The Orange County Board of Supervisors was approved funding through the State of California’s Department of Health Care Services’ (DHCS) to expand its Whole Person Care (WPC) pilot program. Round 2 will provide additional recuperative care beds and expand the WPC system to include homeless shelter programs.

WPC coordinates physical health, behavioral health and social services in a patient-centered approach to improve health and well-being for Medi-Cal beneficiaries struggling with homelessness. The program combines increased communication among hospital emergency rooms, homeless shelter programs, CalOptima, community clinics, OC Health Care Agency (HCA) Behavioral Health Services and Public Health Services, as well as recuperative care providers and other community-based providers to improve access and navigation of services for the homeless population. 

The Board of Supervisors approved the application for the funding in June 2016, pledging to contribute local matching funds of $23.5 million annually over five years from Mental Health Services Act dollars and tobacco-settlement funds. In March 2017, the Board approved an expansion application pledging additional County General Fund dollars as match funding. As a result, the County will receive an increased match in federal dollars, with total spending reaching $31,066,860 over the course of the program.

A federally mandated snapshot of the homeless situation, taken every two years in Orange County, indicated homelessness is on the rise. The 2017 Point in Time Count recorded 4,792 homeless people, more than half living without shelter, according to the OC Register. The 2015 survey documented 4,452 homeless people.

“The County is taking a broad approach to homelessness by building a system of care that enables efficiencies among available resources,” said Chairwoman Michelle Steel, 2nd District Supervisor. “The Whole Person Care Pilot is one of the important steps forward in building a sustainable and coordinated system.”

Orange County received notification in June 2017 that the WPC Round 2 application was approved. Funding for Round 2 of the WPC Pilot proposes to do the following:

  • Incorporate the shelter providers as WPC participating entities.

  • Fund additional recuperative care beds specifically targeted to medically fragile individuals in the shelter programs.

  • Add homeless outreach and navigation staff to four additional community clinics.

  • Include a public health nurse to review recuperative care placements.

  • Provide funding for the bi-directional, electronic sharing of information between the WPC Care Plan and CalOptima’s Care Plan.

The WPC Pilot Round 2 was scheduled to begin July 1, 2017, and will fund approximately 27,320 recuperative care bed nights through Dec. 31, 2020.

“Increasing recuperative care beds and adding another entry point into the Whole Person Care Pilot system is exactly what’s needed,” said Supervisor Todd Spitzer, 3rd District. “Working with the homeless population in a holistic way that addresses health, addiction, job re-entry and mental health services will provide relief to emergency rooms in ways we haven’t seen before.”

Recuperative Care is acute and post-acute medical care respite for homeless persons who are too ill or frail to recover from a physical illness or injury but are not ill enough to be in a hospital or skilled nursing facility. Recuperative Care is short-term residential care that allows homeless individuals the opportunity to recover in a safe environment while accessing medical care and other supportive services, and can be offered in a variety of settings, including freestanding facilities, homeless shelters, motels, nursing homes, and transitional housing.

“This cost-efficient model incorporates links to services to stabilize high-risk patients who would otherwise rely on the emergency room for their primary care,” said Supervisor Shawn Nelson, 4th District.

With the initial WPC application, the WPC Pilot focused on referrals to Recuperative Care primarily from hospitals, as well as a smaller number of persons that could be referred directly from community clinics to avoid unnecessary emergency department visits. With WPC Pilot Round 2, some of the additional bed days will be used specifically for referrals from County- funded shelter programs such as the Courtyard. This also enhances linkages for referrals from the Health Care Agency's (HCA) Behavioral Health Services and Public Health Services teams for persons with medical or co-occurring physical and mental health/substance use disorder issues. 

“The need for a program like this has been years in the making,” said Supervisor Lisa Bartlett, 5th District. “As a member of the CalOptima Board of Directors, seeing it expand to offer more services and greater access is another huge step in a coordinated approach to caring for our most vulnerable population.”

The WPC goals are consistent with the County’s ongoing efforts to meet the needs of those without stable housing. To learn more about WPC, please visit www.ochealthinfo.com/WPC. To learn how the County is working with cities and community-based organizations to build a system of care to improve the countywide response to homelessness, visit its Care Coordination website at http://www.ocgov.com/gov/ceo/care.

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