Press release from the Drug Task Force:

On Friday December 9, 2022, Agents with the Humboldt County Drug Task Force obtained information that indicated stolen property from a burglary, being investigated by Eureka Police Department, was located at a residence located near the intersection of Wabash St. and B St. in Eureka.

A Humboldt County Superior Court search warrant was obtained for the residence, and with the assistance of the Eureka Police Department and the Humboldt County Sheriff’s Office, the search warrant was executed. Numerous subjects were located on the premises and detained. During a search of the property 16 stolen firearms were located, along with stolen ammunition, and miscellaneous stolen property.

Woods.

As a result of the search, Solomon Woods was taken into custody on the following charges:

• PC 29800(a)(1)- Possession of a firearm by a prohibited person
• PC 496(a)- Possession of stolen property
• PC 30305(a)- Possession of ammunition by a prohibited person
• PC 30605- Possession of an assault weapon
• PC 1203.2- Violation of probation

Anyone with information related to this investigation or other narcotics related crimes are encouraged to call the Humboldt County Drug Task Force at 707-267-9976.

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As the end of the year draws near, the Eureka City Council is gearing up for some pretty big adjustments — namely saying goodbye to Councilmember Natalie Arroyo after an eight-year stint on the council and welcoming two new faces aboard, G Mario Fernandez and Renee Contreras de Loach. Mayor Susan Seaman will also bid the council adieu and hand the reins over to Mayor-Elect Kim Bergel.

The council mentioned this bittersweet transition several times during this week’s meeting but agreed to save the heartfelt goodbyes and the sappy stuff for the council’s last regular meeting of the year on Dec. 20. 

I’ll bet you’re wondering what else happened during Tuesday’s meeting. Let’s take a gander!

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The council signed off on a fleet of eight new police patrol vehicles during this week’s regular meeting. The vehicles will augment the Eureka Police Department’s existing fleet and replace patrol vehicles that are over 13 years old with upwards of 100,000 miles accrued.

The item, which was pulled from the agenda’s consent calendar for further discussion, asked the council to allocate an additional $515,000 to the Eureka Police Department for the purchase of eight fully outfitted Chevrolet Tahoe vehicles from CAP Fleet through Northwood Auto Plaza in Eureka for a total cost of $551,717.08. 

“We’re struggling a bit because we’re sending officers out in the field every day in cars that were put into the field in 2008, 2009, 2010 and they’re worn out and they’re breaking down all the time,” said Eureka Police Chief Todd Jarvis. “We’re at a critical point where we need to get the equipment to be able to serve the public.”

Jarvis | Screenshot

Public Works Director Brian Gerving acknowledged that the Chevy Tahoe – one of the biggest SUVs on the market – doesn’t exactly fall in line with the City’s commitment to reducing greenhouse gas emissions, but said hybrid and electric vehicles are hard to come by.

“We’ve been asked to look at other options but there are a few points there,” Gerving said during Tuesday’s council meeting. “Availability. Just like any other vehicle, they’re difficult to come by. Suitability [is another issue]. They just don’t have the space and the performance necessary for these response vehicles. Staff has had a practice for the past  – as long as we have records – of obtaining pursuit-rated vehicles or special service-rated vehicles for our emergency response, whether that’s fire or police.”

Even still, he said staff would continue to explore options to incorporate more electric vehicles into the city’s fleet.

Jarvis further explained that “pursuit-rated” implies a different level of construction that makes the patrol vehicle “a little more hearty” and a little safer.

“It makes it safer for the officers that are operating it and for the citizens that are around it because it does have better brakes, better suspension [and] it allows us to run all the equipment we have because it has upgraded electrical systems and things like that,” Jarvis said. “We’re not looking at these so that we can chase people all over town.”

Following staff’s brief presentation, Councilmember Leslie Castellano acknowledged the immediate need for new patrol vehicles but suggested staff act more proactively to procure hybrid and electric vehicles in the future. 

