HomeMy WebLinkAboutMINUTES - 06222010 - C.105RECOMMENDATION(S):
Accept the attached reports from the Health Services Department on the Continuum of Care
Plan for the Homeless and the Healthcare for the Homeless programs.
Direct Staff to continue to report on an annual basis to the Family and Human Services
Committee regarding progress of the Ten Year Plan to End Homelessness and the Contra
Costa Inter-Jurisdictional Council on Homelessness.
FISCAL IMPACT:
No fiscal impact.
BACKGROUND:
The Health Services Department presents a joint report to the Family and Human Services
Committee on an annual basis regarding the Continuum of Care Plan for the Homeless and
Healthcare for the Homeless. On June 7, 2010 the Committee received the attached report
on these programs. After the presentation and discussion the Committee recommended that
the entire report be forwarded to the Board of Supervisors.
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
Action of Board On: 06/22/2010 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYE:John Gioia, District I
Supervisor
Gayle B. Uilkema, District II
Supervisor
Mary N. Piepho, District III
Supervisor
Federal D. Glover, District V
Supervisor
ABSENT:Susan A. Bonilla, District IV
Supervisor
Contact: Dorothy Sansoe,
925-335-1009
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the
Board of Supervisors on the date shown.
ATTESTED: June 22, 2010
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.105
To:Board of Supervisors
From:Family and Human Services Committee
Date:June 22, 2010
Contra
Costa
County
Subject:Report on the Continuum of Care Plan for the Homeless and Healthcare for the Homeless
CONSEQUENCE OF NEGATIVE ACTION:
CHILDREN'S IMPACT STATEMENT:
ATTACHMENTS
FHS Report
WILLIAM B. WALKER, M.D.
HEALTH SERVICES DIRECTOR
WENDEL BRUNNER, M.D.
PUBLIC HEALTH DIRECTOR
CONTRA COSTA
PUBLIC HEALTH
HOMELESS PROGRAM
597 Center Avenue, Suite 325
Martinez, California
94553-4675
PH 925 313-6124
FAX 925 313-6761
Contra Costa Community Substance Abuse Services Contra Costa Emergency Medical Services Contra Costa Environmental Health Contra Costa Health Plan
Contra Costa Hazardous Materials Programs Contra Costa Mental Health Contra Costa Public Health Contra Costa Regional Medical Center Contra Costa Health Centers
TO: Family and Human Services Committee
FROM: Cynthia Belon, L.C.S.W.
Director, Homeless Program
RE: Annual Report on Homeless Continuum of Care
Cc: Wendel Brunner, M.D.
Director, Public Health
DATE: June 7, 2010
RECOMMENDATIONS
Accept this report from the Health Services Department; and
Direct Staff to continue to report on an annual basis to the FHS Committee regarding progress of
the Ten Year Plan to End Homelessness and the Contra Costa Inter-Jurisdictional Council on
Homelessness; and
Forward this report to the Board of Supervisors for acceptance.
BACKGROUND
Preparation for our Ten year Plan began in 2002 with the West Contra Costa County Homeless
Summit. Hosted by Supervisor John Gioia and (then) Richmond Mayor Irma Anderson,
strategies that emerged from the Summit, along with information collected from 22 focus groups
with homeless consumers, resulted in the draft of the Ten Year Plan in early 2003.
In Spring 2004, the Board approved “Ending Homeless in Ten Years,”a county-wide Plan for the
communities of Contra Costa County. The Advisory Board, along with the Homeless program,
began with three main tasks: creation of a blueprint to detail the actions for carrying out the
Plan’s five main goals; creation of a Homeless Management Information System, for purposes of
data collection on outcomes and program effectiveness throughout the continuum; and the
development of public education designed to enhance the understanding of homelessness. In
early 2008, the Homeless Continuum of Care Advisory Board, established in 1997, merged with
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the Homeless Inter-jurisdictional Interdepartmental Workgroup, the initial group responsible for
overseeing the implementation of the Ten Year Plan, to become, with Board approval, the Contra
Costa Inter-Jurisdictional Council on Homelessness. A Consumer Board was also created to
provide valuable information to the Council on the effectiveness of programs and the gaps in
services.
The Homeless Program continues to work with and support the Homeless Inter-Jurisdictional
Council and community based homeless service providers to ensure an integrated system of care
from prevention through intervention for homeless adults, youth and families within our
community with the overall goal of ending homelessness. To accomplish this, the Homeless
Program has been a provider of comprehensive services, interim housing and permanent
supportive housing as well as contracting with community agencies to provide additional
homeless services and housing.
Attached are several reports, providing a comprehensive description of the performance
measures, goals and objectives, outcomes and demographic information for the continuum of
homeless service delivery system. This data is collected through our Homeless Management
Information System (HMIS), which gathers unduplicated continuum-wide information from
several (but NOT all) homeless service providers.
During 2009 (January through December), a total of 5114 persons used homeless services. Of
this amount, 1647 persons were newly identified homeless, or those who had not been in the
system prior. Sixty-nine percent (69%) of the newly identified homeless were single adults
without children; 14% were families with children; and 17% were couples with no children.
This shows a slight decrease in the numbers of newly homeless from the year prior (2543
out of 5782 people were newly homeless in 2008), even with the continual economic
situation.
Children and youth comprised 25% of the total, a 2% increase from last year; 16% were persons
over 55, a 1% increase from last year.
Over half of homeless residents reported coming from West County (51%), an 8% increase from
the prior year; 30% from Central County, an 8% increase from the prior year; and 14% from East
County, which is a 1% decrease from prior year.
In 2009, 1744 persons from emergency shelter, transitional housing and support service
programs have moved to more stable housing. Sixty six per cent (66%) of persons in
emergency shelters exited to transitional or permanent housing, and 81% of those in
transitional housing exited to permanent housing. In our own adult interim housing
programs (Brookside and Concord emergency shelters), 59% of the residents moved into
permanent or permanent supportive housing. In our own youth emergency shelter
program (Calli House), 38% of the residents moved to permanent or permanent supportive
housing and 27% moved into transitional housing.
