HomeMy WebLinkAboutMINUTES - 12092003 - C116 TO: BOARD OF SUPERVISORSs�,�-6-- �,,o�
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FROM: FAMILY AND HUMAN SERVICES COMMITTEE
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DATE: DECEMBER 9, 2003 g ;
SUBJECT: HEALTHCARE FOR THE HOMELESS mos, �'�~
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SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION:
ACCEPT reports from Health Services Department on Healthcare for the Homeless—Grant Year
11101/2002 through 10/31/2003 and the Homeless Continuum of Care, as recommended by the
Family and Human Services Committee.
BACKGROUND:
The Contra Costa Homeless Continuum of Care Program was referred to the Family and Human
Services Committee December 3, 1996. Reports are submitted annually to the Committee to update
the Board of Supervisors on the achievements of the homeless programs during the previous fiscal
year. Additionally, periodic reports on the Contra Costa Healthcare for the Homeless Project are
required pursuant to their federal grant.
The 2003 reports were presented to the Family and Human Services Committee November 17,
2003, and are attached. They include information and details on expansion of the homeless program
and services during the past year through the award of numerous grants, primarily from the Federal
government.
CONTINUED ON ATTACHMENT: YES SIGMA RE:
COMMENDATION OF COUNTY ADMINISTRATOR _ RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
r
ACTION OF BOARD ON r� �' APPROVE AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
i./ UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN
AND ENTERED ON THE MINUTES OF THE BOARD
AYES: NOES: OF SUPERVISORS ON THE DATE SHOWN.
ABSENT: ABSTAIN:
ATTESTED
JOHN SWEETEN,CLERK OF THE BOARD OF
Contact Person: Wendel Brunner,M.D. SUPERVISORS AND COUNTY ADMINISTRATOR
CC: William Walker,M.D.
Cynthia Belon
CAO
BY: DEPUTY
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WILLIAM B. WALKER, M.D. CONTRA COSTA
HEALTH SERVICES DIRECTOR
`NENDEL BRUNNER, M.D. PUBLIC HEALTH
PUBLIC HEALTH DIRECTOR 597 Center Avenue, Suite 200
CONTRA COSTA Martinez, California
94553
HEALTH SERVICES Ph (925) 313-6712
Fax (925) 313-6721
E- MAIL ADDRESS
wbrunner@hsd.co.contra-costa.ca.us
To: Family and Human Services Committee Date: November 12, 2003
Federal Glover, Supervisor, District 5 t
John Gioia
Supervisor, District 1
From: Wendel Brunner, MD, Directory Re: Report on Healthcare for
By: Pat Morris-Gooding, Manager The Homeless—Grant Year
Healthcare for the Homeless Program 11/11/02 to 10/31/03
In 2003, the Health Care for the Homeless Mobile Clinic Team experienced some
changes in attendance at the 18 clinic sites throughout the County. Clients staying in
various shelters over longer periods than in the past influence the attendance at the
shelter clinics. During the summer months, different than last year, some shelters
operated at only partial capacity. Additionally, the Project's attempts to respond to
requests to serve more clients at multi-service sites revealed that the clients at these
facilities had already been served at shelter sites. These are among the findings that
have been obtained by the Mobile Team while assessing the community in order to
analyze viability of shifting service delivery locations.
The collaboration with the John Muir/Mt. Diablo Community Health Alliance mobile clinic
affords the Mobile Team the continued opportunity to bring health care to persons not
connected to shelter community sites. The use of the John Muir/Mt. Diablo mobile clinic
sites serve numbers of homeless clients who, because of the lack of transportation, have
difficulties accessing care at the local clinics.
In September 2002, the Health Care for the Homeless Project launched a new medical
information system for the production of patient records. We have been perfecting this
system throughout the year. Working closely with Information Systems, we are close to
accomplishing a system which will meet medical records requirements as well as gather
required reporting data to the Department of Health and Human Services Health
Resources and Services Administration.
It is with disappointment that I report we are not yet able to establish a clinic for farm
workers at the Cecchini Farming property. We were unable to find a clinic time
that did not conflict with the workers' schedules and was time-appropriate for the
workday of the Health Team: The health care needs of this community are being met
with the Saturday clinic provided by the John Muir/Mt. Diablo mobile clinic.
Health Care for the Homeless is active in assisting with discharge planning for homeless
patients discharged from the hospital. Discharges from the hospitals to the homeless
shelter are becoming more appropriate. The Homeless Project and Health Care for the
Homeless plan to complete all education presentations to the local hospitals by the end
of this year.
