Amanda Wilkinson, LCSW Supervisor, Case Management Homelessness at enloe Amanda Wilkinson, LCSW Supervisor, Case Management

Healthcare challenges High frequency users Crisis needs Phone access Transportation Lack of Primary Care Physicians Lack of accepting skilled nursing facilities

The Cost of Homelessness Data was pulled from demographics and diagnoses that include the following sources: Shelter addresses “Homeless” as an address Jesus Center address Any diagnostic code of “homeless”

Visit Trends Diabetes Alcohol Related Mental Health/Suicidal Ideation Drug Abuse Respiratory Issues/Cough Mouth and Teeth Back pain General Symptoms Chest Pain Abdominal Pain Injury Prescription Refills

Estimated Costs For the time period of July 1, 2012-June 30, 2013: Patient Count  |  2,835 Total Charges (after payments received)  |  $10,217,277 For the time period of July 1, 2014-June 30, 2015: Patient Count  |  3,810 Total Charges (after payments received)  |  $14,245,250

Supportive Resources at Enloe Social Work and Case Management Partnering with shelters, skilled nursing facilities and other agencies to develop safe discharge plans and optimize resources. Basic assistance with bus tickets, clothing, medication as appropriate Transitional Care Coordinators Community Paramedic Program Emergency Department Resource Nurses Increasing access to PCP through partnership with Ampla, NVIH, and Immediate Care.

Considerations for the future… Include Managed Medi-Cal plans and case management providers to investigate innovative reimbursement opportunities Recognize need for access to custodial care authorization Find reimbursement incentives or grants for collaboration amongst agencies Explore Healthcare for the Homeless plans Community collaboration with Salvation Army Decrease barriers to PCP access Increase case management in the out patient setting Mobile healthcare through