Tuolumne County Behavioral Health Housing Projects 2016 Updates Making It Work Small County Optimizing Housing Opportunities

Tuolumne County Population estimated in 2014 = 53,831 Persons under 18 comprise on 21% of the population. Persons over 65 are approximately 24% of the population. Caucasian representation is 91%.

Why housing? Tuolumne County’s point in time census in Jan of 2016 showed 166 unsheltered homeless individuals – and 98 sheltered homeless. Various statistics nationally vary, but overall the conclusion has been that approximately 1/3 of homeless persons are likely to suffer from a severe mental illness. This would equate to around 80 persons in Tuolumne County if the figures remain true. This is not inclusive of “couch surfers” – often a younger population of which last count was 110 in 2013 One last thing: the #1 characteristic of rural homeless is  -- THEY HIDE. As per the the local community organization, “We’re probably getting less than 30% of the actual total of homeless persons in Tuolumne County.”

Other Challenges and Needs for housing: Tuolumne County has a history of high numbers of LPS Conservatorships. 2004 : 32 2008 : 34 2010 : 27 (With housing – 2015 – 14 persons in placements) The only Board and Care in County, closed in 2010 – thus no transitional opportunities from institutional care settings were available in by 2010.

In Tuolumne County, with a population of around 58,000: Need for Change: In Tuolumne County, with a population of around 58,000: The need for change was and continues to be critical to: Support moves to lower levels of care Lower number of people on LPS Conservatorships or considered for such Identify/develop local housing options for persons to return to the community and remain Provide opportunities to maintain stability Reduce inappropriate use of the emergency department Reduce number of hospitalizations Reduce incarceration that is driven by offences that are potentially precipitated or exacerbated by symptoms of mental illness

Status and Development Aug. 2010 – The first project begins, to develop local housing Cabrini House – private Board & Care that was pending closure – TCBHD rents the building from owners. October 2012 – County purchase of “Washington St House” through CalHFA for supportive housing – owned and operated by Tuolumne Cty. Use of CSS funds for General Service Development to purchase Cabrini House (also County owned and operated). 2010-current – 2 Houses rented and multiple apartments with supplemental funding and FSP. 2015 – Joint application with TCBH, ATCAA and CIBHS for Centene rural healthcare grant to provide SOAR to persons with history of incarceration and mental illness including transitional housing owned by ATCAA and case managed through BH with Probation support – up to 7 persons at a time.

The Journey Continues Established the first Housing project through support and guidance from CalHFA and CSH with Tuolumne County as developer, owner and operator and duplicated in 2nd housing plan. Utilized a 24 hour support system and safety center (CAIP – Crisis, Access, Intervention Program) Walk in clinic 24 hours a day/365 days a year Follow-up contact coordination with primary teams Strengthening and developing other supports Immediate assignment of FSP with full array of service including a nurse care manager Engage Social Services for development of a PCAP and IHSS support system for person returning home And critical to success: Two peer drop-in centers with varying opportunities and resources.

Status 2016 Services and processes are incorporated into standard operations and philosophy Continuum of care including multi-disciplines and agencies Ongoing support coordinated through formal and informal service systems Lowest level of care needed Newest developments: Establishment of a Peer Specialist role in life and skills coaching and mentoring in housing programs. Establishment of a SOAR advocate teamed with a Peer Specialist to improve outcomes of SS application.

. . . Does it Work? We still have a long way to go, but the journey thus far has been worth every step. Through Behavioral Health there are currently 24 rented or owned supported living opportunities in Tuolumne County most of which are preparing persons to move into independent housing. The Enrichment Center