Case · 72
Street Medicine
From the street to stable housing
Member
Anonymous
Service line
Street Medicine
Location
Los Angeles, Skid Row corridor
Duration
4 months, outreach to keys
01 —
The outcome
A member living unsheltered was first contacted by our Street Medicine team during outreach. Over four months, they received wound care, behavioral health support, and a successful pathway into permanent supportive housing.
Housed in 120 days
Headline result for Anonymous.
120 days
Outreach to keys
Permanent supportive housing placement.
Wound healed
Fully closed at week 10
No surgical escalation required.
4
ED visits avoided
Estimated based on prior 14-month utilization.
MAT started
Day 78
Member-led decision after months of rapport.
02 —
Background
Where the member started.
A 58-year-old member living unsheltered for 14 months was first encountered by the Street Medicine team during a regular outreach route. Initial contact focused on a non-healing leg wound and untreated hypertension.
In their words —
“They came back, week after week, even when I told them to leave. That's the only reason I'm sleeping in a bed tonight.”
— Street Medicine Member, Los Angeles
03 —
The challenge
What stood in the way.
- 01
Untreated wound at risk of progressing to osteomyelitis.
- 02
No primary care relationship and no active Medi-Cal MCP assignment on record.
- 03
Moderate substance use disorder and prior negative shelter experiences.
- 04
No ID, no birth certificate, no proof of California residency.
04 —
Our approach
How we built the plan.
Move 01
Meet the member where they are — literally — across multiple outreach visits before proposing housing.
Move 02
Stack medical, behavioral, and document recovery in parallel.
Move 03
Use a Housing First model with low-barrier permanent supportive housing as the target placement.
05 —
The solution
Step by step, what we actually did.
- 01
Month 1 — Trust and wound care
Six on-site visits delivered wound debridement, antibiotics, and BP medication; established a consistent point of contact.
- 02
Month 2 — Documents and benefits
Recovered birth certificate via vital records partnership; activated Medi-Cal MCP enrollment and ID restoration.
- 03
Month 3 — Housing assessment
Coordinated CES assessment; matched to a permanent supportive housing unit; began MAT for SUD.
- 04
Month 4 — Move-in and wraparound
Move-in completed with covered move-in kit; weekly home visits transitioned the relationship from street to indoor care.
06 —
Services involved