“To really implement something like that we would need to kind of think ahead probably a few years, in terms of the charging infrastructure and even getting on waitlist for vehicles,” she said. “Are those the kinds of things that council should or could be giving more direction on in terms of that kind of forward-thinking?”

Staff is already looking into it, Gerving said, but they’re still a few years out. “We just don’t see the availability of suitable [electric vehicles] for large portions of our fleet just yet.”

Councilmember Scott Bauer mentioned that a friend of his has been on a waitlist for a fully electric truck for over a year and half because of global supply chain issues.

“We’re stuck in this world post-COVID where we don’t have the things we need to transition to a clean fuel economy,” he said. “I think the city has done a lot with transitioning our municipal fleet to electric … and in this situation, when it comes to first responders, we’re kind of stuck right now. … I only know one municipality that has electric pursuit vehicles and that’s Fremont.”

Bauer made a motion to approve the funding allocation. Councilmember Natalie Arroyo offered a second before acknowledging that “it will disappoint some folks.”

“As far as planning ahead for the greening of our fleet, I think that’s incredibly important,” she said. “The Humboldt Transit Authority, for example, we had high hopes for having all electric, chargeable buses and that just did not work in this community for the range we needed them to have. Now we’re going the hydrogen route. So that’s another thing to consider exploring as we install the infrastructure to have hydrogen fueling.”

The council passed the motion in a 4-0 vote with Councilmember Kati Moulton absent.

###

Keeping with the law enforcement theme, Mayor Susan Seaman invited Chief Jarvis to discuss the City’s anonymous gun buyback program. The buyback program is intended to promote “responsible, safe, and secure gun ownership” by removing “unwanted guns that could potentially get into the hands of criminals,” according to EPD.

“This is in response to some interest that you showed after the Uvalde school shootings. We’ve had several since then throughout this country and we’re trying to put this [program] together so that we can get this done while you’re still the mayor,” Jarvis said to Seaman. “We’ll have officers there to meet you and secure the firearm. Please, if you do come down, just leave the firearm locked in your vehicle, make contact with the officers and they’ll come down to the vehicle with you and they’ll safely remove the firearm.”

Jarvis emphasized that the process is completely anonymous. “We’re not asking for an ID. We will run each of the firearms once this is over and if there’s anything that’s been reported stolen that’s been turned in to us, we will try to track down the owner and return it if we can.” The firearms will be destroyed after they are accounted for.

Individuals who turn in firearms will receive a Visa gift card – $50 for rifles and shotguns and $100 for handguns and assault weapons – to further incentivize participation in the program. Even if the gun is broken or non-functioning, EPD will still accept it.

“This has been very successful in other communities,” Jarvis added. “[The intent] really is not to take guns away from people, but if people have unwanted firearms that they don’t know what to do with, this is an avenue for them to relinquish them and know that they’re not going somewhere where they will fall into the wrong hands.”

The gun buyback program will take place on Sunday, December 18 from 10 a.m. to 3 p.m. at the Wharfinger Building, 1 Marina Way, in Eureka.

###

The council returned to several other items relating to the City’s water and wastewater infrastructure that were discussed during its last meeting on Nov. 17. 

The council approved a revision to the City’s Private Sewer Lateral Ordinance. The ordinance, adopted by the city council in 2019, shifted the responsibility of maintenance and repairs of the lower lateral – which is the sewer pipe connecting a property’s plumbing system to the public sewer main under the street – solely to the property owner.

Since the city adopted the ordinance, staff have reported ongoing issues with laterals not being replaced by property owners when they should be, largely due to the cost. To alleviate this issue, staff proposed the implementation of a set fee and a point-of-sale trigger to “significantly accelerate the rate at which aging sewer laterals are replaced.” 

The council reviewed the proposed revisions during its Nov. 15 meeting and agreed to move forward. After a brief discussion at this week’s meeting, the council voted 4-0, with Moulton absent, to implement the proposed changes.

The council also unanimously passed a resolution approving the issuance of both water and wastewater bonds as well as an amendment to the City’s municipal code in accordance with the 2022 California Building Standards Code.

