We know that ensuring a seat at the table for people with lived experience is critical to understanding their perspectives and identifying opportunities to transform care in meaningful ways. But truly listening and responding is just as important.

In November 2022, the Center for Health Care Strategies (CHCS) convened close to 60 people, representing over 25 homeless service and health care organizations across California at the first in-person convening for Partnerships for Action: California Health Care & Homelessness Learning Collaborative. This initiative, made possible by the California Health Care Foundation, aims to strengthen cross-sector collaboration between health care and homeless service providers to improve service delivery and ultimately, health and housing outcomes for people experiencing homelessness. The learning collaborative aligns with broader reform efforts in California, like CalAIM, that promote improved care for people who are unhoused or at risk of experiencing homelessness.

At the Partnerships for Action convening, participants engaged in conversations spanning many topics, such as operating a street medicine program, leading a homeless services organization, and implementing facets of CalAIM like Enhanced Care Management and Community Supports. After the first day, one of our project advisors, Lawrence Lincoln, who was previously unhoused in the Bay Area, voiced that he felt that the discussion had gotten overly technical, particularly about CalAIM, and that the group was losing sight of who the initiative intends to serve. At the start of day two, Lawrence shared the below poem with meeting participants as a reminder to not get lost in the technical aspects of policy and program implementation.

Lawrence’s words are — and were to those in the room — a powerful signal to honor the voices of the people we are working with, and on behalf of — especially people who have been marginalized by our systems of care and historically shut out of conversations that shape policies and programs. We are sharing Lawrence’s poem with his permission with the hopes of inspiring others to slow down and listen.

Author Lawrence Lincoln was a former street health patient of Alameda County Health Care for the Homeless, a participant in the Partnerships for Action Learning Collaborative. Lawrence notes that their street medicine program, and the care that he received at the affiliated Trust Health Center, was, and continues to be, “one of the main pillars of my recovery and ascension from the streets into a life of purpose and meaning.”

Because We Learn to Trust

By Lawrence Lincoln

7 years ago
I lived under a blue tarp
Under an overpass
With 100 other traumatized people
Many of us frequent flyers at the ER
Health care was where we found it.

We were only 8 blocks away from the Trust Clinic
Where Alameda County Health Care for the Homeless,
Dr. Bird, and Jared launch street medicine from
But it was a world away
A world we had fallen off of
A world we had come to not trust
Because they came to our camp
Because they trusted us
Because I learned to trust them
I am alive
I live in a house
I am here
With all of you.

Yesterday, I sat in a room
With you fine people
I felt how strong you are
All of you devoting your lives to the work that saved mine.
All of you struggling against
Insurmountable odds to bridge the gap
Between the world and those of us who have
Fallen off it.

I felt that, as the voice of the client
The people, once apart from you afraid, alone, on the other side
Of a divide we are all here now
Trying to bridge
I should say something to you
To encourage you
To thank you
To tell you that
Beyond CalAIM
Beyond In lieu of services
Beyond managed care
Beyond county
Provider and
We are here
We are, all of us, a resource
Trust us
Love us
Know that what we all are is love.

Us working together
More than anything else
Will make homelessness
Not the problem
But the place we recognize each other.
Us trusting in our shared humanity will make
What we do work.

On the street it is easy to lose sight of the world
How we are connected to it
What is really going on
In the trenches of providing care
It is easy to lose sight of what caring is all about.
What is really going on
What it is really all about Is being together
Alive in the same world
Making tomorrow a safer place
Than yesterday
Than 7 years ago.

Tomorrow I will interview a doctor to find out how CalAIM is
Helping her care for a marginalized community
Tomorrow you will all be back
Working hard to make Partnerships for Action work in your communities
I am here to tell you that things that once seemed impossible
Are possible
That out of 100 traumatized people
My community
My family on the street 7 years ago
18 of us have found sustainable housing
And live lives that don’t require self-medicating
The same number of us are no longer alive
All of us, still here, have learned to trust and work with street medicine and the people who provide it.
We know that we have allies in a world we once felt abandoned by.
We get self-care and harm reduction.
We know another place to go, other than the ER for medical attention and help finding our way.
We know that our health care providers know us
And we know them.
Hard as it is to be one of these numbers,
It is way better than it would have been
If all of us
The State of California
The federal government
And all the communities you serve
Haven’t tried to trust and work together
To make health care happen
Keep the faith
Keep up the good work!
And for real
Thank you!

E pluribus unum
(Out of many, one)
Experientia Docet
(Experience teaches)
Fiat Lux!
(Let there be light)

Lawrence Lincoln

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