Stanislaus Homeless Alliance SHA SEPTEMBER 11 2019 1

Stanislaus Homeless Alliance (SHA) SEPTEMBER 11, 2019 1

Stanislaus Homeless Alliance Focused Areas of Policy and Outcomes Reporting Shelter/Housing Shelters (triage/intake) Transitional Housing Permanent Supportive Housing Affordable Housing Program Services Community Accountability Mental Health Community Standards & Reporting Substance Use Treatment Employment/Job Training Law Enforcement & Social Service Interventions Supportive Services Diversion Programs Prosecution & Detention

Behavioral Health Services Overview Ruben Imperial Behavioral Health Interim Director County of Stanislaus Jeff Sabean Administrator, Stanislaus Recovery Center County of Stanislaus Kevin Panyanouvong Chief, Adult System of Care County of Stanislaus 3

Overview: Homeless Populations 1. 2019/2020 Planning Priorities 2. Mental Health Treatment 3. Substance Abuse Disorder Treatment 4. Housing Services

MISSION In partnership with our community, our mission is to provide and manage effective prevention and behavioral health services that promote the community’s capacity to achieve wellness, resilience, and recovery outcomes.

Planning Priorities Homelessness: • Develop a homelessness coordinated system of care strategy within the behavioral health system that clearly identifies the number of Behavioral Health & Recovery Services (BHRS) clients that are experiencing homelessness, real-time housing and shelter waitlist, and evidence -based substance use disorder (SUD)/mental health (MH) interventions. • This defined system of care should include interventions for addressing behavioral health issues and accessing the spectrum of care to include prevention, mild/moderate, early intervention and treatment for severe mental illness (SMI). Conservatorship: • Develop an overall conservatorship strategy that defines the coordination of care, evidencebased interventions, placement capacity, and the treatment capacity needed to serve the population.

Planning Priorities • Substance Use Disorder Treatment: Develop a vision for a community-wide drug and alcohol treatment system, leveraging new opportunities with the Medi-Cal Organized Delivery System. This vision would include both county and private sector efforts, making up a broad Continuum of Care to effectively serve local priority populations, such as the individuals experiencing homelessness or those identified through our CARE program.

BHRS 2017/2018 Treatment Mental Health Treatment 8, 668 Early Intervention 3, 147 SUD Treatment 2, 719 State Hospital/IMD/TBC 224 Conservatorship 194 SMI/SED Outreach and Support Services 5, 137 Prevention SUD Prevention, Outreach & Support 6, 700 Prevention: Awareness, Education & Engagement 64, 000 Prevention Support 1, 575

Behavioral Health Services Overview Cont. – Substance Use Disorders Treatment JEFF SABEAN, MA. , LMFT. , LAADC. ADMINISTRATOR, STANISLAUS RECOVERY CENTER

Substance Use Disorder Treatment: Services MEDI-CAL ORGANIZED DELIVERY SYSTEM • March 2018; Fiscal plan approved by Board of Supervisors • April 2019; Expanded Services Began – 6 agencies, 9 sites, multiple levels of services • July 2019; New Provider Redwoods Family Treatment (12 bed Women’s Residential) began • August 2019; New Provider Nirvana Began 3 new sites, 4 levels of service (Men’s Res, Women’s Res, OP/IOT) and Outreach and Engagement at MOE’s Began SERVICES • Care Coordination Team • Residential • Outpatient • Recovery Services • Opioid Treatment Programs • Withdraw Management • Outreach and Engagement (New)

SUD Treatment: Programs Residential Recovery Services • Nirvana Treatment Program • BHRS Stanislaus Recovery Services • Redwood Family Treatment Center (Women) • First Step SVCFS (Women) • BHRS Stanislaus Recovery Center (Co-occurring) • Aegis Treatment Center Outpatient • Center for Human Services Opioid Treatment Programs • BHRS Genesis Treatment • First Step SVCFS (Women) Withdraw Management • Last Resort (Adolescents) • BHRS Stanislaus Recovery Center • BHRS Stanislaus Recovery Services

SUD Treatment: Data • 2019/2020 Performance Measures for the expanded Medi-Cal Organized Delivery System services are currently under development to meet the state mandated reporting requirements and BHRS Planning Priorities. • February 2019 SUD Demographic Data shows approximately 12% of individuals report being homeless. Current strategies to reduce homelessness include: ◦ SUD Residential Treatment ◦ Recovery Residence with SUD OP Treatment ◦ SUD Peer Navigator to engage and connect individuals at MOES to SUD Treatment

SUD Treatment: Data

SUD Outreach and Engagement

Behavioral Health Services Overview Cont. – Mental Health Treatment KEVIN PANYANOUVONG, LCSW CHIEF, ADULT SYSTEM OF CARE / PREVENTION & EARLY INTERVENTION

