Despite having one of the highest rates of uninsured people in San Francisco, Treasure Island has no permanent medical service, nor does the city plan to establish any, even as new developments are expected to bring 20,000 residents by 2042.
Few options exist for the roughly 2,800 residents on the island, 38% of whom live below the poverty line, according to the 2020 Census. They are encouraged to call 911 and rush across the Bay Bridge to city hospitals in a medical emergency.
The San Francisco Department of Public Health ran a nurse clinic there but closed it in 2024 due to staffing shortages. Residents can still call a hotline and request services, but since then the island had not received on-site health services — until this October, when a bookmobile-like medical van arrived.
HealthRight 360, a San Francisco-based nonprofit health provider, rebooted mobile and street medicine operations previously rolled out in two other underserved neighborhoods: the Tenderloin and the Mission. The van works in tandem with services that HealthRight 360 delivers and can provide referrals to a residential stepdown program for those in substance abuse recovery.
With a $500,000 grant from Sutter Health, HealthRight 360 expanded its mobile medical team, extending the reach of the organization’s federally qualified health center. The vehicle — more the dimensions of a large delivery truck than of a light-duty van — includes two private exam rooms with services including preventive screenings, wound care, vaccinations, lab work and case management. It serves people who are uninsured, eligible for Medi-Cal or experiencing housing instability or homelessness.
Nella Gonclaves, executive director of One Treasure Island, a community service organization addressing income inequality and housing affordability, highlighted the need for preventive and acute-care services in a neighborhood accessible only by the Bay Bridge and a ferry line that runs roughly hourly.
“There are people here that have chronic health conditions, and it’s not always convenient or they’re not always capable to go into the city,” Goncalves said. “If they have something that they might just need a question answered — or ‘Take a look at this, does it look like I need to go?’ — that’s why we’re excited to have medical services on the island.”
But she said medical van uptake has been extremely slow, estimating that only two to four people had visited it. This was not surprising, she said, since many resources gain traction by word of mouth on the island.
Meeting people where the need is
HealthRight 360 launched the mobile unit van in 2019 to bridge the health care discrepancies in communities it identified as needing more convenient access options. It came to a sudden stop when the COVID-19 pandemic hit in early 2020. Since San Francisco had other proven forms of street medicine services and with time of the essence, the van was deprioritized amid staffing shortages, according to HealthRight 360. Wesley Saver, director of policy and public affairs for HealthRight 360, said the van removes apprehension around health care access and meets people where they are.
“Many individuals may delay or skip care because of fear, because of costs or logistics, even for issues that are manageable or preventable,” Saver said. “And when care is delayed, minor health issues can escalate into emergencies. The lens that we are approaching this one in is very much through equity, ensuring that even people who might otherwise fall through the cracks — whether that means they’re uninsured or underinsured, recently housed or undocumented — have access to the same compassionate, evidence-based care that anyone else would receive.”
Sutter helped HealthRight 360 target locations in the city where the van could complement other services provided by the Department of Public Health. Will Douglas, community health director at Sutter Health, said Treasure Island was one of the first places they identified.
Community health assessments point to Treasure Island as one of the city ZIP codes with the highest number of “preventable emergency room visits.” Studies show that residents with regular access to a primary care provider experience medical crises less often.
“In Treasure Island it’s a little bit of a health care desert,” Douglas said. “If you look at some of the top health concerns in the city, you may not realize or think of it as a neighborhood that is underserved, but Treasure Island certainly is. And things might be changing over there.”
Even as residential high-rises and townhouses spring up, bringing higher-income residents in coming years, Douglas said, the existing island population remains isolated from many city services.
Growing residential care capacity
HealthRight 360 has a “residential step down” program on Treasure Island, part of its citywide behavioral health offerings. The 90-day service provides 190 beds for residential treatment for substance abuse. Upon completion, those treated become eligible for housing for up to two years and receive ongoing outpatient treatment.
This program in particular highlighted for HealthRight 360 that residents unstably or recently housed needed to be connected with health care, so it partnered with One Treasure Island to plan the medical van.
Development plans for the island include a behavioral health building owned by the Department of Public Health and managed by Mercy Housing and HealthRight 360. It would include 242 residential step-down beds to provide recovery and sober living housing, as detailed in a 2023 research report by Tariq Jacobs, a research fellow with the Non-Profit Housing Association of Northern California and the Bay Area Housing Internship Program.
A June social media post by an architecture firm working on the project cited a lower number of beds; The report made no mention of primary-care services available on site. The Department of Public Health and the Treasure Island Development Authority did not respond to requests for information about this project.
One Treasure Island plans to develop a “wellness hub” in the coming months to hold over residents while development brings more permanent health resources to the island. The hub, hosted in the organization’s community center, will invite medical professionals from the health department and other organizations to provide services such as health screenings, hearing tests, eye exams and blood pressure measurement. It will also provide referrals for those needing to see specialists.
Goncalves, noted that the “wellness hub” will also host monthly workshops on preventive resources, particularly focused on assisting residents being relocated from old military housing to newer affordable units as developers build them.
The mobile van visits the island Wednesdays at HealthRight 360’s residential step-down program at 1202 Mariner Drive, and Thursdays in front of the Sherry Williams Community Center.
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