Meeting_Body
OPERATIONS, SAFETY AND CUSTOMER EXPERIENCE COMMITTEE
EXECUTIVE MANAGEMENT COMMITTEE
JANUARY 16, 2020
Subject
SUBJECT: QUARTERLY UPDATE ON METRO’S HOMELESS OUTREACH EFFORTS
Action
ACTION: RECEIVE AND FILE
Heading
RECOMMENDATION
Title
RECEIVE AND FILE Update on Metro’s Homeless Outreach Efforts.
Issue
ISSUE
In spring 2016, Metro created the Metro Homeless Task Force to address the displaced persons that have turned to Metro system and property for alternative shelter. Out of the Task Force, Metro created the Metro Transit Homeless Action Plan which was presented to the Metro Board of Directors in February 2017. The Action Plan’s goals are to enhance the customer experience, maintain a safe and secure system, and provide coordinated outreach. Components of the plan include Metro’s coordination with County and City Measure H and Measure HHH. The plan also called for the hiring of two C3 teams (County, City, Community) through the County Department of Health Services as indicated by Metro’s Board of Directors. The C3 teams are to provide coordinated and responsive outreach to the homeless and to ultimately get them in housing resources.
Background
BACKGROUND
In 2017, after an extensive study and community review, PATH was contracted (via The Dept. of Health Services) to begin a pilot program-two multi-disciplinary teams (MDTs-consisting of a Mental health Specialist, a Substance Abuse Specialist, and a Generalist often with lived experience-supported by a medical professional shared between the teams) on the Metro Red Line, M-F, 7 am to 3:30 pm. After a few months of operation, the data supported adding additional coverage and in 2018 the Metro Board decided to expand to eight teams operating across the system, with some teams working 11 pm to 7:30 am and others 7 am to 3:30pm. Flexibility has been built into the approach, and the current deployment of teams during two shifts has proven to provide the best coverage and greatest flexibility in addressing the shifting needs on the system.
Discussion
DISCUSSION
The PATH MDT approach to homeless outreach is an evidence-based “whatever it takes” practice proven effective in building rapport and helping people who are experiencing homelessness to move off the streets and into permanent housing in accordance with their needs, abilities and desires. PATH teams offer services and support including meeting simple basic human needs, support in obtaining required documentation, connections to mental and physical health support, transportation support, housing location support, referrals to programs designed to assist people in finding/obtaining/maintaining permanent housing, etc. The approach is supportive, and thus PATH works in partnership with security and law enforcement whose approach typically focuses on security and enforcement for the benefit of all Metro riders.
Daily:
PATH teams “huddle” at Union Station daily at 7 am, providing teams an opportunity to communicate and receive any specific news/info/assignments in response to any requests from Metro, Metro Security, LAPD, other law enforcement, service and community partners. A typical pattern of deployment is engaged (please see below) with the understanding that we are available to respond to specifics of each day. PATH team members will typically be reaching out to offer services as well as continuing the engagement process and providing on-going support to those with whom they have already connected.
Communication:
All PATH team members are equipped with cell phones and ipads. Program Managers coordinate requests for immediate response and all are in constant communication regarding location and availability. Given the changeable nature of the work, this is essential. Team documentation takes place in the field.
The communication with Metro Security and other law enforcement partners is continual. LAPD and others will attend morning huddles as needed to communicate any needs/concerns.
Data:
PATH teams enter data into the federally-mandated Homeless Management Information System (HMIS) to record information/case notes/documentation. Data collection, analysis, and presentation are performed by the Health Service Department. The PATH teams provide Metro with a basic monthly report including numbers of contacts, numbers of folks connected to services, and number of folks who have been connected to permanent support programs, with YTD and Contract-to-date totals.
Oversight/Cooperation:
The PATH Metro MDTs work in partnership with the Health Services Department which provides guidance, training support, data support, etc. PATH’s communication is continual and they meet at least monthly for review and support. PATH deploys Program Managers who directly oversee MDTs as well as Associate Directors who provide direction, administrative leadership and support, as well as “boots-on-the-ground” guidance, engagement and accompaniment for the MDTs. PATH also provides licensed clinical support for the teams. The PATH team is in regular communication with Metro Security as well as with the Metro Project Manager to coordinate services and meet pressing needs.