Outreach and Engagement: Services • “Whatever it takes” • Individual Engagement • Referrals • Behavioral Health Services Navigation • Transportation that helps with access to services or community supports • Crisis-oriented respite housing – avoid unnecessary incarceration and psychiatric hospitalizations • Short-term housing, and linkage to services

Mental Health Treatment: Full Service Partnership Model • Adult Full Service Partnership (FSP) programs • Unique to FSP programs are a low staff to are designed for adults who have been client ratio, a 24/7 crisis availability and a diagnosed with a severe mental illness and team approach that is a partnership between would benefit from an intensive service mental health staff and consumers. program. • Adult FSP programs assist with housing, • The foundation of Full Service Partnerships is employment and education in addition to doing “whatever it takes” to help individuals providing mental health services and on their path to recovery and wellness. integrated treatment for individuals who have a co-occurring mental health and • Full Service Partnerships embrace client substance abuse disorder. driven services and supports with each client choosing services based on individual needs. • Services can be provided to individuals in various community settings.

Mental Health Treatment: FSP Model • Outreach and Engagement activities / “Whatever it takes” • Comprehensive assessment and treatment • Crisis intervention and immediate support 24 hours/day, 7 days/week • Outreach and engagement • Medication management, support, and education • Risk focused assessment and intervention • Physical health screening, care coordination, and referral • Focus on self-help and wellness • Vocational and educational services • Case management & Housing support • Benefits and entitlements assistance • Family engagement and support • Education and life skill coaching, including money management • SUD/Dual diagnosis assessment and intervention • Provide learning opportunities as support for individuals in their recovery • Peer support/community integration

Full Services Partnerships Adults • Stanislaus Homeless Outreach Program • Integrated Forensic Team • High Risk Health & Senior Access • Turning Point Integrated Services Agency • Co-Occurring Disorders Children & Youth • Central Star Youth with SED • Juvenile Justice

All FSP

FSP Discharge Data

Co-Occurring Disorders FSP 2017/2018

Assisted Outpatient Treatment (New) • Assisted Outpatient Treatment (AOT) is a civil court-order for treatment of individuals with severe and persistent mental illness who meet strict legal criteria. AOT allows for a Qualified Referring Party (QRP) to refer an individual for mental health treatment without the consent of the individual. A QRP could be: • Often, these individuals experience severe mental health symptoms which impact their ability to recognize the need for treatment. • Roommate • Goals of AOT include: preventing harmful outcomes such as relapse resulting in hospitalization, incarceration, or trauma; supporting individuals in maintaining stability and achieving personal goals; and assisting individuals to attain positive relationships with family, friends and other natural supports. • Agency Director • Currently developing update report for Board of Supervisors • Family • Hospital Director • Licensed Therapist • Peace Officer

Housing Overview • Permanent supportive housing is an intervention that combines affordable housing assistance with voluntary support services to address the needs of chronically homeless people. The services are designed to build independent living and tenancy skills and connect people with community-based health care, treatment and employment services. Permanent supportive housing has been shown to lower public costs associated with the use of crisis services such as shelters, hospitals, jails and prisons. • Transitional housing is an intervention that is designed to provide homeless individuals and families with the interim stability and support to successfully move to and maintain permanent housing. Transitional housing provides stabile housing with appropriate supportive services for a limited period, usually from two weeks to twenty-four months. • BHRS currently has 58 Transitional housing beds/slots and 142 Permanent supportive housing vouchers. BHRS is presenting an overview of the housing services and programs at the October Learning Retreat.

Homeless Emergency Aid Program (HEAP) Leng Power Homelessness and Housing Manager County of Stanislaus Kathy Harwell Executive Director, Community Services Agency County of Stanislaus Kyle De. Jesus Housing and Supportive Services Manager County of Stanislaus 26

Homeless Emergency Aid Program (HEAP) HEAP is a $500 million block grant, authorized by Senate Bill (SB) 850, designed to provide direct assistance to cities, counties, and Continuums of Care (Co. C) to address the homelessness crisis throughout California. Based on 2017 Point-In-Time Count Based on Percent of Statewide 2017 Homeless Population Total HEAP Funding for Stanislaus County $6, 000. 00 $1, 236, 985. 95 $7, 236, 985. 95 27

HEAP Funding Allocations Capital Improvements 1. Access Center and Emergency Shelter- Modesto ◦ Amount- $4. 1 Million ◦ Status- Both the Emergency Shelter and Access Center are in development and construction. The Emergency Shelter is projected to be completed by mid-November 2019 and the Access Center is projected to be completed by the end of December 2019/January 2020. 2. Oakdale Rescue Mission- Oakdale ◦ Amount- $65, 000 ◦ Status: In development 3. Naomi House- Patterson ◦ Amount- $350, 000 ◦ Status- In development 4. Housing for Heroes- Turlock ◦ Amount- $585, 000 ◦ Status- Pending 28

