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Whole Person Care

Stakeholder Presentations

Date Topic/Link to slide deck Presenter/ Link to email Description

2020 02 21 SF Mental Health Reform Anton Nigusse Bland

In March 2019, Mental Health Reform in San Francisco launched with the mayoral appointment of Dr. Anton Nigusse Bland as director. Through this appointment, Mayor London N. Breed sought to identify solutions for behavioral health challenges faced by... the City, especially those linked to increasing homelessness. With this charge, the Director of Mental Health Reform worked within the San Francisco Department of Public Health and with the broader behavioral health community to define the vision, goals, and target population for the reform effort. Building on this initial charter and framework, the Mental Health Reform team began to make recommendations in September 2019 and to take actions to launch transformative reform. Dr. Nigusse Bland will present an overview of Mental Health Reform work in 2019, highlight the current initiatives, and describe the strategic alignment with complementary City initiatives that aim to improve behavioral health services for people experiencing homelessness in San Francisco.

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2020 01 17 Research of Frequent ED Users: Focusing Solely on Medical Utilization Misses the Whole Person Caroline Cawley, Maria Raven, Hemal Kanzaria

Frequent emergency department (ED) users often have complex behavioral health and social needs, yet policy makers usually focus on this population’s medical system use without examining its use of behavioral health and social services systems. To... better understand the wide-ranging medical and nonmedical needs of frequent and super-frequent ED users (defined as ≥ 4 and ≥ 18 ED visits per year respectively), we compared medical, mental health, substance use, and social services use among nonfrequent, frequent, and super-frequent ED users in San Francisco County, California. We examined Medicaid claims data in the years 2013-15 linked to records from San Francisco County’s Coordinated Care Management System (CCMS), a county-level integrated data system.

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2019 10 18 CCSF Shared Priority Pilot Maria X Martinez, Barry Zevin

Please join our October 18th Whole Person Care Stakeholder update to hear from and converse with Maria X Martinez, Dr. Barry Zevin and others as they present on the “CCSF Shared Priority” Interagency Pilot, which brings together Health, Housing, and... Human Services to adopt a “whatever it takes” approach to place our most vulnerable clients experiencing homelessness into housing or other safe settings.

The three-month pilot to implement Street-to-Home plans will include assigning care coordinators, dispatching interagency response teams, and prioritizing timely access to resources that include low-barrier and intensive treatment services, disability services, housing navigation services and benefits.

Lessons from this pilot group will be applied to better serve all people experiencing homelessness in San Francisco.

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2019 09 19 Tipping Point Community on Findings from the Chronic Homelessness Initiative Nina Catalano

In July 2017, Tipping Point Community launched an initiative to reduce chronic homelessness in San Francisco. As part of this initiative, Tipping Point and the UCSF Department of Psychiatry came together to share expertise and strategies about how... to improve outcomes for San Francisco residents experiencing long-term homelessness who also have behavioral health care needs. This project focused on:

- Identifying critical gaps that exist in the current system, including in services and treatment, coordination across agencies and providers, and data availability;

- Identifying existing and planned efforts to address these gaps; and

- Making recommendations for where philanthropic, private and/or public investment could have an impact, including prioritization based on cost, impact, and urgency.

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2019 07 19 Street-Based Care: A Collaborative Approach Deb Borne, Paul Harkin, Eileen Loughran

This presentation will address the barriers, successes and lessons learned by DPH, harm reduction organizations, and Department of Homelessness and Supportive Housing in their commitment to address the health needs of people living in... encampments.

San Francisco’s strong history of harm reduction, community engagement, and flexibility to meet people where they are at has contributed to this collaborative being so successful and accepted in the community.

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2019 06 21 Street Medicine's Low-Barrier Buprenorphine Program Barry Zevin

Join us for a presentation on Street Medicine's Low-Barrier Buprenorphine Program. Dr. Barry Zevin will provide an overview of San Francisco's innovative approach to breaking down barriers to treatment and health care for public injectors and high... risk, high vulnerability individuals experiencing homelessness, who are not getting what they need elsewhere in the system. The presentation will be followed by a Q&A session.

