HomeMy WebLinkAboutBOARD STANDING COMMITTEES - 05092016 - FHS Cte Agenda Pkt
FAMILY & HUMAN SERVICES
COMMITTEE
May 9, 2016
1:00 P.M.
651 Pine Street, Room 101, Martinez
Supervisor Candace Andersen, Chair
Supervisor Federal D. Glover, Vice Chair
Agenda
Items:
Items may be taken out of order based on the business of the day and preference
of the Committee
1.Introductions
2.Public comment on any item under the jurisdiction of the Committee and not on this
agenda (speakers may be limited to three minutes).
3. CONSIDER recommending to the Board of Supervisors the appointments of Brenda
Brown to the Child Care Provider 2 - Central/South County seat and Eric Peterson to the
Community 1 - West County seat on the Local Planning and Advisory Council for Early
Care and Education, as recommended by the County Office of Education.
4. CONSIDER accepting the reports from the Health Services Department on the
Continuum of Care Plan for the Homeless and the Health Care for the Homeless and
directing staff to forward the reports to the Board of Supervisors. (Lavonna Martin, Chief
of Homeless Services and Rachael Birch, Health Care for the Homeless Project
Director)
5. CONSIDER accepting the report from the Employment and Human Services
Department, Workforce Services Division, on the Supplemental Nutrition Assistance
Program (SNAP), known in California as CalFresh. (Kathy Gallagher, Employment and
Human Services Director)
6.The next meeting is currently scheduled for June 13, 2016.
7.Adjourn
The Family & Human Services Committee will provide reasonable accommodations for persons
with disabilities planning to attend Family & Human Services Committee meetings. Contact the
staff person listed below at least 72 hours before the meeting.
Any disclosable public records related to an open session item on a regular meeting agenda and
distributed by the County to a majority of members of the Family & Human Services Committee
less than 96 hours prior to that meeting are available for public inspection at 651 Pine Street, 10th
1
floor, during normal business hours.
Public comment may be submitted via electronic mail on agenda items at least one full work day
prior to the published meeting time.
For Additional Information Contact:
Enid Mendoza, Committee Staff
Phone (925) 335-1039, Fax (925) 646-1353
enid.mendoza@cao.cccounty.us
2
FAMILY AND HUMAN SERVICES COMMITTEE 3.
Meeting Date:05/09/2016
Subject:Appointments to the Local Planning and Advisory Council for Early Care and
Education
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 25
Referral Name: Child Care Planning/Development Council Membership
Presenter: Ruth Fernandez, LPC
Coordinator/Manager
Contact: Enid Mendoza, (925)
335-1039
Referral History:
The review of applications for appointments to the Contra Costa Local Planning and Advisory
Council for Early Care and Education (LPC) was originally referred to the Family and Human
Services Committee by the Board of Supervisors on April 22, 1997.
Referral Update:
Please see the attached request from the LPC and candidate applications.
Recommendation(s)/Next Step(s):
RECOMMEND to the Board of Supervisors the following appointments, to the Contra Costa
Local Planning and Advisory Council for Early Care and Education with terms expiring April 30,
2019, as recommended by the County Office of Education:
Child Care Provider 2 - Central/South County seat: Brenda Brown
Community 1 - West County seat: Eric Peterson
Fiscal Impact (if any):
No fiscal impact.
Attachments
LPC Memo and Candidate Applications
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
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FAMILY AND HUMAN SERVICES
COMMITTEE 4.
Meeting Date:05/09/2016
Subject:Continuum of Care for the Homeless / Health Care for the Homeless
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 5
Referral Name: Continuum of Care Plan for the Homeless / Health Care for the Homeless
Presenter: Lavonna Martin and Rachael Birch Contact: Enid Mendoza, (925) 335-1039
Referral History:
This referral to the Family and Human Service Committee was originally made by the Board of
Supervisors on December 3, 1996. Since that time, the Health Services Department regularly
updates the Committee on the services provided to the homeless.
Referral Update:
Please see the attached reports.
Recommendation(s)/Next Step(s):
ACCEPT the reports provided on the Continuum of Care Plan for the Homeless and the Health
Care for the Homeless and DIRECT staff to forward the reports to the Board of Supervisors.
Fiscal Impact (if any):
Informational reports; no fiscal impact.
Attachments
Homeless Continuum of Care Report
Health Care for the Homeless Memo
Health Care for the Homeless Presentation
23
WILLIAM B. WALKER, M.D.
HEALTH SERVICES DIRECTOR
CYNTHIA BELON, LCSW
BEHAVIORAL HEALTH DIRECTOR
CONTRA COSTA
BEHAVIORAL HEALTH
HOMELESS PROGRAM
1350 Arnold Drive, Ste. 202
Martinez, California
94553-4675
PH 925 313-6124
FAX 925 313-6761
TO: Family and Human Services Committee, Contra Costa County Board of Supervisors
FROM: Lavonna Martin, MPH, MPA, Chief, Homeless Services
RE: Annual Report on the Homeless Continuum of Care
DATE: May 9, 2016
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 of the effort to end
homelessness and the activities of Contra Costa Inter-Jurisdictional Council on Homelessness (Homeless Advisory
Board).
BACKGROUND
In November 2014, the Board approved “Forging Ahead Towards Preventing and Ending Homelessness: An Update to
Contra Costa’s 2004 Strategic Plan”, that renewed our 2004 plan with the latest data, best practices, and community
feedback and reaffirmed our commitment to the Housing First approach. As such, “Forging Ahead” establishes this
guiding principle: “Homelessness is first a housing issue, and necessary supports and services are critical to help people
remain housed. Our system must be nimble and flexible enough to respond throught shared responsibility,
accountability, and transparency of the community.” The Strategic Plan Update identifies two goals: 1) Decrease the
length of time people experience homelessness by focusing on providing Permanent Housing and Services and; 2)
Decrease the percentage of people who become homeless by providing Prevention activities. To achieve these goals,
three strategies emerged:
1) Implement a coordinated entry/assessment system to streamline access to housing and services while
addressing barriers, getting the right resources to the right people at the right time;
2) Use best, promising , and most effective practices to give the consumer the best possible experience through
the strategic use of resources; and
3) Develop the most effective platforms to provide access, support advocacy, and connect to the community
about homelessness and available resources.
The Homeless Program partners with the Homeless Advisory Board and Continuum of Care to develop and carryout
an annual action plan that identifies the objectives and benchmarks related to each of the goals and strategies of
Forging Ahead. Further, the Homeless Program incorporates the strategic plan goals into its own delivery system of
comprehensive services, interim housing and permanent supportive housing as well as contracting with community
agencies to provide additional homeless services and housing with the goal of ending homelessness in our
community.
Attached is a summary of Key Activities and Accomplishments of the Homeless Continuum of Care for fiscal year 13-
14/14-15, as well as the Contra Costa Homeless Continuum of Care Annual Report that provides a summary of
program services, outcomes, and consumer demograhics for Fiscal Year 2014-2015.
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HOMELESS PROGRAMS KEY ACTIVITIES AND ACCOMPLISHMENTS
FY 14-15/15-16
The Homeless Program, partnered/s with the Council on Homelessness, service providers, and other community
stakeholders, to implement the following key activities and achieve the following outcomes.
1. Housing and Services
• Thirty-two additional rental assistance vouchers were added to the Continuum of Care.
• Work continues towards the development of permanent supportive housing units for homeless
individuals and families on the Concord Naval Weapons Station. The Homeless Program, in concert with
the Council on Homelessness, continues to work with the City of Concord to develop a timeline to bring
the units on-line.