During the past two years, 3172 homeless persons and families from the continuum were
placed into permanent supportive housing. 85% have retained their housing for more than
Page 3
one year. This is a 10% INCREASE in housing retention from the prior year, which is
significant in reflecting the success that has been achieved in ending homelessness in our
community.
KEY ACTIVITIES DURING 2009
The capital development of a 24-bed respite program continued in Concord at 2047 Arnold
Industrial Way. This program, in partnership with Healthcare for the Homeless, and in
coordination with the local hospitals, will provide recuperative care to homeless persons
discharging out of hospitals, are in need of additional medical stabilization, and do not have a
home nor can be returned to the streets. Funding for construction was received from the State
Housing and Community Development Department; County Conservation and Development;
and Concord Community Services Department. The construction was completed in March 2010,
and it is scheduled to open on June 10th with an opening event from 3-5 p.m. We anticipate
serving 380 homeless persons per year.
Stimulus funds were awarded to Contra Costa County for homeless prevention and rapid re-
housing of homeless single adults and families in the form of rental assistance and support
services for those persons who are having difficulty maintaining their current rental housing or
have lost their rental housing within the last 18 months. The project is sponsored through
County Dept. of Conservation and Development and the Cities of Richmond, Antioch, Concord,
Walnut Creek and Pittsburg. A partnership of agencies, led by Shelter, Inc., and including the
County Homeless program, are providing assistance to those who have an income at or below
50% of the area median income, have been employed within the past year or will soon be re-
employed, and other criteria established by the Federal government.
Homeless court, begun in 2007, continued during the 2009 year with 11 court sessions
held at homeless program locations rotating between Richmond, Concord and Antioch. This
opportunity clears the accumulated fines for infractions that homeless residents receive, and for
which they would not have the ability to pay, creating obstacles towards their reintegration into
society. 284 Defendants were seen, bringing 1143 cases to be heard before Superior Court
Judge Steven Austin. The Defendants performed a total of 56,060 hours of community
service in order to have the cases dismissed. The success of Homeless Court is extraordinary in
view of the many challenges the clients have faced to get there, and to see the resulting positive
outcomes. Parents are able to regain visitation or custody of their children; clients can now
apply for jobs that require that they first get their driver’s license back; and they can also rent
apartments once their record has been cleared. Many of the clients continue to provide
community service at the programs where they received services.
This year we began a new program called Permanent Connections, funded through HUD
McKinney-Vento Supportive Housing, a scattered site housing model for homeless transition age
youth18-24 with disabilities. Ten housing units are available for youth with mental illness,
substance abuse, HIV/AIDS, or dual/multiple diagnoses. The program is designed to provide
ongoing supportive services with an emphasis on assisting them to maintain their housing and
Page 4
thrive. To date, 4 young adults have moved into their apartments, with an additional six moving
in within the next two months.
The SSI Eligibility evidence-based practice, named Project AACT (Application Assistance for
Contra Costa Titles 2 and 16), was started within our own adult interim housing and youth
continuums as a new project to assist disabled, homeless persons in applying to SSA, with the
assistance of a Case Manager, for SSI benefits. The goal is for homeless persons to experience a
significant reduction in the time it takes to receive an initial award decision by SSA.
Our Homeless Management Information System has continued to broaden the type of
information collected and provide more information on quantitative outcomes to the Inter-
jurisdictional Council (see Outcomes Report). During 2009, we also added service utilization
collection tools throughout the continuum, customized for each homeless service provider
agency, to provide individual and aggregate data on services provided. Reports will be available
beginning in 2010.
The Homeless Program has been actively involved in the Contra Costa Reentry Initiative
Task Force, for purposes of developing a continuum of services and housing for incarcerated
individuals who will be reentering our community. The Homeless Program Director, Cynthia
Belon, LCSW, is a member of the Task Force representing Health Services, and is on the Sub-
Committee focusing on the creation of a strategic plan. In addition, the Program Manager of the
Homeless Adult Continuum (Arturo Castillo) and the Program Manager for the Homeless Youth
Continuum (Jenny Robbins) are participating in the West County and East County Reentry
Service Provider Committees. Within Health Services, the homeless program participates in
the Health Services Cross Divisional Violence Prevention Meetings, where one of the agenda
items has been to create the continuum of service delivery for those reentering the community
from jails/prisons. Approximately 17-20% of the homeless single adults who have used the
interim housing programs (emergency shelters) are on probation, parole or both. The homeless
program has served as the main entry point for incarcerated individuals who are homeless upon
discharge from prisons and jails, or who find themselves homeless shortly after discharge, and
will continue to be the main contact within Health Services for these individuals as they begin to
transition into the community.
In June 2009, we held a Project Homeless Connect in Richmond, co-sponsored by the City of
Richmond, and served 800 homeless community residents, our largest turnout to date. In
September, 2009, we held our first Homeless Health Connect in Concord, co-sponsored by the
City of Concord, focusing on health and wellness services, with vision care exams and glasses
offered for the first time by Vision Service Plan. Almost 300 homeless residents received health-
related services on that day.
Our next Project Homeless Connect is scheduled for September 16, 2010 in Antioch.
Contra Costa County’s Homeless Continuum of Care
Outcomes Report by Homeless Program Type
For Period: 1/1/2009 - 12/31/2009
Report Run Date: 5/5/2010
The purpose of this report is to highlight some of the outcomes of various programs that
serve homeless adults, youth, and families being served in Contra Costa County’s Homeless
Continuum of Care. This report summarizes data collected in Contra Costa’s Homeless
Management Information System. HMIS or the Homeless Management Information System
gathers unduplicated, continuum-wide statistics from several participating homeless
providers. A list of these participating agencies can be found on page 5 of this report.
Key Points
1
1. 1744 persons from emergency shelter,
transitional housing, and support-service
programs have moved to more stable
housing.
- 1310 exited from Emergency Shelters and of these,
65.65% exited to transitional or permanent housing.
- 344 exited from Transitional Housing and of these,
81.10% exited to permanent housing.
- 877 exited from SSO programs and of these,
68.99% exited to transitional or permanent housing.
Housing situation at exit
0
20
40
60
80
100
Program Type% moved to more stable housingES
TH
SSO
2. Eighty-five percent (85%) of individuals and families in Permanent Supportive
Housing have retained their housing for 1 year or more.
