Street medicine team delivers lifesaving care through county’s only homeless respite program
Christian Murdock, The Gazette
A dynamic germ-fighting duo is helping people who live on the streets win the battle of recovering from wounds, illnesses and hospitalizations with the efficacy and empathy of having been there themselves.
Because they have.
“I’ve got one word for them — phenomenal,” growled John Burchfield, a former Marine who said he went “a little crazy” when his wife died three years ago and spiraled into homelessness.
“They’re kick-a–,” he said with admiration, after Greg Morris and Codi Natelli got done with him last Wednesday.
Physician assistant Greg Morris, center, and emergency medical technician Codi Natelli with Ascending to Health replace the dressing on a patient’s wound after cleaning it Wednesday in Dorchester Park. Morris said they try to clean a patient’s wound every couple days to prevent infection and promote healing.
Morris, a physician assistant, and Natelli, an emergency medical technician, tended to an angry-looking red strip on Burchfield’s forearm where doctors had done surgery a few weeks ago.
It’s easy for bodies not to mend like they should when they spend their days and nights outside and are subjected to malnutrition, substance use and temperature extremes.
“Being on the street ages you in dog years,” Natelli said, apologizing for the analogy.
But it’s the best one she knows to describe how fast the harsh living conditions take a toll on human bodies. Dogs age at an accelerated rate compared to humans, according to the American Kennel Club. Depending on its size, a 10-year-old dog is equivalent to a human’s age of 56 to 79 years old.
Emergency medical technician Codi Natelli with Ascending to Health receives a kiss from Elvira while visiting a homeless group Wednesday in Dorchester Park. Natelli grew up homeless on the streets of Atlanta and was again homeless after her ex-husband left her and her son.
“We’re seeing advanced-age diseases in their 30s, 40s and 50s that we would usually see in people in their 70s and 80s,” she said. “Most (street people) don’t live that long.”
It’s not uncommon for chronically homeless people — those who have a mental or physical disability and have been without stable housing for one year or more — to develop serious conditions like chronic obstructive pulmonary disease or congestive heart failure in their mid-30s, Natelli said.
Morris and Natelli work hard to extend the expected shortened life span.
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Ascending to Health, the organization Morris founded in 2012 in Colorado Springs as a pilot and continues to head as CEO, runs the only primary respite care program for homeless people in El Paso County and is one of just two in the state. The other is in Denver.
Before the pandemic, Morris had a stable respite setup, but funding problems led him to close his center for four months and restart as a mobile service.
After the pandemic, his organization rented a defunct motel on South Nevada Avenue for convalescing homeless people to heal but relocated in January to a new office at 875 W. Moreno St.
The location offers a walk-in primary-care clinic for anyone in need of medical attention. In 2024, 326 patients recorded 1,012 visits. Revenue from the clinic, which accepts all types of health insurance, helps fund the organization’s medical street program and respite services.
Under the current system, Morris’ nonprofit accommodates up to 22 respite patients in scattered motel rooms in town. Recuperating clients receive free daily nursing care, medication administration, delivered meals, groceries and social support. Patients are referred by facilities in the CommonSpirit Health network and Compass Health Systems.
CommonSpirit Health, a nationwide Catholic network of hospitals and medical clinics, has a mission of caring for vulnerable populations, said Becky Brockman, communications manager for the system’s mountain region.
The partnership with Ascending to Health continues care after hospitalization, she said via email.
“We understand this patient population may have a unique set of needs in challenging environments, and our care team works closely with Ascending to Health to ensure each patient receives the respite care they need to heal.”
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Raised on the streets
But medical needs are vast on the streets, where Morris has been treating homeless people for more than 30 years, after spending a week in 1994 living among the community to gain perspective on the challenging lifestyle.
Natelli has been homeless for two extended periods in her 36 years of life. She was raised on the streets of Atlanta as a child of junkies and as an adult became homeless for another three years, after her husband left her and their son.
“I know what it’s like to struggle to survive,” she said. “It changes you on a fundamental level. The standard is “’Eww, they’re homeless.’ I want to know what got you here, and how I can help you.”
From their backgrounds, Morris and Natelli build trust with patients, some who won’t provide their names or much information but all who seem to appreciate the personal assistance.
“We see bipolar, schizophrenia, paranoia,” Natelli said. “Even some of the more aggressive individuals aren’t aggressive with us. Because you can threaten me all you want, but I’m still going to bandage your foot.”
Toting equipment in bags and backpacks, Morris and Natelli make the rounds three times a week in local parks, under bridges and in camps where homeless people live. Volunteer health workers sometimes join them.
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They do impromptu treatment for an average of 25 people and as many as 40 in an afternoon, uncovering cuts and gouges, damage from flying fists, infections, bug bites, upper respiratory illnesses, episodes of seizures, sepsis, fractures, frostbite, cases such as pneumonia and other problems.
They also monitor and maintain chronic conditions such as high blood pressure and diabetes, and help those who need it get a higher level of care. They fill medications and deliver them, and they hand out essentials: water, snacks and socks.
