Assembly Standing Committee on Accountability and Administrative Review

Welcome to the Joint Hearing of the Assembly Housing and Community Development Committees, Health, Human Services, and Accountability and Administrative Review Committees, four Committees together, I think, for the first time to review the state's programs to address homelessness. I know this is a huge topic for many of us, and it's exciting to see all these Committees and our respective staffs work together and also want to thank Members of those Committees who are here as well to answer some questions.

All of our Committees share oversight over the state's response to homelessness and the agencies and departments that manage those responses. And I also want to also recognize our Chair of Budget Sub Four, Ms. Wendy Carrillo, who oversees the budget implications of the homelessness funding. Our work can often be siloed, and this hearing is a chance for us to understand better the programs across our subject areas that address homelessness and understand what is working and where there are opportunities for improvement.

And we know that improvement is needed, and I think many of us see that when we go home. Every Thursday when we're back in our districts, Friday, Saturday, and Sunday, I think the number one issue that we all hear about in our districts is the homelessness, the growing encampments, the concern, the humanitarian issues, the public health concerns, as well as the lack of ongoing funding for affordable housing.

So it's important that I think we have a chance to hear from the agencies who are working collaboratively on this to hear and have a better understanding of what we can do to be better. As the Chair of the Housing Committee, my focus is on the impact of the lack of affordable housing and rising rents and that impact on homelessness and the housing crisis. We know that too many families right now are rent-burdened and/or are losing their homes in the State of California.

Our state housing plan tells us that we need an additional 2.5 million housing units needed here in the state, of which over one million are needed to be affordable for our lower income households. The lack of affordable housing options is the root cause of the growing number of people falling into homelessness. We have made huge strides over the last seven years to shift longstanding entrenched policies that have kept our housing numbers down. We've made it easier to build affordable housing.

We have increased the amount of land that must be zoned for affordable housing by over a million units, we have funded affordable housing on a level that we haven't seen before, and we are holding our local governments accountable to zoning and the approval process like we've never seen before. But I also want to be clear that the reason that we are in this crisis that we're in is because we have made conscientious policy choices decades ago that have led us to where we are.

We have made it hard to build in California, right? We have underfunded affordable housing. When we lost redevelopment money, we lost a really critical tool, and we have no ongoing funding for affordable housing right now. And that remains a really big challenge that we Democrats and Republicans have to tackle because our constituents deserve it. And I look forward to working with folks on all sides of the aisle to help tackle this problem. The hearing is about moving forward. It's about showing progress.

It's about figuring out what is working and what is not working, and to have that conversation with the public because the public deserves to know what we are doing here on this issue, and about how we can make progress more efficiently and more quickly to move people experiencing homelessness into safe, permanent housing. We have to treat this problem like a crisis, and it warrants all of our attention to do so, and we as elected officials need to be held accountable to that.

And it demands that we actually act on this, that we do the work that we need to do, that we make tough policy choices, that we make tough budget choices over the next couple of years, and we treat this like the crisis that it is. So I want to turn it over to my Co-Chairs of the Committee to make remarks, opening remarks, and then we will hear from our first panel, which I will be introducing. I will turn it over to our Chair of Health Committee, Mr. Wood.

Thank you, Madam Chair. Thank you for being here this morning. Housing and homelessness are issues throughout the five counties that I represent in my district. I'm sure that's no different for every single one of my colleagues. The reasons are complex, right? A person or family can become homeless for many reasons.

It may start because of a lack of--an ever-rising cost of housing combined with disproportionate wages or it may start because of job loss or mental illness or substance abuse or any combination of the three. That complexity requires solutions, but more than that, it reminds us that we also need to make an investment in prevention.

Right now, homelessness results in crisis-driven and expensive events: law enforcement calls, ambulance rides, emergency room care, jail stays, detox treatment, and then eventually trying to find the person housing and providing the wraparound services they need. In my district, which includes five counties, almost all show an increase in homeless individuals in the last point-in-time count. It's not difficult to see, even without counting. In Sonoma County, 32 percent said their current homelessness was their first. The top cause was a loss of a job, with the primary reason, the cost of rent. Some results were good.

A 40 percent drop in homeless families. If that statistic is accurate, something's working in that population, but on the other hand, there was a 29 percent increase in chronically homeless individuals, a 67 percent increase in the number of unaccompanied children and under 18, and transitioning ages 18 to 24 from 2020 to 2022, and a 37 percent increase in homeless veterans. In Humboldt County, 48 percent say they are suffering with mental illness and/or substance abuse. At Cal Poly Humboldt, housing and food insecurity have been significant issues.

Although housing has been an issue for many years, just a few weeks ago, students were informed that on-campus housing will not be provided for any returning students, only freshmen or transfers starting this fall, putting students up Super 8 Motel or the Motel 6 in Arcata, instead causing students to consider dropping out or transferring out of Cal Poly Humboldt.

We heard recently Cal Poly Humboldt officials are even thinking of housing students on a floating barge anchored in Eureka, about eight miles from the university campus. What could possibly go wrong there? I support finding ways to increase housing. I support investing in ways to solve housing and homelessness at the local level. To stay with the solution to homelessness is housing oversimplifies the issues, but it is the start to providing the additional services they may need, and certainly more affordable housing may well prevent future Californians from becoming homeless. Thank you, Madam Chair.

Thank you, and next, I want to turn it over to our Chair of Government Accountability, Ms. Petrie-Norris.

Thank you, Madam Chair. On any given night, 173,000 Californians find themselves without a place to sleep. Homelessness all across our state is a tragedy. It is a humanitarian crisis. And as Chair Wicks and Chair Wood have acknowledged, it is the number one issue for our constituents up and down the state in communities, urban and rural, poor and rich, East Coast, West Coast, north and south. It is the number one issue that our constituents want us to address.

And recognizing that over the course of the last three years, the Legislature--in partnership with the Governor's Office--we've made historic investments. We've invested billions and billions of dollars in programs to increase the stock of affordable housing across the state and to improve our homelessness response. These investments really do underscore the urgency of the crisis and the urgency with which we are acting to respond. But the reality is that writing the check is the easy part. The hard part is now--the hard part is delivering.

The hard part is actually getting people off the streets and into permanent homes. And so I'm really grateful for the opportunity to convene this hearing today because as the Legislature, we need to understand what programs are working and what programs are not. Where are we seeing a return on these investments and where are we seeing real results on the ground? We've got an opportunity to identify best practices and success stories and then roll those out all across the state equally.

We've got to understand where are the dollars not delivering and where do we need to spend our taxpayer dollars more efficiently and effectively? So I want to say thank you to all of our panelists who are joining us today, to my fellow Chairs for convening this hearing, and all the Members that are here today. Grateful for your partnership and leadership and for your commitment to addressing this crisis and ending homelessness here in California. Thank you, Madam Chair.

Thank you. And I also want to recognize and have do opening remarks, our Chair of the Assembly Human Services Committee, Mr. Corey Jackson.

Thank you very much, Madam Chair. I want to thank everyone for being here. I'd like to thank my fellow Chairs also for being willing to take this intersectional approach, understanding that it's going to take a heavy lift from multiple cross sections of policy, of our community, and as our society as a whole. I think it's important as Chair of Human Services that we understand that housing people is only the first step to this problem.

And once we are able to get folks into housing, then we need to get them on a path to get out of crisis mode, stabilize, heal, and be on a path to upward mobility. So this is the long game. This is not a quick fix, and we must make sure that we're disciplined enough to be able to stay the course and make sure that we not just see this one big investment, but we're going to have to make multiple big investments. It's about priorities.

And I am proud to say that this Legislature is making this one of its greatest priorities as well. We know that homelessness is an issue that touches every part of our state and is vital that as policymakers we come together across jurisdictions, party lines, to better serve our most vulnerable amongst us. So I value this opportunity to take a deep dive into the state support structure and look forward to a robust conversation, and of course, many more to come. Thank you very much, Madam Chair.

Thank you, and before our first panel, also want to recognize the Chair of Budget Sub One, Mr. Joaquin Arambula, who also is here in addition to our Budget Sub Four Chair. So thank you both for being here, as well as the other Members who are here, and now we will begin our first panel. If we could get Secretary Castro Ramírez and Secretary Mark Ghaly up here, that would be great. Secretary Ramírez and Secretary Ghaly--oh, okay--are co-chairs of the State's Interagency Council on Homelessness.

The Council oversees coordinating the many departments and agencies that manage the programs that address homelessness, and we'll hear today from these two secretaries on what the Council is doing to better coordinate our responses, and with that, the floor is yours.

Like many states across the nation, California's housing and homelessness challenges have been long in the making. As was noted earlier, for decades we simply have not built enough housing. The problem is so severe that in our state, for every 100 low income working households, there are only 30 affordable and available homes. Almost 60% of California renter households pay more than 30% of their income on housing, and almost 80% of extremely low income households spend more than half of their income on housing costs.

Limited housing supply, low vacancy rates and high rents are squeezing low income families and putting them at risk of homelessness. These adversities disproportionately impact black, indigenous, and people of color. There are a number of factors, as was noted earlier, that contribute to people experiencing homelessness, including poverty and unemployment. However, while the contributing factors are varied, we know our response must center on building more housing, housing that is affordable and that provides the supports to help people exit homelessness.

Ultimately, no agency can address a challenge of this scale on its own. It really requires coordination. It requires an all of government approach. It requires the level of intersectional collaboration that was noted earlier, and it requires a partnership with service providers that are on the ground doing this work every single day. Today, I will provide an overview of the state's homelessness response, specifically the work of the California Interagency Council on Homelessness and the progress that the state is making as we face this challenge head-on.

First, let me start with the council. The council was established to oversee the implementation of the state's Housing First policies and to forge cross sector collaboration across state departments. Just last year, the council was restructured to include Secretary Galley and me as cochairs with the goal to further enhance the collaboration between housing and health systems. Today, Cal ICH is comprised of a 20 member council that includes 18 representatives of state agencies and departments.

To directly complement the work of the council, the Cal ICH Advisory Committee was established. It's comprised of 31 members, including people with lived experience and stakeholders with vast expertise rooted in advancing evidence-based best practices and solutions. In a sense, the structure of the council is representative of what I believe we all hope to see in government, government that is coordinated and that is representative of the communities that we're serving. Now, I'd like to briefly discuss several of the recent council initiatives.

In 2021, the council adopted the first action plan for preventing and ending homelessness in California, which is focused on action-oriented coordination and alignment among state funded programs to improve transparency and accountability. The plan has five action areas, including our ongoing efforts to provide safe and effective sheltering, interim housing, and permanent housing. Another critical component of our state level coordination is data, data that can be used to assess our service delivery outcomes, emerging trends, and to also inform the state's policy response.

To this end, in 2021, Cal ICH launched the Homeless Data Integration System, or HDIS. HDIS was established to leverage the existing data infrastructure that's available to local homelessness management information systems, or HMIS. I know a lot of acronyms here. For well over a decade, local HMIS data was captured but never filtered up and aggregated to us at the state level. Those days are past us.

Now with HCIS provides us with the ability to be able to track various local inputs at the state level, playing a pivotal role in our overall policy response. Tachika Wickrema, my deputy secretary for homelessness, will discuss how we're using the HEIS data and how it was used to shape the development of the statewide homelessness landscape assessment, which is also on the agenda. Next, let me speak to progress.

With the support of the council, with your support, with the support of the Legislature, and in partnership with local communities, we are making real progress. And this progress has been made possible because of our focus on policy and funding solutions that we know work. Over the last several years, the Governor and the Legislature have made tremendous headway in providing a variety of new land use laws and housing policies designed with one overall goal in mind, to build more housing.

These policies have been complemented, as was noted by the Chair, by unprecedented investments in housing and homelessness solutions. Specifically, these resources range from long-term capital subsidies funding, more funding for the Low Income Housing Tax Credit program, flexible aid through the Homeless Housing Assistance and Prevention program, and the Encampment Resolution Funding program, and the results are promising. From 2018 to 2021, the state provided funding to produce and preserve nearly 60,000 units of permanent affordable housing.

These units are bound by affordability covenants for 55 years, so we will see the benefit for the long haul, over 55 year period at a minimum, and there are more units in the pipeline. Just last week, the Governor announced funding to support nearly 10,000 new units that will be created. We are committed to using every tool that's available and to doing everything that we can to accelerate our work to get people housed.

While our state and many across the nation have witnessed year over year increases in unsheltered homelessness, there are a few bright spots here in the state. Between 2020 and 2022, unsheltered homelessness in California increased at half the rate of the national average. In large part, these strides can be tied to the successful Room Key to Home Key strategy that was deployed as part of our response to the pandemic, which assisted unhoused Californians.

Home Key alone has led to nearly 13,000 short term and permanent units that were created. So I'm optimistic. I'm optimistic about our collective progress, the foundational systems that we have put in place and the capacity that has been built in communities. Providing real, lasting change requires coordination, continuity and a full spectrum of supports, including prevention, rehousing efforts, interim and permanent housing options, and supportive services. It also requires that we take intentional steps to remedy the disproportionate impact of homelessness on communities of color.

Just last week, I visited three different communities, all supported with state funding. Each had its unique aspect to their response, but there was one common denominator, and that was collaboration. For example, in Bakersfield, I joined Mayor Goh, county and health officials in celebrating the expansion of a comprehensive navigation center that is serving people experiencing homelessness. In downtown Riverside, I visited a Home Key site in a walkable neighborhood near transit and key amenities that support homeless LGBTQ plus youth that are living with HIV or AIDS.

In Los Angeles, I joined Mayor Bass and county supervisor Solis in the opening of an 82 unit permanent affordable housing community, which includes onsite supportive services. I applaud these communities that are working together with us every single day to build more dignified, stable, and affordable places for people to call home. Thank you for your leadership and partnership. And now I'd like to turn it over to my colleague, Secretary Dr. Mark Ghaly.

Great. Are you able to hear me? I think so, yes. Secretary Castro Ramirez, thank you for that handoff and to each of the Chairs, appreciate the chance to be with you this morning to talk about an issue that I know I've had a chance to speak to many of you individually about over the last few years.

I just want to lift up a few of the opening comments because I think the Chairs each framed an important piece of this puzzle that we're trying to solve that's important to focus on. I think, Chair Wicks, you talked about the policy decisions that we're trying to make right of from decades ago that were problems. We have the same sort of policy problems, not just on the housing side, but on the health and human services side.

And I would like to thank some of the things that you all have supported. The Governor has led on. We are starting to turn the tide on those. I'll talk about some of those in a minute. Chair Wood, you talked about the complexity and the focus on prevention.

I think there's a lot that you'll hear from both, two of our leaders, two women in the room with me today, Director Kim Johnson and our Medicaid Director, J. C. Cooper, who will share in a little bit about how we're using some of the tools in our toolkit to really address those complexities. Chair Petrie-Norris, you mentioned that the easy part is writing the check and the hard part is about implementation. And I can't agree more.