3. Number of newly housed clients in Permanent Supportive Housing: 123 persons
4. Forty-four percent (44%) of all clients who exit from Emergency shelters,
Transitional housing and Supportive Services Programs had some type of cash
income at program exit. Of all those who exited,
18.85% exited with Employment Income 9.12% exited with TANF
1.11% exited with VA disability/pension 20.71% exited with SSI/SSDI
20.71%
9.12%
1.11%
18.85%
Total Clients
Employment Income
VA Disability/Pension
TANF
SSI/SSDI
2
General Assumptions
a. Transitional housing is defined as a temporary living situation where an individual or family may stay
up to 2 years and receive support services during their tenure. Permanent housing is defined as
independent housing or residing with family or friends that is intended to be a permanent living
situation.
b. This report provides unduplicated continuum-wide statistics, using the last day of the report period as
the effective point-in-time date. Although this report is regarded as a continuum-wide report, there are
several agencies that are not currently participating in the HMIS project and therefore are not
represented on this report. These agencies include but are not limited to the Bay Area Rescue
Mission, STAND Against Domestic Violence, and the Crisis Center. A list of programs, which ARE
currently participating in HMIS, is available on page 5.
c. Quality assurance. Several data quality procedures have been instituted to make sure this report
represents the best information we have at the current time. All agencies that contribute data are
required to abide by our continuum’s HMIS Policies and Procedures and have entry and exit
protocols in place to ensure admission information is accurately reflected.
Questions and Further Assistance
For questions, please email the County Homeless Program at homelessprogram@hsd.cccounty.us.
3
Continuum-wide Outcomes Report
I. How many homeless persons were served during the period of January 1, 2009 – December 31,
2009? __5111__
II. How many individuals and families exited from Emergency Shelter, Transitional Housing and
Support Service programs during the period? __2531__
Of those, how many individuals left for more stable housing? __1744__
Reporting Program
Discharge destination
Emergency
Shelters (ES)
Transitional
Housing (TH)
Support Service-Only
Programs (SSO)
Place not meant for habitation (e.g. a vehicle or anywhere outside)0 1 25
Emergency Shelter 138 14 104
*Foster care home or foster care group home 2 0 0
Hospital (non-psychiatric) 16 2 2
Hotel or motel paid for without emergency shelter voucher 11 0 5
Jail, prison, or juvenile detention facility 27 5 3
*Owned by client, no housing subsidy 3 0 10
*Owned by client, with housing subsidy 1 0 0
*Own house/apartment 31 7 20
*Permanent Supportive housing for formerly homeless persons 35 6 24
Psychiatric hospital or other psychiatric facility 20 0 1
*Rental by client, no housing subsidy 52 73 80
*Rental by client, VASH subsidy 3 0 13
*Rental by client, other (non-VASH) housing subsidy 2 15 83
*Rental room/house/apartment 97 133 124
*Staying in a family member’s room/apartment 154 18 74
*Staying in a friend’s room/apartment 73 6 35
*Staying or living with family, permanent tenure 44 16 29
*Staying or living with family, temporary tenure 58 4 34
*Staying or living with friends, permanent tenure 22 5 22
*Staying or living with friends, temporary tenure 85 5 29
Substance abuse treatment facility or detox center 65 1 22
*Transitional housing for homeless persons 198 18 28
Deceased 0 1 1
Other 14 0 14
Don’t Know 150 11 87
Refused 9 3 8
Total:1310 344 877
Stable housing Total:860 279 605
Note: All asterisked options are considered to be ‘more stable housing’ for those exiting ES or SSO programs.
Transitional housing and temporary tenures are not considered ‘more stable housing’ for clients exiting TH
programs.
4
III. How long have clients in Permanent Supportive Housing programs retained their housing?
Length of Stay Total Percentage
Less than 1 month 10 1.08%
1-2 months 15 1.62%
3-6 months 45 4.86%
7-12 months 67 7.24%
12-24 months 150 16.20%
25 months to 3 years 235 25.38%
4-5 years 128 13.82%
Over 5 years 276 29.81%
Total:926 100.00%
IV. Of those who exited ES, TH, and SSO programs, what were their sources of income at exit?
Income Source ES TH SSO
Alimony or Other Spousal Support 4 1 4
Child Support 6 3 8
Earned Income 137 133 208
General Assistance 67 9 0
Pension from a former job 4 0 2
Private Disability Insurance 0 0 1
Retirement Income from Social Security 18 4 25
SSDI 61 8 69
SSI 187 18 185
TANF 91 53 88
Unemployment Insurance 24 6 36
Workers Compensation 2 1 2
Veteran’s Disability Payment 6 0 5
Veteran’s Pension 14 0 3
Other 12 28 14
Unknown 1 0 1
Total (duplicated):634 877 697
*Note: These income categories are not mutually exclusive. Clients may have reported zero or multiple
income sources at time of exit.
5
V. How many homeless or formerly homeless persons utilized each project type between January
2009 and December 2009?
Emergency Shelters: 1307
Projects reporting: Brookside Shelter (County Program), Concord Shelter (County Program), GRIP
Emergency Shelter (Greater Richmond Interfaith Program), Mountain View House (SHELTER, Inc.),
Winter Nights Shelter (Interfaith Council of Contra Costa County).
Transitional Housing: 577
Projects reporting: Project Independence (Rubicon Programs), Appian House (County Youth Program),
Bissell Cottages (County Youth Program), Transitional Housing for Families (GRIP), Lyle Morris Family
Center (SHELTER, Inc.), Pittsburg Family Center (SHELTER, Inc.), REACH Plus (SHELTER, Inc.), San
Joaquin (SHELTER, Inc.).
Support Services Only (Case Management/Life Skills/Housing Assistance) Programs: 3,367
Projects reporting: Money Management (Rubicon), FERST Multi-service Centers (Anka Behavioral
Health), Resource Center (GRIP), Project Independence (Rubicon Programs).
