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All Alone

Antecedents of Chronic Homelessness

August 25, 2015 / By Daniel Flaming and Patrick Burns
Underwriter: the Conrad N. Hilton Foundation

All Alone - Monthly Public Assistance CaseloadThe number of Los Angeles residents experiencing chronic homelessness continues to grow even after housing over 10,000 individuals in the past three years. The flow of individuals into chronic homelessness is unabated—the pathways have not been closed.  Public assistance programs are Los Angeles’s primary interface with individuals experiencing homelessness. Roughly a quarter of LA County’s population receives some form of public assistance, including those who are homeless or who are at risk of homelessness.  Public assistance programs can be a catalyst for connecting at-risk and homeless recipients with crucial services and reducing the massive public costs associated with chronic homelessness. The vital role is to identify tripwire events among all recipients, particularly children and transition-age youth, and quickly connect at-risk individuals with needed employment, behavioral health and housing services provided by other organizations.

Preventing Homelessness

Prevention is critical for reducing the number of people who experience homelessness as well as the number who become chronically homeless. Housing alone will not provide a solution until the pathways into homelessness are narrowed. Given the size of Los Angeles’ homeless population, needs now overwhelm available solutions.

All Alone - Needs and gaps for preventing homelessnessEmployment and prevention are the foundation for an effective response to homelessness. This includes readily available and effective mental health and employment services. For many individuals, employment is a genuine possibility as well as the only realistic option for escaping acute poverty, but many need help to move past the wreckage caused by homelessness and find a job. We estimate that employment and prevention services are an adequate response for roughly 70 percent of individuals who experience homelessness, but that 20 percent of individuals have an acute need for these services and are unable to obtain them.

Deeply subsidized housing is needed to enable jobless individuals to avoid homelessness. However, HUD funding for the Section 8 Housing Choice Voucher Program, the primary resource for making rental housing affordable to low and very-low income households, has declined since 2010. The wait for vouchers is now longer than ten years. Chronically homeless individuals with acute disabilities are given priority access to Section 8 vouchers, but this still leaves the majority of currently and formerly homeless individuals with very long waits for affordable housing. We estimate that only one in ten individuals in this segment of the population touched by homelessness is able to obtain a Section 8 voucher.

Supplemental Security Insurance (SSI) and low-cost market rate housing enable low income individuals with disabilities to avoid homelessness. SSI benefits provide up to $889 a month in cash aid, which enables individuals to pay for basic necessities, including low cost housing, for example, at board and care facilities. We estimate that 49 percent of indigent adults with disabilities in Los Angeles County who are eligible for SSI are not receiving it. This represents 24,000 individuals. We estimate that homeless individuals in this gap population make up roughly 5 percent of Los Angeles adults who experience homelessness.

Permanent supportive housing is housing that is permanently affordable to an individual and has on-site services such as case management. This wrap around housing is costly because it requires both deep rent subsidies, often through Section 8, and funding to pay for ongoing supportive services. Chronically homeless individuals with acute needs are now being given higher priority for access to permanent supportive housing, but because of the scarcity of housing units with supportive services, most do not receive this type of housing. We estimate that this gap population makes up roughly 8 percent of Los Angeles adults who experience homelessness.

In summary, based on our rough estimates of needed and available solutions to homelessness, 42 percent of people who experience homelessness do not receive the help that they need to exit homelessness, as opposed to being aided while they remain homeless. The primary reason is that there is not money to pay for the solutions. The shortfall in the types of help needed by different groups experiencing homelessness shows that Los Angeles will need to spend far more than it has been willing to spend in order to end homelessness. The problem will be more solvable if fewer people become homeless. This requires more effective efforts to prevent homelessness, beginning with children who are vulnerable to becoming homeless as adults. This report focuses on addressing that challenge.


All Alone - Monthly entrances into homelessnessOver 13,000 public assistance recipients were newly identified as homeless each month from 2002 through 2010. A quarter of these individuals entering homelessness, 3,700 in the average month, were chronically homeless as a result of experiencing four or more stints of homelessness within three years.

Over 100,000 children did not have a home in the average month.

Recipients of cash aid have far higher reported monthly rates of homelessness (General Relief 59 percent, CalWORKs 22 percent) than recipients of other types of public assistance (food stamps 6 percent, Medi-Cal 3 percent).

Half of all homeless public assistance recipients are children.

African Americans make up a share of homeless public assistance recipients that is almost six times as great as their share of the overall county population. Thirty-seven percent of African American recipients are identified as homeless each month.

Married couples have a clear advantage in retaining shelter; only 2 percent are identified as homeless each month compared with 12 percent of single adults.


Fewer than one in ten children with disabilities are identified. More complete recognition of vulnerabilities among children who are at risk of homelessness as they enter adulthood will make it more feasible to reduce the feeder pipeline from childhood poverty and homeless episodes into adult homelessness and chronic homelessness.

Disabilities are under-reported by half in public assistance records for the overall population of cash aid recipients. Disabilities are associated with higher rates of homelessness and chronic homelessness. Disabilities are six times more prevalent among General Relief recipients—who typically are destitute single men—than in any other assistance program. Thirty-one percent of recipients have disabilities.