###

And last but certainly not least, the council agreed to give Eureka’s 20/30 Park a new name – “Da’ Yas,” which means “where the cypresses are” in Soulatluk – to go with its incoming improvements, which will include all-new playground equipment, an upgrade to the park’s baseball field and some exciting new amenities.

Humans can be resistant to change and, understandably, some folks weren’t happy to hear that 20/30 Park would be renamed. The park was named after and made possible by the 20/30 Club, an association of young men in their 20s and 30s who did good deeds around town, but the club hasn’t been active for quite some time and the City felt as though it was time to make a change.

The City has been working with the Wiyot Tribe for the last year to come up with a short list of Soulatluk names for the park’s rebranding. After polling the community, they landed on “Da’ Yas” to honor the cypress trees that populate the park.

The council unanimously approved the adoption of the park’s new name in a 4-0 vote, with Moulton absent. 

Early on in the meeting, the council also approved a request for up to  $592,119 in funding for new playground equipment for the park. The item appeared on the council’s consent calendar and was passed without further discussion.

###

You can find a recording of Tuesday’s meeting at this link.

After a courageous battle with cancer, Leslie Ann Sampson passed away on November 28, 2022, at her Loleta home, surrounded by family and friends.

She was born on July 6, 1949, in Sacramento and attended area schools, graduating from Roseville High School and attending Sierra College. Leslie worked for the telephone company in Roseville before moving to the North Coast area in the mid-1980s. She opened an antique store and a clothing store in Ferndale, and later moved to a vocational instruction position with the Humboldt County Office of Education. Her passion for sales and customer service led her to work for Abraxas in Ferndale, as well as the Eureka Reporter and the Shamus T Bones restaurant.

In May 2005, Leslie married John Sampson, beginning a 17-year relationship that allowed her to blossom and spread her wings. Family and friends were vital to Leslie, and she and John enjoyed an active social life with both extended family and a widening circle of friends. They traveled both within the United States and abroad, always in the company of close friends, seeking new horizons and cherishing new experiences and locales. Leslie was always eager to meet new friends, and moved from a place of gentleness and kindness to everyone she encountered, offering encouragement and support to countless individuals in the community. A collector of this and that, she was always enlarging her extensive sock collection with a new flamboyant treasure.

Leslie is survived by her mother, Marilyn; her loving husband, John Sampson; daughter, Megan; son, Collin; and grandchildren Wyatt, Kate, Jon-Jon, and Ray. Her four-legged guardian, Remi, remained by her side until her passing. She was preceded in death by her father, Stanley Cain.

The family would like to thank Hospice for the dedication and support provided, with a special thanks to Terry and Sara.

A party honoring Leslie will be held at the family’s home on May 6, 2023, at 2 p.m.

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The obituary above was submitted on behalf of Leslie Sampson’s loved ones. The Lost Coast Outpost runs obituaries of Humboldt County residents at no charge. See guidelines here. Email news@lostcoastoutpost.com.

Brrr!

Snow is falling across the upper elevations of Humboldt County, creating a winter wonderland atop Berry Summit and dropping three accumulated inches (and counting!) at Titlow Hill. Time to check your generators and bust out the thick blankets because more inclement weather is on the way.

Strong south winds are in the Friday forecast, with gusts of 50 to 70 miles per hour. 

“Expect localized power disruptions, difficult driving conditions, and a high risk for falling limbs and trees,” warns the local office of the National Weather Service. 

State Route 299 remains open as of this writing, with no restrictions, but anyone traveling that route should obviously use caution. Hwy. 36 is open, too, but chains are required (except on four-wheel-drives with snow tires) east of Mad River.

If you must drive across those routes, check the road conditions first. (Here’s the handy CalTrans website for that.)

The Humboldt County Sheriff’s Office issued a press release this afternoon urging locals to “recreate responsibly” and including its annual reminder that the Kneeland-Greenwwood Heights area is not a public playground.  

