View of San Francisco homeless healthcare based on city-wide administrative data

To understand the provision of healthcare for people experiencing homelessness, it is necessary to define who is homeless currently or in the past, create unduplicated counts, and review the comparative validity of that count against other point-in-time counts and estimates. Once these decisions have been made, population profiles can be created by tracing service utilization, medical and mental health diagnoses, substance use, social and criminal justice conditions, deaths, demographics, benefits availability, and system costs.

In this presentation the San Francisco Department of Public Health (SFDPH) will discuss progress we have made in developing our standardized SF Healthcare for the Homeless status reports, and review current data. These reports reveal rates of disease progression, early mortality, relative risk compared to other populations, and rates and types of recovery due to health and housing interventions.

Our annual reports are based on administrative data held in the Coordinated Care Management System (CCMS). CCMS is a comprehensive data warehouse that draws critical information from stand-alone databases in many medical, mental health, substance abuse, housing, shelter and criminal justice programs. Patients whose bio-psycho-social histories are held in CCMS include target populations considered vulnerable, i.e., the homeless, public inebriates, elderly, and other users and of urgent/emergent care systems over the past 10-20 years. To date, CCMS contains over 300,000 adult individuals who have used the City's safety net services. Over 90,000 have at one time been flagged as homeless.