Contra Costa
o; Community Substance Abuse Services Contra Costa Emergency Medical Services Contra Costa Environmental Health Contra Costa Health Plan •
• Contra Costa Hazardous Materials Programs •Contra Costa Mental Health Contra Costa Public Health • Contra Costa Regional Medical Center • Contra Costa Health Centers
•
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WILLIAM B. WALKER, M. D. CONTKA COSTA
HEALTH SERVICES DIRECTOR PUB LIC HEALTH
WENDEL BRUNNER, M.D. HOMELESS PROGRAM
PUBLIC HEALTH DIRECTOR
CONTRA COSTA 597 Center Avenue, suite 355
Martinez, California
HEALTH SERVICES 94553
Ph (925)313-6124
Fax(925) 313-6761
MEMO TO: Family and Human Service Committee
FROM: Cynthia Belon, L.C.S.W. CT
RE: Report on the Homeless Continuum of Care
DATE: November 10, 2003
This memo is to provide you with an update on the activities of the Homeless Continuum
of Care Advisory Board and the Homeless Program during the past fiscal year.
The Homeless Program has continued to expand its programs and services through
numerous grants, primarily from the Federal government.
Through the consolidated application process submitted to HUD on an annual basis,
Contra Costa County received $7.5 million dollars, almost twice the award given the year
prior. Although the majority of these funds are used to sustain the existing network of
services and housing to the homeless, an additional award of$700,000.00 to provide
permanent supportive housing to homeless families was granted.
We are currently working with the City of Pinole towards the development of a 17-unit
complex, of which 12 units would be identified for homeless families. Of the
$70000.00, $500,000.00 will be used for capital costs, and $200,000.00 will be used for
ongoing services to the homeless families who reside there.
This past year, the Homeless Program received $200,000.00 from the Administration of
Family and. Children Services—Homeless and Runaway Youth Funds—to develop and
implement a transitional program for homeless young adults, ages 18-21. This is the next
step in housing for homeless youth who may be residing in the emergency shelter for
single adults, or who come from the streets. Community Services also contributed
$25,000.00 for operating costs.
This 6-bed program is operating in El Sobrante, and provides housing and services, and-
assists young adults to become self-sufficient and ready to move into permanent housing
within 18 months.
Both the transitional youth program and the emergency youth shelter, a 6-bed facility in
Richmond for 14-17 year olds, will be managed by the Homeless Program directly, as of
November 30th. Opportunity West will be the fiscal agent for personnel costs associated
Contra Costa Community Substance Abuse Services Contra Costa Emergency Medical Services Contra Costa Environmental Health • Contra Costa Health Plan •
Contra Costa Hazardous Materials Programs *Contra Costa Mental Health • Contra Costa Public Health Contra Costa Regional Medical Center Contra Costa Health Centers •
with the program. This will allow for further program expansion in the area of service
delivery.
The emergency single adult shelters continue at capacity, with 841 females and 1671
males, or 2512 total, currently on the waiting list, a significant increase from last year.
The emergency shelters for families also continues at capacity, with 314 families, or
I I i
approximately 1500 individual family members, on the waiting list.
The Homeless Program's Project Synergy, funded through HHS —SAMHSA/CSAT, has
begun it's second year of providing homeless individuals immediate access into treatment
for substance abuse, mental health co-occurring disorders. A collaboration between the
Homeless Program, AOD and County Mental Health, along with numerous community-
based organizations, the project continues to exceed it's outcome objectives. This year,
the evaluation will be conducted by the Public Health CHA-PE program instead of Cal
Research.
Significant steps have been achieved in the implementation of the Homeless Management
Information System, mandated by HUD to be operating by October 2004. This will
provide more accurate data on the quantitative and qualitative aspects of homelessness,
and provide longitudinal data analysis on a local and Regional basis.
As part of this HMIS project, Contra Costa County Homeless Program is involved in a
Regional collaborative, organized and facilitated by the Schwab Foundation, who will be
providing some funding for shared technical assistance for Counties within n the Bay Area.
The provision of Ombudsperson services, formerly staffed through the Homeless
Program, is now being provided through the HOPE program—Homeless Outreach
Program to the Encampments—through a subcontract with Phoenix, Inc. Formerly
funded through a Federal grant from HHS—SAMHSA, this program is now being funded
through the new Federal Interagency Collaborative on Homelessness for the next 3 years.
The program has two teams comprised of a Psychologist, Peer advisors and a Public
Health Nurse who can perform outreach to encampments through out the County and
assist with providing linkages to services, housing, medical care, etc. To date,, this
program has identified almost 3000 individuals who are living outside in the County.
The ombudsperson's former role in relation to the shelters will be handled through the
written appeal procedure and/or through the client directly contacting Keith Bussey,
Adult Emergency Housing Director.
