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Safe Haven Clinic Institute
(SHCI)

What Is The SHCI?

This is where the planning happens. The Safe Haven Clinic Institute is a 501c3 (community benefit organization) working toward innovations to end homelessness and addiction through capacity building, technical assistance and education. As an institute, we are a learning organization and think tank which ensures our decisions are guided by wisdom. We connect funds to the frontline innovation in the Safe Haven Clinic space by endorsing pilot projects linked through the Safe Haven Clinic Collective – but we don’t operate those sites in any way.

Help transform this Safe Haven Clinic ideal into a reality by learning more About the Safe Haven Clinic Institute, understanding the History of this organization, or by joining the movement.

What Would A Safe Haven Clinic Be And Why?

Improved health among the unhoused is necessary for achieving stable housing and thus ending homelessness. After years of exploration, SHCI has come to believe in a utopian model of street level care delivery for improving the overall health of complex homeless populations called the Safe Haven Clinic.

The Safe Haven Clinic model is an innovation that is yet to be fully tested and has the potential for making a positive impact on the overall health of complex homeless populations.

In the Safe Haven Clinic model, services are ideally integrated under one roof and co-located with the homeless populations being served. Safe Haven Clinic services ideally include 24/7 nursing and case management, Street Medicine, Medical Respite, Sobering and Pharmacy care for people experiencing street level homelessness. With a low threshold to entry, street level homeless patients would be able to stay in the Safe Haven Clinic for 12 hours up to 14 days with 24/7 nursing and case management providing continuous staffing. Such a high level of clinical care is needed by many homeless people to heal from the extreme stress of living unhousd and prepare them for transitions to permanent supportive housing.

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Why Safe Haven Clinics?

Current systems of care are failing people experiencing the co-occurring epidemics of homelessness and addiction. The pandemic has further amplified foundational inequities. Combined Street Medicine, Medical Respite, Sobering and Pharmacy offers a synergistic solution.

What Would A Safe Haven Clinic Be?

Safe Haven Clinic services would be integrated under one roof: 24/7 nursing, Street Medicine, Medical Respite, Sobering and Pharmacy care for people experiencing homelessness and/or addiction. With a low threshold to entry, patients, patients would be able to stay for 12 hours up to 14 days.

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Why Safe Haven?

Current systems of care are failing people experiencing the co-occurring epidemics of homelessness and addiction. The pandemic has further amplified foundational inequities. Street Medicine, Medical Respite, Sobering and Pharmacy offering a synergistic solution.

Street Medicine Institute (SMI): SMI has become the global leader in developing the field and practice of Street Medicine and has helped cultivate or improve Street Medicine programs in over 85 cities located in 15 countries across 5 continents.

From the hospital to the streets: Bringing care to the unsheltered homeless in Los Angeles Author links open overlay panel by Brett J.Feldman, Jeniffer S. Kim, Laura Mosqueda, Hurnan Vongsachang, Josh Banerjee, Charles E. Coffey Jr., Brad Spellberg, Michael Hochman, Jehni Robinson. Sept 2021.

Street Medicine: Creating a “Classroom Without Walls: for Teaching Population Health by Noemi “Mimi” Doohan, MD PhD, MPH & Ranit Mishoi, MD, MHS. Nov 2019.

Street medicine: an example of reality-based health care by Jim Withers, MD. J Health Care Poor Underserved. Feb 2011.

Finding Patients Where They Live: Street Medicine Grows Along with Homeless Population by Soumya Karlamangla for the LA Times. Feb 2020.

The Homeless Get Sick; ‘Street Medicine’ Is There for Them by David Montgomery for Stateline. Sept 2018.

In the Woods and in the Shadows, Street Medicine Treats the Nation’s Homeless by Laurie McGinley for The Washington Post. Nov 2017.

Video: The Street Medicine Movement by Jim Withers, MD. TEDxPittsburgh. July 2015. 

Street Medicine

Brings care to people experiencing homelessness where they live using mobile interdisciplinary medical teams. The brick and mortar Safe Haven Clinic offers Street Medicine teams the space to provide open access, and follow up visits when not operating mobile clinics.

Why is partnership with law enforcement and 1st responders a benefit to Street Medicine and how does the Safe Haven Clinic model help?
The ideal relationship goes both ways. Street Medicine teams get referrals for where to bring back pack medicine directly to the streets. And 1st responders and law enforcement bring people needing care directly to the Safe Haven Clinic, bypassing hospital emergency departments, and in some cases, jail.

