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Tag: Permanent Supportive Housing

The Work Behind Work: Combatting Homelessness with Jobs

February 14, 2024 / By Seth Pickens, Daniel Flaming, Manuel Gomez and Ana Alvarez

The most common reason unhoused individuals give for why they do not have a place of their own to live is unemployment and lack of income. Homelessness is primarily a problem of income. Upstream interventions that lead to employment will significantly reduce the number of men, women and children who experience homelessness.

Recognizing and Helping High-Need Homeless Individuals: Five Homeless Predictive Screening Tools

March 2, 2023 / By Daniel Flaming / Economic Roundtable

Preventive vs. Remedial Screening Tools The Economic Roundtable has developed five predictive screening tools to identify and prioritize high-need homeless individuals who will have high future public costs because of ongoing crises in their lives that are resolved in expensive institutional settings, including jails and hospitals. 
Photograph by Mark Boster, Los Angeles Times, "A police officer talks with a homeless woman on a downtown freeway overpass in March," 2016. Photograph originally accompanied the Los Angeles Times article "L.A. agrees to pay nearly $950,000 in two cases involving the homeless" by Emily Alpert Reyes, June 14, 2016.

Model-Based Triage of Permanent Supportive Housing: Improving the Allocation of Supportive Housing Resources

July 1, 2018 / By Jane Carlen, Halil Toros and Daniel Flaming / Santa Clara County Center for Population Health Improvement (CPHI)

This streamlined triage tool was developed for the Santa Clara County Center for Population Health Improvement (CPHI). It provides an empirical tool for prioritizing patients for permanent supportive housing using close-to-real-time data that is available to CPHI. In addition, an industry-wide switch in medical diagnostic classification systems necessitated a conversion of all diagnostic variables from the ICD-9 classification system to the ICD-10 system. 
Image courtesy of the U.S. Department of Housing and Urban Development (HUD). "Cityscape" is published three times a year by HUD's Office of Policy Development and Research (PD&R). Modified by the Economic Roundtable, to announce ERt's refereed paper appearing therein, Spring 2018.

Prioritizing Homeless Assistance Using Predictive Algorithms: An Evidence-Based Approach

April 6, 2018 / By Daniel Flaming / County of Santa Clara, Destination: Home

The current issue of HUD’s peer-reviewed journal, Cityscape, includes an article on the Silicon Valley Triage Tool that was developed by the Economic Roundtable. This statistical model provides a fair, objective tool for triage—prioritizing which individuals should have immediate access to permanent supportive housing. Santa Clara County voters have approved major investments in affordable housing for people experiencing homelessness, but the number of individuals who need housing still substantially exceeds the amount of housing that is available for them.   
Nurse coordinator Mark Block gives food and water to a homeless man living under an overpass on Oakland Road as staff members from Santa Clara County's Valley Homeless Program check on the homeless in San Jose, Calif., on Thursday, June 22, 2017. (Patrick Tehan/Bay Area News Group)

Prioritizing Which Homeless People Get Housing Using Predictive Algorithms: An Evidence-Based Approach to Prioritizing High-Cost and High-Need Homeless Persons for Permanent Supportive Housing

April 29, 2017 / By Halil Toros and Daniel Flaming / Economic Roundtable

This paper explains the methods used to develop the Silicon Valley Triage Tool for identifying homeless individuals in jails, hospitals and clinics who have continuing crises in their lives that create very high public costs. The model is very robust and accurate, taking advantage of advanced prediction methodologies and a unique and exceptionally valuable database created by Santa Clara County, home to Silicon Valley, linking service and cost records across county departments for the entire population of residents who experienced homelessness over a six-year period – a total of 104,206 individuals. 

Silicon Valley Triage Tool: Identifying and Housing High-Cost Homeless Residents

February 17, 2016 / By Halil Toros and Daniel Flaming / County of Santa Clara, Destination: Home

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.  
Photography by Daniel Flaming, taken in downtown Los Angeles, June 25, 2014. Owned by Economic Roundtable, creation of ERt staff.

