Street medicine providers can’t get reimbursed by Medi-Cal. A state bill could change that

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Physician assistant Brett Feldman treats a man who lives in a tent overlooking a freeway in downtown Los Angeles. Joseph Becerra, a community health worker, and State Senator Sydney Kamlager watch. Photo by Ethan Ward/LAist.

The Street Medicine program at USC’s Keck School of Medicine is one of roughly 28 programs in California that offer health care to people experiencing homelessness on the streets rather than a traditional medical facility.

“We leave our offices and go to the people under bridges, behind dumpsters, wherever they are outdoors,” says physician assistant Brett Feldman, who leads the program.

Even though all his patients qualify for Medi-Cal, his team can’t get reimbursed by the state.

“The street is not recognized as a legitimate place to deliver health care,” he says.

Assembly Bill 369 would change that. Currently sitting on the governor’s desk, it would allow street medicine teams to act as primary care physicians and get reimbursed regardless of location.

“Generally, our unhoused population, when they need care, they find their way to emergency rooms or urgent care. This costs taxpayers a lot of money,” says State Senator Sydney Kamlager, who represents LA and authored the bill. “So the implementation of street medicine teams that are allowed to be reimbursed for the health care that they are providing will save Californians money, and it will increase the health care outcomes of Californians.”

If passed, the law would apply only to legitimate street medicine programs that deliver medical services and are connected to a larger institution, such as a university or government agency.

“We certainly don't want rogue teams popping up,” says Kamlager. 

Ultimately, Feldman says this law would save lives.

“In LA, 1,300 people died on the streets in the last year,” he says. “That's not just a number for me, some of them were my friends and patients. What we would need to come anywhere close to meeting the demand is to be able to get reimbursed for the care we're providing."

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