8.13.2008

Fifty-six had ..."Tri-Morbid" indicators, meaning the homeless person was a substance abuser plus had serious mental & health problems."

My job is about to change significantly. We're working on implementing a new approach to assist those most likely to die on the streets over the next year. By utilizing a "vulnerability index," we hope to pinpoint those in dire need, make people in the community aware of just how close to death these individuals are, and then focus all our resources on helping them get off the street. In reality, it's not much different than what I do every day. The big difference lies in the narrowing of scope and focus in order to marshal significant amounts of time and resources directly on those who most need it. A couple of the aspects of the new effort I'm a tad uncomfortable with; having to tell people I've previously assisted that they aren't close enough to dying to receive services from me is a bit....disconcerting, not to mention uncomfortable. Of course I won't say it like that, but essentially, that is kind of what we're saying. Also, I'm not yet sure how we're going to overcome the barriers that keep people who want off the street mired right where they are, since at this point we have no answers from those who can help to change these things, either. Honestly, we're simply going on a gut feeling that by informing the public about those who will probably die on the street this year if some intervention does not occur, the news will sufficiently shock the consciences of those in our community who can break down some of these barriers. Whether it will work as intended remains to be seen, but our hope runs high at the moment. Regardless of whether we're successful in this new endeavor, one thing is certain, sick and injured people on the streets of our city will die this year because they are on the street. That is enough to motivate us and I'm hoping it will be the kickstart needed to begin some real change in the way Nashville addresses the needs of her homeless population.....

(a number of these stories have been previously posted here on this blog and I apologize for any redundancy)

NPR covered the Project 50 work: http://www.npr.org/templates/story/story.php?storyId=17401929 they came out with the LA teams to do the surveys...

LA Times http://articles.latimes.com/2007/nov/19/local/me-homeless19

Santa Monica - this describes the town hall meeting they had, too http://www.the-tidings.com/2008/020808/santamonica.htm

TV coverage from New Orleans press release on vulnerability: http://www.wwltv.com/topstories/stories/wwl022808jbhomeless.7028a71.html (you may have to get a login ID from TV station)

and plans to close encampment: http://www.wwltv.com/topstories/stories/wwl061108tpcleanuphomeless.218f476f.html

NY Times used data from Vulnerability Index (Common Ground not mentioned) in this piece. http://www.nytimes.com/2008/05/28/us/28tent.html?fta=y

Friday, February 8, 2008
Large percentage of Santa Monica's homeless at risk of dying

By R. W. Dellinger
text only version

Every five seconds, a face scrolled across the big screen in the packed auditorium of Santa Monica Library. Lots of blank stares and half-asleep expressions, and an occasional smile. Many heads were wrapped in scarves, hoods and blankets or covered with watch caps against the rainy night air.

One young man with a mustache was wearing a Dodgers' cap. Another had on a red "Mississippi State" sweatshirt under a windbreaker.

An African American man in glasses made a V-sign with two fingers. An African American woman was waving a hand.

A pretty lady had a knit cap pulled down over her blonde hair and forehead like she was posing for Vogue. And an older white guy had his pants rolled up, showing off his bare legs, amputated six inches below the knees.

The faces belonged to some of the 110 hardcore chronically homeless in the oceanside community identified in a new city survey as likely to die in coming months if they aren't helped to get off the street.

The summarized report, released January 31, was based on a head count and interviews done by 60 city employees, county social service agencies, volunteers and Common Ground. The New York nonprofit reportedly reduced the number of homeless in Times Square by 87 percent from 2005 to 2007. The local research was done during four late nights.

On January 25, 277 men and women were counted sleeping outside in Santa Monica between 3 and 5 a.m. A couple days later, teams of three went back and interviewed 261 of the individuals over three more nights.

Using a "vulnerability index" developed by a Boston researcher, 110 homeless people - 42 percent - met at least one high-risk criterion for dying on the street.

Fifty-six had what Common Ground calls "Tri-Morbid" indicators, meaning the homeless person was a substance abuser plus had serious mental and health problems. Forty-four were over 60 and at-risk because of their age, while 25 had cirrhosis and 21 had been hospitalized or gone to an emergency room more than three times recently.

"Essentially, this is holding up a mirror to the community of something you might not actually see," said Becky Kanis, director of innovations for Common Ground, who helped coordinate the hands-on study. "But the counting is only the first step. You have to have a list and profile of exactly who is living outside to take away the anonymity

"A number is almost anonymous," she stressed. "But when you take away the anonymity, you make it even more real, more tangible, more actionable. These are your neighbors. And our goal is to house the 10 most chronic and vulnerable people in your community. Because there's lots of research showing that housing in and of itself increases people's health."

Kanis pointed out that the average age of someone in the most vulnerable group was 55, which was "disproportionately elderly" in Santa Monica compared to other cities. Moreover, most (74 percent) were lopsidedly white (70 percent of the at-risk residents of L.A.'s skid row are black); 77 percent were males; and 31 percent were veterans. Nearly a third had been homeless locally for more than 15 years.

More than half of the people sleeping on the street in Santa Monica reported they were homeless before they got to Santa Monica, with most coming from West L.A., Venice and San Pedro. The number one reason for choosing the beach city was the good weather, followed by safety and an abundance of social services.

Concerning income, 37 percent of the vulnerable homeless said they were receiving Social Security or disability benefits and 15 percent got General Relief welfare. Some 15 percent reported having no income at all, while 10 percent said they were working off the books, 8 percent panhandling, 3 percent working at regular jobs on the books, and 1 percent doing recycling.

"The number one most chronic and vulnerable homeless person in Santa Monica is a 49-year-old white male," Kanis pointed out. "He was in foster care, grew up in Texas. And when he was 19, he was already homeless, and he made his way to Santa Monica 30 years ago. So you guys have basically grown up with him.

"He panhandles and hangs out at the beach. He has cirrhosis, and meets criteria for tri-morbidity: serious physical illness, mentally ill and substance abuse."

Santa Monica's human services manager, Julie Rusk, said the city - using Common Ground's "Street to Home" model - would start as soon as possible to house with support services the 10 most vulnerable homeless and then continue to house more on the list based on their vulnerability score.

"It's so easy for all of us, myself included, to get completely overwhelmed by large numbers and the daunting task at hand," she noted. "But what's really clear to me is 110 vulnerable people is something we can get to work on in Santa Monica."

John Maceri, executive director of Ocean Park Community Center and one of the late-night street interviewers, was asked to speak about what it was like to seek out and talk to the hardcore homeless on their own turf.

The service provider said two things were brought home to him. First, how "very, very sick" these urban dwellers were. And second, how it was going to take the whole community - city officials, police department, social service agencies, churches and business leaders - working together to make any significant dent in such an entrenched social problem, which Santa Monica has been trying to cope with for years.

But then he talked about a woman named Betty he interviewed who was 80 and had been living on the street for 20 years.

"She really has gotten under my skin," Maceri confided. "Because the first night it was pouring rain on the 13th Street Promenade, and she was sitting on a bench between Santa Monica and Arizona, leaning over a broken umbrella and the rain was pouring down on her.

"She was the very first person we encountered, and that image still haunts me," he said. "I think it's a good reminder that the project is not about just paperwork and statistics. It's about real people - really, really ill and vulnerable people."

Smiling does a body good

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