Helping hands: As voters head to the polls to decide on Measure H, cooperation is proving key to addressing South Bay homelessness
A homeless man talks to a PATH caseworker in Redondo Beach this week. PATH began assigning caseworkers to the feedings at St. James church last year. Photo
Patrick sits on the staircase of a Aviation Boulevard stripmall, just east of Pacific Coast Highway. It’s a cold morning with persistent rain. His jacket, several sizes too big, envelops him. He keeps his head down, occasionally lifting it to glance at nothing in particular, and speaks just loudly enough to be heard over the idling of a nearby police cruiser.
Several uniformed Hermosa Beach Police officers are on the scene, but the questions Patrick is answering come from a jeans-clad woman armed with a laptop and a clipboard. Mary Hoisington is a clinician with the Los Angeles County Department of Mental Health. And since the beginning of 2017, she has been spending her week assisting local police departments on calls as part of the Beach Cities Mental Evaluation Team (MET). The team is a “co-response” unit in which clinicians like Hoisington accompany police officers on field response calls involving people thought to be suffering from mental illness. The team had been called to the scene after police received calls from passersby that a man matching Patrick’s description had been accosting them.
Patrick, like the majority of clients the team encounters, is homeless. (His name, and that of other homeless people appearing in this story, has been changed for confidentiality purposes.) Bringing on a clinician like Hoisington has significantly improved the ability of local governments to deal with some of the issues posed by the South Bay’s growing homeless population. It has become an increasingly popular use of the health department’s resources, with departments from 36 cities in the county now regularly deploying a clinician.
One of the most valuable tools that Hoisington brings to encounters with those suffering from mental illness is the ability to access and interpret county health department records. The vast majority of homeless people that police departments encounter have some previous institutional history, but the Health Insurance Portability and Accountability Act, a 1996 federal law known as “HIPAA,” limits the availability of sensitive medical information collected by public agencies. Police officers approaching, for example, a homeless woman suffering from apparent delusions, do so without critical information about her medical history. County clinicians like Hoisington, however, have access to these records, and can inform how officers deal with case.
“I can say, ‘Hey, no, no, this guy just got out,’ or ‘Hey, this guy is high-risk.’ They didn’t have that information before,” she said.
Bringing together disparate sources of information and expertise is proving an increasingly important part of the battle to end homelessness in the South Bay. There are dozens of different nonprofits, governmental agencies and faith-based groups devoted to the issue. But over the past few years, as the area’s homelessness crisis has heightened, they are increasingly collaborating across jurisdictional and ideological boundaries to find more permanent solutions to the problem. Their efforts provide a preview of what experts say is possible with the enhanced funding that would become available with the passage of Measure H, a quarter-cent sales tax increase on the March 7 ballot to provide services to the approximately 46,000 people experiencing homelessness in Los Angeles County.
Patrick was calm during the interview. A former welder, he was in his late 50s and claimed to have been on the streets since age 22. He was born in Southern California, but did not like to stay in one spot too long and often moved about the region.
His quick, terse answers conveyed a familiarity with institutional questions. His answers did not indicate danger so much as a resigned hopelessness, a lack of faith that Hoisington or anyone else could do anything to improve his situation. At one point, he said that he was not sure if he had any living family members.
But just as officers’ approach is informed by Hoisington’s access to medical records, hers is helped by information from police investigations. (Officers in Redondo Beach stopped her in the middle of a recent interview after learning that the person she was speaking to was sought on a high-risk warrant.) As she retreated to the car to search for Patrick in various county databases, HBPD Officer George Brunn came to the car. Brunn had been on duty for several hours already, and had seen Patrick earlier that morning, loudly screaming near the intersection of Pier Avenue and Sunset Drive.
Hoisington got the phone number of the “RP,” or reporting party, who made first contact with the person to get additional details. Information from a “credible third party” can be a deciding factor, Hoisington said. And the average person is usually surprisingly adept at distinguishing criminal behavior from mental illness. In Patrick’s case, the reporting party, a woman, had told the dispatcher that she just wanted the man to get help. But she also revealed that Patrick had made multiple threats to her boyfriend.
“That’s why this credible third party information is so important. She was fearful for her safety. If we left and he did something…We’ve got to get him help today,” Hoisington said.
