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Local News

County Supervisors Review Details of Report on Homeless Deaths

The board votes to mobilize a multiagency effort to better reach out to those living on the streets

Detailing 45 homeless deaths during the past 15 months, a report the Santa Barbara County Board of Supervisors discussed Tuesday will be used as the basis for developing an action plan to prevent more deaths.

The supervisors voted unanimously to coordinate more strategy among departments that reach out to the homeless in an effort to better help them.

“The issue is highly complex,” said Dr. David Lennon, who works as the county’s medical director for health care for the homeless. He was the primary author of the report and led Tuesday’s presentation.

The report highlighted, in greater detail, the circumstances around the deaths. Nearly 90 percent of the 45 homeless who died had some type of mental health diagnosis, ranging from adjustment disorder to schizophrenia. However, according to the report, a majority didn’t make contact with the county’s Alcohol, Drug and Mental Health Services at any point, even if they were referred by an outside agency to get substance abuse help. Improving the continuity among agencies, especially between the Public Health Department and ADMHS, also was a topic of discussion.

The process leading up to the report began when social worker Ken Williams approached the county Public Health Department in 2007. The Homeless Death Review Team was formed, including representatives from the county Alcohol, Drug and Mental Health Services and the Social Services departments, the Santa Barbara Police Department, Casa Esperanza and Santa Barbara Cottage Hospital.

The review team held its first meeting in October 2007, but it didn’t meet again until last January. In February, the county supervisors commissioned a review in response to the deaths that occurred over the winter. Drug and alcohol deaths were by far the largest category listed in the report, and though no homicides were listed, “we are under the understanding that one case has been reopened” to determine whether it was a homicide, Lennon said.

One person died of hypothermia, but Lennon said he had repeatedly been told that shelter beds were available but had refused help. Getting patients in for follow-up visits also was a challenge highlighted in the report. The average follow-up for ADMHS patients was nine months, and 10 months for Public Health patients.

Only 13 percent of the deaths were veterans, a fact that shouldn’t underscore the reality, Lennon said. He reminded the board that of the total number of veterans helped by Public Health, nearly half are homeless.

Deaths are recurring throughout the county, Lennon said, not only in the South County.

The report also looked at violence among the homeless, which came up during the board’s discussions. There was a lack of information about violence against the homeless, primarily because homeless people often don’t report violence through formal channels, and there’s no organized system to gather that data.

Williams collected data from January to May of this year for the report, based on his daily work with the homeless and from information forwarded from the police department and Cottage Hospital. During those four months, Williams recorded 39 reports of violence, of which 25 involved assault, five were rape and three were domestic violence.

“Only seven informed Ken that law enforcement was notified, while 17 involved a visit to the emergency room or hospitalization,” stated the report, which added that although the information is limited in scope and unvalidated, Williams’ findings represent “a good snapshot of violent experiences reported by people living on the streets.”

“He was meeting the same barriers we found,” Lennon said.

The group came up with recommendations as well, including adding a database field for people who are possibly homeless in medical examiner and public health forms. Garnering more specific information about patients would provide a greater pool of data to draw from as agencies continue to track the homeless.

Discussion on Tuesday also included hiring someone to work as a nurse or case manager for some of the most severe cases among the chronically homeless.

“You have a small percentage of homeless that are the highest at risk, and those are the ones we need to focus on,” county Supervisor Salud Carbajal said. “It seems so simple ... yet we can’t seem to do it.”

Ensuring resources are being used properly and in an efficient way would be key, and encouraging agencies — particularly ADMHS and Public Health — to communicate better could only help. Creating a centralized system to track homeless cases would be critical, Carbajal said.

“In the past we’ve been hopeful that’s going on, but it’s clear from this report that we’re working in these silos,” he said. “It baffles me how we in government can’t get it together. ... It’s kind of ridiculous.”

Public comment during Tuesday’s meeting brought out several homeless advocates. Mike Foley, executive director of Casa Esperanza, commended Lennon and the Homeless Death Review Team for their work on the report. He also lamented the loss of homeless champion Roger Heroux, who died in December, and speculated on what he would say after reading Tuesday’s report.

“He would say you cannot ignore mental health,” Foley said.

The number of homeless entering Casa Esperanza requiring mental health assistance has more than doubled since last year, Foley said.

“As we look down the face of winter, we’ve got an urgent situation to deal with,” he said.

Good Samaritan Executive Director Sylvia Barnard called on the supervisors to look at drug and alcohol treatment for shelters.

“It’s the biggest issue before us,” she said. Stressing that her shelter is filled above capacity, “we need your departments, and we need a more integrated approach.”

Commenters stressed the need for county departments to work with the strategies of Bringing Our Community Home, a nonprofit organization dedicated to ending chronic homelessness in the county. The group has been vocal about its 10-year plan to end chronic homelessness.

The Board of Supervisors voted unanimously Tuesday to have BOCH staff work in concert with three departments so that a report on coordinated efforts can be brought to the board.

Noozhawk staff writer Lara Cooper can be reached at .(JavaScript must be enabled to view this email address).

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