2. System Governance, Design and Delivery
• Work is in progress to develop a coordinated assessment system to streamline and coordinate program
participant intake, assessment and prioritization for housing. The Contra Costa Homeless Continuum of
Care has selected the Vulnerability Index – Service Prioritization Decision Assistance Tool (VI-SPDAT) as
the comprehensive and standardized assement tool and began administering the tool February 2015.
Training for all Homeless Service providers was completed 1/15/16.
• The Housing Authority of Contra Costa County has worked with the Council on Homelessness to develop
a homeless preference to support “graduates” of permanent supportive housing.
• Work with the Council on Homelessness to draft a governance charter and revise the by-laws for the
Contra Costa Council on Homelessness was completed and approved by the Board of Supervisors on
1/19/16. The new Council has 17 voting member seats that reflect a variety of stakeholders needed to
address homelessness in Contra Costa.
3. Outreach/Engagement/Community Awareness
• Project Homeless Connect was held in Richmond August 6, 2014. Over 750 participants had access to
free services including health care, vision screenings, homeless court, benefits enrollment, and pet
vaccinations and also received summer hygiene kits and free transportation to-and-from the event. The
next PHC will be held October 13, 2016 at the Contra Costa County Fairgrounds in Antioch.
• The point-in-time count of homeless individuals living on the streets and in shelters was conducted over
a three day period in January 2016. Three thousand, five hundred (3,500) individuals were identified as
homeless the night of January 27, 2016 in Contra Costa. This is a 6% decrease in the number of
individuals counted last year.
4. Funding and Special Initiatives
• Successfully competed for HUD Continuum of Care Program Homeless Assistance funds which brought
more than $11M to Contra Costa homeless service providers.
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• Contra Costa was selected to join Zero: 2016, a national campaign coordinated by Community Solutions,
to end homelessness for 237 veterans by the end of 2015, and 763 chronically homeless individuals by
2016. To date, 229 veterans have been housed and 250 chronically homeless individuals have secured
housing.
• In June 2014, the County Homeless Program completed an analysis of the Cost of Homelessness on the
Healthcare System. Using 2013-2014 Fiscal Year data, 6,601 unique individuals were identified as
homeless in the Continuum’s system of care. Just under half of those individuals (3,170) also utilized
mental health, primary health, or alcohol and drug treatment offered through the Contra Costa Health
Services Department for a total of $45,412,145. While many consumers incurred few and nominal
healthcare expenses, a small minority, twelve percent (12%), of the homeless population that accessed
the county health services amassed almost three-quarters of the total county healthcare costs (>$32M).
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CONTRA COSTA HOMELESS CONTINUUM OF CARE
2014-2015 Fiscal Year Annual Report
This report provides a summary of activities, service data, and outcomes for the Contra
Costa Homeless Continuum of Care for Fiscal Year 2014-2015. The Continuum of Care is
a local planning body - comprised of health and human service providers, members of
the faith community, businesses, funders, education systems, and law enforcement - all
working in partnership with consumers to develop, organize, and implement a housing
and support services delivery system for homeless individuals across the County.
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Contra Costa Homeless Continuum of Care
TABLE OF CONTENTS
Annual Report Summary…………………………………………………………..Page 2
Contra Costa Council on Homelessness Overview …………………………………Page 3
Programs and Services……………………………………………………………Page 4
Program Outcomes and Performance Measures…………………………………..Page 5
Program highlight…………………………………………………………………Page 6
Zero:2016 ………………………………………………………………………..Page 6
Cost of Homelessness……………………………………………………………...Page 8
Coordinated Entry………………………………………………………………...Page 9
2015 Point in Time Count…………………………………………………………Page 10
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ANNUAL REPORT SUMMARY – A LETTER FROM THE CHAIR
VISION and CHANGE are the two words that best sum up fiscal year 2014-15 for Contra Costa’s Homeless
Continuum of Care (the Continuum). The year began amidst a collective re-enVISIONing of the provision of
housing and services for all of those who are homeless in Contra Costa County. An unprecedented number and
scope of community members took part in this effort, including partner agencies that provide such services,
faith and other community members, homeless and formerly homeless individuals, hospitals, police, and local
government. An important guiding principle emerged - “Homelessness is first a housing issue, and
necessary supports and services are critical to help people remain housed.”
The end result of the extensive community discussion and planning efforts was Forging Ahead Toward
Preventing and Ending Homelessness - a fresh strategic plan to guide our County’s efforts in addressing
homelessness in the next decade. The Plan concentrates on goals to increase permanent housing opportunities
and preventing homelessness, with three key strategy areas to meet these goals:
1) Coordinated Entry of homeless people into the systems of care (to streamline the process for clients,
effectively address barriers, implement a Housing First approach, and better match clients with the
appropriate level of housing and services);
2) Performance Standards (to systematically evaluate the impact of efforts on clients and integrate
evaluation and performance measures with implementation of programs and practices); and
3) Communication (to increase access, support advocacy, and connect the community with information
about homelessness and available resources).
The Continuum invested many hours to conceptualize and develop these three strategies, with guidance from a
number of evidence-based and evidence-informed resources. These efforts were aligned with the Contra
Costa Council on Homelessness (the Council) Zero: 2016 campaign to end veteran and chronic homelessness.
This campaign acted as a catalyst to bring new stakeholders to the Continuum’s efforts, leverage new
resources, encourage greater communication, and use data to inform programming and systems change. And
then began the process of actually implementing CHANGE! The Council was heavily involved with Zero: 2016
planning and development, roll-out of the Coordinated Entry system, and updating Performance Measures.
This report demonstrates the impact of these efforts. Included is a summary of Continuum-wide outcomes
with a brief review of annual Performance Measures as well as process and outcome measures for the various
types of programming provided by Continuum partners. As you will see, many Contra Costa residents who
were homeless improved their housing and living situations in 2014-2015.
The Council is looking forward to a year of continued successes in the Continuum’s ability to meet the needs of
our most vulnerable community members. In the 2015-2016 Fiscal Year, the Council will focus on even
broader system change to improve housing resources and services across the county.
Teri House, Chair
Contra Costa Council on Homelessness
For more information, email homelessprograms@hsd.cccounty.us.
*A description of the Continuum of Care and the Council on Homelessness is provided on page 3
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THE CONTRA COSTA COUNCIL ON HOMELESSNESS
The Contra Costa Continuum of Care (the Continuum) is a network of providers, agencies, local governments,
current and former consumer of services, and community members that coordinate the funding and provision of
housing and services for homeless families and individuals. As a cohesive entity, the Continuum provides short-
term financial assistance, emergency shelter, transitional housing, permanent supportive housing, substance use
disorder treatment and supports, primary care and mental health services, housing navigation, and case
management.
The Contra Costa Council on Homelessness (hereinafter referred to as the Council) provides the necessary
leadership to ensure that the Continuum implements comprehensive, evidence-informed programming to
address homelessness across the county. The Council’s fourteen member Executive Board is appointed by the
Contra Costa County Board of Supervisors to provide guidance and assist in the development and
implementation of long range planning and policy formulation of homeless issues in Contra Costa County. It
also serves as an advisory body to Contra Costa Health Services Department’s Health Care for the Homeless
Program, in compliance with US Department of Health Resources and Services Administration (HRSA)
requirements.
The Contra Costa Council on Homelessness provides monthly forums that bring the Continuum of Care together
for communication and coordination of the County's Strategic Plan to End Homelessness, education to the
community on homeless issues, and advocacy on federal, state, and local policy issues affecting people who
are homeless or at-risk of homelessness.