Permanent Supportive Housing: 859
Projects reporting: Garden Park Apartments (CCIH), West Richmond Apartments (Rubicon Programs),
Shelter Plus Care (County Program), Permanent Connections (County Youth Program), Giant Road
Apartments (Rubicon Programs), Permanent Housing for People With Disabilities (GRIP), Idaho
Apartments (Rubicon Programs), Mary McGovern (SHELTER, Inc.), Next Step (SHELTER, Inc.), Rapid
Re-housing (SHELTER, Inc.), Transitional Housing Partnership Program (SHELTER, Inc.), Sunset
(SHELTER, Inc.), HHISN Programs – ACCESS, Access Plus, SIPS-AAA, Project Coming Home,
Lakeside Apartments, Villa Vasconcellos.
*Note: These categories are not mutually exclusive. Clients may have participated in more than one
project type within the reporting period, and may also be involved in two project types at the same time.
1
Contra Costa County’s Homeless Continuum of Care
Homeless Demographics Report
For Period: 01/01/2009 – 12/31/2009
Report Run Date: 3/08/2010
The purpose of this report is to highlight the demographic profile of homeless adults, youth,
and families being served in Contra Costa County’s Homeless Continuum of Care. This
report was prepared by the HMIS Policy Group under the direction of the Contra Costa Inter-
Jurisdictional Council on Homelessness (CCICH). HMIS or the Homeless Management
Information System gathers unduplicated, continuum-wide statistics from several
participating homeless providers. A list of these participating agencies can be found on
page 6 of this report.
Key Points
What region are you from?
East
County
14%
Central
County
30%
West
County
51%
South
County
0%Outside
Contra
Costa
5%
1. A total of 5,114 people used
homeless services from January
2009 to December 2009
2. Of these, 1,647 people were
considered newly identified
homeless, or clients that have
never before entered our system
of services.
3. When individuals were asked,
"What city did you come from," a
significant percentage said they
came from cities in West Contra
Costa County.
4. Nearly 25% of Contra Costa's homeless population is children and youth, and
16% are over the age of 55.
2
General Assumptions
a. This report provides unduplicated continuum-wide statistics, using the last day of the report period as
the effective point-in-time date. This means that if a client entered several programs (or the same
program several times) within the period, this client is counted only once and the report displays only
the latest answer to each question as of the last day of the report period. For example, using a
time period of Jan – Jun ‘08, if Jane Doe entered 3 distinct programs within the period, and her
answer to Prior Living Situation was different on all three occasions, this report will de-duplicate her
answer to her latest answer as of June 30th, 2008.
Although this report is regarded as a continuum-wide report, there are several agencies that are not
currently participating in the HMIS project and therefore are not represented on this report. These
agencies include but are not limited to the Bay Area Rescue Mission, STAND Against Domestic
Violence, and the Crisis Center. A list of programs, which ARE currently participating in HMIS, is
available on page 6.
b. There are several questions where no answers are provided, which are represented by the category
“Not Stated”. A high occurrence of “Not Stated” may be seen for questions that are not required for
certain subpopulations (e.g. homeless youth, children, etc.).
c. In this report, a household without children may represent either a couple with no children or
represents a relationship where one adult provides care for the other (e.g. A father and his adult
son).
d. Quality assurance. Several data quality procedures have been instituted to make sure this report
represents the best information we have at the current time. All agencies that contribute data are
required to abide by our continuum’s HMIS Policies and Procedures and have entry and exit
protocols in place to ensure admission information is accurately reflected.
Questions and Further Assistance
For questions, please email the County Homeless Program at homelessprogram@hsd.cccounty.us.
3
Total Homeless Persons Served in Contra Costa
I. How many homeless persons were served during the period of January 1, 2009 – December 31,
2009? 5,114 individuals.
II. Of those served, how many were newly identified homeless (clients that have never before
entered our system of services)? 1,647 individuals.
III. What is the demographic profile of all homeless clients served during period?
1. Where participants presented themselves as homeless:
City Slept In Last Night Total Percentage
Newly
Homeless
Antioch 355 6.94%108
Concord 876 17.13%242
Martinez 214 4.18%68
Pittsburg 140 2.74%46
Richmond 1748 34.18%565
San Pablo 193 3.77%69
Walnut Creek 30 0.59%11
Other Central County 95 1.86%35
Other East County 88 1.72%31
Other South County 7 0.14%4
Other West County 124 2.42%61
Outside Contra Costa County 182 3.56%102
Unspecified Contra Costa 32 0.63%0
Invalid or Not Stated 1030 20.14%305
Total:5,114 100.00%1,647
Note: Several questions are asked about each participant’s geographic origin, including where they spent the previous night,
what is their current address, and where they last resided for at least 90 days. Acknowledging that no single response offers an
accurate picture of where each person found himself or herself homeless, we report where participants spent the previous
night (before entering continuum services) wherever possible. Where this is unavailable, we report where they last resided for
at least 90 days.
2. Gender:
Gender Total Percentage
Newly
Homeless
Female 2171 42.45%730
Male 2933 57.35%908
Transgender 2 0.04%0
Not Stated 8 0.16%9
Total:5,114 100.00%1,647
4
3. Household configuration:
Household Configuration Total
Newly
Homeless
Households without children 823 262
Households with children 476 192
Households of one (single individuals) 3,436 1,098
4. Age (calculated based on this report’s run date)
Age Range Total Percentage
Newly
Homeless
0-5 304 5.94%134
6-13 343 6.71%120
14-17 132 2.58%43
18-24 477 9.33%223
25-34 766 14.98%263
35-44 941 18.40%293
45-54 1,337 26.14%371
55-61 594 11.62%146
62+ 211 4.13%45
Not Stated 9 0.18%9
Total:5,114 100.00%1,647
5. Employment status:
Unemployed? Total Percentage
Newly
Homeless
No 523 10.23%114
Yes 3110 60.81%732
Not Stated 1,481 28.96%801
Total:5,114 100.00%1,647
6. Chronic homeless status of total served participants:
Is the client chronically homeless?Total Percentage
Newly
Homeless
No 2,968 58.04%1,069
Yes 1,405 27.47%277
Not Stated 741 14.49%301
Total:5,114 100.00%1,647
Note: Chronically homeless persons are defined as unaccompanied individuals who have a disability and have been
continuously homeless for a year or longer, or 4 times in the past 3 years.