# # #

Curl up with a mug of hot chocolate and read the rest of the the Sheriff’s Office’s advice below:

With more winter weather ahead this weekend, Humboldt County residents are encouraged to recreate responsibly when visiting areas of our county with snow. Having a safe snow day starts with basic preparedness:

1. Stay Warm – Be sure to bring water-resistant snow clothing, gloves, hats and scarves to protect against hypothermia. Bring a change of clothes for the drive home and pack extra blankets in case your vehicle becomes disabled.
2. Check the Road Conditions- Most public access properties require vehicles equipped to handle the snow. Use a 4-wheel drive vehicle and always carry chains.
3. Utilize Public Recreation Locations- Residents are asked to use public recreation locations only, such as the Horse Mountain Botanical Area in the Six Rivers National Forest. Though there may be snow, the Kneeland-Greenwood Heights area is private property and trespassers can be prosecuted.
4. Bring Provisions- Whether going sledding or just traveling through a snowy area, bring food and water in case your vehicle becomes disabled. Always take your trash with you when you leave.

If your vehicle becomes disabled in the snow and you are not in need of emergency assistance, contact a private towing service. If in need of an emergency rescue, call 9-1-1. Then,

• Stay in the vehicle.
  1. If you leave your vehicle, you will become disoriented quickly in wind-driven snow and cold.
  2. Run the motor about 10 minutes each hour for heat.
  3. While running the motor, open the window a little for fresh air to avoid carbon monoxide poisoning.
  4. Clear snow from the exhaust pipe to avoid gas poisoning.
• Be visible to rescuers.
  1. Turn on the vehicle’s parking lights at night.
  2. Tie a bright colored cloth, preferably red, to your antenna or door.
  3. After snow stops falling, raise the hood to indicate you need help.

Humboldt County property owners in snow-prone areas are encouraged to install visible No Trespassing signs to alert snow-goers of private property. Contact the Humboldt County Sheriff’s Special Services Division for assistance at (707) 268-2528.

UPDATE 2:50 p.m.: One of the winning bidders, RWE Offshore Wind Holdings, LLC, sent the following response to the Outpost’s request for additional comment:

 “RWE is committed to thoughtfully engaging Tribes and tribal fisheries at all stages of project development,” Dominik Schwegmann, head of offshore development U.S. West for RWE, wrote in an email to the Outpost. “Prior to the auction, RWE has met with a number of Tribes to learn about their heritage. We look forward to meeting with all affected Tribes to continue discussing their interests surrounding our new lease area off the Northern Coast.”

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The Yurok Tribe is having second thoughts about offshore wind.

During a virtual press conference this Thursday morning, Yurok Tribal Vice-Chair Frankie Myers expressed disappointment in the fact that the two provisional winners of the offshore wind lease auction for the Humboldt Wind Energy Area – California North Floating, LLC and RWE Offshore Wind Holdings, LLC – had not “engaged with the Tribe in a meaningful way” prior to or immediately following the auction.

Myers

“It’s beyond frustrating,” Myers said. “This has been a long process. We’ve gone through this with other organizations … we’ve attended conferences for well over a year making sure that all of those who were interested – or potentially interested – in bidding on these leases within our ancestral territory knew and understood that … we were going to be actively involved and wanted to participate in conversations early on. To have none of the folks who won the bid even reach out to say ‘Hey, we’re thinking of coming your way!’ we take as absolutely disrespectful.”

On the contrary, “several other bidders” had contacted the Yurok Tribe ahead of this week’s auction to discuss plans for the floating offshore wind project and assure the Tribe that it “would be [an] active participant” throughout the decision-making process, Myers said. “Turns out, none of the [entities] who actually won the bid came forward to talk to tribes.”

Forty-three separate entities, ranging from regional groups to international energy giants like Shell, qualified as potential bidders for the Bureau of Ocean Energy Management’s (BOEM) offshore wind lease auction. California North Floating, LLC, a subsidiary of Copenhagen Infrastructure Partners, and RWE Offshore Wind Holdings, LLC, a German multinational energy company, placed the winning bids for two leases within the Humboldt Wind Energy Area, which spans more than 132,000 acres approximately 20 miles west of Eureka, for a total of $331.5 million.