Other service partners: Berkeley Food and Housing, East Bay Community Recovery Project, Monument Crisis Center, and West
Contra Costa Unified School District
30
7,597 Individuals Served
• 5,883 were homeless; 952
were in Permanent Supportive
Housing
• 711households with children
• 948 minors
• 1,710 chronically homeless
• 479 homeless veterans70
minors
1,860 chronically
PROGRAMS AND SERVICES
The Continuum serves thousands of homeless and formerly homeless people of all ages and demographics
through the many service providers delivering homeless prevention and intervention programs.
Continuum programs fall under seven different categories.
Emergency Shelters provide temporary shelter for people that
have no safe and healthy sleeping arrangements. Consumers
generally come from uninhabitable locations (encampments,
streets, or vehicles), are fleeing domestic violence, or lost
temporary housing.
Support Services Only programs include a variety of services to
assist homeless individuals get back on their feet and/or simply
provide basic health needs. This programming includes Drop-in
Centers and Employment Programs.
Transitional Housing is short-term housing for underage youth
and families to get them off the streets and into more stable
living environments until permanent housing can be established.
Rapid Rehousing programs provide financial assistance and
services to prevent individuals and families from becoming
homeless and help those who are experiencing homelessness to be quickly re-housed and stabilized.
Permanent Supportive Housing links long-term, safe, affordable, community-based housing with
flexible, voluntary support services designed to help the individual or family stay housed and live a
more productive life in the community.
Street Outreach provides basic hygiene supplies, housing and shelter referrals, food, and water.
Prevention Programs provide short-term financial assistance to help families and individuals stay in
their homes and avoid entering homelessness.
3864
1407
1123 952 831
480 386 319 270
Drop-In
Centers
Emergency
Shelters
Street
Outreach
Permanent
Supportive
Housing
Rapid
Rehousing
Employment
Programs
Transitional
Housing
Benefits and
Money Mgmt
Prevention
Individuals Served by Program Type*
*Individuals utilizing multiple programs are included under each program type.
31
PROGRAM OUTCOMES
The Council reviews a variety of metrics to determine program performance across the Continuum. One key
metric are the Performance Measures, or outcome measurements required by the US Department of Housing
and Urban Development (HUD) to track outcomes in HUD-funded Continuum of Care programming.
Performance Measures are critical in understanding areas of improvement and to determine how many
consumers are achieving positive outcomes within various types of programming.
2014-2015 System-wide Performance Measures
The Contra Costa County Homeless Continuum of Care established Performance Measures for all types of
programming (Emergency Shelter, Transitional Housing, Rapid Rehousing, Support Services and Outreach, and
Permanent Supportive Housing). Three of the key Performance Measures are provided below.
27% of consumers in
Emergency Shelters
exited straight into
Permanent Housing
81% of consumers in Rapid
Rehousing exited to Permanent
Housing opportunities; only 9%
returned back into homelessness
after being placed into
Permanent Housing
97% of individuals placed into
Permanent Supportive Housing remain
in their housing for at least a year;
70% retained for at least 3 years.
Sub-population Outcomes
Additional measurements collected by the Continuum provide a deeper understanding of how consumers move
through the system as well as how different populations achieve housing. Movement through the system from
no or temporary housing to permanent housing is the best indicator of success. In the 2014-2015 Fiscal Year,
we see that consumers, regardless of service type utilized, improve their housing and living situations.
Population Prior Living Situation % Exiting to
Permanent Housing
Veterans 55% came from encampments; 45%
came from emergency shelters or
temporary living situations
36%
Chronically Homeless 55% came from encampments; 43%
came from emergency shelters or
temporary living situations
22%
Minors (under 18 yrs) Prior sleeping arrangement is not
collected for minors
55%
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“I enjoy being part of CCIH’s program because they helped me acquire housing and assisted me with my
educational goals to become an EMT (Emergency Medical Technician). I was paired with a good roommate.
Without CCIH I don’t know where I’d be.”
-Cory
PROGRAM PARTNER HIGHLIGHT
Contra Costa Interfaith Housing Scattered Site Housing
In 2015, Contra Costa Interfaith Housing (CCIH) launched its new scattered-site
permanent housing program to provide housing for 48 chronically homeless adults
struggling with mental health and other complex issues. In addition to obtaining
affordable permanent housing, residents in this program receive intensive support
from a mobile service team of case managers and mental health clinicians who visit
them in their homes. Case managers partner with residents to set goals specific to
their unique needs including from mental health, sobriety, employment, and access to
essentials such as food and primary health care. This supportive housing model is
cost-effective and successful in preventing high cost emergency room visits,
hospitalizations, and incarceration while offering dignity and support to chronically
homeless adults.
This is a new housing model for CCIH which already provides permanent housing and/or supportive services
at four affordable housing sites which serve more than 1,000 formerly homeless and very low-income Contra
Costa residents.
For more information about Contra Costa Interfaith Housing, please visit www.ccinterfaithhousing.org.
33
Getting to Zero
# entering
homelessness
each month
# exiting
homelessness each
month to
permanent housing
≤
CONTRA COSTA ZERO: 2016 CAMPAIGN
In January, 2015, Contra Costa joined 70 other communities across the U.S. working to quickly and efficiently
reduce the number of veterans and chronically homeless people in need of permanent housing through the
national Zero: 2016 campaign organized by Community Solutions. The campaign aims to house all homeless
veterans by the end of 2015, and all people who are chronically homeless by 2016.
Guided by the Contra Costa Zero: 2016 Leadership Committee, a sub-committee of the Council on
Homelessness, local Zero: 2016 efforts are focused on meeting housing placement goals for homeless
veterans, individuals who are chronically homeless, families, and unaccompanied youth through cross-sector
collaboration, systems development, and the use of data to drive change and achieve success.
Using a formula offered by Community Solutions, Contra Costa’s housing placement goals for veterans and
chronically homeless were derived by combining 2015 Point in Time data (see page 11) with a multiplier
designed to estimate the number of newly homeless people entering the system each month. Housing
placement goals established for
Contra Costa’s Zero campaign
are to house
• 237 veterans; and
• 763 chronically homeless.
Each month, targets are revised
based on the total placements
remaining and length of time
left to meet the final placement
goals. “Zero” will be achieved
when the number of homeless
individuals and families who are
permanently housed each month
is equal to or greater than the
number of individuals who are
entering homelessness.
In 2015-2016, Contra Costa’s Zero: 2016 campaign efforts will focus on landlord engagement to address the
shortage of housing opportunities for veterans and chronically homeless. Data will also be incorporated into
program efforts to better understand the breadth of housing needs and assets in the county. Additionally, the
Continuum of Care will establish “by-name” lists that identify each and every veteran and chronically
homeless person in the system of care that needs housing.
Contra Costa Zero: 2016 Leadership Committee partner agencies
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$45 Million in Health Care Costs
COST OF HOMELESSNESS ON THE HEALTH CARE SYSTEM
Cities and counties across the United States bear extraordinary financial and social costs related to
homelessness and lack of related resources such as health care and prevention. Contra Costa County
continues to analyze data from across multiple county programs to determine the cost of homelessness at the
local level. Health costs include Primary Health Care (emergency, inpatient, and outpatient), Mental Health
Care (emergency, inpatient, and outpatient), and Alcohol and Other Drug Services (outpatient and
residential).
Using 2013-2014 Fiscal Year data, 6,601 unique individuals were identified as homeless in the Continuum’s
system of care. Just under half of those individuals (3,170) also utilized mental health, primary health, or
alcohol and drug treatment offered through the Contra Costa Health Services Department for a total of
$45,412,145.
