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MINUTES - 06052007 - C.110
FHS # TO: BOARD OF SUPERVISORS E_SE`L=`°� Contra FROM: Family and Human Services Committee COS't', DATE: June 5, 2007 ` ,4 County sr9-�oK�' SUBJECT: Update on the Continuum of Care Plan for the Homeless and Health Care of the Homeless SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: ACCEPT'the attached reports from the Health Services Department on the Continuum of Care Plan for the Homeless and the Health Care for the Homeless Project, as recommended by the Family and Human Services Committee. FISCAL IMPACT: No impact from accepting this report. BACKGROUND: The Family and Human Services Committee reviewed the attached reports updating the Board of Supervisors on the activities and accomplishments of the Continuum of Care Plan for the Homeless and the Health Care for the Homeless Project. This report is being forwarded to the Board of Supervisors for acceptance in conformance with applicable grant requirements providing for regular and routine communication with the governing board. CONTINUED ON ATTACHMENT: YES SIGNTURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURES : Feder I Glover,Chair Susan Bonilla,Member ACTION OF BOARD ON APPROVED AS RECOMMENDED _ O�R VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. UNANIMOUS(ABSENT AYES: NOES: ABSENT: ABSTAIN: Contact: Dorothy Sansoe(5-1009) cc: Health Services Department ATTESTED t �;2 0,:�F;7 County Administration N CULLEN,CLERK OF THE BOARD OFSUPERVISORS BY: DEPUTY WILLIAM B. WALKER M.D. _ CONTRA COSTA HEALTH SERVICES[DIRECTOR WENIDEL BKUNNER, M.D. PUBLICPROGRAM PUBLIC HEALTH DIRECTOR HOMELESS L ROGRAM CONTRA COSTA 597 Center Avenue, Suite 325 HEALTH SERVICES Martinez, California 94553 Ph (925) 313-6124 Fax (925) 313-6761 TO: Family and Human Services Committee FROM: Cynthia Belon, L.C.S.W. e� RE: Report on status of Homeless Continuum of Care Plan DATE: May 1, 2007 Cc: Dr. Wendel Brunner, Public Health Director This report provides an update on the accomplishments made towards meeting the goals of the 10-year Plan to End Homelessness, approved by the Board in 2004. Implementation of the Plan has been moving forward under the leadership of the Homelessness Inter-Jurisdictional Inter-Departmental Work Group (HIJIDWG) and the Homeless Continuum of Care Board (COCB). Attached please find the following individual reports, which together,provide a comprehensive summary of the work that has been completed to date and is currently being done: Timeline of Contra Costa Coordinating Efforts to End Homelessness (1985—2007): Provides the highlights of the work since efforts began in the County. Contra Costa Ten Year Plan: Highlights of Implementation Underway: Identifies plan priorities and examples of projects within the homeless service continuum that addresses each priority. Results of the Plan Implementation—System Transformation: How the homeless service continuum has evolved to accomplish the goals within each priority outlined in the 10-Year Plan. Key Partnerships and New Resources Attracted: Timeline of critical events that resulted in change within the homeless service continuum. In addition, reports are included for the services provided by the outreach teams; the single adult shelters located in Richmond and Concord from July, 2006—April 2007; Homeless Hotline report from July, 2006—April 2007; the number of homeless people who have been housed to date; Project Homeless Connect,held in December, 2006; and the Homeless Count, conducted in January, 2007 are included. To date, there are 2601 homeless individuals, families and transition-age youth who have been placed in permanent supportive housing. We have a housing retention rate of 85%, with a turnover in housing of 15%. • Contra Costa Alcohol and Other Drugs 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 NEW PROJECTS: Acquisition of the Concord single adult shelter is almost completed, using CDBG funding to purchase the site. We have been awarded State EHAP funds to renovate the unused portion of this facility, to be-used as a 24-bed respite care shelter program for medically vulnerable homeless adults and seniors. Once renovation is completed, the multi-service center currently operating on Detroit Ave. in Concord will relocate to this site. This will create a one-stop shop that will include all of the services provided at a day center ie. Showers, food, laundry, transportation, case management, substance abuse assessments and referral, and housing assistance, along with the 24-bed respite care program and 75-bed adult shelter. In January, 2007,we began a new program, called Transitions Home, funded through SAMHSA/CSAT (federal), to provide dedicated AOD detox and treatment capacity to residents of the Richmond single adult shelter who seek assistance with their substance abuse and related issues. The funding also includes a sub-contract with Neighborhood House for the detox and treatment beds and a sub-contract with Rubicon to provide money management, employment counseling, and benefits assistance to the clients participating in this program. We are currently working with County Mental Health to open an 8-bed transitional housing program for homeless transition-age youth in Richmond, utilizing Prop. 63 funds. It is estimated that over 70% of the homeless transition-age youth that enter our system have a mental health disability and the mental health services will meet an identified need in the existing program. This will be an expansion of our existing homeless youth system of care, and in addition to the 6-bed homeless transitional youth program that operates in El Sobrante. Another Project Homeless Connect is being planned, to be held in Concord sometime in June, 2007. This is an opportunity for the community to join with service providers from County and other, in providing services in one location to homeless people, and illustrate that ending homelessness is a community-wide responsibility: After meeting with several City Managers to discuss issues related to homelessness and the work of the 10-Year Plan,Dr. Brunner and I will be attending a City Manager's meeting in June, 2007 to discuss the development of a partnership between County and Cities to work together in ending homelessness. Lastly, over the past few months, there have been discussions with the hospitals regarding discharge planning of homeless individuals into our shelter system, which occurs frequently. There is agreement to continue this dialogue and formalize this system, to reduce hospital stays of homeless patients that are ready for discharge and can be referred to a "lower" level of care (either the future respite care program and/or, the emergency shelter). Included in this discussion will be a request for financial support from the hospitals for their utilization of the shelters/respite care program for patients that they discharge. Timeline of Contra Costa County Coordinating Efforts to End Homelessness 1985 --- -1986: Concerned people in the county begin drafting, "A Plan for Dealing with Homelessness in Contra Costa County" --- -1987: The Task Force on Homelessness reports to the Board of Supervisors on Homelessness in Contra Costa County and includes Recommendations for Action --- -1991: A symposium is held to address homelessness in Contra Costa County --- 1994: Contra Costa County Board of Supervisors mandates that a comprehensive, integrated plan for homeless services must be developed for the County. In response, the Ad Hoc Homeless Task Force is created to coordinate a countywide planning process and write the county's first official Homeless Plan. --- --1997: The Board of Supervisors officially establishes the Homeless Continuum of Care Advisory Board(CoCB) under Board Order C.86 --- -1999: The CoCB meets to oversee the planning process, to review the original plan, and to update the 2001-2006 Contra Costa Continuum of Care Homeless Plan. --- --2000: Contra Costa County begins the process of developing a new five-year Homeless Continuum of Care Plan. The CoCB coordinates the planning process. --- --2001: The plan is adopted. The CoCB is the lead agency for the Continuum of Care Planning Process, reviewing accomplishments of the Five Year Plan and setting new objectives in response to changing circumstances. --- -2003: The CoCB adopts by-laws that include assuming all previous functions of the Contra Costa Homeless Advisory Committee and the new responsibilities under federal and state regulation of the Homeless Continuum of Care Boards. --- -2004: The Board of Supervisors approves Ending Homelessness in Ten Years:A County-wide Plan for the Communities of Contra Costa County. This plan embraces key concepts of the Five Year Plan but does not replace it. HIJIDWG, a newly formed group, is charged with the implementation of the Ten Year Plan provisions. This group begins meeting regularly. --- --2005 to present: On parallel tracks the CoCB and HIJIDWG continue to work towards ending homelessness, with similar issues and membership 2007 Contra Costa County Ten Year Plan: Highlights of Implementation Underway I. PRIORITY ONE: Help Homeless People(Re-)Gain Housing As Soon As Possible • New Paradigm Program Model: Basic Housing Assistance Center o Project Example: Multi-service centers in Contra Costa County are becoming Basic Housing Assistance Centers (BRAC). BHAC's aim to provide responsive services to individuals and families in need of support to retain housing during difficult times. Services include identifying housing problems, offering a flexible approach to housing, and providing support,counseling and other services that foster housing stability. Services BHAC's may provide include: emergency rental assistance;case management and wrap around services; housing search assistance; legal assistance;landlord mediation and tenant education; money management; and credit counseling. • New Paradigm Program Model: Interim Housing o Project Example: Contra Costa County's Interim Housing Facilities,which provide intensive case management services focused on connecting clients with appropriate permanent housing as quickly as possible, reducing average time spent in the facility, and increasing the number of clients that enter the facility. These facilities have embraced a new method of assessing people, and acting as gateway to a newly enriched service package and access to housing. • New Paradigm Program Model: Housing First o Project Example: Project Coming Home,which focuses on taking chronically homeless people directly off the streets and placing them in appropriate permanent supportive housing,bypassing Interim and Transitional housing, so clients can address whatever issues they need to address in the safety of their own homes. • New Paradigm Program Model: Countywide Affordable Housing Trust Fund o Project Example: Contra Costa County is pursuing an Affordable Housing Trust Fund. Successful Trust Funds include Miami-Dade County,where a regional Homeless Trust was established.To fund the trust, business leaders and the Miami-Dade County Commission successfully lobbied the State Legislature to permit the County to levy a 1%food and beverage tax at all restaurants that have a liquor license and gross more than $400,000 per year. With the necessary State enabling legislation in place, Dade County then passed a municipal ordinance enacting the tax. The Trust provides a dedicated source of funding for the County's homeless programs. (Fifteen percent of the tax proceeds go to domestic violence programs.) Funds are paid into the Homeless Trust,which is charged with overseeing the implementation of the Continuum of Care plan. • New Paradigm Program Model: "Mainstream Resources" by Funding supportive services with Medi-Cal billing o Project Example: Anka Behavioral Health in Contra Costa bills Medi-Cal for many of the services they provide to homeless clients. o Project Example: The three Contra Costa homeless health clinics bill for funds as Federally Qualified Health Centers, another Medi-Cal funding stream. II. PRIORITY TWO: Provide Integrated,Wraparound Services To Facilitate Long- Term Residential Stability • New Paradigm Program Model: Integrate services at the system level o Project Example: Project Coming Home is a multi-agency collaborative effort. to provide integrated outreach, treatment, housing, and support services to chronically homeless individuals. Service system integration means that partner agencies, which have previously worked completely separately, have developed the capacity to work together, sharing information about clients and coordinating in their service provision. PCH erases the artificial line between homeless and mainstream services so that people and information can move easily between programs, thus maximizing the likelihood of successful outcomes and ensuring that resources are used in the most cost-effective manner possible. This model has been in effect now for 4 years, and can begin to be the model for shifting how we work with additional populations. • New Paradigm Program Model: Integrate services at the client level o Project Example: HHISN provides supportive services for some Shelter Plus Care clients through two multi-disciplinary, mobile teams.These teams help clients meet immediate needs and link them to healthcare, residential treatment or housing. These teams are a mix of mainstream and homeless partner agencies.Team staffing includes a clinical director, supervisor,team leader, public health nurse,co-occurring disorder specialist,care coordinator, peer counselor, money manager, and veterans care coordinator.The services provided include assessments, services and referrals for primary health care, mental health and alcohol and other drug treatment, assistance in applying for health coverage and other benefits, peer support and advocacy. This model is the basis of the County's MHSA implementation, expanding beyond even just homeless people. • New Paradigm Program Model: Enhance homeless people's access to mainstream services o Project Example: SSI/SSDI Outreach, Access and Recovery,which provides training and technical assistance in increasing access to SSI/SSDI benefits by working with the SSA and training