“Everything we do in the clinic, we do out here,” Natelli said, “but if we can get them in the clinic, we also can help them apply for resources like Medicaid and Medicare, Social Security and housing.”
Reluctance to seek care
Last week, a tarp that had been covering someone’s possession-laden shopping cart became a makeshift exam curtain in a local park for Morris and Natelli to assess a man’s groin pain. And a concrete barrier police erected to block the parking lot served as a table for dressing a leg wound.
“Bringing street medicine into the camps has had a huge impact on getting primary care to people who won’t access services,” Morris said. “And it’s no doubt kept a lot of people out of emergency rooms.”
The work feeds their souls, which in turn nourishes the spirits of people they assist.
One man had a wound the diameter of a cantaloupe, but the pair’s consistent handiwork shrunk it to under 2 inches.
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Wound care is important because if not taken care of properly, tissue damage can worsen and lead to amputation, just like frostbite and diabetes, Morris said.
Of the 489 wound care visits the pair treated last year, 60% were limb-saving interventions, Natelli said.
Referrals for frostbite cases increased from less than a handful each winter pre-pandemic to 30 or more during COVID and has scaled back to 15 to 20 each cold season, Morris said.
But homeless people are often reluctant to seek medical care and often do so only in emergencies, said Jesse Ballard. He’s been homeless off and on since 2013 and doesn’t go anywhere without his canine companion, Elvira.
Ballard has been dubbed a community “elder,” watching out for people in the group he hangs with.
Many homeless residents don’t trust today’s health care system, he said. “They just want to bill people.”
“We’ve had individuals hit by cars who didn’t want to go to the hospital,” Natelli noted.
Ballard has had Morris and Natelli render first aid several times, for scratches, cuts, skin rashes, drug withdrawal and insomnia.
“They’ve been amazing,” he said. “It’s easy to get injured being on the street. Anything can happen.”
A skinned knee can quickly become an oozing abscess, Natelli agreed.
Ballard sought out a hospital after an altercation that led to a broken jaw and an eye injury and said he felt like patients came second to the cost of treatment.
‘Much-needed service’
All patients released from hospitals in the UCHealth system receive a “safe discharge plan,” which for homeless people can include information about shelters and provided transportation from bus passes to taxi vouchers and wheelchair-accessible rides, said Cary Vogrin, spokeswoman for UC Health’s southern Colorado facilities, which include Memorial hospitals in Colorado Springs.
“The health and safety of all our patients as they recover from a hospital stay is always a top priority for UCHealth,” she said by email.
With scarce beds for homeless people to recuperate from surgeries or other health ordeals, the community’s need for a dedicated respite center is widely agreed upon.
“Recuperating after a hospitalization is oftentimes difficult, and medical respite care — short-term residential care for those without permanent, stable housing — is a much-needed service in the Pikes Peak region,” Vogrin said.
Such facilities are often the result of community collaborations, she said.
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“With reports of shelter beds closing, budget shortfalls and expected cuts to health care funding, we anticipate there will be an even greater need for such services in the near future,” Vogrin said.
Traditional long-term care facilities usually won’t take people who have a history of drug use, a sexual offense on their record or complex mental conditions, Natelli said. Those conditions exclude many homeless people.
A lack of overnight shelter for disabled or sick people means some are left with no choice but to resume residency on the streets during or following sickness.
Organizations like Springs Rescue Mission, the city’s main shelter for individual homeless adults, and Catholic Charities’ Marian House soup kitchen provide medical and mental health workers for quick care for clients but don’t have full-time medical personnel at their centers.
Clients who stay at Springs Rescue Mission must be able to attend to “activities of daily living,” which include bathing, toileting, dressing, eating and other bodily functions.
“We have many individuals who use wheelchairs, walkers, canes and oxygen. Sometimes when an aging or disabled individual begins to struggle with some of those activities of daily living, a fellow guest will step up to help,” said Cameron Moix, director of communications for Springs Rescue Mission.
“But because of the nature of our organization and our lack of medical staff, we are not able to support those needs ourselves.”
Some people who use wheelchairs or walkers can’t navigate the shelter’s bunkbeds and sleep on mats on the floor, which they don’t like and therefore are reluctant to use the shelter, Ballard said. Outlets for oxygen machines also can be in short supply.
Sam, who needs a wheelchair to get around and declined to give his full name, for the past three years has lived at the rescue mission’s Greenway Flats, a graduated level of independent housing with support services.
“I can manage there all right with the wheelchair,” he said.
Greenway Flats features an elevator and is ADA-compliant and accommodating, Moix said. Also, The Studios, a new transitional housing project the rescue mission developed, has ground-level access for 14 individuals to address mobility concerns, he said.
Natelli said Ascending to Health is trying to strike a deal to have some of its respite patients use space on the rescue mission’s campus, but it’s not known yet whether that’s a possibility.
“As a society, everyone’s dropped the ball,” she said.
Contact the writer: 719-476-1656.