Three leases were also awarded to Equinor Wind US, LLC, Central California Offshore Wind, LLC  and Invenergy California Offshore, LLC for the Morro Bay Wind Energy Area for a total of $425 million.

In the years leading up to the recent auction, Myers said BOEM had made a concerted effort in including the Yurok Tribe by ensuring that “we were engaged at every step of the process.”

“If you look at the Final Sale Notice, you’ll see language throughout that speaks to tribal sovereignty, that speaks to tribal governance and to the importance of bringing tribal participation along, and that’s what we asked for,” he said. “We understand the limitations that BOEM has. We understand that they do play within a box and we wanted to make sure that within the box they did the best that they could. … Could they have pushed the envelope further? Absolutely. But did they come to the plate? Did they make meaningful conversation? Yes. Yes, they did.”

However, Myers emphasized that the Tribe’s conversations with BOEM were only a part of the consultation process. “And, from the Yurok’s view, consultation doesn’t get us to where we need to be at the ended of the day.”

“The Yurok people are viewing offshore wind as a conversation,” he continued. “We’re not in a position to support it and we’re not in a position to oppose it. We don’t know what it’s going to be yet, but what we do know is what we’ve learned over the last 150 years in dealing with industry. What we do as indigenous people, what we do as Yurok people is look to the past to help guide our future. And I can tell you, after having seen industry come into our area with this exact same playbook, it has never ended well for our Yurok people.”

Moving forward, Myers said the Yurok Tribe will continue to work with its consultants as well as other North Coast tribes and stakeholders to enhance engagement with the two lessees, as well as the state and federal government. 

The Outpost requested additional comment from the two lessees, California North Floating, LLC and RWE Offshore Wind Holdings, LLC, but did not receive a response before the publication of this story. We will update this post when we hear back.

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PREVIOUSLY:

• Biden Administration Proposes Offshore Wind Lease Sale, Including Two Spots Off the Humboldt County Coast
• IT’S ON: Humboldt Offshore Wind Leases to Go Up For Auction on Dec. 6
• Harbor District Announces Massive Offshore Wind Partnership; Project Would Lead to an 86-Acre Redevelopment of Old Pulp Mill Site
• Offshore Wind is Coming to the North Coast. What’s in it For Humboldt?
• North Coast Fishermen Fear for the Future of Commercial Fisheries as Offshore Wind Efforts Advance
• North Coast Tribes Advocate for ‘Meaningful, Impactful Partnership’ with Potential Developers Ahead of Tomorrow’s Highly Anticipated Offshore Wind Lease Auction
• SOLD! BOEM Names California North Floating and RWE Offshore Wind Holdings as Provisional Winners of Two Offshore Wind Leases Off the Humboldt Coast

Another lengthy trial continuance has been granted for Arcata rancher Ray Christie, who is facing worsening medical problems.

This morning Judge Gregory Elvine-Kreis granted defense attorney Rick Richmond’s motion to continue the trial, which had been scheduled to begin Jan. 17.

The trial on felony animal cruelty charges was last continued because of Christie’s cancer diagnosis. Now the 57-year-old rancher also has a heart condition and vascular issues.

Outside of court today, Richmond said the site of Christie’s cancer surgery is not healing properly and he needs a second operation.

“During the course of his treatment it was discovered he had a heart condition that may require surgery,” Richmond said. Then, doctors diagnosed Christie with a vascular problem in his leg. That could mean a third surgery.

Christie is unable to come to court and appeared this morning via Zoom.

No new trial date was scheduled. A hearing for a possible trial-setting will be held on March 8, approximately five years after multiple law-enforcement agencies raided properties owned or leased by Christie.

He has already been to trial once and was convicted of numerous misdemeanor counts of dumping cow carcasses too close to state waters. The jury deadlocked on four felony counts of animal cruelty.

