Enhanced Care Management Overview

Doctors Without Walls (DWW) has a long history of providing urgent care and making referrals to other medical providers. Today, our Enhanced Care Management (ECM) program goes beyond that by offering comprehensive support, both medical and non-medical, to meet the needs of each person we serve. We don’t just see our clients; we work closely with them, helping them get to appointments, advocating on their behalf, and being involved in every detail of their lives. This hands-on approach is crucial for the homeless individuals we assist. Whether it’s a quick check-in or arranging medically tailored meals for someone with cirrhosis and/or other chronic health issues, we’re there every step of the way. Through our free street medicine services, DWW aims to deeply understand each client’s needs.

While clients initially seek medical care from us, we also help them with scheduling and traveling to appointments and advocate for them during those visits. Our ECM program extends support beyond medical needs, connecting clients with vital resources like food and shelter. The success of our ECM program relies on recommendations from our volunteer Street Medicine teams. When a clinician identifies a client who could benefit from enhanced care, they introduce them to a Case Manager. The Case Manager then explains how the ECM program works and how it will provide the comprehensive care the client needs. Together, they complete a Medical Assessment Form, which then the Case Manager and ECM Volunteers create a personalized goal-oriented Care Plan.

Our ECM Program is designed to adapt to the needs of our clients as we help them transition off the streets. We aim to support each individual until they reach their Care Plan goals and remain available for any crises that might arise.