Agenda

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FAMILY AND HUMAN SERVICES COMMITTEE

Meeting Date:	11/15/2021
Subject: Health Care for the Homeless 2021 Update
Submitted For:	Monica Nino, County Administrator
Department:	County Administrator
Referral No.:	5
Referral Name:	Health Care for the Homeless / Homeless Continuum of Care
Presenter:	Dr. Ori Tzvieli, Public Health Director; Heather Cedermaz, Family Nurse Practitioner	Contact:	Enid Mendoza, (925) 655-2051

Information

Referral History:

Since 1990, the Health Care for the Homeless (HCH) Program has provided health care services to the homeless population in Contra Costa County through mobile clinics, stationary health centers, the Concord Medical Respite facility, street medical outreach clinics and the medication-assisted treatment program. Health care services provided by the HCH team include routine physical assessments, basic treatment of primary health problems such as minor wounds and skin conditions, respiratory problems, TB screening, acute communicable disease screening, coordination and referrals for follow up treatment of identified health care needs, dental services, health education, behavioral health services, medication assisted treatment for opioid addiction, and outreach and enrollment services. A significant portion of the homeless patients seen by the HCH team have chronic diseases, including asthma, hypertension, diabetes, and mental health/substance abuse issues. They also have disproportionately more dental, substance abuse and mental health needs than the general population.

The Family and Human Services Committee last received a Health Care for the Homeless report at its November 13, 2019 meeting. The report highlighted the increasing needs of the rapidly growing senior homeless population and provided an update on the increase in Medication Assisted Treatment for homeless patients with Opioid Use Disorder. It was noted that the number of patient visits was trending upward, male patients outnumbered female patients at a rate of 2:1, and the median age of patients was 45. Information on the four service models (ambulatory clinics, street outreach, mobile clinics, and shelter-based care) was provided. Ongoing challenges with the aging homeless population and the reticence of certain jurisdictions to provide appropriate sites for permanent and mobile clinics was discussed.

Referral Update:

The attached presentation includes program updates since the last report. Most importantly, it highlights the impact safe, non-congregate shelters has on the behavioral health and medical outcomes of our unhoused. In response to COVID-19, the Health Care for the Homeless program has provided direct medical and behavioral health services, COVID-19 testing, COVID-19 vaccinations and support services to those individuals living on the streets, in our shelters and in our Project Roomkey hotels.

Recommendation(s)/Next Step(s):

ACCEPT the annual Health Care for the Homeless report as presented by the Public Health Division of the Health Services Department, and forward to the Board of Supervisors for their information.

Fiscal Impact (if any):

This report is informational and there are no fiscal impacts associated with the acceptance of this report.

Attachments
Health Care for the Homeless Memo to FHS
2021 Health Care for the Homeless Presentation