From the Desk of the County Manager, February 13, 2026

Homelessness is a growing crisis with far-reaching consequences for individuals and communities alike. The health disparities are particularly severe—people experiencing homelessness face mortality rates three to four times higher than the general population and experience chronic health conditions at disproportionate rates[1]. Addressing this crisis requires comprehensive, compassionate solutions that prioritize health, dignity, and pathways to stability.

Stability starts with access to care. Research has shown that, when people experiencing homelessness can connect to health services and supportive resources, they gain improvements in health, expanded opportunities, and it creates the stability people need to succeed. Durham County is working to make that possible by expanding daytime services and strengthening pathways to primary care and behavioral health for our unhoused neighbors.

Through the American Rescue Plan Act (ARPA), the County awarded Housing for New Hope (HNH), a $2 million grant to lead a comprehensive street medicine initiative. In partnership with Central Pines Regional Council (CPRC), HNH’s Unsheltered Neighbor Interventions, Therapies, and Engagement (UNITE) project aims to deliver barrier-free physical and mental health services to individuals experiencing homelessness, connecting these individuals with providers, resources, public benefits, and other critical services to improve their overall health and well-being.  

With the support of the ARPA grant, the UNITE team has been working to strengthen outreach and improve access to essential services for unhoused neighbors across Durham County. Recent efforts have been focused on improved care coordination, expanded primary care access, and building strategic partnerships to enhance future service delivery. The team has prioritized comprehensive assessments and benefits enrollment while laying the groundwork for behavioral health supports and expanded medical capacity. Collectively, these steps are creating a stronger network of integrated care systems and ensuring individuals are receiving the help they need to move towards stability.

Impact at a Glance:

• Every UNITE participant receives a Housing Barrier Assessment and a health and/or wellness evaluation (100% completion rate for current program participants).
• SSI/SSDI Outreach, Access, and Recovery (SOAR) service clinics are held 2-3 times monthly.
• The UNITE team is providing pop-up health clinics during Open Table’s monthly Free Store, providing on-site medical services in partnership with Community Health Labs (CHL), with additional locations for pop-up clinics being added currently.
• The UNITE team, with other partners including the City of Durham, has facilitated additional shelter and medical services for unhoused residents during recent extreme cold weather (white flag conditions), with a particular emphasis on serving the most medically vulnerable individuals during this period.
• 70% of participants have already increased their use of primary care services.

These efforts represent more than a series of initiatives, they reflect Durham County’s commitment to health, stability, and opportunity for all residents. By targeting health issues that so often prevent the stability needed for obtaining housing security, we are not only addressing immediate needs but building a foundation for long-term stability and success. Together, we are creating a community where every person has the chance to thrive, and every resident has access to support.