Seattle City Council Public Assets & Homelessness Committee 3/1/23

the March 1st, 2022, sorry, March 1st, 2023 meeting of the Seattle City Council's Public Assets and Homelessness Committee will come to order.

It is 2 p.m.

I am Andrew Lewis, Chair of the Committee.

Vice Chair Mosqueda is excused from today's meeting.

Will the Committee Clerk please call the roll?

Council Member Herbold.

Council President Juarez.

Here.

Council Member Morales.

Here.

Chair Lewis.

Present.

Chair, there are four members present.

Approval of the agenda.

If there's no objection, the agenda will be adopted.

Hearing no objection, the agenda is adopted.

Chair's report.

Today, we're only gonna have one agenda item, although it is gonna be a big and very important agenda item, a report back on the COLEAD Just Care Outcomes, Conditions for Success and Impact.

The materials for that presentation have been distributed, including the report completed by Dr. Catherine Beckett at the University of Washington.

So very much looking forward to jumping in to that item of today's business.

Moving forward to public comment.

I'm going to go ahead and set the public speaking time at one minute.

And people know the remote versus in-person rules.

Why don't we start with the remote public comment period and the public comment period will be

Thank you, Mr. Chair.

Our first remote public commenter is George Scarola.

George, you'll need to press star six, and then you'll have one minute to speak.

Hello?

Hi, George, we can hear you.

Okay, great.

My name's George Scarola.

I'm speaking as an individual.

Here, George, I can't really hear you.

Can you speak a little louder there, please?

My name is George Scarola.

I'm speaking as an individual today.

I wanna tell a story about a guy I met at my gym south of Seattle.

He has a pair of pliers tattooed on his calf.

I asked him why.

He's a plumber he says and he's a happy plumber.

He's making a hundred thousand dollars a year.

We got to talking and later he asked me what I do.

I said I do homelessness.

And he told me the story of his life.

He's been living had been living on the streets of Seattle in and out for years in and out of King County Jail in and out of shelters.

And he asked me have I ever heard of a program called LEAD.

said, yeah, we saved my life.

Thank you, George.

Our next caller is Jake Alper.

Jake, please press star six, and then you'll have one minute to give public comment.

Hi, my name is Jake Alper.

I just want to share that as a West Seattle homeowner, I've been horrified to learn of the increase in threats and violence directed at my neighbors living in RVs.

Recently, several of our neighbors received a threatening letter followed by dumping of suspicious materials and gunshots in the area of their homes.

This isn't surprising given that the city knows bias crimes against unhoused neighbors increased 229% last year.

These neighbors deserve respect and safety as much as any homeowner.

The city's only response has been sweet, driving them to new areas to be threatened by different house neighbors.

This is appalling and pointless.

Where's the safe RV lot?

What is Seattle doing other than trying to hide visible homelessness to protect the comfort of house people?

If you can all do better, I think we can all do better.

Thank you, Jake.

We will now move to in-person public comment.

Our first in-person public commenter is Jesse Burleson.

Jesse, please approach the microphone and following Jesse, we'll have Sandy Ruffin.

Both should work.

Good afternoon, council members.

My name is Jesse Burleson.

I'm here to bring awareness to the fact that violence is being perpetrated against the homeless in a most rampant rate.

Last Monday, I received this letter on the windshield of my RV.

I'd like to read it to the council if I may.

Dear friend, I am sincerely sorry you are in the position you are in.

However, this is not a good place for you to park and live, even temporarily.

When the first lot of RVs showed up here last year, it brought the neighborhood together.

Our kids are scared.

Our wives were harassed.

Some of you are sex offenders, drug dealers, or addicts, all of you make a mess.

Everyone here has handled this differently.

Some file reports, some complain to the mayor, but now we are fed up.

And some people are ready to make your life sheer hell and will dance on or keep you warm or be drivable.

They are ready and looking to fight.

This will happen likely soon.

You have been warned.

I am a military veteran.

This is a declaration of war.

I have seen war.

War is an ugly thing.

Where is our frickin' safe lot?

I'm priced out, and I can't afford to pay rent in this town.

I had people come by offer me housing yesterday, told me, we'll help you with the move-in cost.

Well, that's well and fine.

But if you can't afford the rent to begin with, you're setting me up for failure.

Sir, your time has expired.

I'm sorry, but if you want to connect after the council meeting today, I'd be interested in learning more.

Seriously, please.

Thank you.

Um, just really quickly, uh, there's apparently an issue with the public speaking mics, um, being picked up for the council members appearing remotely.

Um, I'm sorry.

Could, could, would you try speaking into the other microphone?

Is that working?

Son, is that working?

We're not getting anything.

Can you confirm that the podium mics are enabled on the Crestron controller?

Yeah, IT thinks that the mics might not be.

How's that?

Maybe it was because I had my mask on.

There we go.

Now we can hear.

Okay.

So it sounds like IT, it was because the speaker was wearing a mask.

So it sounds like the mics are operating okay.

Thank you.

have a motion to adjourn the meeting.

Dear friend, I am sincerely sorry your extension you are in.

However, this is not a good place for you to live, even temporarily.

When the first lot of RV showed up here last year, it brought neighborhood together.

Our kids are scared, our wives are harassed.

Some of you are sex offenders, drug dealers or addicts.

All of you make a mess.

Everyone here has handled it differently.

Some file reports, some complain to the mayor, but now we are fed up and some people are ready to make your life sheer hell.

and will damage your vehicles so they will no longer keep you warm or be drivable.

They are ready and looking to fight.

This will happen likely soon.

You have been warned.

I take this as a declaration of war.

And as a military veteran, I know about war.

I've seen killing.

And if you people don't do something to get us someplace safe to park, that's exactly what's gonna happen.

Somebody is gonna get killed.

Maybe even an innocent child.

Thank you.

Thank you, Jesse.

Our next speaker is Sandy Ruffin.

After Sandy, we'll have Chanel Horner.

Hello.

I am one of Jesse's house neighbors, and I just want to say I've seen the letters, I've seen guns shot near their RVs to scare them.

I've seen people dump trash and do much, much worse to their homes.

These people deserve a safe lot.

Lifetime Seattle residents who are priced out, most of them working full-time or some have medical emergencies and can't pay their bills.

Good neighbors, better neighbors than some of my house neighbors, and they're having to deal with this.

where's the RV safe lot, who's taking care of them, who's gonna keep them safe when neighbors decide to do worse in the middle of the night.

And for council members who may not have heard Jesse speak the first time that those letters were left on multiple RVs in one neighborhood and then followed up with a lot of action going from annoying to threatening.

So thank you for your time.

Thank you, Sandy.

Next is Chanel Horner followed by Celine Russo.

Hello, my name is Chanel Horner, and I've been going to KCRHA meetings as a lived experience person living in an RV and or living in my bus for over a year now.

And I know that Lehigh is responsible for refining the RV lot, but I think the city could do a lot if they help donate property because right now at this point, We've been waiting since last March.

I think they had, they got approved last March, I believe, and they had a lot of money.

I mean, they got a lot of freaking money to build this lot, and we have nowhere to park, and we got all these blocks everywhere, and nobody's done shit about, sorry, but the blocks need to be, somebody needs to be fined for these blocks.

I mean, they're taking up all our parking spot, and we don't have a place to park, and you guys are pushing us out of the industrial area into the neighborhoods.

Things like this happen in the neighborhoods.

The neighborhoods don't want to park.

We don't want to park next to these businesses.

