Jim Dunford MD FACEP City EMS Medical Director Professor Emeritus Emergency Medicine UC San Diego Medical Center City of San Diego 13 million population 8 th largest US city ID: 616064
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Slide1
San Diego Police and Fire-EMS Innovation to Address Recidivism
Jim Dunford,
MD, FACEP
City EMS Medical Director
Professor
Emeritus (Emergency Medicine)
UC, San Diego Medical CenterSlide2
City of San Diego
1.3 million population8th
largest U.S. city
4
th largest homeless populationSlide3
SD Homeless Outreach Team
SDPD
PERT
HHSASlide4
Serial Inebriate Program (SIP)Slide5
SIP partners
Police Department
Fire-EMS
Mental Health
Systems
Sheriff’s
Department
Alcohol
and Drug Services
City
Attorney
Public
DefenderSuperior Court
Medical ClinicSlide6
Convict
- 647(f)PCTreatment in lieu of custody
Case manage w services
Positive support groups
Negative reporting
SIP approachSlide7
SIP funding
2001-2003
Alcohol
& Tobacco Settlement
2003
- presentCity - housing
County
-
treatmentSlide8
SIP:
acceptance vs. duration of sentence
Dunford JV et al. Impact of the San Diego Serial Inebriate Program (SIP) on use of emergency medical resources.
Ann Emerg Med
. 2006;47(4):328-336
acceptanceSlide9
Average charges per month, serial alcoholics:accepted (156) vs. declined (112) treatment
Dunford JV et al. Impact of the San Diego Serial Inebriate Program (SIP) on use of emergency medical resources.
Ann Emerg Med
. 2006;47(4):328-336Slide10
SIP: graduation and completion rates
Completion
remain sober x 6 months
attend 4, 90-minute sessions/week
show effort to obtain housing and employment
Graduation
“ “ and become financially stable and procure drug-free housing
Dodson J. The effectiveness and efficiency of SIP. The Sage Project. San Diego State
University.
Spring 2016 Slide11
http://centerforhealthreporting.org/project/health-care-911
Resource Access Program (RAP)Slide12
RAP community paramedicsSlide13
registry
HIE
StreetSense
RAP alertingSlide14
RAP: real-time situational awarenessSlide15
Effect of RAP: contacts and charges
Tadros AS, et al. Effects of an emergency medical services-based resource access program (RAP) on frequent users of health services
Prehosp Emerg Care
2012 Oct;16(4):541-7.
n = 51 clientsSlide16
Effect of RAP: Fire-EMS resources
Tadros AS, et al. Effects of an emergency medical services-based resource access program (RAP) on frequent users of health services
Prehosp Emerg Care
2012 Oct;16(4):541-7.Slide17
Project 25
36 individualsHomelessHigh impactSelected by:SDPD
SD Fire-EMS
Mental healthSlide18
Project 25: impact on public services
Reaser
L. Project 25: Housing the most frequent users of public services among the homeless.
Fermanian
Business and Economic Institute. Pt. Loma Nazarene
Unversity
. 2015
* Includes crisis houses, detox centers, homeless shelters, legal assistance, Psychiatric Emergency Response Team
2010 Base to 2013Slide19
Project 25 results
Reaser
L. Project 25: Housing the most frequent users of public services among the homeless.
Fermanian
Business and Economic Institute. Pt. Loma Nazarene University. 2015Slide20
Spice awareness: EMS
vs. Poison Center
§
52.3301 San Diego Municipal Code Slide21
America’s Finest City