Health Care of the Homeless Homelessness In the U.S. Michael Arnold, Executive Director Los Angeles Homeless Services Authority

National Demographics of Homelessness in U.S. 643,067 homeless on any given night in U.S. (HUD ’09 – in Emergency Shelters, Transitional Housing Programs or sleeping in locations not meant for human habitation) 37% are unsheltered –21% of families with children are unsheltered 110,917 (17%) are chronically homeless (homeless for over 1 year, or 4 or more episodes of homelessness in 3 years) 930,000 school age children are literally homeless, or living in doubled or tripled up housing

National Demographics of Homeless in U.S. 20.5% (1/5 th ) of the total U.S. homeless population reside in California Approx million in the U.S. will use a homeless shelter or transitional program over a 12 month period. While total homelessness in U.S. has decreased over past four years, current economy may drive significant increases in future.

National Demographics of Homeless in U.S.

National Demographics of Chronically Homeless in U.S.

National Demographics of Homeless In U.S. Homelessness and Disabilities Nearly 4 in 10 sheltered homeless (37.8%) has a disability, compared to 26.4% of the population living in poverty, and 15.5% of the total U.S. population. Profile of Homeless in U.S. Adult – 78% of all sheltered homeless are adults. Male – 61% are male. Minority – 62% are members of minority groups Middle-aged – 38% are years old Alone – 64% are in one- person households

National Demographics of Homeless in U.S. CharacteristicIndividuals *Persons in Families* Gender of Adults Overwhelmingly Male Overwhelming female adults Race Twice as likely to be minority Almost half are African American Age Three Quarters over 30 More than 4/5s are under 31 Veterans More than 1 in 10 are veterans Emerging veteran population Disabled More than 4 in 10 are disabled Low rates of disability The profiles of homeless individuals and persons in families differs considerably. * 5 th HUD AHAR – Sheltered Data

National Demographics of Homeless in U. S. IndividualsEthnicityFamily 34.1%Black47.9% 45.4%White23.6% 10.4%Latino13.9% 10.2%Other14.7% Gender 72.7%Male20.4% 27.3%Female79.6% Characteristics of Sheltered Homeless

National Demographics of Homeless in U. S. Characteristic% of All Sheltered Homeless Persons % of Population at the 2008 Poverty Level % of U.S. Total Population Male63.7%40.5%48.7% Female36.3%59.5%51.3% Disabled38.7%26.2%15.5% Veteran11.1%5.2%9.7% Age <1822.2%33.9%24.3% Age %45.7%46.4% Age >5017.2%20.3%29.3%

Demographics of Homeless in Los Angeles County Los Angeles County Statistics –Covers over 4,000 square miles in extremely diverse terrain – oceanfront, mountains, desert, rural, suburban –88 cities –9,848,011 people (2009 est.- U.S. Census) Over 1 million living in unincorporated areas of County

Demographics of Homeless in Los Angeles County 48,053 homeless on any given night (2009) –24% (10,245) chronically homeless –11% persons in families –89% single adults –7.5% of total U.S. homeless population –2/3 unsheltered 24% with Mental Illness 41% with substance abuse problem 2% HIV 10% Victims of domestic violence 17% Veterans 2% Unaccompanied Youth

Demographics of Homeless in Los Angeles County CharacteristicLA CountyU.S. Totals Male65%63.7% Female35%36.3% Black/African American47%38.7% Hispanic/Latino29%11.6% White/Caucasian21%38.1% Other3%11.7% Veterans17%11.1% Chronically Homeless24%17%

Demographics of Homeless in Los Angeles County

Causes of Individual Homelessness Lack of access to affordable housing Mental illness and/or physical disability Lack of resources (Poverty) –No or low job skills –Inadequate education –Substance abuse –Discharge from public systems – correctional, health, mental health, foster care, armed forces

Causes of Family Homelessness Lack of access to affordable housing Domestic violence Mental illness and/or physical disability Lack of resources (Poverty) –No or low job skills –Inadequate education –Substance abuse –Discharge from public systems – correctional, health, mental health, foster care, armed forces –Lack of access to child care, transportation,

Finding Solutions – Trends in Reducing and Ending Homelessness Policy and funding shifts to redefine homeless Continuum of Care Models –Outcomes based rather than managing homeless Number housed versus number served –Targeting – focusing on high impact homeless populations Chronically homeless Families veterans

Finding Solutions – Trends in Reducing and Ending Homelessness New Programs –Rapid rehousing as a first response –Diversion – avoiding initial shelter entry through housing placement –Prevention – keeping people in stable housing Anecdotal to Evidence Based Planning –Emphasis on evidence based data –Broad implementation of local Homeless Management Information Systems

Finding Solutions – Trends in Reducing and Ending Homelessness New Programs –Rapid rehousing as a first response –Diversion – avoiding initial shelter entry through housing placement –Prevention – keeping people in stable housing Anecdotal to Evidence Based Planning –Emphasis on evidence based data –Broad implementation of local Homeless Management Information Systems