Title
Probation Department and Health & Human Services Agency recommending the Board engage in a discussion regarding transitional housing of clients in El Dorado County.
FUNDING: Various.
Body
DISCUSSION / BACKGROUND
On September 13, 2022, Item 27 (Legistar 22-1248), the Board of Supervisors approved the Draft Response to the 2021-22 Grand Jury Final Report. During this conversation and in relation to Case 21-06, the Board directed staff to return to the Board with a discussion on Transitional Housing and the use of hotels.
Probation:
The Probation Department provides Emergency Housing for clients as a key component of their case plan through Community Supervision programs. The attached document addresses the questions and concerns presented by the Board of Supervisors on September 13, 2022, regarding the use of hotels by the Department.
Health & Human Services Agency (HHSA):
Self Sufficiency:
CalWORKs Temporary Homeless Assistance Program (HA):
The HA Program serves eligible CalWORKs applicants or recipients who are experiencing homelessness or are at risk of homelessness. A family is considered homeless when the family lacks a fixed and regular nighttime residence; or is residing in a shelter or a place that is not designed as regular sleeping accommodation.
Temporary HA provides a payment of $85 per day for a family of four or fewer, and an additional $15 for each additional family member, not to exceed $145 per day. This is a program entitlement that is issued to the recipient on their electronic benefit (EBT) card via the California Statewide Automated Welfare System (CALSAWS). Temporary HA can be provided for up to 16 calendar days in a 12-month period as an entitlement to those eligible. The family is responsible for securing their own lodging, the County can assist by giving a list of local hotels/motels but does not arrange lodging for the family.
CalWORKs Housing Support Program (HSP):
HSP provides temporary housing assistance while seeking permanent housing for CalWORKs recipient families. This program mandates “client choice” as part of its Rapid Rehousing approach. Clients choose motels that are willing to accept payment from the County based on a variety of reasons such as proximity to their child’s school, childcare, bus transportation or general safety and cleanliness of the motel. HSP families work with their Social Worker to identify the motel. The approval process requires communication with the motel to ensure they understand the payment process, a pre-approval letter for the stay outlining dates and rate and then the motel submits an invoice to HHSA for payment after the stay.
Housing Disability and Advocacy Program (HDAP):
HDAP assists homeless and disabled individuals with application for disability benefit programs, while also providing housing support. The HDAP requires that participating counties offer outreach, case management, benefits advocacy, and housing support to all program participants. HDAP participants choose motels that are willing to accept payment from the County based on a variety of reasons such as proximity to medical providers offices, bus transportation or general safety and cleanliness of the motel. Participants work with their Social Worker to identify the hotel. The approval process requires communication with the motel to ensure they understand the payment process, a pre-approval letter for the stay outlining dates and rate, and the motel submits an invoice to HHSA for payment after the stay.
General Assistance (GA) Program:
The GA Program is a repayable assistance program. Each adult receiving GA must sign a lien that is recorded with the County Clerk’s office. The monthly housing allotment usually allows for approximately 2-3 nights dependent upon eligibility and motel room rate. There are limited motels that work with the GA program. At the time eligibility is determined, Social Service Aides contact the motels to determine availability and participants are issued vouchers to the hotel that has availability. The motel then submits the voucher and invoice for payment after the stay.
Behavioral Health:
Substance Use Disorder Services (SUDS):
The SUDS Division currently offers a specific service, Recovery Residences, to clients enrolled in SUDS who are recovering from substance use disorder. Recovery Residences services are an ancillary component of the DMC-ODS Waiver and are defined in HSC 11833.05 as follows:
For the purposes of HSC Section 11833.05, “recovery residence” means a residential dwelling that provides primary housing for individuals who seek a cooperative living arrangement that supports personal recovery from a substance use disorder and that does not require licensure by the department nor provides licensable services, pursuant to Chapter 7.5 (commencing with HSC Section 11834.01). A recovery residence may include, but is not limited to, residential dwellings commonly referred to as “sober living homes,” “sober living environments,” or “unlicensed alcohol and drug-free residences.”
Recovery Residence homes are safe, clean, sober, residential environments that promote individual recovery through positive peer group interactions among house members and staff. Recovery Residence homes are alcohol and drug free and allow the residents to continue their treatment and/or develop their individual recovery plans and to become self supporting.
SUD Recovery Residence residents MUST be engaged in medically necessary substance use treatment and/or recovery services to be provided off-site. A client is normally offered and placed in Recovery Residence upon completion of a residential treatment episode with no stable environment to discharge to. They would participate in the required activities during their stay.
A typical length of stay is approximately three months. Clients may extend their stay at the Recovery Residence with other counties’ funding streams or self-pay. The Recovery Residences that SUDS contracts with are in Placer and Nevada counties. Sometimes a client will transfer their Medi-Cal benefits to the other county and obtain services (funding) that way. This is done when the client has decided to remain in the other county long term.
Contracted Recovery Residences are run by a contracted provider. The provider has a certified counselor assigned as accountable for running the Recovery Residence. There is usually a live-in “house leader” or volunteer to assist residents. In addition, all El Dorado County clients who are funded for the Recovery Residence must be enrolled and participating in treatment/recovery services and obtain support through the treatment provider. The support is centered on substance use disorder treatment and recovery. Depending on the client, SUDS staff may have routine phone check-ins with the clients, if necessary, during this phase of their treatment.