We don't want to park in these streets or causeways.

We want to park somewhere where we're allowed.

And it's not really fair that Lehigh hasn't gotten that place yet.

Bellevue's going to open a new park in another month.

It's all because Bellevue donated property.

If we donated property, we'd have a place now.

Thank you, Chanel.

Our next public commenter is Celine Russo, followed by Alex Zimmerman.

All right, as a West Seattle homeowner, I feel neither threatened or harassed by Jesse, but I am disgusted by that letter.

I'm extremely disappointed in the city's response of sweeps with no support.

This forces people to move every few weeks and face threats in a different location.

This policy of sweeps is not only cruel and inhumane, but dangerous.

When the city lies to house residents that services and housing are being offered, which they are not, the city is encouraging vigilante justice and violence against our RV and tent neighbors.

These threats are increasing and they dovetail with the violence already inherent in living outside.

Why is the city spending $38 million on sweeps and a $2 million grant for an RV safe lot sits unused?

The city declared a homeless emergency quotes 10 years ago in Seattle, and we can't even get one safe lot built.

I love the suggestion of donating property.

The city can do something at this point.

We need to get it done now.

We can't allow this violence to continue.

We cannot allow it to continue in one of the richest cities in this country.

It's not okay.

Thanks.

Thank you.

Our next speaker is Alex Zimmerman followed by Ajane.

Thank you.

Ha!

Sieg Heil, my dear Nazi-Gestapo killer.

You kill every year 300 people and you're not in jail.

That can happen only in Seattle.

Yeah.

So why this happen?

Why you kill 300 homeless?

Your salary, $150,000.

You spend for homeless, $50,000 for each.

One bedroom apartment costs $1,000 per month.

It's $12,000.

What is the reason to spend $50,000 when for $12,000 you give everybody one bedroom apartment or studio?

It don't have sense.

And you're doing this business for four years.

I think it's time for you to move out because by definition, you're a criminal, a bandit, a killer.

If you don't show us faces, this is another plus.

So you need to be in jail.

It's exactly what they talk.

You all my consul post to be jailed, because by definition you killer.

You post to be in jail.

All of you, stand up America, cleanse this chamber from this bandita.

Our final public commenter is Ajane.

You'll have one minute.

Sometimes in our lives, we all have pain.

We all have sorrow.

But if we are wise, we know that there's always tomorrow.

Meaning there is always tomorrow.

Meaning if you even make mistakes, regardless of your job occupation, because we are all equal in the eyes of God.

We are talking about the homeless, which I talk about all the time, and you are pushing them aside.

We all need somebody to lean on because anything can happen.

and I just hope you listen to us, because we are all equal.

Thank you, have a nice day.

Thank you, Mr. Chair, that is all of our public commenters.

Thank you so much, Mr. Clerk, and we'll proceed to the item on our agenda, the presentation on Lead Co-Lead, I do want to take chair's prerogative for a moment to acknowledge the righteous frustration of the audience members over the continued failure of the city and the King County Regional Homeless Authority to establish the safe lot that the council has funded for, I think, three budgets running now.

and I wish I could say more from the dais right now about that, but the extent of what I can say is just that this council feels that frustration keenly, and we'll continue to make that funding available, and we'll continue to push for our executive partners to implement that RV safe lot, because it is an important priority, and thank you for coming down here to advocate for it today.

So with that, we will move to our agenda item on lead co lead, and it's great to be in a position to welcome Dr Beckett back to the committee.

We've previously heard a report on this research during the preliminary the preliminary report on Just Care a couple of years ago, and then the broader panel of our partners who have brought Just Care and its multiple iterations into life over the course of the pandemic and continue to do this work.

And hopefully, we'll continue to do this work in a greater resourced way as we go forward on our partnership with the KCRHA and other local leaders to make sure that we take full advantage of the lessons that are within this report and presentation.

So who should I hand it over to first?

Should I hand it over to you, Lisa Dugard, to introduce the panel and then introduce Dr. Beckett?

Yes, that's the plan.

Thank you so much, Chair Lewis.

Good afternoon.

It is really a privilege for us to be here with the council.

The Seattle City Council has been really a stalwart supporter of this work from early days.

And in a very real sense, it would not have come to fruition and we would not have been able to sort of complete the learning arc that we're going to present today without very strong council intervention to make sure that the work remained alive.

My name is Lisa Dugard.

I'm a co-executive director at PDA.

Today actually is the very first day, March 1, 2023, that our name is Purpose, Dignity, Action.

We are no longer the Public Defender Association.

We provide project management and design support for community-based alternative safety strategies and As alluded to in public comment by George Scarola, whose story I wanted to hear the end of, the origin of this work really traces back to LEAD, Law Enforcement Assisted Diversion, also known as Let Everyone Advance with Dignity.

LEAD is a program now replicated around the country.

I'm actually in Minneapolis right now consulting with their LEAD initiative that's just getting off the ground.

It was born in Seattle in 2011. And the basic idea is to provide wraparound case management for as long as it takes to stabilize and foster recovery for people who otherwise are highly likely to be engaged by the criminal legal system related to behavior that is problematic.

oftentimes for themselves than for other people, but it relates to drug use, mental illness, or poverty, and so is susceptible to strategies and solutions of community-based care rather than punishment.

So LEAD provides that street-based case management and care coordination and has for the last more than a decade.

In 2020, we had just seen an increased sort of a hard-fought decision by the city to step up its commitment to LEAD so that we could start taking considerably more referrals.

And when those funds came online, that happened to coincide really with the very early days of the COVID pandemic.

And that presented obviously, you know, comprehensive challenges for everybody in every way.

But for us, managing LEAD, and we had been on the cusp of building a new workforce that would provide this case management to many more people, we were presented with an immediate set of challenges that COLEAD and Just Care ended up being the answer to.

We had resources that were clearly badly needed, as you may, like if we can all go back to what it was in that, in the spring of 2020, summer of 2020, It was evident that as badly as many people had needed lead case management and flex funds before the pandemic, all the more so was that the case in 2020 as people who had been in shelters, those shelters were quote unquote de-intensified congregate shelters in order to prevent COVID transmission.

So some people were transferred to non-congregate facilities, but many others were just turned out into the street because Nobody knew what else to do, and there wasn't a ready alternative.

Many of the folks that we work with in LEAD already had not been welcome guests in the congregate shelter systems.

They were already outside, but now we're cut off from public spaces like libraries and community centers, and also from the behavioral health and physical health care system altogether.

Everything was closed, and I just, you know, sitting where we are today, it's hard to really recall how dramatic the situation was, those who had had jobs in the gig economy or with a W-2 were pretty, you know, pretty early on getting the message that there would be relief strategies if their jobs closed down, that people who had been making their living in the sort of gray economy or the illicit economy did not have those relief strategies.

They did not have places to go and seek support.

They did not have places to be during the day.

So folks were just gathering out outdoors in large numbers and increasingly in locations that in the past had been used by other members of the public, but now with the shutdown were largely abandoned to other uses.

And so That was the situation in the summer.

We had resources, but we did not have referrals to lead case management coming through law enforcement, which was the original model because law enforcement officers were themselves getting sick, being instructed to limit their human contact in order to avoid getting sick.

And there was nowhere to take people for low level offenses either because the jail booking criteria had been sharply reduced courts were effectively closed.

So, it was sort of, you know, us or nothing, it started to feel like we did have resources but we knew that it wouldn't make a great deal of sense to go and offer street based case management in the circumstances that people were living in, because the systems that we had been helping folks navigate were shut.