case managers to prepare complete applications for clients. There have been 3 efforts in this area: 1) PCH was successful in flagging cognitive disorders and getting homeless people on SSI; 2) HomeBase was funded to replicate this, and we now have the training materials prepared, are ready to meet with the SSA and DDS; and 3) Contra Costa has signed on to be a pilot community for the SOAR Initiative in California, and HomeBase is seeking foundation funds to implement. o Project Example: Contra Costa County's General Assistance office is working to implement strategies that would streamline and increase access to GA for homeless persons. III. PRIORITY THREE: Help People to Access Employment that Pays a "Housing Wage" • New Paradigm Program Model: Prioritize homeless people for employment assistance in One Stop Centers o Project Example: One stop centers provide employment,education, and training services all in one place. These centers also include partner programs such as Unemployment Insurance, Job Services,Vocational Education, Vocational Rehabilitation, and Youth programs. In early 2006, Rubicon developed agreements with EastBayWorks One-Stop operators to co-locate Rubicon project staff at One-Stop Centers in San Pablo, Concord and Antioch. Through this arrangement Rubicon facilitates increased access to One Stop services and resources for homeless participants, as well as offer outreach to WIA program participants who need additional services offered by Rubicon. In the first two months of this program,60 persons have been served. • New Paradigm Program Model: Targeted employment programs for homeless persons o Project Example: In the last year, approximately 350 homeless persons participated in Rubicon's workforce services in Contra Costa County.130 of these participants received support for transitional work in Rubicon businesses or subsidized work experience with community employers. Rubicon helped 115 homeless persons in Contra Costa County obtain employment and achieved a 13-week job retention rate of 55%. Anka Behavioral Health also began work on a landscaping training program and has signed a contract with the County Public Works Department to do this work with homeless individuals. IV. PRIORITY FOUR: Conduct Outreach to Link Chronically Homeless People with Housing, Treatment and Services • New Paradigm Program Model: Expand existing outreach capacity o Project Example: Project HOPE outreach teams operated by Anka. Team staffing includes a clinical director, public health nurse, co-occurring disorder specialist, care coordinator/case manager, peer outreach worker, and veterans outreach and care coordinator. The team offers clients their first choice of assistance, and sustains relationships over time to support transitions to needed care. The services provided includes assessments, services and referrals for primary health care, mental health and alcohol and other drug treatment; assistance in applying for health coverage and other benefits; peer support and advocacy to help access services and linkages with the veterans care system.The teams currently operate 8 hours/day, 5 days a week. They need to be expanded to provide 7 day/week, 24 hr/day coverage, and more teams to cover the entire county simultaneously. • New Paradigm Program Model: Enhance coordination between outreach teams and other providers o Project Example: The Forensic Team meetings bring together participants from law enforcement and the homeless, mental health and substance abuse sectors to case conference about clients being released from jail or who are in frequent contact with the criminal justice system. This model should be expanded to make HOPE the contact for city and County agencies, businesses and concerned individuals for questions and assistance in dealing with homeless people. V. PRIORITY FIVE: Prevent Homelessness from Occurring in the First Place • New Paradigm Program Model: Expand homelessness prevention services o Project Example: Eviction Prevention Team with linkages to Landlord-Tenant Court will educate both landlords and tenants about the rights and obligations of each in providing and maintaining affordable rental housing. This way unnecessary evictions can be prevented without the need for emergency cash assistance in instances where the tenant lacks such knowledge. The Team composition could include: Legal Aid,Tenant's Union/Advocates, Housing Authority, Consumer Credit, Landlords and Property Managers, and Homeless Service Providers. This idea is slated for Plan Implementation Years 5-7. Results of our Ten Year Plan Implementation: Our Transformed System We have gone from "Housing Ready" (predicates access to permanent housing on"graduating" from programs) to "Housing First" (stresses the immediate return to independent living): ✓In family housing, at SHELTER, Inc. o Seeing new (non-repeat) clients o Clients are being housed quickly o There are fewer repeat clients but more clients to serve ✓In emergency shelters, through converting them to interim housing facilities o Client stays are shorter. The goal is for people to be in interim housing for the absolute minimum of time necessary to access permanent housing. o Case management is more intensive o A Housing Specialist was hired to place clients into appropriate permanent housing quickly o As soon as a consumer walks through the door, staff work to address whatever the client needs to get housing,like an ID, credit counseling, etc. ✓In transitional housing, by converting Project Independence and THPP to permanent housing We are converting from multi-service centers to basic housing assistance centers: ✓Multi-service centers will support Basic Housing Assistance Centers o Multi-service centers will be one stop shops to resolve problems homeless people face o Services will include identifying housing problems, offering a flexible approach to housing, and providing support, counseling and other services ✓Care Coordinators at the BHACs work toward housing consumers from the moment that they walk in the door ✓A "Housing Specialist" training is in the planning stages, where current housing specialists will share information with case managers about resources that are available and skill development. ✓Staff do a Housing Assessment at intake, and create a Housing Plan for them to follow ✓There is a culture shift at the BHACs and staff are trained in the culture shift to begin thinking about housing all clients the minute they walk in the door Project Coming Home, our Signature Strategy, has morphed in the following ways,becoming mainstream and sustainable: ✓ Expanded to include HOPE Plus, which provides 1) additional multi- disciplinary outreach to engage clients and encourage homeless persons to access treatment and 2) additional dedicated residential detoxification beds, residential treatment beds, and day rehabilitative treatment. ✓ Expanded to include the Serial Inebriates Program, which funds 40 one- bedroom apartments to provide supportive housing assistance to chronically homeless persons who have been living on the streets and have a long-term addiction to