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HomeMy WebLinkAboutMINUTES - 12042001 - C.164 TO: BOARD OF SUPERVISORS Contra FROM: William Walker,M.D.,Health Services Director - -s Costa C DATE: December 4,2001 ^ �/�Unty SUBJECT: Adoption of the Homeless Continuum of Care Advisory Board's Five-Year Homeless Plan SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: Adopt the Homeless Continuum of Care Five-Year Strategic Plan 2001-2006. _ FISCAL IMPACT: No County funds are required. The Homeless Continuum of Care 5-year strategic plan is the planning tool in which homeless services are developed for Contra Costa individuals,youths,and families. It also sets the framework for funding priorities within the County's continuum of services for the homeless population. BACKGROUND: In July 1996, Contra Costa County adopted its first Five-Yeas Strategic Plan to address the increasing phenomenon of homelessness. During the past eleven months, the Homeless Continuum of Care Advisory Board has worked diligently to develop a comprehensive plan to lead the County into the next five years. Development included conducting five community meetings in each one of the Supervisorial Districts to garner input from community members concerning homeless issues and solutions. As a result of the Community Meetings and many hours of work by the Homeless Continuum of Care Advisory Board's Five Year Plan Committee, a comprehensive plan to address the needs of the homeless in Contra Costa County was produced. The Five-Year Plan is consistent with the requirements of the Department of Housing and Urban Development to provide continued funding for Contra Costa County's Consolidated Application recipients. Each year, this HUD funding brings millions of dollars to Contra Costa that enables us to provide services to our homeless citizens. ATTACHMENT: SIGNATURE: i RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMEND O OARD COMMITTEE ✓APPROVE OTHER SIGNATURE(S): �1 [1 ACTION OF BOAR O .IJPC'C�aY1)2y- � _ 3-,-Zg APPROVED AS RECOMMENDED X OTMER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE I UNANIMOUS (ABSENT O- A-P.i) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. Contact Person_ Keith Bussey 5-6574 CC: Health Services Administration Health Services Contracts and Grants Health Services Homeless Program L ATTESTEDo+- JO N SWEETEN,CLERK OFTAE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR ADMINISTRATOR BY ,DEPUTY e.wry oocmem:wom­­­—­­­rdaeso¢mo�sa a�� CONTRA COSTA COUNTY HOMELESS CONTINUUM OF CARE PLAN July 1, 2001 — June 30, 2006 A Five-Year Strategic Plan For Preventing & Reducing Homelessness TABLE OF CONTENTS Acknowledgments....................................................................................................................i Executive Summary .......................................................................................... ....ii ................ I. Introduction......................................................................................................................... 1 ThePlanning Process.................................................................................................. 1 GuidingPrinciples.......................................................................................................2 Previous County Planning Efforts...............................................................................4 Compliance with HUD Planning Requirements.......................................................... 5 If. Homelessness In Contra Costa County..........................................................................G Dataon Homelessness......................................................................................... 9 Statementof Need.............................................................................................. 23 III. Recommendations.........................................................................................................35 Employment, Assels &Incomes...........................................................................40 Outreach & Health Set-vices.............................................................................. 51 SupportServices.........................................................................................................61 Housing& Prevention...............................................................................................71 Administration, Coordination, Funding....................................................................81 I.V. Summary Charts of flan Action Steps ............................................................... 94 Acknowledgments The 2001-2006 Contra Costa Continuum of Care Homeless Plan was developed through a community-based planning process coordinated by the Contra Costa County Homeless Continuum of Care Advisory Board(CoCB). Staff support was provided by the County Office of Homeless Programs(COHP). The Homeless Plan would not have been possible without the dedication of those who participated on the CoCB and the staff of the COHP. Homeless Continuum of Care Advisory Board • Jennifer Baha, Shelter, Inc. • Mary Lou Laubscher • Sharon Bernhus, St. Vincent de Paul • Lloyd Madden,County Employment& • Janet Bruce, GRIP Human Services • Tom Conrad,CC Interfaith Trans. • Ginger Marsh, Citizen • Dean Coons, Citizen • Megan Monahan, Shelter, Inc. • Nesbit Crutchfield, Phoenix Programs • Michael Shimansky • George Evans,Crisis Center • Michael Starks, Association of Homeless& • Kathleen Hamm, County Community Housing Service Providers and St. Vincent Development Department de Paul • Benita Harris, Rubicon Programs • Theresa Talley-Wilkerson, City of • Paul Helier, City of Antioch Richmond • Teri House, City of Concord • Bobbi Vann, Deliverance House • Kathy Lafferty, Cambridge Community • Gwen Watson, Alliance for the Mentally Ill Center Contra Costa Office of Homeless Programs • Cynthia Belon • Lavonna Martin • Keith Bussey • Trish Cargile Their generous commitment of time and expertise over the past year is greatly appreciated. In addition,special thanks is given to all those who participated in community and subcommittee meetings that provided essential input to guide the development of the recommendations made in the 2001-2006 Contra Costa Continuum of Care Homeless Plan. This includes the many citizens who attended the community meetings, the housing and service providers who attended the Five-year Planning Subcommittee meetings,and most especially, the clients who attended the community meetings and shared their first-hand observations and experiences about what is needed . to prevent and reduce homelessness. HomeBase,a legal and technical services provider on homelessness concerns conducted the planning process and drafted this document. Thanks to Martha Fleetwood,Tony Gardner, Lynn Nesselbush, David Pilotti, Jessica Flintoft, and Joy Jaeger. 2001-2006 Contra Costa County Homeless Continuum of Care Plan I EXECUTIVE SUMMARY - The Contra Costa Homeless Continuum of Care Plan 2001-2006 lays out a comprehensive, strategic response to homelessness—a strategy developed in collaboration with the entire community. This plan seeks to improve and expand efficient programs in homeless services of all types,creating a single, unified system of care free from unnecessary duplication. This document is an update of the first county- wide Continuum of Care Homeless Plan,which was adopted in 1996. Many of the developments envisioned here are built on the solid foundation of that document. A comprehensive review and update of the county homeless service system has revealed three important developments in the local Continuum of Care.: The first development is the rapid rise in rental values. According to a January 2001 HUD report on housing fair market rents, the price of a two-bedroom apartment in Contra Costa County is $1,155 per month. The local FMR has been on the rise for the past five years, with the latest figures showing a 25% increase above what they were in 1999. The second development has been the record low level of unemployment due to a rapid increase in the number of low-paying jobs. According to the state's Employment Development Department, unemployment in the county is as low as 2.5%. Many of the new job opportunities are in the service and retail sectors—jobs that usually pay little more than the minimum wage. As a result, homeless people can find work but are still barred from the local housing market. The final development concerns the number of homeless people in the county. On any given night, as many as 4,828 people were homeless; as reported in the 2001 Contra Costa County Continuum of Care Application. The county's Health Services Department, which keeps records on client's housing status, reported 14,757 incidents of homelessness over the last year among health service clients alone. One of the major tasks of this Plan is to document and explain the important new features of the Continuum of Care in the four areas of homeless response—employment, housing, health, and supportive services. Because self-sufficiency must be the crux of a feasible response to homelessness,the Plan emphasizes new provisions for employment opportunities and income supports for homeless people. The hope is that the services of the Continuum of Care will enable many homeless people to afford housing and retain employment. The section on employment and incomes focuses on expanding programs that enable people to address issues that have prevented them from maintaining employment. Regional multi-service centers will be staffed to provide employment services. There are recommendations for exploring connections with employers, for services helping people learn on-the-job, and for removing barriers that often keep people from being successful employees. Also included here are recommendations to help homeless people access income supports that can supplement incomes. A major focus of the Plan is the aid that can be given to help homeless people avoid health crises. Without support, homelessness alone may be too much for many people to overcome, but homelessness coupled with an illness or a chemical addiction can be truly insurmountable. The recommendations on health programs address the need to expand the accessibility of existing services to help people avoid the threat of illness. 2001-2006 Contra Costa County Homeless Continuum of Care Plan ii This includes expanding the number of mental health professionals and combining the regional mental health clinics with the regional inulti-service centers. This section also calls for greater access to drug and alcohol treatment programs for people within the homeless service system. In addition, new efforts must be made to alleviate the conditions that lead to a high incidence of disease and infestation among homeless people. This Plan details a strategy to use all existing services as they were envisioned. The local Continuum of Care has a full array of programs for homeless people—it is a model of comprehensive service; but it can benefit from careful improvement and expansion. This Plan focuses on expanding key support services that enable people to address the issues that interfere with their ability to maintain stable housing without delay. The goal.is both to help prevent homelessness as well as to assist those already homeless to regain their housing. The regional multi-service centers will be developed to coordinate client access to the full service continuum. Subsidized childcare and free and low-cost transportation coordinated through the multi-service centers will be expanded. Also included here are recommendations to provide for the many needs of homeless runaways and youth. The need for affordable housing options, which shaped much of the original Continuum of Care Plan, has never been more critical than it is today. Every section of the Plan reflects this need, and directs energy to helping homeless people to secure stability in housing. Employment, health, support services—each segment of the Continuum of Care is integrated to eliminate the barriers a person may have in maintaining a place to live. The housing recommendations focus on the development of a range of housing options that meet people's income and service needs, thereby enabling them to achieve stable housing and maximum self-sufficiency. Included in this Plan are recommendations for developing more permanent housing affordable to people with the lowest incomes and expanding the supply of permanent supportive housing for homeless people with on-going service needs. Also included is a recommendation aimed at addressing the barriers to the development of housing and services for people who are homeless or who have low incomes. The Contra Costa County Homeless Continuum of Care Plan seeks to establish a homeless service system that enables homeless and formerly homeless people to live independently and to afford housing within their communities. The Plan divides this strategy into these four substantive topics (in addition to a fifth topic of administration) for efficiently ending homelessness for each individual who reaches the system. These action steps are built upon the strength of the existing service delivery system, the best developments that are taking place today, and a set of attainable objectives that are cost effective and make sense in the existing system. 2001-2006 Contra Costa County Homeless Continuum of Care Plan I I. INTRODUCTION On November 8, 1994, the Contra Costa County Board of Supervisors mandated that a comprehensive, integrated plan for homeless services be developed for the County. Shortly after, the Ad Hoc Homeless Task Force was created to coordinate a countywide planning process and write the county's first Homeless Plan. Five years later,the Contra Costa County Homeless Continuum of Care Advisory Board met to oversee the planning process to review the original plan and update it as the 2001-2006 Contra Costa Continuum of Care Homeless Plan. When the Board of Supervisors originally mandated the creation of a long-term plan for responding to homelessness,the Board endorsed certain goals recommended in a 1994 report by the Health Services Department. These goals included: • Increase clarity about the scope of the homeless problem and the roles of the existing structure of services in the County; • Identify gaps in services and priorities for addressing them; • Provide an opportunity for elected officials and the community to examine what is already being done to address the problem and to build consensus; • Recommend the most appropriate structure to achieve an integrated and effective homeless delivery system; • Recommend how to strengthen individual components and to overcome barriers in categorical funding and program to maximize funding and effectiveness; and • Position the County to meet the HUD Continuum of Care requirements for future McKinney funding. A. THE PLANNING PROCESS Beginning in September 2000,Contra Costa County began the process of developing a new five- year Homeless Continuum of Care Plan. Based on the previous five-year plan, the planning process reviewed progress in housing and service development, evaluated current needs and established new priorities for action. The planning process was coordinated by the countywide Homeless Continuum of Care Advisory Board (CoCB), with support from the County Office of Homeless Programs(COMP)and consulting assistance from HomeBase, a legal and technical service provider on efforts to address homelessness. Designed to be inclusive, the planning process included five community meetings, held in each of the supervisorial districts. These meetings solicited input on homelessness and its solutions from community members, providers, faitli-based organizations, the business community, government staff,and people who are homeless or formerly homeless. Based on this input and 2001-2006 Contra Costa County Ilomeless Continuum of Care Plan 1 on countywide homelessness data, the CoCB Five-Year Plan Subcommittee met seven times with key service providers and stakeholders to identify priorities and develop action steps for each of the Plan's five chapters. A draft of the Plan was released for comment by jurisdictions and service agencies in April 2001 and then opened to public comment in the following months. The final version was submitted to the.Board of Supervisors for approval in the fall of 2001. B. GUIDING PRINCIPLES The following principles guided the development of the Contra Costa County Homeless Continuum of.Care Plan 2001-2006. They also offer a point of reference for the implementation of the Plan and future planning efforts. • Preservation of Existing Levels of Service is a Top Priority Preserving the operation of existing affordable housing and services in the face of budget cuts and changes in public policy is a top priority and all efforts should be undertaken to do so. While the current level of services is by no means adequate to meet the volume of need, it provides a base level of care that should be maintained as long as the need exists. To allow needed programs to close their doors due to lack of funding,only to scramble in the future to open new programs to address the same need, is inefficient and a waste of resources. • A Comprehensive& Integrated Service System Is Essential To Preventing& Reducing Homelessness Generally, homelessness arises because of the intersection of a variety of factors in an individual's life and unless all the causes are addressed in a timely and coordinated fashion, long-term stability cannot be achieved. Therefore, each program within the service system must have linkages with other programs and all components of the Continuum of Care and social services safety net—from prevention to permanent affordable housing—must be in place. The goal is to create an integrated system of care that allows people to move easily within the system,obtaining the full range of services they need in order to acquire permanent housing, maximize their self-sufficiency and move beyond the risk of homelessness. • Homelessness Can Be Effectively Addressed Only Through Collaborative Efforts Involving All Jurisdictions and All Segments of the Community The responsibility for addressing homelessness rests with all of us, and not just with those communities that currently have the largest numbers of people who are homeless. This means that the cities,county, region, state and nation must work together to develop and coordinate their policies and programs across jurisdictional lines. It also means that all sectors—public, private, faith-based, and non-profit—must be involved and contributing to the effort to develop and maintain the continuum of housing and services needed to prevent and reduce homelessness in Contra Costa County. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 2 • Prevention is the Most Cost-Effective& Humane Strategy for Addressing Homelessness Prevention means providing people who are at-risk of homelessness, including those who have low incomes,are disabled, or face unexpected crises, with the assistance they need to avoid losing their housing. This requires a comprehensive and integrated network of support services that can help people address their needs, while they still have their housing. In addition, in order to facilitate early and therefore more effective interventions, all social service programs should incorporate a homelessness prevention focus by training staff to recognize early warning signs and provide appropriate referrals and follow-up. • Advocacy is Needed to Change the Public Policy and Economic Decisions that have Helped to Produce Homelessness It is vital to recognize the relationship between public policy decisions to reduce or eliminate critical support services, such as benefit programs and mental health services, and the rising number of people without homes in our communities. Likewise, it is important to see the connections between the increasing economic pressures felt by the "middle-class"and the economic forces causing homelessness for those whose income level places them closer to the edge. Advocacy to affect public policy decisions is essential in order to reverse the forces causing homelessness and creating economic insecurity in our society. • Public Education is a Key Aspect of the Effort to Address Homelessness Increased awareness and understanding of the causes and extent of homelessness is essential to building the support necessary for siting and operating programs and is critical to countering the stigma that makes it difficult for people to fully reintegrate themselves back into the community. Ultimately, homelessness cannot be solved without a deep commitment on the part of society that none of its members be without the opportunity to meet personal, basic needs. • People who are Homeless are Full and Equal Members of Our Community People who are homeless enjoy the same rights and share the same responsibilities as other members of the community. Acknowledgment and respect for their civil rights should infuse all public policies and program regulations. Likewise, homeless people have a responsibility to take advantage of available opportunities and work to maximize their self-sufficiency. • Planning Should Produce Concrete Results in the Lives of Those it Aims to Reln This Plan will be effective only if it results in greater opportunities for people to address the core issues that led to their homelessness or placed them at-risk of becoming 2001-2006 Contra Costa County Homeless Continuum of Care Plan 3 homeless. The end result should lead to actions that improve the quality of people's lives in ways that are real and lasting. C. PREVIOUS COUNTY PLANNING EFFORTS This Plan builds on previous efforts that have taken place in Contra Costa County. Documents that were reviewed for assessing needs and developing recommendations include the following: • A Beginning Plan for Dealing with Homelessness in Contra Costa County, 1986 • Report to the Board of Supervisors on Homelessness in Contra Costa County and Recommendations for Action,by the Task Force on Homelessness, July 1987 • Long Term Affordable Housing Solutions to Homelessness, by the Community Homeless Action&Resource Team(CHART), April 1989 • Strategic Plan on Homelessness, by the Social Services Department,November 1989 • Symposium on Homelessness in Contra Costa County, Planning Session Summary, October 1991 • A Homeless Prevention Plan: Creating Options and Opportunities for the Homeless of Contra Costa County(1992-1995), by the Association of Homeless & Housing Service Providers • Report of the Contra Costa County Mental Health Advisory Board Ad Hoc Planning Committee,June 1993 • Housing Report of the Contra Costa County Mental Health Commission, June 1994 • Contra Costa Consolidated Plan, FY 1995-1999 • Richmond Consolidated Plan, FY 1994-1997 • Contra Costa County Continuum of Care Homeless Plan 1996-2001. • Contra Costa Consortium 2000—2005 Consolidated Plan. • Contra Costa County CalWORKS Housing Assistance Action Plan& Implementation Strategy 2001-2006. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 4 D. COMPLIANCE WITH HUD PLANNING REQUIREMENTS This planning process, while oriented to addressing the needs of Contra Costa County, was also designed to fulfill the recommendations set by the United States Department of Housing and Urban Development(HUD). The Department has recommended the adoption of a Continuum of Care plan in its administrative publications including The Guide to Continuum of Care Planning and Implementation. A long-range strategic plan can unite regional responses by articulating clear goals for shared situations and by receiving endorsements from public figures with the influence to affect mainstream spending. This Plan will be the basis for developing annual strategies to respond to homelessness for federal funding applications. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 5 II. HOMELESSNESS IN CONTRA COSTA COUNTY Overview of the Causes of Homelessness Contra Costa County community members are not immune from the threat of homelessness. Rather, at least 14,757 people in our county experience homelessness each year. More than two-thirds of them are members of a family, including almost 7,000 children. On any given night, more than 4,800 people are homeless, living on the streets or in temporary accommodations, such as an emergency shelter,a motel,or a relative's couch. In addition, many others are at-risk of becoming homeless, such as the nearly 17,000 extremely low-income households in the county who are paying over 30% of their income for rent and struggling to make ends meet. As elsewhere in the nation, homelessness is usually the end result of multiple factors that converge in a person's life. The combination of loss of employment, inability to find a job because of the need for retraining, and the high housing costs in this county lead to some individuals and families losing their housing. For others, the loss of housing is due to chronic health problems, physical disabilities, mental health disabilities or drug and alcohol addictions along with an inability to access the services and long-term support needed to address these conditions. Regardless of personal circumstances, three root factors allow for people to become homeless: • SHORTAGE OF AFFORDABLE HOUSING: The lack of affordable housing in Contra Costa County is both one of the factors pushing people into homelessness and one of the barriers making it difficult for people to regain housing, once homeless. With some of the highest housing costs in the nation and a two- bedroom market rate rent of$1,155/month,' many people arc unable to find housing that is within their means. In 1999,only 45% of renters at all income levels in the county could afford a two-bedroom unit at the then Fair Market Rent of$861." Almost 2,000 people"'are currently homeless and in immediate need of permanent housing. However, according to the Consolidated Plan,'the county has a severe shortage of rental housing affordable to people with extremely low incomes. Further fueling this crisis is the loss of precious affordable housing stock, an estimated 212 units of affordable Section 8 housing in the county in only the last few years! The county population soared in the last five years but residential construction tapered off during the same years, according to a report of the Association of Bay Area Governments.'i All people who are horncless share the need for access to housing that is affordable. Ultimately, once other service needs are addressed, access to housing affordable for one's income is the only way out of homelessness. 2001-2006 Contra Costa County Ifomeless Continuum of Care Plan 6 • LACK OF ACCESS TO SUPPORT SERVICES: Access to key support services is paramount and must be addressed in order to facilitate the move back into permanent housing. These support services include: case management, health care, mental health services, drug and alcohol treatment, employment and training services, childcare, transportation, housing placement assistance, and more. The .following provides some indication of the need for these services: • In April 2001, it was estimated that 637 individuals and 475 members of families, or 23%of the total homeless population, were chronically abusing substances." • Over 67%of homeless individuals and almost 10% of homeless people in families are in need of mental health care.""' The need for mental health care for children is known to be grossly underestimated within this 10% need figure. • Thirty-four percent"`of women who were homeless in one year reported that they had experienced domestic violence at some point in their lives. An estimated 233 individuals and 394 family members were estimated to be victims of domestic violence in 2001." • Physical disabilities and health problems, including HIV/AIDS, are a factor in many people's homelessness. Tile county has the 11"' highest incidence of AIDS in California, with 80% of those with HIV/AIDS possessing a monthly income of less than $900.'i • Families constitute 66%"'of the people that are homeless in Contra Costa County. Child care is essential to their being able to obtain employment, attend job training programs and access other support services to help them regain housing and address issues contributing to their homelessness. e Low INCOMES: In a 1995 survey of the Contra Costa homeless community, 90% of people had a gross monthly income of$1,000 or less, over 60% had a gross monthly income of$500 or less.'iii The disparity between incomes and rents for low-income people has only grown greater. A person working 40 hours a week needs to make$18.94/1-tour, or 329%of the minimum wage, to afford a two-bedroom Fair Market Rent unit in Contra Costa County."' Families in Contra Costa need to earn even more to achieve a decent, modest standard of living: a single-parent family needs to earn $21.24/hour, 369% of the minimum wage.'"Not only low wages, but also low benefit levels and limited eligibility make it less possible for low-income people to house themselves. Over 15% of the homeless.,population is employed,"' but low wages still put housing and self-sufficiency out of reach. The trend continues to worsen, as more 2001-2006 Contra Costa County liorneless Continuum of Care Plan 7 working people become or remain homeless. For those without jobs, barriers to finding and keeping employment include: the lack of access to showers and telephones, lack of job skills, limited employment options in today's poor economy, and discrimination by employers who are reluctant to hire homeless people. Strategies aimed at preventing and reducing homelessness must address each of these three root causes in order to be effective. The following two sections provide more in-depth information about homelessness in Contra Costa County. Section A outlines the data available on the number of people who are homeless,their demographics and their service needs. Section B lays out a comprehensive statement of homeless-related need derived from meetings with people who are homeless or formerly homeless,providers and community members. It encompasses both what was identified as being needed to prevent homelessness as well as what is needed to help those already homeless back into housing. 2001-2006 Contra Costa County I lomeless Continuum of Care Plan 8 A. Data on Homelessness This section presents the available data on homelessness in Contra Costa County. Unfortunately, data on the number of people who are homeless, their demographics and their needs is extremely limited due both to the difficulties in obtaining this information and to the lack of resources available to conduct such data gathering and analysis. However,a picture of the magnitude of the homeless population in Contra Costa County and their needs was derived based on the following five data sources: • A series of community meetings conducted by the Contra Costa County Continuum of Care Board in 2000-2001; • Contra Costa County Health Services Department data on all county services provided to homeless people; e Contra Costa County Employment and Human Services Department data on the CaIWORKS""and the General Assistance (GA)program; * A survey of homeless people conducted by the Contra Costa County Health Services Department; and Year-end reports and other statistics from county programs and non-profit providers of services to people who are homeless. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 9 Estimated Number of People Who Experience an Episode of - Homelessness Each Year in Contra Costa County •Homelessness is not an isolated circumstance in Contra Costa County. Rather, it affects over 14,700 people per year. • The majority of people who are homeless are members of a family. Over half are children. Population Breakout • At least 14,757 people were homeless at some point . during the year • 66% (9,814) were family ': `'` `' 34% S: members ..1 KTC h •ET�gy • 34% (4,944) were individual adults 66% `",y n w.. ■ Individuals ❑ family Source: Derived from Contra Costa County Health Services Department data ie Members The preceding estimates of the number of people who experienced an episode of homelessness were derived frotn data from the Contra Costa County Employment and Human Services Department and County Health Services Department.""' The number of homeless families is based on the number of families who received assistance from the Aid To Families With Dependent Children Homeless Assistance Program (CalWORKS). According to CalWORKS,applicants are considered homeless if they do not have pennanent housing, including those who are living in a temporary shelter, residing on the streets or in a place not designed for human habitation,or living temporarily doubled up with friends or family. The number of individuals who were homeless for one year is derived from data on the number of people who applied for General Assistance(GA) and the percentage of recipients who self-declared that they were homeless. The Health Services Department maintains an unduplicated count of all people accessing services who declare themselves homeless. These figures were used as a baseline figure frotn which proportions of family members and individuals were derived. These numbers are a recognized undercount; they are minimum figures since they represent only people known to have been homeless because they declared themselves to be homeless and accessed services from the Health Services Department. These numbers 2001-2006 Contra Costa County Homeless Continuum of Care Plan to do not include all of the family members and individuals who did not need or access services through the County Health Serbices Department during the year. Estimated Homeless Population by Region •Homelessness is a significant problem in all regions of the county. Homeless Population Regional Breakout Central 22% _f Fact ==r: 31% West ; ; Source:Derived from Contra Costa "�,l'1�-- County Social Services Department 47°/ -' * data on CaMORKS recipients&GA o - recipients-22 A breakout of the estimated number of people who are homeless in each region was derived from the estimated yearly count using Contra Costa County Social Services Department caseload data for Cal WORKS and GA.19 2001-2006 Contra Costa County Homeless Continuum of Care Plan 1 I Estimated Number of People Who Are Homeless Each Night in - Contra Costa County •Each night in Contra Costa County, at least 4,829 people are living on the streets or in temporary accommodations, such as an emergency shelter or on a friend or relative's couch. • The majority are members of a family. Almost half are children. Estimates of the number of people homeless on any given night in Contra Costa County were derived based on data from the Contra Costa Employment and Human Services Department, Health Services Department,and surveys conducted by the Contra Costa County Health Services Department Homeless Program.20 Those considered homeless are people who do not have permanent housing, such as those living in a temporary shelter or transitional housing program,residing on the streets or in a place not designed for human habitation, or living temporarily doubled up with friends or family. Data on Homeless Sub-Populations The following data is based on year-end reports and other statistics from public and non- profit providers of homeless services. It is supplemented with data from a survey conducted by the Contra Costa County Office of Homeless Programs and the year 2000 community meetings. This survey was conducted as part of an outreach effort to people who were homeless in order to obtain input to guide the development of the Homeless Plan. As part of this outreach effort, focus group interviews were conducted with over 200 people at fifteen programs, including emergency shelters, transitional housing programs, soup kitchens,drug and alcohol detox and residential treatment programs, and a multi-service center for people with mental health disabilities. (See Appendix It for a listing of the programs where focus groups were held.) At the close of each focus group, participants were asked to fill out surveys. A total of 192 people filled out the surveys, 76% were homeless, 10%were formerly homeless and 14% had never been homeless but considered themselves at-risk of homelessness. Given that the people who filled out the survey were not selected by a random or scientific process, the survey results are not statistically representative and cannot on their own be used to depict the needs of the county's overall homeless population.21 However, in combination with the other provider-based data, a picture of the needs of people who are homeless in this county can be discerned. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 12 1. PEOPLE WITH DRUG OR ALCOHOL ADDICTIONS •Drug and alcohol addiction is a problem for a significant number of those who are homeless. •Residential detox programs and long-term residential treatment are the types of drug and alcohol services most often used by people who are homeless. •Drug and alcohol addiction affects both individuals and families. • In year 2000, 1,882 homeless people in Contra Costa County accessed some type of drug or alcohol treatment through the Health Services Department.22 This is a minimum figure because it does not include those who received treatment but chose not to declare themselves as homeless, and it does not include people with drug or alcohol problems who were homeless, but did not access any type of treatment. Given that the demand for alcohol and drug treatment is greater than the supply, the number of people with a drug or alcohol problem cannot be determined solely by looking at the number of people who access these services. • Over 1,000 homeless people in the county are estimated to be chronically abusing substances, with over 1,300 needing some level of substance abuse treattrhent.23 • Estimates of the proportion of the homeless population in Contra Costa County with drug or alcohol problems range from 23% to 59%, with a mid-point of 41%. Sources for these estimates include the following: ✓ Dividing the 1,882 people who accessed drug or alcohol treatment in one year by 8,251,24 the overall estimate of the number of homeless adults in that year, yields a percentage of 23%. ✓ Fifty-nine percent 25 of those surveyed by the Contra Costa County Office of Homeless Programs reported that they had a drug or alcohol problem. ✓ Fifty-nine percent of the adults served at Shelter, Inc. Reach Plus Program during 1999 had a problem with drugs and/or aleolhol.26 • Of the national homeless populattion, it is estimated that 38% have an alcohol problem, and 26%have a drug problem. 2001-2006 Contra Costa County I lomeless Continuum of Care Plan 13 2. PEOPLE WITH MENTAL HEALTH DISABILITIES • Almost 25%of those who are homeless have a mental health disability. •Both individuals and families need access to mental health services. • In one calendar year, 2,740 people who were homeless were served in the county mental health system.28 This is a minimum figure because it does not include those who received services but did not declare themselves as homeless and it does not include those who were homeless and had a mental health disability but did not access any type of services. Given that many people who need mental health services are unable to access them,the number of people with mental health disabilities cannot be calculated solely by looking at the number of people who access services. • In a year's time, at least 33%of the adult homeless population in Contra Costa County was estimated to have a mental health disability. Sources for this estimate include the following: ✓ Dividing the 2,740 people who accessed mental health services by the 8,25129 adults estimated to be homeless in a year yields a percentage of 33%. ✓ Seventeen percent 30 of the people surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they had a mental health disability. • At any point in time in year 2001,an estimated 1,376 homeless people, or 28%, were estimated to need menuil health care, with 461 being seriously mentally i1L31 • Nationally,the rate of mental health issues in homeless people is much higher,an estimated 39%.32 3. PEOPLE WI{O ARE DUALLY DIAGNOSED •Over 10%of the homeless population have both a mental health disability and a problem with alcohol or drug use. •Almost 75%of homeless people tvho have a mental health disability also have a problem with alcohol or drug use. e Twelve percent33 of those surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they had both a mental health disability and a problem with drug or alcohol use. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 14 • In the survey, 72%of those who indicated that they had a mental health disability also said they had a drug or alcohol problem. Twenty percent of those who indicated that they had a drug or alcohol problem also said they had a mental health disability.34 • The April 2001 analysis estimated that 325 homeless people had both a mental health issue and a substance abuse problem.35 4. VICTIMS OF DOMESTIC VIOLENCE •Domestic violence is a significant aspect of their homelessness:for many women and their children. • Thirty-four percent 36 of the women surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they had experienced domestic violence at some point in their lives, either as a child or as an adult. • Now, an estimated 627 homeless people are victims of domestic violence.37 • Nationally, about 4%of homeless individuals/households became homeless because of abuse/violence in their immediately previous home.38 5. PERSONS WITH HIV/AIDS • There are approximately 720 people currently living with AIDS in Contra Costa County,and over 4,900 people with HIV/AIDS.39 • 623 people living with HMAIDS were in need of homeless services in 2001.40 • A 1996 County survey of no-/low-income people with HIV/AIDS found that 4%of the respondents were currently homeless, 18% were in temporary housing, and that 31% had ever experienced homelessness since learning of their HIV infection.41 • rorty-one percent of the clients recently served at the Contra Costa AIDS Program were hotneless.42 6. YOUNG ADULTS •Almost 1/4 of homeless individuals are young adults (age 18-24). • After outgrowing or being released from foster care,juvenile detention facilities, psychiatric facilities, or criminal justice facilities, many young adults graduate into 2001-2006 Contra Costa County Homeless Continuum of Care Plan 15 homelessness. Nationally, between 21%and 53% of foster care youth move into homelessness.43 • Nationally, it is estimated that 7.6% of youth aged 12-17, or 1.6 million, experience homelessness in a given year.44 • At any point in time in Contra Costa County, there are an estimated 130 homeless youth on their own in need of services. 45 7. PEOPLE WITH PHYSICAL DISABILITIES AND HEALTH PROBLEMS •Physical disabilities and health problems are a factor in many people's homelessness. • Nationally, homeless people have age-adjusted mortality rates three to four times expected. 46 •Twenty percent of those surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they had a physical disability.47 • Twenty percent of those surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they had health problems and 10% of those surveyed said that they had stayed in the hospital during the past 12 months.49 • Five percent of the adults served at Shelter Inc., Reach Plus during 1999 had a chronic health problem.49 8. PRISON DISCHARGEES • Many people leave prison and jail and enter homelessness. Often, they are discharged without any resources for housing, and thus, must use homeless shelters. • Twenty percent of those surveyed by the Contra Costa County Health Services Department Homeless Program reported that they had spent time in jail during the previous 12 months.50 2001-2006 Contra Costa County Homeless Continuum of Care Plan 16 9. HOSPITAL DISCIIARGEES • Significant numbers of people who are homeless report that they were discharged from a hospital in the past year. • Nationally, homeless people utilize inpatient hospitalizations over three times the rate of the general population, and almost twice the rate of the poverty population.5� 10. VETERANS •Over 10%of the homeless population are veterans. • Sixteen percent of those surveyed by the Contra Costa County Health Services Department Homeless Program indicated that they were veterans.52 That is significantly less than the 33% recorded across the nation. • An estimated 434 veterans were homeless at any point in time in 200 1.53 Data on Income Level, Education and Employment 1. INCOME LEVEL • The majority of people who are homeless have a gross monthly income so low that it makes it nearly impossible for them to find housing that is affordable. 2001-2006 Contra Costa County 1-lomeless Continuum of Care Plan 17 Gross Monthly Income (Note: 1994 Dollars) 70 _ 60 s0 v 40 u C,, 30 Ic 20 10 0 <S500 $500-1000 $1000-1500 $1500-2000 $2000-2500 >$2500 Source: Contra Costa County Health Services Department survey of homeless people • In 1994,eighty-seven percent of homeless people surveyed by the Contra Costa County Health Services Department Homeless Program had a gross monthly income of$1000 or less, 62% had an income of$500/month or less.54 • The ratio of all low-income renters to all low-income units is about 2:1 in Contra Costa County and around the Bay Area.ss • The Section 8 Program is increasingly overburdened and under effective in high-cost housing areas such as Contra Costa County. The Contra Costa County Housing Authority maintains a Section 8 housing voucher wait list that has been closed for the past four years, but still includes over 2,000 names.56 2001-2006 Contra Costa County Homeless Continuum of Care Plan 18 2. EDUCATION LEVEL •People who are homeless have a varied educational background. A significant number, at least 1/3, have completed some college or obtained a degree. 14% Education Level Attained 33% 22% 0 Not Completed High School or GED 0 Completed High School or GED ■Some College 31% o AA or BA Degree or Graduate School Source: Contra Costa County licallh Services Department survey of homeless people 32 • In the survey conducted by the Contra Costa County Health Services Department Homeless Program,47%of the respondents had completed some college or obtained a degree, 31% had completed high school or the GED, and 22% had not completed high SCIloo1.57 • National levels of education of homeless people estimate that 62% of homeless people have a high school degree/GED or higher, 22% with some college, and 2% with a bachelor's degree or more.58 3. EMPLOYMENT DATA •Despite the obstacles, over 15%of those who are homeless are employed. • Seventeen percent 59 of those surveyed by the Contra Costa County Health Services Department Homeless Program were currently employed. Additional Data on Homelessness • The majority of people who are homeless have had at least one previous experience of homelessness. •Public transit is the predominant means of transportation for most people who are homeless. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 19 • Sixty-four percent60 of those surveyed by the Contra Costa County Health Services Department Homeless Program had been homeless more than one time. About half of homeless people nationally have been homeless at least once before.61 • Eighty percent62 of those surveyed by the Contra Costa County Health Services Department Homeless Program said they use the bus or BART to get to appointments or to work. • In the survey conducted by the Contra Costa County Health Services Department Homeless Program, respondents indicated that during the previous twelve months63(The percentages do not add up to 100%because the survey respondents were able to give multiple responses to the question.): ✓ 43% had lived on the streets, ✓ 22%had lived in a vehicle, ✓ 59% had been in a shelter or transitional housing, and ✓ 45% had stayed with a friend. Data on the Population At-Risk of Homelessness •Almost 17,000 extremely low-income households are paying an excessive portion of their income for rent and are therefore at-risk of homelessness. •Many people's incomes are so low that they are unable to meet their basic needs, including food and medical care. •Due to cutbacks in benefit programs, many current recipients may lose their only source of income and the only thing standing between them and homelessness. • Of all renters in Contra Costa County,42% are unable to afford a one bedroom at FMR, 52% unable to afford a two bedroom FMR,and 67% unable to afford a three bedroom.64 • For low-income renters, the situation is dire: a person working for minimum wage in Contra Costa County would have to work 105 hours/week to afford a FMR one bedroorn unit, 132 hours/week to afford a two bedroom, and 181 hours/week (which is actually impossible)to afford a three bedroom.65 • The new CalWORKS benefits programs eliminated or reduced the benefits available to many households under AFDC, including those dependent on CalWORKS, GA, SSI and Medi-Cal. Without these benefits, the number of'people at risk of homelessness has grown. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 20 ✓ Between FY 1994-95 and FY 1999-2000,the county's average monthly caseloads decreased from 4,600 single adults and 14,977 families to only 693 single adults and 10,919 families. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 21 B. Statement of Need This statement of need is the product of the voices of homeless people and community members at community meetings in 2000-2001 and similar meetings field in 1995. These voices have been integrated here to form a comprehensive statement of homeless related need. A series of community meetings were held between October and January 2001 with the goal to: * Identify the unmet service and housing needs of people who are currently homeless or at-risk of homelessness; * Solicit input about the concerns of the larger community in relation to homelessness; e Obtain feedback about how the service delivery system is presently operating; and, • Solicit program and policy recommendations about how to best prevent and alleviate homelessness.in Contra Costa County. As part of the first Contra Costa County Homeless Plan, meetings had been held with people representing diverse viewpoints, including members of the community, service providers and people who are currently or formerly homeless. In preparation for the new, updated Homeless Plan, five community meetings were held, each co-sponsored by one of the County Supervisors and held in the local district. These meetings were attended by over 200 people including community members, members of the business community, people who were homeless, and local service providers. The feedback from all the meetings and all the viewpoints was synthesized to yield a comprehensive statement of homeless-related need, encompassing both what is needed to prevent homelessness as well as what is needed to help those already homeless back into housing. This statement of need formed the foundation for the development of the recommendations in this Plan. The needs have been organized into two categories: ♦ Overall Needs,and ♦ Sub-Population Perspectives&Additional Needs. Overall Needs Certain needs were raised as being important to all segments of the homeless and at-risk population—to single adults, families, those with a mental health disability or a drug or alcohol addiction, and youth. These needs were identified as being essential to preventing people from falling into homelessness and/or assisting those already homeless to regain and maintain housing. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 23 AFFORDABLE HOUs[NG The principle barrier to moving out of homelessness is the scarcity of affordable housing. Rental units in Contra Costa County are priced far beyond the reach of people with extremely low-incomes or anyone who depends on General Assistance(GA), Temporary Assistance to Needy Families(TANF),or Supplemental Security Income(SSI). An estimated 1,700" `homeless households are in need of permanent affordable housing. Nearly 17,000 households with extremely low-incomes are,at-risk of homelessness because they are bearing an excessive housing cost burden(total housing costs exceed 30%of the gross household income).' The size of the need is also demonstrated by the over 2,000 households on the waiting list for Section 8 Rental Assistance(awaiting new number)." Many community members expressed their fear that governments fail to see the need for new affordable housing for people with extremely low-incomes. The situation is exacerbated by the number of neighborhoods that can delay the construction of affordable housing with local zoning laws and environmental regulations. To end an episode of homelessness, a person requires a stable income to cover their rent and other living costs. For many homeless people, this income stream, at least initially, is General Assistance(GA). However, there is virtually no housing that is affordable at this income level. The median rent in Contra Costa County averages$1,155/month for a two- bedroom apartment,"" while a GA grant only slightly more than$300 a month. For those who are employed, high rental costs still pose a significant barrier. The average wage earned by those who graduate from TAN is$6.61/hour,""' a number far below the salary that is necessary to cover the county's median rent of$1,155 and be left with enough money to support a family. For those whose housing costs are excessive, the threat of falling back into homelessness will continue to be present. Many providers and members of the community spoke of the need for shared housing programs that would match potential roommates and provide training in successful shared living so that people can better afford housing. They also identified housing linked with support services as an important housing arrangement for people with disabilities. In addition to the lack of low-cost housing, many people are unable to obtain housing because of bad credit histories, previous evictions and because they cannot come up with the steep move-in costs necessary to enter housing(first and last months' rent plus security deposit). 2001-2006 Contra Costa County lionteless Continuum of Care Plan 24 EMPLOYMENT AT A LIVING WAGE Access to stable employment at a living wage was identified as an essential aspect both of preventing future homelessness, helping those currently homeless to regain self- sufficiency, and strengthening the community. For those already homeless, a spectrum of employment-related needs was identified. The lack of help in developing resumes and polishing interview skills were stressed as a barrier to getting jobs that pay a living wage. For others,a lack of job skills poses the main barrier; they need education, apprenticeships, vocational training and re-training. In regard to training, many people stressed that they thought training programs should be tightly linked to actual jobs, and that those who finish programs should receive assistance in lining up employment. Finally,an overall lack of stable jobs at a living wage was identified as a significant issue. Given the high cost of housing and the sinking wages of low paying jobs, strategies to promote job creation in positions with a likelihood of advancement were felt to be particularly important. DIGNITY There was a near consensus in each of the community meetings that the dignity of homeless people should be acknowledged in every segment of the homeless service continuum. When accessing services, many participants expressed their desire to see everyone treated with respect, and for case managers perform their jobs with professionalism. Several people described various experiences during which they felt mistreated or simply ignored when accessing services. Suggestions included dignity training for all shelter and program staff, including social service providers—staff in einergency.rooms, WIA One-Stops, and at the Social Security Agency—serving people who are homeless. TRANSPORTATION Lack of transportation was consistently raised as a barrier for people trying to move out of homelessness. People are unable to get to job interviews and to jobs because they do not have a car or gas money to drive their car. Others find it difficult to access services or keep their appointments with their Social Services caseworker. The size of the county and the limited public transportation makes it difficult to get from one area to another without taking the whole day. The problem is especially severe in East County where there are communities that are not served at all by public transportation. Suggestions included operating a van service between programs, developing a discount bus pass for people with low incomes and creating volunteer ride programs- 2001-2006 Contra Costa County homeless Continuum of Care Plan 25 EARLY INTERVENTION: TIMELY PREVENTION & EMERGENCY SERVICES In the meetings of 2000 and 1995, early intervention to prevent homelessness was stressed as a way to keep neighborhoods together, avoid the most expensive services, and provide a humane solution to homelessness. While providers and clients saw prevention as an important priority, they also expressed frustration about the limited availability of services that can reach people before they become homeless. Many social service programs do not ask people about their homeless status to identify those at risk of homelessness. Many providers cannot even serve people until they hit a crisis that is certain to cause homelessness. For instance, rental assistance programs do not provide assistance until people receive an eviction notice and consumer credit counseling programs do not help until people are already behind in payments;too often this is too late to prevent homelessness. Providers stressed the importance of identifying people at risk of homelessness early and then providing services to them immediately after identification. COMMUNITY EDUCATION, INVOLVEMENT& ADVOCACY Providers and community members felt that community education is an important way to increase the public's understanding of homelessness and build support for programs that prevent and alleviate homelessness. Mobilizing public opinion and conducting advocacy in support of safety net programs was seen as essential in the current political context. Homeless people spoke of the need for further community education to counter the stigma and discrimination they run into from prospective employers and landlords. In addition, participants at all the meetings acknowledged that the larger community has an important role to play in addressing homelessness and that government and the non-profit sector would not be able to do it all. Sub-Population Perspectives & Additional Needs As with the general population, the homeless population is composed of many diverse sub- populations. Each group has different perspectives on what is needed and how it should best be provided. The following is an overview of some of the different perspectives along with a listing of any additional needs that were identified for that sub-population. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 26 1. INDIVIDUALS It is estimated that over 4,944 individual adults experience an episode of homelessness at some point during the year and that over 1,618 are homeless on any given night..'iv The most important needs for many individuals are an adequate and stable income stream and a place to live. Many expressed frustration about the difficulties of paying the rent U on two or three jobs and focused on the need for services to help them obtain more profitable jobs. Others focused more on problems with General Assistance(GA)and Section 8,which are so low that it makes it practically impossible for them to find housing and get back on their feet. For many individuals, independence and control over their lives is of paramount importance and this affects how or if they access services. Those individual adults choosing to use the shelters expressed hope about providing more services at the shelters. They expressed the desire for longer periods to remain in the shelters, to give them the time they will need to line up new housing and find strong job training programs. Many people thought the need was there because there are very few options available once their time is up at the emergency shelters. Others thought that the shelters should be more flexible for people looking for jobs. The early curfew may make it more difficult to work for employees on the swing and graveyard shifts. Single men also expressed some frustration about the overall lack of resources and assistance available to them. While they felt that families need and deserve assistance, they thought that the focus on families and children results in their getting short shrift, and that they too need a break in order to get back on their feet. Additional Needs * More Emery Shelter Beds:Beds: There are not enough shelter beds for all the individuals who are homeless. A need for more emergency shelter beds for individual adults was identified, especially in East County. Some people were interested in places they could stay for an extended period of time and receive other services (like the Central County& Brookside shelters), while others were more interested in shelter that could be accessed for three or four days at a time to provide some respite from the streets and allow them a chance to clean up. 2. FAMILIES It is estimated that over 10,000 parents and children in Contra Costa County experience an episode of homelessness each year. On any given night, it is estimated that over 900 families are homeless, including an estimated 1,700 children."' While the majority of homeless families are single women with children, providers report that intact families and men with children are also part of the mix. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 27 Affordable childcare and affordable housing were identified as the two most important needs for families and the two hardest needs to meet. Women in transitional housing talked about their fear of not being able to find housing they can afford in neighborhoods where they would choose to raise their children. Even with job training to increase their skills and earning capacity,women were nervous about their ability to be self-sufficient given the combined costs of rent and childcare. They worried about not being able to make it now that there is a limit on Section 8 rental assistance vouchers;part of the success of the women who had previously moved out into permanent housing was attributed to their having had Section 8 assistance. Employment services and job training were also raised as important to families because these services enable parents to increase their earning capacity. In addition to money management skills,parenting classes were identified as being vital,especially by younger women interested in not repeating patterns from their own family histories that they felt contributed to their homelessness. They felt that parenting classes were a form of homelessness prevention for their children. Other issues raised included the need for more services for intact families. At several of the meetings,men spoke of having been forced to separate from their families so that they all could access services. Also, the need for drug and alcohol and mental health services which are oriented to serving the whole family and not just the disabled adult was reiterated. Additional Needs: • Affordable Childcare:The lack of affordable childcare offered on a flexible schedule was identified as a major barrier to women leaving welfare and returning to work. As long as women are on welfare,their income will be low enough that they will be perpetually at risk of homelessness. For much of the employment they can find, few childcare programs offer services during their work hours. Lack of childcare was also seen as a barrier to women attending job-training programs that can help them to raise their earning capacity. In addition, many said that a lack of childcare inhibits their ability to access other services to help them regain housing and address the issues contributing to their homelessness. • Prenatal Care: There was strong concern that adequate health care has not been provided for mothers during pregnancy and with children ages 0-5. Many expressed a need for expanded integration among service providers. Prenatal care providers may not be integrating programs with county providers in the fields of mental health and substance abuse, or with HHISN. Programs should develop a virtual continuum of care where the different providers work in close contact with one another sharing expertise and services to better serve homeless clients with complex needs. County institutions have no system for transitioning pregnant women into services when they are released. It was suggested that 2001-2006 Contra Costa County t{orncicss Continuum of Care Plan 28 an outreach worker be placed in the county jails to identify pregnancies among women being released, to bring them into prenatal services. It was suggested that service providers advocate for increased Medi-Cal coverage for pregnant women and teenage girls. Under the current Medicaid system, many homeless women are not covered for medical care after childbirth or at anytime before pregnancy begins. Women are only covered while they are in term and up to 60 days proceeding childbirth. Once the 60-day time period has elapsed,coverage terminates unless the client is enrolled in TANF. It was further suggested that public advocacy organizations, such as the Healthy Families Program, raise the issue of extending Medicaid coverage at the state level, with the support of the Contra Costa County Board of Supervisors. 3. PEOPLE WITH MENTAL HEALTH DISABILITIES It is estimated that 28%of people who are homeless have a mental health disability. On any given night,this is over 461 households. Over 70% are believed to be dually diagnosed with a drug or alcohol problem in addition to their mental health disability." 'i People with mental health disabilities, providers and community members all stressed the need for expanded availability of mental health services. Many people felt that parks,general homeless shelters, hospitals and jails are currently functioning as de facto trental health programs because so many people end up in these places due to the lack of other options for them. The situation is more severe according to many, because key services have been cut back or denied funding, including the ACCESS program. The need for more supportive housing was stressed by both clients and providers. In addition, many people felt that they needed help in finding housing. They also identified the need for on-going services, once housed, to help them manage bill paying and other responsibilities. Many stressed the importance of representative payee services that help clients manage their funds and pay their bills, thereby helping people to maintain their housing. Currently, the number of supportive housing beds available for those with mental health disabilities falls short of the need. It is anticipated that this shortfall will be exacerbated in the near future due to pending budget cuts that will decrease the number of available beds. In addition,the Contra Costa County Mental Health Commission's Housing Report found that 1,700 people with mental disabilities are currently living with care giving parents who are over age 65; many of these individuals will need supportive housing in the near future when their aging parents can no longer care for them. Some mental health clients were comfortable obtaining assistance through programs like the Phoenix multi-service centers which only serve people with mental health disabilities. However, others wanted to be able to access the help they need through mainstream programs where they do not have to identify themselves as having a mental health disability. Finally, a great deal of anger, frustration and paranoia was expressed about the system. In reference to General Assistance(GA) and Supplemental Security 2001-2006 Contra Costa County 1lomcless Continuum of Care Plan 29 Income(SSI),people felt there is"too much red tape for too little assistance." Many felt the rules were set up to stop people from getting aid, rather than to help them get the assistance they need. The concern of internal barriers to treatment services,such as fear and denial,was also raised regarding this population. Studies have documented the persistence of people denying the severity of health problems."" Many have explained their reluctance to undergo medical treatment as fear of losing control of their lives,others have more specific fears of being arrested, of mistreatment at the hands of service providers,and of losing their children to Child Protective Services. Additional Needs e More Emergency Shelter Beds:A need for more emergency shelter beds was identified. Many wanted to see more emergency beds through shelters that serve the general population but have capacity,through staffing and program structure,to serve people with mental health issues. * Outreach: It has been suggested that the programs developed in the next five years focus on engagement through intensive outreach and by establishing trust with clients unlike anything done in Contra Costa County in the past. This new continuum of care will also increase communication and teamwork among providers and agencies that handle housing needs, mental health services,and alcohol and drug problems. Homeless people with comorbidity issues will no longer be left on their own, and the continuum of care will provide one place to come for many kinds of treatment. • Supportive Housing: The need for affordable housing linked to support services was identified as a primary need for this population. While the level of services needed will vary over time, there is a long-term need for some level of service connection. It was felt that supportive housing is the best way to ensure that people can retain their housing, avoid homelessness,and diminish their need for crisis services. The array of support services linked to supportive housing will vary depending on the specific needs of the population served,but may include mental health services, representative payee/money management services, drug and alcohol treatment,peer support groups,and employment and training. • Expanded Access To Mental Health Services:There is a need for expanded access to mental health services for both people who have a severe and persistent mental health disability and those with less serious disabilities, including those who have situational disorders due to a particular life crisis. Services that are needed include counseling and therapy,case management, independent living skills, peer support groups, and crisis services. 2001-2006 Contra Costa County t{omcless Continuum of Care Plan 30 4. PEOPLE WITH DRUG& ALCOHOL ADDICTIONS It is estimated that at least 41%of the homeless population has a drug or alcohol problem. On any given night,this is over 830 households. Sixty-one percent are believed to be in adult-only households and 39% in family households. Over 66%are believed to be dually diagnosed with a mental health disability or HIV/AIDS in addition to their drug or alcohol problem(awaiting new data)."v... Many people expressed frustration about the difficulty in accessing drug and alcohol services,especially residential treatment programs. People in detox complained that the lack of access to residential treatment means that there is `no next step from detox' and that it is just a revolving door-they will soon be back out on the streets and probably using again. While most agree that it is appropriate that people go through some hoops in accessing programs in order to demonstrate their motivation and commitment to getting clean, they also felt that the length-of the waiting lists(3 months- 1 year) make it excessively difficult for anyone to succeed. People in detox programs spoke emotionally about how hard it is to stay organized and motivated to make the weekly call necessary to stay on waiting lists when you are homeless, on the streets, and surrounded by drugs and alcohol. Because of the nature of homelessness,there was consensus that residential treatment is generally the best form of treatment for homeless people. People in drug and alcohol programs emphasized repeatedly that their primary goal is to stay clean and sober. In addition, they are focused on finding employment and a place to live in a clean and sober environment. Some people expressed concerns that their years of addiction had left large gaps in their work history, which could interfere with their ability to find work. This was especially a concern for young adults who felt that they lacked both work history and skills. Others raised concerns about not having anywhere to go when they finish the program except back to the streets or to their old neighborhoods where the odds of their being able to stay clean are greatly diminished. Many expressed a need for assistance in helping them to secure housing and other services for when they leave the program. The need for drug and alcohol programs to incorporate a stronger ancillary services component, including life skills, housing advocacy, mental health services, employment services and case management, was raised repeatedly. Some providers noted that people are entering programs in worse condition than ever before, many with dual and triple diagnoses. This makes the ancillary services component as well as longer treatment times absolutely essential. In addition, many stressed the need for after-care and follow-up services to help clients stay clean and sober outside of the program. People in residential treatment programs did not think that the mainstream homeless programs effectively serve people with addictions, saying that,"it is too easy to put one over on the staff." Many stressed over and over that drug and alcohol treatment has to be provided first;otherwise the other services will not help and provision of them will just be a waste of resources. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 31 Finally,many expressed frustration with the fact that, despite the obvious need, many drug and alcohol programs are cutting back on services because of loss of funding. It was felt that all steps should be taken to keep programs open since it is more cost- effective to keep a program going than it is to start a new one in the future. Additional Needs •More Residential Treatment Programs: More residential treatment beds are needed for all population groups. While this has remained a priority over the last five years,the number of beds has fallen since that time. In particular,the need for programs that treat the whole family and that can address issues of domestic violence were identified. Also, single women and those with a dual diagnosis were identified as being especially in need of programs to serve them. • Intensive Case Management: Intensive case management was identified as an important component of treatment. It is needed to help clients access ancillary services to address their other needs,such as employment services, life skills, medical care, mental health services and permanent housing. It was also identified as a vital after-care component that helps to facilitate the client's successful adjustment outside of the treatment program. Because of the particular issues posed by addiction,case management staff working with these clients must understand addiction, the process of recovery and how to deal with relapse. •Transitional Clean & Sober Housing: Many people,after finishing residential treatment,still need structure and support in order to remain clean and sober and achieve long term self-sufficiency. Facilitated clean and sober shared living was identified as a successful program model. 5. YOUTH& YOUNG ADULTS It is estimated that almost 700 young adults(ages 18-24)experience an episode of homelessness each year. An estimated 131 youth(ages 14-18)are homeless on any given night."" Youth ages 14-18 who have clear evidence of physical or sexual abuse are served by Child Protective Services(CPS)and put into the Foster Care system. However,because of a lack of resources,CPS accepts only children and youth whose abuse is severe. Some of those interviewed complained that those who do enter the system are not adequately served and that many who leave the foster care system at age 18 or 19 do not have skills or a support network to sustain themselves. Too many are believed to fall into homelessness. Youth who do not meet the CPS criteria for abuse, yet who are in crisis and have left their homes have virtually no access to assistance. Previously, Sherman House provided short- term residential services but the program was closed due to funding constraints. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 32 It was felt that ensuring that youth graduate from high school and have basic living skills and job skills is a priority. A need for places where youth can go for recreational activities, to socialize and which foster their self-esteem was also identified as important. There are not many services targeted for the needs of young adults(18-24 years of age) who are homeless or at-risk of becoming homeless, many of whom are believed to have come out of the foster care or the juvenile justice systems. As they are not permitted access to adult emergency shelters, they rotate from place to place, live in vehicles and end up on the streets after they burn-out their support networks. Many have trouble finding and keeping employment because of poor job skills, inadequate social skills and low self-esteem. Special programs are needed to serve this population as employment and training programs geared to adults who already have some job skills and life experience do not meet their needs. Additional Needs r • Youth Shelter: It was recommended in every district that a youth shelter be provided for runaways and homeless teens. Young people who experience homelessness are not permitted into the adult emergency shelters, and they rotate from place to place, living in vehicles, and finally ending up on the street after their support networks are burnt out. • Better Preparation for Youth Leaving Foster Care:The foster care program needs to put more emphasis on ensuring that youth complete high school and have basic living skills before they leave foster care. • Prenatal Care: Many pregnant teens living on the street have very little access to prenatal health care. This population numbers among the most vulnerable in the community and the possibility of a medical emergency is very high. Many see the value of expanding SSI services to cover prenatal teens or creating a county funded program that can extend basic medical services for young teenage women. • School Programming It was suggested that service providers advocate for the proper use of the Title 1 federal set-aside in school districts. Title I funding for school districts mandates an allocation of part of the school budget for children of homeless families. It was further suggested that advocacy be made for McKinney Child Education funding to support existing education prograrns in East and Central County. This could ensure that the county is applying for all available funds and that it allocates funds appropriately. • Emancipation Programs and Life Skills: Many see the need for life skills services designed especially for homeless youth living on their own. This could include the creation of a complete continuum of care for homeless youth. Expand homeless youth services so all organizations provide vocational assessment and counseling, educational counseling, and life skills training to help young people overcome the causes of homelessness. Special programs would include emancipation services available to homeless youth, such as informational flyers describing the significance of being emancipated and legal aid that the youth can use to become emancipated. 2001-2006 Contra Costa County homeless Continuum of Care Plan 33 6. PEOPLE WITH IRWAIDS It is estimated that 18%of people living with HIV/AIDS in Contra Costa County are homeless. This is over 460 people. Many of them are believed to be dually diagnosed with a mental health disability and/or a drug or alcohol problem in addition to their HIV/AIDS diagnosis. Sixty-seven percent are believed to be in adult-only households and 33% in family households.' According to the Contra Costa County AIDS Housing Plan (December 1996), low incomes, the expense of on-going medical care and the high housing costs in Contra Costa County combine to make many people with HIV/AIDS homeless or at-risk of homelessness. Many people receive their income from Supplemental Security Income(SSI) or General Assistance(GA)and it is not enough to cover rent, medical care and other costs of living. In addition, those who are dually or triply diagnosed, having a mental health disability and/or a drug or alcohol problem in addition to a HIV/AIDS diagnosis, face even greater difficulties obtaining and maintaining housing. Access to a variety of support services, including case management, drug and alcohol treatment, mental health services, money management, transportation, attendant and home health care, and nutrition services is needed. It was also noted that people who are discharged from hospitals who are homeless and still in need of medical care are not being served in existing emergency shelters_ Facilities with appropriate services are needed for this population until they can get back into permanent housing. Additional Needs • Service-Enriched Emer-ency/Transitional Housing_Emergency/transitional housing with on-site medical services for people with a variety of illness, including HIV/AIDS, is needed. People being discharged from hospitals who are homeless and still in need of medical attention would be served here until appropriate permanent housing can be arranged. • Supportive Housing Low cost housing linked to support services was identified as a primary need for people who are disabled with HIV/AIDS. This was felt to be especially important for people who are dually or triply diagnosed(have a mental health disability and/or drug or alcohol addiction in addition to a HIV/AIDS diagnosis)and for those who have families and/or young children. It was felt that supportive housing is the best way to ensure that this population can maintain stable housing. 2001-2006 Contra Costa County I Iomeless Continuum of Care Plan 34 III. RECOMMENDATIONS OVERVIEW The recommendations in this Plan are organized into five broad issues that reflect the overarching areas of need identified through the planning process. The recommendations on each issue outline the priority actions for achieving specified goals. The five issues, which cut across every aspect of preventing homelessness and responding to the needs of homeless people, include employment and financial assistance, support services and basic needs, medical care and outreach,temporary and permanent shelter opportunities, and planning and public education. PRIORITIES All of the recommendations in the Contra Costa County Homeless Continuum of Care Plan 2001-2006 address prevention and such basic human needs as housing, hygiene, medical and mental health care, and access to adequate income to support oneself. Prioritization among these basic necessities and between the various sub-populations, each of which have significant and compelling levels of need, is extremely difficult. The realities of the homeless crisis have made almost all of the needs a priority. If the system of care let too many of the gaps in services go ignored, Contra Costa County could face a more serious and persistent problem in the future. However, it is also true that the resources available to address these needs are limited and that the system's short-term capacity to expand and implement new programs is finite. Therefore, in order to help guide the implementation of the Contra Costa County Homeless Continuum of Care Plan 2001-2006 and the allocation of resources over the next year, the Contra Costa County Homeless Continuum of Care Advisory Board has identified a number of recommendations as high priorities. This high priority designation means that these recommendations address high priority needs and should be addressed in the short-term (Years 1-2). Annual priorities will be identified each year to guide the on-going implementation of the Contra Costa County Homeless Continuum of Care Plan 2001-2006. Annual priorities will also be set for the County's consolidated NOFA application. Relative priorities of Low, Medium or High were attached to each category of need based on an evaluation of the following: • the magnitude of the unmet need for the sub-population • the unmet need as a relative percentage of the overall need for that sub- population • the project is ongoing or soon to be implemented as part of the Continuum of Care • how addressing the need accomplishes the following six objectives: • Promotes Coordination • Feasibility Over Time 2001-2006 Contra Costa County 1{omeless Continuum of Care Plan 35 • Is Cost Effective • Addresses the Shortage in Affordable Housing • Prevents Homelessness • Addresses a Basic Need. The support services and system priorities were identified by considering the services and system needs identified through the needs assessment process and evaluating how addressing them would accomplish the objectives outlined above. IMPLEMENTATION OF THE CONTINUUM OF CARE PLAN Upon adoption by the Contra Costa Homeless Continuum of Care Advisory Board(CoCB), the Contra Costa County Homeless Continuum of Care Plan 2001-2006(Plan) was forwarded to the Contra Costa County Board of Supervisors and to each of the eighteen cities for approval. The COCB is responsible for the implementation of the Plan and on-going planning and oversight for the homeless services system. The COCB will provide a formal structure to facilitate on-going coordination and collaboration among all the components of the homeless services system for purposes of service delivery, planning and resource management, fund-raising, and policy and program development. The Office of Homeless Programs (CORP) will staff the COCB and play a central role in coordinating the County's overall response to homelessness. Each of the action steps for years 1-2 in the Plan contain the following information in the form of a chart to facilitate their implementation: • Status (existing-planned) • Responsible entities • Potential funding sources. High priority action steps should be implemented in Years 1-2. Medium priority action steps will be implemented during Years 3-4 and Low priority action steps will be implemented in subsequent years. Several action steps that were not made High priorities may be completed in a shorter time if they involve minimal resources to implement,are already underway to some extent, or are part of the work assigned to the CORP. The Plan includes a range of action steps, some of which are already operational and others that need further planning as a first step in their implementation. This further planning will include all the involved parties and will focus on fleshing out the details of program structure, operation and funding. Preventing and reducing homelessness in Contra Costa County requires an on-going and substantial effort. Just as homelessness did not arise in our communities overnight, it will not be solved overnight. Rather, real and lasting solutions will come about through sustained and concerted efforts over the long run that seek to address the underlying causes of the problem. The magnitude of the need and the fiscal realities of the county, its cities, the state and the nation mean that obtaining the funding necessary to implement the Plan will require an aggressive, 2001-2006 Contra Costa County Homeless Continuum of Care Plan 36 creative and collaborative effort involving public agencies,business, congregations, non-profits and the general community. This process has already begun; housing and services proposals have been submitted for the HUD 2001 Continuum of Care Homeless Assistance Competition, and to Department of Health and Human Services SAMHSA for mental health outreach and substance abuse treatment, as well as youth programs. Funding has recently been received from the California Department of Mental Health through the Supportive Housing Initiative. HOW TO READ THE PRIORITIES AND ACTION STEPS Many of the action steps in the Plan are interrelated and therefore several may be listed under one priority statement. In addition,many action steps may relate to more than one priority statement,therefore,one action step may be addressed under several priority statements throughout the Plan. The action steps are also labeled with one of three priority levels (HIGH PRIORITY, MEDIUM PRIORITY, Low PRIORITY). These categories were established by the CoCB. DEFINITIONS(Terms as used in this Plan.) At-Risk of Homelessness, refers to people who have extremely low incomes who are paying more than 30% of their gross monthly income for housing; have a disability, physical, mental health, drug or alcohol addiction, or medical, that threatens their housing stability; are in foster care, hospitals or the corrections system and have nowhere to go upon discharge; or are threatened with the loss of their benefits due to cutbacks and policy changes in federal, state and local benefit programs. Continuum of Care, refers to the full service delivery system including prevention, outreach and assessment, emergency shelter, support services, transitional housing and permanent housing. Dually-Diagnosed/Co-occurring disorder or Comorbidity, refers to people who have a combination of two of the following diagnoses: mental health, drug or alcohol addiction and HIVIAIDS. Extremely Low Income, refers to incomes, which are at or below 30%of the area median income. Family Household, refers to households that include at least one adult and children. High Priority, refers to those recommendations targeted to be addressed in the short-term (Year 1-2). (see Implementation Priorities definition) Homeless, refers to people who do not have permanent housing, including people living on the streets or in parks, in shelters and transitional housing, in sub-standard housing, and in vehicles or other places not designed for human habitation. This conforms to the federal definition published in the HUD Continuum of Care and HOPWA Programs Application of 2001, which is as follows: - 2001-2006 Contra Costa County Homeless Continuum or Care Plan 37 A homeless person is a person sleeping in a place not meant for human habitation or in an emergency shelter;a person in transitional or supportive housing for homeless persons who originally came from the . street or an emergency shelter. The following is the definition of homeless from the McKinney-Vento Act, 42 USC Sec. 11302 (1999): In general...the term'homeless'or'homcless individual or homeless person'includes-...(1)an individual who lacks a fixed,regular,and adequate nighttime residence;and(2)an individual who has a primary nighttime residence that is (A)a supervised publicly or privately operated shelter designed to provide temporary living accommodations(including welfare hotels,congregate shelters,and transitional housing for the mentally ill);(I3)an institution that provides a temporary residence for individuals intended to be institutionalized;or(C)a public or private place not designed for,or ordinarily used as,a regular sleeping accommodation for human beings. Implementation Priorities. HIGH PRIORITY means the action step should be implemented in Years 1-2, MEDIUM PRIORITY means implementation during Years 3-5 and Low PRIORITY means implementation in the future. These will be reviewed annually by the CoCB; and separately for consideration in the annual NOFA process. Low Priority, refers to those recommendations targeted to be addressed in six years or sometime in the future. (see also Implementation Priorities definition) Mainstream Programs. The federal block grant-supported social safety net and community service programs available to the community at large and poor people. This includes but is not limited to health, social service, and employment programs funded through the following grants: • Medicaid(Medi-Cal) • State Children's Health Insurance Program • 7ANF(Cal WORKS) • Food Stamps • Mental Health Block Grant • Substance Abuse Block. Grant • Workforce Investment Act • Welfare-to-Work Program • Community Development Block Grant • Community Services Block Grant Medium Priority, refers to those recommendations targeted to be addressed in three to five years. (see also Implementation Priorities definition) Youth/Young Adult refers to emancipated people between the ages of 14-25. The definition also includes all youth under 18. Youth also refers to any child aged out of foster care. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 38 ABBREVIATIONS BOS—Board of Supervisors CAO—County Administrator's Office CBOs—Community-Based Organizations CDD—County Community Development Department CoCB—County Homeless Continuum of Care Advisory Board COHP—County Office of Homeless Programs CRA—City Redevelopment Agency CSAS—County Community Substance Abuse Services Division FBO—Faith-Based Organization HA—Housing Authority HHISN—Health, Housing, and Integrated Services Network HICC—Homeless Inter-Jurisdictional Coordinating Council HSD—County Health Services Department MHD—County Mental Health Division WIB /WIA—Workforce Investment Board/Workforce Investment Act SSD—Social Services Department 2001-2006 Contra Costa County Homeless Continuum of Care Plan 39 A. EMPLOYMENT, INCOME, AND ASSETS "With the wonderful economy in the Bay Area, [the homelessness] situation is getting better, right? No. It's getting worse." John Gioia, Contra Costa County Supervisor OVERVIEW For someone earning minimum wage in Contra Costa County, 138 hours of work a week would be required to rent a two-bedroom unit(that's nearly 20 hours of work a day). A gap this wide is a recipe for homelessness. To rent the same apartment on forty hours a week,a tenant must make at least$18.94 an hour, what would be equivalent to 329 percent of the minimum wage (National Low Income Housing Coalition, Out of Reach, 2001). In recent years, many jobs no longer pay enough to cover local housing expenses. Earnings trends suggest that the situation, if it is left alone, may get much worse. The earnings of the lowest-paid workers have continued to fall in the last twenty years(while those making the highest salaries increase their earnings every year). In 1979, workers at the bottom tenth percentile of all wage earners made$6.52 an hour. By 1998, the hourly wage had dropped to$5.84." Families receiving welfare are also in an unsustainable position. According to the Contra Costa County CaIWORKS Housing Assistance Action Plan &Implementation Strategy, the 2,483 families enrolled in the CalWORKS program earn $897.16 a month on average. That amount is less than 30 percent of the Area Median Income, placing the county's CalWORKS families squarely into the category of extremely low- income earners. Contra Costa County is committed to providing employment and income services that will result in positive outcomes for people who are homeless in the form of higher wages and a stronger purchasing power. Preparing homeless people for work and, at the same time, developing new job opportunities will remain significant elements in the county's strategy over the next five years. This Plan will build on the strength of current efforts in Contra Costa County funded by several sources and involving numerous programs. In 1995, the Contra Costa Economic Partnership was created to take steps to set county policy, improve the existing infrastructure, and to develop new jobs. Employment programs that make up a part of the social service safety net should identify the clients who are at risk of homelessness. CalWORKS gives job placement support and post- hiring training to welfare recipients who face the most serious barriers to work such as illiteracy, mental and physical disabilities,drug addiction,and the lack of work experience. However, CalWORKS programs have only limited services for clients who become homeless. Yet, such mainstream programs—like Cal WORKS—have not begun to work with clients who become homeless, and until they do, the homeless service providers will be forced to manage homelessness and neglect concerted efforts to end it. 2001-2006 Contra Costa County i-fomeless.Continuum of Care Plan 40 EMPLOYMENT AND INCOMES: COHESIVE STRATEGY Provide Employment Opportunities and Income Supports to Homeless People in Order to Enable People to Afford Housing and Retain Employment. These recommendations focus on expanding key employment services that enable people to address the issues interfering with their ability to maintain stable employment. The goal is both to help prepare homeless people for work as well as to assist them in finding and retaining profitable employment. The regional multi-service centers will be staffed to provide employment services. This includes recommendations for exploring connections with employers,services helping people learn on the job, and removing barriers that often keep people from being successful employees. Also included here are recommendations to help homeless people access income supports that can supplement incomes. Finally, it is recommended that the homeless service providers assist local public social support systems to track the number of clients who become homeless. Objectives: To enable homeless, and formerly homeless,people to find well paying employinent and save enough money to afford housing within their communities. To access all available incoine supports and provide any additional support that community-based organizations have not utilized. WORKFORCE DEVELOPMENT OVERVIEW Job training and work placement are county priorities in its strategy to provide homeless people a chance to enter the workforce and become economically self-sufficient. Workers in very-low income occupations earn less now then they did ten years ago, and consequently, service providers are seeing higher numbers of working people seeking homeless services. The incomes of people in the bottom 20% of earners have always hovered on the brink of inadequacy. Yet, up to ten years ago, the average wage of this group improved along with the entire workforce over the years. Things changed in the 1990s; between 1995 and 1997, incomes of the poorest 20% fell while incomes of other earners continued to rise. An increase in the number of available positions, if they pay the same wages, will not boost the position of working homeless people—better skilled workers will. If a homeless person with a job can gain experience and develop marketable skills, they will be more likely to demand better pay. With unemployment hovering near to 4.0% for the last five years, a skilled, formerly homeless person could find a welcoming reception in the job market. STRATEGY: Strengthen efforts to prepare homeless people for employment that will be sufficient for living independently by integrating life skills and vocational training with job programs and by providing support to clients. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 41 Priorities: A. Strengthen and expand efforts to prepare homeless people to enter the workforce. B. Expand County programs that reinforce the connection between housing and employment. C. Maintain and expand adult learning and literacy programs. PRIORITYA: Strengthen and expand efforts to prepare homeless people to enter the workforce. ACTION STEPS HIGH PRIORITY:' 1. Strengthen vocational training first. Options include training for jobs in childcare, machine operation, cooking, welding, computer repair, and heating and air conditioning repair. Give educational vouchers for vocational school —such as truck driving school, welding school, travel agent school, and real estate sales school. MEDIUM PRIORITY: 2. Maintain and expand in-house job programs. In permanent supportive housing across the county, offer more in-house jobs with rigorous clear job descriptions. Strengthen the residential culture to prepare formerly homeless unemployed individuals for a successful transition into the competitive job market. These jobs should be the entry point into three tiers of jobs. The first tier, for the individuals with the most barriers, will include in- house jobs connected to supportive housing with a strong residential culture. The second tier will include positions at agency businesses. The final tier will be placement with case management in the competitive job market. MEDIUM PRIORITY: 3. Give pre-employment support. Provide intensified pre-employment support including work culture orientation and literacy training provided by volunteers and current staff. Expand services on resume preparation,job search and placement support, and design a mentor system to track job retention. Provide homeless workers special services such as instructions for filing applications and creating resumes and mock interviews. MEDIUM PRIORITY: 4. Ensure WIA/WIB One-Slops provide information and referrals,job listings, resume services and linkages to life skills support and basic education. 1 Implementation Priorities. HIGH PRIORITY means the action step should be implemented in Years 1-2,MEDIUM PRIORITY means implementation during Years 3-5 and LOW PRIORITY means implementation in the future. 2001-2006,Contra Costa County Homeless Continuum of Care Plan 42 MEDIUM PRIORITY: 5. Offer workplace training for formerly homeless and at-risk TANI• recipients. Track people eligible for TANF and provide pre-employment skills education and workplace culture training so they can realistically achieve work readiness and employment goals adequate for self-sufficiency. PRIORITY B: Expand county programs that reinforce the connection between housing and employment. ACTION STEPS MEDIUM PRIORITIES: 1. Increase the use of pre-employment training in tandem with temporary and permanent housing developments. 2. Create a rental subsidies program that is administered as part of employment training programs and offer access to employment training and placement services. PRIORITY C.- Maintain .Maintain and expand adult learning and literacy programs. ACTION STEPS NIGH PRIORITY: 1. Maintain adult education services. Maintain the level of adult education offered in the transitional shelters. Maintain the funding of the Adult Homeless Education program of the County's Office of Education. MEDIUM PRIORITY: 2. Expand adult education and increase flexibility. Create new education and educational programs for adults who are illiterate or left high school without graduating. Any new adult education must have the flexibility and accessibility to allow for individualized and small group instruction. Instructors will teach students with respect to foster a strong sense of self-esteem in each student. MEDIUM PRIORITY: 3. Increase strength of existing case management programs. Link literacy programs with case management services to include needs assessment, to set educational goals, to access other services, and to monitor clients' progress. The providers will continue to use managers who were previously homeless. MEDIUM PRIORITY: 4. Incorporate life skills into literacy. Use individual learning plans to document student needs,education goals, and plan activities_ Computer-assisted instruction, emphasizing- 2001-2006 Contra Costa County Ilomeless Continuum of Care Plan 43 life skills and critical thinking should be included in programs that provide wrap-around services for dually diagnosed homeless individuals. Wake County,North Carolina has published examples of their lesson plans, which combine life skills and literacy. MEDIUM PRIORITY: 5. Connect literacy programs with services. Use staff from other local services and from non-profits to help in literacy instruction. Link courses with shelters. Contact libraries to coordinate training with library staff. EMPLOYMENT OPPORTUNITIES OVERVIEW Contra Costa County is devoted to developing new employment opportunities for low-income and homeless individuals. Most of this work,however, is limited to urban areas in West County. As part of the strategy to expand the employment base, local redevelopment agencies offer resources and technical assistance to existing businesses in redevelopment areas. The county initiates redevelopment by adopting a community plan,which can cover code enforcement, housing rehabilitation,new construction, and improvements in the infrastructure. A successful employment development program assists homeless people in small but profitable entrepreneurial ventures. Other job opportunities have been explored with private businesses that agree to take on people who are homeless and people with physical disabilities. STRATEGY: Expand well paying employment opportunities for people who are currently or formerly homeless by planning with employers and integrating advancements into job placement services. ACTION STEPS Low PRIORITY: 1. Maintain Employer-Agency Relationships. Approach the largest employers in Pittsburg, Martinez and Concord and propose that they take a lead in forming a nonprofit organization to train unemployed or underemployed homeless people in local trades where the demand for labor is high. Use work currently done with Chevron as a model of future relationships. Explore the feasibility of hiring staff to work as employment brokers to stimulate interest in the local industry for training programs designed for homeless people. Provide support for supervisors, including links to nonprofit case managers to assist with difficulties between the employer and the employees. Provide financial incentives for the first three to six months of employment to encourage participation and training. Interview the heads of manufacturing companies in the county's urban areas to learn about manufacturers' hiring priorities. This work would supplement rather than duplicate efforts already made by local offices for Economic Development. Contact and create an early warning system to identify firms that are at 2001-2006 Contra Costa County Homeless Continuum of Care Plan 44 risk of going out of business or relocating outside of the County. Assist manufacturers to find appropriate sites for operation or expansion and securing building permits. Design agency funded training programs with manufacturers to provide the company a reliable, industry-trained labor pool. Low PRIORITY: 2. Integrate job advancement into job placement services. Expand the current job placement services to include a range of internship and apprenticeship opportunities, encouraging private businesses to train and employ homeless people in the county. Adopt a progressive model of employment for people who are homeless consisting of no less than three tiers of job placement. For the individuals with the most barriers, offer in- house job programs connected to supportive housing with a strong residential culture. Track in-house employees until they are ready for agency businesses before being placed in the competitive job market. HIGH PRIORITY. 3. Offer financial incentives to businesses that hire and train people who are homeless. Offer wage and tax credits and grants to employers who will hire people enrolled in services by paying the costs of training and supervising workers without experience. Offer a stipend of$500 after the first six months and provide a $1,000 stipend if the term of employment lasts twelve months. All funds will be given to the employer to pay to the employee, thereby promoting the relationship at the workplace. MEDIUM PRIORITY: 4. Expand the number of livable wage jobs for very-low income and homeless people through additional social-purpose businesses that employ homeless people. MEDIUM PRIORITY: S. Adopt three tiers in homeless employment programs with in-house employment, nonprofit enterprises, and the competitive job market. Operate job placement services in three tiers according to client's experience, stability, and the ability to adjust to a workplace environment_ For individuals with the greatest barriers to employment, offer in-house jobs connected to supportive housing with a strong residential culture. Track in-house employees until they are ready for jobs at nonprofit operated businesses. Case managers will recommend the competitive job market for clients when they are ready to apply. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 45 WORKER SUPPORT SERVICES OVERVIEW With the advent of Welfare Reform and the subsequent CaIWORKS programs, government assistance now depends on the consumer's ability to obtain and keep a position in the workforce. Under the restrictions and time limits imposed by Welfare Reform, comprehensive countywide support for people moving from joblessness into the workforce is an essential element to reducing homelessness. Support services for people looking for work must provide assistance in a variety of ways. The progress of single working mothers can often be stifled by domestic violence. People who are first time employees have a special need for financial support to supplement their incomes. In addition, incomes of new employees are often inadequate to pay for housing and basic necessities, and the possibility of returning to homelessness is a serious risk. In order to successfully make the transition from homelessness to a life of employment and self-sufficiency, many people will utilize these supports temporarily while they secure a job that pays a living wage. STRATEGY: Enable people who are homeless and living with barriers to work to overcome their difficulties and find success on the job by accessing income supports and offering assistance to fragile people. Priorities: A. Expand programs providing people who are homeless access to existing public benefits and providing skills to manage these benefits. Q. Maintain a minimum level of income supports for those not making a living wage under the Work First paradigm,and assist new members of the work force to find necessary income supports. C. Identify and alleviate the major barriers to employment for homeless individuals with special needs. D. Ensure life skills programs can meet the needs within the county while maintaining a flexible,dignified service. 2001-2006 Contra Costa County homeless Continuum of Care Plan 46 PRIORITY A: Expand programs providing people who are homeless access to existing public benefits and providing skills to manage these benefits. ACTION STEPS NIGH PRIORITIES: 1. Expand Individual Development Account(IDA) programs targeted.for homeless clients at job placement sites. IDA programs help homeless people save money for housing, and even provides matching funds to help low income people reach their financial goals more rapidly. These programs have had a successful beginning in several local programs. In order to open these services to additional homeless people, it is recommended that IDA programs begin at job placement sites, which do not yet offer such services. MEDIUM.PRIORITY: 2. Fund legal services to help more homeless people apply for SSI,and help assist SSI recipients barred for substance abuse reapply under alternative categories. Also, have county service providers screen GA cases for potential SSI eligibility with benefits clinics in the shelters. Finally, provide training and technical assistance on SSI and VA benefits for case managers. MEDIUM PRIORITY: 3. Improve the capacity of the payees who receive funds on the behalf of the social security system. Federal law requires that payees receive SSI grants, a system that has led to abuse and lacks a level of dignity that ought to be a basic part of serving SSI recipients. Payees will be screened for experience in working with clients with special needs. MEDIUM PRIORITY: 4. Training for medical providers on the SSI. application process. Every year, medical providers, psychologists and any other professional who works with people seeking mental health services must attend one course on the eligibility requirements of federal laws and the forms necessary to receive aid. Every office given mental health advice must have the Social Security manual on serving people who are homeless. MEDIUM PRIORITY: 5. Expand county money management programs to include a volunteer pool of tax preparers who would help homeless people apply for current and past federal Earned Income Tax Credits(FITC). Establish training and produce technical assistance materials regarding FITC applications for case managers. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 47 PRIORITY B: Maintain a minimum level of income supports for those not making a living wage under the Work First paradigm, and assist new members of the work force to find necessary income supports. MEDIUM PRIORITY: Create a privately-funded income-subsidy trust and a privately-funded tuition trust focused exclusively on homeless services. Establish a pool of funding from alternative sources to provide technical assistance and actual benefits to homeless persons. Funds could be in the form of hotel and food vouchers, rental subsidies,and other need-based expenses for those who are not eligible for other public benefit programs or who are awaiting approval.. PRIORITY C. Identify and alleviate the major barriers to employment for homeless individuals with special needs. MEDIUM PRIORITY: Provide domestic violence assessment and sensitivity workshops to services providers who work at job placement and training programs. Expand current domestic violence programs into a community-wide response strategy with visible and accessible services to victims at the neighborhood level. Have service providers develop tools and techniques to serve client needs. Create new ties between safe haven workers and job counselors and trainers. PRIORITY D: Ensure life skills programs can meet the needs within the county while maintaining a flexible,dignified service. ACTION STEPS HIGH PRIORITY: 1. Maintain current levels of life skills services. Maintain the case management and life skills services provided in existing homeless programs. Workshops on life skills cover topics such as parenting, money management, nutrition, adult literacy, pre-employment education,and apartment hunting. RIGID PRIORITY: 2. Implement programs for homeless non-custodial fathers. Help non-custodial fathers become more engaged as parents with counseling on legal and child support obligations. In conjunction with the program,offer counseling on peer mentoring,anger management, homeless services,and substance abuse. 2001-2006 Contra Costa County I lomeless Continuum of Care Plan 48 HIGH PRIORITY: 3. Foster dignity in case management and training programs. Expand case management staffing to lower workloads. Staff sensitivity training could be conducted on a quarterly basis, using different local advocacy groups to lead each session. The quality of these services can also be improved by developing specific standards and criteria to guide case managers in their work. 2001-2006 Contra Costa County 1-lomeless Continuum of Care Plan 49 B. OUTREACH AND HEALTH SERVICES OVERVIEW Homelessness is an agent of disease. People experiencing homelessness have the greatest need for health care though they are among the least likely to receive treatment; they live in the crucible of the street, in the elements, exposed to countless illnesses, and are easy targets for the sources of drugs and violence. The link between homelessness and health problems was established by a 1988 study by the National Academy of Sciences;homeless people were 60 percent more likely to be hospitalized each year than a member of the general population."' The prevalence of physical trauma among homeless people has far outpaced the general population in deaths,hospitalizations, and the incidence of rape and emergency room visits. Often wearing inadequate clothing and with nowhere to go no matter what the weather, homeless people experience a high rate of heat stroke, heat exhaustion and hypothermia. Skin infestations, lice, scabies, and peripheral vascular diseases such as edema spread quickly due to poor hygiene and crowded living conditions. Those who must forage in trashcans to live are plagued by food poisoning. The expense of homelessness in a community is felt as much in the area of health care services as in any other. With such a high rate of illness, homeless people are more likely to use the most expensive health care services. At any given time, homeless people use one-fourth of all inpatient hospital beds.""' According to a study in the New England Journal of Medicine, hospital visits by homeless people average four days longer than visits by non-homeless people. That is approximately$2,414 more for every hospital visit."v A report done in Hawaii on hospital admissions revealed that 1,751 homeless adults were responsible for 564 hospitalizations and $4 million in admission cost."' The rate of hospitalizations for psychiatric care for a homeless person was 100 times more than non-homeless patients. Researchers estimated that the cost was close to $2,000 per patient_ The long delay between onset and treatment is the cause of the number of health effects with unusual severity recorded among homeless people. Shelter populations that receive little health care are stricken by epidemics more often—in a 1988 study, 12% of shelters experienced an epidemic of a diarrhea( disease."" Nights spent in the shelters and on the streets can exacerbate chronic illnesses such as hypertension, cardiac failure, arthritis, bronchitis, and pulmonary disease. The traditional subpopulalions of homeless people—people physically or mentally disabled, alcoholics, drug users, the elderly and children—have little prospect of escaping homelessness without adequate health care. Homelessness poses a terrible threat to these populations,and many are at risk of permanent injury. Children, for example, have less developed immunities to bacteria, are at a heightened risk of becoming victims of violence and are unable to withstand toxins. Moreover, premature births and prenatal drug exposure occur at higher rates among homeless people and often result in permanent defects and higher rates of infant mortality."" 2001-2006 Contra Costa County Homeless Continuum of Care Plan 51 The fundamental principles of an effective service delivery system have been well established; _ these include outreach, accessible regional locations, a range of services,and a knowledgeable medical staff. The county currently has a mobile medical outreach team run by Health Care for the Homeless to treat sicknesses at the earliest opportunity. There are only eleven clinics that see homeless clients across the county five days a week. The number of drug and alcohol treatment centers has fallen in the last five years,and there are a limited number of mental health service providers in the county. Besides the limited services, health service agencies invest very little in homeless programs—one-twentieth of one percent of the HHS budget supports Health Care for the Homeless, SAMHSA and homeless and runaway youth programming."'iii HEALTH SERVICES: COHESIVE STRATEGY Improve Access to Health Care Services for People in Crisis The recommendations contained in this section address the need to expand the accessibility of health services to help people avoid the threat of illness. This includes expanding the number of mental health professionals and combining the regional mental health clinics with the regional multi-service centers. This goal also calls for greater access to drug and alcohol treatment programs for people within the homeless service system. In addition, new efforts must be made to alleviate the conditions that lead to a high incidence of disease and infestation among homeless people. Objective: To enable people to avoid health crises, thereby preventing homelessiiess and assisting those already homeless to regain their housing. PREVENTATIVE HEALTH CARE AND TREATMENT OVERVIEW People experiencing homelessness have the greatest need for health care though they are among the least likely to receive treatment. Currently,each region within Contra Costa County is home to one county health center. Additional medical services are offered at the Richmond Souper Center and the Bay Point Wellness Center. However, many homeless people suffer from untreated ailments and are eventually hospitalized. Providing medical aid to people who are homeless or at risk of homelessness will help them avoid the crisis situations that prevent them from stabilizing their lives and reentering the community. By treating illnesses early, hospitals will be able to reduce the number of inpatient beds occupied by people who are living on the street and have developed critical illnesses. Prevention measures will also benefit most people who are homeless. In the next five years, the county will improve the delivery system of current services to homeless people through training and organization. In addition, efforts to prevent and alleviate the harmful effects of the physical and social environment of homelessness will be intensified to 2001-2006 Contra Costa County Homeless Continuum of Care Plan 52 reduce the incidence of diseases and infestations that are so difficult to control among homeless populations. STRATEGY: Intensify efforts to alleviate the harmful effects of the physical and social environment of homelessness to reduce the incidence of disease and infestation that can have detrimental health effects on people at-risk of homelessness. Priorities: A. Open up general healthcare services to people experiencing homelessness through advocacy,outreach and sensitivity training. B. Prevent the spread of disease and the severity of illnesses among homeless people by providing information on health and hygiene, by offering early treatment,and by bringing services to the patients. C. Increase medical treatment available to homeless people by eliminating traditional barriers to services, expanding existing services, and treating the most prevalent health problems found on the street. PRIORITYA: MEDIUM PRIORITY:1 Open up general healthcare services to people experiencing homelessness through advocacy, outreach and sensitivity training. Utilize state Medicaid (Medi-Cal). Advocate for the expansion of eligibility criteria for health care to extend to all homeless people. Help people utilize Medicaid(Medi-Cal). With the coming of TANP, the Social Security Administration has seen a drop in the number of people collecting Medicaid that coincides with the reduction of the federal welfare roles. Why have the number of Medicaid recipients fallen with the welfare roles? It is because people who are no longer eligible for welfare mistakenly believe that they cannot receive assistance under Medicaid. It is a question of understanding Medicaid eligibility, and in the next five years, case managers and program directors will work to ensure people eligible for Medicaid understand they have an entitlement. PRIORITY B: NIGH PRIORITY: Prevent tate spread of disease and the severity of illnesses among homeless people by providing information on health and hygiene, by offering early treatment, and by bringing services to the patients. 1 Implementation Priorities. HIGH PRIORITY means the action step should be implernented in Years 1-2,MEDIUM PRIORITY means implementation during Years 3-5 and Low PRIORITY means implementation in the future. 