General Deployment strategy and line coverage specifics:
At any given time PATH teams will be found across Metro rail/bus lines, responding to specific observations and requests as well as doing outreach to people in need. Staff are deployed at 3 a.m. - 11:30 a.m. and 11 a.m. - 7:30 p.m. Focus is on the Red Line, with Union Station as a priority. When the teams reach terminus points the teams leave the trains and outreach the bus system as well.
Union Station coverage:
Swing shift red line team specifically cover Union from 3:30-5:30am. Red and Gold line teams also sweep Union each time they pass through Union throughout the shift, which provides additional hours of coverage throughout the day.
Day teams rotate to specifically cover Union from 7:30-9:30am. If there are individuals seeking assistance, the team remains longer to provide services. If the team is not encountering anyone looking for services, they disperse to their assigned lines. Red and Gold line teams also sweep Union each time they pass through throughout the shift, which provides additional hours of coverage throughout the day.
Security/LAPD contacts day time manager and nighttime managers when individuals are interested in services at Union or other stations, and when a team is not on-site, the closest available team member is assigned to respond.
Both teams begin their shifts with a huddle at Metro headquarters. The swing shift teams then disperse to the terminus points to outreach as the gates open. The day shift teams attend the huddle, and then either meet with clients for pre-scheduled appointments, or proceed to their assigned lines for outreach.
Once an individual is encountered who is interested in services, the team spends time working toward housing and related services with that individual. Team members accompany clients to appointments such as medical or mental health, take individuals to obtain documentation such as ID’s, attend housing related appointments, take clients to shelters, etc. The bulk of outreach work is in assisting the individuals with the tasks necessary to obtain housing and health. As the program has continued, the teams have become very familiar to folks experiencing homelessness on the system, and much of the team’s time is spent with these follow-up activities. When the teams are not working with a specific individual, they spend their time outreaching their assigned lines and locating new individuals to assist.
People who are experiencing homelessness may have difficulty trusting staff members or express that they are not initially interested in services. In these situations, the team continues to build rapport through repeated contacts, offers of assistance, or items such as food and water. For individuals who have been homeless for a considerable amount of time or have serious mental health issues, the team may spend months or even years building rapport before a person agrees to move forward with housing related services.
In addition to working with individuals, the team also attends outreach coordination meetings throughout the county in order to obtain additional resources and coordinate client care.
PATH Impact Stories resulting in Stable Housing
I. November 2019: Family of four was engaged on Metro Property at Wardlow Station on the Blue Line Train. Emergency motel room and other services were provided in the Los Angeles area. Family consists of Hispanic father, mother, 4 year old daughter and 3 year old son. There are three other step children not with family presently. The father became homeless in 2014 due to loss of employment. The mother became homeless in 2016 when she was kicked out of her home, with the 4 year old daughter, due to larger family issues. The mother was able to link herself to the Dream Center and able to gain assistance from the program. After being there for some time the mother and father were reunited while at the Dream Center. They were discharged from the Dream Center and returned to being homeless. The Metro outreach team found them at the Wardlow Metro Station. Outreach staff provided emergency housing in a Los Angeles Motel while working to connect them with appropriate resources. Outreach connected family with the Union Rescue Mission’s Family Program, and they entered shelter on Skid Row. However, the Skid Row environment exacerbated the daughter’s asthma. Metro Outreach re-established emergency assistance in the motel and then continued to coordinate/collaborate with case management from the Union Rescue Mission Family Program. Outreach staff worked closely with family to obtain necessary documents for housing, apartment searching, and ongoing support and advocacy. With the support of PATH, Family Solution Center Rapid Rehousing and Metro Outreach program, the family was able to move in to their own two-bedroom apartment on the day before Thanksgiving. Client quote,” keep on pushing forward and never give up.”
