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San Diego Launches Project To Help Hardcore Homeless


Home Again of United Way announced Project 25 yesterday, a project to take the 25 hardest homeless cases and provide them with housing and services. The project involves multiple partnerships with groups such as the City and County of San Diego.

MAUREEN CAVANAUGH (Host): I'm Maureen Cavanaugh, and you're listening to These Days on KPBS. Last week on this show, we heard from Los Angeles Times reporter Christopher Goffard who did a series of articles about LA's Project 50. It's a new approach to the problem of homelessness that identifies the people on the streets who are most at risk, and gives them a safe place to live, with access to services but no rehab required. Now United Way of San Diego has announced the launch of its own version of this approach. It's called Project 25, Home Again's Frequent User Initiative. Joining me to explain how the program will work is my guest, Brian Maienschien, director of the United Way’s Home Again campaign. And, Brian, good morning.

BRIAN MAIENSCHIEN (Director, Home Again Campaign, United Way): Good morning, Maureen.

CAVANAUGH: First of all, tell us a little bit about the Housing First concept of fighting homelessness.

MAIENSCHIEN: Well, the idea is that the individuals who are homeless need a housing unit in order to address the needs that they have, and whatever that may be. Typically, for the chronic homeless population, it’s going to be some mental health issues, maybe physical health issues, and so, as you can imagine, being on the street is not conducive to tackling any sort of health issues. So the idea is once the housing is there then the other problems are able to be resolved and the research on this is very strong that it works. And so that’s been kind of the more – the way to go about addressing this population, particularly the chronically homeless who are a more difficult part of the population to address.

CAVANAUGH: Because typically people who are chronically homeless might have a very hard time in actually qualifying for any program that would house them or would provide services, is that right?

MAIENSCHIEN: Oh, absolutely. And, you know, it’s challenging. It’s challenging. If you look at what those individuals would need to navigate, they’ve got to go make an appointment over here for their mental health issues, maybe somewhere across town for their physical issues, whatever else it is that they’re dealing with, trying to find housing, maybe trying to find employment. All those different things for somebody who doesn’t have a motor vehicle, a way to – I mean, you can imagine trying to take the bus to five different locations. That would be challenging for anybody…


MAIENSCHIEN: …let alone somebody who’s suffering from some sort of disability.

CAVANAUGH: So what segment of the homeless population is this approach aimed at? You said the chronically homeless. How many are we talking – people are we talking about, though, in San Diego?

MAIENSCHIEN: In San Diego, the chronic population is about 15 to 20% of the overall homeless population. And these are individuals who have been homeless for longer than a year or four times over a three year period, and have some disabling condition. Typically, it is a mental illness of some kind. And although they make up a smaller percentage of the overall population, they use a tremendous amount of the resources. They use over 50% of the resources. So skipping any sort of moral and ethical issue that’s involved there, just from a purely economic standpoint, I think it’s really important to address this population and that’s what I wanted to do with Project 25.

CAVANAUGH: I’m speaking with Brian Maienschien. He’s director of the United Way’s Home Again campaign. We’re talking about a new approach to treating chronic homelessness in San Diego. It’s called Project 25. Now, you told us Project 25’s goal to get people into housing with support services available to them. And it also – you also call this a Frequent User Initiative. And I think you just touched on that, the idea being that the people that this project will house use services an awful lot and actually can cost our community an awful lot of money.

MAIENSCHIEN: Absolutely, Maureen. These individuals typically will go to the emergency room, for example, you know, 30, 40, 50 times a year and that alone right there is exorbitant. And so by what Project 25 will do is by providing the housing, by providing the services and a case manager, which is also critical, we’ll change that behavior. If they need, you know, some sort of mental health medication, that will be accessible to them. And so I think without question we’ll see, for the individuals that were going 30, 40, 50 times a year, cutting them down to 1, 2, 3, 4 times a year. Look at the savings just on that. Now if you take that across the whole spectrum, where else they’re costing taxpayer money, it’s a very significant amount of money. And so, again, we’ll make a huge difference in those people’s lives individually and, I think, there’s a value there but, again, kind of even putting that aside, from just the economic standpoint, it’s important to do something. And this project really addresses those hardcore, high cost chronically homeless individuals.

CAVANAUGH: Now last week we heard about Project 50 up in Los Angeles.


