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.
COVID-driven loss of jobs and employment income will cause the number of homeless workers to increase each year through 2023. Without large-scale, government employment programs the Pandemic Recession is projected to cause twice as much homelessness as the 2008 Great Recession. The Economic Roundtable used data from the 2008 Great Recession to estimate the linkage between job loss and homelessness and forecast the amount and type of pandemic-driven homelessness in Los Angeles, California and the United States.
Proposed Healthy Terminals Acts in New Jersey and New York would add a healthcare benefits supplement of $4.54 per hour, on top of the current PANYNJ minimum wage, for covered airport workers to use in purchasing quality healthcare. We estimate the legislation would affect 34,533 airport workers at Newark Liberty, LaGuardia and JFK Airports, helping many end dependence upon Medicaid.
Households in the Los Angeles metro region paid $7.2 billion for packages from Amazon.com in 2018. Less publicly visible was more than $790 million paid out in public subsidies and uncompensated public costs that supported Amazon’s profitability. It is time for Amazon to come of age and pay its own way. This means paying its full costs to the communities that host it and the workers who create its profits.
In major U.S. metropolitan areas, the number of long-term homeless needing housing far exceeds the available housing supply, making it difficult to move persistently homeless individuals off of the streets. One of the most promising approaches to reducing these numbers lies in early identification and quick, effective intervention to help those most likely to become persistently homeless. Two new screening tools from the Economic Roundtable can help the most vulnerable people get access to the public services they need as soon as they become homeless, or even before they are homeless, and reduce the flow of people into chronic homelessness.
Reliable estimates of time spent homeless during a year are important for an evidence-based intervention framework. Understanding the prevalence of short-term versus persistent episodes of homelessness enables accurate allocation of resources based on differing levels of need. The prevailing approach to homelessness prevention and intervention is “progressive engagement.”
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.
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.
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.
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.
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.
Construction is a $152 billion industry in California, employing 895,000 workers. One out of six construction workers in the Golden State, that is 143,900, sank into the informal economy in 2011. Informal construction workers earn about half of what their formal counterparts bring home and their households are three times more likely to live in poverty.
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.
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.
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.
The most concrete characteristic of a recession is that demand disappears for some of the commodities produced by workers and unwanted unemployment is imposed on a large segment of the labor force. With growing job losses in the current recession it is important to know, whose boat falls when the economic tide recedes?
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.,