200t-2006 Contra Costa County Homeless Continuum of Care Plan 53 Develop a public education campaign to promote prevention. Provide homeless people and service providers information on birth control,and on avoiding lice,scabies, preventing HIV/AIDs, hepatitis, Tuberculosis, and STDs. Health Care for the Homeless should approach people in food lines, at lunchrooms, in congregate living facilities, and at schools to help them become aware of the causes and consequences of these ailments. PRIORITY C: Inerease medical treatment available to homeless people by eliminating traditional barriers to services,expanding existing services, and treating the most prevalent health problems found on the street. ACTION STEPS MEDIUM.PRIORITY: 1. Provide respite for hospital discharges. Local hospitals discharge patients who have no permanent residence long before they are strong enough to survive on the street. Within each regional service cluster there is a need for beds dedicated to people recovering from illnesses and in need of medical attention. When these facilities are developed, they will take referrals from the hospitals and provide a place to rest,and help maximize nutrition for stays of up to 20 days. HIGH PRIORITY: 2. Expand primary care in service regions. Strengthen overall medical services available in multi-service centers. Expand health care to include: ✓ testing and treatment for sexually transmitted diseases ✓ birth control ✓ prenatal care—Provide outreach at government institutions to prevent homelessness at time of discharge. Offer a broad range of integrated services from existing service providers including substance abuse and mental health. ✓ pediatric care ✓ dental care—Provide vouchers and referrals to treatment for people living in the shelters. Provide toothbrushes and toothpaste and descriptions of the affect methamphetamines have on teeth and what a user can do to mitigate those effects. Solicit dentists to provide care on a pro bono basis. ✓ podiatric care 2001-2006 Contra Costa County Homeless Continuum of Care Plan 54 MENTAL HEALTH: OUTREACH, TREATMENT OVERVIEW Any community seeking to end homelessness must address the needs of people chronically living in the shelters and on the streets. Very few chronically homeless individuals are ever likely to pay for housing through employment. Many could be dually diagnosed with mental health issues and chemical dependencies. One study has demonstrated that there is a prevalence of comorbidity—the combination of a mental illness and drug abuse—in the homeless population."' In this report,42 percent of all homeless drug abusers could be diagnosed with a mental illness. Internal barriers, such as fear and denial, are very strong among dually diagnosed homeless people. The persistent denial of personal health issues has been documented among people who are dually diagnosed.xl The source of this reluctance may be the fear of losing control of their lives by risking medical treatment. Some have admitted that they are afraid of being arrested and mistreated during services. Others fear losing their children to Child Protective Services. Currently,access to Contra Costa County mental health services is extremely limited and there is a threat of a further reduction in services. There is an increasing need to involve the mainstream service providers such as recipients of the Mental Health Performance Partnership Block Grant, the Community Health Centers, Medicaid, Section 811 Supportive Housing for Persons with Disabilities Program,and Veterans Medical Centers. In the homeless service system, only people who are diagnosed with a severe and persistent mental health disorder and are at-risk of hospitalization can obtain services. People with significant mental health disorders often fall short of this diagnosis, and people with situational disorders are even less likely to find services. County-funded mental health services targeted specifically for people who are homeless or at-risk of homelessness include the three regional health service centers and the Antioch emergency shelter operated by Phoenix Programs. In addition, the Health Care for the Homeless team's mental health treatment specialist visits a variety of sites, including Contra Costa County's emergency shelters, providing assessment and individual counseling. No diagnosis is required for these services. The strategy over the next five years will focus on engagement through intensive outreach. This program will establish a trusting relationship with clients that have largely been ignored in the past. The outreach services will be the entry-point for a continuum of care leading to permanent housing for homeless people with mental disabilities. The continuum will increase communication and teamwork among providers and ultimately end cases of chronic homelessness that have lasted for years. STRATEGY: Expand access to mental health services for people who are homeless or at-risk of homelessness. This includes both those who have a severe mental health disability and those in need of services to cope with a specific life crisis,such as homelessness. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 55 Priorities: A. Expand outreach services to act as the entry point for the mental health continuum of care of Contra Costa County. B. Create a dignified, professional and comprehensive treatment service for people who are homeless and mentally ill—integrate existing services into a seamless continuum of care. C. Increase efficiency and hours of operation at the mental health facilities by combining the regional mental health clinics with the regional multi-service centers. PRIORITYA: Expand outreach services to act as the entry point for the mental health Continuum of Care of Contra Costa County. ACTION STEPS HIGH PRIORITY: 1. Expand outreach programs in existing services. Expand and unify existing programs within each service region to conduct outreach to people who usually are not served. Expand the outreach team of Health Care for the Homeless by integrating the Project HOPE design. Allow outreach workers to use funds to purchase small goods or services in order to build the confidence of homeless people who are slow to trust providers. HIGH PRIORITY: 2. Coordinate with the social service institutions. Coordinate programs with the police force, the mental health hospitals,county hospitals, private physicians, and correctional institutions. Seek members from programs receiving funds from the Mental Health Performance Partnership Block Grant, Substance Abuse Prevention and Treatment Block Grant, and the Section 811 Supportive Housing for Person with Disabilities Program. Recommend that these mainstream programs track every client's housing status and keep a record of the number of clients who are,or become,homeless. Designate one homeless outreach officer within each law enforcement agency who will. be responsible for working with the county's social service network and establish referral protocols to help him guide other law enforcement officers. Establish a working group with hospital staff to record the rate of homeless people with mental illnesses served. Establish ties with courts and district attorneys to assist homeless people with mental illnesses before they are prosecuted and jailed. Low PRIORITY: 3. Recruit pro bono psychiatrists for outreach. Start a volunteer program to include psychiatrists who work for a variety of agencies to serve homeless mentally ill on a pro bono basis. Seek funding from the American Psychiatric Foundation. The project will work concurrently with homeless service providers and the regional service centers. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 56 PRIORITY B: Create a dignified, professional and comprehensive treatment service for people who are homeless and mentally ill—integrate existing services into a seamless continuum of care. ACTION STEPS HIGH PRIORITY: 1. Provide mental health services that are integrated with housing and homeless services. Identify financial sources to provide counseling services(e.g.,group, individual and anger management counseling) in housing and service sites. Develop more supportive housing designed for clients with mental health disabilities. HIGH PRIORITY: 2. Increase the range of services for mental health treatment. Services will include a range of new treatment and early intervention services. The new services should focus on making early interventions to avert additional suffering and avoid hospitalization. Psychiatric care and access to psychotropic medication should also be provided. HIGH PRIORITY: 3. Ensure that the mental health system of care is able to accommodate dually diagnosed patients. Ensure intensive case management is available for those dually diagnosed. Integrate treatment and create treatment phases, including group sessions. Keep clinicians abreast of new theories, practices, and procedures by making available continuing education classes; provide longitudinal training for all continuum clinicians. Services should be tailored to deliver the finest system of care possible. Contact patient families and friends to try to involve people the patient knows on a personal level. Doctors and service providers should be trained in cultural sensitivity and on the relevance of culture for the various clients they see. Provide facilities with the means to offer clients substitute activities to replace addictions. HIGH PRIORITY: 4. Design the system of care to accommodate children. Many children suffering from mental illnesses have few resources. Design the system of care to accommodate children. Medical professionals working on a volunteer basis could supplement current staff. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 57 ALCOHOL AND DRUG TREATMENT OVERVIEW One of the most insurmountable health barriers to a stable life continues to be addictions to chemical substances: chemical dependency can trap homeless people in a pattern of extreme self- neglect elfneglect and a learned indifference that can lead to years of lost opportunity. Homeless service providers see a high number of chemically dependent clientele; SHELTER, Inc., Reach Plus required treatment for 39 of 82 clients in the first four months of 2001. In Contra Costa County, there are approximately 45 detox beds and over 200 drug and alcohol treatment beds, including 48 beds for families. In addition,there are 151 clean and sober transitional housing beds, including 25 for families, and 53 transitional housing beds for people who are dually diagnosed with a mental health disability. These beds serve all county residents and are not specifically set- aside for people who are homeless. This is not enough capacity to serve nearly 1,000 people who are homeless on any given night and in need of alcohol and drug treatment. Almost 200 people are dually diagnosed with a mental health disability, including over 65 adults who are in families with children. STRATEGY: Expand access and success of substance abuse programs in treating homeless people by providing accommodations for families and follow-up services. ACTION STEPS HIGH PRIORITY: 1. Expand the number of treatment beds for drug and alcohol treatment services within Contra Costa County. HIGH PRIORITY: 2. Expand the provision of beds for children at treatment centers. Expand the provision of lodging for children at residential treatment programs so that mothers do not choose between treatment and family separation. A possible alternative to keeping families together at the service location is offering drug treatment to outpatients. It is recommended that a program combining outpatient services with intensive case management and rental subsidies be established. The rental subsidy would be for one year,giving the family time to go through treatment and get back on stable footing. The family would be able to access the treatment needed,obtain stable housing and receive assistance in addressing other ancillary needs, such as employment and money management. HIGH PRIORITY: 3. Address the housing and service needs of homeless people who have completed drug and alcohol treatment programs. Address the need for follow-up services after completion-of a treatment program, including assistance in finding permanent housing, 2001-2006 Contra Costa County i iomeless Continuum of Care Plan 58 r 1( .p ! case management, and continuing support groups, in order to help people both regain and maintain stable housing and stay clean and sober. Target beds at county operated residential treatment programs, for people who are dually diagnosed as part of the new Continuum of Care for people with mental disabilities. HIGH PRIORITY: 4. Maintain or expand the variety of treatment options for the service providers in the Continuum of Care. 2001-2006 Contra Costa County I lorneless Continuum of Care Plan 59 C. SUPPORTIVE SERVICES OVERVIEW "Today most American communities plan how to manage homelessness—not how to end it." Services are necessary for many homeless people,but homeless services must not become a method of managing homelessness. Education,childcare, food, and clothing—this is a list of services everyone in the community uses. It is unreasonable to expect a segment of the population to get them exclusively from the homeless service system. The homeless service system in Contra Costa County focuses on short-term support to assist every individual to move into permanent housing. The resources for basic supportive services have rapidly grown in the last five years: basic needs expanded to new levels, outreach begun for many of the hardest-to-serve homeless populations, and the county's once piecemeal Continuum of Care was reorganized into three regional service clusters. Within each service cluster,homeless services have become collective efforts between public, private,and faith-based organizations to shorten the experience of homelessness. Now, at the heart of the county's Continuum of Care, the regional multi-service centers have measured up to the challenge of serving large portions of the county. The Greater Richmond Interfaith Program Souper Center in Richmond and the Phoenix Programs Multi-Service Centers act as the regional entry-points for intake and case management. Each is equipped to help new arrivals with provisions for basic needs that include a supply of vouchers, stores of personal items,and on-site services. The services in this system are often given as a package designed to equip clients with everything they need to become stable as quickly as possible. SUPPORT SERVICES: COHESIVE STRATEGY Expand the Availability of Key Support Services to Enable People to Regain their Housing or Prevcnt its Loss These recommendations focus on expanding key support services that enable people to address the issues interfering with their ability to maintain stable housing without delay. The goal is both to help prevent homelessness as well as to assist those already homeless to regain their housing. The regional multi-service centers will be developed to coordinate client access to the full service continuum. This includes recommendations for expanding subsidized childcare and free and low-cost transportation coordinated through the multi-service centers. Also included here are recommendations to provide for the many needs of homeless youth and runaways. Objectives: To make information about prevention services, emergency assistance, suppol"t services and affordable housing more readily available to people in need, to providers, and to the community at-large. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 61 To provide regionally coordinated access to a broad range ofservices in order to both facilitate prevention of homelessness and shorten the length of time of any homeless episode. To enable people to meet their basic needs for shelter,food, hygiene and a place to be, until they can move back into housing. To access mainstream programs and to collect data on the incidence of homelessness among the clients of mainstream providers, in order to facilitate future planning efforts in the prevention of homelessness. BASIC NEEDS OVERVIEW What are the chances of finding a job if you have no place to go to take a shower and you've worn the same clothes for weeks? Finding a place to bathe,enough food, or even a phone is a real challenge for anyone experiencing homelessness. Even in a county that provides a full range of resources for someone who is homeless, it is likely to take the entire day to fulfill the most fundamental needs. According to a HomeBase study, homeless individuals spend over 37 hours a week simply obtaining life's necessities. In a community without provisions for food, clothing, or personal hygiene, escaping homelessness would be nearly impossible. The National Alliance to End Homelessness recently reported that most homeless people identify their major needs as employment, housing,and financial support to pay rents, though they most often receive clothing, transportation assistance and help in getting public benefits."" Many support services provided tend to prolong homelessness or do nothing to shorten the homeless experience. It is recommended that the multi-service center focus its efforts on providing the services that can best prevent homelessness or end a homeless crisis. STRATEGY: Expand regional multi-service centers to provide coordinated access to the full service continuum, including information and referrals, prevention services, emergency assistance, basic hygiene services,and support services. Priorities: A. Initiate planning across the county to enhance multi-service centers and expand the network of existing public, non-profit, and faith-based services linked through the centers. This will include consideration of how to facilitate greater coordination of service delivery and information-sharing among providers. B. Maintain existing services at the multi-service centers and expand multi-service programs to help alleviate any unmet need among people experiencing homelessness. _ 2001-2006 Contra Costa County Homeless Continuum of Care Plan 62 C. Integrate the regional multi-service centers with the county mental health service centers. D. Integrate housing to quickly place homeless people as soon as space becomes available. E. Improve and expand food programs to provide people who are homeless the physical well-being necessary to successfully locate housing, find work, and stabilize their lives. PRIORITYA: HIGH PRIORITY:' Initiate planning across the county to enhance multi-service centers and expand the network of existing public, non-profit and faith-based services linked through the centers. The multi-service centers will continue to build up the existing community service networks in the county's three regions. Every multi-service center in the county will offer access to a broad range of services through a combination of on-site service provision at the lead agencies and concrete linkages with other providers in the region. Three services—information and referral, case management and drop-in services, and showers and laundry—form the core of the multi-service center around which other services will be added and integrated over time. In addition to these core services, each multi-service center is developing into a service hub that responds to local needs. The regions will improve local multi-service centers to respond to the opportunities and needs in the communities they serve. PRIORITY B: Maintain existing services at the multi-service centers and expand multi-service programs to help alleviate any unmet need among people experiencing homelessness. ACTION STEPS HIGH PRIORITY: 1. Create a package of basic services and expand rnulti-service centers. (A) Began in 1996, the network of multi-service centers do not yet run at full capacity— hours of operation are still limited to the work week for most, and a full range of services are not yet available. In the next five years, the multi-service centers should expand in the following ways: 1 Implementation Priorities. HIGH PRIORn,Y means the action step should be implemented in Years 1-2,MEDIUM PRIORITY means implementation during Years 3-5 and Low PRIORITY means implementation in the future. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 63 ✓ Begin the expansion to include mental health services, with a possible full- time nurse that handles intake at the center ✓ Set up showers and bathrooms at each center ✓ Increase hours of operation to seven days a week ✓ Have bimonthly coordination between center staff and housing providers ✓ Expand employment referrals and on-site job and vocational education services ✓ Train staff on services available to homeless youth ✓ Connect the centers with mainstream programs for data collection on the number of clients who become homeless. (B) Create a comprehensive homeless basic services package using resources at multi-service centers and from public, private, and faith-based programs within the regional service cluster. (Shelters provide similar services.) Services at the center could include meeting all of the following basic needs: • Crisis counseling • Referral services to health care and other service needs • Phone, mail boxes, postal supplies, voicemail, and phone cards. • Storage space • Showers and restroorns • Clothing • Personal needs kit. 2. Establish quality control for the multi-service centers. Create a system for quality review for multi-service centers countywide. Quality control will be handled by the Contra Costa County Continuum of Care Board. PRIORITY C": HIGH PRIORITY: Integrate.the regional multi-service centers with the county mental health service centers. Begin the process of integrating the mental health centers with the multi-service centers_ Two systems of centers have developed in Contra Costa County: one is designed to serve homeless people diagnosed with a severe mental illness; the other established three regional service 2001-2006 Contra Costa County Homeless Continuum of Care Plan 64 clusters for all homeless people in the county. Operating two separate systems is inefficient and inconvenient for clients when they come to one center seeking services offered at another. PRIORITYD: Integrate housing to quickly place homeless people as soon as space becomes available. ACTION STEPS NIGH PRIORITIES: 1. Integrate current system. Integrate current housing placement programs countywide. . Share funds to create one comprehensive system available to all service providers, multi- service centers and housing providers. 2. Track the number of available beds and the number of people turned away at each service location. These numbers will be used to evaluate housing needs among homeless populations within each regional service cluster. PRIORITY E: Improve and expand food programs to provide people who are homeless the physical well- being necessary to successfully locate housing, find work, and stabilize their lives. ACTION STEPS HIGH PRIORITY: 1. Maintain existing pantries and meal services. Maintain all existing free dining rooms, food voucher programs,and grocery programs that benefit homeless children and adults. Expand in underserved areas including East County and weekends in West County. NIGH PRIORITY: 2. Access Federal Food Stamp Program. Have applications for food stamps available at all locations that serve homeless people. Staff will be trained in the eligibility and application requirements of the food starnp program. Question clients on their success with the program. Low PRIORITY: 3. Provide sensitivity training. Provide staff at food pantries and lunchrooms training in treating clients with respect and professionalism. Educate staff to identify and communicate with clients who suffer from mental disabilities and from developmental disabilities- 2001-2006 Contra Costa County Homeless Continuum of Care Plan 65 TRANSPORTATION OVERVIEW This Plan is designed to meet its goal of providing transit that can be used by people who are working and living in local shelters and transitional housing. However, devising a strategy that is both feasible and effective is a major challenge in Contra Costa County. There are three major population centers in the county separated from each other by great spans of largely undeveloped land. In the next five years,government investment in rapid transit has been adjusted down from the levels invested in the 1990s. Therefore, the Continuum of Care will focus on making the most from the resources that are already in place, advocating for revised routes in the current bus lines to get services to the shelter opportunities in the county. The Continuum of Care will also seek limited and controlled bus pass discounts to help working homeless people with transportation without duplicating aid and support provided by other programs they may access. PRIORITY A: Expand the number of homeless people who use rapid transit services within the county. ACTION STEPS HIGH PRIORITY: 1. County will advocate for routes that travel from low-income communities, including the routes between shelters and business centers, especially for express buses. MEDIUM PRIORITY: 2. Advocate for more reverse commute bus lines at lower rates to help people living in the urban centers to travel to jobs located in suburban areas. MEDIUM PRIORITY: 3. Offer discounted passes for clients in case management. Transit passes should be distributed to support case management services and provide an economically feasible way for homeless people to travel to work and service locations. The passes could be administered through collaboration between the county and Transit Authority. To avoid a large loss in resources,case managers could sell monthly passes for five dollars, and the only people eligible for the discounts could be those who are homeless and receiving case management services. The county could also cap the number sold each month. YOUTH EDUCATION AND SERVICES OVERVIEW Homelessness means a loss in opportunity. People who are homeless suffer from illnesses and are incarcerated at a higher rate than the general population. Children have the most opportunity at stake in a homeless episode. The more time spent in homelessness, the more severe the loss is 2001-2006 Contra Costa County Homeless Continuum of Care Plan 66 likely to be. Startling statistics collected by the National Coalition to End Homelessness included the following: 79%of 49 homeless children in NYC scored at or below the 10th percentile for children of the same age in the general population (Fox 1990); • 13% of 147 homeless students in the sixth grade scored at or above grade level in reading ability, compared with 37%of all fifth graders taking the same test(Fox 1993); • 43%of children of 163 homeless families were not attending school; • Attendance rate for homeless students is 51% vs. 84% for the general population (Mazy and Hall 1990); • 15%of 368 homeless students were long-term absentee vs. 3.5%general population(NYC Public Schools 1991). In Contra Costa County,on any given day, there are an estimated 934 families with children who are homeless on the streets, in emergency shelters, transitional housing,or temporarily doubled- up with friends and family. As the number of employed homeless people continues to rise, access to affordable childcare will continue to be one of the most pressing needs of families who are homeless. When childcare becomes scarce, parents are less likely to find employment, access training, and seek out support services. Although several childcare programs do serve homeless families, few have the flexibility to accommodate the odd hours of employees in service sector jobs. With many low-income families working in the service industry, the greatest need is for childcare centers that can serve clients on weekends and evenings. STRATEGY: Expand the availability of childcare programs and utilize the supports for homeless children that are available through the public schools. Priorities: A. Offer more childcare services to homeless people who work -especially for those working evenings and weekends. B. Serve homeless children through supports within the public school system and the public social support systems in order to foster learning, improve attendance, and Promote positive social interaction. B. Design life skills services for homeless youth living on their own. 2001-2006 Contra Costa County homeless Continuum of Care Plan 67 PmRiTYA: Offer more childcare services to homeless people who work-especially for those working evenings and weekends. ACTION STEPS MEDIUM PRIORITIES: 1. Expand current programs to evening and weekend daycare. Advocate for the expansion of resources and hours of childcare center operation to accommodate employees who work in service sector occupations. Address need for the care of sick children and infants,as well as for drop-in childcare services. HIGH PRIORITY: 2. Maintain and expand homeless families' access to mainstream childcare programs. Create collaborations between homeless service providers and mainstream childcare providers. Survey licensed childcare providers to determine if any additional capacity exists. Support child advocate programs, maintaining the existing child advocacy programs that have helped homeless families find appropriate available childcare. HIGH PRIORITY: 3. Push for increased funding. Advocate at the state and federal level for increased childcare subsidies for children of all ages and ensure that families who are leaving welfare receive transitional childcare. Lobby to ensure childcare subsidies for low- income children have a percentage that is set aside for homeless children. MEDIUM PRIORITY: 4. Solicit new volunteers. Increase volunteer participation in childcare programs serving homeless children to improve the ratio between staff and children and provide more on- on-one attention. PRIORITY B: Serve homeless children through supports within the public school system in order to foster learning, improve attendance, and promote positive social interaction. ACTION STEPS HIGH PRIORITY: 1. Advocate for continued McKinney Child Education funding. Identify and advocate for continued federal funds to support existing education programs in East and Central County while maintaining the work done in West County. Work with the county to ensure that it is applying for all available funds and that it allocates funds appropriately. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 68 NIGH PRIORITY: 2. Advocate for the Title I set-aside in school districts. Title 1 funding used by school districts mandates an allocation of part of the school budget for children of homeless families. Advocate to ensure that this money is being used efficiently and effectively. HIGH PRIORITY: 3. Inform case managers and teachers.To improve supports within the classroom, provide teachers with workshops on shelter procedures and dignity issues. Establish cross training between school district personnel and case managers. Expediate the enrollment of homeless children to minimize time away from school. Supply all school staff serving homeless children with resource directories to make appropriate referrals for services. HIGH PRIORITY: 4. Avoid switching schools. When a family becomes homeless, allow children to remain in the same school throughout the school year even when a family moves to a different district. Provide the family transportation to enable the child to continue at the same school. The absence of continuity has been shown to affect student performance; by facilitating attendance in one school, teachers can foster student learning in a stable classroom environment. MEDIUM PRIORITY: 5. Seek more supplies and tutors. Organize a volunteer donation program to collect and distribute books and school supplies to homeless children. Expand existing tutor programs to serve more students. PRIORITY C: Design life skills services for liomeless youth living on their own (including emancipated children under 18,children from 18—25,and those aging out of foster care). ACTION STEPS HIGH PRIORITY: 1. Equip homeless youth services for the full continuum of care. Expand homeless youth services to provide vocational assessment and counseling, educational counseling, and life skills training to help young people overcome the causes of homelessness. HIGH PRIORITY: 2. Support group home children. Provide an organized service package for young adults graduating from group homes and foster care. Before they leave on their own, connect them with job placement and pre-employment services. rind transitional housing slots for children without an income sufficient to secure housing. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 69 HIGH PRIORITY: 3. Create life skills training for teen parents. Ask service providers to create a new life skills program tailored for teen parents. Include childcare, money management, and pre- employment training. MEDIUM PRIORITY: 4. Expand emancipation services. Increase emancipation services available to homeless youth, such as informational flyers describing the significance of being emancipated and legal aid that the youth can use to become emancipated. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 70 D. HOUSING & PREVENTION "This is one of the wealthiest counties in the country,and still affordability is a problem at every level." County Supervisor Mark DeSaulnier OVERVIEW Is there any question that housing is a necessity of modern life? Family, safety, health,. employment, self-worth, community involvement, daily human interaction—every aspect of our existence will swiftly be derailed if we cannot find a place to stay, whether it is subsidized housing,an apartment, or a townhouse. As our society's understanding of poverty evolves, we are beginning to view access to habitable shelter"l'r`as a universal legal right and housing as the most reliable measure of poverty, more accurate than the unemployment rate and more telling than measures of wealth. While housing is possibly the most important factor in the fight to end homelessness, scarcity has reached a critical level. In Contra Costa County, according to the National Low Income Housing Coalition, 45 percent of all renters cannot afford fair market rents, and wages of poor renters have fallen by 19 percent since 1990. The margin of low-income renters to low-cost rental units has recently reached a new high of two renters for every unit. The pace of construction has lagged as well, and in the past ten years one-third of the needed units have been built compared to previous decades, while job growth continues to attract new residents. Leadership is needed to take on the housing crisis in Contra Costa County. Meanwhile, homeless service providers and social service agencies will continue to design housing programs that support homeless people. With housing as the most extensive component of the Continuum of Care,collaboration with the mainstream is of the highest import. The responsibility of mainstream service providers to work toward reducing homelessness has been highlighted throughout this Plan and in the national response to homelessness. "Homeless people have a substantial history of prior contact with health and human services, so these treatment providers need to explore the housing status of clients.""" Mainstream social and health service providers should not only establish the housing status of their clients, they must make a positive investment in housing those who are homeless. According to the director of the Contra Costa County Office of Homeless Programs, 84 units of affordable housing opened in the last month of 2000. On the heels of an additional emergency shelter, the service providers in Contra Costa County have demonstrated that they are prepared to keep pace with demand. Contra Costa County is committed to maintaining a diverse and complete continuum of housing that will make an impact in the effort to end homelessness. The need for expanding the supply of affordable housing is imperative with so many searching for housing and many more at risk of losing their homes as costs continue to rise. Affordable housing developers and community based organizations are prepared to continue to build even in the face of increasing funding uncertainties, especially in federal programs including Section 8 housing subsidies, Section 8 vouchers and certificates, the size of CDBG and HOME programs, and the competitive process of the McKinney-Vento Homeless Assistance Act. 2001-2006 Contra Costa County Horneless Continuum of Care Plan 71 HOUSING: COHESIVE STRATEGY Expand Affordable Housing Options in Order to Enable Homeless People to Achieve Long- Term Housing Stability These recommendations focus on the development of a range of housing options that meet people's income and service needs,thereby enabling them to achieve stable housing and maximum self-sufficiency. Included here are recommendations for developing more permanent housing affordable to people with the lowest incomes and expanding the supply of permanent supportive housing for people with on-going service needs. Also included is a recommendation aimed at addressing the barriers to the development of housing and services for people who are homeless or who have low incomes. In addition, there are recommendations calling for the provision of housing locator services to help people find and retain housing as well as the expansion of rental assistance funds to help people cover rent during a time of crisis. Objectives: To provide a range of housing options that meet the income and service needs of homeless people, thus enabling long-term housing stability. To assist homeless people in accessing housing. PREVENTION OVERVIEW If Contra Costa County's vision of prevention services was fully realized, the incidence of homelessness would be dramatically reduced. The range of prevention programs is as diverse as the population that the Continuum of Care was designed to serve. These programs identify individuals at the brink of homelessness and help them keep their homes with temporary support until they can make it on their own. Statistics on quality of life—as published by the Federal Interagency Council on the Homeless—show that the effort made to prevent homelessness is the most cost effective and compassionate approach, and Contra Costa County is invested ill implementing these strategies. 2001-2006 Contra Costa County I Iomeless Continuum of Care Plan 72 STRATEGY: Prevent the homelessness that occurs through evictions from rentals and foreclosures on low-income families that are at-risk of homelessness. ACTION STEPS NIGH PRIORITY:' 1. Support existing and new emergency rental assistance programs strictly for preventing homelessness (Contra Costa Consortium 2000—2005 Consolidated Plan,p. 75). Maintain programs that provide emergency rental assistance and services that help low-income renters and homeowners, who would otherwise become homeless, remain in their homes. MEDIUM PRIORITY: 2. Expand the resources for emergency rental assistance programs. Providers that offer emergency housing assistance should reconsider the necessity of any eligibility criteria that is based on applicants' future income. All local community-based organizations that provide case management to homeless people should help clients become aware of programs such as the One-Time Emergency Assistance Grants planned by the Contra Costa County Housing Assistance Alliance (Contra Costa County CaIWORKS Housing Assistance Action Plan &Implementation Strategy, 2000, p. 26). HIGH PRIORITY: 3. Support creative strategies to locate,secure, and make available housing affordable to homeless people. Expand the resources of case managers working with homeless people. Provide additional funds to work with landlords to help place clients. New funding could be used to guarantee rent payments and security deposits, create master leases, and develop new relationships with landlords. MEDIUM PRIORITY: 3. Expand availability of homeless prevention services. Continue to include prevention services as part of the comprehensive service package offered in referrals and direct assistance at the local multi-service centers and transitional housing programs. Prevention services include life skills training, money management, legal assistance, and subsidies. Educate case managers and clients in homeless prevention. Explore partnership possibilities for referrals to the county's Tenant Counseling Programs(Contra Costa County CaIWORKS Housing Assistance Action Plan & Implementation Strategy, 2000, p. 26). 1 Implementation Priorities. HIGII PRIORITY means the action step should be implemented in Years 1-2,MEDIUM PRIORITY means implementation during Years 3-5 and LOW PRIORITY means implementation in the future. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 73 EMERGENCY SH-ELTER OVERVIEW For many homeless people that live on the street, safety is found in emergency shelter. Until prevention strategies are fully funded, sheltering remains an indispensable component in the Continuum of Care since emergency shelter beds can be provided in rooms,housing units, hotels, and in dedicated rentals. Intake at a shelter is the first place of contact.for many people who use homeless services—they often provide the most basic needs in one location whether it is food,clothing, or an in-house job. In the three regional service clusters that make up Contra Costa County, the demand for shelters extends to the chronically ill, to homeless families, to individuals, and to winter shelter space. This Plan reflects these needs and is designed to provide solutions for the gaps that remain in services across the county. STRATEGY: Provide an adequate supply of emergency housing assistance for families, pregnant teens, youth,and individuals. PRIORITYA: Expand emergency housing assistance and respite care for homeless people (See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 74). ACTION STEPS NIGH PRIORITIES: 1. Develop emergency shelter space for homeless youth. Create emergency programs targeted to address the special needs of youth leaving foster care, exiting the juvenile justice system, or learning to survive on the street. Emergency programs should provide priority to pregnant teens and have the resources for specialized support and security. A social worker with Contra Costa County has identified pregnant homeless teens as an extremely vulnerable and sorely under-served population in need of emergency housing in every region of Contra Costa County. (Low priority: Advocate for financing needed to develop and use the former military property now eannarked for homeless families and youth.) HIGH PRIORITY: 2. Develop emergency shelter opportunities for homeless families(large and small, with teenagers and boys over 10,and single dads with children). Create emergency temporary assistance that accommodates working families—with longer hours of operation, in-house day care,and case managers who can provide employment - counseling and support. - 2001-2006 Contra Costa County Homeless Continuum of Care Plan 74 MEDIUM PRIORITY: 3. Develop respite care opportunities for homeless people leaving hospital care (see Health Care and Outreach, Action Step C-1,p. 45). MEDIUM PRIORITY: 4. Develop shelter opportunities for adult male and female homeless individuals. MEDIUM PRIORITY: 5. Actively initiate long-term engagement. Ensure that intervention is long-term and continues after a client leaves the shelter. Although the client's willingness to continue with a case manger is threatened by the circumstances of homelessness, each case manager should actively engage with their clients in meetings at least once a.month. PRIORITY B: ACTION STEP MEDIUM PRIORITY: Ensure case management that is provided with sheltering has an adequate housing focus, including housing specialists and locators. Ensure that staff fulfill their duties as housing counselors at shelter programs. Current lists of vacancies are already collected on shared housing and rentals, and independent investigations into local affordable housing are also made. It is recommended that staff create a link between current housing referral services and housing information and case mangers, as an initial step in improving the information and referral process within the county. Contact should be made with landlords and shared housing resources. Shelter staff should also team with other local programs that are working with landlords and Section 8 tenants to better utilize resources. Explore partnership possibilities to make referrals to the county's Tenant Counseling l"rograms (Contra Costa County Ca1WORKS Housing Assistance Action Plan & Implementation Strategy, 2000, p. 26). TRANSITIONAL HOUSING OVERVIEW While there is increased pressure to create more permanent housing as a system response to homelessness, "home ownership does not make a good life""' free from the risk of homelessness. Transitional housing is the most specialized of the homeless housing resources. It provides a secure place for people with barriers to work,giving them the time they need to stabilize their lives, land a job, and begin to save for a rental. There are many personal challenges that can be overcome in transitional housing. Transitional housing may provide temporary support for unskilled youth, people graduating from treatment programs, families, and 2001-2006 Contra Costa County Homeless Continuum of Care Plan 75 people suffering from chronic illnesses when they are prepared to leave an emergency shelter but not ready to live on their own. Transitional housing provides a community environment for homeless residents seldom seen in other housing programs. The communities offered by transitional housing programs can help chronically homeless people finally reach stability. The subpopulations that thrive in transitional housing include battered women,people with mental and physical disabilities,and people recovering from chemical dependencies(Contra Costa Consortium 2000—2005 Consolidated Plan,p. 74). There are several non-profit transitional housing programs operating within the county and one county owned facility(p. 74) with another online in May 2001. The two most significant drawbacks to transitional housing may be the growing waitlists (with a twelve-month delay between application and intake)and the lack of housing for program graduates.'Ivi Service providers working in Contra Costa County are committed to continuing a strong complement of transitional housing programs for people who are chronically homeless,have bad credit, and multiple service needs. Transitional housing provides people with significant issues more time to resolve them through services and case management enabling them to move into stable housing. STRATEGY: Sustain the local transitional housing programs at the highest quality possible with attention to a complete and effective service component and a safe environment for homeless people. ACTION STEPS HIGH PRIORITY: 1. Plan ahead for funding to sustain existing transitional housing beds for homeless people. Develop a community guide tracking system for locating sufficient grants,and create a development plan to support resources coming into agencies. Seek financial backing within the county from everyjurisdiction to establish a countywide support system. HIGH PRIORITY: 2. Support the development of additional transitional housing opportunity throughout the county, including a transitional facility for homeless households in West County. PERMANENT AFFORDABLE HOUSING OVERVIEW Market rents in Contra Costa County were up to $1,155 a month for a two-bedroom apartment, which is affordable only for families making more than$16 an hour. While real estate values soar to record highs, available affordable housing will continue to dwindle into greater scarcity. Affordable housing—defined as a house or an apartment that consumes no more than 30 percent 2001-2006 Contra Costa County Homeless Continuum of Care Plan 76 of the tenant's adjusted gross income—will play a decisive role in the fate of many homeless families. Because the need for additional affordable housing has become so acute, the lag in building up the current stock demands creative but realistic solutions. The Contra Costa County Homeless Continuum of Care Plan 2001-2006 combines a number of approaches designed to preserve the stock of existing affordable housing, and create new units that are affordable to low income families. The top recommendation for developing new affordable housing is the acquisition, rehabilitation and construction of additional rental units priced below the market rate. The Contra Costa Consortium 2000—2005 Consolidated Plan supports this goal with a proposal to fund new projects with the Redevelopment Agency Housing Set-Aside, tax-exempt bond financing,the Community Development Block Grant, and the HOME program. An expansion in housing advocacy services is also recommended to help people find and secure affordable housing in the extremely tight Contra Costa County housing market. In order to expand access to these important services, it is recommended that housing advocates be placed at each of the regional multi-service centers and that case workers across the county work with social service agencies to locate landlords and additional affordable housing. STRATEGY: Develop more housing affordable to homeless families and individuals using the homeless service system. ACTION STEPS HIGH PRIORITY: 1. Develop additional units of housing throughout the county affordable to people who earn 30% of the area median income or less(See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 67). HIGH PRIORITY: 2. Advocate for new federal, skate,and local funding, tax incentives, fee waivers and subsidy programs to support the development of housing affordable to very low income and homeless people(See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 67). HIGH PRIORITY: 3. Rehabilitate existing affordable housing for homeless people in order to preserve the current housing stock(See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 70). One example of an ongoing program is the low-interest loans offered to rehabilitate any rental or owner-occupied unit that is priced for extremely low-income renters. To extend affordability restrictions that may be expiring in the next five years, owners should be offered deferred or residual receipts loans on condition of an extended period of affordability. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 77 HIGH PRIORITY: 4. Advocate with local jurisdictions to offer incentives to developers, thus encouraging the market to make an investment in affordable rental housing targeted to homeless people(See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 75). Offer, for example, zoning regulations that can accommodate high-density affordable housing near services, transportation and other appropriate areas. Partial fee waivers and subsidies could also be offered for affordable housing projects that will house homeless people. Expedite the zoning and permitting process. Provide dedicated staff to hand-walk developers through the permitting process for housing projects intended for homeless people. Strengthen and support the housing development activity of non-profit community-based organizations. MEDIUM PRIORITY: 5. Explore and support new forms of accessing housing such as leasehold co-ops. Tenant owned single room occupancy(SRO)housing created for homeless people has proven to be,one of the safest and most sustainable affordable housing models in the nation. After initial funding for rehabilitation or construction,these co-ops are paid for by interim lease programs where tenants pay their installments with Section 8 vouchers and the other kinds of public assistance they receive. HIG14 PRIORITY: 6. Expand funding for damage deposits for homeless people. Fund programs that provide landlords with a damage deposit and first and last month rent for tenants using Section 8 vouchers. Pursue a joint project with the Landlord Damage Claim Fund sponsored by the Contra Costa County Department of Employment and Human Services and the local housing authorities (Contra Costa County CalIVORKS Housing Assistance Action Plan &Implementation Strategy, 2000,p. 27). HIGH PRIORITY: 7. Advocate for an increase in the number and value of Section 8 vouchers (See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 75). Advocate for a program to provide project based Section 8 Certificates to support extremely-low income rental units. The Section 8 voucher progratn provides an essential rental subsidy to many homeless people. The utility of the program has been inhibited by an insufficient monthly subsidy and a waitlist, which does not recognize the immediate needs of homeless people. Community-based organizations and local jurisdictions should focus on improvements for both issues. Also, the Contra Costa Consortium 2000—2005 Consolidated Plan calls for a new preference for people with housing costs in excess of 50% of their gross monthly income and for people who are homeless.""" 2001-2006 Contra Costa County liomeless Continuum of Care Plan 78 PERMANENT SUPPORTIVE HOUSING OVERVw,w Permanent supportive housing was intended to assist people who are unable to stabilize their lives and lack a consistent resource of specialized services. The most effective programs provide support for substance abuse, mental illnesses, HIV/AIDS,and chronic health conditions—with marked success even where traditional treatment programs have failed. People who benefit from permanent supportive housing face the greatest barriers to attaining stable lives on their own; they have difficulty retaining work; and they rarely locate housing they can afford. One of the most significant functions of permanent supportive housing in Contra Costa County is the kind of support service providers can give to people diagnosed with mental disabilities. Since the deinstitutionalization movement in the 1970's and the cuts to supportive services in the years following, Americans with mental illnesses have been forced into the streets at a precipitous rate. Many entered cycles of violence and illness that took them through emergency rooms, the courts, and the jails. The advent of supportive housing programs marked the turning point that may end this cycle of neglect. Through supportive and transitional housing programs, communities have come to the aid of this abandoned segment of society. The community-based organizations of Contra Costa County are committed to completing this work locally for homeless people living with mental illness within its communities. STRATEGY: Expand the supply of permanent supportive housing for extremely-low income and homeless people with on-going service needs. PRIORITYA: ACTION STEP HIGH PRIORITY: Increase the stock of supportive housing for homeless people with on-going service needs(See Contra Costa Consortium 2000—2005 Consolidated Plan, p. 75). Supportive housing should be developed for all homeless people for whom this model provides a significant appropriate life opportunity. 2001-2006 Contra Costa County H0117CICSS Continuum of Care Plan 79 PRIORITY P,: Maximize the resources available for supportive housing by identifying public and private sources of capital funds and encouraging mainstream affordable housing developments to include scattered site supportive housing units. ACTION STEPS MEDIUM PRIORITY: 1. Plan ahead for funding to sustain existing supportive housing beds. Develop a community-wide grant tracking system for locating sufficient grants, and create a development plan to support resources coming into agencies. MEDIUM PRIORITY: 2. Support Contra Costa County [dousing Alliance in their collaboration to begin new supportive housing projects. The homeless service providers should seek access to planned supportive housing. The new projects are part of the Contra Costa County Department of Employment and liutnan Services action plan for 2001. Funding has been identified from HOME, CDBG, and tax credits. To implement the project, the planners will work with participants to identify the best sites and funding sources. The lead agencies of the project will be DEHS and local housing developers. Initial budgets project a cost of$80,000 to $130,000 a unit plus ongoing service costs (Contra Costa County Cal WORKS Housing Assistance Action Plan & Implementation Strategy, 2000,p. 27). HIGH PRIORITY: 3. Access mainstream funds for the services needed in permanent supportive housing. Additional integrated services for homeless people would reduce the high cost of serving homeless clients at social and health services, such as the criminal justice system, in emergency rooms, and in extended hospital stays. ✓ Advocate for shared programming and funding in the legislature ✓ Charge Medi-Cal, the managed care system, and the criminal justice system to fund integrated programs targeting those who are homeless. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 80 E. ADMINISTRATION, COORDINATION, FUNDING OVERVIEW Implementing the action steps in the Contra Costa County Homeless Continuum of Care Plan 2001-2006 requires administration, coordination, and funding. Strong community-wide collaboration between the county, cities, and community-based organizations is an important part of attaining each element of the Continuum of Care. The Contra Costa County Homeless Continuum of Care Advisory Board (CoCB) provides a forum for the county, city,and community to coordinate their response to homelessness, and it serves as the oversight community group for preparation of the annual county-wide consolidated HUD funding proposal. The Board of Supervisors appointed the CoCB to report to the Board on the issues of homelessness in the county. The CoCB membership at this time is drawn from a broad range of people, which includes housers, service providers, faith-based organizations, municipalities, and formerly homeless people. The CoCB led the effort in drafting this Plan. The CoCB will annually review the Plan, making revisions when necessary. The Contra Costa County Director of Homeless Programs(COHP)guides the work of the CoCB, participates in the planning process, oversees the operation of the Continuum of Care, and leads the coordination of services. The COHP has the overall responsibility of coordinating programming and planning at the local and county levels, thereby facilitating the work called for in this Plan. The Contra Costa County Homeless Programs Director is the head officer of the COHP and surveys homeless service providers for data used in planning and in the annual federal funding process. The COHP Director should focus on bringing together the organizations that serve homeless people, such as government departments, non-profit service providers, and faith-based entities. Special attention to city-county programs, and intra-county programs should take place in these coming five years. Finally, the Director should seek to expand the role of the CoCB, giving it the responsibility of consolidating and coordinating countywide fund-raising and data collection efforts. The Association of Housing and Homeless Service Providers(AHHSP) represents the county's homeless housing and service providers for advocacy,cross-training and networking, which strengthens the implementation of Continuum of Care goals. AHHSP is independent of the CoCB and CORP; AHHSP has two representatives on the CoCB. The CoCB and the AHHSP both focus on educating the public on the realities of homelessness, and pursue legislative opportunities for change. Objectives: To enhance the effectiveness ofservice delivery and maximize the efficient use of - all targeted mainstream resources. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 81 To facilitate coordination among all components of the system for purposes of planning and service delivery, resource management and fiend-raising, and policy and program development. STRATEGY: Coordinate homeless-related services and housing into one integrated Continuum of Care system with the capacity for on-going strategic planning. Priorities: A. The COHP Director will support the work of three inter-related groups formed to implement this Plan: the COCB, a County Departments Working Group on Safety Net and Community Services Responding to Homelessness, and an Inter- jurisdictional Cities-County Homelessness Coordination Committee. B. The COHP Director will facilitate greater coordination at the level of service delivery in each region and throughout the county's Continuum of Care and local safety net services. C. Develop a countywide management information system to facilitate collection and analysis of data on homelessness and homeless services. D. Reinforce mechanisms for consumer input into the development and operation of the homeless services system. E. Explore the development of new avenues for raising the resources necessary to implement the Plan and fund housing and services to prevent and alleviate homelessness. F. Make an annual evaluation of the Plan. 2001-2006 Contra Costa County Hometess Continuum of Care Plan 82 PRIORITYA: The COHP Director will support the work of three inter-related groups formed to implement this Plan: the COCB,a County Departments Working Group on Safety Net and Community Services Responding to Homelessness, and an Inter-jurisdictional Cities- County Homelessness Coordination Committee. ACTION STEPS HIGH PRIORITIES: 1. The COHP Director will lead the emergence of the CoCB as the:countywide forum for monitoring implementation of all aspects of this Plan. The CoCB will develop annual Board goals and a membership structure that supports the implementation of this Plan. All aspects of Board operations(structure, composition, bylaws, attendance, policy, term limits) should be revisited in Year-One of the implementation of this Plan. Goals and objectives that support the Board's mission should be articulated in furtherance of this Plan. Conflict of Interest rules to use in setting funding priorities should be adopted. The relationship between the CoCB and AHHSP, the Working Group, Coordinating Committee, the community, and elected officials throughout the county should be defined in CoCB protocols. The COHP Director shall guide the efforts in developing the CoCB. Special attention should be given to encouraging local entitlement jurisdictions to actively participate in the CoCB. Having a Board with strong jurisdictional representation will preserve the Board's continuing role in allocating federal funding in the event of the creation of block granting for McKinney-Vento Act funds. As follows, the Working Group and Coordinating Committee should each have a seat on the CoCB. HIGH PRIORITIES: 2. Create the County Departments Working Group on Safety Net and Community Services Responding to Homelessness. The Working Group should provide a forum for coordination among county departments and agencies on policy, program and fiscal issues related to homelessness and prevention. The Working Group's mission should be to ensure that departmental policies, programs and budgeting are consonant with the Plan; to provide an inter-departmental perspective to the Board of Supervisors on proposed policy changes affecting the county's response to homelessness; and to facilitate joint planning, grant-writing and program development. A major issue identified by local providers and homeless organizations nationwide is the failure of the homeless service system to tap the resources of the appropriate mainstream social safety net services."'iii As the homeless service system developed over the last 1 Implementation Priorities. Mai PRIORITY means the action step should be implemented in Years 1-2,MEDIUM PRIORITY means implementation during Years 3-5 and Low PRIORITY means implementation in the future. 