Census data indicate that the most frequent disabilities among cash aid recipients are ambulatory and cognitive limitations.


Employment rates and earnings are too low to provide a path out of poverty for most recipients. The monthly employment rate in 2010 was 9 percent for nonhomeless General Relief recipients and 32 percent in 2010 for nonhomeless CalWORKs recipients. For recipients who do find employment, earnings are too low to move them out of poverty. The median monthly earnings in 2010 for employed nonhomeless General Relief recipients was $501 and for employed non-homeless CalWORKs recipients was $806.

Even more challenged were recipients with disabilities, who found jobs only one third as often as the overall population of CalWORKs and General Relief recipients (8 versus 24 percent). Disabilities greatly compound the risk of unemployment and homelessness.

Vulnerable Youth Transitioning into Adulthood

Extended participation in cash benefit public assistance programs is more frequent among recipients with childhood experiences of homelessness. Experiences of homelessness while transitioning from childhood to adulthood are associated with reduced employment rates and highly elevated rates of disabilities for both women and men.

Mental health and substance abuse services are scarce for the population of single adult males with extended dependence on public assistance, which is at highest risk of chronic homelessness.

Participation in General Relief is particularly prominent among young adult men who have experienced homelessness. Having a history of homelessness, being male, and being dependent on General Relief for income maintenance is associated with greatly increased likelihood of recurrent homelessness. This risk is an order of magnitude greater for African American men.

Individuals with homeless experiences in their backgrounds and repeated episodes of homelessness are increasingly vulnerable to disabilities as they age if they have continuing dependence on General Relief as their source of income. General Relief recipients who experience homelessness are 415 percent more likely to have long-term dependence on public assistance than those who do not experience homelessness. This is a seedbed of chronic homelessness.


Public assistance programs by themselves have limited capacity to provide health and mental health services; however, they are the best positioned public programs for identifying these needs. The critical role for assistance programs is not to fund all of the services needed to prevent chronic homelessness, but to connect individuals needing those services with other agencies that can provide them.


The intake and assessment process for public assistance programs does not include questions about whether children have disabilities. Often problems are identified after they have grown into chronic disabilities rather than when families are assessed for public assistance or when problems first emerge. This is particularly the case for CalWORKs children with all types of disabilities and for both CalWORKs and General Relief adults experiencing mental health problems.


1. Modify the intake process for CalWORKs to include questions about whether children have special needs.
2. Modify the intake process for CalWORKs and General Relief to include questions about whether adults need behavioral health services.


Tripwire events for flagging risks and occurrences of homelessness include:
1. Homelessness
2. Prolonged or repeated episodes of homelessness
3. Homeless children
4. Domestic violence
5. Children who are not attending school regularly
6. Long-term unemployed adults


Public assistance programs should quickly open the door to integrated public and private heath, mental health, housing, and case management services for individuals and families that experience any of the tripwire events indicating risk of recurring or prolonged homelessness.


All of the combined human service resources of health, mental health, justice system, housing, social service, and educational agencies are required to close paths into homelessness and restore a place in the community for individuals who have experienced homelessness. Public assistance programs can be a catalyst for connecting at-risk and homeless recipients with crucial services and reducing massive public costs for chronic homelessness. This requires growing beyond the role of isolated eligibility determination programs to expeditiously and reliably providing crucial linkage services.


1. When any tripwire event occurs immediately reassess the case.
2. Immediately notify appropriate service providers about the event and assessment results.
3. Facilitate access and rapid face-to-face engagement of recipients needing services with appropriate service providers.
4. This strategy of rapid engagement with needed services should be facilitated by co-locating mental health services in public assistance offices.


Mental health, substance abuse, and other needed behavioral health services should be made accessible to all who need these services. Among CalWORKs recipients, the primary group with access to these services is welfare-to-work participants; among General Relief recipients, the primary groups are recipients who are employed or SSI eligible. Access to services that can prevent, stabilize, or reverse disabilities and prevent movement into chronic homelessness should be readily available to all public assistance recipients. Access to services is especially important for children and transition-age youth.


Facilitate access to the following services children, adults and families that experience any of the tripwire events:
1. Home visits by a public health nurse for any family with children
2. Mental health services
3. Substance abuse rehabilitation services


Anecdotal information indicates that families are reluctant to interact with children’s services workers or probation officers because of concern that this may result in individuals being removed from the home. Medical, mental health, and rehabilitation services are more likely to be accepted by recipients, and wide availability and use of these services can have a crucial effect on preventing homelessness.


Initiate an extensive recipient education campaign to win the trust of participants in the services that are offered to them.


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Area of Work: People
Tags: Barriers, Behavioral Health, California, Children, Chronic Homelessness, Disabilities, Earnings, Employment, Family, General Assistance, General Relief, Homelessness, Indicators, Jobs, Labor Market, Los Angeles, Mental Illness, Permanent Supportive Housing, Planning, Poverty, Prevention, Priorities, Problems, Public Assistance, Screening, Service Integration, Social Safety Net, Social Services, Tripwires, Unemployment, Welfare, Welfare Dependency, Work, Work History, Young Adults