Just north of San Francisco, in one of the most affluent counties in California, Marin County’s homeless population is on the rise. NorthBay biz profiles local nonprofit agencies that are trying to make a difference.
The problem in Marin is compounded by high housing and land costs and the difficulty of finding affordable housing sites. The economic downturn has added pressure on families and individuals struggling to make ends meet in a county that has the highest per-capita income in California—and an accompanying high cost of living.
According to the Marin County Department of Health and Human Services (H&HS), the income required for a family of three to attain self-sufficiency is $68,800 annually. In April 2009, the Marin County Civil Grand Jury cited H&HS statistics that 35 percent of the county’s households “could not pay for the most basic services.” The Health and Human Services report further indicated there was “clear evidence of a significant upward trend in the number of homeless and precariously housed in Marin County.”
Underlying the new approach is an emphasis on the most efficient use of the millions of dollars of public and private money spent each year on homeless services. One component of the approach is to provide a variety of affordable housing, including emergency shelters, transitional housing and permanent housing to let families and individuals make the transition into permanent housing. Another component is addressing the needs of the chronically homeless. It’s estimated by many homeless advocates, both in Marin and nationally, that about 10 percent of the homeless population requires 50 percent of the funds that are spent.
A room and a job
Homeward Bound of Marin creates opportunities for homeless individuals and families to move out of homelessness by providing skills training, supportive services, shelters and transitional housing. Mary Kay Sweeney is executive director of the nonprofit organization, which has 12 interrelated programs throughout Marin County, and oversees a $4.5 million budget. The agency has a variety of public and private funding sources.
She says it became clear, years ago, that a different approach than the annual emergency shelter scenario was needed. “We began to notice when we were operating the winter shelter that the same people were returning every year,” says Sweeney. “It became evident there was a year-round need. We decided to launch into a year-round facility dedicated to helping people move out of homelessness.”
The agency has three categories of housing: families can use emergency services for up to six months and then move into transitional housing for up to two years; permanent housing and supportive housing is available for single adults and families; and transitional and permanent housing for individuals with persistent mental illness. Homeward Bound provides 440 beds every night.
“We want to be even more successful,” says Sweeney. “Many people have been homeless for a number of years and they need a lot of support. Without adequate life skills, people aren’t going to be able to secure a living wage job, so we provide some training opportunities as well. The current economic climate is particularly challenging for folks on the bottom rung of the ladder.”
One area where Homeward Bound has been more than moderately successful is in helping families. “Eighty-one percent of the families we serve find housing,” says Sweeney. “They tend to be more motivated [than singles] to move forward.”
The agency also operates a culinary academy (where residents can learn skills to find jobs in the food industry) and runs its own catering service. “We try to hook into a different model,” says Sweeney. “We try to identify people based on their skills, talents and capabilities, as opposed to their deficits. The social service model has always been, ‘I’m the helper, you need help, and we’ll fix you.’ But people are much more resilient and intelligent than that, and it’s much better if they own their progress.
“We sit down with everyone and ask how we should proceed to help them and what their goals are. It often involves money management and job training. The ultimate measure of success is when people get into their own housing,” she says.
New purpose, new plan
Ritter Center in San Rafael has been helping those in need for 30 years, meeting the needs of low-income families and individuals. “Our strongest reputation was as a place where residents in Marin could bring their used clothing, and we would turn around and give it out for free,” says Diane Linn, executive director.
“What’s happened in the last year and a half is a new strategic shift, from charity care to change care,” says Linn, who formerly worked with the homeless population as a member of the board of commissioners in Multnomah County, Oregon. “How do we stop the cycle of homelessness? We adopt a new strategic plan to reduce the number of chronically homeless…to really stabilize the situation of our clients.”
(The federal department of Housing and Urban Development’s definition of a “chronically homeless” person is an unaccompanied homeless individual with a disabling condition who’s either been continuously homeless for a year or more, or who has had at least four episodes of homelessness in the past three years.)
