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San Diego Police and Fire-EMS Innovation to Address Recidivism

Explore the effective programs implemented by San Diego Police and Fire-EMS to address recidivism rates among the homeless population and frequent users of public services. Discover the impact of the Serial Inebriate Program (SIP) and Project 25, as well as the resource access program (RAP) and Spice awareness initiatives.

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San Diego Police and Fire-EMS Innovation to Address Recidivism

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  1. 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 Center

  2. City of San Diego • 1.3 million population • 8th largest U.S. city • 4th largest homeless population

  3. SD Homeless Outreach Team SDPD HHSA PERT

  4. Serial Inebriate Program (SIP)

  5. SIP partners Police Department Fire-EMS Mental Health Systems Sheriff’s Department Alcohol and Drug Services City Attorney Public Defender Superior Court Medical Clinic

  6. SIP approach • Convict - 647(f)PC • Treatment in lieu of custody • Case manage w services • Positive support groups • Negative reporting

  7. SIP funding • 2001-2003 • Alcohol & Tobacco Settlement • 2003 - present • City - housing • County - treatment

  8. SIP: acceptance vs. duration of sentence acceptance 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

  9. 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):328-336

  10. 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

  11. Resource Access Program (RAP) http://centerforhealthreporting.org/project/health-care-911

  12. RAP community paramedics

  13. RAP alerting HIE StreetSense registry

  14. RAP: real-time situational awareness

  15. Effect of RAP: contacts and charges n = 51 clients 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.

  16. 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.

  17. Project 25 • 36 individuals • Homeless • High impact • Selected by: • SDPD • SD Fire-EMS • Mental health

  18. Project 25: impact on public services 2010 Base to 2013 * Includes crisis houses, detox centers, homeless shelters, legal assistance, Psychiatric Emergency Response Team 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

  19. 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. 2015

  20. Spice awareness: EMS vs. Poison Center§52.3301 San Diego Municipal Code

  21. America’s Finest City

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