SACRAMENTO, Calif. — Every weekend, and most weekdays, Sacramento Street Medicine teams can be spotted walking the streets of Sacramento carrying large red backpacks filled with medical supplies. Medical volunteers, community health workers, health care providers and patient navigators travel on foot into encampments, usually deep into wooded areas, riverbeds or the heart of downtown Sacramento.
In the absence of exam rooms and clinic tables, Sacramento Street Medicine provides health care and social support to members of Sacramento’s unhoused community living in these encampments. The organization’s approach is simple: go to where people are.
As a volunteer-run nonprofit, Sacramento Street Medicine provides all services free of charge, relying on teams of medical professionals, trainees and community health workers. Its main goal is to provide a structured and longitudinal approach to care.
Licensed medical professionals conduct medical evaluations and write replacement prescriptions when medications have been lost or stolen. Patient navigators assist residents in replacing identification documents that are often necessary to refill medications or receive public benefits.
Community health workers make 211 calls and help residents apply for CalFresh and other shelter and housing assistance. Medical volunteers take vital signs, provide wound care and document each encounter.
Longitudinal charts and HOUSED BEDS assessments (an acronym for multiple clinical assessments) are also completed to monitor residents’ medical and social needs, as many of Sacramento Street Medicine’s residents experience chronic conditions such as asthma, diabetes and hypertension that require consistent management and follow-up care.
Camp leads are assigned to specific encampments and return regularly to monitor how residents are doing. Sacramento Street Medicine currently serves seven different encampment sites, with rotating outreach teams between them to ensure consistent follow-up.
The work requires repetition. Seeing the same individual again helps build trust and continuity of care. However, encampment sweeps disrupt that model.
When encampments are swept, residents are forced to leave with little warning. Their belongings can be lost in the process, including medications, identification documents, benefits papers, clothing and tents.
For those dealing with long-term illness, losing medication can have serious health consequences. Replacing identification can also require fees, documentation and a mailing address, forcing some people to start over from scratch.
In some cases, residents can be cited or arrested during sweeps. If they are unable to move quickly enough, they may also receive fines they often cannot afford to pay. When they return, their belongings are usually gone.
For Sacramento Street Medicine teams, the effects are significant. Outreach shifts that were consistently focused on follow-up care can become relocation efforts, as volunteers walk to new areas trying to find familiar faces. While some patients can be located again in different encampments, many others are not.
It is worth noting that outreach services for Sacramento’s unhoused community have expanded over the last several years. However, continuity — the ability to see the same patient the following week — remains crucial to successful outreach and sustained care.
Sacramento Street Medicine has always been based on the principle of meeting people where they are. But when that “where they are” changes multiple times, it creates challenges not only for residents, but also for the service providers trying to help them.
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