Cindy Cavanaugh, Director of Homeless InitiativesEduardo Ameneyro, Homeless Services Division

Manager

Sacramento County Homelessness

Care Coordination Meeting, March 25, 2019

Plan Elements

Describe magnitude and characteristics of homelessness, chronic homelessness and the NPLH target population

Inventory existing efforts underway and partners in ending homelessness

Describe current resources and identify critical gaps

Lay out County and stakeholder plans to address unmet needs in key focus areas

Sacramento County Homeless Plan

4

Guiding Principles

Take a county-wide approach Set concrete goals

Provide frequent, coordinated communication

Expand opportunities for citizen involvement

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The State of Homelessness in Sacramento

7

Race and Homelessness

5

Gender and Homelessness

9

People in Families(N=1,514)

Chronic Homelessness

10

Mental Illness Among Homeless Chronically Homeless and Unsheltered Chronically Homeless

8

Refined high-cost utilizers across HMIS, Sheriff, BHS systems

N = 250

Average annual cost (2015-16) = $42,383

$-

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

1 26 51 76 101 126 151 176 201 226

Summary of cost distribution across 250 high-utilizing homeless individuals in Sacramento County

Average annual cost to Sacramento County public systems across high-cost, PSH-fit 250 individuals (2015-16)1

Dollars (N=250)

250

1. Average annual cost calculated by averaging individual costs across analyzed systems in 2015 and 2016. Note that cost estimates are not exhaustive. Notable omissions include physical healthcare (deprioritized in part due to limited expected County budget impact), correctional health costs, and any reflection of impact on economic development. While costs are primarily County focused, some (such as billable BHS costs) may be reflective of other jurisdictional budgets; in other analyses, such as cost-benefit analysis, these costs are removed. “PSH-fit” estimated by reviewing 2015-2016 HMIS records, excluding individuals with any days spent in permanent supportive housing over the past 12 months, as well as those lacking (non-PSH) HMIS interactions in last 12 months, and focusing on those with longer and more-acute needs exhibited by a chronically homeless flag in HMIS and/or a recorded VI-SPDAT score >14 and/or a history of homelessness greater thank one year. 2. Average victimization cost based on estimates from McCollister et al. (The Cost of Crime to Society, 2010), intended to calculate the cost to society of various criminal acts, including both “tangible” costs (e.g., direct economic losses, property damage) and “intangible” costs (e.g., productivity loss, quality of life). Total victimization costs based on list of primary charges for top 250 population in 2015-16; for the sake of clarity (to smooth otherwise highly variable data), they have been averaged among this population, rather than applied to the relatively limited set of specific individuals to whom these victimization costs can be attributed. (Note that many charges, including most drug- and alcohol-related charges, do not incur a direct victimization cost.) 3. Assumes that high-utilizing homeless populations generate at least average costs to other County agencies. Includes non-specific core County costs (such as DHA – Admin, DHA – Aid Payments, Code Enforcement, Regional Parks, District Attorney) averaged across 2016 point-in-time count population. Key sources: Sacramento Steps Forward, Sacramento Sheriff’s Department, Sacramento Behavioral Health Services, Sacramento City and County Cost of Homelessness Estimates, McCollister et al.

Sheriff’s Department costs

BHS (Medi-Cal) costs

BHS (Non-Billable) costs

HMIS / Shelter costs

Other county costs3

Victimization costs2

County Flexible Supportive Re-Housing Program Top 250 and New Flexible Housing Pool

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Flexible Supportive Housing Program

Launched FSRP February 1, 2018

Two kinds of services:• Intensive Case Management • Property Related (tenant and owner)

• 3 community providers

• 2 community providers

In permanent housing as of March 2019 209 persons

Annual Costs (County General Fund) $3.4 Million

Flexible Housing Pool – Scaling Re-Housing Solutions

Expand/modify program with Flexible Housing Pool through HEAP• Short term assistance

Launch May 2019Serve up to 600 persons through shelter and outreach referrals

Applying FSRP Lessons to date Client Level CollaborationFlexibility – contracting, services, housingBuilding capacity: training,

One-Time State Funding through HEAP $8M, two years of operation

County Flexible Supportive Re-Housing Program Top 250

Notable Demographics of 191 participants, December 2018

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Formal Probation 132

Lifetime Sex Offender Registrant 15

Physical Disability 115

Mental Health Diagnosis 154

Substance Use Addiction 127

Co-occurring mental health issues and substance use disorders

112

System Resources and Programs Drop-In Center/Day Shelter Programs: Seven (7) programs

throughout the county.

Year-Round and Seasonal Overnight Shelters: Thirty-three (33) shelters with a total of 762 beds for singles, families, and youth.

Temporary Housing/Transitional Housing Programs: Sixteen (16) programs offering a total of 669 beds for singles and families.

Rapid Re-housing Programs: Ten (10) programs with 661 slots (permanent housing units or rooms) for singles and families.

Permanent Supportive Housing Programs: Twenty-seven (27) programs for chronically homeless adults or families and adults or families experiencing mental illness, housing a total of 3,028 people in 2,119 households.

