July 14 Support for AB 543 – Medi-Cal: Street Medicine

July 14, 2025

Assemblymember Mark González
1021 O Street, Suite 4130
Sacramento, CA 95814

RE: Support for AB 543 (González) – Medi-Cal: Street Medicine

Dear Assemblymember González,

On behalf of the Marin County Board of Supervisors, I write in support of AB 543, which would remove critical barriers to care for Californians experiencing unsheltered homelessness by establishing presumptive eligibility for Medi-Cal and authorizing reimbursement for care delivered through street medicine. These reforms are urgently needed to align the Medi-Cal system with the realities of street-based care and support the medical professionals who are reaching people where they are.

In Marin County, nearly 1,100 individuals continue to experience homelessness (2024 Point-in-Time Count), including nearly 800 who are unsheltered. While Marin has made measurable progress—reducing chronic homelessness by 41% since 2017 and placing more than 2,300 individuals into permanent housing—unsheltered residents continue to face some of the steepest barriers to care. Our outreach teams and clinical partners routinely encounter individuals with chronic illnesses, behavioral health, and life-threatening injuries who are disconnected from healthcare. AB 543 would meaningfully reduce these barriers by:

• Establishing presumptive eligibility for full-scope Medi-Cal for individuals experiencing homelessness—so that care can begin immediately;
• Allowing licensed street medicine providers to deliver and be reimbursed for services in non-traditional locations such as encampments, alleyways, or vehicles;
• Enabling direct referrals for medications, diagnostics, and durable medical equipment, without unnecessary delays from network assignment requirements;
• Improving data sharing between Medi-Cal and county systems to enhance care coordination and identify high-need individuals.

Licensed clinicians who carry supplies on foot and treat unsheltered patients where they are, including encampments, too often work without reimbursement due to administrative barriers. AB 543 removes many of those barriers to reimbursement, and improves integration into the existing health system. For counties like Marin that have invested in a Housing First approach and seen measurable results, AB 543 will continue to close gaps in our continuum of care.

We appreciate your leadership on this important issue.

Sincerely, 

Mary Sackett, President
Marin County Board of Supervisors

CC:       Marin County Board of Supervisors
            Senator Mike McGuire
            Assemblymember Damon Connolly