HEAP Funding Allocations Youth Services 1. Youth Navigation Center ◦ Amount- $1 Million ◦ Status- Stanislaus County CSA engaged in a request for proposal (RFP) process in which Center for Human Services (CHS) was selected as the vendor to create the Youth Navigation Center and provide related services. Youth Navigation Services are scheduled to begin in October of 2019. 29

HEAP Funding Allocations Services 1. Flex Funding and Rental Assistance ◦ Amount- $875, 000 ◦ Status- Disposition of these funds are being reconsidered by CSOC due to no application that were received during request for proposal (RFP) process. 30

HEAP Funding Allocations ◦ The projects will allow for Stanislaus County to meet the following deadlines and conditions; ◦ At least 50% of HEAP funds contractually obligated by January 1 st, 2020 ◦ 100% of HEAP funds expended by June 30 th, 2021 31

Governor’s Council of Regional Homeless Advisors Meeting Kyle De. Jesus Housing and Supportive Services Manager County of Stanislaus 32

Council of Regional Homeless Advisors ◦ Held on Friday, September 6 th at the Stanislaus Veterans Center ◦ Agenda ◦ ◦ ◦ Opening Remarks/Council Member Introductions Homeless Coordinating and Financing Council Overview Homelessness in Stanislaus County: A Local Perspective Mental Health and Homelessness: Working Group Presentation & Discussion Solutions to Address Street Homelessness: Working Group Presentation & Discussion ◦ County/City presented on the following: ◦ ◦ ◦ ◦ Focus on Prevention Initiative Housing Continuum New Governance Structure- SHA Mental Health Program and Services Modesto Outdoor Emergency Shelter Public and Private Sector Collaboration/Partnership Access Center and Emergency Shelter

SHA Learning Retreat Kyle De. Jesus Housing and Supportive Services Manager County of Stanislaus 34

SHA Learning Retreat ◦ ◦ ◦ Date: Friday, October 4 th, 2019 Location: 4835 Sisk Road, Salida, CA 95369 (Salida Library) Time: 9: 00 AM to 4: 00 PM Open to the public RSVP athttps: //www. eventbrite. com/e/stanislaus-homeless-alliance-learning-retreat-tickets-70705438871 35

October SHA Standing Meeting Kyle De. Jesus Housing and Supportive Services Manager County of Stanislaus 36

October SHA Standing Meeting ◦ The next SHA standing meeting is scheduled for Wednesday, October 9 th, 2019. ◦ Due to the California Transportation Commission meeting, which will be held in the Board Chambers on Wednesday, October 9 th, 2019, the October SHA standing meeting will begin one hour later than usual at the time of 6: 30 PM. ◦ For SHA agendas, minutes, materials, and live stream recordings, please visithttps: //csocstan. com/get-involved/sha/ ◦ If you would like to be added to the SHA email distribution list, please email Claudia Gomez at gomezc@stancounty. com 37

Updates on Homelessness Projects Cities may share updates on current homelessness projects within their respective jurisdictions 38

Housing Opportunities – New or Expanded Capacity Category Project Partner(s) Jurisdiction # of Units # of Beds Cumulative # of Beds Estimated Date of Availability Permanent Supportive Glendale Annex Housing Authority Modesto 3 3 3 September 2019 Shelter Women's REST STANCO Modesto 5 8 September 2019 Permanent Supportive Palm Valley Housing Authority Modesto 39 39 47 October 2019 Shelter SA Shelter Expansion Salvation Army Modesto 50 97 October 2019 Permanent Supportive Granger Project STANCO Modesto 4 4 101 October-November 2019 Transitional Family Housing (9 th Street - Master Lease) County Unincorporated 22 50 151 November 2019 Seasonal Empire Migrant Center (Winter Family Housing) Housing Authority/STANCO Unincorporated 22 75 226 November 2019 Shelter Access Center & Emergency Shelter Salvation Army/Modesto/County Modesto 182 408 November 2019 Transitional Kansas House Housing Authority/Modesto 100 150 558 Dec 2019 – Jan 2020 Shelter Naomi's House Cambridge Academy Patterson 10 10 568 January 2020 Transitional Naomi's House Cambridge Academy Patterson 15 15 583 January 2020 Permanent Supportive Kestrel Ridge Housing Authority Modesto 8 8 591 April 2020 Permanent Supportive King Kennedy Cottages Housing Authority/Modesto 23 23 614 June 2020 Permanent Supportive Palm Cottages Housing Authority/Turlock 4 4 618 June 2020 Permanent Supportive Park Cottages Housing Authority/Turlock 8 8 626 June 2020 258 626 Subtotal

Thank You! WRAP-UP 40

Questions? 41