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Solving Chronic Homeless

Author: Bonnie Durrance
September, 2019 Issue

Helping homeless members of the North Bay community find housing or shelter may seem impossible at times, but one national initiative has flipped the process on its head—and it’s working.

The initiative is called Housing First, and it means just that.

“It used to be, ‘Yeah, you need to sober up before we let you into our shelter,’ or, ‘You’ve got to get rid of your pet before we let you in,’” says Tom Schwedhelm, mayor of the City of Santa Rosa. “So, they’d force the homeless person to give up their pet—their friend, who treats them well—to get shelter. That’s a barrier.” Those barriers to housing are being taken down in the North Bay, one person at a time.

Housing First was adopted into California law in 2016, by the creation of the Homeless Coordinating and Financing Council. What it says, simply, is that to solve homelessness, you provide people homes. Officials no longer wait for people who may be scraping by to change their ways. You remove old obstacles, get them into housing—with their pets, partners or property—and then help them stay there. “Just because you’re giving them a home doesn’t mean you don’t have other issues,” says Schwedhelm. “So, [the housing] has got to have wrap-around services.” Issues such as substance abuse and mental and physical health are not overlooked, but these circumstances, as well as others that may attend the condition of homelessness, are more easily dealt with once the person is in out of the rain and other harsh conditions.

The cost of homelessness

“Homelessness is not just a social issue,” says Jennielynn Holmes, Senior Director of Shelter and Housing at Catholic Charities in Santa Rosa. “It’s a health issue, a moral issue and an economic issue.” She says that people experiencing homelessness are three or four times more likely to die prematurely than someone who’s housed. That constitutes a health emergency and launches a moral question: how do we, as a community, deal with our most vulnerable? And that query begs the two-sided economic question: What will it cost to solve this problem? And what does it cost to ignore it?

The cost of homelessness presents itself daily. People living on the street or without shelter—subject to illness, injury, crime and the effects of drug and alcohol abuse—are more likely to show up on a regular basis in county emergency systems, or in the jails or court systems, creating a burden for social services. Holmes points out that money spent on preventative care would save the ambulance companies, fire department, hospitals, Emergency Room (ER) units, police and court systems from the costs of frequent and various health emergencies suffered by the homeless population. “A 911 response ties up a lot of funding and a lot of resources,” she says. “ER visits are expensive and people without homes often have to stay in the ER or in the hospital because there is no place for them to go to be discharged to.”

Sonoma County is well aware of the issue. Project Nightingale, started in 2011 and run by Catholic Charities of Santa Rosa with cooperation and support from area hospitals, provides shelter for homeless community members recuperating from a hospital stay, with on-site healthcare services and 24-7 staffing. “Nightingale saves a lot of money in the long run,” says Holmes. “I know several people who’ve come through the Nightingale program and actually moved into independent housing and have been housed now for years,” she says. If we consider that the answer to homeless is housing, a bridge like Nightingale is an example of a pathway toward success.

Who gets served first?

Before Housing First, those seeking government subsidized, Section 8 housing would fill out an application and then wait five to seven years until they were called. First come, first served. Now, it’s no longer the person who happened to have been the first in line years ago that has priority. It’s the person who is most in need that is first served. The Vulnerability Index—Service Prioritization Decision Assistance Tool (VI SPDAT) assesses need in much the same way as an emergency room. 

“Say I go to the ER with a stubbed toe at 7 a.m., and you come in at 8:30 a.m. with cardiac arrest,” says Holmes. “Are they going to see me because I got there first? Or, are they going to see you because you have a life-threatening illness?” They’ll tend to the cardiac arrest, of course. Vulnerability is the guideline for admission to Housing First, with the help of the VI SPDAT. This survey helps place people into categories and prioritize care. “You don’t want to over-serve someone who needs few services,” says Holmes. “And you don’t want to under-serve someone who needs a lot of services.”

The common sense of this model is easier to grasp when considering the “new homeless.” These are people who have become homeless—directly or indirectly—because of the 2017 fires. Imagine telling such a person that housing is available, but first, their PTSD and depression caused by the fire must be treated. The beauty of the new model is the plain and simple common sense of it: The solution to homelessness—is housing. “We’ve made good headway,” says Holmes. Last year Catholic Charities housed 651 people, permanently ending their homelessness with this new solution.

The Palms Inn

One example of a creative public/private partnership that is working well in Santa Rosa is the Palms Inn, a 14-unit former motel that the owner, together with the county, Catholic Charities and the Veterans Administration (VA) converted to permanent supportive housing for veterans and formerly homeless individuals in 2016. Since its start, the project has shown that Housing First works. The Palms Inn enables communities to directly help vulnerable individuals enjoy the basic dignity of waking up in a safe home, with the support needed to maintain their new lives. The benefit to the community follows naturally. “In the first year, we saw that veterans’ homelessness went down 23 percent, chronic homelessness went down 20 percent and homelessness in Santa Rosa went down 16 percent,” says Holmes. “And that was just with one major building.”

If housing is the answer to homelessness, then wouldn’t it make sense if the crucial task of finding housing is entrusted to housing experts, people trained in real estate—which people trained in social work typically are not? According to Holmes, the answer is yes. “We hired a team of housing locators who are not social-work trained, but are real estate and property-management trained,” she says. “They help us work with landlords and understand how we can better serve them, which ultimately helps us serve our people.” Important note: nothing works without keeping landlords happy. “When you have the right support in the housing market, [people in from the street] stay housed. All the studies show that. Even locally, we’re able to prove that.”