CAVANAUGH: Social workers went out and found about 50 of the people they said were most at risk of dying on the streets, took them in, found a hotel room for them with support services, and that’s still going on. It’s still kind of a trial program up in Los Angeles. You must be familiar with that. It’s – Our program sounds pretty much like that. What are the differences, though?

MAIENSCHIEN: I don’t – I’m not intimately familiar with…


MAIENSCHIEN: …what Los Angeles’ program is. I think the key here that we want to focus on in San Diego is the cost because I just think that’s the most – You can’t argue with the data and the facts. You can’t argue if facts are released that Joe Smith cost the taxpayers $300,000 last year. That’s just a flat out fact. And then with housing and services and a case manager, they cost $30,000. I think then – I think that’s just the cleanest and simplest way to show whether it’s elected officials, the public, the people who are even in the homeless provider community, this is the type of savings we see. I think, additionally, too, the other benefit of it is, we are taking the most difficult and I think it shows that, look, we’re able to have this success with the 25 most difficult. Think what we’ll be able to do as we move down this list. The next 25 are going to be easier. And the 25 and the 50 and the 75 after that, each, as you kind of move down that list, each one of them’s going to get easier and easier until eventually you’ve gone through the list.

CAVANAUGH: How will these 25 people be identified?

MAIENSCHIEN: They’re going to be identified by – it’s – we’re starting with the cost in working with the county, coming up with their cost for medical treatment, whether that’s emergency room visits, mental health visits. We’re starting with that. From there, we have a first of its kind partnership where we have the police department, the sheriff’s department, the district attorney, Father Joe, Alpha Project, Rescue Mission, we have about 12 very broad organizations that have signed on to share this data. So we’ll start with that list then we’ll be able to go to the police department, the sheriff’s department, each one of those, and say, okay, how much did Joe Smith cost you last year? We’ll put it all together and then we’ll have a very accurate number as to how much this individual cost.

CAVANAUGH: One of the most controversial aspects of this Housing First concept is, in many cases, homeless people are required to give up their substance abuse in order to find shelter, in order to even qualify to have support services. I know in the Los Angeles program, they do not have to go into rehab. Will people have to go into rehab here in order to get this housing?

MAIENSCHIEN: They’re going to have a case manager who’s going to come up with a plan for each individual. And that plan, if there’s a substance abuse problem, is going to include addressing the substance abuse problem. So we’re going to see some very marked improvement, I believe, in these 25 individuals.

CAVANAUGH: I see, so – But is it a deal breaker?

MAIENSCHIEN: It’s not a deal breaker but, again, they’ll have housing, they’ll have services and they’ll have a case manager. Just the vast, vast majority of individuals are going to be able to see significant improvements in their lives. You know, is it conceivable there’s going to be one or two who don’t? Of course. But I think statistically we’re going to be able to see that, you know, of the 25, you know, 22, 23 of them made really marked improvement. And I don’t want to be in a position where because of 1 or 2, we’re not doing something that’s really beneficial. And, secondly, we’re collecting the data and we’ll publish that. I mean, we’ll be the first ones to show that if it’s two or three or how ever many, you know, that showed no improvement. And if that’s the case, if these individuals still cost the same at the end of this, we’ll publish that and we’ll know that this isn’t a program that we need to pursue. I think, you know, I can say with 99% certainty and as can anybody who’s worked on this across the country that the savings will be significant and we won’t be in that position. But if we are, we are, and we can cross off something and move on to something different that will work. But if you look, again, nationally, you know, Malcolm Gladwell, bestselling author and, you know, he’s written about this. And so – and has, through his writings, kind of advocated for something of this nature. So I think it’s a well settled position that a program like this is going to end up saving taxpayers significant dollars.

CAVANAUGH: Now, where will the 25 people who are involved in Project 25, where will they be living?

MAIENSCHIEN: They will be – we don’t have that – We don’t have an address for them yet because that’s going to depend on whoever’s ended up being awarded the contract. And so we’re making the funding available and then we’ll work with the provider who will provide the services and will locate the housing. So we’ve very flexible on that. It may end up being in one location, it may be in a couple of locations. We’re certainly very flexible on how that’s going to work out.

CAVANAUGH: And what kind of timeline are you looking at here? When are you hoping to get some of the homeless people into housing?

