SHARP DOWNTOWN SENIOR SERVICES

Community Needs Assessment Integrated Services – Physical health – Mental health – Psychosocial services – Socialization

Challenge Separate funding streams Appeal to city/county Separate organizations

SOLUTION COORDINATED CARE: (a virtual “PACE-like” Program)

INTEGRATED CORE SERVICES Physical Health Social Work & Social Services Mental Health THE CLIENT

ORGANIZATIONS INVOLVED

48 years serving the San Diego Community $$___ in under & uncompensated care to San Diego Residents in 1999 Leading Provider of HealthCare in San Diego Recognized Nationwide for Competencies in Numerous Medical Specialties Originator of Sharp Senior Health Center Comprehensive Senior Care Model Commended by JCAHO 1997 & 2000 for Sharp Senior Health Center SHARP Memorial Hospital

SHARP Mesa Vista Hospital Leading Provider of Inpatient, Outpatient Adolescent and Adult Mental Health Services in San Diego County Six years of Coordinated Care Delivery with Senior Community Centers PET Team HOT Team Member Dedicated Geriatric Psychiatry Program

Senior Community Centers 25 years serving seniors in San Diego Daily Meals Provided to Approximately 1,000 seniors Leading Provider of Senior Nutrition and Psycho-Social services in the County Innovator in Low-income Senior Housing

FUNDING SOURCES SMH Medicare Medi-Cal Grants Private Donations CDBG Capital $$ SCC SD County Grants Private Donations SMV Medicare Medi-Cal Grants Private Donations

PHYSICAL HEALTH SERVICES Primary Care Podiatry Nutrition Assessment Pharmacy Assessment Health Education Coordinated Ancillary/Specialty Care

 Medication Assistance Program  RN Case Management  Health Screenings  Insurance/Billing Assistance  Medical Social Work

MENTAL HEALTH SERVICES  Psychiatric Consultation  SRO Manager/Resident Outreach  Mental Health Education  PET Team  Inpatient/Outpatient Care  Outreach Case Management

PSYCHO-SOCIAL SERVICES Socialization Nutrition Social Services Harm Reduction Home Delivered Meals Case Management Residential Living

Case Study Mr C. 63 yo wm Dx: Multiple medical problems – Hx stroke, MI, – DM – HTN – Hypercholesterolemia – Nocturia, incontinence

Mr. C (continued) Social issues – MediCal eligibility problems – Housing – Boredom – Lack of self esteem

Mr. C (continued) Psych issues – Referred pt to Cross Cultural Grant Program (through Mesa Vista- pts seen at SCC)