Gotta have faith
A woman accepts a plate of food during a feeding of the needy at St. James Church last week. St. James holds feedings three times a week. Photo
St. James Church in Redondo has hosted its Feed the Needy lunch three days a week for over 25 years. In addition to a hot meal, they provide clothing, toiletries and the occasional sleeping bag.
Over time, the offering has built up a dedicated following among the local homeless population. Linda Cabibbo, a former social worker, has volunteered with the program for about 15 years, and estimated that the thrice-weekly feedings typically attract between 40 and 70 people. About 70 percent of them, she estimated, are long-term, repeat visitors. But in recent years, there has been an uptick in the population they serve.
“We are absolutely seeing new faces,” Cabibbo said.
Cabibbo’s anecdotal observations are borne out by data. The Los Angeles County Department of Public Health’s Service Planning Area 8 stretches from Inglewood to San Pedro and, according to data from the January 2016 Greater Los Angeles Homeless Count, there were 3,663 homeless people in the region, an increase of 22 percent over figures from 2015. (Initial numbers for 2017 count, which took place in January of this year, will be provided to the federal Department of Housing and Urban Development in April, and finalized in May or June.) Of these, 240 were in the Beach Cities, 216 of them in Redondo.
Homelessness advocates have found that the surge has transformed the approach taken by local governments.
“There has been a tremendous turnaround in interest in the last five years,” said Nancy Wilcox, co-chair of the South Bay Coalition to End Homelessness. “Three or four years ago when our coalition would talk to other cities, they’d say, ‘We don’t have a homelessness problem.’”
Lt. Wayne Windman, of the Redondo Beach Police Department, said his officers began noticing a significant uptick in the area about five years ago. Over that time, he said field responses to calls involving homeless have increased about 300 percent.
“Our calls for service have exploded,” Windman said. “I’ve been here 37 years, and we’ve always had our regulars. But for us, it has become much more noticeable.”
Starting in April of last year, Cabibbo said, St. James partnered with People Assisting The Homeless (PATH), which now stations a case worker at the church every other Monday. The relationship, Cabibbo said, bloomed out of a desire to find a more permanent solution to homelessness. While ministering to the needy will always be part of the church’s mission, the partnership could allow them to do something more.
“We wanted to see what we could do beyond just feeding them,” Cabibbo said. “What could we do besides putting a plate in their hands?”
Because the feeding has built up a dedicated following over the years, it gives PATH caseworkers one of their most important tools: access. Johanna Sanchez, a street outreach social worker with PATH, was stationed at St. James on Monday. Churches, she said, provide the best way of “reaching the unreached.”
“So many times, individuals experiencing homelessness are transient and hard to reach. If all else fails, we know we can find them here the following week,” Sanchez said.
Faith-based organizations are also doing some organizing of their own. In February, St. James hosted a meeting of about about a dozen local parishes, along with PATH and law enforcement officials, to discuss coordinated responses to homelessness. PATH now also stations caseworkers at feedings in other churches in the area, including St. Andrews Presbyterian and First United Methodist.
Shortly before lunch on Monday at St. James, Sanchez met with a client named Michael and discussed his attempts to secure housing. Michael was alert, informed and inquisitive. (Among his first questions was the potential impact of the passage of Measure H.) He had previously submitted forms to apply for permanent housing, and was eager to know what was happening.
Sanchez searched through her files, and found a possible match with a property owner in Long Beach. Although there is a wide variety of government-administered housing options, Sanchez said, she has built relationships over time with individual property owners throughout the county. And based on good experiences with previous clients she has sent their way, they have become the first resource she turns to when she has suitable new clients.
“Once [a property owner] knows someone from PATH is involved, they’re willing to work with the client,” she said.
Michael expresses some initial hesitation about shared housing, but Sanchez is persistent, offering to drive him there to check the place out and speak to potential roommates.
He gradually softens. They make plans to meet and check out the Long Beach option. He stands up to head for lunch, leaving the meeting seemingly in a lighter mood than when he arrived.
Sanchez seems pleased, but knows her work is not done.
“And if I don’t meet up with you, I’ll see you at St. Andrews on Thursday!” she calls out after him.