At that same time, there were rumors of large amounts of COVID relief funding coming from the federal government and how those funds were going to be programmed began to be clear.

And we noticed that there was not a clear plan to make those emergency relief funds reach the large population of people who are extraordinarily heavily impacted by COVID living outdoors without relief sources, struggling with behavioral health conditions.

And like others around the country, we noticed that the hotel industry was hard hit and that there were suddenly non-congregate facilities that potentially were available to house or lodge this population.

So long story short, We initially asked for permission to make temporary use of LEED funding to secure unused hotels and to stand up a team of intensive case managers who would support people who came inside to those facilities.

And then later, first with the help of the King County Council and King County, and then with the City of Seattle, again, with leadership from this council, we were able to tap some COVID relief funds to keep those programs going through the spring of 2022. There were two objectives, right, that we had.

One was just to provide immediate relief for both individuals who are really stranded and in dire dire straits.

And the other was and sorry relief also for neighborhoods that by the fall of 2020 we're going to start to try to come back online after the economic shutdown had that the arc of that initial shutdown was coming to a close and really couldn't resume normal operations because of the intensity and seriousness of the conditions on the street as people were trying to live their full lives out in public.

So we're trying to secure immediate relief for folks.

We were also, though, trying to learn something about this very unusual, really, for us, unprecedented opportunity of what might happen if people were given really dignified lodging facilities that permitted privacy, permitted people to be able to be by themselves when that was needed for their own peace of mind, and honestly, for others sometimes, if folks could be surrounded with really robust care teams.

And if we offered those resources for people who had not traditionally used the shelter system or been welcome in the shelter system, The initial question was, would people accept that offer and at that back in 2020. And in the year before there had been a lot of discussion about so quote unquote service resistant populations, and there had become sort of a mechanical process of people would be offered congregate shelter.

often would say no to that and then would be swept or displaced from a location on the theory that they had turned down services.

So what else remains as a policy option?

We wanted to find out if we offered a different kind of care and a different kind of services, if there would be a different response.

We were not the first to try offering non-congregate shelter and testimony hear about how often people will accept tiny homes had given a strong indication that non-congregate shelter might reach a different population.

But we didn't really know if there was an intentional concentration on a population living in the streets that was chronically homeless facing greatest barriers and at high exposure to the criminal legal system because of specific circumstances, if we would see a high rate of uptake.

And then the other thing that we didn't know is if we did, and if folks would accept that kind of care and level of care and support, could we force systems to make a place for them from that point on?

Could we create a road to permanent housing for this population?

As well, what kind of behavioral health stabilization and care would we be able to arrange for this group of people that really is has been studied by King County as the familiar faces population.

Overwhelmingly, this was a population that had been cycling through jails and courts for years to little avail and with little progress and a fair amount of harm and at great cost.

Could we create another road that went beyond just temporary shelter?

So we are really here today to describe the approach that is taken and my colleagues, medical director, clinical director and housing manager will lay out the approach that we take, what has really proven to be a strength of this model and what are the challenges that we have encountered that if those were addressed, we could see further progress.

And then Dr. Beckett will present the most recent research that she and research colleagues completed looking at outcomes after a full arc of two years of this approach being up and running.

And particularly, my last comment, taking into account the sort of change in circumstances that we encountered in the winter and spring of 2022, when we did finally achieve a channel to permanent housing resources of a different sort than we had had in the past and what happened to our ability to place people in permanent housing.

So turning it over now to Dr. Katarski and Shivana Gaylor, I think, to kick us off.

Thank you, Lisa.

I'm Dr. Singh Katarsky, as Lisa said, a medical director and interim director for the COLE program.

My pronouns are she, her, and it is really amazing to be here with you all and to have this opportunity to talk a little bit about what we've done and to have Dr. Beckett here to go over what this new research is showing.

So I just want to build a little bit on what Lisa had said before, just to kind of frame up a little bit about COLEAD and Just Care for anyone who may be new to us and not aware of sort of where we came from and what we are.

So as Lisa said, LEAD has been a longstanding program, previously known law enforcement assisted diversion, let everyone advance with dignity.

We have some, we have a few acronyms here so I will do my best to try to also just state them so that we're not assuming that everybody knows what they are.

So, as Lisa said.

in 2020 as services shut down.

So if you think of LEAD as a service provider to be able to go out into the communities, out to reach people who are living unhoused and to work with them to help them gain access to services.

Lead has done that for quite a long time with wonderful success, but doing so in the field specifically and connecting people to services.

So when those services had to close their doors because of the pandemic, it really left that program you know, in a bit of a lurch trying to figure out what the best way to help people would be.

That is the pivot to co-lead.

The co aspect of co and lead is to describe that COVID, it is born in COVID, but also co-responder.

So, and with that shift, co-lead took the framework of providing services for folks took that framework and then added to it a couple of components, one of which a significant one is with the lodging component that Lisa spoke about.

So what would it look like if we did bring people in and help stabilize them with lodging while still providing services and connecting to services?

So co-lead is the backbone of Just Care.

And so Just Care is, you can think of Just Care as the response to the felt impact in our communities of people living in encampments and some of the realities of what we felt in our communities by our neighbors, our businesses, of people living unsheltered, struggling to live in conditions that were frankly not fit for humans to be living in and experiencing significant, sometimes significant, unmet mental health need or untreated substance use disorder and sort of some of the behavioral effects that can come out of that.

We can't really talk about just care without really talking about one of the key components, which actually starts right at the beginning, which is outreach.

So a really core component is our outreach teams go into the field and do the field work in order to, which means going out finding people who are experiencing homelessness, often in encampments, and meeting the people exactly where they are and taking weeks to get to know them.

So a key component here is that CoLEAD and Just Care is a relationship-based model.

We meet people.

We learn where they are, what they are going through, what they have been experiencing, and we build relationships with them.

And the reason that this is so important is because when working with people who have been experiencing chronic homelessness, who are having challenges, they may have criminal legal system involvement, they may have physical or mental health issues that have, you know, where they have experienced difficulty trying to even access services.

We know that there are many barriers that people face.

There are many barriers that people face accessing these services across our nation, especially in our healthcare system.

Adding into that, living unsheltered with that instability, oftentimes issues with not having identification, not knowing or having your health insurance, these types of barriers can really limit any access that somebody would have to seek any type of help.

So with such levels of rejection and living in environments that oftentimes people have pretty significant trauma history, I think it's an understatement to say that many people are hesitant to have the conversation with somebody coming to them and offering them something, whether that's offering services or asking them if they want to become a program.

And so as a result of that, a lot of the people that we work with have been labeled as resistant or labeled as unwanting of services or unwanting.

And in reality, that's not what we have found.

We have not found that people are unwanting or resistant.

We have found that when we work with them and we get to know them for the people that they are, and we think about, we hear what they need, and we think about what we can do to individualize and find a good match for them, find a match when it comes to a type of lodging or resource that we can bring to them, what they need in order to meet their identified goals.

When we do that and provide that dignity, people say yes, they say yes.

And as we'll see with the research, it really does help when we look at the overall path all the way from our outreach to the permanent housing that we'll talk about in a bit.

After outreach and that match is made, we are able to then bring people inside into, as I've said, temporary lodging, but temporary lodging that's designed to really provide them with dignity and be less of a congregate type of shelter.

And while they're there, that stabilization of having that lodging allows case managers to provide intensive case management support.