5
7. Race and Ethnicity of total served participants:
Race and Ethnicity Total Hispanics Percentage
Newly
Homeless
White 2,140 284 41.85% 587
Black/African American 2,341 26 45.78% 820
Asian 50 1 0.98% 15
American Indian/Alaskan Native 351 287 6.86% 145
Native Hawaiian/Other Pacific Islander 72 10 1.41% 27
Asian & White 3 0 0.06% 0
Am. Indian/Alaskan Native & Black African Am. 14 5 0.27% 12
American Indian/Alaskan Native & White 47 12 0.92% 7
Black/African American & White 28 3 0.55% 5
Other Multi-Racial 60 5 1.17% 20
Race Not Stated 8 0 0.16% 9
Total:5,114 633 100.00% 1,647
Note: We follow HUD conventions for describing race and ethnicity. Persons are separately asked which racial category (-ies)
they identify themselves as, and whether or not they identify as Hispanic.
8. Monthly income level of total served participants:
Monthly Income Level Total Percentage
Newly
Homeless
$0 2,440 47.69%917
$1-500 432 8.45%155
$501-$1k 1,554 30.39%395
$1001-$3k 601 11.75%158
$3001-$5k 23 0.45%9
over $5k 6 0.12%2
Not Stated 58 1.13%11
Total:5,114 100.00%1,647
Note: Income includes all sources of income, from employment income to government income
9. Clients with Disabilities
Disabling Condition Total Percentage
Newly
Homeless
Don't Know (HUD) 99 1.94%3
No (HUD) 2,173 42.49%837
Refused (HUD) 5 0.10%0
Yes (HUD) 2,780 54.36%797
Not Stated 57 1.11%10
Total:5,114 100.00%1,647
6
10. Types of Disabilities reported by clients who reported to have a disabling condition:
Disability Type Total Percentage
Newly
Homeless
Alcohol Abuse (HUD 40118) 1,304 25.50%255
Both Alcohol and Drug Abuse (HUD 40118) 112 2.19%8
Chronic Health Condition 77 1.51%2
Developmental (HUD 40118) 108 2.11%33
Drug Abuse (HUD 40118) 1,343 26.26%255
HIV/AIDS (HUD 40118) 91 1.78%6
Mental Health Problem (HUD 40118) 1,515 26.62%262
Other 109 2.13%21
Physical (HUD 40118) 0 0.00%56
Physical/Medical (HUD 40118) 1,012 19.79%166
Total:5,671 100.00%1,064
Note: Unlike all other sections of this report, these categories are not mutually exclusive. Many participants reported multiple
disabilities.
7
IV. How many homeless or formerly homeless persons utilized each project type between January 2008
and April 2009?
Permanent Supportive Housing: 860
Projects reporting: Garden Park Apartments (CCIH), West Richmond Apartments (Rubicon), Shelter Plus
Care (COHP), Giant Road Apartments (Rubicon), PHPWD (Greater Richmond Interfaith Programs),
Idaho Apartments (Rubicon), Mary McGovern (SHELTER, Inc.), Next Step (SHELTER, Inc.), Rapid Re-
housing (SHELTER, Inc.), Transitional Housing Partnership Program (SHELTER, Inc.), Sunset
(SHELTER, Inc.), HHISN Programs – ACCESS, Access Plus, SIPS, PCH, Lakeside.
Transitional Housing: 558
Projects reporting: Project Independence (Rubicon), Appian House (County Youth Program), Bissell
Cottages (County Youth Program), Transitional Housing for Families (GRIP), Lyle Morris Family Center
(SHELTER, Inc.), Pittsburg Family Center (SHELTER, Inc.), REACH Plus (SHELTER, Inc.), San Joaquin
(SHELTER, Inc.).
Case Management/Life Skills/Housing Assistance Programs: 3,369
Projects reporting: Money Management (Rubicon), FERST Multi-service Centers (Anka), Resource
Center (GRIP), Project Independence (Rubicon).
Emergency Shelters: 1,316
Projects reporting: Brookside Shelter (County Program), Concord Shelter (County Program), Emergency
Shelter (GRIP), Mountain View House (SHELTER, Inc.), Winter Nights Shelter.
*Note: These categories are not mutually exclusive. Clients may have participated in more than one
project type within the reporting period, and may also be involved in two project types at the same time.
ServicePt v4.01-Contra Costa County HMIS
Living Situation at Discharge (Permanent Housing Only)
Contra Costa County HMIS Project
Total Discharged and Destination Client Count Percentage
Foster care home or foster care group home (HUD)6 0.10%
Other (HUD)55 0.91%
Owned by client, no housing subsidy (HUD)12 0.20%
Owned by client, with housing subsidy (HUD)3 0.05%
Own house/apartment 99 1.64%
permanent supportive housing for formerly homeless persons (such as shp, s+c, or sro mod rehab)(HUD)1 0.02%
Permanent supportive housing for formerly homeless persons(such as SHP, S+C, or SRO Mod Rehab)(HUD)146 2.42%
Rental by client, no housing subsidy (HUD)247 4.10%
Rental by client, other (non-VASH) housing subsidy (HUD)133 2.21%
Rental by client, VASH Subsidy (HUD)17 0.28%
Rental room/house/apartment 1,089 18.07%
Staying in a family members room/apartment 633 10.50%
Staying in a friend's room/apartment/house 287 4.76%
Staying or living with family, permanent tenure (HUD)105 1.74%
Staying or living with family, temporary tenure (e.g., room, apartment or house)(HUD)113 1.87%
Staying or living with friends, permanent tenure (HUD)79 1.31%
Staying or living with friends, temporary tenure (e.g., room apartment or house)(HUD)139 2.31%
Total Discharged (may contain duplicate clients):3,164 52.50%
* Note: Some clients may have
multiple entries and exits. Thus, Total
Discharged does not reflect an
unduplicated number of clients.