2001-2006 Contra Costa County I lomcless Continuum of Care Plan 83 five years, many safety net services have begun to rely on the Continuum of Care to aid clients threatened by homelessness. The trend has led to an increase in the spread of homelessness that the Continuum of Care was never designed to extinguish." See also related action step B.4. in the next section. The Working Group should intensify the efforts of the federal block grant-supported social safety net and community service programs(a.k.a. mainstream agencies)to meet the needs of homeless people and those at risk. Homeless and housing related questions should be designed and inserted into intake/client assessment of all relevant programs, to record the incidence and risk of homelessness among clients, to invest in prevention and housing, and to then coordinate solutions throughout the Continuum of Care. The Working Group should also establish awareness and sensitivity workshops for government agency staff regarding the treatment of homeless clients. The Working Group should participate in the regional planning meetings for the development of multi-service centers in order to identify county resources that should be linked to the multi-service centers and plan for how services will be coordinated regionally and countywide. Members of the Working Group should include all county departments and agencies that have a role to play in addressing homelessness, including the following: Community Development, Community Services,County Administrator's Office,County Counsel, General Services, Health Services, Housing Authority, Office of Education, Workforce Investment Board(WIB), Sherift's Department, Social Services and Veteran's Services. Participation shall be mandated by county programs receiving government funds targeted to homeless people, or whose reporting requirements and funding applications include homelessness. Representation should be at the department head level. The Working Group should be convened by the Contra Costa County Administrator's Office and should meet regularly. The Working Group will be chaired by the CAO,and staffed by the Contra Costa County Director of Homeless Programs. The Working Group should send a representative to each meeting of the CoCB to report out major decisions under consideration, for feedback from the CoCB on strategies under discussion,and to report to the Working Group on CoCB activity. HIGH PRIORITIES: 3. Establish an Inter-jurisdictional Cities-County Homelessness Coordination Committee. The Coordination Committee should provide a forum for coordination between the county and all entitlement city departments and agencies on policy, program and fiscal issues related to homelessness and prevention. The Coordination Committee's mission should be to ensure that policies,programs and budgeting are consonant with this Plan;to provide an inter jurisdictional perspective to the Mayors, City Council's,and Board of Supervisors on proposed policy changes affecting the city and county response to 2001-2006 Contra Costa County Homeless Continuum of Care Plan 84 homelessness; and to facilitate joint planning,grant-writing, grant awards, and program development. The Coordinating Committee would have a mission of responding to homelessness by allowing each community to offer basic human needs services, including food and housing without regard to housing status. It will identify specific actions on which there is a need for formal agreement between jurisdictions. The Coordinating Committee should intensify the efforts of the mainstream social safety net to record the incidence and risk of homelessness among clients, to invest in prevention and housing. The Coordinating Committee should be convened under the auspices of the City-County Relations Committee of the Mayor's Conference,and should meet quarterly. The Coordinating Committee will be chaired by a Mayor's Conference designee, and staffed by the Contra Costa County Director of Homeless Programs. All local cities will be encouraged to participate. Participation shall be mandated by county and city programs receiving government funds targeted to homeless people, or whose reporting requirements and funding applications include homelessness. The Coordinating Committee should send a representative to each meeting of(lie CoCB to report out major decisions under consideration, for feedback from the CoCB on strategies under discussion, and to report to the Coordinating Committee on CoCB activity. PRIORITY B: The COHP Director will facilitate greater coordination at the level of service delivery in each region and throughout the county's Continuum of Care and with local safety net services. ACTION STEPS NIGH PRIORITIES: 1. Develop strategies for discharge planning to prevent homelessness to conform to the amended Section 402 of McKinney affecting all of HUD's homeless assistance programs. The statute requires each government grantee to create a discharge coordination policy. Develop practices and protocols to insure that publicly funded institutions, such as health care facilities, foster care or other youth facilities, and correction programs, do not discharge persons to the streets,or otherwise result in homelessness for this vulnerable population. The COHP Director may work through the Work Group and Coordinating Committee created above to accomplish this immediate objective, including identifying funding sources and housing for those being discharged. MEDIUM PRIORITY: 2. Provide procedures for the sharing of information and the protection of client confidentiality. The Contra Costa County Director of Homeless Programs will work with homeless service providers to develop protocols and procedures that allow for the sharing of appropriate information, while protecting client confidentiality. This 2001-2006 Contra Costa County iiomcicss Continuum of Care Plan 85 discussion should occur as part of the planning taking place in each region to develop multi-service centers, which are the linchpin of regional service coordination. Multi- service center case coordinators will play a lead role in coordinating the different providers serving a particular client to ensure that one inter-disciplinary plan is developed and that information-sharing occurs. MEDIUM PRIORITY: 3. COHP Director will promote the creation of agreements among homeless service providers. There is a need for agreements among providers in each region and throughout the county regarding the development of inter-disciplinary.service plans, the sharing of information between providers in a manner that does not breach.client's rights, and the process for ensuring that each client receives a coordinated service package. Such cross-case management has already begun, and the COHP Director can expand those achievements across the county to all appropriate homeless services. HIG14 PRIORITIES: 4. Coordinate the Continuum of Care with mainstream programs, thereby opening non-homeless services to homeless people. The COHP Director has been charged with staffing the Working Group and Coordinating Committee under Priority A, potential vehicles to achieving this goal. Throughout this Plan,action steps address the need to involve the social service basic safety net and community services in the response to homelessness. The COHP Director will particularly focus on the strategies seeking to coordinate homeless assistance with each of the following mainstream health, social service, and employment programs: • Medicaid(Medi-Cal) • State Children's Health Insurance Program • TANF(Ca1WORKS) • Food Stamps Mental Health Block Grant recipients • Substance Abuse Block Grant recipients • Workforce Investment Act • Welfare-to-Work Program MEDIUM PRIORITY: S. Tile CORP Director will take the lead in facilitating greater coordination at the level of service delivery. Link with AARP. The need for greater coordination at the level of service delivery is essential for two reasons. First, limited resources will be expended more efficiently by eliminating duplication of services. Second, clients will receive services without needless confusion. One of the issues identified by both providers and clients is the duplication of case management services between agencies. Sometimes a client will have several case managers, each proscribing a different treatment plan. This is not only a waste of resources, it is confusing to a client who may receive conflicting messages from their case managers about what they need to be doing and when. Since many people have 2001-2006 Contra Costa County Homeless Continuum of Care Plan 86 intersecting issues that together caused their homelessness, in order to regain housing they need a menu of different services that are coordinated together to address the full range of their needs. PRIORITY C.- Develop :Develop a Countywide Homeless Management Information System (HMIS) to facilitate collection and analysis of data on homelessness and homeless services. HIGH PRIORITIES: 1. The COHP will staff planning sessions of the CoCB to develop HMIS that can enable homeless service providers to collect uniform information about clients over time. All agencies within the county serving homeless people will be asked to participate. This information can help to improve services and planning as well as to more accurately determine the size, characteristics, and needs of the county's homeless population. MEDIUM PRIORITY: 2. Create an automated referral system. Develop a referral system using a proven computer platform. This system should enhance the effectiveness of the housing network and ensure facilities operate at maximum capacity. Clients would also benefit if the system could improve the chance of matching residents with programs that fit their needs. PRIORIT3'D: Create mechanisms for consumer input into the development and operation of the homeless services system. ACTION STEPS HIGIi PRIORITIES: 1. Conduct a yearly consumer survey. Information gathered should be analyzed by agency directors to guide program development and shared with the CoCB. Feedback from consumers about the operation of homeless programs is essential to ensure that programs serve clients in the most effective and humane manner possible. Likewise, consumer feedback is also needed on the system-wide level to inform the development of programs, to prioritize needs and resources, and to craft public policy. Consumer input was incorporated into the development of this Plan through the on-going participation of consumers in the many community meetings where consumers were given the opportunity to provide specific feedback on their needs and their experiences with the existing system. This level of consumer participation is needed on an on-going basis to guide the decisions made by the CoCB about homeless policy and programs. 2001-2006 Contra Costa County Ilomcless Continuum of Care Plan 87 HIGH PRIORITIES: 2. Facilitate involvement of people who are homeless and unemployed as full participants in the CoCB and other bodies addressing issues related to homelessness. Three positions on the CoCB are designated for people who are currently or formerly homeless. In order to ensure that homeless people have the ability to fully and actively participate on the CoCB, it is recommended that the COHP and the CoCB explore how to put effective recruitment and training mechanisms into place. For those people who are interested, training could cover topics such as the role of the CoCB and how to be an effective board member,how to effectively communicate.one's knowledge and experience about homelessness,and how to develop leadership skills. Unemployed homeless participants should be provided with travel and food vouchers as well as payment for meetings attended to enhance the ability to participate. In the past, homeless CoCB members have found it difficult to balance their duties with the CoCB and fulfill their basic human needs at the same time; support will help reduce the hardship some may endure while participating on the CoCB as a homeless member. PRIORITY E: Explore the development of new avenues for raising the resources necessary to implement the five-year plan and fund housing and services to prevent and alleviate homelessness. ACTION STEPS MEDIUM PRIORITY: L Advocate for additional financing or economic incentives for the developers of housing that are affordable for families and individuals with very low incomes. HIGH PRIORITIES: 2. Bring together a COCB subcommittee to identify new public and private funding sources and identify the best ways to secure that funding. As new competitive grants are offered,a coordinated effort will assure that homeless programs in Contra Costa County access those funds and put them to use quickly and appropriately. In the field of homeless assistance, many funding streams require collaboration or concerted efforts to receive the funding. PRIORITY R Make an annual evaluation of The Contra Costa County Homeless Continuum of Care Plan 2001-2006. HIGH PRIORITY: 1. The Contra Costa County Office of Homeless Programs will produce annual reporting and strategy setting. The annual report will be done in coordination with all Contra Costa County entitlement jurisdictions. The CORP will work with the CoCB to set the annual homeless strategy. This work should lead to the evaluation of what has been accomplished under the Contra Costa County Homeless Continuum of Care Plan 2001-2006 Contra Costa County Homeless Continuum of Care Plan 88 2001-2006 and to set the priorities for the coming year. At present, this activity will fulfill a portion of the HUD annual funding requirement. The annual report may also be developed as a tool for communicating with the Board of Supervisors, Mayors, City Councils,other elected officials, and the public. HIGH PRIORITY: 2. The COUP Director will provide the ongoing evaluation of the progress of the action steps. Appropriate and timely response will be taken on issues that arise in the Continuum of Care. COHP will maintain the relations among the parties providing services. COHP will track the new issues that could affect homeless services such as a change in supply or regional crises. The COHP will evaluate the system-wide integrity of available services and housing units. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 89 p U 5 W � yy N� G O N cll N 4 v N 'non 7 � O U � d e N N � ., •A �' Q 7 U y O Cpl• cn -94 c e go � p, to �. ''�'. •b O U �. a v x pp o� � p 0 0 U to U o = x �• oo al -.. O �. �U oA�_U tct C: _ y '3- C •d - O lu MAS :v o Ad, 0� ssz« . IV. SUMMARY CHARTS OF PLAN FIRST AND SECOND YEAR ACTION STEPS 200t-2006 Contra Costa County Homeless Continuum of Care Plan 91 The following charts lay out in brief,by Section, all of the priorities and action steps selected by the planning committee as Year 1 or Year 2 priorities. A priority for year one or two is a commitment to commence action in the first or second year of the Plan toward achieving the step. Also stated is whether identical or similar action is already"Existing", or"Planned" in the community; who, by general description, will participate in the implementation of the action; possible sources of funding; and which of the Contra Costa County Homeless Continuum of Care Advisory Board subcommittees will oversee implementation of the action step. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 93 I;:.--� c c o 0 Cc "o A aQi W A aai R ¢ cu c o 14 x U • q Q :0,0 00 !C v x o c x o c o Y 7r: 'C�zs W O c 3 o '� x o c .c G, • 0 0 0 0 0 0 0 0 H F., z _" WU - 7 A ? 0 40 i o O W ='iY o v oCo ocn o v r r =En 83 0 on z ►a ''''' ¢ °c° oa � .c H p o n. a a� o o u V) W ::. u a>i a h lu c a on c o y L _� h .+ +'�+ d ate.+ v CC :.Y.:q L• V41) 'b .y t• W L'. y cd G O cd r h C y: 1 O vi .0 � � O c y y O .. y C O E En a h+ti u V ca .C > w cd is GL O " W D m O cc E N O p N 7 a u 41 W 'Q dl V L1. O cz r W O u >. 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At-Risk of Homelessness, refers to people who have extremely low incomes who are paying more than 30% of their gross monthly income for housing; have a disability, physical, mental health, drug or alcohol addiction,or medical,that threatens their housing stability; are in foster care, hospitals or the corrections system and have nowhere to go upon discharge; or are threatened with the loss of their benefits due to cutbacks and policy changes in federal, slate and local benefit programs. Continuum of Care, refers to the full service delivery system including prevention, outreach and assessment, emergency shelter, support services,transitional housing and permanent housing. Dually-Diagnosed/Co-occurring disorder or Comorbidity, refers to people who have a combination of two of the following diagnoses: mental health,drug or alcohol addiction and HIV/AIDS. Extremely Low Income, refers to incomes, which are at or below 30% of the area median income. Family Household, refers to households that include at least one adult and children. Homeless, refers to people who do not have permanent housing, including people living on the streets or in parks, in shelters and transitional housing, in sub-standard housing, and in vehicles or other places not designed for human habitation. This conforms to the federal definition published in the Continuum of Care and HOPWA Programs Application of 2001, which is as follows: A homeless person is a person sleeping in a place not meant for human habitation or in an emergency shelter;a person in transitional or supportive housing for homeless persons who originally came from the street or an emergency shelter. The following is the definition of homeless from the McKinney-Vento Act, 42 USC Sec. 11302 (1999): In general ... the term'homeless'or'homeless individual or homeless person includes-...(1)an individual who lacks a fixed,regular,and adequate nighttime residence;and(2)an individual who has a primary nighttime residence that is (A)a supervised publicly or privately operated shelter designed to provide temporary living accommodations(including welfare hotels,congregate shelters,and transitional housing for the mentally ill);(13)an institution that provides a temporary residence for individuals intended to be institutionalized;or(C)a public or private place not designed for,or ordinarily used as,a regular sleeping accommodation for human beings. Implementation Priorities. HIGH PRIORITY means the action step should be implemented in Years 1-2, MEDIUM PRIORITY means implementation in the next three to five years following, and Low PRIORITY means that these action steps are deemed good ideas to be 2001-2006 Contra Costa County Homeless Continuum of Care Plan 112 considered in the future. Many of the action steps in the Plan are interrelated and therefore several may be listed under one goal statement. In addition, many action steps may relate to more than one goal statement, therefore, one action step may be addressed under several goals throughout the Plan. Mainstream Pro rams. The federal block grant-supported social safety net and community service programs available to the community at large and poor people. This includes but is not limited to heatth,social service, and employment programs funded through the following grants: • Medicaid(Medi-Cal) • State Children's Health Insurance Program • TANF(Cal WORKS) • Food Stamps • Mental Health Block Grant • Substance Abuse Block Grant • Workforce Investment Act • Welfare-to-Work Program • Community Development Block Grant • Community Services Block Grant Youth /Young Adult refers to emancipated people between the ages of 14-25. The definition also includes all youth under 18. Youth also refers to any child aged out of foster care. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 113 APPENDIX B: LIST OF ABBREVIATIONS ABBREVIATIONS BOS—Board of Supervisors CAO—County Administrator's Office CBOs—Community-Based Organizations CDD—County Community Development Department CoCB—County Homeless Continuum of Care Advisory Board COHP—County Office of Homeless Programs CRA—City Redevelopment Agency CSAS—County Community Substance Abuse Services Division FBO—Faith-Based Organization HA—Housing Authority HHISN—Health, Housing,and Integrated Services Network HICC—Homeless Inter-Jurisdictional Coordinating Council HSD—County Health Services Department MHD—County Mental Health Division WIB /WIA—Workforce Investment Board/Workforce Investment Act SSD—Social Services Department 2001-2006 Contra Costa County Homeless Continuum of Care Plan 114 APPENDIX C: DATA SOURCES Continuum of Care Community Meetings Designed to be inclusive,the planning process included five community meetings, held in each of the supervisorial districts. These meetings solicited input on homelessness and its solutions from community members, providers, faith-based organizations, the business community, government staff, and people who are homeless or formerly homeless. Based on this input and on countywide homelessness data, the CoCB Five-Year Plan Subcommittee met seven times with key service providers and stakeholders to identify priorities and develop action steps for each of the Plan's five chapters. The following list summarizes the many comments the subcommittee considered. EMPLOYMENT, INCOME, AND ASSETS • Adopt a three tier job placement model. • Maintain and expand in-house job programs. • Give pre-employment support • Ensure PIC/WIB One-Stops provide information and referrals,job listings, resume services and linkages to life skills support and basic education. • Offer workplace training for TANF recipients • Open colleges for single parent families. • Put vocational training before education. • Increase the use of pre-employment training in tandem with temporary and permanent housing developments. • Create a rental subsidies program that is administered as part of employment training programs and offer access to employment training and placement services. • Expand Building and Grounds to East County. • Integrate job advancement into job placement services. • Have County contracts contingent on a contractor's use of hiring targets for people who are homeless, formerly homeless or receiving welfare. • Maintain existing nonprofit based and independent homeless enterprises established to train and employ homeless people. • Explore new sheltered markets. • Fund legal services to help more homeless people apply for SSI and help assist SSI recipients barred for substance abuse reapply under alternative categories. • Raise the requirements of the payees who receive funds on the behalf of social security system. • Training for Medical Providers. • Expand Rubicon's MMR program to include a volunteer pool of tax preparers who would help homeless people apply for current and past federal Earned Income Tax Credits(EITC). 2001-2006 Contra Costa County Homeless Continuum of Care Plan 115 • Give extra resources to job services at Rubicon and Phoenix to develop or expand a program for Individual Development Accounts. • Establish a pool of funding to provide in-kind aid,such as hotel and food vouchers, for employed residents not qualified for aid under other programs • Advocate at the state level to maintain current TANF benefit levels and eligibility criteria. Advocate for a lower number of work hours required over single parent families. • Create a privately-funded income subsidy trust and a privately-funded tuition trust.. • Provide domestic violence assessment and sensitivity training to services providers who work at job placement and training programs. • Develop non-traditional job opportunities for women. • Maintain and expand Phoenix's ACCESS program to provide services and job placement to additional consumers. • Establish connections with local Department of Disabled Students to assist clients with learning disabilities. • Expand the number of bilingual case managers at job centers in Richmond and at the County shelters. • Establish a Work First policy for homeless refugees and immigrants enabling them to enter the work force at any level to provide them with an income and with experience in mainstream society. • Establish a team of work advocates from existing staff who will call employers on the behalf of employees if trouble arises and who will advocate at the county-level for increased income subsidies. HOUSING, ACCEPTANCE, PREVENTION • Support existing and new rental assistance programs. • Provide special subsidies for single parent working families. • Create a rental guarantee program. • Publicize services in homelessness prevention. • Expand caseworkers' roles in tenant advocacy. • Bring prevention services to at-risk youth. • Bring prevention services into drug treatment facilities. • Integrate prevention services into the procedures for releasing inmates from local prisons and jails. • Bring prevention services to the families of incarcerated criminals. • Provide discharge planning for respite care. • Intensify the county's public education campaign in the local newspapers and television stations. • Appoint a government aid to help site. • Prepare ready-made advocacy briefs. • Educate community leaders on the homeless crisis. • Engage newly elected officials early. • Mobilize the interfaith community. • -Strategize community acceptance with a local strategic team. 2001-2006 Contra Costa County Ilomeless Continuum of Care Plan 116 • Adopt a countywide model for community acceptance. • Utilize dispute resolution early on to avoid legal proceedings. • Support special populations within existing shelter. • Expand case management to include housing counselors. • Provide quarterly dignity training for shelter staff. • Enforce drug policies. • Adopt and apply minimum standards of care for staff. • Expand transportation to shelter locations. • Provide more emergency shelter beds for pregnant teens. • Prepare to replace expiring grants with new funds. • Develop emergency shelter for youth. • Develop emergency shelter for families. • Expand housing services in emergency shelter.. • Investigate unused buildings as possible emergency shelter space. • Train faith-based groups to be shelter providers. • Give priority to in-term women in all family shelters. • Engage at-risk immigrants. • Dedicate shelter beds within each regional service cluster to people with acute care needs. • Advocate for state and federal financing for cleanup costs. • Plan ahead for funding to sustain existing transitional housing beds. • Create an automated referral system. • Link clients with families and friends. • Legislate to keep prices down. • Advocate for expanded Section S. • Expand the resources of tenant advocates. • Equip tenant advocates to provide assistance to senior citizens. • Expand funding for damage deposits. • Continue necessary upkeep to existing affordable housing. • Fund new housing with leasehold co-ops.. • Fight for affordable housing set-asides in new housing developments. • Develop housing through abundant funding streams. • Form a committee devoted to developing new housing strategies. • Increase case management for finding and keeping housing. • Recruit local landlords for Section S vouchers in every regional service cluster. • Prevent the conversion of affordable housing to market rates. • Create an assistance program for affordable housing developments. • Develop best practices in homeownership. • Coordinate all housing and community plans with the Continuum of Care 5- Year Plan. • Develop Shelter Plus Care permanent funding source using models that have been successful across the nation. • Plan ahead for funding to sustain existing transitional housing beds. • Offer more money management services. • Fund for additional wrap-around services. - 2001-2006 Contra Costa County Homeless Continuum of Care Plan 117 • Unite clients with providers to develop reasonable_ accommodations for residents with disabilities. • Access mainstream funds for programming through HHISN. • Bring services to members of subpopulations living in other housing. • Supportive housing for dually diagnosed children and families. OUTREACH AND HEALTH SERVICES • Expand coverage of state Medicaid (Medi-Cal). • Help people utilize Medicaid (Medi-Cal). • Provide transportation from service providers to hospitals. • Train medical practitioners in dignity issues. • Unify and intensify county outreach efforts. • Inform clients on Medi-Cal eligibility and applications. • Offer referrals for prenatal care. • Continue to place health workers at service locations. • Increase diagnostic services in housing and support services. • Develop a public education campaign to promote prevention. • Provide respite and convalescent services for hospital discharges. • Start an public education campaign to site programs. • Expand primary care in service regions. • Prepare HMOs for homeless clients. • Treat high blood pressure. • Help clients manage their diabetes. • Continue case conferencing between providers. • Expand integration among service providers. • Advocate for increased Medi-Cal coverage for pregnant women and teenage girls. • Expand outreach programs in existing services. • Adopt the single outreach client model. • Maintain Concord's mobile health team. • Coordinate with the police force. • Recruit pro bono psychiatrists for outreach. • Provide incentive funds. • Provide mental health services that are integrated with housing and homeless services. Fund in-house group sessions and classes. • Open a shelter for homeless people with mental illness is in East County. • Design a drop in center for homeless with mental illnesses. • Increase the range of services for mental health treatment. • Train shelter staff to identify mental illnesses • Provide technical assistance to shelter and other front line staff to recognize clients in crisis. • Find low-cost or volunteer counselors. • Establish a countywide referral procedure. • Establish a multi-tiered housing continuum for dually diagnosed. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 118 • Design the mental health continuum of care to accommodate dually diagnosed patients. • Design the continuum of care to accommodate children. • Continue to support uncertified recovery providers. Hire bilingual staff at drug and alcohol clinics. • Double general drug treatment capacity. • Actively initiate long-term engagement. • Modify programs for people with disabilities. • Address the housing and service needs of homeless people who have completed drug and alcohol treatment programs. • Maintain existing family shelter programs. • Address family dysfunction through child development services. • Offer family based therapy. • Ensure caseloads remain low. • Provide beds for children at treatment centers. SUPPORTIVE SERVICES • Integrate current system. • Keep a stock of nonprofit housing. • Create a package of basic services and expand multiservice centers. • Establish quality control for the multiservice centers. • Integrate mental health centers with multiservice centers within the county. • Maintain adult education services. • Expand adult education and increase flexibility.\ • Increase strength of existing case management programs. • Incorporate life skills into literacy. • Connect literacy programs with services. • On-site libraries. • Maintain current levels of life skills services. • Foster dignity in case management and training programs. • Expand operations and locations. • Implement programs for homeless non-custodial fathers. • Maintain existing pantries and meal services. • Access Federal Food Stamp Program. • Further coordinate food distribution efforts at the Food Bank Network. • Find volunteers for Summer/Breakfast Food Programs. • Expand food storage. • Create urban gardens. • Coordinate Advertising. • Provide sensitivity training. • Reach people in SROs. • Create nutrition guidelines. • Seek kitchenware and food from local restaurants. • Offer training to cooks. • Integrate nutrition into money management and life skills programs. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 119 • Coordinate service providers and transit for special needs populations. Interface with existing paratransit services to ensure that disabled and elderly homeless people are being served by transit in their area. Ensure that school buses are serving homeless housing and service sites. • Expand route deviation night services. • Advocate for a higher number of reverse commute lines.. • Offer tokens or vouchers. • Offer discounted passes at providers. • Establish shuttle bus para-transit system within every region. • Subsidize taxi and shuttle services. • Maintain childcare programs. • Increase homeless families' access to mainstream childcare programs. • Expand services to shelters. • Push for increased funding. • Solicit new volunteers. • Pool mutual caregivers. • Off—hour day care. • Advocate for the Title 1 set-aside in school districts. • Advocate for McKinney Child Education funding. • I.nform case managers and teachers. • Support Children Moving schools. • Avoid moving schools. • Include homeless issues in curriculums. • Provide study environments. • Seek more supplies and tutors. • Equip homeless youth services for the full continuum of care. • Support group home children. • Create life skills training for teen mothers. • Expand emancipation services. • Create group home tutor programs. 