Why the Silicon Valley Triage Tool is Important: The number of homeless people needing housing far exceeds the available housing supply, and there is not a fair, objective system for prioritizing who gets to be housed. The triage tool addresses this problem by identifying individuals for whom the solution of housing costs less than the problem of homelessness.
This report identifies the characteristics of the most vulnerable, distressed and costly homeless residents of Santa Clara County to guide strategies for stabilizing their lives through housing and supportive services, improving their wellbeing and reducing public costs for their care. The county spent $520 million a year providing services for homeless residents over the six years covered by this study. Costs are heavily skewed toward a comparatively small number of frequent users of public and medical services. Individuals with costs in the top 5% accounted for 47 percent of all costs and had average costs of over $100,000 per year.
Different conditions of body and mind found among homeless adults provide a basis for predicting who will have very high public costs – in the 10th cost decile. This report presents a triage tool developed specifically for use in hospitals or clinics where there is not access to data from other agencies about the use of non-medical public services.
The triage tool, or crisis indicator, identifies homeless individuals in hospitals and jails who have continuing crises in their lives that create very high public costs. This redesigned tool is four times more accurate than the earlier screening tool released in 2010. The tool is developed for use in jails, hospitals and clinics where homeless individuals with high levels of need and high public costs are most likely to be found. Discovery of the exceptionally high public costs for people in the 10th cost decile has led to interest in identifying these individuals and giving them high priority for access to permanent supportive housing. This group accounts for well over half of all public costs for homeless adults, and their costs decrease by 86 percent when they live in permanent supportive housing.
The central question investigated in this study is the public costs for people in supportive housing compared to similar people that are homeless. The typical public cost for residents in supportive housing is $605 a month. The typical public cost for similar homeless persons is $2,897, five-times greater than their counterparts that are housed. This remarkable finding demonstrates that practical, tangible public benefits result from providing supportive housing for vulnerable homeless individuals. The stabilizing effect of housing plus supportive care is demonstrated by a 79 percent reduction in public costs for these residents.
A comprehensive strategy with 25 actions, accountable agencies, timelines, and performance benchmarks to prevent and end homelessness in Los Angeles County. From 2002 through 2004 the Economic Roundtable and the Institute for the Study of Homelessness and Poverty at the Weingart Center carried out research, listened to ideas from community stakeholders, and met with public officials in order to prepare this strategic plan for ending homelessness in Los Angeles County.