Homelessness is a major issue in San Luis Obispo County, which is why the County created 50 Now, a successful housing-first program that permanently houses and provides intensive support services to 50 of the most vulnerable, chronically homeless individuals in San Luis Obispo County.
Housing-first programs are considered a best practice by the Federal government for addressing chronic homelessness. These programs combine housing with intensive services to stabilize individuals and families, thereby reducing public costs associated with incarceration and hospital visits. The County partnered with Transitions Mental Health Association (TMHA) and the Housing Authority of the City of San Luis Obispo (HASLO) to successfully create and implement the 50 Now program.
As of October 2016, 64 homeless people in San Luis Obispo County were placed into housing through this program, along with six family members (70 people total). Of those placed into housing, 54 (77 percent) remained in 50 Now housing or moved to other, permanent housing situations. Of the 54 people who were placed into housing in 2016, 39 (72 percent) remained in housing for at least six months. Twelve people (17 percent) left the program voluntarily or were terminated, and four (6 percent) passed away.
Program Performance Objectives
- 50% of successfully housed participants will report improved self-sufficiency via a standardized assessment tool within 12 months of being housed.
- Housed participants with a history of incarceration will demonstrate a 50% reduction in number of bed days in an incarceration setting, in the first 12 months of being housed compared to the previous 12 months.
- Housed participants with a history of citations and arrest will demonstrate a 50% reduction in number of citations and arrests, in the first 12 months of being housed compared to the previous 12 months.
- Housed participants with a history of emergency room (ER) and hospital stays will demonstrate a 50% reduction in the number of bed days in ER and hospital settings, in the first 12 months of being housed compared to the previous 12 months.
- Housed participants with a history of Psychiatric Health Facility (PHF) stays will demonstrate a 50% reduction in number of bed days in San Luis Obispo County PHF, in the first 12 months of being housed compared to the previous 12 months.
- In the first 12 months, 30 of 50 participants will be screened for case management
- In the first 12 months, 30 of 50 participants will be assessed for Affordable Care Act qualifications and apply for benefits if appropriate.
- 60% of participants housed will remain in housing for at least 6 months.
- 50% of successfully housed participants will be offered opportunities for educational development, participation in TMHA’s Supported Employment Program or other employment opportunities, and/or involvement with peer education activities.
- In the first 12 months, 60% of participants will increase or maintain income entitlement benefits; in months 13-24, 80% will increase or maintain income (General Assistance, SSI, SSDI, and CalFresh).
Outcomes as of October 2016
- All participants showed improvements in self-sufficiency. Progress was measured using a standardized self-sufficiency measurement tool.
- Housed participants with a history of incarceration had 98 percent fewer bed days in jail. Jail data was obtained from the County Sheriff’s office. Data was gathered for 34 individuals who signed releases, not all of whom had arrest records. Total number of bed days in the one year before housing was 231, and the total number of bed days post-housing was 5.*
- Nearly all participants (97 percent) had fewer citations and arrests. Jail data was obtained from the County Sheriff’s office. Of the 34 individuals that provided releases for this information, 10 had been arrested within a one year period immediately prior to being housed, for a total of 35 arrests in the one year prior to housing. Post-housing, there was only one arrest among the participants.*
- Overall, there was an increase in the number of days participants were hospitalized, but a 52 percent decrease in total emergency room visits. According to CenCal, which provided this data, the increase in the number of days hospitalized was due to a single individual who was in the hospital for an extended period of time. This is an outlier in the data. The actual number of people who were hospitalized before and after housing was relatively small, according to County officials.
- Housed participants had 69 percent fewer in bed days at the County public Psychiatric Health Facility (PHF). Aggregate data was reported by County Mental Health Services. In a year of pre-housing, there were five PHF admissions for a total of 13 bed days.** As of August 20, 2016, there were two PHF admissions for a combined total of four days among 34 persons placed into housing for whom releases could be obtained.*
- 44 out of 50 participants were screened for case management. Data was reported by TMHA.
- 44 out of 50 participants were assessed for Affordable Care Act qualifications. Data was reported by TMHA.
- 72 percent of 50 Now participants remained in permanent housing for at least six months. Data reported by TMHA for all persons placed into housing at least 6 months prior to the report. Out of 54 persons placed into housing six months or more prior to October 12, 2016, 72 percent (39) have remained in permanent housing as of October 12, 2016, with 7 percent having left for other, permanent housing with family.
- All successfully housed participants were offered various opportunities to ensure their success. For most participants, the focus of services in the first six months is on stabilization in housing. Additionally, many participants have disabilities that may significantly limit future work potential.
- 84 percent increased or maintained income entitlement benefits. Data was reported by TMHA and provided for all participants.
Program participants enter permanent housing straight from the streets or emergency shelter with few barriers to housing entry and are offered services (though participation is not required), and there is no time limit in the length of stay in the housing. Participants in housing-first programs still must agree to meet regularly with their case manager, pay their rent on time, comply with the terms of their lease, and allow their neighbors the peaceful enjoyment of their own premises.
TMHA reported in October 2016 that a lack of affordable housing continued to be a challenge countywide, particularly units that are at or below 40 percent of the fair market rent for San Luis Obispo County and where the landlords are willing to accept housing choice vouchers. Affordable, accessible units and units that accept pets are particularly difficult to find.
The County continues to work with partner agencies and cities in identifying ways to secure more permanent supportive housing.
For example, in 2015, the County partnered with the Family Care Network to purchase nine affordable units to house homeless families. The County also submitted an application for funding from the U.S. Department of Housing and Urban Development under a 2016 Continuum of Care competition that would, if awarded, create additional permanent housing beds for chronically homeless individuals.
The current contract amount with TMHA is $648,323, and is paid with realignment funds. For more information on ways the County is working to end homelessness, visit www.slohomeless.com.
*Information for some performance measures could only be collected with signed consent from 50 Now clients. Due to privacy laws, releases for certain types of information must expire within one year or less. That necessitates obtaining new consent each year. Some clients who entered the program since the program are no longer in the program, for the reasons noted above (e.g. death, moving from the area, program departure, etc.), and are thus not available to provide written consent. As a result, the number of occurrences in outcome measures 2, 3, and 5 are less than the previous report.
**In the May 2015 report to the Board, pre-housing data was reported for the time period of January 1, 2012-December 31, 2013.