Period Start Date: 1/1/2008 12:00:00 AM
Period End Date: 1/1/2010 12:00:00 AM Total discharge records in continuum: 6,027
Page 1 of 1 4/14/10 6:03:37 PM
ServicePt v4.01-Contra Costa County HMIS
Calli Shelter Report
Period Start: 1/1/2009 12:00:00 AM
Period End: 1/1/2010 12:00:00 AM
Report Run Date: 5/19/10
1271. Total Number Served = total records
104 unduplicated
Where were you living prior to entering this CCYCS program?Total Percentage
Alameda County 26 20.47%
Antioch 8 6.30%
Bay Point 4 3.15%
Clayton 1 0.79%
Concord 4 3.15%
Danville 1 0.79%
Discovery Bay 1 0.79%
El Cerrito 2 1.57%
El Sobrante 1 0.79%
Hercules 3 2.36%
Orinda 1 0.79%
Other County not listed here 17 13.39%
Pinole 4 3.15%
Pittsburg 2 1.57%
Pleasant Hill 1 0.79%
Richmond 42 33.07%
San Pablo 6 4.72%
Santa Clara County 1 0.79%
Solano County 2 1.57%
Total:127 100.00%
Age Range Total Percentage
18 12 9.45%
19-21 99 77.95%
22-24 11 8.66%
14-15 3 2.36%
16-17 2 1.57%
Total:127 100.00%
ServicePt v4.01-Contra Costa County HMIS
Race Total Hispanics Percentage
Black or African American (HUD)71 3 55.91%
White (HUD)28 0 22.05%
American Indian or Alaska Native (HUD)21 16 16.54%
Asian (HUD)4 0 3.15%
American Indian or Alaska Native (HUD) and White (HUD)1 1 0.79%
Black or African American (HUD) and American Indian or Alaska Native (HUD)1 1 0.79%
Native Hawaiian or Other Pacific Islander (HUD)1 0 0.79%
Total:127 21 100.00%
Income Level Total
$0 89
$1-500 11
$501-$1k 23
$1001-$3k 4
Total:127
Gender Total Percentage
Female 60 47.24%
Male 67 52.76%
Total:127 100.00%
Prior Living Situation Total Percentage
Emergency shelter, including hotel or motel paid for with emergency shelter voucher(HUD)38 29.92%
Foster care home or foster care group home (HUD)4 3.15%
Hotel or motel paid for without emergency shelter voucher (HUD)1 0.79%
Jail, prison or juvenile detention facility (HUD)2 1.57%
Other (HUD)1 0.79%
Owned by client, no housing subsidy (HUD)1 0.79%
Place not meant for habitation inclusive of 'non-housing service site(outreach programs only)'(HUD)23 18.11%
Rental by client, no housing subsidy (HUD)2 1.57%
Staying or living in a family member's room, apartment or house (HUD)22 17.32%
Staying or living in a friend's room, apartment or house (HUD)21 16.54%
Transitional housing for homeless persons (including homeless youth) (HUD)12 9.45%
Total:127 100.00%
Household Configuration Total Percentage
Family with Children 6 4.72%
Single 121 95.28%
Total:127 100.00%
ServicePt v4.01-Contra Costa County HMIS
Disabilities Total
Alcohol Abuse (HUD 40118)8
Both alcohol and drug abuse (HUD 40118)1
Chronic Health Condition 3
Developmental (HUD 40118)7
Drug Abuse (HUD 40118)11
Mental Health Problem (HUD 40118)57
Other 1
Physical (HUD 40118)2
Physical/Medical (HUD 40118)4
Total:94
Source of Income Total
Earned Income (HUD)14
General Assistance (HUD)11
Other (HUD)2
SSDI (HUD)3
SSI (HUD)24
TANF (HUD)2
Unemployment Insurance (HUD)1
Total:57
3. Total Discharged During Period = 118 (cannot be de-duplicated)
City Of Origin Total Percentage
Alameda County 13 11.02%
Antioch 6 5.08%
Byron 1 0.85%
Concord 8 6.78%
El Sobrante 3 2.54%
Hercules 1 0.85%
Martinez 1 0.85%
Other County not listed here 6 5.08%
Other part of Contra Costa 1 0.85%
Pacheco 2 1.69%
Pinole 1 0.85%
Pleasant Hill 1 0.85%
Port Costa 2 1.69%
Richmond 56 47.46%
San Francisco County 1 0.85%
San Pablo 6 5.08%
Solano County 1 0.85%
zzNull 8 6.78%
Total:118 100.00%
* This total will not match intake total if 1 or more
clients have more than one source of income.
* This total will not match intake total if 1 or more
clients have more than one disability.
If Disability Type is Other:
as a child
asthma
Asthma Epilepy
LEARNING disabilities
Seizures
ServicePt v4.01-Contra Costa County HMIS
Reason For Leaving Total Percentage
Completed program 39 33.05%
Left for housing opp. before completing program 36 30.51%
Criminal activity / violence 14 11.86%
Other 12 10.17%
Unknown/Disappeared 7 5.93%
Non-compliance with program 6 5.08%
Disagreement with rules/persons 3 2.54%
Needs could not be met 1 0.85%
Total:118 100.00%
Discharge Living Situation Total Percentage
Don't Know (HUD)5 4.24%
Emergency shelter, including hotel or motel paid for with emergency shelter voucher (HUD)22 18.64%
Foster care home or foster care group home (HUD)1 0.85%
Hotel or motel paid for without emergency shelter voucher (HUD)1 0.85%
Jail, prison or juvenile detention facility (HUD)7 5.93%
Other (HUD)2 1.69%
Psychiatric hospital or other psychiatric facility (HUD)4 3.39%
Rental room/house/apartment 1 0.85%
Staying in a family members room/apartment 13 11.02%
Staying in a friend's room/apartment/house 10 8.47%
Staying or living with family, permanent tenure (HUD)7 5.93%
Staying or living with family, temporary tenure (e.g., room, apartment or house)(HUD)5 4.24%
Staying or living with friends, temporary tenure (e.g., room apartment or house)(HUD)6 5.08%
Substance abuse treatment facility or detox center (HUD)2 1.69%
Transitional housing for homeless persons (including homeless youth) (HUD)32 27.12%
Total:118 100.00%
If Other:
board and care
Board and Care
1
CONTRA COSTA HEALTH SERVICES DEPARTMENT
CONTRA COSTA COUNTY
TO: Family and Human Services DATE: June 7, 2010
Committee Members
FROM: Andrea DuBrow, Project Director, Health Care for the Homeless
SUBJECT: Health Care for the Homeless Annual Report
Recommendations
1. Accept this report from the Health Services Department; and
2. Forward this report to the Board of Supervisors for acceptance; and
3. Direct staff to continue to report on an annual basis to the FHS Committee
regarding progress and status of the Health Care for the Homeless Program and
to submit an additional written report to the Board of Supervisors, at six-month
intervals.