And that is some of the things I've described.

Helping people navigate if they have legal system involvement that they need help with.

If they don't have IDs and they need to get their IDs in order, you know, you can't do much without your identification.

It's one of the first things that's going to be asked for pretty much any service that you're about to try to do or try to get housing, a job, anything of that type, you need that ID.

Activating healthcare and getting their insurance going, addressing any acute needs, acute healthcare needs.

It's not an easy system to be able to sign up for health insurance, and it can really sometimes take some support and help with navigating that system.

And when people have health insurance, they are then able to start utilizing healthcare services that actually fit their need and not relying on the emergency room to meet their primary healthcare needs.

We also have found that when people come inside and they experience the stabilization of being inside and having case management support and having their basic needs met, shelter, food, water, that they are able to then take a breath, and start identifying their own goals.

And we all know that the fastest way for people to identify goals and meet change is through intrinsic motivation.

It's when it's something that we want.

And when we do that with our participants, when they've set their goals and meet their goals, what we have found is that they can meet them at such a rapid rate.

We're able to do things so much more quickly than we even thought.

and allow them to then continue forward.

And nearly every, I mean, everybody, everyone who comes in, every participant essentially does have a goal of permanent housing.

So, and also as one of their goals, getting to permanent housing, us trying to do that.

So, as I said, some of the difficulties that we face, some of the barriers that our participants face, we definitely have experienced some significant challenges when it comes to accessing, as I mentioned, physical health care services, primary care, but also behavioral health, including services for substance use disorder.

And I'm actually going to let our clinical director, Shavonna Gaylor, speak to that.

Shavonna?

Thank you so much, Dr. Sam and Lisa.

I am so honored to be here, you all, and one of the most encouraging aspects of being here today was hearing the community express their passion, their concerns, but from a place of humanity and care.

As we're looking at it, as you see, we have our expertise, our compassion, our clinical skills, our community response all come together to be able to really deliver a comprehensive strategy to everyone who is in need, to our individuals who are in need, who are our most vulnerable in our society, from a place of humanity.

And to hear that in the participant, the community members, was very encouraging.

So when we're looking at the overall dynamics, we can't ignore, as Dr. Sim was mentioning, the significant mental health and substance use challenges that our population is facing.

And when we look at that substance use, especially as a coping strategy, albeit maladaptive, we have to see how it's such a multi-layered challenge.

for people, for our population, as well as for the community.

Yes, it is difficult.

However, it requires navigation of access to and availability of needed services.

And that's our significant barrier that we're facing.

We can have the expertise a space of compassion, humanity, and dignity.

And then we will continue to build and grow in our clinical skills, being person-centered, looking at harm reduction, being trauma-informed in the way that we interact with every individual that we face, whether they are served through us or we're the ones providing linkage to them to another organization.

However, the challenge that we find sometimes is that coordination and collaboration with finding the efficient services that they need.

Oftentimes we hear that we just need to put everybody in treatment, right, they just need treatment.

However, inpatient substance use services can be weeks if not months out.

So when you have an individual who is vulnerable who is struggling, and who has identified that maybe I'm willing, although substance use has been a way that I've been able to survive emotionally, mentally, through significant layers of behavioral mental health and trauma over the years, I may be receptive to considering what does a different life look like?

Are we connecting to who I was or who I desire to be?

when there's not readily available that service to say okay where is it wait wait okay you're ready let's wait about a few weeks or a few months that is a significant barrier to barrier to us meeting those needs so we absolutely need to consider how do we um make our built the volume of our services and our resources available to address the underlying circumstances that may be contributing to where we are at this point.

Additionally, we look at some of the other challenges that we may face as far as crisis response.

Oftentimes, the crisis response that we need tends to be that behavioral health support, and the access to those services are significantly limited.

For example, we recently had an individual who we have been able to offer comprehensive support to, and she was having a significant time and was struggling and we needed support, and what she needed was mental health stabilization.

However, access to those services were not readily available.

So what ended up happening did not ultimately meet her needs.

Did we buffer that with our level of humanity and care coordination and our wrapping around her?

Yes.

However, there still is the outstanding need for her mental health stabilization, and that we look at, in addition, substance use tends to be a significant barrier to housing, which Crystal is going to talk to us about all of the hard work that's put into housing.

We also have to look at substance use as a disqualifier for housing.

We know that relapse rates are incredibly high for all individuals, but especially high for those unsheltered.

So what does that look like when we are dealing with multiple layers of substance use and mental health needs that are underlying And we're seeking to eliminate the barriers to to that stabilization for the individual, and we can ultimately get them into services and or into housing and look at that approach, however, if substance being.

not using substances as a barrier to being able to be housed.

And we know that relapse is a part of that recovery process.

How do we build in that humanity with all of the layers and all the services and linkages to be able to look at all of our services from that harm reduction modality and from that place of compassionate care and all of those pillars that we stand for, making sure that we model and also teach and train and provide that as a linkage to others as well.

The additional options, like I said, looking at housing, which Crystal is going to help us with, when we look at our transitional housing while wrapping around individuals, what we provide is temporary housing with the additional services so that we can guide them into that next area of stabilization.

I want to turn it back over to Dr. Sin and make sure there's no areas that I may have missed, and then we can definitely dive into how Crystal is able to utilize that component of the process.

We have the process of outreach, then we comprehensive with all ways in that comparing care and compassion wrapping around with our case management services, with ultimately leading to long-term stabilization through housing and consistent services that will eliminate a lot of those barriers and provide the support that's needed for ongoing joy, ultimately, for ongoing restoration and healing.

Dr. Sin.

Thank you so much, Shavonna.

And yeah, I just want to emphasize the points that you made.

So, you know, we say barrier a lot when we're talking about people living unsheltered and, you know, attempting to either go into some sort of shelter, transitional shelter, or into permanent housing.

And, you know, in some cases, substance use or previous or current criminal legal system involvement, they are afraid they're a ban, it's a ban, and that's what people are facing that they cannot access they cannot get in they cannot take those steps with an outright ban.

for things that don't allow any level of recourse or individual consideration.

And so I just want to state that for CODI Just Care, we really look at the individual.

We look at their history, where they are now, what they're experiencing, and we don't ban.

We take all of that into consideration to figure out what's going to work best for someone.

And that has worked incredibly well for us.

And I also just want to name that as we then for us in our our lodging our temporary lodging sites and our program.

But as we then move people into permanent housing situations, we still experience some of that barrier, some of that banning.

And with that, I would like to turn this over to Crystal Erickson are regarding the housing components, Crystal.

Crystal, you're muted.

Sorry.

Thank you.

Hi, everybody.

My name is Crystal Erickson.

I'm the housing manager for COLEAD through PDA.

And I'm thankful to be here today as well to just talk with you guys about what housing has looked like for our program and some of the challenges we've had, but also just some of, you know, just the successes that we've had as well.

So traditional access to housing has been normally through coordinated entry, having to go and take an assessment and just wait, wait months up to a year for a resource or access resources that may not be a good fit.

for a particular individual who's unhoused.

And what has really been a game changer for our program has been access to housing with our direct partnerships and resource access to permanent supportive housing, to Section 8 vouchers and whatnot.

So when we do have those options, we have more success with housing participants.

So in the early part of 2020, or no, during 2020 and the early part of 2021, we had very limited resources for housing.

Like I explained, it was very difficult to get folks connected to any resources.

And that was one of their number one goals was they wanted permanent housing.