2.001-2006 Contra Costa County liomeless Continuum of Care Plan 120 APPENDIX D: DATA SOURCES In developing the Contra Costa County Homeless Continuum of Care Plan, extensive research was made into the services, policies, and politics surrounding homelessness. A great deal of information was found in the research library at HomeBase/The Center for Common Concern, which has over 2,500 books, reports, and other publications on homeless issues. In analyzing the homeless situation in Contra Costa County, the drafters of Contra Costa County Homeless Continuum of Care Plan relied on the expertise of service providers, the insights of many homeless people, and research in the field. However, there were still several key documents that were used extensively to describe homelessness in the local communities. The list that follows catalogs a few of the most significant documents that were relied on throughout this process. • 2001 Continuum of Care Homeless and Safety Net Providers Survey • 2001 Results of the Social Service Department Homeless Assessment • A Beginning Plan for Dealing with Homelessness in Contra Costa County, 1986 • Report to the Board of Supervisors on Homelessness in Contra Costa County and Recommendations for Action,by the Task Force on Homelessness, July 1987 • Long Term Affordable Housing Solutions to Homelessness, by the Community Homeless Action & Resource Team (CHART), April 1989 • Strategic Plan on Homelessness, by the Social Services Department,November 1989 • Symposium on Homelessness in Contra Costa County, Planning Session Summary, October 1991 • A Homeless Prevention Plan: Creating Options and Opportunities for the Homeless of Contra Costa County(1992-1995), by the Association of Homeless & Housing Service Providers • Report of the Contra Costa County Mental Health Advisory Board Ad Hoc Planning Committee, June 1993 • Housing Report of the Contra Costa County Mental Health Commission, June 1994 • Contra Costa Consolidated Plan, FY 1995-1999 • Richmond Consolidated Plan, FY 1994-1997 • Contra Costa County Continuum of Care Homeless Plan 1996-2001. • Contra Costa Consortium 2000—2005 Consolidated Plan. • Contra Costa County CalWORKS Housing Assistance Action Plan & Implementation Strategy 2001-2006. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 121 APPENDIX E: PARTICIPANTS AT COMMUNITY MEETINGS Name and Affiliation Carolyn Robinson Senator Tom Torlakson's Office Brian Arnold, Program Manager Contra Costa County Jim Nichols Contra Costa County Laura Lockwood, Director, Capital Facilities & Debt Mgmt Kathleen Hamm,CDBG Planner Community Development Dept. Mark Southard,CDBG Planner Community Development Dept. Aminta Mickles, Program Manager CSAS Robert Kajdan, Manager CSAS Lloyd Madden Employment& Human Services Department John Cullen, Director Employment& Human Services Department Coordinator Family, Maternal and Child Health Program Barbara Chase FEMA Board Carmen Beyer, Program Coordinator HIV/AIDS Program Robert McEwan, Executive Director Housing Authority Ralph Hoffman, Commissioner District III 2001-2006 Contra Costa County Homeless Continuum of Care Plan 122 Mental Health Commission Ellen Danchik Mental Health Department Linda Cherry, Analyst Mental Health Department Jana Oxenreider Prenatal Care Guidance Program Patricia Martin, Community Health Worker Prenatal Care Guidance Program Andrea Dubrow, Executive Assistant Public&Environmental Health Advisory Board James Nichols, Lieutenant Sheriff's Office Drug Court Coordinator Supervised Treatment& Recovery (STAR) Drug Court Ruth Atkin Veterans Affairs Department Nancy Casazza, Board Member West Contra Costa Health Care Winston Rhodes, Senior Planner City of Brentwood Brooke Littman, Housing Manager City of Concord Teri House, Community Services Manager City of Concord Don Mort, Lieutenant City of Concord Police Department William Shinn Concord Human Relations Commission Dick Waldo, Vice Mayor Town of Danville - 2001-2006 Contra Costa County Homeless Continuum of Care Plan 123 Rochelle Flotten, Assistant to the Town Manager Town of Danville David Boatwright, Housing Coordinator Pleasant Hill Redevelopment Agency Theresa Talley-Wilkerson City of Richmond Raymond Lambert City of Richmond Manuel Rosario, Deputy Director Richmond Housing Authority Kelsey Worthy, Administrative Analyst City of San Pablo Nancy Tataka, Vice Mayor City of San Ramon Sage Foster,Team Leader County Health, Housing, Integrated Services Network George Evans, Homeless Services Manager County Crisis Center Sharon Bernhus County Emergency Family Shelter Nurse Al, PHN Health Care for the Homeless James Aruna, Office Administrator Headh Care for the Homeless James Littlejohn, Executive Director Boys &Girls Club of Martinez Kathy Lafferty Cambridge Community Center Judy A. Moore, Director of Employment Services & Housing Catholic Charities of the East Bay 2001-2006 Contra Costa County Homeless Continuum of Care Plan 124 Solomon Belette, Administrator for Community Services Catholic Charities of the East Bay Ron Pellurn, Housing Advocate Catholic Charities of the East Bay Ann Snyder CCISCO Dennis McCray, Associate Director- Center Point, Inc. Brian Arnold, Program Manager Center Point, Inc. Dan Ramirez Center Point, Inc. Sylvester L. Bayor, Office Manager Chance to Begin, Inc. Dave Shroeder Community Center of Martinez Tom Conrad, Executive Director Contra Costa Interfaith Transitional Housing, Inc. Liz Orlin, Program Officer Corporation for Supportive Housing Cassandra Youngblood CSD Bobbi Van Deliverance House Leslie Gallen,Client Services Specialist Diablo Valley AIDS Center Sue M.ankini, Program Coordinator East Bay Detox— BiBett Joan Carol Pickett, Director Elizabeth's House Maternity Home Pregnancy Centers of Contra Costa County Kirit MacDonald, Housing Services Specialist 2001-2006 Contra Costa County Homeless Continuum.of Care Plan 125 Families First Lindsay Johnson, Program Manager Food Bank of Contra Costa& Solano Andrew S. David Food Bank of Contra Costa& Solano Jubin Amber Fresh Start John Holloway Fresh Start Susan Prather Fresh Stan Mary Ann VanBuren, Executive Director Friends Outside221 Janet Bruce GRIP Souper Center Al Coolidge Independent Living Resource Jackie Tillman, Board Chair Loaves & Fishes of Contra Costa County Richard Richardson, Executive Director Loaves & Fishes of Contra Costa County Merlin Wedepohl, Executive Director SHELTER, Inc. Jennifer Baha, Director of Program Services SHELTER, Inc. Kitty Duma, Progam Director of Pittsburg Family Center SHELTER, Inc. John Shanley, Executive Director Mt. Diablo Habitat for Humanity Isabel Paez, Family Relations Manager Mt. Diablo Habitat for Humanity 2001-2006 Contra Costa County Homeless Continuum of Care Plan 126 Patti Pelosi, Director Clinical Resource Management Mt. Diablo Medical Center Joel Reskinoff, Medical Social Worker Mt. Diablo Medical Center Herb Putnam NAMI James Berquin, Executive Director New Connections Michael Barrington, CEO Phoenix Programs, Inc. Cheryl Maier Phoenix Programs, Inc. Judy Tiktinsky, Deputy Executive Director Phoenix Programs, Inc. Carlos Morales, Chief of Clinical Services Phoenix Programs, Inc. Nesbit Crutchfield Phoenix Programs, Inc_ Anne Prescott, Member Pinole Youth Committee Carl B. Metoyer, Executive Director Richmond Neighborhood Housing Services, Inc. Ron Cooper, Executive Director Saint Vincent De Paul Society Judy Sparks Saint Vincent De Paul Society Shirley Krieg Saint Vincent De Paul Society Ginger Marsh Soroptomist International United Way of the Bay Area 2001-2006 Contra Costa County Homeless Continuum of Care Plan 127 Ngozi Gloria Chukuu, Director Supported Living Services Las Tampas, Inc. The Salvation Army Tranquillium Center Hazel Wesson, Executive Director AIDS Community Network Tricia Halin, HIV Housing Advocate AIDS Community Network Rhonda Penkert, Executive Assistant YMCA of Contra Costa County Reporter Contra Costa County Times April Ann Hunter Hunter Consulting & Associates Lamont Campbell, General Manager Hospice Thrift Stores Eizo& Mary Kobayashi Homeless/former homeless persons Megan Monahan Homeless/former homeless persons Anita Roche Homeless/former homeless persons Zettie Roland Homeless/former homeless persons Dorothy Vance Homeless/former homeless persons Kay McVay, President California Nurses Association Mary Lou Laubscher Citizen 2001-2006 Contra Costa County Homeless Continuum of Care Plan 128 Dean Coons Citizen Michael Shimansky Citizen Jean &Chuck Bush Citizens Frances Greene Citizen A C Hollister, MD Health Committee of Contra Costa County Advisory Council on Aging Doris & Ralph Copperman Gray Panthers Maribel Aguja Housing Rights Gwen Watson League of Women Voters Alliance for the Mentally III Marcy Orosco Cassandra Madden, Project Assistant Contra Costa College Kenneth Reynolds, FOPS Assistant Contra Costa College Geri Cohen West Contra Costa Unified School District Rochelle Reed, Community Outreach John Marsh Elementary School Representative Nystrom Elementary School Cinda Wert Rapp Teacher—Infant Program, West Contra Costa Unified School District Mary Mangiapane Christ the King 2001-2006 Contra Costa County Homeless Continuum of Care Plan 129 Jean Warkakis Christ the King Henrietta Griffith Christ the :King Ivan Wojnar Christ the King Pat Mooser Christ the King Barbara Hansen Christ the King Dolores Loague Concord United Methodist Church David Simmons, Minister Mt. Diablo Unitarian Universalist Church Pastor Don Smith Mt. Diablo Unitarian Universalist Church Florence Pierson Social Justice Alliance of the Interfaith Council Rabbi Roberto D. Graetz Temple Isiah 2001-2006 Contra Costa County Homeless Continuum or Care Plan 130 APPHNDix F: ENDNOTES 'California Budget Project. Locked Out!California's Affordable Housing Crisis. (Sacramento, CA: California Budget Project, May 2000): 17. "California Budget Project: 15. The Fair Market Rent for 2001 in the county for a 2- bedroom unit is $1,155. (Federal Register, 24 CFR Part 888, 2 Jan. 2001:168.) "'Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart: 736 individuals and 1,252 people in families are in need of permanent supportive housing. 'V Contra Costa County Consolidated Plan, (2001-2006): 22-3. "California Budget Project: 44. V'Association of Bay Area Governments,Projections 2000. Forecasts for the San Francisco Bay Area to the Year 2020,(December 1999): 87. V" Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. Viii Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart: 67%=1,086/1,618 and 10%=290/3,21 1. See page 31 of the Homeless Plan. "Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. "Contra Costa County Consolidated Plan,(2001-2006): 27. ""Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart: 66%=3,211/4,829. See page 33 of the Homeless Plan. ""National Low Income Housing Coalition. Out of Reach: The Growing Gap Between Housing Costs and Income of Poor People in the United States. (September 2000. <http://www.nl lhc.org/cgi-bin/oor2000.pl?gctstate=on&getcounty=on&county= contracostacounty&state=CA> website accessed 13 Feb. 2001). "California Budget Project. Making Ends Meet.: How Much Does it Cost to Raise a Family in California? (Sacramento, CA: California Budget Project, Oct. 1999): 20. 2001-2006 Contra Costa County[lomcless Continuum of Care Plan 131 See page 34 of the Homeless Plan. CaIWORKS is the state of California's program under the Temporary Assistance for Needy Families Act of 1996. The previous welfare legislation was the Aid To Families With Dependent Children - Homeless Assistance Act. Here, to be consistent, all references to programs funded under either of the welfare bills will be referred to by its current name,CaIWORKS. 18 Methodology For Calculating The Estimated Yearly Count A. Homeless Families: According to the Contra Costa County Social Services Department, 3,750 families received assistance from CalWORKS in Fiscal Year 1994 (July 1994-June 1995). CalWORKS is a statewide program that is administered locally by the Contra Costa County Social Services Department. The previous welfare legislation was the Aid To Families With Dependent Children -Homeless Assistance Act. Here, to be consistent, all references to programs funded under either of the welfare bills will be referred to by its current name,CalWORKS. It provides two types of cash assistance to homeless families: 1)Temporary Assistance to pay for motels or other temporary shelter arrangements, and 2) Permanent Assistance to help with move-in costs for permanent housing, including last month's rent, security deposit and utility hook-up costs. In order to qualify for this assistance, families must be receiving or eligible to receive CalWORKS, have no more than $100 in the bank or on hand(excluding the current month's CalWORKS income), and they must be homeless. According to CalWORKS, applicants are considered homeless if they do not have permanent housing, including those who are living in a temporary shelter, residing on the streets or in a place not designed for human habitation, or living temporarily doubled up with friends or family. In Fiscal.Year 1994-95, families were not eligible to receive CaIWORKS if they had received it in the previous 24 months. This limitation was changed on January 1, 1996 to exclude families who have ever received it before in their lifetime. The number of families who received CaIWORKS assistance in FY 1994-95 (3,750 families) was multiplied by the countywide number for the average size of a CalWORKS family(2.77) to yield the number of family members(parents and children) who were homeless at some point in FY 1994-95 (10,388). The number of families (3,750) was also multiplied by the countywide average number of children in a CalWORKS family (1.86) to yield the number of children who were homeless at some point in FY 1994- 95(6,975)- 3,750 (number of families who received CalWORKS) x 2.77 (average family size) 1.0,388 family members who were homeless in FY 1994-95 3,750(number of families who received CaIWORKS) 2001-2006 Contra Costa County Homeless Continuum of Care Plan 132 x 1.86 (average number of children) 6,975 homeless children in FY 1994-95 These numbers are a known undercount. They are minimum figures that include only those homeless families who received CAWORKS. They do not include many other families who were homeless but did not receive CalWORKS, such as: • Homeless families ineligible for CaIWORKS because of their immigration status or because they did not meet the income and savings limitations necessary to qualify; • Homeless families ineligible to receive CalWORKS because they had already received it in the previous 24 months; • Homeless families who were eligible but who for whatever reason did not apply for it. An informal survey of family emergency shelters and transitional housing programs was conducted by the Contra Costa County Health Services Department Homeless Program revealed that 59% of the families who had stayed in the programs were either ineligible for CalWORKS or did not apply for other reasons. This is an additional 662 families who are not represented in the estimate based on the CaIWORKS numbers. B. Homeless Individuals: According to the Contra Costa County Social Services Department, 19,214 people applied for General Assistance(GA)during one year's time. GA is a state-mandated, county-funded program that provides cash assistance to individuals who are not eligible to receive assistance from other government programs. The maximum monthly cash benefit is $300. GA regulations pay a grant to cover rent (up to $158) directly to the landlord by the Social Services Department and the remainder ($142) is paid directly to the recipient to cover personal needs. Homeless people are referred into the county emergency shelters and receive the $142 payment. If there is no room in the shelters, they can receive the full $300 payment. The number of GA applicants in one year(19,214)was multiplied by the percentage of applications that were new(53.5%) to yield the number of unduplicated GA applicants (10,279). The number of unduplicated GA applicants(10,279)was multiplied by the percentage of approved GA applicants who declared themselves as homeless (28%) to yield an estimate of the number of individuals who experienced an episode of homelessness in one year(2,878). 19,214(number of GA applicants) _x._535 (duplication rate) 10,279 unduplicated applicants in a year 1 ,279 (unduplicated applicants) 2001-2006 Contra Costa County Itomeless Continuum of Care Plan 133 x .28 (percentage of people who self-declare as homeless) 2,878 homeless individuals in a year This number is a known undercount. It is derived from figures based only on people who apply for GA and who declare themselves to be homeless. It does not include many other people who were homeless, such as: * Homeless people who did not apply for GA. Many people choose not to apply because they do not think the low benefit level($300/month) is worth the difficulty of complying with the program requirements, such as participating in job search and/or alcohol and drug counseling. Homeless people who receive GA but who do not declare themselves to be homeless. Applicants are not required to identify themselves as homeless and many people choose not to. Data from 1994— 1995 was used to infortn the proportions of families and individuals who experience homelessness in Contra Costa County. The actual numbers were updated with year 2000 figures from the Health Services Department. 19 Methodology For Calculating The Homeless Population In Each Region The breakout of homeless families by region is based on the relative proportions of the CalWORKS caseload in West, Central, and East county. Fourty five percent of the CalWorks caseload was in West county, 21% was in Central county, and 34% was in East County.. The breakout of homeless individual adults by region is based on the relative proportions of the GA caseload in West, Central, and East County. Fifty-five percent of the GA caseload was in West County, 25% was in Central County, and 20% was in East County. 20 Methodology For Calculating The Estimated Nightly Count The Health Services Department maintains an unduplicated count of homeless people receiving services each year. It is these numbers that update the base numbers, calculated below. A. Homeless Single Adults: According to the Contra Costa County Social Services Department, the average monthly General Assistance(GA)caseload was 4,624 cases in one year. Because the monthly caseload is the total number of all cases open at some point during the month, it is higher than the average daily caseload. The average daily caseload is about 85%of the average monthly caseload. Applying this percentage to the average monthly caseload yields an average daily caseload of 3,930 cases(4,624 x .85). The average daily caseload of 3,930 was multiplied by the percentage of approved GA recipients who declare themselves as homeless (28%) to yield an estimate of 1,100 individuals homeless on any given night(3,390 x.28). This number is an undercount— 2001-2006 Contra Costa County Homeless Continuum of Care Plan 134 see Endnote I.B. for a more detailed explanation of the limitations of this estimate. The calculation of the number of homeless men and women is derived by multiplying the relative proportions of the number of men and women receiving GA by the overall nightly estimate of the number of homeless individuals (1,100). B. Homeless Families: The number of families who are homeless on any given night is derived by averaging a low and a high-end estimate. The low-end estimate is based on CalWORKS data. According to the Contra Costa County Social Services Department,an average of five days of temporary shelter was provided for families who received CalWORKS temporary assistance during a six-month period. Assuming that 5 days is the average length of homelessness for families yields an estimated nightly count of 51 families. (365/days/yr divided by 5 days=73,and 3,750 families homeless over the course of the year divided by 73 = 51 families homeless on any given night.) Based on the experiences of providers serving this population as well as on surveys of homeless families, the average length of homelessness for families is thought to be considerably longer than 5 days. The discrepancy between the CalWORKS data and the experiences of providers and many homeless families is likely due to the fact that CalWORKS recipients do not include all homeless families and are not reflective of the overall population of families who experience homelessness. The high end estimate is derived from a survey conducted by the Contra Costa County Health Services Department Homeless Program. Of the 192 people surveyed, 16 indicated that they had children living with them. Of these, 16 families, 6% had been homeless less than I month, 25% had been homeless for one to three months, 50% had been homeless for three months to one year, and 19% had been homeless for over one year. In order to derive a nightly count of homeless families, this data on the length of time homeless was applied to the yearly count using the following assumptions: • Under one month assumes the family was homeless for exactly two weeks. The yearly count is multiplied by the proportion of families homeless for under one month (6%)and divided by 26. • One to three months assumes the family was homeless for exactly two months. The yearly count is multiplied by the proportion of fatnilies homeless for one to three months(25%)and divided by 6. •Three months to one year assumes the family was homeless for exactly six months. The yearly count is multiplied by the proportion of families homeless for three months to one year(50%) and divined by 2. • Over one year assumes the family was homeless for exactly-one year. The 2001-2006 Contra Costa County Homeless Continuum of Carc Plan 135 yearly count is multiplied by the proportion of families homeless for over one year(19%). Adding together the results of the four calculations yields an estimated nightly count of 1,81.6 families. (This methodology was developed by Shelter Partnership, Inc. of Los Angeles.] This estimate is assumed to be a high end calculation because it is derived from a small sample of families in emergency shelters, transitional housing, residential treatment programs,etc. This sample cannot be assumed to be reflective of the overall population of homeless families and is likely biased toward families who have been homeless longer amounts of times. An average of the low end and high-end figures yields an estimate of 934 families homeless on a given night. The CalWORKS average family size and average number of children(See Endnote LA.)were used to calculate estimates of the number of family members(parents and children)and the number of children homeless on any given night. Based on this, 2,587 family members were estimated to be homeless on any given night in FY 1994-95, including 1,737 children. 21 In addition, to the lack of a random or scientific sampling process, the applicability of the survey data is also limited by the fact that the surveys were filled out by the respondents themselves_ The quality and completeness of the surveys is not consistent; some people did not understand how to fill out certain questions and others chose not to answer all the questions. Accuracy is particularly an issue with the questions that asked people to self-report information on personal issues, such as mental health disabilities, drug and alcohol use, and domestic violence. Given the differing motivations people have in answering these questions, a precise estimate of the overall percentage of the homeless population affected by these issues cannot be obtained solely by looking at the proportion of people who identified themselves as having a particular problem on the survey. 22 Department of Health Services. Year 2000 Data on Homeless People Served. 23 Office on Homelessness, Department of Health Services,Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 24 6,628 is the estimate of the number of homeless households in FY 1994-95 (2,878 adult only households plus 3,750 family households—see endnote I for sources). For convenience, this number is used as the estimate of the number of homeless adults although it is likely that some of the family households contained more than one adult. 25 113 of the 192 people surveyed (59%) indicated that they had a problem with drug or alcohol use. 26 Source: Shelter, Inc. of Contra Costa County 200 APR. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 136 27 Urban Institute. Homelessness: The Programs and the People They Serve, Findings of the National Survey of Homeless Assistance Providers and Clients. Technical Report. (Washington: Urban Institute, Dec. 1999): 8-1. 28 Contra Costa County Health Services Department. Year 2000 Data on Homeless People Served. 29 Association of Bay Area Governments,Projections 2000: Forecasts for the San Francisco Bay Area to the Year 2020, (December 1999): 87. 30 32 of the 192 people surveyed(17%) indicated that they had a mental health disability. 31 Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 32 Urban Institute: 8-1. 33 23 of the 192 people surveyed (12%) indicated that they had both a mental health disability and a problem with drug or alcohol use. 34 23 of the 32 people(72%) who identified themselves as having a mental health disability also said they had a drug or alcohol problem. 23 of the 113 people(20%) who identified themselves as having a drug or alcohol problem also said they had a mental health disability. 35 Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 36 24 of the 70 women surveyed (34%) indicated that they or their family had a problem with domestic violence. 37.Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 38 Urban Institute: 4-9. 39 Contra Costa County Consolidated Plan, 2001-2006: 27. 41)Oftice on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 41 Contra Costa County HIV/AIDS Housing Plan, 1996: 44, 49-50. 42 Contra Costa Consolidated Plan, 2001-2006: 27. 2001-2006 Contra Costa County Homeless Continuum of Carc Plan 137 43 Robertson, Marjorie J., and Paul A. Toro. "Homeless Youth: Research, Intervention, and Policy."Practical Lessons: The 1998 National Symposium on Homelessness Research. Eds. Linda B. Fosburg and Deborah A. Dennis. (Washington: Dept. of Housing and Urban Development, Aug. 1999). 44 Robertson and Toro. 45 Office on Homelessness, Department of Health Services, Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 46 Kushel, Margot. Health Status of Homeless Persons. (Feb. 2001. http://ww.igs.berkeley.edu:880/events/homeless/papers/Kushel PresentatioiVindex.htm Website accessed 29 Mar. 2001). 47 39 of the 192 surveyed(20%) indicated that they had a physical disability. 48 39 of the 192 people surveyed(20%) indicated that they had a health problem. 19 (10%) said they had stayed in the hospital during the previous 12 months. 49 .Source: Shelter Inc., of Contra Costa County, 2000 APR. 50 36 of the 192 people surveyed (20%) reported that they had spent some time in jail in the previous twelve months. 51 Kushel. 52 30 of the 192 people surveyed(16%) reported that they were veterans. 53 Office on Homelessness, Department of Health Services,Contra Costa County. 2001 HUD Continuum of Care Application. Gaps Analysis Chart. 54 103 of 167 survey respondents(62%) had a gross monthly income below$500,42 (25%)had an income in the range$50041000, 12 (7%) had an income in the range $1000-$1500,4 (2%)had an income in the range$1500-$2000, 2 (1%) had an income ill the range$200042500 and 4(2%)had an income over$2500. 55 California Budget Project. Locked Out! 56 Contra Costa Consolidated Plan, 2001-2006: 22. 57 40 of 184 survey respondents(22%) had not completed high school or the GED, 57 (31%) had completed high school or the GED, 61 (33%) had completed some college, 26 (14%) had obtained a degree. 58 Urban Institute: 3-6. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 138 59 32 of the 192 people surveyed (17%) were currently employed. 60 94 of 147 survey respondents(64%) were homeless more than one time. 61 Urban Institute: 4-9. 62 153 of 192 survey respondents said they use the bus or BART to get to appointments or to work. 63 83 of 192 people surveyed (43%) had lived on the streets, 42 (22%) had lived in a vehicle, 114 (59%)had been in a shelter or transitional housing, and 86 (45%)had stayed with a friend. 64 National Low Income Housing Coalition. 65 National Low Income Housing Coalition. X'x See Endnote iii. xx Contra Costa County Consolidated Plan(FY 1995-1999): 20. Xxi See Endnote lviii. xx" See Endnote ii. Loprest,P., Families Who Left Welfare: Who Are They and Hotiv are They Doing?, (Urban Institute, 1999): 12. xx.v See page 12 & 15. Xx"See page 12 & 15. See Endnote viii. Stark L, "Barriers to Healthcare for the Homeless,"(1998). See Endnote vii. There are an estimated 834 homeless people(individual adults and adults in family households) who have a drug or alcohol problem. An estimated 244 are dually diagnosed with a mental health disability and 310 are dually diagnosed with an HIV/AIDS diagnosis. Overall, 66% of those with a drug or alcohol problem have some type of dual diagnosis. xxix See Endnote xlvi. XXX See Endnote xlii. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 139 I x"National Alliance to End Homelessness,A Plan: Not a Dream, 2000. H.omeBase, Meeting the Health Care Needs of California's Homeless Popr.Ilation xxx'u Kushe[, Margot B., "Health Status of Homeless"2001. xxx" Salit S.A. 1998. xxxv Rosenheck, R. 1999. xxxVi Gross TP, "Shelters for Battered Women and Their Children: an Underrecognized Source of Communicable Disease Transmission." xxx"" Wright, "Poverty, Homelessness, Health Nutrition,and Children." xxxv"' Walter Leginski, "Health Issues in Homelessness," Urban Homelessness & Public Policy Solutions:A One Day Conference 2001. _ " 'x Stark L, "Barriers to Healthcare for the Homeless." A of Stark L. National Alliance to End.Homelessness,A Plan:Not a Dream, 2001. Aii A Plan:Not a Dream, 2000. xt"' See in general Stone,Shelter Poverty, 1993 (documents the development of access to habitable shelter as a measure of poverty). xt'" Walter Leginski, "Health Issues in Homelessness," Urban Homelessness & Public Policy Solutions:A One-Day Conference, January 22,200 1. xtv Bostic, Raphael W. "Homeless Population Dynamics and Policy Implications," Urban Homelessness & Public Policy Solutions: A One Day Conference 2001 (Mr. Bostic is a poverty expert for the Federal Reserve Board). x["' cited in"Economic and Housing Issues in Homelessness," Urban Homelessness & Public Policy Solutions:A One Day Conference 2001. x1"" Currently most Section 8 vouchers are awarded to people who have never been at risk . of homelessness according to Prof. Edgar O. Olsen of the University of Virginia at the Urban Homelessness & Public Policy Solutions:A One-Day Conference, 2001. xI""' Leginski, Walter, "Health Issues on Homelessness,"2001. "x See id. 2001-2006 Contra Costa County Homeless Continuum of Care Plan 140