Living on the streets of California is a deadly affair. The life expectancy of an unsheltered person is 50, according to national estimates, nearly 30 years less than that of the average Californian. As homelessness spirals out of control throughout the state, so too do deaths on the street, but it’s those whose lives are the most fragile who are least likely to get medical care.

Now, the state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness. Through a series of incentives and regulatory changes, the Health Care Services Department is encouraging Medi-Cal insurers to fund and partner with organizations that bring primary care into encampments.

They’re known as street medicine teams. There are at least 25 in California.

“Oh crap. This is where she was, and they just swept that,” said Brett Feldman on a Friday morning in November, looking at a green tent, crumpled and abandoned on Skid Row in Los Angeles. Feldman, a physician assistant, is searching for a female patient in her 40s with severe and unmanaged asthma. She cycles predictably in and out of the hospital, and Feldman knows she’s due for another hospitalization soon.

The road is streaked with water from a cleaning truck, and sanitation workers in fluorescent vests sweep up debris. Parking enforcement and police cruisers line the section of road where a homeless encampment once stood. Nearly 5,000 people live in the half-mile block infamous for the hypervisibility it affords the state’s unrelenting homeless crisis.

Burdened by disproportionate rates of addiction, mental health disorders and chronic disease, people experiencing homelessness are some of the state’s neediest patients, but few receive anything more than emergency services. Barriers like lack of transportation and cumbersome insurance rules keep most from getting regular health care. Instead, they drift through the emergency room during a crisis, racking up high costs to the system and deteriorating physically in the interim.

Delivering health care this way is costly and not particularly effective for the patient or the system. More than half of the state’s $133-billion Medi-Cal budget is spent on the top 5% of high-needs users, according to the California Department of Health Care Services.

“Where we have been falling short, especially with this population, is their reality is so different from ours that we haven’t been building reality-based systems for them,” Feldman said. “They have Medi-Cal. They’re eligible for all these benefits, but they can’t access these benefits.”

The state’s efforts to bridge the gap between eligibility and access is supported in part through CalAIM, a multi-year plan to revamp the state’s low-income health insurance program. Grants to hire staff or invest in billing or data collection software offer some stability to teams that have historically been volunteer- or charity-operated. The department also issued a rule change in November allowing street medicine teams to tap into and manage homeless patients’ Medi-Cal benefits, meaning providers can be reimbursed for their work.

“One of our core principles of CalAIM is breaking down the walls of health care and meeting people where they are,” said Jacey Cooper, director of the state’s Medi-Cal program. “We really feel like street medicine helps us do that.”

“They have Medi-Cal. They’re eligible for all these benefits, but they can’t access these benefits.”
— Brett Feldman, physician assistant

What is street medicine

Several months ago, Feldman’s Skid Row patient suffered a brain injury from lack of oxygen during an asthma attack. She’s now confined to a wheelchair and reliant on a friend for basic needs like finding food and using the toilet.

Newer asthma medications might be able to help end her hospitalization cycle, but until recently only her assigned primary care doctor, whom she has never seen, was allowed to refer her to a specialist for assessment under Byzantine Medi-Cal rules. Feldman had been trying to get her a primary care appointment for more than a year, to no avail.

Under the new rules, however, Feldman could have referred the asthmatic patient directly to the lung specialist she needed or gotten prior authorization for the medication since it was recommended during a hospital stay. Instead, without adequate medical care to address her condition, her life has been irrevocably altered.

Statistically, she’ll be lucky to live longer than a few more years.

“She used to be a staple down here. She knew everybody,” Feldman said. “Now, she can’t walk, is confined to her tent. She’s lonely because she’s used to being part of the Skid Row community. She had a very full life despite being unhoused.”

Feldman, co-founder and director of the street medicine program at the University of Southern California’s Keck School of Medicine, said the goal of street medicine is to give some autonomy back to people who usually have very little power left in their lives.

Each day he and a team of providers scour the county streets diagnosing chronic and acute conditions, treating mental illness and substance use, delivering medicine, drawing blood for tests and following up with patients who request a visit. Community health workers hand out food and hygiene supplies and help them navigate hurdles as they try to obtain housing and social services.