alcohol. ✓ Components the Health, Housing and Integrated Services Network (HHISN) and HOPE Outreach team are used for the basis of the county's Mental Health Services Act Community Services and Supports Plan. ✓ Expanded to include Transitions Home, which provides intensive services and alcohol and other drug treatment to persons in the county Interim Housing Facilities and those who are discharged from jail, prison, and other institutions. We are increasing access to mainstream benefits for people who are homeless: ,/We have made a request for the SSI/SSDI Outreach, Access and Recovery (SOAR) Initiative to launch in Contra Costa County, which would increase access to these benefits for persons experiencing homelessness by working with the SSA office and generating first-time approval application packages. ,/We are developing a training on identifying cognitive disorders as SSI/SSDI eligibility when there is no other qualifying condition. ✓We are collaborating with the county General Assistance office to create a list of action steps to increase access and retention of GA for people experiencing homelessness. Our performance measurement tool is being accepted: ✓ Case managers from were trained on the use of the Matrix and have begun using it with their clients ✓ In using the matrix, our case managers are finding that the matrix: o Empowers the client o Helps create the client's case plan o Is helpful in case conferencing and staff meetings o Is helpful in prioritizing work with clients o Is useful in helping the client visualize his/her situation and choose a place to begin change o Proves that the supportive services do work o Highlights progress that is not shown elsewhere ✓ We are looking at linking the matrix into our HMIS, so that we can generate system-wide information about our progress We have quantified the cost of the housing we need: ✓ $150 million for acquisition/ rehabilitation of 1,000 units ($150,000 per unit) ✓ $240 million for new construction of 1,000 units ($240,000 per unit) ✓ $13.15 million for masterleasing of 1,000 units (rental assistance, maintenance, operations, and housing search) We are quantifying the cost of implementing other Plan components by next meeting Ten Year Plan Implementation: Key Convenings and New Resources Attracted June 2004: Contra Costa County Board of Supervisors adopts Ten Year Plan to End Homelessness. July 2004: Project Coming Home (Ten Year Pian Signature Strategy) is featured as a best practice in collaboration among homeless service providers at the federal HUD, HHS, and VA Chronic Homeless Initiative grantee meeting in Washington, DC. Oct. 2004: Ten Year Plan kick-off event, featuring invited speaker Phillip Mangano, Executive Director of the federal Interagency Council on Homelessness. The event included a keynote speech by Mr. Mangano, and numerous break-out sessions where over 200 nonprofit service providers, city and county staff, and business personnel brainstormed next steps in implementing the Ten Year Plan. One session was attended by all 5 Board Supervisors, all County Department Heads, and numerous city mayors and council members. It was at this session that the Homeless-Jurisdictional, Inter-Departmental Work Group (HIJIDWG) was created. Jan. 2005: Contra Costa implements its first street and shelter count of homeless persons, blanketing the county in the early morning hours to get an accurate count of the homeless in our community. 5,768 homeless persons were counted by more that 150 volunteers. May 2005: Project Coming Home (Ten Year Plan Signature Strategy) is again featured as a best practice in collaboration among homeless service providers at the federal Interagency Council on Homelessness Chronic Homeless Initiative grantee meeting in Washington, DC. Sept. 2005: County Health Services opens 3 new health clinics to bill as Federally Qualified Health Centers, a mainstream funding source through Medi-Cal. The clinics provide a range of health services, and staff a Benefits Counselor to help people apply for the mainstream benefits for which they are eligible. Oct. 2005: Project Coming Home (Ten Year Plan Signature Strategy), through Anka Behavioral Health, is awarded a highly-competitive 5-year, $2 million federal Substance Abuse and Mental Health Services Administration Treatment for Homeless grant. The grant, which finds the HOPE Plus portion of Project Coming Home, provides 1) multi-disciplinary outreach to engage clients and encourage homeless persons to access treatment and 2) dedicated residential detoxification beds, residential treatment beds, and day rehabilitative treatment. Oct. 2005: Project Coming Home (Ten Year Plan Signature Strategy), through COHP and Anka Behavioral Health, is awarded a highly competitive (11 awarded nationally), $1 million HUD Housing for Persons who are Homeless and Addicted to Alcohol grant. The grant funds 40 one-bedroom apartments to provide supportive housing assistance to chronically homeless persons who have been living on the streets and have a long-term addiction to alcohol. Nov. 2006: Project Coming Home (Ten Year Plan Signature Strategy), and its components the Health, Housing and Integrated Services Network (HHISN) and HOPE Outreach team are used for the basis of the county's Mental Health Services Act Community Services and Supports Plan. Oct. 2006: Project Coming Home (Ten Year Plan Signature Strategy), through COHP, is awarded an additional highly-competitive 5-year, $2 million federal Substance Abuse and Mental Health Services Administration Treatment for Homeless grant. The grant, which funds the Transitions Home portion of PCH, provides intensive services and alcohol and other drug treatment to persons in the county Interim Housing Facilities and those who are discharged from jail, prison, and other institutions. Dec. 2006: Contra Costa hosts its first countywide Project Homeless Connect, where 266 volunteers helped 509 homeless individuals access 17 different services, including health care, dental exams, alcohol and other drug treatment, shelter, food, clothing, massages and wheelchair repairs. Jan. 2007: Contra Costa implements it second count of homeless persons in the streets, encampments, and in shelters. 