Treatment Decision Factors for Clinicians

Prioritize treatment decisions for unsheltered patients based on the following:

• Triage emergent and grave disability situations vs. urgent needs vs. chronic needs.
• Improve or maintain a patient’s personal safety in their environment.
• Reduce pain and suffering.
• Reduce risky or harmful behaviors.
• Improve the patient’s overall health.
• Address concerns from the mental, physical, substance use and trauma perspectives.
• Tailor treatment regimen to a patient’s ability, wishes, lifestyle, practicality and level of tolerance and adherence.
• Follow a respectful process of negotiation, persuasion and collaborative decision-making.

This decision-making framework stipulates that the clinician should adapt the treatment plan and document the recommendation based upon the above priorities for decision making. For example: 

• If a patient cannot come into the clinic for a blood test, could a medication be prescribed that does not require a blood test, even if it is not the typical first-line treatment option?
• When a patient cannot afford the ideal medication, can an alternative be prescribed or the care plan modified in some other way to reach a similar outcome?