Napa builds trust

Enthusiastically practicing Housing First, Napa County works with Abode Homeless Services to help with shelter and housing issues. “They are our primary housing provider for our coordinated entry program,” says Brandon Gardner, Napa Police Department Outreach Specialist. He’s been the go-to person on the Napa Police Department Outreach team for more than 10 years. “Abode finds the housing and then, working with the county's new housing and homeless services division, they secure our grants that help people into housing.”

According to Gardner, the Housing First model started positively impacting the community two years ago. “People who are most vulnerable are quickly moved into coordinated, entry-controlled shelters and case managed until they get housed,” he says. “Those who are left out and about, we’re able to help them get into housing a bit easier because they’re not at the highest vulnerability or risk levels.” Gardner cites mental health, medical issues and drug and alcohol dependence as the largest risks for the homeless community. He says that the city and the outreach team have made significant progress since 2007, in large part because of Housing First. “It was just chaos. Anybody could go into a shelter. People were in and out. It’s definitely more controlled now.”

Another factor is Napa County’s two-pronged approach to end homelessness. “We have two outreach teams,” says Gardner. “One is more on the enforcement side. Then there’s the Abode outreach team, and they go out and do all the assessments. Between the two teams, we’re hitting clients three times a week all over Napa County.” Gardner says there’s been a shift in general philosophy in Napa County. “We’re not here to ‘write you up,’” he says. For example, they don’t waste time penalizing the homeless with ‘No camping’ tickets—even though there’s a no camping ordinance. “In 2007, we were constantly writing no camping tickets,” he says. “We’d write them up for absolutely everything possible. Now, we look at it differently—it’s community service.” This new outlook is making a difference all around. “Now our attitude is, ‘how can we help you get better?’ If they need social services, I’ll take them to social services. If I have to sign them up for Social Security, I’ll sign them up for Social security. We do what it takes to help them get off the street and get better. That’s essentially what we do.”

The result is a sense of friendliness instead of fear. Not that everything is always perfect. “As case managers, our job is to go there at least once or twice a week and see how things are going—talk to the client or the landlord and find out if there are any issues,” says Gardner. “It can be difficult. Because of the Housing First model, you put people in first and then you address the issues. So you do have alcohol and drug issues that have to be addressed when they get in the house. And that’s our job to do that, as case managers.” But it’s easier to help someone who has a regular place to live. “If a person is sleeping by a hotel one night and I say I’ll meet you in the morning to get you some help, they may have moved on,” he says. “Whereas with the Housing First model, if they have a house or a roof over their head or even are in a shelter, we’re able to get them services the next day.”

Working together in Marin

“We weren’t doing [Housing First] to fidelity in any way,” says Christine Paquette, executive director of the St. Vincent De Paul Society of Marin County. “Then at one point a few years ago, a group of us learned about a model—the Homeless Outreach Team—that worked with one person at a time, by an actual name list. We decided to bring that model to Marin.” Iain De Jong, an organizational consultant out of Toronto who is particularly passionate about ending homelessness in developed countries, also inspired them. “We all agreed we were going to follow Iain’s proven model, without question. And that’s what we did. We were honestly astounded at the results.”

Getting everyone on the same page was not a snap. “It was a lot of hard work,” says Paquette. “We realized if we have a list of people, by name, and we work our hardest to get those people the housing they need, then we’re going to start actually tackling the problem.” No matter what the person had done five years ago, or no matter how severe their diagnosis, or no matter whether or not the group thought the person would ultimately be successful, the goal remained: get the person housed. As Paquette says, their mission gained clarity: “This is the person, and they need to be housed, now how are we going to do it?”

This is not to say they were blind to the reality of the individuals on their lists, but they were definitely reversing the order of operations. First, get them housed and supply them with the needed services for stability, and then address the conditions they would continue to be faced with. So, the person—and the landlord—is given a commitment that there will be ongoing financial and social help so the landlord is covered should there be damages or problems. It sounds so simple, but was it?

“Before, everyone was doing what they were supposed to be doing, but no one was working together,” says Paquette. “Everyone was trying to do everything.” Now they work with the Marin Housing Authority, which enables them to keep track of people by name. They also know where their clients are, what their situation is, what housing they might quality for, and who’s next on the list. “Now we are all working together and if something isn’t working, we all take responsibility for figuring out how to fix it.” And if someone isn’t working out in the place where they’re housed, the caseworker works with them so that it doesn’t come to an eviction, which is a bad thing for everyone. “Now, we intercede before the eviction happens.” The result? This year’s annual Point in Time Count, which takes the census of those experiencing homelessness on one night in January, showed Marin homeless population at 1,034, down from 1,117 in January 2017. Most importantly, the count shows that the number of people who are chronically homeless has decreased by 28 percent. Not perfect, but definitely progress.

Real progress is the point

Each county is seeing consistent improvement in results and with that, enthusiasm has increased. They want the community at large to know what they’re doing, how it’s working and what they need. “We know how to solve homelessness,” says Holmes. “What we need now is community support and understanding and resources.” Community support is essential.

“It’s a community-wide issue that needs a community-wide response, including the cities,” says Schwedhelm. The basic response needs to be driven by a mindset that values the person experiencing homelessness.

According to Paquette, the North Bay must continue to improve its culture of intervention and be more respectful of people and their circumstances, rather than blame or judge them. The homeless are simply people that need a roof over their head. Nobody can do everything, and nobody can do it alone. “It takes the community,” says Gardner. “This is a hand up and not hand out. We need landlords, employers and businesses in the North Bay to work with us in our efforts to end homelessness. You will see first hand, the hidden talents and treasures that reside within our homeless population when given a chance to recover from the demons of street life.”




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