While many consumers incurred few and nominal healthcare
expenses, a small minority, twelve percent, of the homeless
population that accessed the county health services amassed
almost three-quarters of the total county healthcare costs.
These 12% are referred to as the high-cost consumers in this
report and is consistent with other cost studies on homelessness
that identifies the top 10-15% of consumers as high-cost users.
For this evaluation, high-cost consumers are individuals
incurring over $25,000 in total costs across the three county
health services. This cut-off was established after identifying
that the majority of the 3,170 consumers (60%) costs less than
$5,000 in medical and behavioral health care costs and a
small minority (12%) incurred over $25,000.
Among high-cost users, primary
health inpatient and mental
health outpatient were the
greatest expenses; with
$46,729 and $7,763 in
average annual costs
respectively.
During 2015-2016, the County
will continue to analyze data to
incorporate additional costs,
including clean- up of
encampments along the water
canals and emergency services
transportation. Analyses will also
review service expenses for
consumers that go into Permanent Supportive Housing to understand savings in healthcare and local
government once homeless individuals become housed and receive support services. For the full report, click
here: Cost of Homelessness Study.
12% of
utilizers
incurred
71% of
healthcare
costs
88% of
utilizers
incurred
29% of
healthcare
costs
$13 Million
$32 Million
$-
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
Primary Health
Emergency
Primary Health
Inpatient
Primary Health
Outpatient
Alcohol, Drug, and
Other Substances
Mental Health
Emergency
Mental Health Inpatient
Mental Health
Outpatient
Average Health Care Costs by Service Type among High-Cost Users
35
What is the VI-SPDAT?
The VI-SPDAT is a “supertool” that
combines the strengths of two widely used
existing assessments:
1. The Vulnerability Index (VI),
developed by Community Solutions, is
an outreach tool currently utilized in
more than 100 communities. Rooted
in leading medical research, the VI
helps determine the chronicity and
medical vulnerability of homeless
individuals.
2. The Service Prioritization Decision
Assistance Tool (SPDAT), developed
by OrgCode Consulting, is an intake
and case management tool utilized in
more than 70 communities. Based on
a wide body of social science research
and extensive field testing, the tool
helps service providers allocate
resources in a logical, targeted way.
The VI-SPDAT helps identify the best
type of support and housing intervention
for an individual by relying on three
categories of recommendation:
Permanent Supportive Housing, Rapid
Re-Housing, or Affordable Housing.
FIRST STEPS TO COORDINATED ENTRY
The Continuum continues to design and implement a coordinated entry system that streamlines access to
services for homeless consumers in need of housing. The Council established a Coordinated Entry sub-
committee to research best and promising practices around coordinated entry, identify a universal screening
tool, and develop a Continuum-wide implementation strategy.
The VI-SPDAT (Vulnerability Index-Screening Prioritization
Decision Assistance Tool) was adopted by the Council as the
evidence-informed tool to identify the appropriate housing
type and level of services for homeless individuals based
upon their physical and behavioral health needs. The VI-
SPDAT is a simple-to-administer that can be completed in
the field, over the phone, or in person. The Continuum’s
efforts with Coordinated Entry included pilot testing the VI-
SPDAT and case conferencing for housing placement based
on VI-SPDAT scores. Over the past fiscal year, the CoC:
• Launched a CoC-wide pilot of the VI-SPDAT
assessment tool
• Designed our coordinated entry process
• Began pilot of Housing Placement Committee to
test the referral process
• Identified the need for housing navigators and
housing locators to ensure successful placements
During the 15-16 Fiscal Year, Continuum service providers
will be encouraged to enter VI-SPDAT scores into the
Homeless Management Information System, allowing
facilitation of Housing Placement Committee meetings using
the assessment scores to identify appropriate housing
placements.
36
3,715 individuals:
• 1,326 unsheltered
• 704 sheltered
• 1,685 other
“Other” homeless category
includes other temporary living
arrangements eligible for HUD
funded services and would be
homeless if not for temporary
accommodation they had the
night of the count.
2015 POINT IN TIME COUNT
The 2015 Point in Time (PIT) count was a great example of collaboration and innovation among Continuum
partners and community agencies. In past years, the PIT Count was conducted over a one day/night period
and PIT surveys were conducted on a sample of individuals. This year’s methodology was changed to reflect
recommendations made by Housing and Urban Development to
extend the number of days volunteers and street outreach teams were
in the community, administering a survey to community members at
service and community sites, and conducting a full census instead of
sampling across the community. These efforts required partnerships
with service sites, community organizations, local governments, and
about 100 volunteers from the community and partner agencies.
The Point in Time count data is used to both track homelessness trends
across the county and to understand funding and programmatic needs
to ensure housing and other resources for the community. The PIT
numbers also informed goals for the Zero:2016 initiative and helped
to set priorities and strategies for ending veteran and chronic
homelessness.
Outreach teams documented locations of encampments at the time of the PIT Count. These encampments are
identified in the GIS map below.
The full report and a one-page info-graphic
are available on the Council website.
37
RESOURCES AND LINKS
Links provided in this report:
Performance measures Report: http://cchealth.org/homeless/council/pdf/2015-PIT-report.pdf
Zero: 2016 Community Solutions: http://cmtysolutions.org/zero2016
Cost of Homelessness Report: http://cchealth.org/homeless/council/pdf/cost-of-homelessness-in-
contra-costa-county.pdf
2015 Point in Time Report: http://cchealth.org/homeless/council/pdf/2015-PIT-report.pdf
2015 Point in Time Infographic: http://cchealth.org/homeless/council/pdf/2015-PIT-infographic.pdf
Council on Homelessness Website: http://cchealth.org/homeless/council/about.php
Please contact the Contra Costa County Homeless Program at homelessprograms@hsd.ccounty.us for more
information about this report or activities within the Contra Costa Continuum of Care.
38
Annual Update on the Homeless Continuum of CarePresentation to the Family and Human Services CommitteeContra Costa County Board of SupervisorsMay 9, 201639
240
Contra Costa Council on Homelessness•17 voting seats•Representing primary health care, law enforcement, ESG federal programs, County/City government, Housing Authority, faith community, non-profit service providers.•Executive Board meets monthly. Community forum is convened quarterly.341
Continuum of Care FocusFY 14‐151) Defining the need through data2) Service Delivery and Outcomes3) Expanded partnerships4) Systems Change442
Point in Time Count 201651,730 homeless* 620 in shelters* 1,110 on streets1,770 imminently at‐risk9% veterans7% families with minor children15% chronically homeless29% mental health issues3,500 Homeless or Imminently At‐Risk43
One Year PIT Comparison6207041110132617701685201620152015 and 2016 PIT Sheltered, Unsheltered, and At‐RiskShelteredUnshelteredAt‐riskTotal: 3,500Total: 3,7156% decrease644
7,597individualsreceived shelter, support services, and/or housing assistance FY 14-15.•5,883were homelessAn Expanded View745
Facts about the PopulationFY14‐1537% are households with children27% are children (<18)11% are veterans37% are chronically homeless30% have a medical / health condition25% have alcohol abuse issues27% have drug abuse issues34% have a mental health disability846
Disabling condition947
System‐wide Performance Measures FY 14‐15•27%of consumers in Emergency Shelters exited straight into Permanent Housing •81%of consumers in Rapid Rehousing remained in Permanent Housing; only 9% returned back into homelessness.•97%of individuals placed into Permanent Supportive Housingremain in their housing for at least a year; 70% retained for at least 3 years. oAmong those that exit the program, 75% go to other permanent housing opportunities 1048
Cost of Homelessness to Primary and Behavioral Health System1112% of consumers incurred 2/3 of healthcare 88% of consumers incurred 1/3 of healthcare costs$13 M$32 M$45 Million in Health Care Expenditures49
Driving towards functional zeroSince January 2015, we have housed… •229 veterans •250 chronically homeless1250
Coordinated Entry Design1351
Next Years WorkCoordinated Entry ImplementationNew housing for families and veteransWhole Person CareHousing Security FundIntegrated outreach (including street medicine)1452
Need to Contact Us?Lavonna Martin, MPH, MPAChief, Homeless ProgramLavonna.Martin@hsd.cccounty.us1553
CONTRA COSTA HEALTH SERVICES DEPARTMENT
CONTRA COSTA COUNTY
TO: Family and Human Services DATE: May 11th, 2016
Committee Members
Board of Supervisors
FROM: Rachael Birch, 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) Program has provided
health care services to the homeless population in Contra Costa County through
mobile clinics, stationary health centers and the Concord Medical Respite facility.
