Grand Jury 19-20 Grand Jury Report Responses 1 message

An insufficient number of treatment facilities in Santa Cruz County for mental health and substance use disorders leaves homeless individuals without necessary treatment options. x AGREE PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree):

Because Santa Cruz County lacks adequate prevention and diversion programs, individuals who could remain in their homes with minimal cash assistance are ending up homeless. AGREE PARTIALLY DISAGREE – explain the disputed portion x DISAGREE – explain why Response explanation (required for a response other than Agree): The County of Santa Cruz is one of the most expensive places to live in the world, and even substantially funded cash assistance programs would have limited overall impact. The county also has an inadequate supply of affordable housing, and what housing is available is not sufficient to meet the demand for individuals who are very difficult to house. And the community needs far more structured and staff-supported living arrangements to assist high-needs individuals. The county’s cost-of-living issues are exacerbated when measured against household income and other employment metrics, with a lack of sufficient income and economic opportunities, and the PIT County shows job loss (followed by evictions) as the most common self-reported cause of homelessness. In a highly competitive housing market impacted by wildfire and an influx of homebuyers from neighboring Bay Area cities during the COVID-19 pandemic, housing prices have remained unchanged, if not increased. We also need more landlords willing accept homeless tenants with housing vouchers and offer opportunities even to those with past eviction histories. Additionally, there are significant prevention dollars at work in the community which serve to keep people who are “at imminent risk of homelessness” housed. The County contracts with numerous community-based organizations for provision of eviction prevention services and administration of rental assistance funds. A diversion program is in the process of implementation, in coordination with the SmartPath Coordinated Entry System.

The lack of Permanent Supportive Housing (PSH) results in the significant compounding of the homeless issue. x AGREE PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree):

Supportive services are limited to one year; this limitation can contribute to instability, a loss of housing, and a return to homelessness. AGREE PARTIALLY DISAGREE – explain the disputed portion x DISAGREE – explain why Response explanation (required for a response other than Agree): Limitations such as these are the function of certain funding sources, but not all, and this finding does not reflect local policy. In fact, most funding sources utilized for County services do not have such limitations. For example, the County of Santa Cruz Health Services Agency (HSA) Behavioral Health programs do not place limitations on the support services offered to clients. HSA Behavioral Health provides rental assistance through housing vouchers, case management and other behavioral health services based on the needs of the individual and not a set time period. The length of time that persons receive supportive services differs by housing or service program, funding source, and the needs, situation, and preferences of the participant. For example, there is no limit on the length of time that participants in Permanent Supportive Housing (PSH) programs can receive housing subsidies or supportive services. The Disabled and Medically Vulnerable (DMV) Voucher program requires that participants receive a minimum of one year of case management but has no maximum service provision. Rapid Re-Housing Programs vary their provision of services and financial subsidies based on the individual needs and situation of participants. Regardless of the specific program, to facilitate housing retention, if a participant needs services longer than a housing program can provide, most programs identify alternative supports for the participant, rather than having them return to homelessness.

A lack of case managers and outreach results in homeless individuals not having timely access to necessary supportive services. AGREE x PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree): The County of Santa Cruz Health Services Agency (HSA) manages over half of all HUD funded permanent supportive housing programs within our Continuum of Care. The collaborative efforts of outreach workers across all of HSA’s departments, and the inclusion of community-based agencies in these efforts, contributed to a three-fold increase in \clinic visits by the highest utilizers of hospital services in 2019, according to recent data shared by the Central California Alliance for Health. That level of coordination between outreach workers and case managers ultimately leads to improved health outcomes while reducing unnecessary emergency room visits and hospital admissions, critically important during the COVID-19 pandemic. HSA Behavioral Health provides a broad range of targeted services and programs for the homeless including the HOPES Program (Homeless Outreach and Proactive Engagement), the FIT Team (Focused Intervention Team), and our specialty mental health and substance use disorder programs, as well as housing navigation services in the community which are peer staff assisting with connecting to housing in the community. These services were not reflected in this Grand Jury report. The issue of connecting to services goes beyond capacity- there are always going to be a group of homeless individuals averse to ongoing treatment, and while we work with them using harm reduction interventions, we often cannot meet the legal standards required to force an individual into treatment. Further complicating this is the fact that the County does not have enough supportive infrastructure systems to adequately address the behavioral and physical health needs of the number of people experiencing homelessness (such as medical respite beds, a medical detoxification facility, and board and care facilities able to provide 24/7 nursing support). There is also a need for more medical providers trained and deployed to provide street medicine in the field. Without these critical infrastructure pieces available for clients, any crisis response system of case managers and outreach workers, not matter how coordinated, Will be unable to improve outcomes because there are not adequate systems in place to which case workers may refer this population.

There is a lack of leadership from County and City officials to engage the business community in exploring potential solutions to homelessness. AGREE PARTIALLY DISAGREE – explain the disputed portion x DISAGREE – explain why Response explanation (required for a response other than Agree): County Homeless Services Coordination Office has engaged with Chamber of Commerce, Downtown Association, and Business Council of Santa Cruz County to discuss the issue of homelessness, understand impacts to businesses, and explore potential for collaboration. The Downtown Streets Team is an example of a successful government-business collaboration that has included City and County leadership.

Santa Cruz County and Cities, despite owning numerous parking lots, choose not to utilize their parking lots for safe parking programs, which results in an underutilization of resources that could help reduce homeless parking in neighborhoods and business districts. AGREE PARTIALLY DISAGREE – explain the disputed portion x DISAGREE – explain why Response explanation (required for a response other than Agree): City as already utilizing City-owned parking lot(s) for safe parking and County leadership is actively engaged with AFC to identify County lot(s) for FY 2020-21 expansion of the safe parking program.

Faith-Based Organizations are an underutilized resource in the effort to end homelessness. AGREE x PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree): While the Faith-Based community may have more to offer, they have been exemplary partners to date. The Association of Faith Communities operate the Faith Community Shelter and Safe Spaces Parking programs, both of which utilize multiple church sites around the County. The Seventh Day Adventist site is currently hosting a Transition Age Youth shelter-in-place program. Mid-County Homeless Coalition operates the mid- county hygiene program.

Due to the inconsistent collection of Homeless Management Information System (HMIS) data, the accuracy of funding decisions for service providers is negatively impacted. AGREE x PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree): To date, HMIS data has not been a factor in funding decisions, however that is already in the process of changing. There has been a tremendous effort over the past year to engage with each homeless services provider to review their HMIS data, including quality of the data, and to understand how their individual project’s performance impacts the overall homeless response system performance. Agencies have invested significant time and effort to review and correct data quality issues. HAP and County leadership are committed to using data as part of funding decision-making processes. To this end, effective October 1, 2020, the County Human Services Department is assuming responsibility as the HAP’s HMIS Lead Agency in order to utilize the department’s existing data evaluation team, strengthen homeless system data analysis, and better inform decision-making.

There are tools available, such as Santa Clara County’s “Silicon Valley Triage Tool," that could be applied to Santa Cruz County to allow the County to better understand the true cost of homelessness enabling the County to use public resources more efficiently. x AGREE PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree):

If underutilized parcels of land throughout Santa Cruz County were identified, such as the area near Coral Street in Santa Cruz, and the parcel adjacent to the County Government Mental Health Building in Watsonville, these parcels could potentially be used to increase the number of beds and services to support the homeless. x AGREE PARTIALLY DISAGREE – explain the disputed portion DISAGREE – explain why Response explanation (required for a response other than Agree):