Whole Person Care

People who struggle with chronic homelessness, mental illness and substance abuse cannot break the cycle of hopelessness and addiction on their own. They need strong, coordinated and effective community-based support systems to get back on their feet and eventually stand on their own. A new pilot program in 18 California counties called Whole Person Care is building these vital support systems from existing local resource networks.

San Mateo County started its Whole Person Care pilot in 2016, in response to Medi-Cal 2020, and aims to help 5,000 people by 2020. San Mateo County Health System (SMCHS) leads the effort, coordinating a group of 15 local partner organizations that provide services ranging from substance abuse counseling and psychotherapy to medical care and housing assistance. The pilot focuses on helping some of the county's highest utilizers of the Emergency Department. HPSM is one of the pilot partners, and all Whole Person Care participants in San Mateo County are HPSM members.

The pilot has allowed the creation and expansion of several county programs such as, but not limited to: 

  • Bridges to Wellness A partnership led by San Mateo County that provides Care Navigation and Mobile Health Clinic support to people in shelters, other field sites, and transitioning from jail and emergency departments, providing field-based medical care and care coordination
  • Community Care Settings Program (CCSP) A partnership with Institute On Aging and the housing assistance nonprofit Brilliant Corners designed to prevent institutionalization and to transition members from institutions to community living
  • Integrated Medical Assisted Treatment Program (IMAT) A partnership led by Behavioral Health Recovery Services (BHRS) that targets high-use Medi-Cal recipients with chronic substance use disorders and housing supports not billable through Medi-Cal

Praise for Whole Person Care

"Getting direct referrals from Whole Person Care partners greatly streamlines the housing referral process, allowing us to find suitable housing for people who desperately need it much more quickly."

Nelly To

Program Director, Brilliant Corners

"Whole Person Care brings all parts of the health system together to treat the ‘Whole Person.’ This collaborative care coordination model enables us to help people with complex needs live longer, better lives."

Lucinda Dei Rossi

Manager of the Whole Person Care Pilot, San Mateo County Health System

"The needs of our most complex members often cannot be adequately addressed by our traditional medical care approaches. Whole Person Care allows us to more effectively support and bridge the psychosocial factors that negatively impact a person’s overall health."

Dr. Susan Huang

Chief Medical Officer, Health Plan of San Mateo