Health care services provided by the HCH 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, coordination and referrals for follow up treatment of identified
health care needs, dental services, health education, behavioral health services
and outreach and enrollment services. A significant portion of the homeless
patients seen by the HCH team have chronic diseases, including asthma,
hypertension, diabetes, and mental health/substance abuse issues. They also
have disproportionately more dental, substance abuse and mental health needs
than the general population.
The clinical team is comprised of a Medical Director, Family Nurse Practitioners,
Registered Nurses, Community Health Workers, Dentist, Registered Dental
Assistance, Mental Health Specialist, Substance Abuse Counselor, Health
Educator and Eligibility Workers.
54
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 four ambulatory care clinics, located in
Antioch, San Pablo, Martinez and Concord, 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. The HCH
Program also has priority scheduling access for homeless patients in all of the
CCHS Health Centers.
During 2015, CCHS treated 32,093 homeless patients who generated 166,589
visits.
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
District 2015
I 30.1%
II 2.5%
III 36.9%
IV 19.4%
V 11.1%
The attached presentation contains additional demographic information on our
Homeless population.
New Actions
The following activities and updates have occurred since the last briefing to the
Board of Supervisors on HCH activities:
New Staff
Linae Young, MPH - Senior Health Education Specialist
Linae was added to our team in January 2016 to manage our expanding
Health Education program. She is responsible for arranging education classes in
our County-run shelters and other community agencies. So far she has
implemented Expressive Art Therapy groups, and Diabetes, Substance Abuse,
Stress Management and Health Care Maintenance classes at County shelters.
Classes and groups have been well-attended and well-received.
New Funding Opportunities
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The HCH Program received a Medication-Assisted Treatment (MAT) grant in
March 2016 to develop a new program focusing on therapy and treatment for
opiate addiction. The HCH Program is currently hiring four Nurses and four
Mental Health Providers to provide these services in Antioch, West County and
Concord. Services will include group counseling, medication treatment using
buprenorphine and case management to assist patients transitioning off opiate
drugs.
Narcan Kits
The HCH Program is now providing Narcan units and Narcan training to team
members and to community organizations. Narcan is an opiate antidote and can
save lives if administered to an overdosing individual.
HIV Testing
The HCH Program is now providing on-the-spot HIV testing in our mobile clinics.
HIV testing technology now allows cheek swabs and 20 minute processing. The
HCH Program has noticed a very low compliance rate for patients referred to the
lab for HIV testing. Due to various barriers or personal reasons, homeless
patients do not comply with referrals to obtain a blood test for HIV testing.
Providing a simple test in the field, the HCH team hopes to increase HIV
screening rates for our population.
Dental Program
The HCH Program has operated a Dental Clinic for almost one year now.
Operating at 16 hours per week, the Respite Dental Clinic has been a much
needed addition. Homeless people have disproportionally more dental problems
than other populations and lack access to dental services. The HCH Program is
working on expanding our dental program and recently applied for a funding
opportunity to add mobile dental units. There is still a lot of work to be done to
meet the large need for dental services among this population.
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HEALTH CARE
FOR THE HOMELESS (HCH)
CONTRA COSTA HEALTH SERVICES
MAY 9 TH , 2016
PRESENTATION TO THE
FAMILY & HUMAN SERVICES COMMITTEE
CONTRA COSTA COUNTY BOARD OF SUPERVISORS
57
FUNDING FOR HCH SERVICES
•Section 330(h) Public Health
Services Act Health Care for the
Homeless grant from the Federal
Government (BPHC/HRSA) –
approx. $2.7M per year.
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NEW FUNDING
Dental Service Expansion – HCH Program
operates a Dental Clinic at the Respite Health
Center in Concord.
Medication Assisted Treatment – MAT services
include Buprenorphine, a medication used to
treat opioid dependence
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WHAT WE DO?
Primary Care
Mental Health
Substance Abuse
Dental Care
Respite Care
Case Management
Eligibility Assistance
Patient Education
Linkages to larger CCHS systems of care
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STRATEGIC PLANNING GOALS
•GOAL 1: Improve Communication within and
between Homeless Providers in Contra Costa
County.
•GOAL 2: Expand BH integration within the HCH
Program
•GOAL 3: Increase preventative services
compliance
•GOAL 4: Improve HCH visibility, service alignment
and integration within CCHS system
•GOAL 5: Reduce barriers to care and provide
comprehensive services to all Homeless clients in
County
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PATIENT DEMOGRAPHICS 2015
•46.5% Male
•53.6% Female
•8.5% Uninsured (16.7% in 2013)
•75.4% Medi-Cal (63% in 2013)
•2% Veterans
•24.1% Best served in language other
than English (22.5% in 2014)
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HOMELESS RACE/ETHNICITY
Race 2015 2014
Latino/Hispanic 31.9% 30.2%
White 28.8% 31.2%
Black/African American 18.2% 18%
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WHERE ARE PATIENTS BEING SERVED?
District 2013 2014 2015
I 20.6% 24.6% 30.1%
II 2.8% 2.4% 2.5%
III 40.5% 36.2% 36.9%
IV 19.9% 19.5% 19.4%
V 10.4% 10.9% 11.1%
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UPDATES
•Education Program
•Diabetes, Nutrition, Hypertension, Substance Abuse,
Cancer, Health Care Maintenance, Stress
Management
•Expressive Art Therapy Groups
•HIV testing
•Narcan kits
•Miller Wellness Clinic
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FAMILY AND HUMAN SERVICES COMMITTEE 5.
Meeting Date:05/09/2016
Subject:SNAP/CalFresh (Food Stamp) Program Update
Submitted For: FAMILY & HUMAN SERVICES COMMITTEE,
Department:County Administrator
Referral No.: 103
Referral Name: SNAP/CalFresh (Food Stamp) Program
Presenter: Kathy Gallagher, Employment and Human
Services Director
Contact: Enid Mendoza, (925)
335-1039
Referral History:
The SNAP Program was originally referred to the Family and Human Services Committee by the
Board or Supervisors on February 15, 2011.
This program was formerly known as Food Stamps and is the Federal Supplemental Nutrition
Assistance Program (SNAP). In California, the name of the program is CalFresh.
Referral Update:
Please see the attached report from the Employment and Human Services Department.
Recommendation(s)/Next Step(s):
ACCEPT the report from the Employment and Human Services Department on the CalFresh
program, formerly known as Food Stamps and federally known as the Supplemental Nutritional
Assistance Program (SNAP) and DIRECT staff to forward the report to the Board of Supervisors
for their information.
Fiscal Impact (if any):
This is an informational report with no financial impact.
