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.
Disneyland Resort is the most iconic theme park in the world. Disney’s best-known characters are present in the park and woven into America’s national culture, recognized and celebrated around the world. People share more photographs from their visits to Disneyland than from any other place in the world, making it the most Instagrammed location on earth. However, employees report high instances of homelessness, food insecurity, ever-shifting work schedules, extra-long commutes, and low wages.
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.
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.
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.
At the peak of California’s most recent drought in 2009, the Los Angeles economy was in severe recession, with unemployment above 12 percent. These twin crises identified a policy opportunity to tackle both challenges together. Public investments in water use efficiency provide economic and job benefits alongside the environmental benefits from using less water.
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.
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).
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.
Poverty adversely affects the lives of Los Angeles residents as well as the City as a whole. Among other things, poverty has a direct financial impact on local government because of above-average per capita costs for municipal services related to police and fire protection, courts, education, and other services in poor neighborhoods.
There are at least three reasons why it has become important for Los Angeles to exert purposeful influence on its own economic trajectory: The population has grown steadily but the number of jobs in the formal economy, where employers comply with labor law, is still below the level of 1990.
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.
There is extensive evidence of a growing informal labor force in Los Angeles City and County, along with stagnant employment in the formal labor market. Between 2000 and 2004, the working age population in the county grew by 4.9 percent, but the number of wage and salary jobs (i.e., the formal economy) declined by 2.3 percent.
Why aren’t more welfare parents becoming economically self-sufficient after participating in the LA County Welfare to Work Program, GAIN (Greater Avenue for Independence)? What has happened to these parents since entering the labor market after GAIN? The answers to these and other questions are presented in “Prisoners of Hope,” a report originally requested by the Los Angeles County Board of Supervisors on December 19, 2000.