And then in the early part of, I think it was about September 21, we got access to emergency housing vouchers through Section 8, and that really opened doors for our participants.

It was a huge game changer.

We were able to connect with participants to see you know, if that would be a good fit for them by, you know, assessing their housing needs, keeping it very housing first centered to what would be a good fit for them, try not looking at places so they were not further displaced away from their community and their access to services.

So we were able to use that resource and then, you know, In the spring of 2022, or 2021, we got access to permanent supportive housing resources with the direct partnership with KCRHA, which also was a huge game changer for our folks.

And they were very receptive to going into housing and having different housing options.

We also are providing care after folks are housed, which is very helpful.

And yeah, that's what we've been doing where we're at.

Go ahead, Lisa.

I'm just going to wrap up the PDA co-lead presentation and we'll turn it over to Dr. Beckett.

Fed, do you want to pop up the pink slide?

Thank you.

Just to provide a graphic demonstration of just how profound the barriers were in the population that we found in the encampment sites where we worked in Pioneer Square, the Chinatown International District, and the downtown core over those two years.

You can see that the vast majority of folks that we encountered were met the definition of chronically homeless and a very significant minority, just under 40% had been homeless for over five years.

Almost everybody had been homeless for over a year and was in that way met the definition of chronically homeless.

So what that means is that these are folks who are being rejected by, not being engaged by, and not sustained with existing structures of care, right?

So this is a population with demonstrated unmet needs.

And then in terms of the clinical characteristics and barriers faced by that population, the yellow bars there show you just how pervasive self-described substance use Issues are almost everybody that we have welcomed inside at COLEAD comes in with diagnosable substance use disorder.

Other mental health issues as well, profound trauma history, the existing serious legal barriers, warrants, pending cases, and criminal history barriers that are posing impediments to various kinds of support and solutions.

people just not having identification and big barriers to getting identification.

So this is what my colleagues have described, but sort of see it summed up here.

If you go to the blue slide, Beth, you'll see we worked with 500 people, a little bit more than 500 people over these two years.

Those are folks engaged, including the small number of people who did not or could not come into COLEAD because their medical needs exceeded our ability to meet them or mental health status exceeded our ability to safely house people.

That was not a large number, but there is a population that is, as the court system says, needs exceeds for COLEAD.

Almost 70% of those who were engaged in the encampments we worked at were BIPOC and those who were offered and those who accepted COVID resources were more so.

The map shows the 14 encampments that we fully were able to resolve.

And I just want to put a really clear description around encampment resolution through the Just Care framework.

It was intentionally organized as an alternative to sweeps and alternative to displacement and alternative to enforcement and it was convened in response to neighborhoods plea for decisive action to improve the order safety and health issues in neighborhoods but without using enforcement and without using dispersal and sweeps.

So that's a reasonable request.

There should be something besides those two strategies.

And we aimed to fill that gap.

In particular, there was a really lovely, compelling letter by pretty much every organization in the Chinatown International District in the summer of 2020, pleading for a strategy to address the public order issues in the neighborhood, but asking that people not be either arrested, jailed, or dispersed elsewhere in the neighborhood or to adjacent neighborhoods.

So these were the locations where we set out to fully resolve an encampment, sometimes more than once, without Without just displacing anyone and that means very simply having a an individual plan that would meet the needs of each person and when that plan was formulated for everybody who was living there.

That isn't always everybody who's in a tent or structure, there are people They're for community people, they're engaged in economic activity, but for everybody who was living in that space, there was a plan that that person accepted and participated in designing the move from.

And when everybody was gone to a destination that worked for them, they actually got there and they had helped to organize that departure.

Then the site was cleaned up with a really quite what evolved into a quite remarkable partnership with Citi.

departments, particularly parks.

I really want to shout out the incredible work that they did in partnership with our field teams.

And that is the sort of like outside looking in.

That's what Just Care felt like.

We'll turn it over to Professor Beckett to talk about what that meant for individual trajectories.

But one last word from me about where are things today.

When COVID relief funding by and large played out in the spring of 2022, it was uncertain whether or not this work could continue.

And with great credit to both the city of Seattle, the mayor's office, and council members who supported this, and then to the King County Regional Homelessness Authority, a plan was devised to essentially bifurcate co-leads so that half of it now lives in the city's public safety portfolio so that we can place individuals who are very impactful in various vulnerable neighborhoods and highly impacted neighborhoods around the city and need to be housed in a housing first strategy to address behavioral health challenges and other issues.

And then half of co lead belongs in the now in the regional homelessness authorities portfolio of work that is responding to encampments on state transportation rights of way that is all funded using state, the state funding pool for right of way response.

RHA, King County Regional Homelessness Authority right-of-way work, the Just Care style of field work continues on.

So really, the way that Just Care's encampment resolution strategy continues to be seen is over there in the RHA right-of-way response.

Okay, handing the mic over to Professor Beckett.

Hello, everyone.

It's a pleasure to be here with you.

My name is Catherine Beckett.

I'm on the faculty at the University of Washington in the Departments of Sociology and Law, Societies, and Justice.

And I'm just pulling up my slides to share with you.

And someone told me the trick.

Let's see the slideshow.

I'm not sure how to get rid of that.

Is this OK for folks, or do I need to do something else?

Can you all see the slides OK?

We can see it.

Dr. Beckett, if you could say play from start, I guess, I think it should probably filled it.

Yeah, I think I can see that just fine.

I think it's up on our screen and chambers.

So okay, you can go ahead.

Great.

Thank you.

Again, it's a pleasure to be here.

And I just want to name quickly that this report that I'll briefly summarize was a collaborative endeavor with Allison Goldberg and Marco Breidel-Forwitz, who are in the PhD program in sociology at the University of Washington.

I will be giving just a brief overview of our key findings, but there are plenty more details in the report itself.

So this was essentially a follow-up to a previous more process-oriented evaluation that we had done previously on the formation of Just Care as a response to the crisis induced by the intersection of homelessness and the pandemic.

And this one is focused more on outcomes and specifically on housing outcomes as well as service related outcomes.

We pulled together data from a variety of data sources that are listed here.

Thank you very much to data analysts from PDA who are helpful in enabling us to access that information.

We also went through case notes to kind of clear up ambiguous entries in the data system and conducted some interviews with key personnel to make sense of some of the things we were seeing and finding.

So I will just jump in and some of this will be very unsurprising, given what you've already heard from folks, but just to kind of put some numbers to the patterns that have already been described by people.

And also, if you ever see small discrepancy between the numbers that I'm showing and numbers that were presented earlier, it probably has to do with the timeframe.

We covered the period from September 1 2020 through August 31 2022 so a two year period, and we focus specifically on exits rather unless otherwise noted.

So these are people who came in but also left so it doesn't include people who were still in the program.

At the time we were collecting the data.

And what you can see here is just the demographics of who's participating in JustServe, who's served by it.

And consistent with the data that Lisa talked through, we see that about two-thirds, just a little bit under two-thirds of folks served by JustCare are people of color.

A little over one-third are white.

Predominantly male, but a little less than one-third female and a small share of non-binary and transgender folks.

And then quite a very wide age range, 20 to 77, with an average range of 40. So that's kind of a demographic snapshot of who is served by Just Care.

Also consistent with some of the themes that were mentioned earlier, we also found that many of the people served by Just Care would meet the definition of people experiencing chronic homelessness.

Nearly everyone of 94% had been living unsheltered for at least one year, and more than half, 57%, had been living unsheltered for more than five years.