Attachments
CalFresh Program Update Report
66
40 Douglas Drive, Martinez, CA 94553 • (925) 313-1500 • Fax (925) 313-1575 • www.ehsd.org
To: Family and Human Services Committee
Contra Costa County Board of Supervisors Date: May 9, 2016
From: Rebecca Darnell, Interim Workforce Services Director
Kathi Kelly, CalFresh Policy Manager
Subject: CALFRESH PROGRAM UPDATE
I. Overview
The CalFresh program, formerly known as Food Stamps and federally known as the
Supplemental Nutrition Assistance Program (SNAP), was designed to help provide
assistance to hungry people, regardless of their age, gender, marital or family status. The
program issues monthly electronic benefits that can be used to buy most foods at many
markets and food stores.
The CalFresh Program helps to improve the health and well-being of qualified
households and individuals by providing them a means to meet their nutritional needs.
At the federal level, the program is administered by the United States Department of
Agriculture’s (USDA) Food and Nutrition Service (FNS). In California, the CalFresh
Program is supervised at the state level by the California Department of Social Services
and is administered at the local level by the Employment and Human Services
Department (EHSD).
Since the Great Recession, we have experienced an unprecedented increase in the number
of individuals applying for CalFresh benefits. In 2006, we had approximately 12,554
families applying for aid as compared to 32,851 in 2015. This represents a 162% increase
in the number of CalFresh applications received during this period
M E M O R A N D U M
Kathy Gallagher, Director
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Over the last ten years, the CalFresh only cases have increased a total of 423% going
from roughly 5,846 average cases a month in 2006 to 30,560 average monthly cases in
2015.
Beyond the CalFresh only average caseload of 30,560 in 2015, we also had an additional
average of 5,034 Public Assistance cases which represent those households that receive
both cash aid (CalWORKs) and CalFresh. This represents a total average of 35,594
CalFresh cases in 2015.
In Contra Costa County, CalFresh puts more than $10 million in State and Federal
Funding into the local economy each month. As indicated by the USDA, research shows
that every $1 provided in CalFresh benefits generates $1.79 in economic activity. Using
the multiplier effect, CalFresh generated $17.9 million into the local economy in the past
year. The return on investment benefits local businesses, landlords, and many service
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015Applications Applications increased by 162% between 2006-2015
CalFresh Only Applications
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015Cases Cases have increased 423% between 2006-2015
CalFresh Only Cases
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providers. CalFresh benefits help families stretch their food dollars to buy more healthy
foods for the whole family.
The average monthly CalFresh benefit issued in 2006 was $3,285,939.58 compared to
2015 issuance of $10,548,167.33. This accounts for an increase of 221% for our
households and the local economy.
II. Eligibility for CalFresh
Households that include single individuals, couples, or families are eligible for CalFresh
benefits if they meet certain income criteria and legally reside in California. For some
CalFresh beneficiaries, eligibility is not asset-based or resource-based which means that
their property, such as vehicles, cash on hand, or money contained in bank accounts, is
not counted.
The amount of benefits a person receives depends on the number of people in the
household who purchase and prepare food together and how much monthly income is left
after certain expenses are deducted. Income consists of earned and unearned income.
Expenses like rent, utilities, dependent care and certain medical expenses are allowable
deductions. For example, a household of one (1) with no income would be eligible to
receive $194.00 a month in benefits and a household of 10 with no income would receive
$1,461.00 a month.
III. Program Accessibility
Over the last several years, in order to make CalFresh benefits more readily accessible to
County residents and families, the Department has increased its efforts in working with
the Food Bank of Contra Costa and Solano County as well as other community agencies
dedicated to the CalFresh-eligible population.
As listed below, these efforts have contributed to the success of our expanding benefits to
those in need of food security.
• The application process has been made easier by eliminating the requirement to apply
through a face-to-face interview process. A telephone interview is now acceptable at
both intake and recertification. A customer may still request a face-to-face interview
if they are more comfortable meeting directly with an eligibility worker.
• Use of telephonic signature has begun at locations that have Automated Call
Distributions capability such as the Medi-Cal CalFresh Service Center (MCSC). The
MCSC will begin with the CalFresh recertification and we hope to expand to the
Hercules office for new applications. As we obtain the necessary technology, the use
of telephonic signature will be used department wide.
• Applicants can now apply for CalFresh benefits online through My Benefits CalWIN
Org portal. Many of our community-based partners have received
orientations/trainings on assisting individuals through this online application process.
In addition, Community Based Organizations (CBOs) can register their organizations
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as vendors in CalWIN. This will allow the CBOs to track the number of applications
they register and the number processed each month by the Department.
• A customer can also access benefits through the use of a multi-program single paper
application. For example, a customer who applies for, and is found ineligible for,
CalWORKs benefits can use this same application (the SAWS 2 Plus) to
automatically apply for CalFresh benefits without completing another application.
• In February 2014, the Department of Health Care Services (DHCS) initiated the
Express Lane Eligibility waiver program in which certain CalFresh beneficiaries were
given MediCal benefits without having to complete and file an application. The
waiver was expanded with no known sunset date.
• The statewide Work Incentive Nutritional Supplement (WINS) Program was
implemented in Contra Costa County on July 1, 2014. Under the WINS program,
CalFresh households who are not in receipt of CalWORKs, but who meet the work
participation hours of the Temporary Assistance for Needy Families (TANF) program
and have a child in the household under 18, will receive an additional $10.00 food
benefit each month. From July 2014 through March 2016 there is a monthly average
of 2,766 households in receipt of this additional benefit.
• Other efforts to increase CalFresh enrollments are outlined in the Outreach section of
this report.
IV. Current CalFresh Service Levels and Program Performance
A. Service Levels:
During Program Year 2014- 2015 the monthly average of individuals (families and
single) who were in receipt of CalFresh benefits was 73,468. This is a 46% increase
from the previous program year.
B. Program Performance:
1. Timeliness Processing Standards
FNS requires states and counties to maintain certain performance measures for the
timely processing of CalFresh applications. These measures require that 90% of
all applications received be processed within 30 days and requires a three (3) day
processing period for those CalFresh applicants determined to require Expedited
Services (ES).
We continue to meet the 30 day CalFresh application processing standard of 90%.
For PY 2014- 2015, 94.6% of applications received were processed within the 30
day processing requirement. During this same period we reached the 90%
processing requirement within three (3) days for those CalFresh ES applications
with a 91.72%. The department continues to show improvement in this area as
there has been consistency with meeting the 90% standard. For the first three
quarters for PY 2015 – 2016 our compliance rate is at 97.32%.
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2. Management Evaluation (ME)
As mandated by FNS, the California Department of Social Services (CDSS) is
required to conduct a Management Evaluation (ME) review of Contra Costa
County’s administration of the CalFresh Program. The federal priority areas for
the ME for FFY 2014 were Program Access, Customer Service, Timeliness of
Application Processing, Payment Accuracy, Quality Control and Training.
While the ME review was to have been held in April 2015, the review was moved
up to November 2014 by CDSS to coincide with the federal Local Program
Access Review (LPAR) of SNAP scheduled by the federal Food & Nutrition
Services (FNS) of the U. S. Department of Agriculture (USDA).
CDSS has requested corrective action in the areas of case reviews, second party
reviews, training, program access, and Expedited Services (ES) timeliness which
are or have been addressed in the current Program Improvement Response.
Program access is being addressed by providing greater signage in district office
lobbies with regard to how to apply for benefits as well as staff promoting the use
of the “online” application. There is also an increased focus on ES evaluation and
eligibility determination. Policy on application processing timelines is being
rereinforced to staff through the use of Monthly Bulletins and CalFresh “Topic of
the Month” distributions. There will also be more accountability and monitoring
attached to these methods ensuring the training takes place during unit meeting
discussions.