All Alone: Antecedents of Chronic Homelessness

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

Public assistance programs are Los Angeles’s primary interface with individuals experiencing homelessness and 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.

Home Not Found: The Cost Of Homelessness In Silicon Valley

May 26, 2015 / By Daniel Flaming, Halil Toros and Patrick Burns / Destination: Home

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.
Photography by Robin Kanouse, "Homeless On The Streets of Los Angeles, California, USA." Uploaded to Flickr Creative Commons on March 1, 2010, taken on February 28, 2010. Protected under the CC BY-NC 2.0 DEED license. The Economic Roundtable did not make changes to the image, and does not suggests the licensor endorses our use.  The Economic Roundtable is not using the the material for commercial purposes, and is not applying legal terms or technological measures that legally restrict others from doing anything the license permits.

Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients

September 1, 2013 / By Daniel Flaming, Patrick Burns, Gerald Sumner - Statistician and triage tool developer and Susan Lee - Corporation for Supportive Housing / Economic Roundtable, the Conrad N. Hilton Foundation, the Corporation for National and Community Service, the Corporation for Supportive Housing, UniHealth Foundation

Evaluating the outcomes for 163 hospital patients screened from April 2011 to May 2013 by the 10th Decile Project in Los Angeles, which works with hospitals to identify the 10 percent of homeless patients with the highest public and hospital costs – the 10th decile – and provide immediate services for placing these individuals into permanent supportive housing.

Photograph of a sleeping, unsheltered homeless resident, downtown Los Angeles, by Daniel Flaming, 2023. Owned by Economic Roundtable, creation of ERt staff.

Hospital to Home: Triage Tool II for Identifying Homeless Hospital Patients in Crisis

November 18, 2012 / By Daniel Flaming, Patrick Burns, Gerald Sumner, Manuel H. Moreno and Halil Toros / Economic Roundtable

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. 
Photograph by St Stev, "Trashcan and a Homeless Man." Uploaded to Flickr Creative Commons on April 1, 2008, taken on February 2, 2008. Protected under the CC BY-NC-ND 2.0 DEED licence. No alteration or commercial use of this photo made by the Economic Roundtable. the Economic Roundtable Has not remixed, transformed, or built upon the material.

Crisis Indicator: Triage Tool for Identifying Homeless Adults in Crisis

August 1, 2011 / By Daniel Flaming, Patrick Burns, Gerald Sumner, Manuel H. Moreno and Halil Toros / the Conrad N. Hilton Foundation, the Corporation for Supportive Housing

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.
Report layout, design and all associated graphics assembled by the Health Consumer Alliance of California, underwriter of the Economic Roundtable's research study and report. HCA is a network of ten consumer assistance programs operated by community-based legal services organizations across the state of California. https://healthconsumer.org/ Images drawn from public domain collections. The Economic Roundtable is not using it for commercial purposes.

Dividends of a Hand Up: Public Benefits of Moving Indigent Adults with Disabilities onto SSI

March 1, 2011 / By Daniel Flaming / the Health Consumer Alliance of California

Counties bear large hidden costs for individuals with disabilities who are indigent or homeless. This includes costs for health care, jails and probation in addition to readily identifiable county costs for public assistance. A large share of this cost is health related – costs that the federal and state governments would pay through Medi-Cal if the individuals were receiving Supplemental Social Security Income (SSI). 

Where We Sleep: The Costs of Housing and Homelessness in Los Angeles

November 1, 2009 / By Daniel Flaming, Michael Matsunaga and Patrick Burns / The Los Angeles Homeless Services Authority

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.
Photograph by David Kjelkerud, "Strategy at Galerienhaus." Photograph uploaded to Flickr Creative Commons on July 29, 2008, taken on July 26, 2008.  Protected under the CC BY-NC-SA 2.0 DEED license. 

10-Year Strategy to End Homelessness

June 1, 2006 / By Daniel Flaming and Paul Tepper / The Los Angeles Homeless Services Authority

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. 

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