Background
Since 1990, the Health Care for the Homeless (HCH) Project has provided health
care services to the homeless population through mobile clinics, as well as
through the CCHS integrated ambulatory system of care, and the Departments of
Mental Health and Alcohol and Other Drugs. Primary health care services
provided by the HCH Mobile Team include routine physical assessments, basic
treatment of primary health problems such as minor wounds and skin conditions,
respiratory problems, TB screening, acute communicable disease screening, and
coordination and referrals for follow up treatment of identified health care needs.
A significant portion of the homeless patients seen in the mobile clinics have
chronic diseases, including asthma, hypertension, diabetes, and mental
health/substance abuse issues.
The mobile team is comprised of a Medical Director, Family Nurse Practitioners,
Nurses, Community Health Workers, Financial Counselor, Mental Health
Specialist, and a Substance Abuse Counselor.
Homeless patients who receive care on one of the mobile clinics are referred into
one of the CCHS ambulatory care health centers for primary and specialty care,
into County mental health and substance abuse services and to Contra Costa
Regional Medical Center for emergency, inpatient hospital, outpatient surgeries,
laboratory and radiology. There are currently three ambulatory care clinics,
2
located throughout the County, designated specifically for homeless patients to
help them transition from the mobile clinic setting into the ambulatory care
system. HCH staff members are present at each of these clinics.
During 2009, CCHS treated 15,094 homeless patients who generated 96,572
visits. This is an increase from 2008, when CCHS saw 12,372 homeless patients
who generated 82,432 visits. The increase is likely due to the economic
recession, which placed further demand on the safety-net system, including
CCHS.
Table 1 (below) indicates the Board of Supervisor’s District where homeless
patients reside. If no residential zip code data are available, the zip code where a
patient received care is used.
Table 1: Percent of Homeless Patients by Supervisorial District, 2009
District 1- Supervisor Gioia 31%
District 2- Supervisor Uilkema 15%
District 3- Supervisor Piepho 2%
District 4- Supervisor Bonilla 20%
District 5- Supervisor Glover 31%
The attached presentation contains additional demographic information on our
HCH population.
New Actions
The following activities have occurred since the last briefing to the Board of
Supervisors on HCH activities:
American Recovery and Reinvestment Act Funding
In May 2009, the HCH Project was awarded an additional $220,000 in stimulus
funds to address the “Increased Demand for Services.” This amount of funding
was calculated by a formula based on the number of homeless patients served
by the HCH Program. Funding is for a two-year period and is providing services
to additional homeless patients.
In July 2009, the HCH Project received a Capital Improvement Project award to
replace the Martinez Family Practice Site (Building 2 on the CCRMC Campus)
with a new modular building. This project will modernize the clinic and streamline
clinic flow for maximum efficiency. The new unit will enhance the effectiveness
and efficiency of providing clinical services to patients through reduced waiting
times for clinic appointments at the Martinez site and throughout the CCHS
3
system. A homeless-specific clinic will be offered at this site upon its opening.
Funding for this project was calculated on a formula basis at $683,000. During
the past year, CCHS devoted time to meeting all conditions associated with the
grant award prior to beginning construction. The federal government is currently
reviewing all documents and we expect to proceed with demolition of the
antiquated structure and its replacement.
In December 2009, Supervisor Gioia and Dr. Walker were invited to the White
House for the exciting announcement by President Obama regarding the Facility
Investment Awards by the Department of Health and Human Services. CCHS
received $12 Million in ARRA funds for the construction of a new West County
health center, to replace the Richmond Health Center. The past six months have
been a particularly busy time as CCHS negotiates the final agreements for this
site, led by Patrick Godley, CFO/COO in conjunction with Supervisor Gioia. We
anticipate that environmental studies will soon be underway, and that
construction will begin after those submissions are approved by the funder.
Stimulus funds through the ARRA have provided close to $13Million for
services and facilities improvement.
Respite Care Program Opening June 2010
Under the direction and leadership of Cynthia Belon, Director of County Office of
Homeless Programs, the respite care program will open this month, with a 24-
bed capacity to serve approximately 380 clients annually with a higher level of
care than what is currently provided in the emergency shelter. HCH staff will
provide the medical care on site in this new unit.
Kate Schwertscharf, HCH Public Health Nurse Program Manager, has developed
medical policies regarding patient acuity for this program, in collaboration with
the HCH Medical Director, Dr. Kate Colwell, and Ms.Belon. To prepare for the
respite program, HCH has been setting up the clinic to be located in the respite
facility and updated its policies and protocols for taking discharge planning phone
calls from local hospitals looking to discharge homeless patients to a shelter.
Upon admission to the respite unit from a local hospital, a diagnostic medical
assessment and treatment plan will be developed for each client. Medical
providers on sight will coordinate with primary care physicians and/or hospital
staff in our integrated health care delivery system. The anticipated average
length of stay will be 14-21 days, or whenever the homeless client is medically
stable and can transition into the general emergency shelter population.
Rentry Program for Individuals Exiting Incarceration
The HCH program has also been working in collaboration with the County Office
of Homeless Programs, the Mental Health Division, and Dr. Walker’s office to
address the transition of prison inmates back into our communities, including
those to be released under Non-Revocable Parole, those being given
“compassionate” release for medical reasons, and others. In particular, the role
4
of the HCH Program has been to develop systems that help clients gain access
to primary, specialty, and behavioral health care and establish a medical home.
Pro-Bono Dental Health Services for Homeless Clients
The Homeless Consumer Advisory Board and HCH recently launched a new
partnership with a small group of private dental providers who will provide
services free of charge to homeless individuals who do not qualify for dental
coverage through other programs. The Advisory Board has been a strong
advocate about the need for this free service given a lack of affordable dental
services, and we are very pleased that a pilot program will address some of this
unmet need. The first client has been receiving free treatment and she will soon
have a set of dentures, at no cost, courtesy of the generous care from Dr.