SUDS requires Recovery Residences to adhere to the El Dorado County Recovery Residences Guidelines and SUDS QA provides annual monitoring of the contracted Recovery Residences at minimum.
Mental Health (MH):
MH has 5 (4 on the WS and 1 in SLT) Transitional Housing (T-House) homes that are used to house clients that meet the criteria of severely mentally ill. The Full-Service Partnership (FSP) Program focuses on securing and maintaining housing for clients who are currently unhoused or would be homeless without this assistance. The program provides case management services, temporary financial assistance, and supportive services to help individuals gain housing stability and end their homelessness.
MH places clients that are receiving treatment services and who are unhoused or face homelessness. These are clients in need of supportive services who need assistance with daily living skills, medication compliance, and clients stepping down from a higher level of care such as a locked facility, state hospital, or Adult Residential Facility (ARF).
Clients pay a set fee from their income. MHSA funding supplements the housing costs. Typical length of stay is 6 months to 1 year. Some clients may stay longer depending on independent housing availability. Individuals graduating the T-House program would secure their own apartment, move in another shared living environment (room and board or board and care), or move in with family.
MH staff provide support 7 days a week for typically 12 to 16 hours a day. Staff provides daily oversight which include medication compliance, crisis support, daily groups, transportation to appointments, and psychoeducation. Clients have access to a phone line from 7am to 8pm that routes them directly to staff for any support needed during these operating hours. After hours clients are given a number to our crisis line that route them to a clinician who is staffed at the local hospital for crisis intervention and support.
A client would stay at a hotel if they have shown they are unable to live in a shared living environment (i.e., violent behaviors, unwilling to remain substance free, or transitioning to another long-term placement). Often times it is circumstantial such as clients pending inpatient treatment for SUDS, have long term housing set up and are awaiting move date, or other extenuating circumstances.
Additionally, MHSA funds are intended to support the overall treatment goals of the client. For children/youth and their families, this may in special circumstances include a short stay at a hotel to provide a stable environment for the child/youth in treatment.
In FY 19/20 MHSA funded a total of 6 hotel stays for individuals in need. 5 were at the Quality Inn and 1 was at the Fireside Lodge in SLT.
In FY 20/21 MHSA funded a total of 3 hotel stays for individuals in need. 2 were at the Quality Inn and 1 was at the West Haven Inn.
In FY 21/22 MHSA funded a total of 3 hotel stays for individuals in need. 2 were at the Quality Inn and 1 was at the Holiday Inn Express in SLT.
Public Guardian:
Occasionally, the Public Guardian has used a conservatee’s personal funds to pay for hotel stays when no other alternative was available and to prevent a conserved individual from being unhoused.
Child Welfare Services (CWS):
CWS has used hotel stays to meet the needs of families and/or foster youth on rare occasions in the past. When the need arises, the social worker works with the family to determine the hotel based on proximity to the child's school, parent's work location, and services. The most recent hotel stays occurred during the Caldor fire for families and young adults in foster care who were displaced.
For those young adults exiting foster care there are two main resources:
Transitional Housing Program Plus (THP-Plus): This is a transitional housing program specific to those exiting foster care. El Dorado County contracts with Whole Person Learning to provide this service. THP-Plus is supervised transitional housing and supportive services for up to three years. Legislation recently changed this from a two-year program to a three-year program and increased the age limit to up to age 25. Participants are responsible for finding their own housing with the support of the Whole Person Learning staff. There is no identified place in the community. They often find rooms to rent, shared housing, apartments, etc. This program serves approximately 9 clients at a time.
Housing and Community Development Grants: CWS receives two grants. One for a Transitional Housing Program (THP) and one for Housing Navigation Program (HNP). These programs are also geared towards current and former foster youth. These grants are contracted out to Whole Person Learning. Whole Person Learning provides housing navigation to help our transition aged youth find and secure housing through the HNP. THP provides rental assistance and case management to help them maintain housing. There is no identified place in the community. They also find rooms to rent, shared housing, apartments, etc.
Procurement and Contracts is currently coordinating with Departments to prepare a Request for Proposals (RFP) #23-952-034 for Temporary/Emergency Lodging Services to provide short-term lodging to participants in programs across multiple county departments. The Chief Administrative Office is assisting in coordinating with Probation and Health & Human Services staff to ensure the RFP addresses the needs of both agencies.
ALTERNATIVES
N/A
PRIOR BOARD ACTION
9/13/22, Item 27, Legistar 22-1248
OTHER DEPARTMENT / AGENCY INVOLVEMENT
N/A
CAO RECOMMENDATION / COMMENTS
Receive information and discuss.
FINANCIAL IMPACT
There is no financial impact associated with this agenda item.
CLERK OF THE BOARD FOLLOW UP ACTIONS
N/A
STRATEGIC PLAN COMPONENT
1) Public Safety: Protects the community, prevents crime, enforces the law, administers justice, provides rehabilitative services, and promptly responds to emergency and calls for service; and
2) Healthy Communities: Improved health, well-being, and self-sufficiency of El Dorado County communities, residents, and visitors.
CONTACT
Brian J. Richart, Chief of Probation
Olivia Byron-Cooper, Interim Director of Health & Human Services Agency