II. October 2019: Participant is a 41- year-old Caucasian. While conducting outreach on the Orange Line, the team connected with client who was sleeping under a tarp. The Orange Line team engaged her and found her to be weak, dehydrated and in need of medical attention. Team nurses examined her in the field and found that client had a large mass on her left breast the size of a softball. At the time team met client, client refused to go to the hospital. The team followed-up with the client the following Monday to discuss a plan for medical treatment. That Monday the team went to see client and contacted 911 due to client being in immediate need of medical treatment. Staff consulted with LAFD and client was transported to the hospital. Staff went to the hospital the following day to find out that the client had been discharged. The client was transported to Valley Presbyterian Hospital. Once client was admitted to the hospital, it was confirmed that client had stage 4 breast cancer. Since being admitted, the client has been advised that her condition is terminal and there is no treatment available. Outreach team worked with hospital social workers to locate client’s family. Client has reconnected with her son, grandchildren, and mother. Client is currently waiting for hospice care and is reconnected with her family. She continues to have a positive outlook. Client will be spending the end stages of life indoors, rather than on the street.
III. September 2019: Participant is a 34 year-old male who had been a heroin addict for the past six years, five of those years he had experienced homelessness. Participant has experienced significant mental health issues for much of his adult life which had gone untreated for the most part. Participant developed a chronic illness with severe symptoms as a result of his addiction. Based on the participant’s chronic physical illness, mental health issues and substance use disorder, a referral was made to DHS HFH IH and he was placed at the Weingart Center a few days later.
IV. Cumulative Performance Metrics:
a. Through PATH C3 Outreach Team workers, 171 homeless individuals were permanently housed beginning May 17, 2019 - November 30, 2019.
NOTE: Per Board Director Bonin’s request, PATH responded that in November 2019, “on 173 occasions, we had individuals refuse to go into shelter beds in Skid Row. On 84 occasions, we had individuals who were willing to accept shelter, but no beds were available.”
NOTE: Per Board Director Krekorian’s request. Law Enforcement definitions for LAPD, LASD, LBPD are explained below.
Definition of Two Performance Metrics used by Law Enforcement: Referrals and Mental Illness
LAPD -Transit HOPE Team
Referrals: “… considers a referral to be a contact that resulted in a positive connection to outreach workers or service providers.”
Mental Illness: “Mental health numbers are based on an individual displaying signs of mental illness, admitted mental illness or a verified history of mental illness related contacts or treatment.”
LASD
Referrals: “…usually those clients who decline our outreach services. We referred them to locations where they can obtain services such as homeless shelters, medical or mental health clinics, counseling, permanent housing, and/or DMV vouchers to obtain CA identifications, etc. These referrals can be in the form of pamphlets or verbal discussions, such as names and locations available to them.”
Mental Illness: “Mental illness means clients who display signs of mental illness such as Bipolar, Schizophrenia, etc., but they don’t meet the level of 5150 WIC criteria.”
LBPD
Referrals: “…usually those clients who decline our outreach services. We referred them to locations where they can obtain services such as homeless shelters, medical or mental health clinics, counseling, permanent housing, and/or DMV vouchers to obtain CA identifications, etc. These referrals can be in the form of pamphlets or verbal discussions, such as names and locations available to them.”
Mental Illness: “A wide range of conditions that affect mood, thinking, and behavior. Verified by self-admission, prior contacts by Law Enforcement or DMH, or observation with evaluation.
LAPD Outreach
November 2019: Transit Services Bureau HOPE Officers sheltered 2 homeless persons out of 21 referrals.
October 2019: Transit Services Bureau HOPE Officers sheltered 2 homeless persons out of 19 referrals. In addition, HOPE Officers:
• Observed Alfredo sleeping on the ground near the Flower and 7th escalator entrance. Officers learned that Alfred suffered from a developmental disability and found to be a “Missing Person” from San Ramon, CA. Alfredo required immediate medical attention and LAFD was contacted for assistance. Alfredo was transported to Good Samaritan Hospital for medical treatment. Officers were able to locate and contact Alfredo’s family. Approximately eight (8) hours after Alfredo was medically stabilized, Alfredo’s family from San Ramon came to Good Samaritan Hospital and picked him up. Alfredo’s family stated that “without the intervention of the TRSG HOPE Team, Alfredo would have likely perished alone on the streets of Los Angeles.”
