Emergency rooms across the Sacramento region are treating far more unhoused patients, with visits rising from about 21,000 in 2019 to roughly 34,000 in 2024. Clinicians report frequent mental health crises, substance use emergencies and serious infections, while also trying to connect patients to housing and follow-up care after discharge.
State Data Show Sharp Spike In Visits
According to data from the California Department of Health Care Access and Information, people experiencing homelessness accounted for roughly 34,000 hospital encounters in the Sacramento region in 2024, and their share of emergency department visits rose from about 2.2% in 2019 to 3.2% in 2024. The state analysis also finds that unhoused emergency department patients were more than four times as likely as the general population to have a primary mental health or substance use diagnosis and about twice as likely to arrive with a primary skin disease.
ERs Feel The Strain Of Safety Net Role
That trend is playing out at both downtown and neighborhood hospitals, where emergency departments are treating more people whose unmanaged chronic conditions or untreated wounds have turned into urgent problems. Staff report that those visits often require extra time from social workers and nurses to line up transportation, medications and follow up appointments, services that the emergency room was never built to provide on a regular basis.
Recuperative Beds And New Partnerships Try To Slow The Revolving Door
Health systems and nonprofit groups are adding transitional care options in an effort to keep people from cycling right back to the hospital. As CapRadio reported, a new Community Care Center in North Sacramento quietly opened to a limited number of patients in November, offering overnight recuperative beds and on site case management for people leaving the hospital. Sutter Health notes a separate recuperative program on Stockton Boulevard that was built so patients can recover off the street instead of in an ER waiting room or a tent.
Street Medicine Works The Encampments
Mobile street medicine teams are also bringing basic care directly into encampments and parks. Abridged reports that One Community Health’s street medicine unit launched about a year ago and now runs with a six person team that sets up pop up clinics, treats wounds and uses long acting injectables to manage opioid use disorder where patients live.
Funding Gaps Leave ERs Holding The Bag
Even with those new programs, hospital leaders say the payments that cover care for unhoused patients often do not come close to paying for the staff time and outreach those encounters demand. In an interview with Abridged, Rachael McKinney, president of Sutter Health’s Greater Sacramento Division, said, "The ER kind of becomes the default location for care if you have nowhere else to go." Hospitals point to major investments, including more than $25 million that Dignity Health has put toward a Homeless Health Initiative, but leaders warn that Medi Cal reimbursement levels still leave a significant gap when it comes to funding outreach and extended recovery stays.
Providers and advocates say these stopgap measures can keep some people from bouncing back through the emergency room doors, but they argue that they will not replace the need for more permanent housing, a larger behavioral health bed supply and targeted state funding for care delivered on the street. For now, hospitals, clinics and street medicine teams are stitching together whatever services they can to keep people, and their health crises, out of Sacramento’s already taxed ERs.
