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City Program Helps Santa Monica's Chronically Homeless But Faces "Key Challenge," RAND Study Finds

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By Jorge Casuso

June 5, 2019 -- A City program that provides intensive services for those who have lived on Santa Monica's streets the longest placed most of them in housing and reduced spending on police services and emergency medical care, according to a study by RAND released Wednesday.

But the Santa Monica-based think tank also found that all but one of the 26 chronically homeless people the program helped in its first 18 months continued to require intensive care, posing a "key challenge."

“This is a very difficult population both to convince to receive services and then to manage their many needs on an ongoing basis,” said Scott Ashwood, a policy researcher at RAND who was the study’s lead author.

“There has been a shortage of services in Los Angeles County for homeless people who have this high level of needs," Ashwood said.

Santa Monica invested $600,000 in its Homeless Multidisciplinary Street Team, a group of eight full- and part-time specialists that focuses on providing housing and targeted services for the city's chronically homeless.

The program focused on 26 individuals "who generated a large number of complaints about disruptiveness and frequently used municipal services," according to the researchers.

"Most of the individuals have lived in the community for years and are well known to both residents and first responders."

The researchers estimate that by reducing the number of encounters between the program's clients and public safety providers, the City recouped between 17 percent and 43 percent of the money invested in the team.

Ashwood said the study also found that “there are likely to be many other financial and nonfinancial benefits associated with the program that were outside what we could quantify."

As a result, Ashwood believes the estimates are "conservative.”

But the study also found that despite the focused effort, "only one of the 26 people targeted by the program became stable enough to transition into less-intensive care.

"The RAND evaluation found that the program’s greatest challenge is graduating clients to other support programs," a challenge "complicated by the difficulty of finding appropriate follow-up programs for the population," the researchers said.

"Even after they are housed, the participants still require regular home visits, as well as intensive mental health and substance abuse prevention support."

In a statement issued Wednesday, City officials said that after its first 18 months the program, which was launched in September 2016, "has continued to evolve to improve participants’ health outcomes."

Enhanced coordination with the County and The People Concern, Santa Monica's largest homeless services agency, has resulted in a total of seven participants graduating to other forms of care.

"As slots have opened up, HMST has added new participants for a total of 37 people engaged to date," officials said.

The city’s Homeless Street Team includes a program manager, a wellness case manager, a housing case manager and a substance abuse case manager, researchers said.

There is also a physician, psychiatrist, physician’s assistant and peer support specialist who spend time with the program.

"The team tries to see each of the targeted homeless residents at least twice a week, with many being seen almost daily," researchers said.

"Team members worked for weeks or months to gain the trust of the homeless residents, using a light touch to build relationships in order to convince them to accept housing and services."

Originally, the City had hoped to serve a new set of 25 clients each year, researchers said.

While some large cities, including Los Angeles and New York, have launched similar efforts to target the chronically homeless, "it’s unique for a relatively small city such as Santa Monica to undertake such an effort,” Ashwood said.

Researchers recommend that the program coordinate earlier with other providers to "hand off" the clients, better gauge the potential benefits of the effort and "track a broader array of outcomes."

“We found the effort had positive impact on the clients and that the community views it as a valuable resource,” Ashwood said.

Funding for the study, which cost $77,675, was provided by the City.

Other authors of the study were Karishma Patel, David Kravitz, David M. Adamson and Audrey Burnam.

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