150 volunteers blanket the county in the early morning hours, and 4,444 homeless persons are counted. Summary of Outreach Activity 4,1-07 HDPE 2/1/02- 1( 90/39/03 PCH Engagements . f h a HDPE PClr'a Totals Male 2194 1539 3733 Female 696 707 1403 No info 1 4 5 Total 2891 2250 5141 LENGTH OF HOMELESSNESS i:ength of.,.'Homelessness F1Totals 0-6 months 450 458 908 7-11 months 63 67 130 1-5 years 651 1086 1737 > 5 years 222 422 644 No response 217 217 Total 1386 2250 3636 Age . " ' I `atsti w,HOPE ' PCH,, Totals under25 93 224 317 25-34 238 289 527 35-44 617 595 1212 45-54 541 672 1213 55 & Over 154 283 1 447 No response 187 187 Total 1653 2250 3903 CITY OF INITIAL CONTACT C',ty'of Initial Cotact `^`_ r� ,HOPE PCH:"' Totals Concord 855 691 1546 Richmond 585 641 1226 Antioch 314 249 563 Pittsburg353 65 418 Martinez 204 152 356 San Pablo 177 r4r4M 172 349 Bay Point 113r/ 83 196 F� Pacheco 70 43 113 Pleasant Hill 48 38 86 EI Cerrito 51 7 58 Clayton 42 3 45 Rodeo 17 14 31 Walnut Creek 5 31 36 Brentwood 17 11 28 Oakley 13 4 17 EI Sobrante 6 7 13 Pinole 8 8 16 Danville 2 61 8 Lafayette 4 21 6 Orinda 3 1 4 Bethel Island 3 1 4 Mora a 1 0 1 San Ramon 0 1 1 Other 020 20 Total 2891 2250 5141 Et rnd.ty . *`' HOPE P..CN. Totals Caucasian 1568 1246 2614 African American 870 725 1595 Hispanic 350 204 554 Native American 21 32 53 Asian American 11 24 35 Pacific Islander 8 9 17 Middle Eastern 5 1 6 Other 4 9 13 Total 2837 2250 5087 Education HOPE;). PCH_ Totals No Diploma 564 553 1117 HS Diploma 710 614 1324 GED 112 188 300 Some College 137 387 524 AA Degree 13 22 35 Bachelor's Degree 21 WIA 3758 Masters /Professional De ree 4 6 10 Tech /Vocational De ree 16 47 63 Refused 185 WA 132 317 No Response 1129 264 1393 Total 2891 2250 5141 t. For Contra Costa County, HS DiPloma figures include equivalency, i.e. GED Veterati;Status _ , r, OPE PCH, Totals Veteran` 196 254 450 Non Veteran 1197 1625 2822 Refused to answer 302 76 378 No Response 1196 295 1491 Total 1 2891 2250 5141 Veteran Vietnam Veterans 73 75 `i 8 Non-Vietnam Veterans 123 179 302 LI 5 0 D.isabimg Medica! Corattjon ;;PCH', : Tz;tlmis'Totals Medical Condition 488 269 757 Mental Disorder 440 293 733 Dev. Disability 53 37 90 ETON 995 496 1491 Dru s 993 485 1 1478 4549 Tx HmCs;"Totals Wages 122 95 217 GA 60 40 100 VA 30 15 45 SDI 12 7 19 SSDI 42 24 66 SSI 323 162 485 SSA 29 13 42 None 151 159 310 1284 Housing : *= 4 PCi� RM TzNmis'Totals Shelter Placement 423 468 891 Housin Assistance 44 38 82 973 Self Deterrnmaion � "w C3i Tx Hniss; Vocational Assistance 275 317 592 Benefits Assistance 27 28 55 ID 78 89 167 14 Emergency Seri:vices .r: f. 'PCN `'' Tx Hmis Medical 49 52 101 Substance Abuse 97 93 190 Mental Health 28 28 56 Basic Services 3853 1955 5808 6155 +. Y "rpZ�p41 ;`s'-rrtherSernces;,; x �:HR PCIY > Tx} miss Basic Services 3853 1955 5808 Monthly Shelters Report Report Run Date:5/1/07 Shelter(s):CCHP-Brookside Shelter(44);CCHP-Concord Shelter(43) Period Start:7/1/2006 12:00:00 AM Period End:4/30/2007 12:00:00 AM 1.Total Number Served= 1,076 total records 883 unduplicated (level 2-removes dup's looking at SSN and DOB) 2.Total New Intakes= 764 unduplicated (level 7-only removes dup's looking at re-entries/transfers 172 rollover Alameda County 24 3.14W Antioch 49' 6!41%' Antioch do not use 1' 0.13%: Bay Point 5; 0.65%'i Berkeley 4. 0.52%' Brentwood 4. 0.52% Clayton __.. 4.._.._.0.52%. Concord 130 17.02%; Concord do not use 1 0,13%1 Concord do not use2 1 0.13% Danville 1 0.13% Discovery Bay 1 0.13% EI Cerrito 1 0.13% EI Sobrante 3: 0.39% Hercules 2 0.26% Lafayette 3` 0.39%1 Marin County 22. 0.26%: Martinez 46 6.02W __ _....._.__.._. _......___...._—_._.-.... ...___..o.,. Napa County 2 0.26%. North Richmond 8; 1.05%, Oakland 1 0.13% Oakley 4 0.52%" Other County 21 2.75%. Other part of Contra Costa 11 1.44% Pacheco 1 0.13% Pinole 9 1.18%, Pittsburg 23'. 3.01%1 Pleasant Hill 16'; 2.09%; Richmond 266: 34.82%` San Francisco County 5 0.65% San Pablo 27 3.53% San Ramon 1 0.13% .__._..._....__..._.—..___ e • r r . _ ..° r. • c ,_F . Santa Clara County 1 0.13% Solano County 0. 0.00% Unknown 1: 0.13W Vallejo 1 0.13W Walnut Creek 17 2.23%: zzNull 67 8.77%, Total: 764' 100,00%.' White(HUD) 348 61' 45.55%; Black or African American(HUD) 331' 7 43.32/0 American Indian or Alaska Native(HUD) 47 151: 6.15%j Native Hawaiian or Other Pacific Islander(HUD) 7 9. 0.92%: American Indian or Alaska Native(HUD)and White(HUD) 7; 13 0.92% Asian(HUD) 6. 0 0.79% Black or African American(HUD)and White(HUD) 4 0 0.52%1 Native Hawaiian or Other Pacific Islander(HUD)and White(HUD) 3 4 q 0.39% White(HUD)and Native Hawaiian or Other Pacific Islander(HUD) 3: 1 0.39%i American Indian or Alaska Native(HUD)and Black or African American(HUI 2 0' 0.26%: American Indian or Alaska Native(HUD)and Native Hawaiian or Other Pacifi 1 6 0.13% Native Hawaiian or Other Pacific Islander(HUD)and Black or African Americ. 1 4 0.13% Asian(HUD)and Black or African American(HUD) 1, 0 0.13%, . _. ..._ _-.. ... -- _ Black or African American(HUD)and American Indian or Alaska Native(HUI, 1; 0 0.13%: White(HUD)and American Indian or Alaska Native(HUD) 1 0. 0.13%'. White(HUD)and Black or African American(HUD) 1; 0; 0.13%' Asian(HUD)and Native Hawaiian or Other Pacific Islander(HUD) 0 0 0.00%. Asian(HUD)and White(HUD) 0, 0 0.00%j Total 764, 266i 100.0M 1 Antioch 30 0 5 0 14 0 2 Concord 72 12' 6 0 39 1 '3 Pittsburg 14 0 0. 0; 9 0 4 Walnut Creek 8 2 2 0: 5 0 5 Urban County 91 5 11 0' 42 0; 6 Richmond 123, 22 37, 0! 92� 0' 7 Outside Contra Costa 26 3 6. 0' 20: 0 Null 33 1 5 1 27 0 Female 257.: 33.64%; Male 507 66.36%' Transgender 0, 0.00/0; 0 Total 764; 100.00% 3.Total Discharged During Period= 888 (cannot be de-duplicated) Alameda County 26 2.93% Antioch 57 6.42% o. Antioch do not use 0; 0.00%. Bay Point 6, 0.68%I Berkeley 5 0.56%: Brentwood 2 0.23%; Clayton 4:. .... ._.0.45%. Concord 164: 16.47% Concord do not use 1 0.11% Concord do not use2 1 0.11 Danville 1 0.11% Discovery Bay 1 EI Cerrito 3, 0.34% EI Sobrante 4 0.45%° Hercules 2.. .. 0.23% Lafayette 3. 0.34% Marin County 0 0.00% Martinez 48! 5.41% Napa County 0 0.00%; North Richmond 9 1.01% Null66' 7.43W ...... ...... __.._.. Oakland 0: 0.00%, Oakley 51 0.56% Other County 30, 3.38% Other part of Contra Costa 12, 1.35% Pacheco 2 0.23% Pinole 11 1.24% Pittsburg 20 2.25% Pleasant Hill 18' 2.03% Richmond 326 36.71% San Francisco County 6 0.68% San Pablo 33. 3.72% San Ramon 1 0.11% Santa Clara County Solano County 1 0.11%. Unknown Vallejo 1 0.11 Walnut Creek 17 1.91% Total: 888 100.00% White(HUD) 406 61, 45.72% Black or African American (HUD) 372 7 41.89% American Indian or Alaska Native(HUD) 53. 151 5.97% Native Hawaiian or Other Pacific Islander(HUD) 13 9 1.46%. American Indian or Alaska Native(HUD)and White(HUD) 9� 13 1.01% Asian(HUD) 9, 0 1.01% White (HUD)and Native Hawaiian or Other Pacific Islander(HUD) 5' 1 0.56%; Native Hawaiian or Other Pacific Islander(HUD)and White(HUD) 4 4 0.45%. Black or African American(HUD)and White(HUD) 4; 0. 0.45% American Indian or Alaska Native(HUD)and Native Hawaiian or Other Pacific: 3. 6' 0.34%' American Indian or Alaska Native(HUD)and Black or African American(HUD).' 3' 0 White(HUD)and Black or African American(HUD) 2. 0' 0.23%: Native Hawaiian or Other Pacific Islander(HUD)and Black or African Americar'. 1 4 0.11% Asian (HUD)and Native Hawaiian or Other Pacific Islander(HUD) 1. 0' 0.11% Asian (HUD)and White(HUD) .1. op 011_%., Black or African American(HUD)and American Indian or Alaska Native(HUD). 1' 0: 0.11%. White(HUD)and American Indian or Alaska Native(HUD) Asian (HUD)and Black or African American(HUD) 0 — 0 0.00% Total:..... 888 _._ ..._...256: 100.00% ME 1 Antioch 36 0 5 0 16, -0 2 Concord 89 16 7 0. 52; 0. 3 Pittsburg 14 0: 0. 0 6. 0 4 Walnut Creek 8 1 2 0 6 0 5 Urban County 93; 8 121 0. 51, 1 6 Richmond 153. 27 43 0 112 0 7 Outside Contra Costa 31 6; 6 Oi 2V 0 Null 33. 4 1 1 25 0 r , - Female 293' 33.00% Male 594 66.89%, Transgender 1 0,11% Total: 888 100.00% Unknown/Disappeared 221. 