Virtually everyone, so 99%, report that they had a mental health disorder or substance use disorder, and nearly two-thirds reported that they were experiencing both of those things.

And then finally, a very large majority of Just Care participants report using drugs, and often numerous drugs.

Only 6% reported no substance use or just the use of marijuana.

Also consistent with some of the information that Lisa provided, the needs that people present with are numerous.

Everybody reported needing housing support, but virtually everyone also identified other areas of need, and those were, I think, shown on Lisa's pink slide, just to put some details to that.

And we also found, and this is really drawn from the first report, we also found that the vast majority of encampment residents were offered and did accept temporary lodging.

And this is significant because, again, it kind of counters the narrative that people with behavioral health needs with criminal legal system involvement are service resistant in some way.

And then finally, the need for services is high and also we find that Just Care does in fact provide quite a few different kinds of services and I've listed some of the key ones here for you to have a look at.

I'm presenting these tables not in the order they appear in the report, so apologies for any confusion that that must create.

But on the theme of service need and service receipt, we find that people are well served by Just Care in terms of receiving various services, regardless of what kind of situation they exit the program to.

So even if someone does return to the streets, for example, they will return with having received a number of important services.

So by the time of exit, we found that 89.6% met the definition of housing ready, meaning that they had acquired ID and put together the other administrative or address the other administrative requirements associated with achieving or finding permanent housing.

The share that had healthcare insurance increased from about 40% or 41% upon entry to nearly 90% upon departure.

And then we found that nearly all of the other participants received a variety of other services, including external medical care.

Dr. Sin's team does a lot of work to connect people to the providers that they need, the specialists they need outside of Just Care.

Other kinds of external services that really run the gamut.

including substance use treatment, but many other kinds of external treatments, family services, behavioral health treatment, other internal services, which also run the gamut and are sort of listed in some in the notes below this table.

So again, we find that this is a high need population and that many of those needs are met during people's time in Just Care.

We turn our attention to housing.

This is where we really see a kind of a break in over time.

So with the service need and receipt, that is something that I think is consistent across time.

But the housing effort outcomes do vary quite a bit over time, which is consistent with some of the information that we heard earlier about the new arrangements with King County RHA, for example.

So what we did is we broke the cohort into two groups based on kind of a natural break that we saw in the data.

So if you contrast or look at the experiences of wave one versus wave two, you can see these different outcomes.

So for the group that left before the end of February in 2022 20% ended up in permanent supportive housing or permanent housing could be either a voucher or permanent supportive housing.

20% ended up in temporary housing of some sort and 51% ended up returning to homelessness.

And that's very, very different in this latter period, the more recent period that starts that runs from March 1 2022 through August 31 2022 and here we see that.

close to three-fourths of the people exiting Just Care transitional lodging were exiting to permanent housing of one of those two types that I mentioned, and far fewer were returning to homelessness.

I don't know if folks, depends where your images of people are, but you might be able to see the final column on the right also shows that as a result of that shift, the average number of people per month that Just Care is transitioning to permanent housing has increased very dramatically.

We wanted to see if these housing outcomes varied by race, gender, or age in any kind of meaningful way.

And just to kind of cut to the chase, there is some variation, a little bit by race, a very little bit by gender, and then definitely some by age.

So just to kind of put some details to that picture, what we found is that Black and Latinx participants were most likely to exit to permanent housing.

White and multiracial participants were less likely to exit to permanent housing, but we don't think this is a statistically significant difference.

The numbers also get small in certain categories, so you want to be cautious there.

Not a huge gender difference, just a small gender difference.

But what we do really see is a pretty clear pattern where the older participants are far more likely to exit to permanent housing than the younger participants.

We don't have a definitive answer to what's going on to explain that.

We have some hypotheses we sort of put out in the report, and these include everything from perhaps older people are a little bit more tired and more motivated to work on these issues.

There are also possible, it's possible that some housing providers give priority to people who have been on the streets for longer and that's correlated with age.

So there could be a number of factors at play there, but it's clear that there's mostly variation across age in terms of these housing outcomes.

To conclude, what we find is that the harm reduction-oriented transitional lodging that Just Care is providing can serve as an effective bridge to permanent housing for people with many vulnerabilities and challenges, but that that very much depends on the availability of those permanent housing resources.

That's, again, the big shift that we've seen in the last year or so.

We also find that people who have been living unsheltered for extended periods of time and have many barriers to housing are not generally service or housing resistant.

This is a population that can and should be served and housed.

So thank you very much and I'm happy to answer any questions people may have.

I'm going to turn it over to councilmember Herbold.

Thank you so much for the panel and going over the findings.

If we can go back, Dr. Beckett, I know there will be some questions from committee members to the slide deck.

I might want to reference some individual slides.

I have a couple of questions and I see councilmember Herbold has questions.

I'm glad this is our only agenda item Yes, this one.

I want to break down a little bit because I see that we don't break down the permanent housing to like permanent supportive housing or voucher supported private housing placements.

I wonder if we could talk a little bit about that because my understanding anecdotally is there's sort of an interesting mix in exactly in wave two, what those placements were that might be instructive for some of our future planning around this work.

Yes.

I will say something briefly, but I think others probably are in a better position to put a lot of details in this.

But my recollection is that this was predominantly permanent supportive housing, but there were a significant number of people who also received vouchers.

However, through this period, I believe, Lisa, you can correct me if I'm wrong, but I believe this was mainly folks who exited to permanent supportive housing.

Is that correct?

Actually, on this panel, Crystal is the expert on this.

So a few seconds of warning, Crystal, that I'll pass the baton to you.

But what was noticeable about this period is that we had a brief moment in time to find out what would happen if we took a pool of people and matched each person to their optimal housing resource.

It wasn't trying to force people who really need the level of support that's available with permanent supportive housing into emergency housing vouchers where they have to live largely independently.

And it also wasn't, importantly, forcing people who can live independently with light support into permanent supportive housing, which is more support that they need just because it happens to be the only place available at the moment.

So we had, the fascinating and all too rare experience of having a conversation about a finite group of people who needed to have a plan all at once that just going back to the spring of 2022 was when a number of the hotel-based programs were coming to an end and RHA was asked to make sure that people didn't exit to the street.

So working with the coordinated entry team at RHA, Honestly, they asked us a question I don't think any of us had ever been asked, which was, well, if you could chart any road for each person on this list, what would be the right match?

And stop worrying about what do you think we have?

What would be the right answer?

And it turned out when we finished the rundown of the entire roster of people in Just Care facilities, we needed a place to go by the end of the spring 2022. not more than half needed permanent supportive housing and would find that to be the optimal match.

And that does have ramifications in terms of cost per unit of housing resources that can be a good solution for a population that is chronically homeless.

Crystal, do you wanna, we kind of famously called everybody back to have this discussion on a Friday at four o'clock when folks were headed to get their oil changed or on date night and because we had never been given an opportunity to have that conversation before.

I do want to credit Coordinated Entry for the Coordinated Entry team at RHA for being extremely intentional about making changes in the way that they allocate the permanent housing resources that they had during that entire year to try to shift patterns of racial disparity that had emerged over time and then very persistent in permanent, sorry, in permanent housing access.

And this conversation that they asked us to have with about this population was was a part of that turn.

Crystal what light can you shed on how it ended up playing out with that mixed portfolio.

That was a very interesting time.