The Program Integrity Unit (PIU) which is responsible for gathering and
reviewing data concerning CalFresh program standards to ensure service delivery
is appropriate will include greater monitoring and coordinating of case record
reviews, assessments and error trends. The PIU will be of great assistance in
addressing and maintaining performance areas and in their monthly case reviews
in which error trends are readily determined and addressed.
The next ME review is anticipated to take place at the beginning of FFY 2016.
3. Local Program Access Review
The Local Program Access Review (LPAR) was conducted by USDA FNS staff
during the week of November 17 through November 21, 2014. The last LPAR
completed in Contra Costa County was in November 2004.
The focus of the review was on Program Access, Quality Control (QC) and
Electronic Benefit Transfer (EBT). The purpose is to identify barriers to the
CalFresh Program and to monitor QC operations. This review was occurring at
the same time CDSS was conducting the ME noted above.
Most of the findings and observations in the LPAR are similar to the issues
identified in the ME which will allow for more streamlined implementation of our
Program Improvement Response. Areas to be addressed included application
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processing with focus on interviews, the ES evaluation and determination process,
and wait times in the district offices.
FNS staff were impressed with the cooperation and collaboration of staff and
management and noted that the case review findings were not indicative of the
quality of work provided in the office.
4. CalFresh Error Rate
Every month for every county, FNS selects a random sampling of CalFresh cases
that are to be reviewed for case errors involving miscalculations of income or
household composition which result in benefit issuance errors. Our Quality
Control Unit reviews those cases that are selected and determines our CalFresh
error rate. Based on the number of cases reviewed and the number of errors cited
an error rate percentage is then derived.
While the results have not yet been finalized, Contra Costa County’s CalFresh
error rate is for FFY 2015 is lower than the state and federal tolerance.
Preliminary results reflect Contra Costa County ending the FFY with a 2.19%
error rate, California is at 3.07% and the Federal rate is at 3.09%.
5. Outside Consultants
In our attempt to improve customer service and performance levels we have hired
outside consultants to assess our current business practices. It is anticipated that
there will be recommendations that will improve program access and customer
service. In addition, a quality control consultant has been hired to review existing
practices to improve the Department’s Payment Accuracy and Case and
Procedural Error Rate.
• The Quality Control (QC) consultant has worked with our IT staff in
developing a Case Review Management System tool. This tool will allow the
reviewer to go online to complete the case review as well as produce real time
data reports. This has been instrumental in allowing the unit supervisors and
the Program Integrity Unit to quickly identify error trends so that corrective
action can be taken. In addition, the consultant has assisted with our ability to
fine tune the QC and QA process with focus placed on the root cause of
errors. This has allowed us to mitigate QC errors as well as identify error
trends and develop corrective action strategies.
• The Business Process consultant has evaluated our current CalFresh business
processes and analyzed data to identify areas for improvement. It was
determined that missed appointments are a large barrier for many applicants.
EHSD is evaluating options to reduce missed appointments, including
providing same day appointments, text appointment reminders, and expanding
alternatives to face-to-face interviews such as phone and video conferencing.
EHSD is also planning to conduct a pilot in the Antioch office, testing
whether extra “hands on” help in the initial stages of the process increases the
success rate among new clients. In addition, EHSD is also working to identify
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and reduce “churn,” which is when clients cycle on and off the program in a
short amount of time; specifically, applicants who reapply within three
months of their semi-annual report or recertification being due. If those
clients were able to maintain continuous enrollment, it would greatly reduce
the workload of EHSD staff without an interruption in service for clients.
EHSD has begun work in this area, with a first step being the implementation
of text reminders to clients when their reports are due.
6. Staffing
The Department is continually evaluating its staffing needs and hiring new staff is
an ongoing priority, although the ability to readily fill new and approved vacant
positions continues to be a systemic problem within the County in terms of having
readily available candidates from which to interview and hire. The County
Human Resources Department recently increased staff dedicated to EHSD which
we expect will improve our ability to fill positions more quickly.
V. Outreach and Community Partnership
EHSD is proud of our efforts to increase CalFresh participation thereby ensuring that
more children, families, and individuals are able to put nutritious food on their tables
each day. The Department has convened a CalFresh Partner Group with a goal of
increasing enrollment in the County so that 75% of eligible residents are enrolled by May
2016. The partners include the Food Bank of Contra Costa County and Solano, Crisis
Center, the Multi-Faith ACTION Coalition, First 5, and Meals on Wheels. This group’s
strategies are to increase CalFresh enrollment and reach populations with historically
lower enrollment. Data is not yet available to test whether the goal has been met.
However, it is important to note that CalFresh enrollment has not declined despite an
improving economy. What is already clearly a success is forging a path to partner with
community organizations on a shared goal; the ability to evaluate and modify processes
and procedures, and a mindset that working together is always better.
Successful efforts and key achievements of the group are illustrated as follows:
• CalFresh Enrollment Process Improvements: we are developing new and
strengthening existing business processes for helping people enroll in CalFresh.
EHSD currently works with the Food Bank of Contra Costa and Solano to train
nonprofit staff in CalFresh so they have a better understanding of the program and
enrollment process. This enhanced training and knowledge, as well as a more
specifically identified EHSD liaison for the Food Bank of Contra Costa and Solano,
will not only enhance the quality of training and knowledge in the community, but
will strengthen our community partnerships.
• Outreach:
o The partnership between the Multi-Faith ACTION Coalition, EHSD and the Food
Bank of Contra Costa and Solano is working to cultivate community volunteers
73
who can help people with the CalFresh enrollment process. The Multi-Faith
ACTION Coalition has a roster of 60 volunteers who received CalFresh training
from the Food Bank. They are now ready to be deployed to nonprofit agencies,
places of worship, food distribution sites and shelters to encourage and assist
people to sign up for CalFresh benefits.
o The John Muir/Mt. Diablo Community Health Fund awarded a grant to the Food
Bank for CalFresh Outreach. Partnering with EHSD, the Food Bank mailed
postcards to households currently receiving MediCal but not CalFresh. The Food
Bank also partnered with local school districts to mail to families with children on
free/reduced lunch. To date, 939 families have filled out CalFresh applications
based on these mailings. Funds were also used to print posters advertising the
CalFresh program that are posted in health clinics, food pantries, and other
locations where low-income families are likely to visit.
o We are working with the Pittsburg Unified School District (PUSD) to implement
AB 402, which would allow information sharing between EHSD and the District
so we can reach out to students’ families receiving free/reduced lunch and
encourage them to apply for CalFresh. Families who opt-in are sent applications
to apply for CalFresh, shortening the application process by allowing families to
apply without coming in to the office. PUSD has been working with EHSD and
the Food Bank by adding a question to their school meal application in order to
easily identify families that desire to also apply for CalFresh. The families’
information is then sent to EHSD to begin the CalFresh application process. We
anticipate working with other school districts within the county in the same
manner.
o We are working with Building Blocks for Kids in Richmond to reach out to all of
the eligible families in the Iron Triangle neighborhood to assist them in enrolling
in CalFresh.
o Mayoral Outreach
EHSD, Multi-Faith ACTION volunteers, and Ensuring Opportunity
conducted an outreach campaign with local Mayors to raise awareness of the
CalFresh program and to highlight the program’s economic benefit. During
May 2015, local Mayors issued CalFresh Awareness Proclamations, posted links
to the CalFresh application on their city websites, and advertised the health
benefits of the CalFresh program. To engage the Mayors, the CalFresh Partner
Group members highlighted the economic benefit the program brings to the local
economy.
o We are planning a series of “CalFresh Express” events that will provide an
opportunity to process applications and issue same day benefits while in the
community. After presenting at the April 2015 Mayor’s conference, there is
increased interest from cities in partnering with the County on outreach of this
type.