Alijanian, DDS, of Walnut Creek. Dental services are essential to regaining
employment and exiting homeless.
Summary
This has been an exciting and busy time of growth and planning for the HCH
program in CCHS. We expect that our next report will have significant updates
on the milestones achieved for these new projects, while we also work hard to
sustain the ongoing work of the mobile clinic team and homeless ambulatory
care clinics.
1Health Care for the HomelessContra Costa Health ServicesPresentation to the Family & Human Services Committee Contra Costa County Board of SupervisorsJune 7, 20102Andrea DuBrow, MSW, MPHAdministrative ManagerKate Schwertscharf, PHNNurse Program Manager3Who qualifies as “Homeless?”zAll homeless people in Contra Costa County•Lacking a fixed, regular, adequate nighttime residence•Primary nighttime residence in a shelter, welfare hotel, transitional housing•“Doubled-up” without name on a lease, couch surfing, etc.4Funding for HCH ServiceszSection 330(h) Public Health Services ActHealth Care for the Homeless grant from the Federal Government (BPHC/HRSA) – approx. $850K
5ARRA Funding ReceivedzIncreased Demand for Services- $220K for two years from the Recovery Act, to provide services to additional homeless patients.zCapital Improvement Funds - $683K to replace Martinez bldg 2 with new modular unitz$12 Million award to rebuild Richmond Health Center6Number of Patients in 2009z15,094 unduplicated homeless patientsz96,572 visits: mobile clinics, ambulatory clinics, emergency department, mental health, substance abuse programs.7Number of Patients in 2008 z12,372 unduplicated homeless patientsz82,432 visits: mobile clinics, ambulatory clinics, emergency department, mental health, substance abuse programs.8How Patient Demand is Growing Over Time:z2007 vs. 2008:•20% increase in number of patients served•10% increase in number of patient visitsz2008 vs. 2009:•22% increase in patients•17% increase in visits
9Why the increase?zExpanded ability to provide services through increased grant fundingzEconomic situation creating increased demandzContra Costa Times article, “Local community clinics and public hospitals see big jump in uninsured patients” stated:•“Costa Regional Medical Center has seen a 12 percent boost in emergency room patients in the past year. It typically has less than a 5 percent increase.”zStatewide, California hospitals reported a 33 percent increase in uninsured emergency room patients and a 73 percent jump in consumers having difficulty paying their out-of-pocket medical bills, according to a November survey by the California Hospital Association. 10HCH ServiceszMobile Clinic:•routine physical assessments•basic treatment of primary health problems such as minor wounds and skin conditions•treatment for respiratory problems•TB testing•acute communicable disease treatment•referrals for follow up in ambulatory/specialty care•substance abuse and mental health services 112 Mobile Clinic Teams,5 days a weekzAdult Emergency Shelters Concord & RichmondzCalli House (youth), RichmondzBay Area Rescue MissionzGRIP Souper Center & Family Shelter, RichmondzNeighborhood House of North RichmondzMonument Futures, ConcordzMonument CorridorzHome Depot : El Cerrito, Pittsburg, ConcordzLoaves & Fishes, AntiochzRivertown Resource Ctr, AntiochzMulti-Service Centers, Richmond, AntiochzAOD Treatment FacilitieszSt. Paul’s, Walnut CreekzAmbrose Community Center, BaypointzLove-A-Child, Baypoint12Ambulatory Care ClinicszOperate specialized homeless clinics in the Richmond, Concord and Antioch health centers for homeless patients •Bypasses waiting times for appointments•Bypass financial counseling process•Make the process more “user friendly” for homeless patients•Helps patients transition to mainstream health care delivery system
13Ambulatory Care, Specialty, & Hospital Services•3 ambulatory care clinics specifically for homeless patients at Richmond, Concord, Antioch•Family practice care•Specialty care•Outpatient surgery•Emergency Department•Inpatient care•Laboratory•Radiology•Pharmacy14Mental Health ServiceszMental Health Treatment Specialist provides screenings, assessments, referrals into the Mental Health system for medication and treatment of clients in the shelters and at other mobile clinic sites15Alcohol and Other Drug ServiceszSubstance Abuse Treatment Specialist provides screenings, referrals, and coordination of detox and recovery services specifically for homeless patients in shelters and other mobile clinic sites16Patient Demographics 2009z51% malez49% femalez22% of homeless patients are completely uninsured, on no publicly-funded programz53% Medi-Cal; 2% Medi-CarezAll of our patients at 100% of the Federal Poverty Level and below.
17Race/Ethnicity in 2009Race HCH CountyWhite 35% 51%Latino/Hispanic 27% 23%Black/African American 23% 9%Asian/Pacific Islander 8% 14%American Indian/Alaskan Native 0.05% 0.3%Unknown 5% 2%18Which Supervisor Districts were Patients from in 2009?I- Supervisor Gioia 31%II- Supervisor Uilkema 15%III- Supervisor Piepho 2%IV- Supervisor Bonilla 20%V- Supervisor Glover 31%Total 100%19Which Supervisor Districts were Patients from in 2007 & 2008?District 2007 2008I- Supervisor Gioia39% 30%II- Supervisor Uilkema10% 13%III- Supervisor Piepho8% 6%IV- Supervisor Bonilla17% 19%V- Supervisor Glover23% 26%Other3% 5%20Strong Consumer InvolvementzActive consumer advisory board•Helped to create pro-bono dental services for homeless clients; first patient is receiving services and will receive a free set of dentures courtesy of Dr. Alijanian in Walnut Creek•Consumer attended National Health Care for the Homeless Conference in S.F. last week
21Challenges & OpportunitieszRespite Care program- opening this week! HCH is pleased to collaborate with COHP to provide higher level of medical care to medically fragile shelter clients.zDischarge Planning – improving outcomes for homeless patients leaving the hospital through planning and collaboration with local hospitals, HCH, and COHP .22Challenges & OpportunitieszRentry program for inmates exiting incarceration –developing systems for establishing medical home and behavioral health care for parolees, in conjunction with COHP, Mental Health, CCHS Director’s Office.zDeveloping new strategies to provide clinical care to homeless in encampents along with the Project HOPE team, despite recent budget cuts.zTwo public health nurses are providing medical case management at each adult shelter through creative funding streams