I think our focus is on how do we implement better, how are we transparent about what we're doing, how do we hold ourselves accountable well before anybody else has to, and I hope we'll get into a little bit of that and the focus of, well, what are we doing well and what can we do better on. And then, Chair Jackson, I think you're absolutely right. The first step, this housing first model that we've all talked about for such a long time, it's get people housed first.

But don't forget the entirety of the wraparound that keeps them housed. And I think you'll hear from both Kim and J. C. in a bit about some of the programs that we've put in place that aspire to really support individuals. I've seen firsthand, either in my work in the Bayview Hunter Point Community in San Francisco or the work in LA.

And Lourdes mentioned the opening of a project that, for better, for worse, I had a chance to think about just over four years ago when I was in Los Angeles. That opens now. You know, four years to get something open, I think, is another area of critique. But the point is that we can build, we should continue to build up these environments where people who suffer from not just the sequelae of homelessness, but really deep behavioral health issues, substance use disorder issues, and chronic health conditions.

Over a decade ago, I realized that we do have a homelessness solution for some of the sickest on our streets, and it's called hospitalization at over $3,000 a day, and very compassionate physicians who are in emergency rooms do what we call social admits, get people into the hospital bed because it's too cold to send them out back onto the streets and they end up staying.

And we order CT scans and MRIs to have a good reason, a clinical driver to keep people in that bed and at that sort of price. And frankly, the $3,000 a day data point is outdated. It's probably well north of that for some facilities that we can do better figuring out how to use some of those resources in community settings where people can actually feel connected to others, to loved ones, and enjoy the things many of us hope to enjoy ourselves and in our families.

And J. C. I know will highlight some of the very important parts of CalAIM the community supports that really start to do that depends on a lot of work. It depends on implementation.

It depends on pushing not just us at the state level, but those at the local level because of the way we fund so many of the health and social services in California, function of the size of our history, function of the size of the state itself, but the need to work with our health plans in deeper, more important ways, the push on them to be more transparent, to be more accountable to do this work with the providers in the community, whether they're on the health side or the social service side, is key.

Not just county-run operated programs, but also those nonprofits that I think many of us really enjoy working with and supporting. It really takes the knitting together of all of those pieces to make this implementation plan come together in the way I know each of you expects us to put it together on the streets. I have the privilege of co-chairing the Cal ICH for the last year with Secretary Castro Ramirez. Six of the departments in Health and Human Services are part of that.

They each play a distinct but very key important role. You'll hear from two directors today with regards to their work. I think one of the most important things coming back, Chair Wicks, to how you opened this. We have moved from a place of let's dream up what we can afford and invest in to how do we really hold ourselves accountable. And I think Cal ICH is focused on so many important parts of that accountability. The data piece moving from HMIS to HDIS, it's a treasure trove.

We're just scratching the surface on how bringing together statewide data can empower us to not just make new decisions, but to evaluate the ones that we've already made. So looking forward to the ongoing development of that work and being able to use it as a tool, not just for critique, but for planning and policy change. And then the important role, and I see myself and Secretary Castro Ramirez as chief dot connectors.

As the people who are asking the question, how do we make sure the health, the human services, the housing is deeply connected? You all know we worked hard on something called the Care Act, and the vision of Care Act is in part addressing not directly homelessness, but the severe mental health conditions that often lead to homelessness and keep homelessness more persistent.

And yesterday we held the first workgroup, a group of roughly 15 to 20 individuals that we've invited to help advise on the implementation of the Care Act. And the first topic that work group tackled was housing. What are the housing typologies? Where are we going to find them? How do we pay for them? We talked about something that you, with the Governor supported in the budget, the Behavioral Health Bridge Housing Program, which is nearly available into counties.

That is going to be that bridge, $1.5 billion going out to counties over the next couple of years to find those interim housing sites, to find the immediate available unit, to pay a rental subsidy, to help someone get connected with the various CalAIM community supports, to piece something together, to connect the dots, to make sure that we deliver on this promise that we all have been planning over the last couple of years.

The other piece is the nearly $2 billion, or over $2 billion within the Department of Healthcare Services on Behavioral Health Infrastructure Program that's already impacting communities. We've already seen the building, the groundbreakings, the renovation plans for a number of bed types, treatment slots that cover not just behavioral health, but substance use disorders as well.

That we hope, as Chair Jackson said, gives us the tools to wrap around people effectively, to not just encourage and support them to get housed, but to keep housed, because we know, and I know firsthand that just because you get someone housed doesn't mean they're going to stay there. And we have to work hard to provide the right wraparound services to make that happen.

I could go on and on, and I know that we have Department leaders who are joining to fill in some of the important gaps, to really explain how the grand plan is about a full continuum of services that includes housing, but a lot, lot more than that.

And in the vein of connecting the dots, I think it's really important that as we sit in these venues and talk about the state actions, we don't forget that so much of what happens in California is really at the local level and the need to not just listen to the challenges that we know exist at the local level, but to challenge our local partners to think differently, to think bigger.

You've all invested significant dollars, public dollars, in these programs. I take seriously the responsibility to ensure that the departments within my agency are using those to the greatest extent possible to deliver on the vision that this body and the Governor have set forth. But we have to push locally to think differently about how these dots can connect. Some examples of that are we often hear from cities that services, health, human services. Those are county issues. That's not the case under CalAIM.

There are opportunities for mayors and city leaders to connect with their health plans to do things differently. Secretary Castro and I enjoyed a conversation with Sacramento leaders, city, county COC leaders, just last week talking about how they're using these opportunities in health and human services differently. But the city voice was slightly quiet, right. Not seeing it as that responsibility. I look to all of you to help us encourage those dot connections, push our local partners to do it differently.

Not always do more, but do differently, because I think, and I'll just end with this, Chair Petri Norris, you said it, we can do this. I believe that if our lives depended on us, we could house unhoused Californians, even those with the most severe and complex behavioral health conditions, either substance use disorders or mental health conditions. We're taking a lot of steps in the right direction, but how do we treat this like the crisis that it is?

The situation on the streets is indeed that too many Californians are dying. If this were the storm from the past couple of weeks or a few weeks ago, we would rally all the troops and do something a little different. And I believe with that same mindset, with that same urgency, with that same sense of pressure, that it's our family members experiencing homelessness, that we can and will do it. And you certainly put the resources in place to get that done.

And I feel a great privilege to be able to work to deliver on that vision with Secretary Castro Ramirez and so many other state agency leaders to see not just what we do in the short run, but how we really sort of bend the arc of the lives of the now hundreds of thousands of Californians who experience homelessness on a daily basis to create that environment that I think we can all be proud of. So with that, thank you for the opportunity to be here today.

Thank you both for presenting. And we will now open it up for questions from the dais. And I know Assembly Member Quirk-Silva has a question, followed by Assembly Member Chair Wood.

Good morning to everybody. Thank you for being here and thank you for the important work that is happening across the state. I do have a question, but I also have a statement which is there isn't a lack of effort that has happened in the last decade for homelessness, and yet we are dying our way, quote, dying our way out of homelessness, which means that in Orange County, 45 people die a month. In Los Angeles, it's probably double that.

And when we are reducing homelessness, we have to take that seriously. So my question is, why, in fact, have we not declared this a State of Emergency? We declared Covid, we saw what we could do when we had an emergency in health. And this, in fact, is an emergency from not only the people who continue to fall into homelessness, but everything from prevention, we rarely talk about. I've been now on housing for, I think, four years here at the state, and we've heard a lot.

I know for some of my colleagues, it's, we need more data, we need reports, but we often don't see what happens with that. So my question is, why don't we have a State of Emergency? My second question is, what about our surplus lands? The Governor declared probably three to four years ago in a State of Union.

And by the way, I understand that we had Covid that happened in the middle, but we did an audit on surplus land and we are building almost nothing on state land. So those are my questions. Surplus land, State of Emergency.

Thank you, Assembly Member Quirk-Silva, for the question. On surplus lands, we are leveraging the state-owned lands and unlocking the opportunity to be able to create more affordable housing. Just a few weeks ago, we released, in partnership with DGS, a notice inviting proposals for three state-owned buildings here in Sacramento.

We're also partnering very closely with cities to ensure that they're taking a look at where these lands are located and the ability to be able to create not just affordable housing, but mixed income housing and the connection to other sort of economic development opportunities. I also know that a number of cities across the state are also taking inventory of their city, county-owned lands to look at ways to leverage.

But please know that we are focused on using this resource to produce more housing. With regard to the overall sort of approach to how we're responding to homelessness, I joined the Administration in March of 2020, right at the beginning of the pandemic, and we went right into an emergency response mode, as we all know.

And that emergency response mode where we were all working together at the state operations center across agencies and departments, led to the innovative, not just the innovation that we created through Home Key and Room Key, but also the sense of urgency and the sense of moving with speed and being responsive to local communities.

And I would say that that is the same level of urgency that we continue to have as we deploy and provide and implement housing programs, as we implement new policies and laws to create more housing, as we look at ways to strengthen the partnership between housing and health. Basically, we are continuing to move with a sense of urgency.

The new mayor in Los Angeles, Karen Bass, just did declare a State of Emergency for homelessness. And one of the reasons she did that, I understand from her own remarks that it allows her to move quicker through some of the process or if you want to say, red tape. So that's what I'm many times we get stuck in bureaucratic processes, and if there's a way for us to move quicker to address this, we're going to save lives. Thank you.

Yeah, maybe I can just add a little bit to that last point. I agree with Secretary Castor Ramirez that in actuality, the way we set up a lot of the budget initiatives. So you take, for example, some of the things running through the Department of Healthcare Services, they come with exemptions around some of that red tape that I know that in the case of LA and some other places considering the State of Emergency, that's exactly what they want to get through more quickly.

So we are always looking for approaches to streamline, make things move faster. And to the question about unused state parcels, I think the renewed effort that I hope will quickly become apparent to use those properties more effectively with more urgency to address problems at the local level, is as Secretary Castro, is being sort of reignited and explored. You're right. Kind of started, had major interruption through the COVID emergency and now picking up some of those important ideas. So hopefully we'll be able to show that soon.

Thank you. Chair Wood.

Thank you. And thank you for your presentations. Very much appreciate that. I think one of the things I'll go back to a little bit, Chair Wicks talked about, we're here because of decisions that were made over decades, and then I think some exacerbated by decisions that have been made in recent years. And we'll use the example of redevelopment as a tool that in the community that I came from, a local government, we used for affordable housing projects. We're only a community of 11,000 people.

We didn't build stadiums. We didn't do any of that sort of stuff. We used it for housing. And when those were dissolved, that funding tool went away and our ability to do these projects greatly diminished. One of the cities in my district is using, they actually have bought a piece of land and are helping with the entitlement process, working with an affordable housing developer to actually make this more efficient.

And in a city of 16,000 people, they're moving on a 64-unit affordable housing apartment complex, a partnership with the city. But they can't do that consistently because there's no resource available for cities to use to buy land that can be left there for a longer period of time or a trust that could be revolving. The challenge from my perspective is that you look at large urban areas, it's different.

And we do a lot of our policies around those large urban areas, but our smaller areas, we need technical assistance, we need flexibility, because the landscape is completely different, the needs are completely different, and yet there isn't a lot of that. And so a lot of small communities, rural communities, simply don't have the bandwidth to take advantage of a lot of programs, so they don't even try.

Some of my communities have given up on CDBG program because it's so cumbersome and difficult to work with and the fear of clawbacks for community projects. Going forward, this huge tranche of money is fabulous for the short term, but what are we going to do long term? Because we need a sustainable funding to move these projects forward. And if we're going to focus on prevention, which is important to me, in my district alone, we're seeing increases in certain segments of the population that are becoming homeless.

Increases, more and more increases. We have 173,000 people in California on any given night are somewhat unhoused, and the number continues to grow. And I appreciate that we've 13,000 units, but if the population is continuing to grow, it's two steps forward or a step and a half forward and three steps back sometimes. So my concern is the urgency. But one of the points I want to get to is we talk about coordination and your HEIS data system.

I would hope that we can have health information exchange data that can be coordinated as part of that. I have heard from emergency room physicians who say, you know what? We've got hospitals that are adjacent to one another. People go from one hospital to the other. The hospitals don't communicate. Nobody knows their duplication of services, increased costs. And with that health information exchange types of systems, we can have better data to tackle some of these. I'll never forget this.

When Senator Wiener a few years ago talked about a person in San Francisco who was picked up 150 times in a year by emergency medical services, taken to a hospital, the incredible costs of those kinds of programs. So I think Care Court will help us with programs like that. But those are probably the kinds of things that are happening all over the place and the incredible costs.

And I haven't even touched on the horrible cost of housing when in more than half the states in this country, you can buy a three bedroom, two bath home for $250,000. And these other units that we're doing here are costing upwards of 3, 4, $500,000 plus for studio, $600,000 for studios, not three bedroom, two bath house. We have to do something about the affordability piece of this and housing. Sorry, I will get off my soapbox now, Madam Chair.

This is indeed a soapbox, but that's part of the public conversation. So we appreciate hearing your comments, Chair Wood, and if there's some response here.

Particularly around the HIE, I would love to hear your thoughts about that.

I think you know for the last year and a half, we've been building the California Health and Human Services, frankly, data exchange. And what we are doing in that project is requiring a number of entities, not just on the health side, but also on the social services side, including homeless service providers, to feed in data to an exchange agnostic of the platform.

We're not saying you have to use this HIE health information exchange platform, but that there are required elements. And the goal of that is not just around the health data, but on the social services data. So exactly what you're saying. So that the social worker who meets someone for the first time, who, frankly, has had three other social workers help fill out the same form that he or she is going to fill out, they have a head start.

They have some of that information already, so that we can not just be empowered as providers to support and serve people better, but that those individuals have the information that follows them that they can use to be able to qualify for a unit or a program or whatever it is that they need. So we have required entities that are signing agreements to do that now, agree to start sharing that information as soon as early next year, and hopefully everyone in by the beginning of 2026. So a bit of a runway, but this puts California at a place to finally catch up with some other states that are already doing this.

Thank you. Next we will hear from Assembly Member Bains, followed by Assembly Member McCarty.

Yes. Good morning. First of all, thank you guys so much for your service on this. I kind of want to echo some of Dr. Wood's comments, but thank you for being in Bakersfield about a week ago. Right. And when they were doing their ribbon cutting, I didn't know about that. Never mind I'm the Assembly Member over Kern County, but first and foremost, I'm a Doctor of a recovery center in Bakersfield. And I'll give you a real life situation of what happened last week.

I was walking onto session and I get a call from a mother crying, saying, my child is drinking again. They're doing drugs again. I don't know what to do. Can you please place them in your recovery center? We have no spots open. What do I tell this mother? And what she told me was, if I kick him out of the house, he's going to go to the streets and that'll enable him even more.

