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Homeless people overuse ERs. Sacramento has a $64 million plan to fix the problem

Steinberg has 'no guarantee, but a real chance' on fighting homelessness

In June 2017, the Sacramento mayor spoke about a comprehensive approach to help homeless people in the city.
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In June 2017, the Sacramento mayor spoke about a comprehensive approach to help homeless people in the city.

Sacramento is set to receive about $32 million in federal funds over nearly four years to keep homeless people out of emergency rooms, making it the only city in California to participate in a pilot program meant to reach the state’s poorest and sickest people before they need critical care.

Mayor Darrell Steinberg, who has long focused on mental health issues, said Monday that if approved by the City Council, the funds would help the city take an “aggressive approach” to getting people off the streets by targeting those with the most severe problems and often the greatest resistance to accepting help. The state-run program uses federal health care dollars to target people who overuse expensive services such as emergency rooms and ambulances.

“We’re living with the consequences of untreated mental illness and the lack of a comprehensive way to alleviate homelessness in a significant way,” Steinberg said.

Previously, only counties, tribal agencies or certain other groups could apply for the money, which is officially known as the Whole Person Care pilot program. But after the county of Sacramento decided not to pursue the funding last year, the city asked and received permission from the California Department of Health Care Services to apply alone, Steinberg said.

The city expects the money will let it reach 3,250 people during the 3  1/2 years the program will run, doubling or tripling its current capacity for outreach and potentially putting half of those people into housing. The city also hopes to lower the caseload of outreach workers during the same period by up to 75 percent so that those navigators can give more attention to each client.

The pilot program is run by the state but uses federal money from Medicare and Medicaid. The money can’t be used for housing, but is meant to fund medical and social services that can get people on the path toward housing and help them obtain medical and psychological treatment.

Participating hospitals will create a database of people who frequently come into emergency rooms, said Emily Halcon, the city’s homeless services coordinator. If they qualify for Medi-Cal and are homeless or at risk of homelessness, the city will pay for outreach workers to find them on the streets and intervene before they use expensive critical care services.

“We don’t want it to be you happen to run across a navigator in the system so you get service,” said Halcon. “We’re going to have the resources to go there and find them.”

Along with finding out who is using emergency rooms, Steinberg envisions putting mental health professionals on ambulances and with police to funnel more people into housing programs where they can also receive “wrap-around” services such as counseling and addiction treatment. He also wants to hire more skilled outreach workers so they can serve severely mentally ill people or those resistant to help.

“The amount of time and money that our Police Department, our Fire Department and Public Works spends on the mess that is homelessness, we can put those resources to other community priorities,” Steinberg said.

The city is partnering with local health care providers including Sutter Health, Dignity Health, UC Davis and Kaiser Permanente as well as nonprofit agency Sacramento Covered to gather an initial investment of about $8 million a year for almost four years. For every dollar the city invests, it will get a matching dollar from the state, bringing in up to $64 million by 2020 for health-related services to homeless people and those at risk of losing their housing.

The first year, the city expects to invest $2.3 million of its own money and $5.7 million from health care partners in the program. Sacramento Covered has pledged about $2.2 million annually over four years while Sutter is giving just over $2 million a year. Dignity is contributing $1.5 million annually, Kaiser will give $500,000 a year for three years and UC Davis will contribute $250,000 annually for three years.

The Sacramento program is expected to start by early next year if the City Council votes Tuesday to join the program.

Anita Chabria: 916-321-1049, @chabriaa

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