The first CalFresh Express took place on June 26, 2015, at the Davis Park
Community Center in San Pablo. The event was a true collaboration with the
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Food Bank and other community organizations. The date was selected as this was
the same day that the Food Bank’s Community Produce Program truck was at this
location. Families in the community were provided with fresh fruits and
vegetables on the spot. The UC Cooperative Extension gave out tastings from
this produce and promoted healthy eating through various games and activities.
Volunteers from the MultiFaith ACTION Coalition reviewed the program’s rights
and responsibilities with applicants with oversight from EHSD personnel. West
Contra Costa Unified School District passed out lunches to children playing in the
park. Overall, 74 new applications were taken and 48 (65%) families were
approved for benefits.
The next event is planned for April 29, 2016 at the Ambrose Community Center
in Bay Point. We anticipate approximately 200 applications to be processed
including the availability of issuing same day benefits. We are excited about the
same partners participating making this event even more successful for the Bay
Point community.
• Technology partnership
o EHSD is working with Code for America to utilize a mobile application equipped
with electronic signature. This will allow the streamlining of preliminary
applications through an electronic portal via assistors in our partnering agencies.
The Food Bank and EHSD piloted a new application called CLEAN, which is a
simplified version of the online CalFresh application that can be used on a tablet,
smartphone or laptop. It was designed by Code for America for use by
community based organizations. The application takes only about 5-10 minutes
to complete and is much simpler for outreach workers in the field. Clients’
documents can also be uploaded for submission with the application. The Food
Bank continues to use CLEAN (now called ‘Get CalFresh’). It has greatly
streamlined the application process and makes filling out an online application
while in line at a food distribution event more feasible.
o Read Only Access
To further support Food Bank efforts to assist clients more directly, EHSD is
exploring CalWIN read only access for the Food Bank. Once the technology is
available, Food Bank staff will be able to look up a clients’ case status in real
time, remind clients of their appointments, let them know what paperwork they
are missing, etc. This should improve timely processing while also saving EHSD
staff time. Currently the Food Bank has to contact EHSD staff to get case
updates, so this will significantly streamline access to data.
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• Marketing
o Volunteers from the Leadership Contra Costa alumni group have expressed
interest in helping advertise and market CalFresh to communities with many
eligible people. Developing a marketing plan for CalFresh will require studying
the issue and applying smart advertising techniques to the challenge of CalFresh
enrollment. Leadership Contra Costa has marketing professionals who can help
with this work.
o The month of May has been designated “CalFresh Awareness Month” by several
other California counties. Working with our community partners, the County
Board of Supervisors provided an official resolution and declared May as
CalFresh Awareness month in Contra Costa County.
o We are also working with the City of Richmond to have a similar resolution
adopted at the next Richmond City Council meeting. We are also working with
the cities of Antioch, Pittsburg, Concord, Martinez, and San Pablo on the adoption
of this same resolution.
• Community Training on CalFresh
o The EHSD CalFresh Program Analyst conducts “Facts and Myths” training with
the Food Bank which takes place three to four times per year with 25 to 30
participants from community organizations in each session. Provided in the
training is a CalFresh overview, hands-on outreach application exercise as well as
an introduction to Benefits CalWIN.
This training has been a foundation in developing new partners since 2006 and
training has been attended by aides of the Board of Supervisors, staff from Food
and Nutrition Services (FNS) and regular attendees from WIC, the Monument
Crisis Center, La Clinica, Rubicon, Public Health, Head Start and the One Stop
Centers.
o EHSD also participates in the Food Nutrition Policy Consortium which is chaired
by the Food Bank of Contra Costa and Solano. The group meets to discuss
nutrition related events and activities within the county including CalFresh
outreach opportunities.
o Over the last four (4) years, EHSD has attended an annual Food Bank Summit
which is held on a rotational basis between Contra Costa and Solano
Counties. The purpose of the Summit is to educate, inform and update those in
attendance on topics such as Nutrition Education, Food Safety, what the Food
Bank does, and provide instruction and mandates of USDA on the CalFresh
Program. This is a day-long event and is attended by various county department
representatives, agencies, and CBOs who work closely with the Food Bank.
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o Advocacy
As the CalFresh Partner Group worked at increasing access to increase
participation, it was clear that changes at the local, state, and national level would
be helpful, or sometimes even necessary, to improve access to CalFresh. Current
CalFresh policies limit accessibility, including an application process that can be
arduous for residents with young children, those who work traditional hours,
those who are disabled, and the elderly. Policy changes that allow residents to
apply over the phone, through the mail, or online are recent additions, but work is
still needed to make CalFresh as accessible as possible.
In 2016, the CalFresh Partner Group is looking to CalFresh advocacy to increase
participation. Several partner organizations have legislative platforms that
include CalFresh concerns addressing college student food insecurity, providing
supplemental benefits in the summer to families with school-age children, and
simplifying the application process by using electronic employment databases to
verify income.
VI. Policy Items of Interest
The following changes will have an impact to our CalFresh participation, and/or increase
the workload of our staff.
• Effective June 1, 2016, our clients who have “change reporting” requirements
(homeless, elderly and or disabled) will change to Semi Annual Reporting. This will
allow clients to report only once a year and at recertification. With fewer
opportunities to report come fewer opportunities for our clients to be in non-
compliance and potentially lose benefits. Notices were sent in December 2015, March
2016 and May 2016 informing these households of this change. In addition, posters
have been made for our lobbies advising of this change. Good Cause will be
provided for the first year to help those households who are not familiar with the
Semi Annual Reporting responsibilities.
• Use of a Single Signature application became effective March 1, 2016. This allows
the application process to begin with the initial application submitted. The advantage
is that it is no longer necessary to return the Statement of Facts in order to obtain the
client signature. This process initiates the start of the 30 day processing timeline with
less information upfront than previously received, but it will reduce the need for the
client to return to the district office in order for application processing to begin.
• Telephonic Signature
The telephonic signature is a type of electronic signature that uses an individual’s
recorded spoken signature or verbal assent in place of an actual written signature. The
use of the telephonic signature, as part of the application or recertification process,
will eliminate the need to mail documents in order to gather a client’s ink signature.
In addition, by utilizing this process it will also reduce the amount of cases being
discontinued for failure to complete the recertification process which will assist with
reducing churn. EHSD does not yet have the technology in place to roll out
department wide, so we are utilizing existing technologies at locations that operate an
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Automated Call Distribution center such as the Health Care Access Center. The
MediCal CalFresh Service center will begin to use this process with the
recertifications effective May 2016.
• SNAP to Skills
Contra Costa County is currently participating in the SNAP to Skills led by Seattle
Jobs Initiative (SJI). The Federal and State CalFresh agencies have contracted with
SJI to help selected California counties develop Employment and Training programs.
VII. Important Next Steps
The Department remains committed to providing timely and ready access to CalFresh
benefits for those with food insecurity, and in continuing to serve our CalFresh customers
in a timely and accurate manner. To this end, we have a continual improvement
objective in the areas of outreach, access, enrollment, and services delivery.
Part of this objective is to continue our community outreach efforts and to work even
more closely with our community partners to expand access to CalFresh benefits.
Expanding access includes our continued rollout of electronic and other alternative means
for applying for benefits. We will also continue our efforts to further streamline our
CalFresh application and benefits renewal process, and will also continue to work on
increasing knowledge and awareness of the CalFresh program throughout and to targeted
areas within the County.
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