He's doing drugs, but at least he's doing it at home under my supervision. What about kids that don't have that and they get kicked out to the streets and they can't find a bed in a recovery center? So I reached out. I said, well, I see on Facebook that we just opened up a new navigation center. And when I reached out to my recovery center, they're like, it's already booked, Dr. Baines. We pulled some strings.

We got him into a detox center right away and opened up a bed for him. But this mother had my number. I don't know how she got my number. But what about the mothers out there that don't have a doctor on speed dial to call? This is a real situation, and wraparound services with physicians, with people on the front line of substance use disorder treatment need to be integrated into this process. And they're not, specifically doctors in rural areas like Kern County.

It was fantastic that we opened up the navigation center but where is the integration with the community and recovery centers, residential-based treatment facilities that are there? There's a lot of work we need to do to integrate with healthcare. I pretty sure everybody understands that we cannot wait till 2026.

I can't agree more that we have a long way to go. I think we have made very important starts. We are in many ways trying to connect these. And I would say that substance use disorder services, as I think many of you know, has been in the shadows for really long time. This state has made some important efforts, but we still have a long way to go. The science behind substance use disorders is way behind. The treatment modalities are way behind.

It's often used as the reason why we don't integrate and we don't coordinate as well, especially with housing. It's hard. That doesn't mean that we don't continue to work at it. I think there's a lot that has been gained over the last handful of years with California's organized drug delivery system under Medicaid to increase the availability of treatment slots. The way that they're funded the workforce piece is an urgent issue. We don't have enough substance use disorder counselors. We don't have enough training programs.

We don't have the places to train individuals. But that is starting to change. I'm not calling for patients. There's urgency as well, and we are working to put a lot of those things in place. And I think the ribbing cutting of the center you mentioned, I had the privilege of talking to the individuals who put that together and advising how it comes together, how you integrate some of those services, how you integrate the funding. And they reached out and said, how do we do this?

How are we going to make it happen? And to see it happen, frankly, in relatively short order compared to what is often three to five years, to get something like this open is a testament to the leaders there and the ability to pull that off. And we need to replicate that across the state. Right. And getting the facility open is step one, and then integrating it with everything around it, hopefully in the planning process.

And I would suspect that some of that happened, but there's more to, and I think we should lift that location up as a real opportunity, not just for the rest of the state, but Kern doing more of that and seeing us reach a level of capacity where you can, as the leader of that area, be able to more easily get someone access to the services they need.

Yeah. I would also just add, first of all, thank you so much for reminding us that this is about real people, right, that are struggling, that are looking for the level of support and assistance. And I completely agree with Secretary Ghaly in terms of the role that the state has is in providing the level of technical assistance to move more quickly to get these types of services and really comprehensive places like the navigation center in place.

But the other thing that I think is really important, and this is why Secretary Ghaly and I have been so focused on working with cities, counties, continuums, housing authorities. We need to see more regional coordination, more coordination of the entities that are underground to be able to strengthen the safety net system. Right. And to be able to do a better job in terms of providing the level of information that mothers, families are looking for. And so we are very much continuing to stay focused on that.

I think you all know, through the housing and homelessness Prevention program, through HAPP, communities across the state were required to provide local action plans. And these local action plans include a real understanding of the population that is being served, the services that are being provided, a focus also on outcomes, but critical to the overall sort of action plan. We encourage communities to look at ways to consolidate and to coordinate and to create more regional plans.

And I'm pleased to share that of the 120 or so potential applicants across the state, we received 75 applications. And for us, 75 application means that communities are working together, are forging stronger regional partnerships, and we will continue to do that level of guidance and support and technical assistance because we think it's fundamental right to have that level of coordination on the ground.

Thank you. And just also in the interest of time asking, and we've got, I think, six more questions from Members. If folks could be concise, both my colleagues as well as the panelists, that would be great, although we do love hearing and having this conversation. Next up is Assembly Member Mccarty, followed by chair Petrie Norris.

Thank you. I have a question that, frankly, we could ask of any panel. Like all subcommittees, most of the questions will be for the first panel, by the last panel. Pretty quiet here. But first, this is a big issue. I know there's four committees here. I think there's 30 or so Members, but all 80 Members would be here because this is the collective albatross hanging around our neck for this year and prior years with no easy solution.

And so part of our challenge here is to identify the problem, which clearly we see, and it's evidenced by numbers and driving to work today, we see with our own eyes. And then we have to basically prioritize solutions. And speaking from a budget lens, who chairs one of the subcommittees overseeing half the budget. It's all about choices and money. So the question, I think, in my eyes, is a key one, is that, as Ms. Petrie Norris said earlier, there's roughly 175,000 homeless in California.

And the best solution for them is permanent supportive housing, which is roughly $600,000 per unit. And multiply that times that is about $105,000,000,000. And in the last five years, during amazing budget years, literally once in a generation cycle, we muscled up 12 to 15 billion for homelessness. I guess the Lao says 20 something, but that's behavioral health and some other stuff. So 101215 something in that range. And if we need 105, how do we do that?

And like, I'm sure Dr. Arambula is an ER docs about triage, like serve people the immediate needs. And so I think the issue we see is the debate, shelter versus permanent supportive housing. And what do we do? And everyone says both, but we do both. We're going to fail at both. We have been failing. And so we have to make tough choices. And let me just give you hypothetical here in Sacramento, City, not to bash on our city, but they made a choice.

They set aside, I think 50 million for shelter, for emergency shelter, like some of the vacant land, because you could use vacant land to do shelter, readily available and pretty cheap to build supportive housing. And you're going to need the billion. So it's going to take 34 years sometimes. Not to mention all the NIMBY lawsuits and stuff. So the city decided they had about 50 million that they wanted to focus on shelter.

And recently, in the last six months, they decided, you know what shelter is a band aid, which is true. There's no running water and heat and so forth. So we should focus that 50 million on permanent supportive housing. So there's 5000 people in Sacramento, City of Sacramento, the city who are living outdoors right now. And with that 50 million divided by 600,000 is 83 units. So 83 units are going to have a great solution.

But those 83 units are probably going to take three years at least if we're lucky. In the meantime, 95% have nothing. So I know that we go back and forth, but we have to make tough choices here. And our constituents don't say congrats on serving the 5%. That's attaboy. They go by and they like, we all see it. And my kids walk home from school and walk and it's a reality. They see it. It's not changing easily.

So secretaries, and this could be for every panel, do we keep doing that, a little shelter, little permanent supportive housing and whittle down a little bit or really rip off the band aid and focus on something like getting people off the streets? That's what I would do. I'd rather have people, even if it's not a permanent, at least have access to a bathroom, water, trash cans, maybe like a mental health counselor to come by the shelters.

And some people say, zero, you're just legalizing shanty towns and tent cities. But we do that after major earthquakes across the globe and tornadoes and hurricanes and so forth. And so it just seems to perplex me. Thoughts? Answers?

Yes. Thank you. Assembly Member we need to build more housing. We need to build more permanent housing. We need to build more affordable housing. Chair Wicks pointed to the statewide housing assessment, or the statewide housing plan that was released in 2022 that calls for 2.5 million new units that have to be planned for by 2030. This is very much the issues that we're having with affordability. The issues that we're having with homelessness are tied to the lack of affordable housing.

And we need to continue to stay the course on providing more housing options across the state, ensuring also that we're demanding more from our federal partners when it comes to rental assistance to ensure that some of those units are deeply affordable. We are a very mindful Assembly Member about the concerns with the cost of building units.

And at the state level, we're focused on doing everything that we can to streamline the development process, to better align our housing finance system, working closely with Treasure MA to also ensure that we're consolidating programs so that the development community has more predictability when they're coming for funding or financing. And I think the other important factor to consider is the covenants, the affordability covenants that are tied to these units. Right. These are units that are affordable for the long haul, for at least 55 years.

And so we will continue to look at ways to reduce costs and to ensure that we move more quickly to build units. But I would also agree, Assembly Member, that as we're continuing to build more housing to catch up with population growth, we need to stay nimble and provide other sheltering options, transitional housing, interim housing, to get creative with communities. And so we're doing both. We're doing both. And I think that this situation requires that we continue to do both.

And I guess maybe the last comment that I would say is that the social services piece becomes really important. So it's not just the building and the unit. It's about ensuring that as individuals move into housing, that they have the supports necessary to be stable, but also to work towards their dreams or to work towards what they want to accomplish. And so that's sort of my perspective Assembly Member.

Maybe just a follow up, just as a housing secretary, business and transition as well. And I knew you would say both because everybody says both. And, yeah, my kids want to have both presents for their birthdays, and everybody wants both, but we can't do that. And so if we have a limited amount of money, we're just failing.

And so at what point do we say, okay, maybe we bite the bullet, and just in the minimum focus on 175,000 porcelains who have nothing, who are sleeping in the cold, the rain, the heat, and just the New York model shelter and that just triage that. At what point do we do that if we can't really pencil out both?

Yeah. Well, I would say that for every person that gets housed, we have another two people that enter into the homelessness response system. 60% of the people that are coming in first time experiencing homelessness. Many of these individuals are being evicted, losing their housing, they can't sustain their housing. And so this is what makes this situation very complex. And I think you all have acknowledged that there's a lot of complexity in terms of addressing the housing affordability challenges and the homelessness affordability challenges.

And this is why I think we have to provide a full spectrum of supports. We have to focus on prevention. We have to focus on intervention. We have to focus on interim and permanent housing solutions. I don't think that we're in a place where we can just focus on one and not sort of ignore the other options.

Thank you. Now we'll have chair Petrie Norris, followed by Assembly Member Bonta.

Great. Thank you. So in, I think it was March of 2021, the Inter Agency Council on Homelessness, you adopted your first, I think it was your first action plan. Can you just quickly, quickly and top line walk us through kind of the key goals that were articulated in that action plan? So number of permanent supportive housing units built, number of shelter beds, number of Californians served. And then how are we tracking relative to those goals over the course of the last two years?

Thank you. So let me sort of frame what the action plan is. So the action plan was first. This is the first comprehensive action plan that was adopted by the council in 2021. It does include five action areas with a focus on the spectrum of supports. And it also stands very much on the foundation that as we address homelessness, we need to mindful of the disproportionate impact that homelessness is having on black, indigenous, and people of color.

And so there's equity that is driven across these five areas from the perspective of what are the objectives? Right. And the goals. First and foremost, it is about ensuring that the 18 state departments and agencies that make up the council have identified goals that are related to the five action areas. So in the housing space, the production of more permanent supportive housing units, it is also about looking at ways to strengthen the coordination between housing and health and services.

So it's a roadmap chair that enables all entities within the state that have responsibility for administering homelessness programs to focus their attention on reducing the number of people that, reducing the number of unsheltered homeless individuals that are entering into the homelessness system. It is also about measuring how quickly and how many people are exiting the homelessness response system and moving into permanent housing.

And for the first time, we now have an evaluation and assessment through the homelessness landscape assessment that gives us the data that shows how these entities and the programs that are being administered, the impact and the results that we're achieving. And I know that we have Members of the Turner Center and also my deputy secretary for homelessness who will speak more to the findings, but it does speak to more capacity. We're serving more people through the homelessness response system.

We are producing more units, as I mentioned during my opening statements, 60,000 units produced over a three year period. Yes. And I maybe would ask Secretary Ghaly if you'd like to add anything else.

Yeah, I will. Thanks. In 2021, when the first action plan was adopted, it was before I joined forces. And I think if you look at how it was revised in 2022, you see a significant amount of scaffolding, if you will, around health and human services.

So, California Department of Public Health, our state hospitals, our social services and healthcare services, really setting its own sort of fingerprints on that plan, pushing forward around this really supportive wraparound model that I think really significantly buttresses the idea of how do we make the housing more impactful, more meaningful, more sticky in cases where we have a lot of lessons learned about how it can easily fall apart without those.

So, I think the sort of evolution from 21 to 2022 into 2023 really demonstrates this coordination across housing, health and human services in a way that represents the work of the all 18 departments and the many agencies involved.

Great. If I understand what you're saying correctly, we've got some really great kind of organizing principles, but we don't have specific goals for statewide permanent supportive housing units, shelter beds and Californian served on an annual basis. Has the Interagency Council articulated those?

Not to the level that you're describing in the housing space. We have the housing plan that calls for 2.5 million units by 2030. And so we are measuring both preservation and production goals against the 2.5 million. So each Member of the council has their set of priorities and their goals and their reporting up through the action plan.

I think doing more and doing better isn't actually a plan. And while it might sound overly simplistic, I think it's really, really important as a way to organize our statewide response, to have a specific number that we are aiming for across the state. Because then that enables you as Interagency Council to assign responsibility, whether it's to our state departments, our locals, to actually build that, to create that number.

Right. It's the same way. Like we've got carbs, we have a scoping plan. We break down. We don't just say we want to lower emissions, we have to break that down. And that's the way that we can turn it into really concrete action. So if we don't have those specifics, I would really challenge us to adopt those.

I think it's just a critical piece and Secretary Castro Ramirez can probably speak to it. The action plan guides the work of the Interagency Council and all of its members. I think there's work at Cal ICH around HAPP and other programs that do set collective, sort of taking the collection of plans and initiatives at the local level and putting that together and marching out. This is what will be delivered, if you will, in terms of shelter beds, in terms of housing units.

Now, is that pegged against the goals that you're saying? Maybe not necessarily, but the ability to quantify because of the deepened accountability around how those dollars are being used and what they're being used for, I think is the really first step in that. And I think you'll see more of that coming. It's not the end, it's the beginning of some of that. But you're absolutely right.

Without the goal set, even if it's an audacious goal, even if it's reality tested around $600,000 per unit in some places and hopefully innovative models to bring that way down in other places. We should be able to track that, but I think the substrate to get there is starting to be built and the expectation being put out there.

Got it. Thanks.

Thank you. Next we will hear from assemblymember Bonta, followed by chair Jackson.

Thanks so much, Chair. I just want to focus in a little bit on Cal ICH's work group around racial equity in response to homelessness and housing, and specifically noting the disproportionate impact that Secretary Castro Ramirez talked about in terms of on Black and African American and Latino and indigenous folks in particular. One of the formulas that we just talked about, it's so very simple. Supportive housing, wraparound services, affordable housing.

I just did an affordable faith based housing tour in my district, and within a five block radius, there were 250 units available for development that the faith based leaders wanted to be able to develop. And these are the faith based leaders that set up pop up tents for COVID testing, that got people vaccinated, that on the daily, provide food distribution services, provide supportive services. Everything already there extant in the community existing already.

I wanted to just have you all speak to what we do to move from not only a housing first model, but to a housing next model. Because in our communities already, we have the supportive services and wraparound services, and all they want to do is be able to build their 12 to 8 units on the property that they have next to them or the 150 units that they have that already has a childcare center ready to serve the community members that would be there.