24.92W Left for housing opp.before completing program 190 21.42% Non-compliance with program 134 15.11% Reached maximum time allowed 106 11.95% Completed program 92 10.37% Other 69 7.78%, Disagreement with rules/persons 54. 6.09% Needs could not be met 17 1.92%, Criminal activity/violence 4 0.45%, Death 1 0.11% Total: 888 100.00% Don't know 360 40.54% Emergency shelter 72 8.11% Hospital(non-psychiatric) 12 1.35% Hotel/motel without emergency shelter 8 0.90%: Jail,Prisonfjuvenite detention 8; 0.90%, Other 18. 2.03/o Own house/apartment50'. 5.63% _._ -- _-._ .....__. .. ....__. .._ ... Permanent housing for formerly homeless(S+C,SF 7. 0.79%; Places not meant for habitation 7 0.79%1 Psychiatric hospital/facility 5. 0.56%; Rental room/house/apartment 77. 8.67%' Staying in a family members room/apartment 70 7.88% Staying in a friend's room/apartment/house 143 16.10% Substance abuse treatment/detox center 35 3.94% Transitional housing for homeless 16' 1.80%, Total: 888, 100.00% No 435 49.04%, Yes 453: 51.07% Total: 888 100.00% -- --------_ Homeless Hotline Report Period:7/1/20D6 12:00:00 AM to 4/30/2007 12:00:00 AM Report Run Date:5/1/07 Total Calls: 6,608 Unique Clients: 1,770 (based on client's reported name, DOB, and social security number) Antioch 476 Black or African American(HUD) 2,974 Antioch do not use 65 White(HUD) 2,927 Bay Point 195 American Indian or Alaska Native(HUD) 586, Bethel Island 18 Native Hawaiian or Other Pacific Islander(HUD) 49. Brentwood 38 zzNuil 49 Clayton 8 Asian(HUD) 23, Concord 1,650, Total: 6,608. Concord do not use 3 Concord donot use2 78 -. . _...._ --... - .-- 'Hispanic/Latino 5381 Crockett3 _. _.. _...... __ ;Other(Non-Hispanic/Latino) 6,017 Danville 5. ___ .._.__..._ .._._. __. .. -zzNull 53`; Danville do not use 1 _. .. __._. . _.r _ _.. .....__ . _._...._._- .....,_ _ . ,,.____-... Total:; 6,608; EI Cerrito do not use 2 EI Sobrante 14 Female 1,892; Hercules14' Mate 4,666'.._ ..-. , ...._..__..__.._..._—....__..... ........ ..._..._..._.__._....._._.__..._..__.... Knightsen 2 Transgender 1 . Lafayette 25 Unknown 1, Marin County 4 zzNull 48 Martinez 446 Total: 6,608 Monterey County 1 Moraga4 _ _.. ... 18-21 ; 126;. Oakland 5' -- ---- 22-34 22 34 1003' Oakley 36' _.,. 35-44 ; 1,964 Orinda 10, _.. 45-593,107 Other part of Contra Costa 7B _._.._... _..._... _.... . ... . ... . .. .... - 60+ . 270 Outside Contra Costa 567 _ under 189 Pacheco 23: _......_. .;.. ._.- zzNull 129. Pinole 19, Total:; 6,608 Pittsburg 316, Pleasant Hill 83 „ = Pleasant Hi112 5 Self 5,953' Richdmond 4 Pro-Hope 222 Richmond 1,785 RelatIve/Friend 138' Richmond2 145 Hospital 111. Richmondd 17 ;Other 67; Rodeo 24 Phoenix MSC 29 San Mateo County 7 PDlioe/Sheriff 26 San Pablo 225 zzNuII 21 San Pablo do not use 17 Rubicon Programs 20 San Ramon 47 ;GRIP 6 Santa Clara County 2' (Health Services 6 Sonoma County 1 Parole 4 Unknow_n 4 Shelter,Inc. 4, Vallejo 7 Unknown 1 Walnut Creek 88 Total: 6,608. zzNull 34. Total: 6,608 Contra Costa Regional Medical Center 19 Doctors Hospital L Abandoned Building 40 .John Muir Mount Diablo(Concord) 8 Car or Other Vehicle 153 Kaiser 2 Dont Know(HUD) 6 Other Hospital 1 Emergency Shelter(HUD) 881 San Ramon Regional Hospital 2 Hospital(HUD) 109 Sutter Delta 9 Hotel/Motel without emergency shelter(HUD) 49 zzNot referrred by hospital 6,566 Jail,Prison or Juvenile Facility (HUD) 7; Total 6,608 Living With Family(HUD) 216 Living With Friends(HUD) 375` Provided Emotional Support 21, Nursing Home(HUD 40118) .2 __ _ .. ...... Provided Wait Information5,654 On the Street(HUD 40118) 421. Other(HUD) 167 "Referred to Calli Annex 48 Referred to Concord Shelter 420 Own House/Apartment(HUD) 40 _... ._.. _.. . . .. 'Referred to Richmond Shelter 417, Permanent Housing for Formerly Homeless(HUD) 6; :Unknown 2 Place not meant for habitation(HUD) 1 1161 zzNull - —' .... . ..46,. Psychiatric Hospital or Facile HUD 5, ... . . .. _... _ . Y .. ._ .. ..P. ... .._ �. _..� Total:. 6,608. Refused(HUD) Rental House/Apartment(HUD) 12 Rental House/Apartment(HUD) 3' Substance Abuse Treatment Center(HUD) 92 Transitional Housing for Homeless(HUD) 47 zzNull 2,649 Total: 6,608 Contra Costa Regional Medical Center 64 Doctors Hospital 14 John Muir Mount Diablo(Concord) 20: John Muir Walnut Creek 11; Kaiser 13; Other Hospital 20'. San Ramon Regional Hospital 2 Sutter Delta 19 Unknown 15 zzNot referred by hospital 6,430 Total: 6,608 Total Discharged to Shelter= 885 Antioch 71. American Indian or Alaska Native(HUD) 72 Antioch do not use 7 Asian(HUD) 8 Bay Point 11 Black or African American(HUD) 392` Bethel Island 1 Native Hawaiian or Other Pacific Islander(HUD) 7 Brentwood 5' Whde(HUD) 404; _.... . ... . . ......... ._-._ Clayton 1' zzNull 2 Concord 171, Total: 885: Concord do not use 0, - - Concord do not use2 20 HispanicJLatino 72: Crockett D _ .-..... __ .. ._. .. . .. ._-..._ .... . Danville 2 Other(Non-Hispanic/Latino) 809: zzNull4 Danville do not use 1 _ .. . ...__ .. . .._-. . ...-... _. Total• 685; ElCerrito 1 --._-__._... . __..._._.. ..__._.. ...._._. .---_._,...._ ._.. _.._. EI Cerrito do not use 0 EI Sobrante 1: :Female 325 Hercules 1 Male 558' Knightsen 0 Transgender 0 Lafayette 3 Unknown 0: Marin County 2 zzNull 2: Martinez 79 Total: 885 Monterey County 0 Moraga 0, _ 18-2148 Oakland 0 '22 34 151: Oakley 4. 135-44 198; Orinda 1, .. 45-59411, Other part of Contra Costa 9 _.-._...._ 6D+ 63 Outside Contra Costa 60 "'`' ' under 18 Si Pacheco ..- ..4 -—.___.—_... _.. ...__ _.......... . .. .. ........._. ---... .. =Null9 Pinole 3 Totat:, 885. Pittsburg 3D: Pleasant Hill 11 Pleasant Hi1I2 1 GRIP 6 Richdmond 2. Health Services 3 Richmond 282 Hospital 83 Richmond2 26 Other 37: Richmondd 1 Parole 4 Rodeo 2 Phoenix MSC 23 San Mateo County 1 Police/Sheriff 13 San Pablo 34 Pro-Hope 209 San Pablo do not use 1 'Relative/Friend 9 San Ramon 6 Rubicon Programs 8 Santa Clara County 0. Self 488' Sonoma County 1 Shelter,Inc. 0 Iffiaml ORION Unknown 1: +Unknown 1` Vallejo0 zzNull 1 :.. _ . _ Walnut Creek 19 Total 885 zzNull 9. . .. .Total B85 •.• - Contra Costa Regional Medical Center 14. Doctors Hospital 1 Abandoned Building 0 John Muir Mount Diablo(Concord) 7 Car or Other Vehicle 2 Kaiser 1 Don't Know(HUD) 2 Other Hospital 1 Emergency Shelter(HUD) 124 San Ramon Regional Hospital 2 Hospital(HUD) 40 Sutter Delta 3 Hotei/Motel without emergency shelter(HUD) 15 zzNot referred by hospital 856: Jail,Prison or Juvenile Facility (HUD) 2 Total 865. Living With Family(HUD) 53 Living With Friends(HUD) 88 Nursing Home(HUD 40118) 1 On the Street(HUD 401 18) 58 Other(HUD) 28, Own House/Apartment(HUD) 7 Permanent Housing for Formerly Homeless(HUD) 0 Place not meant for habitation(HUD) 254. Psychiatric Hospital or Facility(HUD) 4 Refused(HUD) 1 Rental House/Apartment(HUD) 7 Rental House/Apartment(HUD) 0 Substance Abuse Treatment Center(HUD) 19 Transitional Housing for Homeless(HUD) 6 zzNull 174' Total: 885: Contra Costa Regional Medical Center 42 Doctors Hospital 5' John Muir Mount Diablo(Concord) 10. John Muir Walnut Creek 6 Kaiser 8 Other Hospital 11 San Ramon Regional Hospital 2: Sutter Delta 11 Unknown 5 zzNot referred by hospital 785. Total: 885 0 N0I", !n00V' ~T CO O N t'�+ ,� lCOICOIC)IN V 0 N Q n U c ° z M VN OQ r N NC3 "+N z�) N d~ N O y � � N = oF pvcliIq V- CL fi Ugn! co C? 0 N Y N N Cl CD N � O 6 O O N C r N OBD rz rr. r� L V Q) U � vN `rLO f— w`� OJz- •- •- �- w c4 a.