Shifting approach
Mental health clinician Mary Hoisington, left, and HBPD Officer Michael Frilot respond to calls as part of the Beach Cities Mental Evaluation Team. A majority of their calls involve homeless people. Photo
Although Michael and Patrick represent two very different institutional points of contact, they are revealing of one of the challenges faced by caregivers of all stripes: hesitancy among some homeless people to accept services offered.
In Patrick’s case, despite his calm demeanor and lack of immediate need — he had an Egg McMuffin and a coffee from a nearby McDonald’s when police found him — safety concerns ultimately led Hoisington to recommend further evaluation by a psychiatrist. Though not under arrest, he was placed in handcuffs. Accompanied by HBPD Officer Michael Frilot, Hoisington took Patrick to Exodus Urgent Care, a county-contracted facility that takes people in for less than 24 hours.
This is itself something of a victory. Hoisington connecting officers with Exodus has given them an alternative to a time-consuming trip to Harbor-UCLA Medical Center, where they often had to wait hours for a space to become available — hours that are now spent back on patrol. But it is the question of what comes next, the search for a more permanent solution, that continues to occupy homeless service providers.
After years of debate among government agencies and academics, consensus is crystallizing around a “housing-first” policy. It is sometimes known as the Utah model for the success that state has had in reducing homelessness — an estimate from 2015 pegged the state’s total unsheltered population at less than 200 people. And while designated long-term housing for the homeless is vanishingly rare in the Beach Cities, nearby areas are beginning to expand offerings. Voters in the city of Los Angeles approved Measure HHH in November, a $1.2 billion bond measure that will build 10,000 units of housing for the homeless, at least some of which will be in parts of the county’s Service Planning Area 8 like Wilmington and San Pedro.
The model does not enjoy universal acclaim. Many in law enforcement, for example, say their experience indicates that not all homeless people want to accept housing, particularly when it is accompanied by rules. Though officers accompanying Hoisington were uniformly courteous to Patrick, they remain wary of the danger some street dwellers can pose, and suspect some of them of malingering to take advantage of government services.
Meredith Berkson, PATH’s regional director for the southern portion of the county, said that this view is a relic of a time when more restrictions and conditions were placed on obtaining housing. It can take months or even years of outreach, she said, but homeless people are ultimately desirous of housing. Hesitancy on their part, she said, may be due to negative experiences they have had with the system in the past.
“We find that through trust and relationship building, we are able to educate them about options available to them, and work through some of the trauma and mistrust,” she said. “It’s likely they’ve been promised a lot, and not delivered as much.”
Indeed, the push for Measure H makes it clear that “housing first” does not mean “housing only.” If anything, the increased focus on long-term housing for the homeless makes the kind of services the measure could fund all the more relevant.
“It takes a very long time of engagement, months or even years, to get someone housed. And a lot of the real work starts when we actually get them housed. You still have all the issues that got them there in the first place,” Wilcox, of the South Bay Coalition to End Homelessness, said.
The shifted approach may be warranted in part because the change in the South Bay’s homeless population is one not just of degree but of kind. RBPD officers conducted an informal survey of the homeless in 2012, and again in 2014. What stood out to Windman and other officers from these outreach efforts was the type of people they were encountering.
“Our perception of the homeless is changing. It’s not just the 70-year-old wino. That’s still out there, but the paradigm is changing. It’s the young adult, it’s the parent struggling with children,” he said.
Conversations with these newly homeless people revealed that many of them had lost jobs during the Great Recession. Some could not find work at all; many had lost full-time jobs and replaced them with temporary or part-time work that did not provide enough to live on, said RBPD Sgt. Jeff Mendence. They came from other parts of the state, and were drawn to the area by its reputation for kindness.
It is these people on the margins of homelessness who arguably stand to benefit the most from Measure H. Federal grants have long focused on the “chronically homeless,”a bureaucratic euphemism for Windman’s 70-year-old wino. But an increasing focus on different groups, including those at risk of soon becoming homeless, could yield dividends for years to come.
“In the past, federal money targeted people who had been on streets for years. Now, hopefully we will have funding to work with people in other categories,” Wilcox said. “Why wait till they’re out on the street? Let’s catch people any place we can.”