And I want to just have you, when you talk about equity, really, are we addressing these concerns from a bottom up strategy and getting out of our heads a little bit and just thinking exclusively about these top down strategies, these are already communities. We need to be able to build up their assets, not try to impose additional structures on them. And I don't think we're taking full advantage of that. So, I wanted you to be able to speak to that a little bit.

And the reality that I was just looking at all of the programs, which there are many, and one of the things that I heard loud and clear from these groups was, at the end of the day, we want to build housing so that we can build our communities.

And there's no guarantee because of the way that we've sliced and diced qualifying into these housing, that they will actually be able to ensure that the mother who's already working and just is looking for a place to have her child in her rest her head, who goes to the church next door, will actually be able to get housing in the facility that they built. And so I think, I know that we are government. I know that we are state.

I know that we think big in some instances, in order to be able to enable our communities, I think we have to figure out how to facilitate the small and the already existing assets, and I wanted you to speak to that a little bit.

I completely agree. Assembly Member.

I think equity is both understanding who's being served, right, or who needs to be served within the homelessness response system, and that equity also means creating greater access for institutions on the ground that are attempting to provide, that have a better understanding of the communities that need the housing and the supports and are in need of state funding to be able to do their work in this year's, through the Housing and Community Development Department, in this year's super notice of funding availability, where the department was able to consolidate, to bring together four housing finance programs under one umbrella to streamline the process for applying for housing finance.

We were very intentional, and the department was very intentional in establishing a set aside within that funding structure for emerging developers, for small community based organizations that are looking to build 468 units. Right, that are very sort of targeted and there is a level of technical assistance that was provided.

Director Valasquez and I were in Compton, met with the City of Compton, and met with a number of folks on the ground that are doing the work already, but don't know how to access funding at the state level. So I think a responsibility that we have as state leaders is to create greater access so that we're able to address the local needs and provide the resources. Because as a community developer, as a community planner, I really believe that housing needs to be.

Housing is one piece of the puzzle, right. Housing lives in communities, and it needs to be connected to the fabric of that community. I just wanted to mention that we were mindful of the fact that the state needs to do more within the tax credit allocation process. We also have worked to establish set asides for BIPOC led developers to also have an opportunity to apply for funding where they're not, just to have greater access.

Right, and in some cases, to apply for funding, not just to create housing units, but to create a more sort of comprehensive Housing and Community Development projects. And then the last point that I would just make, and I'll turn it over to Secretary Ghaly here on equity. But within the new requirement of recipients of HAPP funding, they're required to submit annual local action plans. As I mentioned, as it relates to equity.

They're also required to provide information on the uneven or disparities that they see within their community of people that are overrepresented in the homelessness response system. And they're asked to provide description of the strategies, the sort of targeted strategies that they will be implementing to be more intentional in terms of how services are being delivered and how they're measuring the progress that they're making and also how they're incorporating people with lived experience to help inform the delivery of those services.

I appreciate the question, and I think the opportunity in your question, let's just put the fine point on something we haven't said, which is the data point. California is 6% black, 30% roughly of people experiencing homelessness are black. In LA, that's up to 40%. Right, so this isn't just a health issue, this is a deep racial equity issue. I think you spoke Chair Wicks about some of the historic policies that need to be not just undone but rectified in a number of areas.

I actually appreciate the way you put it. We often think big, and what that usually means is big efforts, partners with lots of deep capacity, and what we find even in some of our own opportunities that we've put out there in community, that the, quote, more sophisticated providers are able to get the dollars and those with less sophistication aren't. And that often translates into the smaller capable I have access to eight units.

It'd be great to fill it with people we're serving in a number of different places. We don't tap into that enough because when you add eight plus eight plus eight, it takes a while to get up to the goal. But frankly, to the point of where are our options and how are we going to continue to struggle through the timelines and the costs of huge projects.

We probably need to spend more time tapping into the more, I would say, homegrown, community based solutions that might be found in faith communities or other communities. And I know Secretary Castro Ramirez thinks similarly that there's a lot of opportunity there and the need to pivot and focus there, I think is needed. That isn't the only thing we need to do to address the racial equity issues in this problem, but certainly one of the things we should tap into more.

Thank you. And with that, next we'll hear from Chair Jackson.

Thank you very much, Madam Chair. There are just two things I wanted to talk about. The first thing is, although transitional housing is a part of our strategy, I'm concerned about some of the time, certain aspects of transitional housing. Right, we know that everyone is on their own journey, on their own time. And even though for a particular amount of time we are able to house them, sometimes we have time certains where we're pushing them back into homelessness.

What things have we done or what can we do to begin to address, right. The opportunities to say, if we're too rigid here and we have a cookie cutter approach, and as human of beings, we're not cookie cutter people, what are we doing to make sure that we address that the systems that we're funding in and of itself might be pushing people back into homelessness. Any thoughts?

Sure. I can tell you, having moved across the state, there's something called recuperative care, which is essentially interim housing that is clinically well supported, often used for people transitioning out of institutions, hospitals, even jails, who would otherwise be homeless with significant health concerns, either behavioral health or physical health, that need that support. And I've been to some counties that say 180 days, the only way we can have throughput is 180 day limit. And then.

Exactly, you've done all of this great work, stabilized an individual, 180 days comes, we're not quite there to find a permanent place. So they exit the program. And where do they exit? They often exit into situations that aren't permanent housing back to the street eventually. Other counties have chosen to say, we hear you, 180 days would be ideal, but if it takes 250 to figure out your next location, that's what we're going to do.

So how do we as the state support the second paradigm so that we don't lose the gains? Something in behavioral health, you talk about consolidating gains, you put all of this work into something and then you're going to let it all go. But if you invest a little bit more, you see it tip, you see it well supported, you see it stick. I think that that, especially in those clinically enriched elements, is going to be important for us to keep our eye on.

What is going to be challenging, though, is some of the rules of the program, how it's funded, how it's supported, even by federal dollars. It's going to have deadlines and timelines on it. And I think the state, through its creativity and its own resources, has an opportunity to figure out a way through that.

And I know that the leaders that I have the privilege of working with are thinking in that way, hoping to create programs that don't sort of have that rigid timeline and deadline and are forgiving and graceful in a way that allows us to have these things be sticky and meaningful over the long run. That does, though, to the point of priorities and making choices.

It means that somebody doesn't get into that bed right away, somebody doesn't replace them in the predicted sort of planned way that we start with. And I think we all need to be okay and understand that that's part of the challenge, that if we don't build up the next thing, the exit, the back door to some of those programs, that we are going to have longer length of stays. And that probably is something that will require some conversation and discussion.

But I certainly have a view that we need to consolidate the gains and support people onto the next.

Secretary Ramirez, right.

Yes.

Home key application. You can check off that transitional housing box. You can also do it for young people, too, and the young people discretion. Right, and so any thoughts or. I'm not expecting you to have the whole answer now, but I'm just trying to begin to make sure that we got to end the cycle here.

Right.

And we might be continuing the cycle in our very own structures that are meant to break cycles. Your thoughts?

I agree. First of all, Chair Jackson, pleasure meeting with you yesterday. And I agree. I think that it is critically important for us to recognize that people are working towards resolving these issues. I think our job is to ensure that we're eliminating or reducing barriers that slow down the process of making the connection between transitional to permanent housing.

I think our job is also to make sure that the programs that are in place are not interfering with the ability of a person to move into a stable, long term, supportive housing environment. And so that includes taking a look at how local communities are using their housing choice voucher programs. That includes taking a look at whether or not communities have too many rules, too many regulations that impede people for moving more quickly.

And so that's the work that is important also for the state to pay attention to. And we are paying attention to that. And then the last thing that I would say is speaking of the home key model. The homekey model provides for. First of all, it's an adaptive reuse model. Right. We're taking hotels, motels, underutilized buildings, converting them into interim and permanent housing. The cost is cheaper. The time that it takes to get those units in place is faster.

And the ability for us to have both transitional housing or short term housing and to have permanent housing, I think that's a level of flexibility that we need to continue to provide and support locals as they develop their spectrum of supports or their continuum of housing options.

Thank you for that. When I'm looking at this from an ecological approach, right. Systems perspectives here, and we're looking at the continuum of what a human being needs to be healthy, to be able to thrive. Right, what we're really facing is a perfect storm of a complete breakdown of the foundations of our state, all the things that the state is supposed to be providing, right. The health and welfare of our citizens.

It seems as though we need to get back to basics of what are the foundations of human existence? Human needs. We know that there's three types of capital that a human needs to be able to be on a strong path to economic and social mobility, right. We know we need social capital. How strong are our families? How well connected are people within their communities to various sources of support? Within that social capital? We have people like us. We're a part of that social capital.

The institutions that we create for our folks to be able to thrive, then, of course, we have human capital, the type of education that we provide to our citizenry, the type of health we provide to them, health care, mental health, the whole spectrum. And then, of course, we have the financial capital, the type of things that people can do to begin to build wealth and to build a strong sense of stability.

When we look at this continuum here, within the strategy that you're all looking at, what do you think is some of our core weaknesses when you look at these various forms of capital that our folks need to be able to thrive and to break cycles of poverty? Is there a point, part that you believe that we still need to do a better job in putting into the calculations and the very strategies of how we're trying to move our population forward?

I know I'm getting in the weeds there. That's my social work hat.

But yes, I really appreciate the way you laid it out. Chair focus on social capital and the relationships that we have with each other and whether or not within our communities. Right. We have the ability to be able to have the support that is necessary when we fall on hard times.

The human capital, the investment that we're making in people and their ability to be able to reach their potential, and the financial capital, which is the way that we deploy investments to support communities, to support people. And I would say that all three matter. And we're trying to do, I think, through in some ways and having really the opportunity to work closely with Secretary Ghaly and with many departments within the state that are doing their best to administer and to provide funding and programs.

I think we're doing our best to stay focused on the three pieces that you have just laid out from a housing perspective. I think housing and the design of housing and how housing is integrated into a community can help build social capital right from the perspective of the work that we do in terms of investing in, our agency also oversees the Department of Consumer affairs, where we provide licensing to professionals and businesses across the state.

So how are we ensuring that individuals that are going through the licensing process are able to move quickly through this process, get their license so they are able to practice their trade, their profession?

So, I would say that we're attempting to address all three and the work that we do, and this is why I think it's critical that this council continue to do its work coming together, working across systems, looking at ways to lift up the good practices that are happening on the ground, and also looking at where we need to improve, where we need to measure things that maybe we're not measuring, as chair Petrie-Norris mentioned earlier.

Thanks for the question, and I think the frame is right on. I'm going to, for the interest of time, restrain myself a little bit because I don't want to take up the whole hour, but a couple of things to say first. I think the question around capital is a really important one, but I think the timing of when that capital is available to people is really important.

So if you look at re-entry and exits out of incarceration or institutions, we're often not there with the capital. Right, and if you look in LA County, which I know the best, there's frankly a superhighway between the jail and skid row. And why is that? Because the wrap, the services at the point of exit have not always been there, I think I'm proud to say.

And JC Cooper will talk a little bit about what CMS Medicaid approved for California, first in the nation just a few weeks ago, was 90 days of reentry support for Medicaid beneficiaries in jails and prisons, in juvenile detention facilities, a really critical time. We spoke earlier about crisis. This isn't just about a statewide crisis. This is about a crisis in people's lives at a moment and being there.

Emergency Department Dr. Rambula's experience, like making sure the capital shows up at the right time, is also part of the effective piece and no better. And I'm sure Director Johnson, if she was up here right now, she would tell you about what EITC and Cal-Works Grants and CalFresh and during the pandemic, the data on how a little bit of extra food assistance, frankly, a lot of extra food assistance tipped people on the right side of falling into homelessness, into poverty. Deeper poverty was very impactful.

So when you talk about the financial capital and you ask, I can't vote, which is most important, but I can tell you we have evidence that a little bit of extra financial support makes a difference.

This whole notion of shallow rental subsidies for a period of time that focuses on prevention, we don't have it right exactly anywhere, but we know that to put a few $1000 at this moment, at this crisis moment, to prevent somebody from losing their place, ending up in their car, feeling persecuted by the streets, deciding to use substances for self medicating, survive, I mean, that road is also pretty well known.

So I guess my frame or my way of answering is all of the capitals that you mentioned, the relational, the financial, the human, are deeply important. But I do think we sometimes get the timing wrong.

And if we can be more exact in how we time the availability of the support of those capital, we may be able to change the arc of the lives of a lot of folks in California and hopefully the overall sense of crisis, whether it's on our streets or in our jails or in a number of other areas.

Thank you for that. Thank you, Madam Chair.

Thank you. And then we will now hear from Assembly Member Korea, followed by Assembly Member Arambula.

Thank you, Madam Chair. And first, let me just say thank you to you both for your service to the people of California and to the incredibly difficult challenges that you face in your position and your partnership with the Legislature. You know, just for purpose of history, the State of California hasn't always been involved in addressing the issues of housing and homelessness. It is a fairly new attempt for us to be involved in this incredibly large-scale crisis that we have all been charged in solving.

And what I'm hearing from my colleagues is a very real disconnect from the Cities, the Counties, the Continuum of Care, all of the entities involved across the 58 counties in the State of California. And the most pressing thing is what is the role of the state? How long will the State of California be invested in finding a solution, and for how long?

Right? Before we try to figure out the Accountability Piece, the Local Control Piece, all of the various different issues related to what type of homelessness crisis we are addressing, whether it's someone living in their vehicle, someone being evicted from their home, someone experiencing chronic homelessness for decades, who's been living on the streets of Skid Row for many, many years. All of these things are different and need to have different solutions to them.

But at the end of the day, we don't have access to the day-to-day. The Legislature, I should say, does not have access to the day-to-day information as how various different entities operate their systems or how those systems are communicating with each other.

And I'm saying if there is an individual experiencing homelessness in San Francisco and they choose to travel the state and end up in Los Angeles, how are the systems tracking that individual in response to the type of services that they've received and where they are in that process to receive housing.

And so while we try to figure all that piece out, at the end of the day, what is the role of the state and how are the both agencies that you have leadership in providing those solutions? What do we need to do different?

Thank you so much, Assemblywoman, and really appreciate your leadership. Also within Sub-Four and the work that has been done investing in the HCIS system, for example, because I think data is critically important to inform the work that we're doing. So I would say that in terms of your question about the disconnect and the role of government, of state government, you're absolutely right. I don't think that for many years we were not focused on housing and homelessness the way that we are now.

Our focus in this space is still relatively nascent, relatively new, over the last four or five years. And we are making up for 30-40 years of not investing in housing the way that we should. And this is not just the State of California. This has happened across the country. The Biden-Harris Administration last year provided a blueprint around increasing the housing supply, recognizing that we have not built enough.