+ �t6 !.r Er N F C eN- co N N N Mtl' 117 !D N Q Wa o a Co o a 0 0 0 0 0 0 r N N N N N N ay7a004 /sy . § / c \ t--qr 7 � S2 $ Rc2 � QQJ U & a s 0 8eoe ® y k ƒ�N 2 2 \ g C-4 CIJ \ % � \ mGT- cov § 2a § 2 %» ƒ 3 3 a \ 0) � k / \ ® \ C � k _ � � k � \ k \ \ ° \ ° k co rl- IC—,) $ aT / © m2 \ Qo / mR / � Ce) a $ y $ a 7 C* 2 co c 9 m © } a ? � m £ § m § 4 / co to n % 7 mm e seam § \ � § / 22 � � = c2 \ � � 42R / ƒ C @a ƒ @ $ ( y \ \) ° � kmmam@ / R \ § \ � G § 22 § J CQ to \ \ � � 2 & ¥ 7q § £ $ / ƒ ° n e E / a ¥ ( k E 0 0 0 ID z Q 2 c k ® LO q> ■ , { B c § 2 > 6 ) G A Project Homeless Connect Demographics Report Run Date: 1126/07 Provider(s): Project Homeless Connect(57) Period Start 12/7/20D6 Period End: 1/26/20D7 12:00:00 AM 1.Total Number Served= 498 unduplicated 2 Total Clients Identified !clients.,at were already in HMIS 161 36 35°/d Newly ldentifie IA"eless�Cirents- -31.7" 6365% Totat:I 498=,' 100.00%� 3.Client Living Situation Alameda County 9E 1 81"10 iAntioch 25i 5.02% Bay:Point Concord 471 9.44% IEi Ceirito - 21 D-00"lo ElSobrante 8= 1.61% Werc les. _ 2 0.40%. (Lafayette 0.20% Martinez ..4.i U.B0%o. North Richmond 0ther'Couhty 1.66y° Pacheco 0.200/1� )Pini a 7j 1.4.t°L Pittsburg ~� 41 0.80% (Pleasant Hill 6; 1 20% IRichmand 3161 63.45% San:F�ncisco:County 2j D.40"/. {San Pablo 331 6.63% ;zzNot Given eta 0.80.% Total: 41 100.00°k Don'tKnow,(HUD) 3�. 0.60% )E em rgency Shelter(HUD) j 117; 23.49% 11-lospiita) (HUD) )Hotel/Motel without emergency shelter(HUD) 41 0.80% Living With Family(HUD) �� �j 53; ���10:646h 5!srvFce>'ro4.°x r_o:re C°.rn�^KH*'4�.R!5 Livinq With Friends(HUD) 69 1 13.86% en the Street(HUD 40118) _ 2 0.409/6 #Other(HUD) _ 371 s 7.4_3% IOwn House/Apartment(HUD) _^��- 10. ,^ 2.01 !Permanent Housing for Formerly Homeless(HUD-1 121 2.41%1 iP(ace:not heantforhabitation(HUD) _ 711 14.26% Psych€atric Hospital or Facility(HUD) — 3' � 0.60%3 €Refused.(HUD) - 2; 0.40 €f2ental House/Apartment(HUD)__ 803 _ 16.06% Substa3 nce Abuse Treatment Center(HUD) jTransitional Housing for Homeless(HUD) j 221 _ 4.42% 3izNotGiven 31^ 0:6Q% Total:j 4981 100.00% 4.Client Demographics - -- --j--M ... ---- _ _ -WN• • . r • !American Indian or Alaska Native(HUD) 17( 5 3.41% American Indian or Alaska Native(HUD)and White€ 0 0.20% Asian(HUD) 4 D D.BO°lo IAsian� (HUD)and Native Hawaiian or Other Pacific 1 0l 0.20% !Black or African American(HUD) ! 271; 4 54 42%r Native Hawaiian or Other Pacific Islander(HUD) 7� 01 1 41% J.White(HUD) _...__._ 136.3 1D zzNot Given u - 61 +^ 45 12.25% Total: _-- 498y _^4 100.00% iNo(HUD) 329 66`DB% Yes(HUD 40 8.03% 2NDt Given_ 3293 _ Total: 4981 100.00% Female 2133 42.77% ,Male •-" _____-_ ._ .._�_._._ _.��. 2751 55.22% Transgender - 1i 0.20%. zzNull 91 1.81% 100.00"h( Swtcn�t v4 3`-Co•:zza Cnrtz Cninm+idYi".5 ;under 16 81 1.61%E 11625 � 32 — 6—.43% t26-35 701 14.D6% ...-... _ `365 J 1441 28.92% €46-55 1571 31.53%1 :56-65 681 13.65% ;over 65 ° 191 3.82% _.... _. 1 Total:1 4981 1 DD.DD%1 i� 1 t a r. lFamilV vnth Children Family without Children y�~ 301 6.02°/r L,npie Null 12 2.41% Total:l 498 100.00°� ra a J £. S"lr LL C-f wj �k t. 80VZ = P91111UaPI ss31awoH �PW911 14S„ j.o aagwnN 'paymdar fou yursnoy agyoddns juaueuuad• 1,E 91, £ZL ESZ 69 0 ,SuLsnOH jeualisue.)l .r. i �T.'k: 14+r..-^= f 4.:E�,".s"�ik<, a--fir•;�Z"'ra.n� r�F 1 9L LL1, 1,6 OZ£ ZS £ jalua:)a:gAjaspjnW '.0 : _ !Yf s 2 D,� _ "' V%' Y+ awaurlike� r�1rt123 lRlu?FH.. P 0 Z LL £L 0 vaP!AO-Id )'PaW r p f`�}ti 0 i uay� dnui56pdo� E 99E Z9 69Z 1,£ s SuisnOH f,)ua5Jaur3 Ean • . .._ .. ..-- 'JP3 pn `»AF V L 16 O£ 9ZL 6Z LZ luaugeall Srua/1040:)Iy ••••_••—••—!pny, wippV]manes mm v!pwy sa!purti W�PINJ pajmdwoveun WP.NPW ul uaipl!VJ u!sfenpu Nl Mi-uM.-A -Iww:� mesas to a I Sheltered -5` OiG b b c 'n a ar;y a A �^I c ¢�— E CADN9 U RbN O dMO..�v O `OG M=M ." QucC G C A., r L �, m b O•".E u_. � O N�c 0 b 9 R L N O O O U c V C �� .n _ d q a G w 9 A R.c O n A E C � R b N A V c u C O b G�L J O. 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OI y °1L°°`L „�sy ="yG yr'V me r"k� oou"� 0 h o ocwc" y n b0 Eno ubi W A� OE3, bE �' EE o"DL1,;'c � L O A W O O N L a L b N y aR L E d i U.A. c L r m m L L N tV E L b RC �b po io u` icy mG� o E esu uycC>m yR�� v+: c Aa y!_La _bEc�=L E _ � w°i�Nb�Jo� �Xn.. > > `b E �+aco E m aEi z 10 E .. u' .= u A o FL- o is ey yL P=!~f u ro.o c uGi m n O.Eb y_ O d S U >L E V L 0 L n O E 0 v G N d f U Y 3 , il l■ l 1� t"�- `"`sty��Y��YYt+L�I"•,(!''1�4b°�'S' `-1.'_v..pr�nr"pA�t.��' f-*� r�F�. ,5T fit'.�-'"��°n�y� !'++, i!"" `kZ`at"�-t�" '�3?bESx"�lr�u�s-"'mix i !i r Se K s,F,.,-r .�"c�7c"'¢p"-"��s ��• P : a rr �'r• •C't t.,.o.+tT J}�� fa ��'�,�!D'pEgr��-t z jl/f ;� �w-s.,nf'"ai,�c ! yf�Z'1'!E+F*^r.+ �I -r4'&'--�.-��'y`a.�c—�--,'--��c•C t. �, +�L ""� '+ $<S w.1"' +,.^3. a. ��1.5'•r�� s*--r-_ .1 '�`°"y/'=!�� c.-'�5^*�vR7:-r�xckT �fi r� •�.+1 a: key,. '�„E..x..�r'_Js�7s-�^4+�'s. �C, r r�(�'d'-4s '� j+--trJ�"�`fa�`°'�`^�r>Y,xrsa* Y s `-mol Referral #5 CONTRA COSTA HEALTH SERVICES DEPARTMENT CONTRA COSTA COUNTY TO: Family and Human Services Committee DATE: May 7, 2007 Federal Glover, Chair Susan Bonilla, Member FROM: Andrea DuBrow, Project Director, Health Care for the Homeless SUBJECT: Health Care for the Homeless Semi-Annual Report Recommendations 1. Accept this report from the Health Services Department; and 2. Forward this report to the Board of Supervisors for acceptance; and 3. Direct staff to continue to report on a semi-annual basis to the FHS Committee regarding progress and status of the Health Care for the Homeless Program. Background The Health Care for the Homeless (HCH) Project has been operated by Contra Costa Health Services since 1990 as an essential component of the CCHS health care delivery system. The HCH Project provides health care services to the homeless population through: mobile clinics, CCHS integrated ambulatory system of care, CCHS Departments of Mental Health and Alcohol and Other Drugs. The mobile clinic services are provided via two part-time large vehicular Mobile Clinics (one vehicle is County-owned, and one is contracted with John Muir Health, Inc.) and a full-time County-owned pharmaceutical mini-bus. Primary health care services provided by the HCH Mobile Team include routine physical assessments, basic treatment of primary health problems such as minor wounds and skin conditions, respiratory problems, TB, acute communicable diseases and referrals for follow up treatment of other identified health care needs. The mobile team is comprised of a Medical Director, four part-time Family Nurse Practitioners, two Public Health Nurses, a Community Health Worker, a Financial Counselor, a Mental Health Specialist, a Substance Abuse Counselor and an administrative assistant. All staff, under the supervision of the Project Director and the HCH Clinic Manager, carry out the support services component of the HCH Team. Homeless patients who receive care on one of the mobile clinics are referred into: one of the ten CCHS ambulatory care health