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

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

3. 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”

4. 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

5. 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

6. 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.

7. 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