So in terms of our agency, BCSH, and our priorities, we're laser focused on doing everything that we can to speed up the production of housing units. And that includes working closely with the Legislature to identify new policies or laws and to implement them and to move with a sense of urgency and speed. As we implement these new policies, we're also innovating, right. We're not just administering the same old housing programs, we're creating new programs and moving more quickly.

And that is not just home key, which we are very proud of and which has become a national model, but it's also the housing accelerator program. Right? Looking at the pipeline of housing developments that were stuck for many years and being creative with federal resources and state resources to fund more units, almost 5000 units funded last year in 2022. We're also very mindful that we have to build more capacity.

When you have not invested the way that we are investing currently, you can't expect for people to all of a sudden have the skill set to be able to build units at scale. So we're very mindful that we have to build capacity at the local level, hence, providing more planning tools, providing more technical assistance.

And to the Chair Wood's earlier comments about the importance of us recognizing that there is diversity in the geography of the communities that we serve, we need to continue doing more to provide the level of technical assistance and support to rural communities, to tribal nations. And so we're very mindful, right, that our services and technical assistance and resources need to reach some of the communities that typically or in the past maybe have left behind.

To your question, Assemblywoman, in terms of what is the role of the state? I think the role of the state is to continue to work with the Legislature to identify laws and policies that enable us to continue making progress towards building more units more quickly at an affordable price for families. I think our job is to implement and execute. I've worked in Federal Government, Local Government, State Government.

I really see my responsibility to ensure that when we're delivering programs, we're delivering them with a sense of integrity, a sense of transparency, a sense of quality, and being responsive to people. And so I think the role of state government is to be executives and to pay attention to how we're implementing and executing the programs that are funded, thanks to the Legislature and thanks to the Governor and to the people of California.

And then lastly, I would say that the role of state government in this is to be humble and to know that we may not have all the solutions right and to take a step back and assess and evaluate and to figure out what more do we need to do. What haven't we been doing? What's the role of philanthropy? What's the role of the Federal Government? So to continuously look at ways to get better at what we do, government is critically important in addressing these issues.

And I think we have very good people that work for state government that are trying to tackle these issues day in and day out within the departments that I administer or oversee, and I work with HCD, CalHFA, Department of Real Estate. I guess in answer to your question, Assemblywoman, the role of the state is very important, and I don't take that lightly. Thank you.

I'll just be brief and say from the perch of health and human services, we run a lot of programs that, frankly, get executed at the local level. So I have never seen sort of a differentiation between what we do at the state, what we do locally, whether it's a city, a plan, COC, or any of the things that the services that come through HHS support.

I think the newer responsibility, especially in this sense, of the social drivers of health and the construct of CalAIM and the support services that, frankly, aren't just a DHC construct, but are deep in the fabric of so many of the departments I enjoy working with.

I think the responsibility to connect the dot and push our local partners who've been administering these programs in certain ways for a long, long time, to see it differently and to see the homelessness crisis as a responsibility of health and human services, that it is a deep health issue.

It is a deep social service issue, I think, is the state leadership enroll, and one that well before we talked about HEAP or HAP or the large dollar investments on homelessness directly to counties, COCs, and cities, I think that HHS was doing all along.

And I think over the last few years, under your leadership and the Governor's leadership, we've taken a real strong position, not just in California, but nationally, about how health and human services is not just a lagging issue on homelessness, but actually a leading issue. And I think that shows up every day and I hope will be a permanent part of the fabric of what we do moving forward.

Thank you. And our next question is from Assembly Member Arambula.

Thank you, Madam Chairs and Mr. Chairs, for the coordination of this hearing and for both Co-Chairs of the Interagency Council of Homelessness for availing yourself and answering our questions. It shows the administration's commitment to facing this challenge head-on and addressing the crisis that we have as a state. But I want to follow up on what you spoke about regarding collaborations and the opportunities that we have when we work with our local mayors and partners when they are available.

I want to uplift the partnerships we've had in Fresno as an example with Project Roomkey and the framing that you spoke about where you're treating it as if it's someone who's in your family makes many of us remember the value that you should treat others as you wish to be treated. And when we focus on that, I believe we will be driving towards the accountability that we need within our programs.

I know later we will hear from Director Johnson about how supportive services are integrated into all of our human services programs, whether or not it's bringing family homes within Child Welfare Services or the Housing and Disability Advocacy Program within DD or within CalWORKS, the Housing Advocacy Program, the Homeless Assistance Program within APS, we've instituted Homesafe as an example and lowered the age of those who qualify for APS services.

As examples of where we are able to embed collaboration and partnerships and supportive services for our most vulnerable populations is a sign of the leadership, Dr. Golly, that you've been leading within this Administration for the last many years and want to focus, if I can, on a question regarding CalAIM. I believe this to be the most transformative and foundational change to our Medicaid program since it began, and I'm impressed with many of the enhanced care management and supportive services that we have discussed.

But I'm hoping that you can speak to what it will mean for CalAIM to provide those supportive services and more specifically, potentially, the six months of transitional rent payments for its beneficiaries. How transformative will this be for California? And knowing that this service is an optional benefit, can you speak to the long-term cost savings that plans may see if they choose to include this?

Yeah, I think a really important frame, and I appreciate the acknowledgement on the collaboration, and I'm grateful for working with leaders who take that very seriously. I hear day in and day out how three or four directors get together to talk about a problem and solve it. I have my own directors telling me, next time we talk, can I invite so and so and so and so because it's really us working together and I feel like that is part of the heartbeat of HHS.

And I'm proud of that. I think it's something that you hire for it. You bring people on who believe that's the approach. And I believe it's trickling across our agency and into the counties we work with. You're absolutely right. CalAIM is very transformative. We talk about so many different aspects of it. It's transforming not just the standard benefits and how they're integrated, let's say, for example, across behavioral and physical health.

It transforms how we pay for the services, but it really puts at the center these social drivers of health, whether it's enhanced care management, which is a statewide benefit, all plans doing it required to qualify people based on need into these programs, create a provider network who can provide, frankly, this super enriched set of wraparound supports in terms of case management coordination, navigation for some of the most complex individuals, many who are experiencing homelessness and then a number of other community supports which are not required benefits but optional benefits being sort of adopted plan by plan across the state in ways that frankly, as we track, we're seeing some increased uptake, but not as much as I think we would like.

And so it's the push, the pull, the insistence on figuring out how to do that. It's happening for a number of different reasons that you see the variable uptake. Some of it is plans aren't used to this work. They're just getting familiar with it. They don't have the partnerships in community. They don't have the bench of people and partners in the homeless services world.

So we're seeing that come up the path, funding that is already out a little by little in communities to develop that capacity, to say homeless service provider, you don't know much about Medicaid today, but how do we support you to figure out how to tap into those resources?

So all of that is happening in the hopes that not just do we see this happen as an optional benefit, but over the next few years in this setting, we have the conversation on how we look at the return on investment, not just on the dollar side, but on the actual stabilization of the lives. I mean, what we're talking about, how much do you get to enjoy that California for all that we often talk about?

I think that's really the return on investment that we're looking at. And as we pick that know, JC Cooper will talk a little bit, have a chance to talk about what the return on investment of some of these programs had been under the whole person care pilots. Right? And our not just hunch, but hard data that this does save dollars. But so much more important than that is, I think it really does transform lives.

So it's not an understatement to say that CalAIM is that kind of transformation. The justice initiative that I mentioned earlier, another part of that more to do on the behavioral health police with the behavioral health community-based continuum waiver concept that is really pushing some of the same ideas, the same partnerships around behavioral health that we're lacking.

So this whole scale transformation that is deep in collaboration does have a return on investment, but not just in the dollars and cents sense, but I think deeper and I think it's a real proud moment that we should all rally around and see continue to build in California.

Thank you. I know we are heading up here against 2 hours. I am reserving the right to have the last question for this panel and then we'll let you go back to your day jobs. But one obviously appreciate your participation today. And obviously, as you can see, there's a lot of interest from the Legislature in solving this problem. My final question for you all is we know there are things that work.

We know that supporting things like evidence based approaches, like supportive housing with wraparound services, that people that need it, that's a very successful model that helps people get off the streets, get on their feet, get their life in order. We know that housing first works. There's things that we know work while at the same time, and I appreciate Assemblymember Carrillo's comments, that the state has not always been involved in solving this problem. Right?

And this is a newer phenomenon over the last decade or so. Right? And I think it warrants state action. But while at the same time we know that we have things work, we also know that in San Diego last year, for every 10 people who came out of homelessness, 13 people became homeless. And so with those numbers, it sort of feels like we're in quicksand and we're doing everything we can to try to solve the problem.

So from your respective points of view, what are just the top one or two structural things that we as a state need to do to solve the problem? And I have my own thoughts as Housing Chair, but I'd be curious and I think these could just be like thirty second responses, just the top key structural things that we could do. If you could wave a magic wand to solve this problem in the next imminently quickly, what would it be?

Yeah, housing first and foremost, continuing to do our best to move more quickly, to build more units, more units that are deeply affordable that have long term affordability covenants. Second thing is we need more rental subsidy and assistance. Across the country, only one in every four families that are eligible for federal assistance through, for example, the housing choice voucher program receive assistance in the State of California. It's 1 out of 13. Right. So we have greater needs. We need more rental assistance resources.

And the third piece, and it speaks to we can't just sort of focus on connecting people to housing and stability. We need to make sure that we're doubling down on inflow, the number of people that are entering into the homelessness response system. What we found and saw clearly with deep federal resources through the emergency rental assistance program, almost 350,000 or just over 350,000 households were able to stay housed, not lose their housing.

I think it is also important for us to think about emergency rental assistance funding and some of the dollars that the state administered provide the flexibility at the local level to be able to do that.

So quickly, Echo Secretary Castro Ramirez. Housing, housing, housing. And not of the 500 to 600k variety. We can do better. There are models. It doesn't have to, I'm sure experts beyond me are going to tell you what those are, but we know them. I mean, Assemblywoman Bonta is referencing some of them in her community. I'm sure you each have a version that isn't $600,000 a door. So what are they? How do we focus on those? I think that's one. Two is workforce, workforce, workforce.

The social health services world that really, does that support that wrap, it doesn't happen automatically. It doesn't happen by a computer. It doesn't happen by an algorithm. It happens by trained people, often with lived experience and frankly, living experience that can really support this. We have some really interesting ideas on the table already. But what more can we do? How do we invest it? How do we make sure that it's real and not constrained by the typical things that constrain building up the workforce?

I think we have to be novel. And the community health worker concept and benefit that is now under Medicaid, this is an opportunity here. I tell Mayors and County Members, talk to your plans about how we're going to use this to really build up the workforce that's focused on this. And then NIMBY. Right. We talk about, not in my backyard. We kind of blow over it. We make it. But it's a real issue. Right. You can't place some of these settings.

We talk about state land or county land. But the most important thing that my team talks to me about is how do we get through when we build a program, whether it's the behavioral health infrastructure program or the community care expansion? How do we get around some of those doors of death, if you will, with a NIMBY problem?

And how do we make sure that you can cite this, so you know, the housing needs to be cited, the programs need to be cited, and they're empty buildings unless we bring up the workforce. And there's good ideas on how to do that faster.

Well, thank you for that. As the Housing Chair, appreciate those comments, and I agree wholeheartedly. I think the need for ongoing funding is going to be critical. Happy to partner on taking on the NIMBYism and all the other issues and streamlining, making it easier for us to build the housing here in California. We are now concluding this first panel. It only took 2 hours, everyone. We only have four more panels, so bear with us, audience. But I want to appreciate the conversation, tremendously.

Thanks for having the conversation.

Thank you. And with that, thank you for coming. I'm going to pass the gavel over to chair Jackson, who is going to moderate panel number two.

Thank you very much, Madam Chair. We will now open the floor up to panel two if they can make their way on up, which will speak more directly to the process and results of the statewide homeless assessment. I know it is hot off the press with a few hundred pages, and so we will forgive those who haven't found the time to read the entire document within 24 hours, but we still expect you to have all the answers. Okay. Will you please introduce yourselves?

Thank you. Chair Jackson. My name is Dhakshike Wickrema. I'm the Deputy Secretary for Homelessness at the Business Consumer Services and Housing Agency. I work for Cabinet Secretary Castro Ramirez.

Hi. Thanks for the opportunity to be here. My name is Ryan Finnigan. I'm a senior researcher at the Turner Center for Housing Innovation at UC Berkeley, and I was one of the analysts for the project.

Fantastic. Would you like to begin with your comments?

Yes, please, Chair Jackson. And I think there's a PowerPoint.

Yep, it's up.

Okay, great. Oh no, not that one.

Oh no.

It's the one which is much more boring looking. It has a California Interagency Council and Homelessness logo on it.

As we know that there's many panels with many presentations.

And maybe while we wait for that, Chair Jackson, I'll just remind people that is a report, as was referenced earlier by the co-chairs, takes advantage of the power of HDIS, the system that was created in 2021. So it's the first time now California can really aggregate data that are collected at the local community level. So there are 44 entities called continuums of care, federally mandated by HUD, the Housing and Urban Development Authority.

Those federal mandates include collecting data on the people being served who are homeless and at risk of homelessness. They're collected through this thing called the Homeless Management Information System. Each local community has this. And through HDIS, now, there we go, we're able to aggregate this local data at the state level and give you a statewide picture. So through Assembly Bill 140, if you go to the next slide, please, there you go.

Through Assembly Bill 140, which is approved in 2021, the California Interagency Council on Homelessness was required to use HDIS and other data sources to provide a picture, a landscape analysis, if you will, of homeless programs that were funded by the state, but also looking at things that sometimes are not funded by the state, and provide an assessment over a three year study period. So that's important because we need full years worth of data, and we were able to get it for three years.

That's 18-19, 19-20, and 20-21. So everything I referenced that Ryan and I referenced today will be time bound within that three year study period for which we had three fiscal years of data. And the assessment asked us to address the following questions: how much state administered funding was allocated to address homelessness in that three year period, and how were those funds used? Who were served by these programs during the three year study period?

What types of services were provided, how much temporary and permanent housing was created, and what were the outcomes, ultimately, of the people receiving assistance within their three year study period? If you go to the next slide, and the research partners were many. If you go to the actual report, you will see there's a whole page of research partners who were involved in this. But Ryan Finnegan on my right, was one of the lead researchers on it, and he's available, as he said, for more questions.

He's from the Terner Center at UC Berkeley, but you also had folks from UC, the Benefit Homeless Institute at UC, University of San Francisco, and you had a technical assistance expert called ABT Associates that was part of helping compile all the data for this. So, as I mentioned, this is a three year study period, it looks at funding sources and users by program. It looks at the inventory of houses created by program and service use patterns, and it looks at the outcomes. Next slide, please.

