The state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness.
Cal MattersThe life expectancy of an unsheltered person is 50, according to national estimates, nearly 30 years less than that of the average Californian. As homelessness remains an ongoing crisis, so does the death rate among those living on the street.Now, the state Medi-Cal agency is endeavoring to improve health care access for people experiencing homelessness.
Burdened by disproportionate rates of addiction, mental health disorders and chronic disease, those who are homeless are some of the state’s neediest patients, but few receive anything more than emergency services. 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.
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.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.
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.
The gash on Schmitt’s right shin was 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.“This is a silver-based dressing, which will kill bacteria in wounds,” Patton told 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.
“We commonly see conditions that you would see in a typical population,” said Dr. Absalon Galat, medical director for the LA County Department of Health Services’ Housing for Health division. “But they’re just not addressed.”
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