centers for primary and Health Care for the Homeless Report to FHS Committee 1 specialty care; County mental health and substance abuse services; and to Contra Costa Regional Medical Center for emergency, inpatient hospital, outpatient surgeries, laboratory and radiology services. There are currently three ambulatory care clinics, located throughout the County, designated specifically for homeless patients to help them transition from the mobile clinic setting into the ambulatory care system. HCH staff members are present at each of these clinics. During 2006, CCHS treated 8,728 homeless patients who generated 76,211 encounters. Please see the attached presentation for additional outcomes data. Governance of Health Care for the Homeless Activities As this committee may recall, Contra Costa Health Services is a recipient of the Public Health Services Act Section 330(h) Health Care for the Homeless funds, and as such, it must meet governance requirements set forth by the Health Resources and Services Administration's Bureau of Primary Health Care. The current governing body for HCH is the County Board of Supervisors, with input from the Homeless Continuum of Care Advisory (COCB) Board. The COCB includes active users of the Health Centers and strives to reflect the ethnic, cultural, gender and geographic characteristics of the populations that use the Centers. The COCB is charged with making recommendations on how service delivery can be made more responsive to the needs of the homeless community. The COCB meets at least 10 times per year and provides formal, written reports that are submitted to the Board of Supervisors at least twice per year. In addition, a Homeless Consumer Advisory Board made up solely of consumers meets monthly with the Health Care for the Homeless Project Director, Chair of the Advisory Board, and staff from the Contra Costa Health Services Office of Homeless Programs. This Consumer Board provides a monthly report to the COCB. Other activities.to ensure consumer input include patient focus groups conducted six times per year and patient satisfaction surveys conducted routinely, reviewed biweekly, and reported back to service providers and program managers monthly. Health Care for the Homeless Report to FHS Committee 2 r ealth Care for the Homeless Contra Costa Health Services Presentation to the Family & Human Services Committee, Contra Costa County Board of Supervisors May 7, 2407 x , Andrea DuBrow, MSW, MPH Administrative Manager Kate Schwertscharf, PHN Nurse Program Manager 1 . .. ......-............. Overview of Presentation *Overview of the homeless population *What we do *Who we serve *)Where we provide services *Consumer involvement *Challenges Homeless Population in CCC 4gpF *There are an estimated 15,000 homeless in Contra Costa County *A January 2007 one day, one point in time count of homeless population found: — 1,749 homeless in encampments or on the streets s — 2,408 homeless in shelters, transitional housing, receiving services 2 m _d Number of Patients in 2006 #8,728 unduplicated homeless patients were seen in the CCHS system of care *Those patients had 76,211 encounters K$� 3 � throughout the CCHS system of care hF ........-...........:........................ _.._...........................-........... ................................................. -.-...................._.__....-........... Ni Who qualifies as "Homeless? " *All homeless,people in Contra Costa " County — Lacking a fixed, regular, adequate nighttime residence, and — Primary nighttime residence in a shelter, welfare hotel, transitional housing — "Doubled-up" without name on a lease, couch surfing, etc. 3 Funding for HCH Services *Section 330(h) Public Health Services Act — Health Care for the Homeless grant from the Federal Government (BPHC/HRSA) — approx. $330K *County funds cover remainder of medical costs each year �c k:': Health Fare for the Homeless Services #Mobile Clinic offers: — routine physical assessments — basic treatment of primary health problems such as minor wounds and skin conditions Y — treatment for respiratory problems — TB testing — acute communicable disease treatment — referrals for follow up treatment — substance abuse and mental health services vv 4 Mobile Clinic Locations # Adult Emergency Shelters * Keller House, Concord Concord& Richmond # Monument Corridor, Calli House (youth), Concord Richmond # Home Depot Shopping # Bay Area Rescue Mission Center, El Cerrito Family& Men's Shelters # Ambrose Community # GRIP Souper Center & Center, Baypoint nv Family Shelter, Richmond # Salvation Army, Antioch # Love-A-Child, Baypoint # Winter Nights Interfaith AOD Treatment Facilities- Shelter, Central &East Ozanam, Wollam, DVR, County Fareuso/Holloman Ambulatory Care, Specialty, and Hospital Services — 3 ambulatory care clinics specifically for homeless patients at Richmond, Concord,Antioch — Family practice care — Specialty care — Outpatient surgery — Emergency Department — Inpatient care — Laboratory — Radiology — Pharmacy mni N, 5 Ambulatory Care Clinics Specialized appointment system: — Bypass waiting times on the main CCHS appointment line — Bypass fmancial counseling process — Make the process more "user friendly" for homeless patients . " Ambulatory Care Clinics *Continuity of care: same medical providers on the mobile clinics and in the Health Centers " *Bilingual English/Spanish fmancial counselor 6 Mental Health Services *Mental Health Treatment Specialist provides screenings, assessments, referrals into the Mental Health system for 46 medication and treatment of clients in the ATF shelters and at other mobile clinic sites Ls it _...-__...._.......-..-.......-.-. Alcohol and Other Drug Services 1 #Substance Abuse Treatment Specialist provides screenings, referrals, and coordination of detox and recovery services specifically for homeless patients in shelters and other mobile clinic sites r , Patient Demographics 2006 v . 5x #58% male #42% female *26% of homeless patients are completely uninsured #All of our patients at 100% of the Federal Poverty Level and below. x r Race/Ethnicity in, 2006 Race/Ethnicity Percentage White 40% FEspanic/Latino 21% Black/African American 29% Asian/Pacific Islander 3% American' Indian/Alaskan 1% ` Native Unknown 7% 8 Which Supervisor Districts are x F Patients-From? - I- Supervisor Gioia 27% lI- Supervisor Uilkema 10% III- Supervisor Piepho 2% IV- Supervisor Bonilla 17% V- Supervisor Glover 23% Unknown 121% ........._...._._..._................. Strong Consumer Involvement *Consumer advisory board meets at least monthly in two areas of the County. *Consumers provide valuable input into the n needs of the homeless population: access � .� to services, types of services, areas for improvement 9 x x is r Challenges s i[^ *Lack of capacity to meet all health care i 4 needs of the homeless *Dental services are insufficient countywide Meeting Challenges r *Likely to receive additional federal funds to expand primary care services to more homeless patients *Hopeful that the new Health Care Coverage Initiative will reach additional uninsured homeless individuals. 10