Linn says Ritter Center’s two-fold mission includes helping low-income working families stay in their homes by providing supplemental food programs, clothing and rental and utilities assistance. “We’ll pay for car repairs if it stands between them and losing their housing or job,” she says.
The other emphasis is on helping chronically homeless clients find housing and “end the cycle of homelessness.” Ritter Center is a “place of last resort” for clients who’ve been shuffled from one program to another, or who may not qualify for a housing and work program. Ending this cycle is complicated and requires a variety of services, such as medical support for mental health or drug and alcohol issues and permanent and supportive housing, which can consist of single-occupancy rooms with meals provided. Linn says the center works in close partnership with other agencies in the county.
“Ultimately, we want a seamless system, a continuum of care. We want to be part of that logical pattern,” she says. “The chronically homeless need permanent support.”
In short, says Linn, three words sum up the solution: housing, housing, housing.
Linn agrees with the estimate that 10 percent of the homeless population require 80 percent of the funds, and in fact says the true ratio may be even higher. “If you factor in hospital stays, ambulance rides, psychiatric evaluations and prison time, it could be more than that,” she says. The 2009 Grand Jury report says H&HS estimated its annual expenditures on homeless services at $13.7 million, most of which came from state and federal grant money that was passed on to nonprofits.
“That raises the question: What is the long-term solution?” says Linn.
She believes it requires continued cooperation among the various groups and agencies, politicians and community leaders. “The strategies have been developed, we just have to adapt them to Marin County,” says Linn. On a nationwide scale, three primary strategies have proven effective: Focus on the chronically homeless, connect support agencies to provide a seamless support system, and prove to the community you’re producing results.
With limited funds growing even more limited in the face of a lingering recession, Linn says, “It’s about how to make good use of the very precious public dollars we have.”
Creating a haven
A piece written by Malcolm Gladwell in New Yorker magazine in 2006, titled “Million Dollar Murray,” told the story of a homeless Reno man named Murray Barr, who was stuck in the cycle of homelessness. A police officer who came to know and befriend Murray tracked the cost of his care over a period of time, including incarcerations, ambulances and hospital stays, and it exceeded $1 million.
In 1999, a state-funded pilot program, AB2034, was an unprecedented success in reducing the costs of services to mentally ill adults who were homeless. Marin County took advantage of the state funding to establish the HAVEN (Health, Advocacy, Vocational and Empowerment Network) program, which used a team of people to case manage homeless clients with psychiatric disabilities in an intensive manner, explains Bruce Gurganus, director of community mental health services for Marin County. In 2006, Governor Schwarzenegger vetoed funding of AB2034 and the HAVEN program closed; a new, similar program, called Odyssey, opened in its stead, funded largely by the Mental Health Services Act (formerly Prop 63), which was passed by voters in 2004 and modeled on the success of AB2034.
The HAVEN Program, which Supervisor Adams points to as an example of a cost-effective and successful program, was a departure from the traditional delivery of mental health services, but it had dramatic results. “These programs aren’t cheap,” Gurganus says. “We provide people with housing, and in Marin, that means we end up subsidizing the housing or paying a nonprofit to build and manage the housing.”
The typical cost is between $16,000 and $22,000 per year, per enrollee, for a team that includes social workers, psychiatrists, peer counselors, housing and employment specialists to provide all the services the client needs, including health care. The alternative, in many cases, is much more expensive. A jail inmate costs about $42,000 per year to house, while a patient in a state hospital will cost taxpayers $180,000, says Gurganus.
When state funding disappeared, the county was forced to shrink the program and revamp it slightly, says Gurganus, “but it’s had some remarkable outcomes in terms of keeping people out of the hospital and jails and moving them into stable housing.”
Between 2001 and 2005, the HAVEN program had the following outcomes (based on 159 individuals enrolled in the program): An average 97 percent of enrollees were no longer homeless; there was a 79 percent reduction in the number of days enrollees were incarcerated; an 87 percent reduction in the number of days enrollees were hospitalized; and a 43 percent reduction in the number of days enrollees were unemployed.