“We know that people who are experiencing homelessness have higher mortality, have higher ER utilization, have higher length of stay when they get admitted,” Cooper said. “We really see this as part of a comprehensive approach to ensuring that we have a true continuum of care for people experiencing homelessness.”

The traditional health care system thrives off efficiency: The more patients move through an office, the more the provider gets paid, resulting in brief appointments and little sympathy for circumstances that make patients late. But that setup doesn’t work for unsheltered people who run the risk of getting their belongings stolen if they leave their camp — or who would rather find something to eat than take care of what may seem like a minor malady.

Less than 30% of unhoused people with Medi-Cal have ever seen their primary care provider, according to a state legislative analysis of a street medicine bill vetoed by Gov. Gavin Newsom in 2021. The measure passed the legislature with broad support but was opposed by the state Health Care Services Department for potential duplication of services. In the veto, Newsom directed the department to work with street medicine teams to fill any gaps left out by CalAIM — one such gap was adjusting billing codes that prevented street medicine reimbursement.

“When you’re focused on those very basic needs, like food, safety, shelter, how are you then able to focus on, you know, managing your diabetes or your blood pressure or some of these risk factors that can lead to more serious downstream effects?” said Dr. Kyle Patton, medical director of the street medicine program at Shasta Community Health Center in Redding.

On a Monday in September, Patton and Anna Cummings, a case worker, trekked through a wooded area on the north edge of town to meet Amber Schmitt, 47, a patient with an infected leg. The ground is muddy from a storm the night before. Schmitt is paying a friend $700 a month to stay in his apartment, but hidden among the trees and rolling hills is her abandoned encampment, along with dozens of others. Schmitt gets $1,000 a month from Social Security, but it’s not enough to afford a security deposit or rent in the area, she said.

The gash on Schmitt’s right shin is mottled and inflamed. She said she scraped it on a fallen branch. Patton cleaned and dressed it for her previously, but she had no choice but to reuse bandages after running out. Now she can barely walk from the pain.

“This is a silver-based dressing, which will kill bacteria in wounds,” Patton tells Schmitt after rinsing the area with a saline wash. “We’ll get you some more dressing too. And then you’ve got some skin breakdown and maceration between your toes. I don’t like the look of that.”

He gives her a fungal cream and a bottle of antibiotics. Schmitt is a leukemia survivor and has had a hip replacement on the same injured leg. Her medical history makes her prone to infections and poor circulation in her extremities, Patton said.

“There’s people that would maybe make the argument that … they have health insurance here in California, they should just utilize the system as is. The reality is because of certain factors within the context of their homelessness, they’re not able to do that,” Patton said.

Although they qualify for comprehensive health coverage under Medi-Cal, the program wasn’t necessarily designed with homeless people in mind. For example, Medi-Cal will pay for transportation to and from a doctor’s appointment, but it requires the patient to provide a fixed address and give several week’s notice to the driver, something most people experiencing homelessness aren’t able to arrange.

Link between homelessness and health

Health data on homeless people are sparse, with no state agency and only a handful of counties tracking the information, but it’s clear that most of their deaths are preventable.

In Alameda and Marin counties, half result from acute or chronic health conditions like cardiovascular disease, cancer or respiratory failure. In Orange County, these make up a quarter of deaths among the unhoused. In Los Angeles County, heart disease is the second-leading cause of death among people experiencing homelessness, second only to overdoses.

Even overdose deaths are considered preventable — yet in San Francisco, overdoses cause 82% of deaths among the unsheltered.s.

“We commonly see conditions that you would see in a typical population, but they’re just not addressed; so out-of-control high blood pressure, uncontrolled diabetes…also substance use in terms of opioids, we see a whole lot more than in the general population,” said Dr. Absalon Galat, medical director for LA County’s Department of Health Services’ Housing for Health division.

Galat’s team started its foray into street medicine in an effort to dole out COVID-19 vaccines, but team members quickly found they needed to do more. The county used COVID-19 relief funds to purchase mobile clinics, and CalAIM funding has helped them hire 60 staff members.

