Growing and Financing Steady Lodging In Los Angeles.

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Give staff the chance to do what they are prepared to do ... SSI/MediCal qualification assets. Use FQHC to contract Behavioral Health staff. Increment Medi ...
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Extending and Financing Supportive Housing In Los Angeles Joshua Bamberger, MD, MPH San Francisco Dept. of Public Health

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Overview Financing strong lodging Comparing structures and administrations Model of giving medicinal services to housed individuals Integration of emotional wellness and therapeutic administrations Mainstream income to pay for administrations

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Financing Supportive Housing

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Tale of 3 Buildings Plaza Folsom-Dore Empress

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$30 million development Private speculators accepting duty credits from Feds Business model incorporates inhabitant rent, rent endowments Plaza Apartments

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Costs $ 448,636/yr in rent sponsorships Sliding scale rent-half pay @$350/month $ 459,830/year in bolster administrations contract $150,000/yr in on location restorative staff $1,058,000 yearly open consumption $445,000 in rent $1,417/customer/month $1.5 million yearly spending plan

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Is Homelessness Cheaper than Housing? All out Public Health Costs to be Homeless $1.9 million Total Public Health Costs to be Housed $1.2 million

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Health cost lessening first year Plaza $ 1,709,000 aggregate; $20,105 per occupant Folsom Dore $521,000 all out; $20,864 per inhabitant Empress (excluding SNF) $ 943,500 aggregate; $11,100 per inhabitant

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Conclusions Increase lodging dependability/diminish costs when Mixed populace structures High centralization of seniors High quality design and lofts Neighborhood with less medication use/deals Case directors can accomplish undertakings Why? Injury

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Financing Healthcare Services

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Mainstream Healthcare Funding Sources Medi-Cal charging FQHC Historic binds to OEO/War on Poverty HRSA Community Health Centers Other Opportunity to end vagrancy

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FQHC Must apply to both Feds for wellbeing focus status and State for experience Rate dictated by aggregate cost/all out patients

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FQHC-charging (cont\'d) Patient must have Medi-Cal Rate for purpose of administration by authorized suppliers No breaking point on time span per visit No more than one visit/day for Primary Care No more than 2 visits/month for other consideration

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MD, DO NP/PA Psychiatrists Psychologists LCSW (2/month) Acupuncture (for SA) Podiatry Dentists RN MFT Case supervisors Med Assistance MSW (not authorized) Types of suppliers Allowed Not Allowed

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Satellites Can open practically anyplace Must not be open over 20hrs/week Must treat pts enlisted in home facility as PC Need Fire Marshall and state endorsement Include in extent of work

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Components of High Productivity Clinical Functions Low bolster staff to supplier proportion High Medi-Cal Penetration Mix of drop in and arrangement Variety of staff expertise set and claims to fame Adherence help One quit shopping

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Housing and Urban Health Clinic

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HUH Clinic Funding FQHC conceded as a component of Federal Grant Functioned as satellite as HCH site Used year of satellite capacity to concoct cost report Made evaluations of staff time doing PC Received 80% of asked for rate $202.40 per visit

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HUH Clinic Staffing 10 mid-levels (2 psych NP) 1 FT MD 1 Part-time Med Director Clinic Director is NP 5 Full or low maintenance specialists (3 FTE) 1 RN, 1 Americorp, 1 EW, 1 Clerk Adherence program: 1 SW, 1 RN, 1 NP

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Components of Model First entryway is correct entryway hybrid of med and psych Build on relationship Reduce understanding holding up time Give staff the chance to do what they are prepared to do Staff set length of visit/blend of drop-in, arrangement Embrace vicarious injury

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Cost Annual Budget: $2.1 million Annual Revenue: $2.3 million Need gift cash for advancement

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LA HCH Medi-Cal uptake: 10% FQHC rate: $120 High bolster staff to clinician proportion Huge destitute wellbeing request Silo\'d emotional wellness and restorative consideration HUH Medi-Cal redesign: 80% FQHC rate: $202 Low bolster staff to clinician proportion Large pop in steady lodging Integrated psychological wellness and therapeutic Comparison of HUH and LA HCH

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Recommendations Invest in SSI/MediCal qualification assets Use FQHC to enlist Behavioral Health staff Increase Medi-Cal FQHC rate Set up facility halfway to serve all individuals in strong lodging

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Conclusions Mainstream subsidizing can bolster center administrations Local assets to bolster rent sponsorships and on location administrations Decrease in downstream $ is more noteworthy than open consumptions contention for day rate

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