County and clinics describe mobile street medicine; providers urge sustainable funding and partnerships
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Summary
County Primary Health Services, Ellica Health Centers and One Community Health described mobile clinics and street medicine outreach, reporting thousands of mobile visits and expressing concern about one-time funding and long-term sustainability.
County health staff and community clinics on March 25 described mobile street medicine efforts that bring urgent and primary care to people living unsheltered, and they urged sustained funding and better coordination with other county programs.
Noel Vargas, deputy director of Primary Health Services, said the county's mobile medical clinic is an extension of the county's federally qualified health center and that teams provide acute urgent care, longitudinal primary care visits, STI testing, immunizations, medication administration and referrals. Dr. Kate Ryslak, a family-medicine and addiction-medicine physician who works on the mobile unit, said the most common conditions seen include high blood pressure, diabetes, congestive heart failure and chronic lung disease, and that substance use disorder and mental-health conditions are also frequent.
"I think the most common conditions that we see are the most common conditions I also see at our FQHC which is high blood pressure, diabetes and congestive heart failure, COPD," Dr. Ryslak said.
Searchable outputs and partner reporting: - Ellica Health Centers told the board its street-medicine program logged more than 3,400 mobile visits in 2024 and provided school-based vaccine clinics (funded by a county COVID-vaccine grant) that vaccinated more than 1,000 children between August and January. Ellica said the vaccine grant funding runs through June and that continuation funding has not yet been identified. - One Community Health, which launched street work in early 2025, reported early metrics including distribution of about 480 outreach kits, an active caseload of 96 patients, coordination of 38 prescription pickups and deliveries, and eight patients placed into transitional housing through multiagency collaboration.
Providers and county staff emphasized partnerships. The county's mobile unit is HRSA-funded as a satellite FQHC site; clinic leaders said they coordinate with Community Health Works (Cohiewo), UC Davis and behavioral-health outreach teams to reach encampments and shelter locations. Ellica and One Community have worked at recurring sites so people know when and where to find care.
Funding and sustainability: presenters urged the board to consider sustainability for mobile programs. Speakers said reimbursable clinical encounters do not fully cover the cost of mobile outreach, and that one-time funds such as ARPA or short-term grants are useful for start-up or capital costs but are not a long-term operational solution. One Community and clinic leaders said they are pursuing a mix of billing, grants and partnerships to sustain services.
Board members and city representatives praised the work and asked operational questions about referrals, specialty care access, and services for specific populations such as pregnant people. Presenters said they can initiate buprenorphine and other medications for addiction care on mobile units and can write prescriptions or arrange specialty referrals when patients are assigned to a primary-care panel.
No formal action was requested; staff and providers said they will continue to coordinate with county and city partners and pursue reimbursement and grant opportunities.