Street Medicine

Brings care to people experiencing homelessness where they live using mobile interdisciplinary medical teams. The brick and mortar Safe Haven Clinic offers Street Medicine teams the space to provide open access, and follow up visits when not operating mobile clinics.

Why is partnership with law enforcement and 1st responders a benefit to Street Medicine and how does the Safe Haven Clinic model help?
The ideal relationship goes both ways. Street Medicine teams get referrals for where to bring back pack medicine directly to the streets. And 1st responders and law enforcement bring people needing care directly to the Safe Haven Clinic, bypassing hospital emergency departments, and in some cases, jail.

Street Medicine Institute (SMI): SMI has become the global leader in developing the field and practice of Street Medicine and has helped cultivate or improve Street Medicine programs in over 85 cities located in 15 countries across 5 continents.

From the hospital to the streets: Bringing care to the unsheltered homeless in Los Angeles Author links open overlay panel by Brett J.Feldman, Jeniffer S. Kim, Laura Mosqueda, Hurnan Vongsachang, Josh Banerjee, Charles E. Coffey Jr., Brad Spellberg, Michael Hochman, Jehni Robinson. Sept 2021.

Street Medicine: Creating a “Classroom Without Walls: for Teaching Population Health by Noemi “Mimi” Doohan, MD PhD, MPH & Ranit Mishoi, MD, MHS. Nov 2019.

Street medicine: an example of reality-based health care by Jim Withers, MD. J Health Care Poor Underserved. Feb 2011.

Finding Patients Where They Live: Street Medicine Grows Along with Homeless Population by Soumya Karlamangla for the LA Times. Feb 2020.

The Homeless Get Sick; ‘Street Medicine’ Is There for Them by David Montgomery for Stateline. Sept 2018.

In the Woods and in the Shadows, Street Medicine Treats the Nation’s Homeless by Laurie McGinley for The Washington Post. Nov 2017.

Video: The Street Medicine Movement by Jim Withers, MD. TEDxPittsburgh. July 2015. 

Sobering Center

A safe place for achieving short term sobriety with a length of stay of 12 hours. An alternative to unnecessary jail or ER stays for public intoxication.

How do Sobering Centers save hospitals and jails money?
Law enforcement and 1st responders divert inebriated people instead to the Sobering Center where they can safely and humanely achieve short term sobriety. That’s an enormous savings for hospitals and jails, where people in need of sobering often end up.

American Society of Addiction Medicine (ASAM)

National Sobering Collaborative

Substance Abuse and Mental Health Services Administration (SAMHSA)

Utilization of a Sobering Center for Acute Alcohol Intoxication by Shannon Smith-Bernardin, PhD, RN, Adam Carrico, PhD, Wendy Max, PhD, and Susan Chapman, PhD, RN, FAAN Academic Emergency Medicine

A pilot study of emergency medical technicians’ field assessment of intoxicated patients’ need for ED care by A.H. Cornwall, N. Zaller, O. Warren, K. Williams, N. Karlsen-Ayala, & B. Zink. The American journal of emergency medicine

Safe sobering: San Francisco’s approach to chronic public inebriation by Shannon Smith-Bernardin & Michelle Schneidermann “Journal of Health Care for the Poor and Underserved”

California Health Care Foundation/Alcohol Management and Program Pilots

Portland police look for new agency to provide roving van, sobering center for people intoxicated or on drugs by Maxine Bernstein for The Oregonian

How Austin’s Sobering Center is offering an alternative to jail by Taylor Goldenstein for the Austin American Statesman

Sobering Center

A safe place for achieving short term sobriety with a length of stay of 12 hours. An alternative to unnecessary jail or ER stays for public intoxication.

How do Sobering Centers save hospitals and jails money?
Law enforcement and 1st responders divert inebriated people instead to the Sobering Center where they can safely and humanely achieve short term sobriety. That’s an enormous savings for hospitals and jails, where people in need of sobering often end up.

