Executive Summary
The Interim Housing Outreach Program (IHOP) is a joint initiative among the Departments of Health Services (DHS), of Mental Health (DMH) and of Public Health (DPH) to care for people experiencing homelessness (PEH) whose health compromises their ability to stay safely housed in interim housing. IHOP provides care on site with the goal of either supporting the client in their current place of residence or transitioning the client to a higher level of care, as appropriate. IHOP’s mission is to keep PEH housed.
IHOP practices a model of complex care management facilitated through the therapeutic alliance between a single anchor care manager and the client. Through this therapeutic alliance, the client has access to care from all three departments as needed. DHS cares for those unable to perform basic activities of daily living. DMH focuses on individuals who need psychiatric care. Lastly, DPH cares for those suffering from substance use disorder. The anchor care manager is commonly a medical case work, and the broader IHOP team includes medical doctors, nurse practitioners, nurses, occupational therapists, social workers and substance use counselors. The anchor care manager will remain with the client for as long as needed to keep the client safely housed.
Lastly, IHOP serves to link PEH to numerous other community resources. An anchor care manager can link clients to resources such as in-home caregiving (IHCG), Countywide Benefits Entitlement Services Team (CBEST), Enhanced Care Management (ECM), among others.
By July 1st, 2025, IHOP will operate in all eight SPAs throughout LA County.
Primary Goals of IHOP
- Provide services to clients with functional deficits due to unaddressed physical/behavioral health needs.
- Offer interim housing providers with technical assistance to manage clients with functional deficits.
- Identify ways to impact policy to better care for these populations in the future.
Target Clients We are actively seeking clients with specific needs:
- DMH focuses on individuals with unaddressed behavioral health and/or substance use disorders.
- DHS is dedicated to those unable to perform self-care and basic activities of daily living (ADLs).
- DPH seeks individuals with substance use challenges affecting interim housing tenancy
What IHOP Offers
- Access to high-quality, real-time physical health and behavioral health services (mental health and substance use disorder services) in 1:1 and group formats.
- Referral and placement of caregiver support for individuals needing ADL/iADL support.
- Referral to Community Based Engagement and Service Teams (CBEST) for SSI/SSDI/CAPI.
- Referral and placement into other housing if needed (recuperative care/ERC/stabilization).
- Referral to housing navigation Integrated Care Management Services (ICMS)
- Technical assistance to improve the ability of shelter staff to care for clients with functional deficits.
- Field-based assessment teams for screening and referrals to community supports, enhanced care management, and other services offered by health plans, including Medi-Cal redetermination.