State of emergency

Sacramento’s homeless often rely on emergency rooms for their medical care. It’s an expensive and dangerous system.

Homeless activist John Kraintz.

Homeless activist John Kraintz.


Homeless activist John Kraintz didn’t know what was wrong with him when he went to the emergency room June 28, complaining of bloody vomit and fever. Doctors at Sutter General Hospital admitted him for three days, made him comfortable, gave him some acid-reducing medication and then sent him on his way.

No ultrasound was performed—a relatively cheap and easy-to-perform test that would have shown a softball-sized cancerous tumor that, just five weeks later, would rupture. That sent Kraintz back to the hospital for emergency surgery, to remove his gallbladder, part of his pancreas and colon.

Such stories are not uncommon for the homeless, who often do not have health coverage and have little access to medical care.

For Kraintz’s hospital stay and operation, Sutter General Hospital is charging $138,938—of which just $20,928 may be recouped from billing the county’s medically indigent program. The hospital’s charity care program will have to cover the rest of the charges.

Until his diagnosis of colon cancer, the 56-year-old Kraintz didn’t have any qualifying conditions that would have made him eligible to receive Supplemental Security Income, which provides Medi-Cal, or Social Security disability insurance or Medicare.

The only doctor he had seen was one located at the free clinic run by Mercy Clinics through Loaves & Fishes, which runs a suite of services for the homeless out of its North C Street complex.

That clinic is not a primary-care clinic, but rather an “episodic” care clinic—not designed for ongoing care, according to Tim Brown, director of Sacramento Steps Forward, the city’s 10-year initiative to end chronic homelessness, begun in 2006.

Kraintz now waits to start chemotherapy—his new doctor has ordered 12 rounds of chemo twice a week for six months—but is also awaiting a new place to live because, with this health crisis, he can’t afford to be homeless any longer.

He’s currently staying at The Salvation Army’s Interim Care Program, jointly run by The Effort—the medical wing of The Salvation Army’s shelter.

“I think I’ve got a bead on a place,” he told SN&R. “And now, with the money from Social Security, I’m not looking for a place with no money.”

Kraintz, a former construction worker, has been one of the leaders of Sacramento’s Safe Ground movement, which has been pushing for a legal campground to be made available to the city’s homeless.

Kraintz says he now also sees a need for better medical screening and other programs for the indigent.

“I think we at Safe Ground have to incorporate into our program how to navigate the medical system, because too many people find themselves in this situation and don’t have the same connections that I have,” Kraintz said.

“I know one guy on the river right now who’s in the exact same position—he’s sick and has nowhere to go. I’m not saying my tumor wouldn’t have been there had we caught it earlier, but maybe it wouldn’t have caused all these problems.”

Brown said that Sacramento Steps Forward has a case-management arm to its program, helping the homeless secure SSI and Medi-Cal benefits, “but with cutbacks, we’re struggling with the case-management piece right now.”

“But it’s definitely got to be a component,” he added.

At last count, there were 2,800 homeless people residing in Sacramento County—1,200 of them on the streets, the rest in shelters and transitional housing, Brown said.