MAIENSCHIEN: Our goal is to have them late December or early January to start transitioning these individuals into housing. And then we’ll – it’s a three-year pilot program. We’re going to chart it on a quarterly basis, so within, you know, the first three to four months we’re going to have some pretty good data coming in just to see even straight out of the gate kind of how the program’s progressing. And, clearly, as it goes on we’ll have better and better data. So I’m really – this is something that’s really – You know, when we unveiled this yesterday, and this is a really historic day for San Diego. We’ll – be huge – the first time partnership between the city, the county, United Way, something like that’s never happened. Then when you add in that we have over 10 organizations who’ve signed on to share data, that’s never happened. So this is a really very, very positive step and I think we’re going to see some very tremendous results. And I think this is going to change the discussion how we address homelessness here in San Diego County.

CAVANAUGH: When you talk about a partnership between the United Way and San Diego City and San Diego County, are the city and county, are they actually giving any money to the – I mean, providing any funds?

MAIENSCHIEN: They’re – Well, it’s in kind. The County’s providing services and the City’s providing the housing and so – and then the United Way is chipping in and providing the case managers and kind of overall program management so between the three of us it’s kind of three legs of a stool. And everybody is – each partner is critical and wouldn’t happen without, you know, with just two of them. So it’s – And a lot of people said, well, you’ll never get all these people to cooperate and work together and kind of set aside squabbles and all that, and we were able to do that. And so I think even for – The other thing, too, is even for future programs that really have very little to – related to Project 25, what we’ve shown here today is that look who can get at the table, look who can cooperate. Everybody can come behind a good idea and move on it. And I think we’ll see programs in the future that will have come together because of Project 25 that may be addressing a whole different segment of the population.

CAVANAUGH: Because you’ve now identified this coalition.

MAIENSCHIEN: Exactly. We now have a coalition that has worked together, that has shown I think to the surprise of many that, wow, you can – we can get all these people at the table, we can get them all to basically set aside whatever their, you know, their little previous squabbles or whatever they think their needs may be to kind of address a bigger and greater, larger need that benefits the whole region and do something that really is very unique and very different. Something like this has never been tried here. It’s – it is a – it is a growing trend across the country but even so, it’s very – they’re very difficult to pull off so you don’t see them in a lot of other places throughout the country. I think we’ll see more and more in the future because I just think it’s going to be shown to be so successful in the jurisdictions that do proceed with it.

CAVANAUGH: Now when you announced Project 25 yesterday and your press releases were distributed and so forth, there was mention of a comprehensive discharge plan and I’m wondering what is the ultimate goal of Project 25? Is it to house the people indefinitely or to have them move on to something else?

MAIENSCHIEN: It’s going to be all of the above.


MAIENSCHIEN: Some of the individuals – because each one of the 25 is going to be different. Some of them are going to have their lives stabilized and will go on and they’ll get jobs and they’ll go on and do other things. Some will go on and move out and live with family members or friends or, you know, they’re going to kind of come across a spectrum. And some of them will need housing, you know, will need housing into the future. So it’s going to be some sort of mix somewhere in there and, again, as part of the pilot program, we’ll be able to figure out in San Diego, here’s about how the percentage breaks down. And as we move on and eventually this becomes Project 75 and Project 150, we’ll have a really good idea as to how we work – how the discharge is going to work. But part of the program is we need to have a discharge plan in place so the provider is going to have to have a discharge plan. We’re going to be flexible on it because we know we’re going to learn some things as we go through this. And what we think exactly how it’s going to work may not be, at the end of the day, exactly how it shakes out. Although, again, I think we’re going to probably end up being pretty close.

CAVANAUGH: And finally, Brian, how will you know that this has worked?

MAIENSCHIEN: I think there’s a number of ways. I think first off, we’re going to be able to show that the economic savings to taxpayers are huge. I think secondly, we’re going to be able to have 25 stories of 25 individuals and I think we’ll be able to see with them, you know, here’s what this person looked like when they came in off the street and now, at this point in time, here’s what they look like. And by that I don’t mean physically, although, by the way, that is part of it…


MAIENSCHIEN: …but here what their life is like now. And, boy, what a difference that has made. So I think there’s kind of two main areas we’ll be able to judge success, is kind of anecdotally how these individuals’ lives have changed because of this intervention, and secondly, what sort of savings are we going to show to the taxpayers?

CAVANAUGH: Brian, thank you for talking about Project 25. Thanks for explaining it.

MAIENSCHIEN: Absolutely, Maureen.

CAVANAUGH: I’ve been speaking with Brian Maienschien, director of the United Way’s Home Again campaign. If you’d like to comment, please go online, Coming up, a phone call from Afghanistan from reporter Tony Perry. That’s as These Days continues here on KPBS.

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