A man on an e-bike has been pedaling through the Tenderloin and Mission neighborhoods this spring, handing out envelopes with $15 in cash. He calls himself Nurse Albert, takes people’s blood pressure and, in exchange, their personal information — including Medi-Cal numbers.
Who does he work for? San Francisco health institutions and social service organizations, including the Department of Public Health and University of California, San Francisco, have no idea. But he is a common sight on certain streets.
Lydia Bransten, the executive director of the Gubbio Project, and a Mission Local reporter saw Nurse Albert handing out money in late March, near 15th and Julian streets in the Mission. It’s an intersection where people often line up for a free meal from El Centro Latino, another nonprofit.
Bransten was concerned. She approached and warned people not to share their details. “I felt like it was not legitimate,” she said. “In this particular case, what’s really dangerous is they’re getting people’s information.”
With a Social Security or Medi-Cal number, “you can continue billing Medi-Cal for that person, whether they’re being seen or not,” she added.
Mission Local is not sure of Nurse Albert’s identity or his credentials, if he has any; he declined to share his name. But multiple outreach workers warned that the behavior witnessed by Mission Local was reminiscent of scammers, who take advantage of people seeking services, sometimes right outside the door of city-contracted nonprofits.
“People will walk into our program and say all kinds of crazy things,” said Bransten, whose Mission nonprofit offers beds during the day. “They come after the most vulnerable.”
Paying out $15, pocketing $75 to $125
While it’s unclear why Nurse Albert was collecting Medi-Cal numbers, outreach workers like Bransten said that, in similar cases, personal information has been used for identity theft. Or, Bransten added, an unscrupulous nurse can pay people on the street to take their blood pressure, call them clients, and then turn around and charge Medi-Cal for healthcare services, pocketing the extra money.
Those Medi-Cal reimbursements amount to much more than $15, doctors said. A general wellness check could yield between $75 and $125.
Outreach workers said scams like these are concentrated in areas of San Francisco with more homeless people. Individuals sign people up for mysterious free phones or illegally pay for signatures for ballot petitions, they said. During the pandemic, tents popped up where people were paid to take COVID tests that could be billed to Medi-Cal, California’s state health insurance, for more than the patrons were given.
A couple people on the street said Nurse Albert was genuinely trying to provide a positive public service, but his identity and licensing information remain unclear.
Dressed in dark blue scrubs and a leather jacket, Nurse Albert stood at the intersection of Eddy and Taylor streets on another day in early March. On nearby sidewalks, people were slumped over next to drug pipes and foil. On his block, however, people congregated around the nurse, who told Mission Local he took their vitals.
When the group dispersed, a few stragglers were disappointed to learn that “Nurse Al” would no longer be handing out cash. He said he’d return again the following morning.
The nurse did not give his full name to Mission Local, but said he worked for a clinic called “CME” before riding away on an electronic bicycle.
The only healthcare program with those initials appears to be “Continuing Medical Education,” a UCSF division that offers educational opportunities for medical professionals. It is not a clinic.
A spokesperson for UCSF said the behavior described did not match their nurses’ conduct: Healthcare workers always carry credentials, and they “do not ask for private information, including social security numbers or Medi-Cal identification, on the street.”
After Mission Local’s inquiries, university staff said they notified the San Francisco Police Department of a nurse potentially exchanging cash for treatment.
A man who said he provides security for Nurse Albert told Mission Local that Albert took down Medi-Cal information through an online “CME” portal, and received his money through reimbursements. The nurse only collected Social Security numbers if someone did not have their Medi-Cal card, the guard said.
The goal is to encourage sobriety and “true harm reduction,” the guard added. Patrons were told not to use drugs while in line and to keep the sidewalk clean. The nurse, he said, was a licensed, dedicated health professional who “risks a lot because he carries a lot of money.”
An alphabet soup, and lack of trust
San Francisco residents do indeed want cleaner sidewalks and services for drug users. Both public safety and public health advocates support an on-the-ground approach to ridding San Francisco’s streets of homelessness and addiction, whether through police foot patrols, street teams, or some union of the two.
People in need are often drawn to San Francisco because of its menu of services. But an overwhelming alphabet soup of street agencies (DPW, DPH, DEM, etc.) and ambassadors in different colored vests can unintentionally open the door to a different public safety risk: scams.
Doubt about who to trust can creep in, especially for unhoused people who are “targeted and victimized so often,” said Naomi Schoenfield, a nurse practitioner who has been working in street medicine in San Francisco for six years.
“The majority of what we’re doing is trying to build trust which has been broken,” Schoenfield said. Unsanctioned operations are “making it more difficult for everyone to build trust.”
The city attorney is aware of such scams. “While we cannot comment on any potential ongoing investigations, we urge the public to exercise caution when asked to share sensitive information such as Social Security or Medi‑Cal details,” City Attorney David Chiu wrote in a statement to Mission Local. “Legitimate service providers typically do not require this information on the street or in exchange for cash.”
There are several city-contracted providers and nonprofit organizations that offer services. Glide, which provides meals, housing and healthcare, was a block away from Nurse Albert’s operation.
Glide staff didn’t know of an individual or program matching this nurse’s description. Nor did the staff of Urban Alchemy, whose community ambassadors were strolling through the area the following morning. Nurse Albert was not at the post where he said he’d be, a few blocks away from the Tenderloin police station.
A team of nurses with the UCSF Roaming Community Health Initiative used to offer gift cards as an incentive for people who received wound care on the street. But never cash, and never with conditions, said Patrick Sorensen, the clinical coordinator.
These days, they only distribute donated socks, water bottles, and granola bars. The most information they collect is a patient’s name and birth date for a private state database of California vaccines.
Reached by phone last week, Nurse Albert’s purported security guard said the pair had been unfairly misjudged and intimidated: They’d been given permission to be there, and were never told to leave by police officers in the area.
Bransten said the nurse’s associate misrepresented Albert’s affiliation. He told her the nurse worked with an organization down the street — the Gubbio Project. She said that was incorrect: She was the executive director of the Gubbio Project, and Nurse Albert did not work for the nonprofit.
“They try to legitimize themselves by being in proximity to actual organizations that are giving people assistance,” Bransten said. “It horrifies me.”
Two months after the encounter with Bransten, the nurse’s security guard said that bullying and “absurd” allegations of illegitimacy had left Nurse Albert overwhelmed. It was a shame, he said, because now Al is less inclined to come around.
Additional reporting by Alice Finno.