American Society of Addiction Medicine (ASAM)

National Sobering Collaborative

Substance Abuse and Mental Health Services Administration (SAMHSA)

Utilization of a Sobering Center for Acute Alcohol Intoxication by Shannon Smith-Bernardin, PhD, RN, Adam Carrico, PhD, Wendy Max, PhD, and Susan Chapman, PhD, RN, FAAN Academic Emergency Medicine

A pilot study of emergency medical technicians’ field assessment of intoxicated patients’ need for ED care by A.H. Cornwall, N. Zaller, O. Warren, K. Williams, N. Karlsen-Ayala, & B. Zink. The American journal of emergency medicine

Safe sobering: San Francisco’s approach to chronic public inebriation by Shannon Smith-Bernardin & Michelle Schneidermann “Journal of Health Care for the Poor and Underserved”

California Health Care Foundation/Alcohol Management and Program Pilots

Portland police look for new agency to provide roving van, sobering center for people intoxicated or on drugs by Maxine Bernstein for The Oregonian

How Austin’s Sobering Center is offering an alternative to jail by Taylor Goldenstein for the Austin American Statesman

Health Resources and Services Administration (HRSA) 340B Drug Pricing Program

National Health Care for the Homeless Council (NHCHC)/Prescription Drugs

RxAssist: Database of patient assistance programs run by pharmaceutical companies to provide free medications to people who cannot afford to buy their medicine.

Descriptive study of homeless patients’ perceptions that affect medication adherence by Matthew J Richler, Pharm.D, Sara Yousaf, Pharm.D, Stephen W Hwang, M.D., M.P.H, Norman F Dewhurst, Pharm D. American Journal of Health-System Pharmacy

Hope for the homeless: how pharmacy is supporting those living on the streets by Julia Robinson for The Pharmaceutical Journal

Pharmacy

Provides on-site prescription medication dispensing and management, including Medication Assisted Treatment (MAT), vaccinations, and laboratory testing.

Why is medication management an important function of pharmacies?
People experiencing homelessness face challenges to accessing lab services, getting their medication refilled or new meds prescribed. Often there is no safe place to store medication, and meds get lost or stolen. Having an on-site pharmacy with medication management support can mean the difference between life and death or preventable disease.

Pharmacy

Provides on-site prescription medication dispensing and management, including Medication Assisted Treatment (MAT), vaccinations, and laboratory testing.

Why is medication management an important function of pharmacies?
People experiencing homelessness face challenges to accessing lab services, getting their medication refilled or new meds prescribed. Often there is no safe place to store medication, and meds get lost or stolen. Having an on-site pharmacy with medication management support can mean the difference between life and death or preventable disease.

Health Resources and Services Administration (HRSA) 340B Drug Pricing Program

National Health Care for the Homeless Council (NHCHC)/Prescription Drugs

RxAssist: Database of patient assistance programs run by pharmaceutical companies to provide free medications to people who cannot afford to buy their medicine.

Descriptive study of homeless patients’ perceptions that affect medication adherence by Matthew J Richler, Pharm.D, Sara Yousaf, Pharm.D, Stephen W Hwang, M.D., M.P.H, Norman F Dewhurst, Pharm D. American Journal of Health-System Pharmacy

Hope for the homeless: how pharmacy is supporting those living on the streets by Julia Robinson for The Pharmaceutical Journal

Medical Respite

Designed for people experiencing homelessness and/or addiction who need medical care but aren’t sick enough to be hospitalized. Examples include end of life care, medically supervised detox from drugs and/or alcohol and general recuperative medical care.

Why is it important to include medically supervised detox in Medical Respite?
A physician directed and nurse led clinic is critical to providing those suffering from substance and alcohol addiction medically safe withdrawal treatment, including MAT. Alleviating painful and traumatic withdrawal symptoms allows people to focus on recovery.

Medical Respite

Designed for people experiencing homelessness and/or addiction who need medical care but aren’t sick enough to be hospitalized. Examples include end of life care, medically supervised detox from drugs and/or alcohol and general recuperative medical care.

Why is it important to include medically supervised detox in Medical Respite?
A physician directed and nurse led clinic is critical to providing those suffering from substance and alcohol addiction medically safe withdrawal treatment, including MAT. Alleviating painful and traumatic withdrawal symptoms allows people to focus on recovery.

Are You Imagining A Fully Integrated Clinical Solution For Homelessness & Addiction In Your Community?

Create a Safe Haven Clinic and improve the quality of care for people experiencing homelessness and addiction.

Join the Collective, join the movement!