Lastly, the Homeless Program recently received a$3.5 million dollar award from the
Federal government's Interagency Collaborative on Homelessness, a partnering of HUD,
HHS — SAMHSA and HRSA; and the VA to provide housing and services to chronic
homeless. Contra Costa is one of 11 grantees nationwide who will be participating in this
Collaborative. (PLEASE SEE ATTACHED DESCRIPTION OF THIS
PROJECT)
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In summary, all of the various programs continue to provide much-needed assistance to
an extremely vulnerable population. Although we have continued to expand our goals
and mission at a very rapid rate in order to meet the demand, we still have a long way to
go.
It is the intent of the Homeless Program to continue to develop and maintain the
collaboration that has occurred between the mainstream service providers, including
County departments and community-based organizations, so that accessibility to services
is enhanced, and to continue to increase the availability of permanent housing for
homeless individuals and families, and including homeless young adults.
In order to accomplish this, we are in the beginning stages of the development of a ten
year plan to end homelessness, and which will include the coordination of efforts to end
chronic homelessness within our County.
Cc: Wendel Brunner, M.D.
Public Health Director
William Walker,, M.D.
Health Services Director
Project Coming Home
Collaborative Initiative to Help End
Chronic Homelessness
The Need
• Housing production has been unable to keep
up with the population growth
• Increasing suburbaniztion
• Reduction in agricultural sector
• Increase in low-wage service jobs
• These factors have contributed to the
growing gap between wages and housing
costs
Homelessness in Contra Costa
County
* Each year, 15,000 people experience
homelessness in Contra Costa
* On any give night,4,800 people are
homeless
* 1,800 are chronically homeless
* 47%of the homeless are in West County,
22%in Central,and 31%in East County
Lead Agency: County Office of
Homeless Programs
• Project Coming Home's single point of
oversight,coordination and accountability
• Coordinate the participation of all the
collaborating agencies through the Contra
Costa Consortium to End Chronic
Homelessness and through the Project
Management Team
• Report to federal agencies
Project Overview
• Multi-disciplinary outreach and services to
the target population
• Creation of homeless-dedicated detox and
residential treatment capacity
• Access to affordable housing
• Comprehensive,integrated support services
attached to the housing
Project Oversight: Consortium to
End Chronic Homelessness
• composed of senior staff representatives of all
partner agencies and additional(invited)members
of the Consortium that represent state government,
state and federal elected officials,and the County
Departments of Employment and Human Services
and Community Services
• meet on a bi-monthly basis in the first year of the
project,and after that on a quarterly basis
• staffed by the Consortium Administrator and
Consortium Project Manager who are responsible
for coordinating partnerships and maintaining
linkages between collaborating agencies
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Outreach (Cont'd)
• Clinical Director(.6 FTE) (Phoenix)
• Public Health Nurse(.5 FTE)(HCH)
Co-Occurring Disorder Outreach Worker(2
FTE)(CORP)
Peer Outreach Worker(2 FTE)(Phoenix)
• Care Coordinator(1 FTE) (Phoenix)
• Veteran's Care Coordinator(.5 FTE)(DVA)
Dedicated Detox and Residential
Treatment Beds
• 10 residential treatment beds for men and 2
for women for 90-180 days
• 2 additional beds for men and women of up
to 30 days
• Access to treatment on demand
• Capacity to serve 60 people per year total
• Veterans may access drug and alcohol
treatment through the DVA outpatient clinic
Treatment Beds (Cont'd)
• County Alcohol and Other Drugs will contract
with Bi-Bett,Cole House,and Neighborhood
House of North Richmond to provide detox and
residential treatment beds
• ISTs will continually visit the client directly
within the drug treatment setting
• Individuals who are in housing and have relapsed
will have their housing saved for them while in
treatment
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Outcomes
• Over 5 years,outreach team will contact
5,250 chronically homeless people: 1,500
each in year 1 and 2, 1,000 in year 3,750 in
year 4 and 500 in year 5. 500 will be
veterans.
• Over 5 years,5,000 will accept primary
health care,2,500 people will accept
supportive and mental health services, 150
will be veterans
Outcomes (cont'd)
• 300 people will receive drug and alcohol
treatment, 100 will be veterans
• 155 people will receive supportive housing
with services,30 will be veterans. Of these
155,70 will receive housing through Shelter
Plus Care and 85 will receive their housing
through subsidies provided by PCH partner
agencies
Evaluation
• CAL Research will evaluate PCH
• Evaluation will include an ongoing process
and outcome evaluation to learn about how
well the goals of this initiative are being met
• Evaluation will include both qualitative and
quantitative data
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