Um, so yeah, we had a mix of participants that we were matching to emergency housing vouchers like Lisa said, and then we have this other group that did not have necessarily, they were maybe more their needs that they had, you know, We had gone over with them or they had exhibited we've observed and shelter were more of like for permanent supportive housing or lighter.

We call it like lighters permanent supportive housing which is just maybe like case management services not as intensive supports housing and so we'll.

the King County Regional Homeless Authority coordinated entry and us, we had come together to come up with a way to strategize how to connect our participants to permanent supportive housing resources.

There was a Plymouth building that was coming open and all the rooms were going to be available.

And so we went through our roster and did our best to make matches for that building.

And then there were some other openings, but it was that direct partnership that we were able to have and build with KCRHA that really open the doors for our folks to have an additional option if they weren't a good fit for more independent living with the voucher as opposed to permanent housing.

Did I hear though correctly that the split in that wave two was about 50-50, which was my original question?

Yeah, that was our original allocation in the plan when given the option to sort of have the right match for each of our current participants.

And what's notable about that is that coming in the front door, almost everybody in our client population, participant population, would have been thought to be a logical candidate for permanent supportive housing.

Right.

So when I look at this wave two exits, the 70% to permanent supportive housing, half of that 70% was a voucher supported in a private placement approximately, and half was approximately permanent supportive housing.

Those were the optimal matches that were designed.

I will say the barriers to using the vouchers are very significant.

So people who that would have been a good plan for them, some of those people ended up having to take permanent supportive housing options because the voucher utilization is just so, so challenging.

So I don't think it probably ended up being actually 50% on both sides of that line, but it could have been.

And I think that's the important in terms of the person's ability and characteristics, it could have been.

So in terms of charting a course for somebody directly from the street, that sort of diagnostic process can look quite different than after people have been able to live in a secure location to identify what's really going on in their life, what their priorities are, and to work on barriers with a robust care team for some months.

And that really does change the picture for a lot of our folks.

So it sounds like what you're saying is because of the services Just Care was providing, there was a surprisingly high voucher utilization rate, successful utilization rate relative to what might have been expected given the population.

Yeah.

So it might not ideally would have been 50 percent, but it was probably something.

I'm not sure if that's what you're asking.

figure out ways to use this model to be more effective at preparing people to be in a position where they have the ability to pursue a voucher placement.

I think that is an interesting takeaway from this that I've been surprised by and would like to learn a little more about and talk to the team about what they might attribute that to.

Go ahead.

Just to concur there, a strong theme from our work, our experience, and that of other providers that we've worked alongside over the past couple of years has been this theme of interest in a flexible, a deep, sustained voucher program.

There really is room for that in the portfolio of permanent housing responses for this population.

And I'm not sure that any of us would have projected that to be as true as it proved to be.

Great.

I have a few more questions, but I'm going to open it up to committee members.

Council Member Herbold.

Thanks.

I also have a few different questions relating to different slides, so maybe I'll just ask my questions related to this particular slide, and then I'll hold my questions, and maybe if you end up on the same slide that I have questions on, I'll follow you then.

I'm going to start with the questions related to the slide.

And just wanting to understand that to a little bit more detail.

I know that coordinated entry has historically been a barrier to serving the population of people that you are serving.

And so does this mean that because of this coordination with RHA, leading you to be able to better access resources that care participants are receiving priority placements?

At that time, yes, that's not an ongoing commitment that Coordinated Entries made to our program, if that makes sense.

We were, that spring, the Executive Pacific Hotel was being sort of decommissioned as part of the city's shelter surge project, and another provider was operating that.

We had our facilities and there were a few others, and so, So RHA and Coordinated Entry were sequentially working to make sure that those hoteling facilities did not come to an end and have people just returning to the streets.

So I think the different client populations tested Coordinated Entry in a different way.

Ours tested Coordinated Entry, as you say, because this was not a population that in the past, because King County's coordinated entry process has prioritized vulnerability, not chronic homelessness, not barriers and not exposure to other systems like the criminal legal system.

So, but they did.

And I think that's the important part is that they fully embraced tackling this population and also the opportunity to learn.

And so seeing that We had very strong, when people were going to permanent supportive housing providers, so there was a receiving team, the report from those teams that people coming in from the COVID program were very well supported.

That had happened very quickly.

We rarely dropped an available unit and failed to complete the match.

All of that was just a really good experience, and everybody was very open to taking that learning on board.

This demonstration project, if you will, it happened to take place at a time when data had been circulating and made available about the pretty marked racial disparity in the population that was prioritized for permanent housing under those old criteria.

And under RHA's approach, they were trying different strategies.

And so I think this demonstration project was one opportunity to really make some changes and find out how that would work.

And it did work very well.

I really give them a ton of credit for leaning very far in in a short period of time.

And so moving forward, how do How do both approaches of prioritizing populations live together side by side?

I mean, it's both so important, right?

Right.

I mean, the editorial comment after so many years of just listening to everyone believes that the population that they work with should be prioritized and one cannot prioritize all circumstances or it's not a prioritization.

But I do think that a braided, you know, obviously no one service provider can be prioritized or that just ends up working very badly and losing legitimacy.

So it's not about that, it's that the model, the COLEAD model, which is to begin with, an approach that multiple organizations have helped to craft.

It is replicable, and it is reaching a population that has to be part of the prioritization stream.

So the term that we use at PDA is braided prioritization, so that doesn't have to be the only column that reaches the top of the ladder, but people in this column do have to reach the top of the ladder.

And for many years, that was not the case, because prioritizing vulnerability tends to deprioritize people who are younger.

And I don't mean young, to Professor Beckett's point.

This population was not super young, but it also was not super elderly.

People who have a high impact in the community are exposed to the criminal legal system tend not to score super high on vulnerability indexes.

But when left as a matter of public policy out in the streets have a very significant impact.

So making sure that this population of people does have priority access to coordinated entry is absolutely critical if we want to see different impacts and different patterns and a reduction in the felt impact in our neighborhoods.

And this cohort was just like the great example of how effectively that can be done if coordinated entry will allow this to be part of the prioritization pool.

And so how is that next, like you have a good vision for how you can have a braided prioritization approach.

It's been tried.

how do we take this proof of concept and ensure that the system that we use incorporates it moving on, the coordinated entry system incorporates that approach moving forward.

I mean, I'll just say very briefly that Coordinated entry is like it's a shared public resource that for the region.

And we have to apply all of the, sorry, all of the learning, I'm in a hotel.

Somebody's bringing me all of the learning from the past several years about the interconnectedness of systems to make sure that people who are otherwise destined to their criminal legal system do get prioritized and coordinated entry.

It's a very simple proposition, but it has never yet been achieved.

So I think city leaders, county leaders, and RHA leadership In the five year plan and in those conversations, this as a value and as a policy commitment, like the time is now.

This was a, this was a takeaway from one table.

For those who go back a few years.

It's been a takeaway from every serious study about the way in which homelessness and the criminal legal system intersect.

I think it's important for us to be able to embed access to permanent housing as part of the public safety strategy that the city and the county adopt and I don't think that there's resistance to this at coordinated entry but there are so many demands that it has to be public officials demand.

Apologies for the interruption.

Thank you very much.

Well, no, I have one more for that slide actually, just real briefly.

Under other outcomes, which looks like it stayed fairly consistent regardless of the wave, what are some common examples of things that fall under the percent other outcome?

Is that like people reunited with family outside of jurisdiction kind of things or like what's happening there?

