Santa Monica Chronic Homeless Project: Registry Creation

February 26th, 2008

City of Santa MonicaCommon Ground

Street to Home 101

• Create a by-name and photo registry of street homeless population

• Prioritize based on vulnerability• Align housing and service resources to

match the need• Align incentives for non-profit providers

to house the most vulnerable first

February 2005

55 people sleeping in the BID

February 2007

7 people sleeping in the BID

Cities Adapting S2H Techniques

Vulnerability Index

• More than 6 months street homeless AND at least one of the following:– End Stage Renal Disease – History of Cold Weather Injuries– Liver Disease or Cirrhosis– HIV+/AIDS– Over 60 years old – Three or more emergency room visits in prior three

months– Three or more ER or hospitalizations in prior year– Tri-morbid (mentally ill+ abusing substances+

medical problem)

Teams

• City of Santa Monica, Human Services Division, Housing Division, Fire/Paramedics, and Police Department

• Los Angeles Homeless Services Authority (LAHSA)

• Department of Veteran’s Affairs

• Los Angeles County Department of Mental Health

• CLARE Foundation• New Directions• OPCC• St. Joseph Center• Step Up on Second • West Coast Care

Baseline Count Results

• 277 individuals sleeping outside

Interview Methodology

• Safety First

• Assertive• Respectful• Sensitive• Persistent

Interview Results

• 261 interviews completed• 94% of Friday night count completed

survey• 220 pictures (84% of respondents

allowed)

Age

49

55

0

10

20

30

40

50

60

70

Age

Santa Monica Outdoors

Vulnerable Cohort

* 44 (17%) were over 60 years old

Race/Ethnicity

21%

12%

66%

16%13%

77%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

African American Hispanic White

Santa Monica Outdoors

Vulnerable Cohort

Average Length of Homelessness

8

11

0

2

4

6

8

10

12

Length of Homelessness

Santa Monica Outdoors

Vulnerable Cohort

* 30% of vulnerable cohort homeless > 15 years

Where Did People Come From?

0

5

10

15

20

25

30

35

40

45

50

LA City LA County California UnitedStates

Not US

Santa Monica Outdoors

135 (53%) were homeless before they came to Santa Monica

Mental Health & Substance Abuse

21

14

60

0

10

20

30

40

50

60

70

Mental IllnessONLY

Substance AbuseONLY

Dually-Diagnosed

Vulnerable Cohort

% Veterans

16%

31%

0%

5%

10%

15%

20%

25%

30%

35%

% veterans

Santa Monica Outdoors

Vulnerable Cohort

34 (54%) of veterans are considered vulnerable

% of respondents with Jail and Prison History

59%

10%

67%

14%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Jail Prison

Santa Monica Outdoors

Vulnerable Cohort

Hospitalizations

58%

18%

42%

82%

0%

20%

40%

60%

80%

100%

% population % hospitalizations

Non-Vulnerable Vulnerable Cohort

Routine Health Care Services

0%

10%

20%

30%

40%

50%

60%

70%

80%

Nowher

eVA

Santa

Mon

ica/U

CLA

Venice

Fam

ily C

linic

Santa Monica Outdoors

Vulnerable Cohort

Emergency Health Care Services

0%

5%

10%

15%

20%

25%

30%

35%

Nowher

eVA

Santa

Mon

ica/U

CLA

St. Jo

hn's

Santa Monica Outdoors

Vulnerable Cohort

Vulnerability Indicators

Risk indicator # of people

Tri-morbid 56

3x hospital last year 21

> 60 years old 44

Liver Disease 25

3x ER last 3 months 7

Frostbite/Cold Weather

17

Kidney Disease 7

HIV+/AIDS 2110 (42%) of those surveyed met at least one High-Risk Criteria

Frequency of Risk Indicators

Risk indicator Skid Row Santa Monica New Orleans

Sample Size 350 261 121

Tri-morbid 21% 21% 17%

3x hospital last year

13% 8% 17%

> 60 years old 10% 17% 5%

Liver Disease 9% 10% 3%

3x ER last 3 months

8% 3% 8%

Frostbite/Cold Weather

7% 7% 8%

Kidney Disease 4% 3% 1%

HIV+/AIDS 2% 1% 5%

% with 1 or more risk criteria

40% 42% 33%

Initial 10 Most Chronic & Vulnerable

• All have been homeless more than 18 years in Santa Monica

• 8 men, 2 women, 1 couple• 2 of 10 had 4 co-occurring vulnerability

indicators• Average age is 54 years old

Typical Profile

• 49 year old white male

• Grew up in Texas in Foster Care – came to Santa Monica 30 years ago when he was 19 years old

• Makes money panhandling & hangs out on the beach

• Cirrhosis

• “Tri-morbid” = mentally ill + abusing substances + medical problem

Community Impact

• 87% reduction in Times Square • Continued reductions in NYC result of this

focus• Project 50 in Los Angeles has housed 10/50 of

the most chronic and vulnerable in less than one month

• Claiborne Encampment in New Orleans – Advocacy Tool

• Washington, DC – 60% reduction in six months in Central Business Improvement District

Next Steps

• Assign ten most chronic and vulnerable people • Gather housing and services resources and

focus on most chronic and vulnerable• If you’re paying for services, pay for people to

house the most chronic and vulnerable• Develop training and service protocols • Review City policies and practices that may

contribute to homelessness or attract people to Santa Monica