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2019 04 19 Learn about SF Respites - Psychiatric and Medical Kelly Hiramoto (Hummingbird),
Devora Keller
(Medical Respite)

Hummingbird Place is a Behavioral Health Respite Center with a navigation center threshold for admission co-located at the San Francisco Behavioral Health Center, 887 Potrero Avenue. The program provides both day drop in and overnight services and... supports. Hummingbird Place serves San Francisco residents who are referred primarily from Psychiatric Emergency Services (PES), ZSFGH Emergency Department, acute inpatient units, and community behavioral health programs including Street Medicine and the SFHN Transitions division. In addition to presenting with behavioral health conditions, individuals may be admitted with physical impairments requiring special needs including those who use a wheelchair, walker, or cane; and those who have vision and or hearing loss, or speech impediments. The goal of the program is to encourage participation and willingness to engage in ongoing recovery and wellness programs to maximize each individual's functional capacity.

The San Francisco Medical Respite Program provides recuperative services for hospitalized homeless persons who are too medically frail to return to the streets but who do not require further hospitalization or skilled nursing facility care. In addition, the program provides stabilizing clinical services for homeless persons unable to safely utilize shelter because of un/under-treated chronic medical conditions. The program is located at 1171 Mission Street (btw 7th & 8th). While providing temporary shelter and meals, the program offers bridging medical and psychosocial services. Clinical staff at Medical Respite provide post-acute follow-up, care coordination, and bridging primary and urgent care. Patients are transported to follow-up appointments, including primary care, specialty care, mental health, methadone treatment, and outpatient IV antibiotic/infusion treatment. The program’s social workers assist with benefits, housing applications and discharge planning. Patients receive referrals to behavioral health care and case management, when appropriate.

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2019 03 15 Linkages to Homeless Benefits Cindy Ward

Cindy Ward, HSA Homeless Benefits Linkages Manager will present four new pilots aimed to improving access to benefits for people experiencing homelessness.

2019 02 15 Coordinated Entry Megan Owens Faught

The Department of Homelessness and Supportive Housing will provide an overview of the Adult Coordinated Entry process, primary assessment, and initial learnings from the Assessment Blitz. There will be a Q+A period following the presentation.

2019 01 18 Homeless Mortality in San Francisco: Opportunities for Prevention Barry Zevin, Caroline Cawley

This Whole Person Care Update will focus on the results of an ongoing review of homeless deaths in San Francisco. SF DPH Street Medicine and SF Whole Person Care have identified deaths among individuals experiencing homelessness using... Medical Examiner reports from 2016 – 2018 and have linked these cases to data from the Coordinated Care Management System (CCMS). This presentation will include a description of these deaths, including demographics, causes and locations of death, and housing, health and social service utilization history. We hope to engage the audience in a discussion of how we can use these results to promote policy change that could prevent similar deaths in the future.

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2018 11 16 Discovery Report by WPC Service Design and Evaluation Teams Amber Reed, Caroline Cawley

Join the Whole Person Care team for a review of our research findings, insights, and deliverables that will inform Whole Person Care’s work and approach moving forward....

Throughout 2018, our team conducted in-person, qualitative interviews and participatory design activities with key stakeholders and partners across City departments, agencies an didsciplines:

- To gauge awareness of the WPC pilot, objectives, and deliverables

- To better understand what is currently working and what is not for adults experiencing homelessness – especially our most vulnerable – with regards to care coordination and data sharing

- To identify opportunities for success and potential risks facing the WPC pilot

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2018 10 19 WPC Update on Current Projects Maria X Martinez

The Director of Whole Person Care updates stakeholders on current projects such as prioritization, benefits advocacy, Top 100 HUMS, interagency collaborations.