1. Santa Monica Chronic Homeless Project: Registry Creation February 26 th, 2008 City of Santa Monica Common Ground

2. Street to Home 101 Create a by-name and photo registry of street homeless population Prioritize based on vulnerability Align housing and service resources to match the need Align incentives for non-profit providers to house the most vulnerable first

3. February 2005 55 people sleeping in the BID

4. February 2007 7 people sleeping in the BID

5. Cities Adapting S2H Techniques

6. Vulnerability Index More than 6 months street homeless AND at least one of the following: –End Stage Renal Disease –History of Cold Weather Injuries –Liver Disease or Cirrhosis –HIV+/AIDS –Over 60 years old –Three or more emergency room visits in prior three months –Three or more ER or hospitalizations in prior year –Tri-morbid (mentally ill+ abusing substances+ medical problem)

7. Teams City of Santa Monica, Human Services Division, Housing Division, Fire/Paramedics, and Police Department Los Angeles Homeless Services Authority (LAHSA) Department of Veteran’s Affairs Los Angeles County Department of Mental Health CLARE Foundation New Directions OPCC St. Joseph Center Step Up on Second West Coast Care

8. Baseline Count Results 277 individuals sleeping outside

9. I nterview Methodology Safety First Assertive Respectful Sensitive Persistent

10. Interview Results 261 interviews completed 94% of Friday night count completed survey 220 pictures (84% of respondents allowed)

11. A ge * 44 (17%) were over 60 years old

12. R ace/Ethnicity

13. Average Length of Homelessness * 30% of vulnerable cohort homeless > 15 years

14. Where Did People Come From? 135 (53%) were homeless before they came to Santa Monica

15. Mental Health & Substance Abuse

16. % Veterans 34 (54%) of veterans are considered vulnerable

17. % of respondents with Jail and Prison History

18. Hospitalizations

19. Routine Health Care Services

20. Emergency Health Care Services

21. Vulnerability Indicators Risk indicator# of people Tri-morbid56 3x hospital last year21 > 60 years old44 Liver Disease25 3x ER last 3 months7 Frostbite/Cold Weather17 Kidney Disease7 HIV+/AIDS2 110 (42%) of those surveyed met at least one High-Risk Criteria

22. Frequency of Risk Indicators Risk indicatorSkid RowSanta MonicaNew Orleans Sample Size350261121 Tri-morbid21% 17% 3x hospital last year13%8%17% > 60 years old10%17%5% Liver Disease9%10%3% 3x ER last 3 months8%3%8% Frostbite/Cold Weather 7% 8% Kidney Disease4%3%1% HIV+/AIDS2%1%5% % with 1 or more risk criteria 40%42%33%

23. Initial 10 Most Chronic & Vulnerable All have been homeless more than 18 years in Santa Monica 8 men, 2 women, 1 couple 2 of 10 had 4 co-occurring vulnerability indicators Average age is 54 years old

24. Typical Profile 49 year old white male Grew up in Texas in Foster Care – came to Santa Monica 30 years ago when he was 19 years old Makes money panhandling & hangs out on the beach Cirrhosis “Tri-morbid” = mentally ill + abusing substances + medical problem

25. Community Impact 87% reduction in Times Square Continued reductions in NYC result of this focus Project 50 in Los Angeles has housed 10/50 of the most chronic and vulnerable in less than one month Claiborne Encampment in New Orleans – Advocacy Tool Washington, DC – 60% reduction in six months in Central Business Improvement District

26. Next Steps Assign ten most chronic and vulnerable people Gather housing and services resources and focus on most chronic and vulnerable If you’re paying for services, pay for people to house the most chronic and vulnerable Develop training and service protocols Review City policies and practices that may contribute to homelessness or attract people to Santa Monica