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«HOMELESS IN SAN DIEGO INTRODUCTION The San Diego County Medical Examiner (Coroner) reports that in the past ten years, 774 homeless individuals have ...»

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The San Diego County Medical Examiner (Coroner) reports that in the past ten years,

774 homeless individuals have died on the streets of San Diego. Homelessness in San

Diego County has reached the tipping point. Not only is the problem a blight on our

community, it is a blight on our humanity. The 2009/2010 San Diego County Grand Jury

understands that homelessness is a complex issue further complicated by the current economic climate, returning military veterans, and early release of prisoners. We believe that the citizens of San Diego have the capacity and the heart to correct this problem. If the residents of San Diego County expect to have decent animal shelters, then let’s expect decent, shelters for homeless people.

The 2009 Regional Task Force on the Homeless report, Point in Time Count Summary, counts 7,892 homeless people of whom 44% are chronically homeless in the County of San Diego (County), excluding children. Some experts believe the number to be significantly higher. Homelessness is a serious issue that is detrimental to the homeless themselves. Homeless is defined as sleeping in a place not meant for human habitation (streets, culverts, abandoned buildings, etc.) or living in an emergency shelter.

Chronically homeless individuals:

1) are homeless for more than one year or more than four episodes in the first three years and

2) are not living with a child eighteen or under and

3) have a long term disabling condition (physical, mental, emotional, developmental, Acquired Immunodeficiency Syndrome [AIDS], substance abuse) The homeless population in San Diego has an unfavorable influence on tourism, businesses, and local residents. Substantial costs for supporting the homeless are passed on to San Diego residents in the form of increased fees and reduced services. Some

examples of these costs are:

 Emergency hospital care  Paramedic health services  Mental health counseling and care  Court and incarceration costs  Police and fire department responses to incidents involving homeless persons that reduce their availability for other types of calls Homelessness can be substantially reduced. The Grand Jury report addresses the

following interventions necessary to reduce homelessness and associated problems:

 Cooperation of the eighteen cities within the County of San Diego and other stakeholders working together on solutions  Interim and permanent housing with service support SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010)  Protection and care of homeless persons and their property  Additional outdoor toilets in downtown San Diego  Additional cleaning of the sidewalks and streets in downtown San Diego During the course of this investigation, the Grand Jury found not onlya need for permanent housing and services throughout the San Diego metropolitan area, but found a crucial need for on-going, year-round temporary housing and services for the homeless.

Studies have shown that public costs are substantially reduced by providing supportive housing. Supportive housing includes medical care, mental health support, substance abuse counseling and other related case management services.


To arrive at this report the Grand Jury:

 Interviewed thirty-two City and County government employees at appropriate levels of responsibility and decision making  Interviewed twenty-seven homeless advocates  Interviewed six homeless service providers and toured their facilities  Interviewed a cross section of homeless individuals  Toured the Alpha Project and Veterans Village of San Diego winter shelters  Reviewed costs of homelessness to the community including reports provided by healthcare organizations, police, sheriff, fire departments, and detention facilities  Analyzed major metropolitan studies and reports evaluating the costs of homelessness to their communities  Reviewed San Diego media reports on the homeless

The Grand Jury reviewed the following specific reports:

 The New York/New York Agreement Cost Study, The Impact of Supportive Housing on Services Use for Homeless Mentally Ill Individuals 2001  The Lewin Group, Costs of Serving Homeless Individuals in Nine Cities, Chart Book No. 367376, 2004  Plan to End Chronic Homelessness (PTECH) in the San Diego Region 2006  San Diego Regional Task Force on The Homeless, Point in Time Count 2009  Where We Sleep – Costs when Homeless and Housed in Los Angeles 2009  Project 50 – 1 year Progress Report (LA) 2009  Hearth, Inc. Ending Elder Homelessness: The Importance of Service – Enriched Housing (Boston) 2009  Home & Healthy for Good – A Statewide Housing First Program, Progress Report, 2009  Building for Success-Second Chance Program  A Street Is Not a Home, Judge Robert C. Coates, 1990 The following metropolitan studies outside the San Diego area examine the treatment of

the chronic homeless and the cost savings to their communities (see Table 1):

SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010)

1. In 2001, The New York/New York Agreement Cost Study concluded that a mentally ill homeless person consumes an average of $40,449 of publicly funded services annually. Once placed into service-enriched housing (affordable housing supported with clinical and social services) the average homeless cost of services is reduced by $12,145 per year per person, which covers 95% of the cost of housing.

2. A nine city study completed in 2004 by the Lewin Group determined the cost of housing a homeless person. The study indicated that supportive housing was the least expensive solution in a majority of cities, as compared to other housing options, such as jails, prisons, shelters, psychiatric, and other hospital

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3. The 2007 Cost of Homelessness Study in Portland, Maine, determined that per person, average homeless services cost before and after permanent supportive housing, decreased from $28,045 to $14,009 annually. The largest savings were in mental health and psychiatric hospitalization, which more than covered the cost of providing housing.

4. The 2009 Massachusetts Study, Home and Healthy for Good, determined the projected annual savings before and after permanent supportive housing was $9,261 per chronically homeless person. The savings came from Medicaid, shelter, and incarceration costs. Additionally, the average annual health care cost for individuals living on the street was $33,327 compared to $8,598 for individuals who obtained housing.

SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010)

5. The 2009 Los Angeles Public Costs Study, Where We Sleep, showed the annualized cost of services before housing at $34,764 and the cost of services with housing at $7,260, a savings of $27,504. The only outlay of providing housing was General Relief vouchers to pay rent. One conclusion of the Los Angeles Public Costs Study was to make increasing use of state and federal block grant funds, to develop affordable housing.

Cities that provide service-enriched housing to the homeless show an annual cost savings and improved use of services when housing is provided. Although the homeless study groups differed in their areas of analysis, from chronic homeless to mentally ill, all the

reports showed savings when the following services provided:

 Medical care  Mental health evaluation and hospitalization  Substance abuse programs  Employment training and placement

The following chart summarizes the cost per homeless person per year:

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SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010) The Grand Jury summarized chronic homeless costs reported as a sampling of police, sheriff, fire, and hospital agencies in San Diego County.

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The tables illustrate the sizeable financial impact of homelessness to the community.

Some of the largest hospitals and government agencies did not specifically track their homeless costs. Below is a summary of the organizations that did not provide responses

to the Grand Jury’s inquiry or had incomplete data on homeless cost numbers:

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During the investigation, the Grand Jury determined that the police, sheriff, and the hospitals need to develop data systems to track homeless costs in the future.

FACTS—Set One A San Diego regional authority can assist in solving the homeless problem.

Fact: In September 2006 the Plan to End Chronic Homeless (PTECH) in the San Diego region was published. The PTECH plan was organized by the United Way with the cooperation of leaders representing all areas of the County of San Diego. The PTECH plan is a collaborative effort recommending solutions for homelessness in San Diego.

Fact: The PTECH plans to establish a Homes First/Housing Plus (first provide the homeless with shelter, then add social services including medical care, mental health and employment counseling.) The PTECH model has limited public and private funding.

SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010)


Finding #01: Homelessness in San Diego County is a region-wide problem that calls for region-wide solutions.

Finding #02: Homelessness in the City of San Diego is an ongoing issue in the downtown area and is most apparent in the East Village neighborhood.

Finding #03: The PTECH report identified many of the homelessness problems and their solutions; however, the lack of an ongoing source of funding has limited the implementation of the Housing First/Housing Plus Plan.

Finding #04: The San Diego region has numerous resources to reduce the impact of homelessness in the community. It is necessary for San Diego governments, homeless service providers and advocates, religious groups, business leaders, and citizens to work cooperatively.


A regional homeless authority is needed to streamline the facility planning and construction, to coordinate the public and private social support services, and to pool funding for a Homes First/Housing Plus Model. A regional authority will require the assistance of a consortium of community leaders in order to be successful.

The following recommendations outline two options for setting up a regional authority:

1. A Joint Powers Authority (JPA) led by the City and the County of San Diego

2. The San Diego Association of Governments (SANDAG) The 2009/2010 San Diego County Grand Jury recommends that the Mayor of the City of San Diego, the City Council of the City of San Diego, and the Board of

Supervisors of the County of San Diego:

10-24: Form a Joint Powers Authority (JPA) and enlist the support of leaders in other cities in the County to develop a regional approach to manage and fund programs to moderate chronic homelessness.

The 2009/2010 San Diego County Grand Jury recommends that the Board of

Directors of the San Diego Association of Governments (SANDAG):

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FACTS—SET TWO There is a need for a San Diego regional homeless consortium with strong leadership to support the Joint Powers Authority (JPA) or San Diego Association of Governments (SANDAG) plan.

SAN DIEGO COUNTY GRAND JURY 2009/2010 (filed May 17, 2010) Fact: There are approximately 4,014 unsheltered chronically homeless persons living on sidewalks, in doorways, river beds, parks, canyons, and other undeveloped areas in San Diego County.

Fact: It is estimated that there are approximately 200 homeless service agencies that provide services including housing, mental health, job training, shelter, and other forms of assistance.

Fact: Studies conclusively demonstrate that providing supportive housing first for homeless persons reduces public costs.


Finding #05: Many chronic homeless in San Diego County do not have shelter at night.

Finding #06: A multitude of homeless service providers exist in San Diego County.

Finding #07: A need exists for permanent intake facilities with supportive services.

Finding #08: Year-round, temporary homeless shelters with supportive services are critical until permanent facilities are operational.


Time has come to reduce the number of homeless persons on the streets. The homeless population is most evident in the downtown and East Village areas. Evidence obtained during the course of this investigation demonstrates that permanent housing is a priority.

Nevertheless, permanent housing alone is not enough. Support services (medical, mental health and substance abuse counseling, educational training and job placement) are paramount and necessary to reunify the homeless population into the main stream of society. It is the obligation of society to intervene and assist in relieving homelessness.

San Diego needs a regional consortium of key stakeholders who will have a role in reducing homelessness. A suggested name for the future consortium is “Homeless and Human Services Council.” Additionally, consortium members should select a Director and an Executive Board to support the efforts of their “Homeless and Human Services

Council”. The following is a recommended list of consortium participants:

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