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The ground-level program in Boulder County is a mobile transition pipeline serving unhoused individuals and those exiting incarceration. This program grows directly out of relationships built inside the system, serving as a direct continuation of the Reimagine program founded by Dante Lamar Owens at Sterling Correctional Facility. The people running this outreach have slept outside, served the time, and navigated every system they now help others navigate. That lived experience is verified field data and the core mechanism by which trust is built fast enough to stabilize someone in acute crisis.
We do not run an office or ask people to sit in waiting rooms. Everything operates directly out of our outreach van in the field. When someone on the street is ready for help, we pull up Colorado PEAK on a phone or tablet to verify active Medicaid on the spot, call facility intake desks directly to secure a bed, and drive them to the facility doors ourselves. This eliminates hours of waiting and locks in a direct relationship from the first contact.Β
When a Street Elder meets someone on the street who is ready for help, we verify active Medicaid on the spot through Colorado PEAK on a phone or tablet. We call regional detox and residential intake desks directly, confirm an open bed, and drive the person to the facility doors ourselves.Β
Because our team handles the intake drop-off, facilities have our contact information for release day. The van meets individuals right at the curb the moment they walk out of detox, residential treatment, county jail, or an acute psych hold. Instead of handing someone a bus pass to return to the creek, we transport them straight into an Oxford House or independent sober living bed coordinated in advance.
Once an individual is housed, our team provides steady peer transportation to daily AA and NA meetings so they build an active recovery community. We run weekly food bank trips, provide rides to clinical outpatient check-ins, and walk individuals directly into Focus Reentry and county offices so food stamps, disability paperwork, and housing waitlists stay active.Β
Street Elder hours are structured to subcontract under licensed clinical provider umbrellas. Encounters are logged in fifteen-minute units under Medicaid codes H0038 for peer support and H0023 for behavioral health outreach. This protects the clinic's mandatory seven-day post-hospitalization retention metrics while generating the ongoing reimbursement that funds daily van operations, fuel, and living wages for peer staff.Β
Stabilized participants are guided into an enduring recovery identity through service to others. Sponsored through state-approved sixty-hour peer specialist training, participants move from receiving services to delivering them, becoming the Street Elders who run field outreach and curbside catches for the next person ready to come off the street.Β