed, which has made BFC’s reopening more difficult.
“Because of a lot of people dealing with burnout and stress and depression during the pandemic and loss of a lot of volunteers during the time that we’ve been closed, we’ve actually really been struggling to get enough volunteers to reopen,” Black said.
While the clinic was able to eventually reopen, BFC has lost the capacity to provide acute care due to a limited staffing capacity. BFC still provides some of these services, however, many are adapted to having fewer volunteers and following COVID-19 safety precautions. On their website, BFC states that many of their services are currently only available over the phone.
Prior to the pandemic, BFC offered many free health services to unhoused communities from their 13 clinic divisions. Current services include testing for HIV, hepatitis, and tuberculosis, influenza vaccinations, peer counseling, testing and treatment for STIs, and assistance enrolling in food benefits and health insurance.
BFC makes these services more accessible to unhoused populations by visiting shelters and syringe exchanges directly, as well as pop-up health fairs and clinics that serve many unhoused people. Of these services, BFC is currently focusing on influenza and hepatitis vaccinations, according to Black.
BFC started providing vaccinations in 2017 when many unhoused populations, especially in Southern California, were experiencing severe outbreaks of hepatitis A due to unsanitary conditions in encampments. According to Black, the City of Berkeley said they didn’t have the capacity and weren’t planning to respond, but BFC was able to get free hepatitis A vaccines from California’s health department. Once BFC had the vaccines, they started visiting homeless encampments and vaccinating residents.
BFC is unable to offer COVID-19 vaccinations due to limited volunteer staff and the absence of equipment that can store the vaccines at the required temperatures.
Black highlighted the importance of employing a “multi-pronged strategy” when reaching unhoused populations to offer health services.
“A lot of [unhoused] people have pretty intense medical trauma that may make them not want to go into certain clinics,” Black said. “But, I think it is really helpful to provide vaccines in a way that meets people, literally, where they’re at.”
Black also said that in the context of COVID-19 vaccination, it’s important to offer vaccination at clinics where unhoused people already get services and at encampments and syringe exchanges to make vaccination more accessible to unhoused people who don’t want to come into traditional clinics.
According to Black, anti-homeless laws make it difficult to follow up with unhoused people. Because actions often necessary to unhoused people that include sitting and laying on the sidewalk, and camping in public are criminalized, unhoused populations often have their belongings confiscated by police officers and are told to move elsewhere.
“If someone is constantly having their belongings taken from them, especially if that includes things like their phone, and they’re dealing with that constant stress and uncertainty, it can be really hard to find someone to follow up with them a few months later,” Black said.
While unhoused people can’t get vaccinated for COVID-19 through BFC, the City of Berkeley provides COVID-19 vaccination clinics for unhoused people.
Dr. Lisa B. Hernandez, the City of Berkeley Health Officer, said that the City of Berkeley is following up with unhoused people to help them receive a second dose of the COVID-19 vaccine by providing follow up clinics.
“We provide follow up clinics at the time interval corresponding to the [date] of vaccine administered. We are also providing information and incentives to unhoused individuals to get vaccinated,” Hernandez wrote in an email to the Jacket.
Beyond COVID-19 vaccination, the City of Berkeley also provides other vaccines at shelters, downtown Berkeley, and other locations accessible to the unhoused community, according to Hernandez.
Henandez said the Preparedness and Immunization programs also annually host pop up flu vaccine clinics at Martin Luther King Jr. Civic Center Park across the street from BHS and Good Shepherd Church.