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County ResourcesDepartment Activities

Office of the County Executive Homeless Coordination, Strategy and Policies

Child, Family, and Adult Services Child Protective Services, Bringing Families HomeAdult Protective Services, Sr. Safe House

Department of Human Assistance Targeted CalWORKS Programs, Homeless Services, funding outreach, navigation, shelter, re-housing, County Initiatives

Department of Health Services Behavioral Health – Mental Health Services and Alcohol and Drug Services; Primary Health; Public Health

Sacramento Housing and Redevelopment Authority

Pubic Housing Authority Finance, Emergency Solutions Grant, Community Development Block Grant, Affordable Housing Finance

Also: Environmental Management Department, Planning and Environmental Review,Parks Department, Probation Department, Public Defender, Sheriff’s Department, District Attorney

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New Initiatives and Change DriversActivity County

County of Sacramento

• Improve Family Crisis and Response Shelters• Full-Service Re-Housing Program• Flexible Supportive Re-Housing Program• Preservation of Mather Community Campus (MCC)• New Youth Services• Homeless Outreach, Navigation and Re-Housing Services• $44 million in expanded Mental Health resources from Mental Health

Services Act (MHSA)• DMS-ODS Waiver to expand substance abuse services• New Supportive Housing through No Place Like Home

City of Sacramento

• Homeless Triage Centers and New State Funding (HEAP)• Pathways to Health + Home: Reduce emergency and crisis medical

services by coordinating care, health and housing

SSF • New State Funding: HEAP and CESH to improve data, coordinated entry, standardization of services

SHRA • PHA Resources targeted to homeless persons and housing• Streamlined funding process for PSH

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15

Sunrise Pointe

Development Sponsor Jamboree Housing Corporation and TLCS, Inc.

Location City of Citrus Heights

NPLH Units/Total Units 22 NPLH units/46 Total Units

DevelopmentPopulation Targets

• All units: Families and Individuals experiencing homelessness

• NPLH Units: 40% chronically homeless, 30% homeless, 30% at risk of chronic homeless experiencing Serious Mental Illness

Services • All residents: 1.5 FTE and 15 hours/week resident services• NPLH residents: County behavioral services and

coordination of other supportive services for 20 years

Project Financing 9% tax credits, County Consortium HOME, conventional, deferred developer fee

NPLH Funding $3,019,967 Competitive

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Capitol Park HotelDevelopment Sponsor Mercy Housing California

Location City of Sacramento

NPLH Units/Total Units 65 NPLH units/134 Total Units

DevelopmentPopulation Targets

• All units: Individuals experiencing homelessness• NPLH Units: 40% chronically homeless, 30% homeless,

30% at risk of chronic homeless experiencing Serious Mental Illness

Services • All residents: 2 FTE and 20 hours/week resident services• Non- NPLH residents: 2.8 FTE case management services• NPL residents: County behavioral services and

coordination of other supportive services for 20 years

Project Financing 9% tax credits, general partnership equity, Affordable Housing Program (AHP), gap source to be identified

NPLH Funding $6,890,825 Competitive$2.8M Noncompetitive

Continuing Challenges

Lack of Affordable Housing

Entry Points are not coordinated

Lack of comprehensive, real-time data

No single system vision or oversight

17 December 12, 2018 Office of County Executive - Sacramento County Homeless Plan

Proposed Solutions

Prevent People from Becoming Homeless

• Strengthen diversion in shelter and navigation• Inventory and improve alignment of community based

services• Improve jail discharge• Improve hospital discharge

Improve Response to the Street Crisis and Improve Quality of Life

• Coordinate navigation and street outreach with community standards

• Regional law enforcement training for first responders• Protocols and education for managing and preventing

disease • Collaborate with impacted business districts

Expand and Improve Shelter and Interim Housing

• Low-barrier shelter expansion through HEAP• Community shelter standards• Improve shelter access through Bed Reservation and

Coordinated Entry

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Proposed Solutions

Expand Targeted Permanent Housing

• Implement Flexible Housing Pool (HEAP)• Coordinate Re-housing efforts with community standards• Evaluate and continue PHA efforts, including move-on and

convention housing initiatives• Inventory local gap financing across jurisdictions• Coordinate NPLH funding and fund new permanent

supportive housing

Leverage and Coordinate Mainstream and Other Resources

• Fully implement $4.4 million expansion• New grant for mentally ill homeless interfacing with jail• Coordinate DMC-ODS waiver with homeless system• Records expungement and jail diversion pilot• Coordinate on Health Homes implementation by Managed

Care• Improve connections to mainstream employment services

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Proposed Solutions

Strengthen System Leadership and Accountability

• Convene County interagency working group• Improve coordinated entry, program and system

evaluation using data• Improve coordination, governance, leadership through

Funder’s Collaborative, provider forums, training• Engage political leadership across County• Hold annual community meetings on Plan progress

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Resources

• Sacramento County Responding to Homelessness

http://www.saccounty.net/Homelessness/Pages/default.aspx

• Sacramento County Homeless Plan, Adopted December 2019

http://www.saccounty.net/Homelessness/Documents/HomelessPlan_Adopted_12-12-18.pdf

• Pay for Success Study by Social Financehttps://socialfinance.org/content/uploads/PFS-Persistently-Homeless-Sacramento.pdf

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