To specifically address the challenge of homelessness, the homelessness and homeless prevention program is grant-based and melds CDBG, ESG and HOME funding to support homeless prevention and eviction prevention programs, operating support for emergency and transitional shelters, direct services for homeless individuals and families, and supportive housing. This program coordinates closely with the Human Services Agency in particular to align its strategies.
Through this program MOH administers the HUD Emergency Solutions Grant program as authorized under the McKinney-Vento Homeless Assistance Act. ESG grants support essential services related to emergency shelter or street outreach; ongoing operations of emergency shelters; and homeless prevention services for those individuals at imminent risk of homelessness.
MOH also utilizes HOME funds for tenant-based rental assistance for individuals and families. Finally, it utilizes CDBG funds to support program preventing homelessness and providing direct services. Homeless prevention programs focus primarily on eviction prevention, including tenant rights trainings, legal representation at eviction hearings, as well as rental vouchers and assistance with first and last month rent. Direct service programs support case management and related services to individuals and families in shelters and on the streets, focusing on those services which will maximize housing stability for those individuals and families.
MOH’s homeless and homeless prevention programs align with the City’s 5-Year Homeless Strategic Plan to achieve the following objectives:
· Increase the supply of permanent housing that is subsidized as required to be affordable to people who are experiencing homelessness, that is accessible and that offers services to achieve housing stability.
· Prevent homelessness by supporting the transition from incarceration, foster care and hospitals into permanent housing, and by intervening to avoid evictions from permanent housing.
· Provide interim housing in shelters to support access to permanent housing until such time as permanent housing is available.
· Improve access points and provide wraparound support services that promote long-term housing stability for those in permanent housing, transitional housing settings and for those yet to be housed.
· Increase economic stability through employment services, mainstream financial entitlements and education.
· Ensure coordinated Citywide action to end homelessness respectful of the needs and rights of people who are homeless.
Eviction Prevention and Intervention
Effective homelessness prevention requires early identification and assistance to help people avoid losing their housing in the first place. Public agencies, including social service agencies, health clinics, schools, the foster care system and city government offices, have an important role to play in this effort as they are often in contact with these households and can provide key information and referrals. Strategies to facilitate the early identification and assistance needed to prevent homelessness include 1) expansion of resources available for rental assistance and for key services that address threats to housing stability; 2) facilitating access to eviction prevention services through education and outreach, expanded legal services and the establishment of specialized eviction prevention programs; and 3) development of standard “just-cause” eviction policies for city-funded programs.
Permanent Supportive Housing
Homelessness locks people into an unhealthy crisis mode of existence, making it difficult for them to regain their health, effectively engage in mental health and substance abuse treatment, and address education and skill gaps that limit their ability to access decent employment. The result is often repeated cycling between shelters, emergency rooms, detoxification centers, and jails – using up precious public service dollars without producing positive outcomes. In order to break this damaging and costly cycle and to help people to end their homelessness, once and for all, the City needs an adequate supply of permanent supportive housing. Such housing provides people with an essential base of stability and security that facilitates their efforts to address the issues that undermine their ability to maintain housing, improve health and well-being, and maximize self-sufficiency and their ability to contribute to the community.
Permanent supportive housing is a nationally-recognized practice that has been shown to be effective: About three-quarters of those who enter supportive housing stay for at least two years, and about half retain the housing for three to five years. In addition, a study of two programs in San Francisco found that people in supportive housing have lower service costs, with a 57% reduction in emergency room visits and a 45% reduction in inpatient admissions.
This housing must be deeply subsidized so that it is affordable to people who have extremely low or no incomes at all. In addition, for virtually all people who are homeless, in particular those who are repeatedly homeless and/or suffering from a disabling condition, the housing must be linked with services. This model is known as “permanent supportive housing” and it ensures that people have access to the full array of health, mental health, addiction, benefits, employment and other services they need to achieve long-term residential stability.
Strategies to enhance the City’s supply of affordable permanent housing and permanent supportive housing for homeless people include: 1) development of new supportive housing owned and operated by non-profit community based organizations; 2) enhancing access to existing housing through subsidies, master-leasing and making tenant selection criteria more flexible; and 3) preservation of existing supportive housing.
Although permanent housing is the primary goal for people who are homeless, interim housing is a necessity until the stock of housing affordable to people with extremely low incomes can accommodate the demand. Interim housing should be available to all those who do not have an immediate option for permanent housing, so that no one is forced to sleep on the streets. Interim housing should be safe and easily accessible and should be structured to provide services that assist people in accessing treatment in a transitional housing setting or permanent housing as quickly as possible. In order to provide the interim housing needed in the City, existing shelters must be restructured so that they are not simply emergency facilities, but instead focus on providing services that link people with housing and services that promote ongoing stability. In addition, to ensure that people who are homeless are willing to access these facilities, emphasis should continue to be placed on client safety and respectful treatment of clients by staff, including respect for cultural differences. The shelter system should provide specialized facilities or set-aside sections to meet the diversity of need, including safe havens, respite care beds, and places for senior citizens.
Increasing Economic Stability
Ongoing housing stability depends upon access to a stable and sufficient income stream. However, many homeless people have education deficits, limited job skills and/or gaps in their work history that make it difficult for them to obtain living wage employment. For these reasons, access to education, job training and employment services are vitally important. There are homeless-targeted training and employment services that offer these services in a way that is designed to meet the special needs of homeless people. While these programs are necessary and should be expanded, homeless people also need access to the mainstream workforce development system, which offers a wider range of resources. However, in order to be effective with this population, these mainstream programs must take steps to increase homeless families’ and individuals’ access and better accommodate their needs.
Some people who are homeless struggle with serious health, mental health or addiction disabilities that interfere with their ability to hold employment, and they must depend upon government benefits programs, including CalWORKs, General Assistance, Food Stamps, Social Security Administration programs (SSA/SSDI/SSI) and MediCal and Medicare. However, the application processes and requirements for these programs are complicated and intimidating and many people need assistance with filling out applications, obtaining supporting documentation and keeping appointments in order to successfully obtain these benefits.
Strategies to facilitate greater economic stability for homeless people include: 1) increasing homeless access to mainstream education and workforce development programs; 2) supporting homeless-targeted employment and training services; 3) increasing homeless access to benefits programs; and 4) assisting homeless children, homeless parents, homeless individuals and homeless unaccompanied youth in accessing public education services, specialized vocational training and higher education counseling.
Wrap-Around Support Services
Most people who are homeless not only need housing but access to services to foster ongoing housing stability, improved health and maximum self-sufficiency. Depending on the individual, these services may be transitional, needed just long enough to help respond to the immediate crisis, or they may be needed on an ongoing, long-term basis. In all cases, the services should be:
• Focused on and linked to either obtaining or maintaining housing;
• Comprehensive so they address the full range of needs;
• Individualized to meet the particular needs of each client; and
• Integrated so that care is provided in a coordinated manner that facilitates maximum effectiveness.
This is what is meant by “wraparound” care. Clients are provided all the services they need to support housing acquisition and ongoing retention through an integrated approach. This includes case management; health care; mental health services; substance abuse treatment; legal services; benefits advocacy; education, training and employment services; life skills and others. Strategies to facilitate the provision of wrap-around care for people experiencing homelessness and to prevent recurrence of homelessness must include expanding the accessibility and availability of treatment and support services; enhancing cross-system and cross-agency service integration; improving homeless access to mainstream services and benefits; and ensuring that all service provision prioritizes housing acquisition and retention.