In September, the county’s fleet of mobile clinics, complete with fully outfitted exam rooms, began visiting areas where services are sparse. Smaller teams of clinicians and case workers roam encampments to follow-up with patients, treat minor issues and bring patients to the mobile clinic. There’s some disagreement among street medicine providers about whether mobile clinics remove enough barriers because they still require patients to travel to a set location, but Galat said his goal is to improve access, whether it’s by wheel or foot.

“People are dying every day,” Galat said. “So we have to try with what we know best in the medical field right now to limit people who are dying.”

The connection between homelessness and health is inextricable, said Dr. Michelle Schneidermann, director of the People-Centered Care team at the California Health Care Foundation, a statewide health policy think tank.

“Either one can lead to the other. A catastrophic health incident or a series of conditions can lead to someone not being able to work, leading to poverty,” Schneidermann said. “We see this all the time, health conditions precipitating homelessness, and the other way around.”

“Until we can end our crisis of homelessness…we have to find a way to deliver care for people on the streets.”
— Dr. Michelle Schneidermann, director of the People-Centered Care team at the California Health Care Foundation

Take Danny Doran, 56, who visited LA County’s mobile clinic at Whittier Narrows Park on a recent Thursday to pick up insulin. He spent his career as a plumber and owned a home in Bishop. Three years ago he fell into a diabetic coma and was hospitalized for months. A friend Doran trusted to pay his bills while he was hospitalized emptied his bank account and disappeared — Doran has been homeless ever since. Several weeks ago he was beaten and robbed by another homeless man, who left him with a fracture in his skull and a tremor in his hands.

“I guess I’m a little bit naive,” Doran said. “We’re all humans and we’re prone to mistakes, you know? So I hate for anyone to have their money stolen like mine was and end up like me on the streets.”

At the mobile clinic, Doran said the doctor on staff agreed to be his primary care physician. His previous primary care doctor stopped accepting Medi-Cal insurance, and Doran hasn’t had regular access to insulin ever since.

“The doc here, she truly has compassion for her patients. I’m glad our paths crossed,” Doran said.

Schneidermann, who is overseeing a study on street medicine programs across California, said CalAIM, which also pays for housing services, is an opportunity for the state to address its most pernicious problem.

“Until we can end our crisis of homelessness…we have to find a way to deliver care for people on the streets,” Schneidermann said.

New programs popping up

Prior to CalAIM and the Health Care Services Department’s rule changes, street medicine programs operated outside of traditional health care, funded by philanthropies or the rare health organization willing to lose money. Now, the department’s changes offer some hope for stability, Feldman said.

Noting that these programs were birthed out of the pandemic, Feldman said they “might not exist in a few years if they’re not supported, but they have all these patients that rely on them.”

A year ago only 25 programs existed across the state, primarily concentrated in urban areas, Feldman said. But ever since CalAIM launched at the beginning of 2022, he’s run into more organizations looking to begin services. CalAIM requires Medi-Cal insurers to coordinate patients’ physical, behavioral, dental and developmental care as well as social services — something many street medicine teams already do. The goal is to make the “system hustle behind the scenes rather than making the patient hustle,” California Health Care Foundations’ Schneidermann said.

One such program is run by Anthony Menacho in Sacramento. Unlike USC, Shasta Community Health or LA County’s teams that are staffed full time, Menacho’s street medicine band is composed entirely of volunteers. They visit six camps every other weekend.

The work was funded initially by a $100,000 grant from Health Net, the largest Medi-Cal provider in the state, but Menacho, who trained as a physician assistant with Feldman at USC, wants to be able to do the work full time and hire more clinicians. He’s working to secure money through CalAIM and the Department of Health Care Services.

“We don’t have the academic resources or people behind us to be able to put in a department or infrastructure on the drop of the dime,” Menacho said. “We run on grants, but that’s not true sustainability. We can’t do it ourselves. It has to be a coordinated effort and I think that’s what CalAIM is trying to do.”

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