1. Opportunities to Address Homelessness in California Sharon Rapport, CSH

2. Homelessness in California  115,738 on a single night (about 250,000 in one year)  21% of nation’s homeless, 1/3 with mental illness  12,789 children are homeless, 898 unaccompanied  36% of nation’s chronically homeless

3. Impact of Homelessness on Californians with Behavioral Health Disorders 1/3 of children in foster care cannot be reunified with birth parents because parents lack a home. Homeless parolees/ probationers are 7 times more likely to recidivate. Each homeless person costs Medi- Cal over $21,500 a year. Those with SUD average over $60,000.

4. Residential Treatment vs. Housing To Receive Care Length of Stay According to Need for Care Supervision Subject to Licensure & “6 and Under” Rule No Landlord/Tenant Rights Apply A Place to Live Length of Stay Determined by Housing Model Security, Not Supervision Not Subject to Licensure Lease or Residential Agreement

5. Studies on Effectiveness of Housing Interventions Data Source: HUD Family Options Study

6. Restrictive Settings to Independence Institutional Settings Restricted Settings (board & care, group homes) Independent Settings

7. Emergence of Housing First  Anyone is ready for housing.  Housing is necessary for recovery from physical, mental health, substance use conditions. Homeless people must be linked to housed first, before services effectively improve health.  Services must be face-to-face, offered where the person lives, and designed to help maintain housing stability, prevent eviction, address behavior.  Tenant participation in services is voluntary: Housing is not contingent on compliance, or discontinued when client uses drugs/alcohol.

8. Compounding Evidence: Permanent Housing with Services Saves Money, Improves Outcomes 2002 2008 2009 2011 2013

9. Response in mid-1990’s-2000’s: Drive to Incorporate Evidence-Based Response  Move people into permanent housing as quickly as possible.  Remove barriers to permanent housing.  2009: Homeless Emergency Assistance & Rapid Transition to Housing Act (HEARTH Act), emphasis on “Housing First,” defunds much transitional housing. Immediate access to housing. Housing is the platform for stabilization Housing is the platform for stabilization.

10. AffordableHousing Decent, safe, permanent housing affordable to people in deep poverty. AffordableHousing Solutions: Housing Affordable to Those in Deep Poverty, Services to Access Housing Stability Rapid Re-Housing  Housing search assistance  Assistance with security deposits, back utility payments, etc.  Rental assistance for 3- 24 months, but no limit on length of stay  Short-term case management Rapid Re-Housing  Housing search assistance  Assistance with security deposits, back utility payments, etc.  Rental assistance for 3- 24 months, but no limit on length of stay  Short-term case management Most Families, People w/o Barriers Supportive Housing  Long-term rental assistance  Long-term voluntary intensive case management to—  Promote housing stability (working with landlords to avoid eviction, money management training, etc.)  Coordinate care Supportive Housing  Long-term rental assistance  Long-term voluntary intensive case management to—  Promote housing stability (working with landlords to avoid eviction, money management training, etc.)  Coordinate care People w/Barriers to Hsg Stability

11. Outcomes for Chronically Homeless Californians

12. Other Outcomes

13. Community Responses: Get People Housed, Coordinate Resources No Wrong Door: Any Entry Point Assess Housing Needs, Coordinate Existing Resources Available Permanent Housing Linked to Services

14. Funding Required for Rapid Re-Housing & Supportive Housing: Capital, Operating, Servs. Capital to build Rental assistance to operate Services to outreach, engage, build housing stability Search assistance Landlord incentives

15. Currently Available Resources for Rental Assistance

16. Available Funding for Capital to Build

17. Solutions for Services Dollars Through Medi-Cal Pilots in Select to Address “Whole Needs” of Homeless Beneficiaries: County + Federal Medicaid Money New Medi-Cal Benefit (“Health Home”) to Fund Services in Housing

18. Sharon Rapport: C: (323) 243-7424 sharon.rapport@csh.org