Downtown IMPACT
Michelle Silva, Program Director
Alyx Earl, Assistant Program Director
995 Gateway Center Way, Suite 300
San Diego, CA 92102
(619) 398-2156
(619) 398-2168
Downtown IMPACT


Downtown IMPACT (Intensive Mobile Psychosocial Assertive Community Treatment) is a program of Community Research Foundation that provides intensive, community-based, case management services for 360 homeless adults in the Downtown region of San Diego County. Downtown IMPACT delivers fully integrated services to clients diagnosed with a serious mental illness, as well as individuals with co-occurring, mental health and substance disorders. The program maintains high fidelity to the evidence-based practice of Assertive Community Treatment (ACT) and follows the Housing First model. The goal of the program is to provide individuals the higher level of community care and to assist them in reaching their goals and living a life that is not dominated by mental illness.


  • A team approach: Individuals work with an interdisciplinary team that blends the knowledge and skills of professionals from multiple disciplines. Psychiatrists, nurses, mental health professionals, employment specialists, peer specialists, and substance-abuse specialists join together to give individuals ongoing, individualized care.
  • Address basic needs:  Individuals receive focused support and assistance to meet basic needs such as food, housing, mental and/or physical health services and medications, and applying for benefits.  Support and assistance are also provided for accessing education, finding employment and managing activities of daily living.
  • In vivo services: Individuals receive ACT services in their homes, where they work, and in other settings in the community as identified by the individual as the most beneficial to them or where support is most needed.
  • Personalized care: Teams work with a small caseload. The staff to client ratio is one to ten allowing staff to have frequent contact with clients.
  • Time-unlimited support: Provides clients with services and needed support for as long as the individual identifies the need for them.
  • Flexible care: Staff manage their schedules around the needs of the clients.
  • Comprehensive care: Provides an array of services to help meet client needs such as medication management, vocational services, substance abuse services, and other services to help clients sustain community living at the highest level of functioning.
  • Crisis intervention: Services are available 24 hours a day, 7 days a week to currently enrolled clients. Staff is always available to handle emergencies.

Eligibility Criteria:

  • Medical Necessity must be established (face to face) to determine the presence of a severe psychiatric disability and need for ACT services per LOCUS assessment (Level 4 - Medically Monitored Non-Residential Services)
  • Has current LPS Conservatorship (may be a designated County Conservator or family member (Private Conservator);
  • Client is homeless or at-risk of homelessness
  • Minimum one hospitalization in the past year, OR multiple ER utilizations, PERT interventions, jail mental health service and/or long-term care hospitalization.
  • Have major impairments in life functioning
  • Person is not connected to outpatient treatment
  • Person is experiencing an acute psychiatric episode that might require ACT level services
  • Is at high risk of admission to an inpatient mental health facility;
  • Has a substantial need for supportive services (including care coordination and outreach mental health services) to maintain current level of functioning in the community, as evidenced by missed appointments, medication non-adherence, or inability to coordinate services from multiple agencies;
  • Does not have a case manager from another program who is able to address mental health needs
  • Must be 18-59 years or older and homeless in the Downtown area of San Diego.
  • Priority is given to individuals who are chronically homeless and/or high utilizers of hospitals and emergency services.

Referral Process

Referrals may be initiated by a social service provider/professional or a concerned family member by calling the program directly at 619-398-2156, or by fax, 619-398-2168.

Hours of Operation

Office hours of operation are Monday through Friday, 8:00am to 5:00pm with outreach provided evenings and weekends. 

Fees and Funding

Downtown IMPACT is funded by the County of San Diego, Health and Human Services Agency, Adult/Older Adult Mental Services. Downtown IMPACT accepts Medi-Cal and Medicare insurance and also provides services for individuals with no insurance. No one is denied services based on inability to pay. Individuals are responsible to San Diego County Mental Health's UMDAP procedures.