And here are some of the key highlights. Now, as Chair Jackson mentioned, it's a very dense report, but we just wanted to pull out some key highlights. I'm sure there's much more. This could be a three hour meeting to really go through the report. But what we found through the three year study, as we looked at the HDIS system, which is, again, this aggregated data from the local level, is across the three years, HDIS reported that 571,246 unique individuals were enrolled in services, shelter, and housing.

So within that three year period, the system served, based on the data that we received, almost 600,000 people, unique individuals. And during the reporting period, when we looked at the state administered programs, we found that about 273,000 people were being touched in one way or the other by state administered programs.

And you can also see, which is good, that every year within the three year study period, more and more people were served, showing more reach into the community through the programs, both state administered and non state administered.

And on the housing question, both interim and permanent, what we found is during the three year study period, the state added more than 17,000 interim housing beds during the three year period and invested in programs that will produce or preserve approximately 60,000 affordable housing units, including about 10,000 units that were set aside for people experiencing homelessness. So you can see a tremendous amount of investment and production of both interim housing and permanent housing during the three year study period. Next slide, please.

And when we look at the funding that was available during the three year study period that we were able to assess, about $9.6 billion was dedicated towards addressing or preventing homelessness within that three year period. And the largest share, just over 5.5 billion, was dedicated for affordable housing production, including, as I mentioned in the earlier slides, units set aside for people experiencing homelessness.

So in the previous panel, you talked a little bit about, this is compared to years past, the Administration and the Legislature has really invested a lot in these last few years, and you can really see the results of that investment in this three year kind of study period. There's a graph also with very small font. I apologize, but the blue kind of shows that's the permanent housing production piece. Next slide, please.

And here's a little bit about the population served off the almost 600,000, to be exact, 571,246. There's demographic data in the report. A lot of demographic data, majority, no surprise. About 56% were individuals, adults over the age of 25. But you do see a significant number of children, again, because, Chair Jackson, when you think about CalWORKS families, it's usually a single mother with two kids, right? So they are part of this.

So you see 24% were children under the age of 18, significant proportion of the folks we are serving. And then you see 6% were unaccompanied young adults, 18 to 24 is how you categorize those. So you can see it's a very diverse group of folks that are being helped. Next slide, please. Speaking of diversity, but not in a good way, this is something that's mirrored across the nation. You can see the racial disparities that exist, which are reflected in the data we collected.

So about 28% of people being served within this three year study period are black people, and they are very overrepresented. And of course, they show up then being overrepresented in the people being served, people being connected to shelter, people receiving services. You also see an overrepresentation of indigenous folks. So you can see about people in the chart, but 28% overrepresentation there.

And as there are four committees here, you can see this overrepresentation not only in the homeless population, you'll see this in the criminal justice system, in the human services system. So these are some of the things, as Secretary Castro Ramirez mentioned, we want to really make sure that local communities are thinking about addressing these racial gaps as they think about the investments as well. Next slide, please. And when you look at service utilization, you can see some of the programs that were the most utilized.

Rapid Rehousing. And Rapid Rehousing is a time limited rental assistance program and has been seen to really help families with children. And you can see the most often population that's using these services is families with children, which is a good thing, because Rapid Rehousing has been shown to work really well for families with children. Homeless Prevention, similarly, is something that's also being used a lot by families with children when it comes to street outreach and emergency shelter programs.

That, on the other hand, is most likely to be used by adult individuals. And then when you look at permanent supportive housing units, that seem to be most used by older adults. But that is also not surprising. And Brian can probably provide us more kind of technical background on this, because supportive housing usually is dedicated for people with very acute issues, chronic illnesses.

So they're going to tend to be older compared to the rest of the population because you're trying to match a more intense housing unit to the people with the more intense needs. And then finally transitional housing was more likely to be used by young adults or youth. Next slide please. And this chart, which actually the Terner Center created, just shows kind of what I had mentioned earlier, the scale of the increase of interim and permanent housing units across the three year study period.

Interim housing, as you know, this three year study period coincided with the height of the pandemic. So some of those interim housing units are probably are project Room Key and Home Key because Home Key also could be interim housing and permanent housing. Those investments included Home kKey as well, but also No Place Like Home and VHP. So you can see once again, visually illustrated the scale of increase over the three year study period of both interim and permanent housing. And last slide. Next slide please.

Just a few bullets on the outcomes. So I mentioned at the top of the presentation about the 571,000 people who were served over the three year study period. At the end of the three year period, you could see 30% of those folks were still enrolled in services, shelter, housing. So they remained. But 70% had exited programs. Some exited to temporary and permanent housing with subsidies. Some exited to housing without a subsidy. That might include reunifying with family and friends. Some exited 25% to unknown destinations.

And this is usually sometimes because there is no data that we are seeing on our end because data was not entered or people left the program and data could not be entered. Seventeen percent exited to sheltered or unsheltered homelessness and 9% remained enrolled in a housing program awaiting housing placement. So that's the end of my presentation. Just the key takeaways and happy to answer any questions. Or we can have Ryan provide a quick overview as well.

Why don't you do your remarks and then we'll open up for questions?

Sure. Yeah, Dr. Wickrema provided a very thorough summary of the main findings of the report. I'll just say that a few comments on the analysis side of things. On the one hand, we observed throughout the reporting period that both the reach and the quality of HDIS data improved across fiscal years.

So while there was a large fraction of people for whom the outcome remained unknown at the end of the study period, within any given fiscal year, the number of people who exited programs and had it not known outcome declined from one year to the next, and that the fraction of people with unknown destinations was pretty similar in California's data as it is in the national HMIS data. But in recent years, the fraction with unknown destinations is actually lower in California's data system than it is in national data systems.

So on the one hand, we see that the HDIS provides a lot of opportunity for continuing to monitor the performance of homelessness systems across the state. And we also see that that potential is improving over the course of the study period, and further investments can increase the reach and the quality of that system.

The other thing that I'll say about the data and analysis for this assessment period is that many of the investments made during the study period could not be observed as having an impact during the period because it takes time to build new housing, it takes time to start new shelter and care programs, to hire staff and case managers.

And so many of the investments made that were studied during the fiscal analysis in terms of new programs being launched and funding for new programs are serving people now, but they were not serving people that were recorded during the assessment period. So in some sense, there is also, given the nature of this snapshot study, a difference in the investments made on the one hand and then the outcomes observed on the other.

Thank you very much. I'll just start off with a few questions, and then if anyone else, just let me know. Okay. First of all, thank you very much for this information. When you look at the data, have any indication at this point on what are the best return on investments that we've made in terms of types of programs, in terms of strategies that were funded? Right? Any indications on things that we should be doing less of and things we should be doing more of now that we begin to look at this data?

There is a reference, and Ryan can probably add more. When you look at returns to homelessness, especially when people get temporary housing subsidies, makes sense, right?

If you have a long term ongoing rental subsidy, you are less likely to return to homelessness because you have a stable rental assistance that's been provided to help you thrive in that housing, versus if you have a temporary rental assistance subsidy, or if you're reunited with family and friends, sometimes you can have an argument with your mother or your brother, whoever you're living with. And so you did find if you had a long term rental subsidy, the stability was greater for folks. So that would be a place where you're getting a good return for your investment when you are having a long term rental subsidy.

And also, I can say one of the opportunities to continue monitoring the return on investment or effectiveness of different interventions is to continue analyzing in terms of the context in which somebody is receiving that intervention. There are many people for whom the short term subsidy was exactly what they needed, but for a lot of folks, at the end of the short term subsidy, we did observe a return to homelessness in the data.

And so in terms of who needs what kinds of subsidies, I think the data provide a foundation for further research in matching what is the kind of intervention that will stably house folks for a long period of time versus in what context is a short term subsidy exactly what somebody needs.

So you just highlighted a red flag that I saw in the data as well, the 17% that has returned to some form of homelessness. Basically, we can basically call that our recidivism rate. Right. In terms of homelessness, what other red flags do you see in the data?

I think what the data does show, which came up in the first panel, is that we need to remember that this is the emergency response system, if you will, on the ground. And sometimes there's inflow which was referenced, and prevention, which is outside the scope of the emergency response system. So we need to do more. For example, on upstream prevention, for example, CalWORKS mother with two kids. What can we do to make sure they don't fall into homelessness?

Because the data did also show that there are people who are showing up in the data system who are newly homeless, meaning we hadn't seen them for two years prior, and now they're showing up in the system. So I think there's probably more research to be done around what did trigger them falling into homelessness. And this is from previous studies, not this study in LA.

There's a study that was done around folks in the CalWORKS system, and you are finding just a small emergency, a car repair, a medical emergency, can tip a family that's already in deep poverty into homelessness. So what more can we be doing and which is outside the homeless system? But it's like when you go to the emergency room, what could the primary care physician have done to prevent the acute diabetes spike or blood pressure spike?

So those are the types of connections which you heard earlier where you're trying to build, connect the dots, opportunities not only within the homeless response system, but before people touch the homeless response system. How can we reach these other systems to make sure they are helping people retain housing and not tip into home? So that would be the other thing, which I don't have an answer, but that is something we should be looking at and thinking about prevention in more kind of sophisticated ways.

I echo Dr. Wickrema's emphasis on prevention. I also think in terms of interpreting some of the outcomes that we observed for people. Like a lot of the Assembly Members have commented already this morning, the reasons that any person might find themselves experiencing homelessness can be complex and varied. So sometimes it is a short term crisis. Sometimes it's an accumulation of small and large challenges. Sometimes it's an intersection of all of these things.

And so when interpreting the results on returns to homelessness, Assembly Person, you're absolutely right that the 17% was really high for the folks with the short term subsidy, indicating that the short term subsidy was not sufficient to maintain housing in the long run. But it can also be potentially complicated to interpret that next to the fact that returns to homelessness were relatively low for people who did not receive a subsidy.

And my interpretation, and a room for more research around that, is that the people for whom these interventions were being given and the ways that they navigated those resources to get back into housing varied. So the question is, like, why would there be these very different levels of returns to homelessness? It can be both about what was it about the intervention that those folks received, but also about who received what kinds of intervention, and what kinds of support did they have surrounding that intervention.

And so there are many moving pieces that contribute to why there might be different levels of returns to homelessness, and more understanding in a complex way of how the given intervention aligned with a person's particular circumstances. And the ecosystem of supports that may or may not be around that person as they receive that intervention is needed to fully know why is it that we see these different rates of returns to homelessness from one intervention to the next?

Thank you. First, we'll have Assembly Member Quirk-Silva, followed by Assembly Member Schiavo.

Thank you. I appreciate this report, and I think it was very well done. And yet it still indicates some of the things that we've already seen, that vulnerable populations are falling into homelessness, particularly people of color.

So one of the things that I was interested is that I didn't see in the report that you just gave us, but is with a very limited amount of support there is out there for subsidies or HUD vouchers, and also the difficulty of people who get those finding a place that will take them, is there any discrepancy in the populations?

For example, if we see that 60% of the fastest growing into homelessness is Latino population, what is the percentage of them having access to those types of rental assistance programs or supports compared to, say, a lesser population that may not have as fast of a rise, or like we saw with the black community, very small percentage across the state, yet very high percentage?

Because there is, where I'm going with this is my concern with access again, which is that you have very limited amount of support systems, and then who gets access to that limited support system in comparison to the homeless population, maybe navigating because of language, not knowing how to go into a social service environment, and access that. So did you see anything in your data or are there any recommendations to make sure that people are, there's equity in distributing these limited amounts of support?

I think Ryan has more detail around what's in the report, but I will, Assemblywoman, I think thank you for that question, because that's an important point around access as well as what we can do to make sure people aren't being discriminated against when they are looking for housing. Now, all of those kinds of details around discrimination around housing vouchers aren't in this report.

But I will say that within BCHSH, there is a civil rights department that's actually looking to make sure there's no, what is called, source of income discrimination. So if you do have a voucher, people should not be, the landlord can't deny you for that unit just because you have a voucher.

And so more to come on that, because that is absolutely essential, that we not only provide access but also, to Secretary Castro Ramirez's point, increase the pool of vouchers so more people are able to access these kinds of units.

And in looking at the data in terms of who was served and by what kinds of programs, what we observed overall was that the racial demographics of the whole population of people served throughout the report period roughly matched the racial demographics of people experiencing homelessness. So there are very stark racial disparities in who experiences homelessness. But then in terms of who is served by systems across the state, it seemed to mirror in large strokes the population that was experiencing homelessness in the first place.

In terms of the particular kinds of programs received, we also looked at who was participating in, say, permanent housing programs and actually moving into a supportive housing placement relative to things like temporary shelter or street outreach or other kinds of supportive services. What we observed when we looked at the kinds of programs that people used were that black individuals and families were placed in permanent housing programs at relatively higher rates than they were represented in the population served overall.

Non-Hispanic white individuals and households were placed in permanent housing programs at relatively lower rates. The differences were not as large as the disparities in who experiences homelessness in the first place, but they're also a little complex to interpret, in part because these different programs are designed to serve different populations in the sense of individuals outside of families who might be older and experiencing chronic homelessness relative to people and families.

And although the numbers of people experiencing homelessness across the racial demographic groups seems to mirror the numbers served in the population, there were also big differences in terms of who experienced homelessness in a family versus as an adult individual. People of color were much more likely in the data of the population served to be served as part of a family relative to non-Hispanic white people who were mostly served as adult individuals.

Therefore, there were different kinds of programs that targeted them for different kinds of services on the basis of whether they were in a family or an individual. So some of that interpretation in terms of who is served at what rates depends on what their situation was at a time in terms of being an individual versus in a family.

All right, now we have Assembly Member Schiavo, followed by Chair Wicks.

Thank you. And thank you to the co-chairs for making space for this conversation, which I think is so important. I'm not on any of these committees, but this is a really important issue and something we're going to be focusing on in my office, especially related to homelessness. And so one of the other red flags that really stood out to me was the 25% unknown, which is kind of a big, scary number.

And if you add that up with the 17% that went back to homelessness, that's 42%. That's nearly half of who we're talking about. So I don't know. One of my questions is, how do we get a better sense of this 25%? Because that's a lot of folks. And also, it was really nice to see that high spike of housing. But if it includes project Room Key and project Home Key, that's not ongoing in the future. Right.

So we know that it's not a trend necessarily, but a spike. And so what does that look like without those going in the future, which is probably a more realistic expectation of what we would see?

Let me ask, to answer the last piece first. You're correct. So Room Key was temporary, was using hotels as non congregate shelter. Home Key, however, is an ongoing investment. As Secretary Castro Ramirez mentioned, if they are permanent, they will remain permanent affordable units for 55 years. So that is a real long term investment Home Key, which is the good news on the first question you had, assemblywoman, around the 25%.

I don't know if you were here, Ryan mentioned, and I'll let him provide more in depth knowledge around that. It is actually lower than national trends. And the reason where someone, a social worker, may not have entered data can be multiple reasons. Imagine you're at a hospital. There's somebody you're serving, or you're in a shelter, you're somebody you're serving. And sometimes those people have left to a good exit and you're calling them, but they're like, you know what? I put my homeless episode behind me.

