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Marc Trotz, Director, Housing

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Title: Marc Trotz, Director, Housing


1
  • Marc Trotz, Director, Housing Urban Health
  • San Francisco Department of Public Health
  • Email marc.trotz_at_sfdph.org

2
Characteristics of the Homeless(n2508)
  • 75 male, 45 African American
  • 30 of males are veterans
  • 63 were current or past cocaine smokers with 35
    reporting current use
  • 39 had a history of using injection drugs
  • 23 hospitalized for mental illness
  • 63 had behavioral health disorder
  • Robertson et al, UCSF, 2003

3
Utilization of Resources
  • 3 times more likely to use ED than general
    population1
  • 40 use the ED at least once each year1
  • 10 used 40 of hospital days2
  • 1Kushel et al, UCSF, 2003
  • 2Fernandez et al, UCSF 2000

4
Why Does the Department Invest in Housing?
  • Reduce over-utilization of high-end healthcare
    resources
  • Increase the effectiveness of DPH services by
    providing a safe and healthy environment for
    clients
  • Provide housing tailored to the needs of clients
    and provide community-based exits from DPH
    institutions

5
Who Do We House?
  • Chronically homeless
  • People with complex medical BH disorders
  • People with a history of institutional care
  • People who have never or not successfully been
    housed

6
Direct Access to Housing Program (DAH)
  • Permanent housing
  • Master-leasing
  • Low threshold - directly from streets and
    institutions
  • On-site support services

7
DAH Services
  • Support services (case mgmt)
  • Medical care (nurses, NP, MD supervision)
  • Behavioral health team
  • Property management
  • Third party rent payment

8
Referral SystemAccess Points
  • Street outreach teams
  • Emergency shelters
  • Community-based organizations
  • High-utilizer case mgmt teams
  • Primary care clinics
  • Institutional settings

9
Practicing Low-Threshold Supportive Housing
  • Screening-in
  • Voluntary services
  • Active engagement
  • Tenants rights

10
DAH Units
New
New
11
Financial Information
  • 400 Support Services
  • 400 Lease
  • 400 Property Management
  • 1,200 per unit per month
  • Residents pay fifty percent of their income
    towards rent
  • (avg. rent paid is 300)

12
DAH Housing Outcomes
  • Two-thirds of residents remain housed for gt 2
    years

13
DAH Housing Outcomes
14
DAH Healthcare Outcomes
  • 58 reduction in emergency room use
  • 57 reduction in hospital inpatient bed use
  • Reduction in length of psychiatric
    hospitalization
  • Kessel and Kushel, UCSF, 2003

15
Windsor Hotel
16
Broderick Street Adult RCF
17
Pacific Bay Inn
18
  • Marc Trotz, Director, Housing Urban Health
  • San Francisco Department of Public Health
  • Email marc.trotz_at_sfdph.org
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