I believe that there are additional details in the report and the note under this table, but what I recollect is that this included a few people died, a few people were incarcerated, and I think one or two people disappeared.

If they went to move in with family or friends, we considered them to be temporarily housed, so they would show up in the temporary housing category.

Great, thank you for that clarification.

I'll hand it back over to you, Council Member Herbold.

Thanks.

I think these next questions and a comment will be more brief.

On Table 1, the demographics snapshot, The note says that the data includes folks who exited care housing, also include folks who are served by Just Care but not placed into housing.

And just wondering if it doesn't include that group of folks, is there any reason to believe that the demographic profile would be different?

So that's what's shown in this other table here.

Right, so we looked at how housing outcomes vary by race and by gender and by age.

And so you can kind of get the answer to that question here.

And again, what we see is some interesting but not super comprehensible variation by race, not a ton, but for example, 58% of the Latinx participants exited to permanent housing, 36% of white folks, 44% of black folks, We don't really have a theory about exactly why.

I will say that in some of the smaller racial groups, the numbers are fairly small.

So it's probably important not to fixate too much on those.

And again, with small gender differences, but mainly the main difference in outcomes has to do with age.

And then on this table, and I think maybe you may have addressed it, is there something else other than the small sample size to have insights for why folks who identified as American Indian, Alaskan Native, multiracial, transgender, non-binary were more likely to return to homeless than others?

Is that just a small sample size or something else?

Really small sample sizes we've got here probably, for example, for the non-binary transgender, I believe we're talking about two individuals, right?

So I think it would be unwise to to fixate too much on those differences.

Yeah.

Thank you.

And then my last thing is just a comment.

Thanks to the careful eye of Christina Kotsubos in my office, I wanted to just lift up because it's very significant.

On table four, the service-related outcomes, 41% of the participants had health insurance upon entry to just care, and more than twice that figure, 89% had healthcare on exit.

That's just a really incredible improvement for that group of folks who, as have been reported, have a significant unmet need.

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really impressive outcomes that I'm glad we're tracked in this research.

I just have a couple of additional questions, then I'm happy to open it up and see if committee members have any additional things to add.

Do we have a good indication, maybe broken down by the waves, on average stay?

It seems like we have the data points where we could extrapolate that based on the exits per month data column.

But average stay per unit, whether for the entire life of the program or broken down by wave would be an interesting thing to inquire over.

Yeah, I'm sorry.

I don't believe we included those figures in the report itself, and I don't have precise numbers for you, but I do know we did look at it at some point, and I do know that the average length of stay has dropped markedly.

And it makes sense, right?

There was no place for people to go.

in the first wave.

And so they, you know, the people who could stay, stayed for as long as they could.

And whereas now that there are these other options ready and available for people, case managers are able to work with them much more quickly and get them through much more quickly.

I don't have the precise numbers for you.

It might be something that we could produce if that would be helpful.

But at least I don't know if you or others want to elaborate on that.

Just the length of stay in the earlier portion of the program was largely a function.

We had no idea how long we could keep this program even running, right?

We were getting month-to-month funding extensions.

People were not sure how long they could stay.

Like Professor Beckett says, if they could tough that out, they would.

we were preparing people because there was no certainty about ongoing support for the possibility that they might need to exit to the street, that whole premise really changed when there was a public policy decision to have that not be the outcome and see how well we could do if there was a channel to housing.

So I don't think this is typical of, I think what you saw at the end is typical of how if we if you use an approach like this intentionally as a community resource, you know, how could it go?

It would go like it went at the end, when public officials did sort of claim this and we want this and we want to have it work as well as possible.

That is the arc of stay that one would see.

Thank you.

And I'm also interested in, particularly in wave two, we see this massive reduction in return to homelessness and that can be attributable to the additional rapid rehousing and coordinated entry resources.

I am curious about the 17.4% return to homelessness to the extent in wave two that you have a, um, I'm just wondering if there's any comment on the number of folks that are eligible for that number for the reasons, just to for our information going forward and what it is about our programmatic offerings related to permanent supportive housing and the voucher things that could close that gap and close that number more.

It may be that Dr. Kotarski will want to comment on this, but this is really, when I said earlier that there are people whom we took on, despite that when we designed COLEAD, we knew that, and frankly when we designed Just Care, which had an array of shelter, lodging, case management partners, we had a gap for people with severe mental illness.

And we just, there were individuals even during this time who were needs exceeds to the kind of care and support that we could provide in COLEAD.

We couldn't safely maintain some people in our community lodging.

It's not congregate lodging, but it is community lodging.

We have staff on site.

We have many other participants who need, whose safety we're responsible for.

There are some people that we just couldn't maintain for the months needed to make a transition to permanent housing.

I will say they are also needs exceeds most of the permanent housing options that exist out there as well.

We don't have, and we had our most recent experience of this last week, very heartbreaking situation.

We don't have a good solution for people who because of psychosis or other mental illness threaten the safety and security of other people and themselves are very vulnerable and need care and support.

That is not a crisis situation.

It's a situation of chronic unsupported, you know, people living unsupported, very mentally ill who need a housing solution.

So why I say it's not crisis, it's not something that like crisis centers fill the gap for and our civil commitment system, which ideally we would be able to access civil commitment and somebody maybe even would be able to come back to us or other residential stay alternatives is really not accessible to programs like ours and participants like ours.

So individuals are released to homelessness because we can't keep some people safely and there is no other piece of our system that's designed to receive such individuals.

It's truly heartbreaking.

Lisa, thank you.

I'm just going to see here if there's other colleagues who are looking to be recognized.

I don't see any additional questions.

I really appreciate that we were able to spend a lot of time on this agenda item today, go through this report.

I appreciate the submittal of the physical report and definitely encourage members of the public and members of the media who might be watching to take advantage of that information that is now generally and broadly available.

you know, I can't say enough about my personal gratitude and the gratitude of a lot of my constituents in the central core, constituents of, you know, of District 7, but also District 1 and District 2, who have been in the catchment area that Just Care has been operational in.

In terms of When things were really bad and were at their worst, this is a team that really stood up and came into the void and worked to make a program bespoke to the problem our community was facing and needed to fix.

And we've learned a lot from it.

We were able to do a lot of good.

And there's a lot of lessons here that have some scalability attached to them and things that we can replicate to continue making progress on these issues.

And then also some things that we've identified that despite our best intentions and our best attempts to close the gap, we're still just not there yet, as Lisa Dugard just indicated, especially in regards to very high acuity behavioral mental health needs.

So, you know, I'm committed to continuing with this work with all the people here and the King County Regional Homelessness Authority and some of our other partners and really appreciate the transparency, the continued commitment to data reporting and internal evaluation to have a culture of constant improvement in these programs that we're doing together.

And a lot of these results speak for themselves.

I mean, we looked at that map of where there used to be encampments and there's whole communities of folks who have been able to receive access to care and good housing outcomes that wouldn't have been available but for the work of the people here.

And I'm really, really grateful for that.

And I know that a lot of people in the city who live or have businesses around the sites of those encampments are also grateful.

So it's a real testament to the strength of your model and your commitment to this work, and I really appreciate it.

Are there any other comments before we close out this agenda item and then close out the committee?

I don't see any.

As I stated earlier, colleagues, this was our only agenda item, and seeing nothing for the good of the order, it is now 3.41 p.m., and I'm going to go ahead and adjourn the meeting.

Thank you all for your participation, and everyone have a good afternoon.

Thank you.

Bye-bye.

Thanks.

Bye.

you.