I don't want to answer this call. So it could be they just don't know where the person went and maybe they went to a good place. Sometimes, you're right, they just go back to the streets. And the person doesn't know, though you as a social worker doesn't know. So that's why it says unknown data. We don't know where they went, which is unfortunate. But what can you do as a social worker?

And then sometimes people just don't have time to enter data, too, because, again, this data at the state level is only as good as the data that was entered at the local community, and we are just aggregating and looking at the data at the state level. But I think Ryan did bring up a good point where it got better over the three year period.

Yeah. The proportion of people who left a program and then their destination was entered as unknown, declined from one fiscal year to the next. So I think the quality of the data in terms of who is reporting on destinations for individuals going through their programs is improving. The other way in which the quality of the data can improve is that there's an increasing number of services and organizations that are participating in HMIS data entry.

So the two ways that we can figure out what somebody's outcomes are in the data are either that the provider enters when somebody leaves a program, did they go into permanent housing, friends and family return to homelessness? The other way we can observe their outcome is when they enroll in another program. And in some cases, for example, that's a good thing, like going from an emergency shelter into a permanent supportive housing placement.

The more that organizations and service providers are entering data into HMIS that the state can then aggregate together, the more we'd be able to observe. And what would show up as an unknown destination from an emergency shelter was actually a move into a permanent supportive housing placement. And now that that provider is participating in HMIS, that destination can be observed. So I think there are multiple ways that the data quality will improve with time. On the Room Key question.

So the numbers that we showed in terms of the stock of emergency housing beds came from HUD's data that report on year round beds. There are multiple ways that local emergency shelter providers can report that data to HUD. They often report year round beds, but many of the Room Key sites, roughly half reported their beds as either seasonal or overflow beds, and thus were not included in that year round trend.

So that year round trend did include a large portion of Room Key units that will not be permanently available. However, many of the Room Key units were not a part of that year round trend estimate. And so I think the Room Key alone does not account for the large increase in emergency shelter.

Chair Wicks.

Thank you, Chair Jackson. First, I really appreciate the data and the work that you all put into it. And I also want to recognize, I know that this was part of compelled because of the budget process, it was put in a budget bill. I want to thank the Chair of budget sub four for advocating for such data. I think it's critical as we think about what investments we need. So I appreciate this and the work that both of you do and your respective teams.

With that, I have two questions. One, I know in the assessment, it mentions that counties have the option of pairing or augmenting certain programs with realignment funds, with MHSA funds, behavioral health related federal grant blocks. I think in 2018 and 2019, that was $17.3 billion they could augment or they augmented and then in additionally Medi-Cal funding. And I think as of August 22, the report says that it estimated that counties could leverage over 11 billion annually via public community behavioral health funding.

So with that augmentation, I just have a question about how those funds are being spent. Can you just provide some more details on the realignment dollars? Are those being used at the local level now to address homelessness? Are those dollars specifically for people experiencing or at risk of homelessness or generally for lower income people who have mental health illness service needs?

And that piece, Chair Wicks, was added by DHCS. And so it might be more appropriate to ask them because we are just looking at kind of overall data and there are kind of focus areas with different programs which were provided to us by our HHS counterparts. So they would probably have much more knowledge than I have.

I will follow up with them. Thank you for that. And then the second question I have is, I know it seems that Home Key has been successful. Obviously, we're not onboarding as much housing as we need to, but it's one of the areas where we have infused a lot of funds, made it easy, quick up and running. Let's get these projects going.

We have one in my neighborhood that's been successful. In your opinion, looking at sort of the programs across the board, is that one of the programs you would really highlight as a key success? And just thinking about, as a lawmaker, if we think about investing more resources, is that a model that you think is successful, one that we should replicate?

I would say yes.

Great. Okay. Those were my questions. That was the easiest answer of the day.

Wow. Actually, Chair Wicks cited the various options that counties have to leverage funds and take advantage of these opportunities. Were there any counties that chose not to take advantage of these options?

The beauty of this report is it's an aggregated kind of statewide look. But then the difficulty is you don't get that kind of county by county kind of. So I think that's a good question, though, Chair Jackson. It's just this report is more kind of an aggregate view of data collected through HDIS.

I understand. Thank you for that. Any other questions at this time? Seeing none. Thank you so very much. And I'll hand over the gavel back to Chair Wicks.

Thank you.

Thank you.

Let's see, we are moving swiftly on to panel three, budget investments. We have Morales, principal fiscal, sorry, I believe we have someone else in her place. Is that right? We'll let her self-introduce. And Sharon Rappaport, Director of the California State Policy Corporation for Service Supportive Housing.

Good afternoon, Chairs and Members. My name is Ginni Bella with the Legislative Analyst Office. I am going to be speaking primarily from a handout today that is in your packets. It is also available on our LAO website and has been posted. We were asked to give a very high level overview of the recent housing and homelessness augmentations that the state has provided in recent years and also give a look at some general observations about the state's approach to oversight of those funds.

So turning to the first page of the handout, I'm going to actually go pretty quickly through these first pages because I think they've been hit on pretty well this morning. But as we know and have discussed, the housing and homelessness programs are really overseen and funded by a variety and different levels of government. The federal government plays a role, state government plays a role, and local governments play a role in funding and administering these programs.

The bottom line here is that we have a lot of different departments, a lot of different levels of government involved, and that presents its own challenges, as we've discussed today. Turning to the second page of the handout, it really gives us an overview of the major housing and homelessness augmentations that have been provided since 2018, '19 till today.

And another point that's already been made today is that you can really see the increase in the number of programs that have been funded by the state since 2018, '19. When you look sort of at the length of the programs here in the tables, and you can also see just the increase in the funding amounts as you look left to right.

So turning to the next page of the table, you'll see that in 2018, '19 there was less than $1.0 billion for these programs throughout the state. And as we look forward six years, we see that up to upwards of nearly 25 billion for these programs. So a real growth in the volume of programs and the level of state funding. A couple of important notes about this table is obviously it doesn't cover everything either, right?

So these are four major departments, Department of Social Services, Healthcare Services, Housing and Community Development, and the California Interagency Council on Homelessness. But as we've also discussed today, there are other departments that play key roles in funding and overseeing homelessness and housing programs in the state, and those are not included in this table, but also would increase that funding level and the amount of programs. Additionally, this chart really focuses on augmentations, discretionary augmentations, that have been provided in recent years.

In some cases, we did have ongoing programs with base level funding that are not reflected here and would also increase that $25 billion number. So real increase over the years in the volume and amount of funding. Turning to page four of the handout, and as we've discussed, there are many different housing and homelessness programs that span different levels of government and even within the state, different departments.

And so a key question comes up is sort of, how does the Legislature provide oversight and ensure accountability when it comes to these programs, when we're dealing with different jurisdictions and different programs, and our office is in really the early stages of beginning to look at each of these programs and better understand what the reporting requirements are for those programs. And we don't have any synthesis of that information yet today, but we do have some key observations, some things we've noticed so far in that work.

The first is that the reporting authority really varies when you look at these programs. Some of it may be established in statute. Other times the reporting is required through departmental direction or through regulations, and sometimes it's a combination of both. So kind of the requirements really exist in different places. The reporting happens at different intervals. Right. So sometimes we get annual reports, sometimes quarterly, and it really varies. Sometimes the Department has more up to date information that's available upon request.

So if we ask for it, we can get it. We've also noticed that there has been an increased reliance on dashboards, which really increase the transparency and the ability for the Legislature and the public to better have a view into more live information about programs and their outputs and outcomes. Examples of this are the Home Key and the Room Key programs, actually, that were provided nearly daily updates so we could really see in live time what the outcomes were of the programs.

Another note that we have is that, and this is not just for housing and homelessness programs. This is really true for a lot of different policy areas. It's really difficult to collect outcome data. It takes a longer time, and it really is something that you don't see those immediate results.

So we often have reporting data that is more focused on outputs, such as the level of spending that is put in there, how much of the spending was actually used and that type of thing, and less about how many people exited into permanent housing or those types of outcomes are just harder to get. The final point we would make is that is one that we just touched upon, which is data reliability.

And as we've said, we are relying on a lot of different entities, levels of government inputting information. And so our information is as good as what is input. So it's often we have to sort of rely on that information and be cautious in making sure we understand the root of the data and any challenges that might exist there.

Turning to the last two pages of the handout, we really provide an example of the evolution of reporting for one of the state's major homelessness programs, the homelessness Housing Assistance and Prevention Program, or HAPP. And we really wanted to highlight this program as an example because it really has changed over time, the reporting requirements. As you'll see in the first two rounds of the program, there was less money involved and there were less reporting requirements, right.

And they really did focus less on outcomes and really were focused more on the amount of dollars spent and those types of reports back. As the program evolved and has become more regular and the funding amounts have increased, you see that there's also this new requirement of action plans up front that really set goals and expectations which make it easier for all of us to sort of hold local governments accountable to meeting those goals.

Additionally, the list of reporting requirements that we are expecting to receive is longer and really more focused on those outcome measures that we talked about today. And a lot of that is enabled by being able to have HDIS and some better information that we can pull up at the state level. Of course, there are still challenges, right. We've evolved. We're getting better at accountability and oversight, but I think we still have lags in data.

So sometimes it's really difficult to be able to make decisions because we don't have the data yet from the prior round. Right. So we might be thinking about allocations for a new round of HAPP money, but not have all the information yet from the prior. So that continues to be a challenge.

Also, because the goals and the action plans are set at the local level, there's a constant need for the Legislature to ensure that the goals and the outcomes and all the expectations set at the local level and approved by Cal ICH are in line with the Legislature's goals when it comes to housing and homelessness. So with that, I will conclude my comments, and I really thank you for having me today.

Thank you. Good afternoon and thank you for inviting me to talk about the California Homeless Housing Needs Assessment. I do have slides. I don't know if I should wait or. Go ahead and. Okay.

Please proceed.

Okay. Oh, thank you. The needs assessment is a recently published. Let me see if I can pull it up here. I think these are all Ginni's slides.

I'll go ahead and proceed, and hopefully those will come up soon. The needs assessment is a recently published report that answers the question of what it would take to solve homelessness by 2035. It identifies how much housing services and interim housing the state needs. There it goes. I'll just skip over the first couple of slides.

Based on the work of my organization has done in other states and communities, the Hilton Foundation had asked us to complete the needs assessment for California, and we partnered with the California Housing Partnership to complete the work just to ground us, California is home to 30.

Can you move closer to the mic?

Oh, I'm sorry. Thank you.

California is home to 30% of the nation's homeless population for one primary reason, people with the lowest incomes cannot afford housing in California. We don't actually have higher percentages or rates of people experiencing serious mental illness or substance use in California, and people who are homeless in other states aren't flocking here. Actually, the data shows that most people experiencing homelessness here are from California or have lived here a long time, well before they became homeless.

So the disproportionate rate of homelessness here is directly tied to the lack of ability to afford housing. As we all know, rents have gone up significantly in recent years. And when rents go up, people who lose their housing first are those who face racism and other forms of discrimination in our housing market. As well, people with the lowest, often fixed incomes, such as seniors and people with disabilities, are often first to fall into homelessness.

Our report shows California will have 225,053 homeless households with unmet housing needs over the next 12 years. And just to clarify this number, it represents the projected number of Californian households who are or will likely experience homelessness and won't be able to get help moved into housing with our current homeless system, our current resources We did break down the unmet housing needs into nine regions, just because housing costs vary so dramatically between those regions.

But every one of these individuals and families is undergoing or will undergo the traumatic and often life-threatening situation of homelessness. For California to meet the housing needs for these 225,053 households, we would need to invest in all of the following building 112,527 new affordable and supportive housing units, which would cost about $5.7 billion on average, over the next 12 years.

We agree that with Secretary Castro Ramirez that we need to build a lot more housing, but we also need to pay for operating costs for those people in those housing units because most can't afford housing, even in affordable housing units. We also would need to pay for rental subsidies, because even if we build that number of units, there'll still be a gap of about 112,000 households who will need to access housing in the private market.

So that would help pay for rental subsidies for those remaining 112,526 households, paying for operating costs of new units and paying for private market rental subsidies would cost an average of $1.8 billion a year. Additionally, about 63,000 households will need services in supportive housing to gain housing stability and thrive. Those services will cost an average of $488 million a year over 12 years. On interim housing, like shelters, navigation centers, and bridge housing, which allows people to be safe while waiting for housing.

We do see a somewhat disturbing trend in a lot of our communities, which is that when people are in shelters, when they leave shelters, they don't have housing to go to, and so they're returning to the streets. And we see this in increasing rates, and that's just because we don't have enough housing.

By building more housing, we could free up shelter beds so that those shelter beds will turn over more quickly and we'll be able to move people into housing, and they'd be able to exit homelessness permanently. More housing will mean more shelter beds access, and those beds will be able to use more effectively. We need a total of $630 million more to build shelters, and that's over the entire period.

So we did not do an annual average, because at a certain point, when we build enough housing and we make housing subsidies available to enough people, we won't have to pay for more shelter beds. We will actually have enough shelter beds in our current system to keep those people safe. So the total of these investments would be $8.1 billion over 12 years if we were to solve homelessness.

And we acknowledge this is a really big number, scary, but it totals less than 2.7% of our state budget. We also can count on about $1.2 billion for each of these years in existing State and Federal Low-income housing tax credits to fund housing for homeless individuals and families. So that leaves a gap of about $6.9 billion a year, over the 12 years.

After year 12, the state would need to invest 4.7 billion annually to pay for ongoing operating rental subsidy and services cost. 87 communities and three states have eliminated homelessness among veterans or people who are chronically homeless. That includes Connecticut, Virginia, and Delaware. Riverside, the City of Riverside has also eliminated or ended homelessness among veterans.

These jurisdictions created a data driven strategy that committed ongoing resources to housing and housing based services and the ongoing resources are the critical part here because no jurisdiction has actually decreased homelessness significantly with one-time funding. And I heard Assemblymember Wood earlier talk about decrease in family homelessness in his district. That's actually a nationwide trend, and that is because the Federal Government is investing, has made it a priority to invest in rental subsidies for families experiencing homelessness, and that money has been ongoing.

By making data informed investments through ongoing funding, this report shows us that California can solve homelessness. I thank you for your attention and time. I'd be happy to tell you more about a process we went through and the data we used if you're interested, but would look forward to any questions you have. Thank you.

Thank you both. I know I have some questions, but I want to defer to Chair Jackson first.

Sure. Thank you so very much for that information. I actually felt inspired by seeing some of those numbers so that, it is doable.

Yes.