September 2019: Transit Services Bureau HOPE Officers sheltered 3 homeless persons out of 30 referrals. In addition, HOPE Officers:
• Observed a homeless woman at Union Station with maggots pouring out of one of her legs. She was placed on a hold then transferred to receive much needed medical treatment. LAPD’s Mental Evaluation Unit worked to have the homeless woman evaluated through the Detective section of LAPD’s Mental Evaluation Unit for conservatorship consideration. Meanwhile PATH was working on housing options.
LASD Outreach
November 2019: Transit Mental Evaluation Units sheltered 8 homeless persons out of 300 referrals. In addition, the Transit MET Units:
• Transported 13 clients to other homeless outreach connection services.
October 2019: Transit Mental Evaluation Teams Units sheltered 4 homeless persons out of 296 referrals. In addition, the Transit MET Units:
• Transported 16 clients to other homeless outreach connection services.
September 2019: Transit Mental Evaluation Units sheltered 3 homeless persons out of 376 referrals. In addition, the Transit MET Units:
• Transported 23 clients to other homeless outreach connection services.
LBPD Outreach
November 2019: Quality of Life Officers sheltered 2 homeless persons out of 17 referrals. In addition, Metro Quality of Life Officers:
• Transported one person experiencing homelessness from the Long Beach Metro 5th Street Station to the Long Beach Health Department Multi Service Center for shelter and services.
• Transported one wheelchair bound person experiencing homelessness from the Long Beach Metro Wardlow Station to the Long Beach Health Department Multi Service Center for shelter and services.
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October 2019: Metro Quality of Life Officers sheltered 1 homeless person out of 14 referrals. In addition, Metro Quality of Life Officers:
• Placed a female subject experiencing homelessness at the Long Beach Multi-Service Center. The Long Beach Multi-Service Center planned for temporary transitional housing.
September 2019: Metro Quality of Life Officers sheltered 1 homeless person out of 9 referrals. In addition, Metro Quality of Life Officers:
• Placed an elderly male subject at the Long Beach Reserve Mission. The Mission assigned the subject temporary housing for one week.
Homeless Projects in Progress:
1. Faith Leader Survey
o Goal: identify faith leaders’ concerns, perceptions and recommendations
o Serves as a basis for open discussion/exploration
o Identifies areas of collaboration to mitigate homelessness on Metro’s system
o Supports continuity of connection between Metro and faith leaders (post-Faith Leader Roundtable event)
2. Faith Leader Roundtable Events
o Opportunity to follow-up and collaborate with faith leaders on:
§ hosting Connect Days
§ partnering with entities that provide necessities (food, shelter, clothing)
§ providing counseling (voluntary)
§ providing welcome home boxes containing household items
§ purchasing welcome home boxes (empty boxes to be filled)
As a result of the Korean Faith Leader Roundtable Event, August 8th, Pastors reconvened, November 15, 2019 at Metro to discuss their expectations of Metro and discuss ways Metro could facilitate connecting Korean churches with social service agencies. Korean Pastor, Timothy Park, had a community-based thanksgiving celebration at MacArthur on Thanksgiving Day. Metro’s marketing department provided bags for distribution at the event.
3. Esri Mapping Tool
The Esri app is a location strategy to reduce homelessness. Introducing the Esri mapping app to C3 Homeless Outreach efforts will prove to be an effective tool to strategically deploy resources where needed in near real- time. The use of the Esri app will expand upon the traditional manner of data collection, thereby increasing efficiency and accuracy in deployment and data collection.
o The Esri mapping app will enable C3 Outreach team members to:
o Identify the geographic location of the homeless transit population in near real-time.
o Count the homeless transit population in point-in-time surveys.
o Connect homeless persons with support and services.
o Report and analyze homeless activity.
o Assess risk factors and indicators.
The use of the Esri mapping tool will enhance the Customer Experience by ensuring that homelessness is addressed rapidly throughout the System.
Attachments
ATTACHMENTS
Attachment A - Homeless Snapshot Outreach September-November 2019
Prepared_by
Prepared by: Joyce Burrell Garcia, Project Manager, System Security and Law Enforcement, (213) 922-5551
Reviewed_by
Reviewed by: Aston T. Greene, Interim Chief, System Security and Law Enforcement, (213) 922-2599
