UCSF Citywide Case Management Programs

Medical-Legal Partnership to Prevent Recurrent Homelessness

Model and Strategy

UCSF Citywide Case Management Programs (UCSF/Citywide) supports the recovery of San Francisco’s highest risk mentally ill adults, reducing their use of institutional and acute care while helping maximize their ability to maintain stable, productive, fulfilling lives in the community. The largest drivers of poor health among clients at UCSF/Citywide are chronic homelessness and unstable housing. Sharing Battery Powered's commitment to addressing homelessness through a people-­centered, data driven approach, we propose creating an innovative Medical-­Legal Partnership (MLP) between Citywide and a local legal aid organization, integrating on­site legal expertise in a health care setting to address the health­-harming civil legal needs that perpetuate recurrent homelessness among our 1500 clients with serious mental illness. The long-term goal of the MLP is to address social determinants of health by identifying and tackling health­-harming civil legal needs, including landlord/tenant issues, evictions, unsafe housing, and public benefits denials, all of which will improve housing access and retention. For example, assistance with benefits will give clients the financial resources to access and retain housing, while assisting with clients’ eviction defense will help curb the tide of evictions that contribute to recurrent homelessness.

Impact

If successful, our project will make substantial headway in helping to resolve a range of legal issues facing our clients by addressing (1) eviction, (2) problematic housing conditions, (3) denial of public benefits, and (4) housing discrimination, which impact their ability to remain in a safe, stable home. Housing-related issues have a substantial impact on physical and mental health. Re-housing of homeless individuals reduces health expenditures and, for those with serious mental illness, improves key mental health outcomes. The Citywide Medical-Legal Partners Project will support a range of efforts to secure and protect housing for our clients by leveraging the expertise of on-site legal counsel. By creating and implementing a systematic screening process, we expect to identify threats to housing earlier, thus preventing homelessness. Additionally, through formal trainings and consultation, our MLP will be a source of ongoing education and training to our clinical teams. This dissemination of our legal partner’s expertise will build the capacity of our clinical staff, allowing them to more effectively recognize, triage, and assist in resolving legal needs over time. Lastly, we have developed a plan to rigorously evaluate the performance of our program, institute continuous quality improvement, and identify best practices to contribute to the evidence base for this innovative approach. The Citywide Medical-Legal Partnership Project will support a range of ongoing efforts to secure housing for our clients by providing a systematic process to utilize legal counsel where relevant. Because screening will be a core part of our process, we expect to identify eviction threats earlier, reducing the risk of homelessness for our clients. By assisting in the resolution of other legal matters such as benefits denial and employment discrimination, we will further empower our clients to obtain and maintain housing by alleviating other financial and legal threats that may place housing at risk. Additionally, through formal trainings and regular staff consultation, our MLP will be a source of ongoing education and training for case management staff, employment specialists, physicians, and other personnel. This dissemination of our legal partner’s expertise will build the capacity of our clinical staff, allowing them to more effectively recognize, triage, and assist in resolving legal needs over time.
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Leadership

  • Fumi

    Fumi Mitsuishi, MD, MS

    Executive Director

  • Carrie

    Carrie Cunningham, MD, MPH

    Project Lead