Gurganus calls the cost of chronically homeless people “so individual. The person who camps out on Mt. Tamalpais somewhere, as long as they don’t attract the attention of the police or start a fire, isn’t costing anything. On the other hand, if that person gets a gangrenous infection and ends up needing surgery, all of a sudden we spend hundreds of thousands of dollars for treatment.”
There’s also the social cost of homelessness. “The cheapest client is one who’s sleeping under an overpass,” says Gurganus. “But is that any kind of humanitarian treatment, or the picture of a community we want? Is that the way the people in our community—our sons and daughters, brothers and sisters—should be living? No. We’re one of the richest counties in one of the richest states in one of the richest countries in the world. We should be able to provide for our citizens in a humane way.”
Gurganus says there’s satisfaction in seeing people’s lives improve. “It’s exciting for us when we see someone literally come in out of the cold, from living without medical treatment or other services, and get their life back,” he says. “We call it ‘recovery’ when they get their lives back.”
The real face of homelessness
A significant obstacle hindering efforts to solve the homeless problem is the stigma attached to the homeless population. “The chronically homeless, the mentally ill and people with substance abuse issues are the visible ones. They’re the ones people identify as ‘the homeless,’ and there’s a stigma attached to it,” says Supervisor Adams. “But the majority of our homeless are people who’ve lost their jobs and don’t have enough to make ends meet. It’s estimated there are at least 1,000 homeless or under-housed children in this county.”
Diane Linn believes the stigma attached to the chronically homeless involves “some very unacceptable behaviors in this community that set people back. We have to be able to unravel the difference between people who make bad choices with drugs and alcohol or breaking the law and those with bipolar disease whose lives have come apart or people coming home from war who aren’t going to be the same again. How do you separate all those?
“If we set our judgment and our compassion as human beings aside, that’s when the fiscal argument comes to bear. Let’s be practical and figure out what really makes sense—and why not include the compassion?”
Supervisor Adams says it’ll take a community-wide effort to solve the problem of homelessness in Marin. “We’re all in this together. Not any one agency or organization can solve homelessness,” she says. “We all have to kick in and do our part to make it work. Businesses, community and faith-based nonprofits. There’s certainly a role for the business community, because when you have a healthy and vibrant community where people are housed and employed, it obviously benefits the bottom line.”
Marin County resident Greg Moss, a managing partner with NAI BT Commercial in San Rafael and a member of the Board of Directors at Ritter Center, says, “I come to it with a business orientation and certainly compassion. As a business person, my sense is we waste a lot of money just reacting to the problem instead of accepting it and bringing the resources to bear to plan for it. We can use our resources more wisely and get a better value for them…compassion for our brothers and sisters can equal good business for us all. It’s not just about altruism, it’s also about making good economic sense.”
Solving the homeless problem in Marin will require a variety of efforts from many agencies. “It’s going to take housing, it’s going to take services, and it’s going to take a community that says, ‘You can make it,’” says Mary Kay Sweeney.
Homeward Bound has been successful in building housing, but she notes it’s a time-consuming and expensive process. “The last facility took us eight years to build. You have to be in it for the long haul. We’ve partnered with Citizens Housing, EAH and nonprofit housing developers,” says Sweeney. “They have the expertise to build this kind of housing and we have the people to fill it.”
In discussions with business leaders, Sweeney’s message is straightforward. “I say to them, ‘We’re serving not only the homeless but the whole community. We’re trying to be your ambassador to help those who are the most vulnerable,’” she says. “‘Somebody has to do it, and we’re doing it for you.’”
She continues, “We’ve been in meetings and have asked them, ‘What do we need to do next?’ They said training opportunities. We did that; we started a culinary academy. We also have our own catering company. They said we need housing; we’ve built housing. They’ve also said, ‘We want to do for ourselves and become more self-sufficient.’ The businesses are meant to be self-supporting.”
And finally, Sweeney thinks these types of programs are good for business. “We’re getting people off the streets. We’re giving people jobs and skills they need to work, so they can participate in this whole economic package.”