The question just becomes, do we have the discipline and do we have the courage to make the right decisions, the big decisions, to make sure that we actually eliminate this problem, not just say that we're addressing the problem. Same question that I've had for others. What's the best return of our investment here? When it comes to the different ways that we've currently invested into this issue? Any great models that we should be investing more in?

Okay, well, I would say housing, permanent housing is the data all show, is the only way actually to reduce homelessness and has the best return on investment. So some of the data showing all these great savings or reductions in emergency room visits, in hospitalizations, nursing home stays, jail, prison, all of those come from people being moved into permanent housing. And for some people, they do need intensive services to help them stay housed. But for most people, they just need an affordable place to live.

And so I would say permanent housing is the solution. And it's important that we not only invest at the right level in housing, but that we make sure we're investing in permanent housing and not other interventions that are frequently funded in California.

Are there any current poor investments we're making right now?

That's a great question. I can't say that there are poor investments, but I do think that we are over investing in interim interventions compared to how much we're investing in permanent interventions. I think our report shows it has to be balanced. We do need interim housing, like shelter beds, to keep people safe.

But if we're not investing even more heavily in permanent housing, those shelter beds will be a bottleneck and people will exit those shelters and return to the streets, and people are still considered homeless while they're in a shelter. So really the only way is to balance those investments is to make sure that we're investing in permanent housing at multiple rates. The amount we're investing in interim housing.

I think we would say again that housing and the high cost of housing in the state is the primary driver of homelessness. So to echo what others have already said, I would just add on that there is, as you will hear in the subsequent panels, a combination of efforts being taken underway that have come at the issue from a lot of different angles. Right?

As we've heard, there is no singular reason that someone may experience homelessness. And so having a coordinated approach that really does look at all of those factors is really important.

Are you saying that we don't have a coordinated approach or that it's just something general?

I think. Well, another point I think, that has come out today is that the state has come a long way in the last five years in really increasing our role in funding homelessness programs, but also in the state's presence. Right. So that having the council here to really look at, take a more coordinated approach, have something like the landscape assessment to really react to, I think is really moving in the direction of increasing that coordination.

Thank you very much.

Thank you. I appreciate this panel. I think we can solve this problem, and I think sometimes we look at it and it feels like this intractable, sort of like the Middle East conflict or something, like, why are we not able to solve this problem? Right?

But I actually think we can. I look forward to working in partnership with you, Chair Jackson, on that, as well as the others on the panel and my other colleagues. It's a matter of us making the right choices and making the right decisions and saying, we can solve this problem. Right? We've sent people to the moon. We can solve homelessness in California. I truly believe we can do it.

And I appreciate the analysis that you presented, Ms. Rappaport, because it talks about what do we need to solve the problem, not kind of what scraps are we fighting for in the current environment, but what is the moonshot goal of if we decide that we're going to solve this, it means we need to put 2.7% of the state's budgets into this problem.

And again, I know it's been mentioned earlier that California, the state government, is sort of newer to this situation in terms of us deciding that we're going to act on it. But I do think our constituents are demanding it of us. And they should be, they should be demanding this of us. So I think they will support our decisions to make these tough choices.

I think whether they're supporting it in terms of demanding it of people like me or on the ballot or any other mechanism by which we can decide as a state that we're going to invest these resources. But I personally am committed to working alongside anyone who's willing to fight for these resources because I think it is so incredibly important. One question is just as a service provider, and I think I know the answer to this, but I want to get your thoughts on it.

Does your organization find that having multiple divergent funding streams with serving different populations with different outcome metrics? Do you all find that as an ideal practice and what is the most effective as a state program or resources from your perspective?

Thank you for that question. Just to clarify, we're not a service provider. We do work, we partner with a lot of service providers. We're more of an intermediary. But yes, I would say universally, all the service providers we talk to say it is very difficult to work with multiple divergent funding streams. And the lack of ongoing funding, I would say, is the most challenging piece of the California dynamic right now.

I agree completely with Ms. Bella that the state has come a long way in the last four years, tremendous distance. But we do need ongoing funding because without that, it is extremely difficult for service providers and local communities to kind of navigate whether they'll get funding the next year or not. And then in terms of working with multiple funding streams, I think it is really difficult to piece together which funding streams pay for which interventions and which populations.

And having to piece those together is extremely challenging and requires a lot of administrative effort, I would say by the state and also by the local government. And that trickles down to the service providers as well.

Great, thank you. Any other questions? Well, I want to thank our panelists for your concise and eloquent report out today. I appreciate the work.

Thank you very much.

And we are moving swiftly on. I want to thank the audience for sticking in there. Let's see. We are going over to panel number four, and with that, I will return the gavel to Chair Jackson.

Thank you very much, Madam Chair. Now we will bring up our fourth panel to hear from our state departments responsible for the Administration of our Homeless Service Programs. And as we let them settle in here, we will have them introduce themselves, and then they can begin with their remarks.

Good afternoon, Chairs. Kim Johnson, California Department of Social Services. Would you like the whole panel to introduce or shall I go ahead with.

Why don't we just have the whole panel introduced so we just.

Hanna Azemati. Director for Housing and Homelessness at the Department of Social Services.

Good afternoon. Jacey Cooper, State Medicaid Director and Chief Deputy Director of the Department of Health Care Services.

Hello Dhakshike Wickrema, Deputy Secretary at Business Consumer Services and Housing Agency.

Hi, Zack Olmstead. Chief Deputy Director at the Department of Housing and Community Development.

Thank you so much again. Kim Johnson, Department of Social Services the Department's Housing and Homelessness Division design, supports, and oversees the delivery of programs that are tailored to the unique needs of children, families, older adults, persons with their disabilities who are experiencing homelessness or housing instability and are served through local social service agencies. The division takes on a variety of activities to help support the effective implementation of these programs within the broader system of care.

We work collaboratively, as you've heard, with our sister departments within the California Health and Human Services Agency, as well as multiple state agencies striving towards that same mission to end homelessness by creating person centered program delivery with a focus on equitable access to safe and stable housing.

As you've heard, I'm also grateful to serve as a Council Member on the California Interagency Council on Homelessness as we work side by side with the department's various stakeholders and those with lived experience in communities to implement that state plan to end homelessness again. At social services, we are overseeing seven housing and homelessness programs that are embedded into the social service delivery system with significant one time program expansion dollars totaling over $2 billion over the last two years.

These programs are made available to county social service programs and tribal governments throughout the state. We encourage and work with grantees to blend and braid the tremendous and significant state infrastructure investments with a wide array of health and social service interventions. I'm pleased to report that as of January of 2022, the Department has made all of these funds available via applicable funding notices and has awarded over $1.5 billion in funds to over 350 grantees to implement housing and homelessness programs statewide.

The remaining 500 million is available via relevant funding announcements, and we are in the process of reviewing submitted applications.

The criteria for awarding these funds is described within the corresponding notices and metrics tracked include, but are not limited to, the number of families and individuals served, the types of services provided, the outcomes which I'll speak more to in just a moment, and along with these significant funding expansions, in 2021, program eligibility was expanded to serve families, older adults and adults with disabilities at risk of homelessness who are not yet in receipt of that eviction notice, which allows grantees to help stem the inflow into the homelessness system.

Additionally, all of the one-time investments in fiscal years 21-22 and 22-23 provide multiyear spending authority to ensure grantees can commit to longer-term supports for individuals and families who are enrolled in our programs. And that, again, allows that flexibility locally to provide that short-term, one-time intervention where it's needed, but also that longer-term service and support.

For the purposes of time, just say that these committees have referenced today the importance of being able to operationalize these investments, and the Department has put forward a number of partners that work on the ground with our counties and tribes to make sure those operations are happening smoothly with a number of technical assistance efforts. I'll specifically call out the fact that we are also working with tribes in government-to-government consultations on the design to create set asides for some of these programs.

In fact, we have five of our seven programs that we administer that are again designated as tribal grantees as it relates to the level of need and program overviews again, we've heard a number of data sources this morning. We know that families with children represent approximately 35% of California's homeless population, as supporting families in obtaining and retaining stable housing leads to better outcomes for parents and caregivers as well as the children across multiple other systems, including education, workforce, child welfare and health.

It's a keystone to not only addressing our homelessness crisis, but more broadly in breaking the cycle of intergenerational poverty, which again disproportionately impacts people of color. To achieve these goals, social services operates three programs that serve families. You've heard a little bit about them today. The Homeless Assistance and Housing Support Programs providing temporary housing, rental subsidies, and supportive services to families participating in CalWORKS.

Our California Work Opportunity and Responsibility to Kids Program. Housing Support Program has served more than 66,000 families and permanently housed more than 31,900 families since the program's inception in 2014. In fiscal year 2021-22, 47,225 families were served through the Homeless Assistance Program. And just to the point of outcomes in this conversation, I'll also note through our evaluation efforts, we have found that 88% of participants housed in housing support program after six months remained and retained being housed.

The Bringing Families Home Program provides the same resources to families in the child welfare system to help keep families together, serving over 4,700 families and permanently housing 2,200 families since its launch in 2016 as it relates to unsheltered populations with a disability, and again noting that our California Homeless Data Integration System reports 46% with a disabling condition and 20% over 55 years old. We know older adults and aged 50 and older are now the fastest-growing population of homeless individuals across California.

By helping these individuals obtain and maintain housing, these programs have a critical role in the state's efforts to turn the tide on homelessness, part of our master plan on aging that we continue to operationalize together, the Department operates four programs that serve this population. Those include the Home Safe program providing housing and support to those in adult protective services, which can be considered amongst the most vulnerable populations in the state. The program has served more than 5,600 people since its inception in 2018.

Again, in looking at the evaluation of post six months of participating in the program, we're seeing 85% of those being served retaining that housing. The Housing and Disability Advocacy Program combines housing assistance with disability benefits advocacy so that people who are unhoused and who have disabling conditions can get the income assistance needed to support longer-term housing stability.

This program has served more than 500 clients and helped permanently house more than 2,800 people since its inception in 2018 and again post six months, 80% of that population has retained that housing. You've heard a lot about Project Roomkey this morning. This was the state's response in the COVID pandemic and what became a national model for protecting people experiencing homelessness and set thousands of Californians on a path to housing stability.

Through the expansion, we were able to do together on this program that has served more than 61,000 California since its launch in 2020. And lastly, the California Department of Healthcare Services and the Department of Social Services working in tandem to design and implement two new programs to support infrastructure projects, including the Behavioral Health Continuum Infrastructure Program and the Community Care Expansion Program. We issued a joint request for applications in January of 2022.

The Department of Social Services administers that community care expansion program, which is providing capital funding and operational subsidies to preserve and expand assisted living settings that can serve people who are homeless or at risk of homelessness. This funding supports residential care options, including residential care facilities for the elderly, adult residential facilities, often referred to as board and care, where we have seen an increase in closures in recent years and serve as a critical housing resource for people with more complex needs.

I'll note again, just hot off the press this morning, we have issued three rounds of funding for the community care expansion program totaling $207 million. 32 projects serving 1,172 individuals. Very briefly, I just also want to mention to you, in light of the conversations that we're having, one story, and then I will again turn it over to others on the panel, and that is from a Housing Support Program Participant who says, my family and I entered the housing program in September. I was defeated.

I had nowhere else to turn. I met my housing worker and within a week my life started changing. I remained faithful through the year. I was in a motel and just when I thought there wasn't a place for us, boom, we got a place. The housing program came through again and helped me get furniture in line. It has been a blessing. Now our future looks brighter because I am not afraid any longer about being unstable or where my family will be next week.

We have started visitation with my spouse's son. My two year old has toys and space. I can breathe easy now. My housing worker was and continues to be supportive. I can't thank the county and state enough for sticking with me through this journey and I think that again represents the tremendous work and support that we are doing across the state in this space.

With that, I will just introduce to you again our Deputy Director of Housing and Homelessness Services, Hanna Azemati, and we are both available for questions. Thank you.

Good afternoon. So again, Jacey Cooper from the Department of Healthcare Services. You heard Secretary Ghaly earlier talking about CalAIM, California, Advancing and Innovating Medi-Cal. So I'll walk through some of the pieces where we're specifically focusing on housing and homelessness.

I would say CalAIM is definitely a long-term commitment to addressing California's housing crisis through strategic use of medical funds and drawing down additional federal funds, which is critical to the long-term sustainability of many of the things being discussed today, because these are reimbursable services into the future as well, not just one time. So we're using a combination of one-time funds as well as ongoing funds, which I think is critical. Based on the conversation from the panel today.

I think one thing that CalAIM is also doing is it's really breaking down the historical walls of healthcare. We're really pushing people out onto the streets to engage with people where they are making sure services are being brought there. And I will walk through some of the stats of our early learnings from the first year of this initiative being live.

I think the other thing I would mention is the first time with enhanced care management and community supports being rolled out, it's the first time we actually have a full continuum of care for somebody experiencing homelessness on the health side. As you heard Secretary Ghaly mention earlier, oftentimes individuals that are experiencing homelessness will languish in an emergency room or an inpatient bed. They will cycle in and out of correctional settings often as well.

And so really making sure there is that full continuum, that step-down service, even in the healthcare setting, is critical. So someone from an inpatient bed isn't languishing there, but they have a transition place to go, whereas someone like us, we may transition to our home for recovery. Often if you're experiencing homelessness, you are put onto the street. So this is really about building that full continuum.

The recuperative care centers that he was mentioning earlier are being funded around the State of California, as well as short-term post-hospitalization, where it's a clinical touch and it allows for healing at a place with the intent of obviously connecting to interim housing or long-term permanent supportive housing. So I think those are critical.

I would also center us in the fact that we just released our independent evaluation of the pilots that were really the forefront of which we used to design many of the components of CalAIM. And that independent evaluation showed not only a reduction of those inpatient ER utilization, but it also showed that there was a higher connection to services. They were increasing the touch to primary care they were having better health outcomes. There was an increase to getting into substance use disorder services.

So by having these coordinated services for somebody, it has shown that you can connect into those services. And it also showed an overall reduced cost for those individuals because coordinated care has demonstrated time over time to really reduce costs and improve health outcomes. So we're really excited about that being released earlier this year. The other piece I would mention is that our community supports in California go far beyond what you may be seeing in other states.

As I mentioned, often states are covering housing transition services or sustaining services, but those recuperative care services, those short-term, post-hospitalization, housing deposits, and rehabilitation are critical components of that continuum that really make sure that we have all of the pieces we need. What we're currently seeing in our data is we were able to, with the first year of launching, have 479 unique enhanced care management providers across the state, focusing specifically on people experiencing homelessness.

We also are seeing that there were 22,795 members experiencing homelessness that received services. And that's data only through quarter three. That's not a full year's worth of data yet, and we will have that probably closer into the spring. We have a data lag that we do need to get through. Additionally, at this time, all 58 California counties have offered to provide the housing services available through those community supports.

There were a lot of concerns, since they were voluntary, that not all of our various plans would pick those up. And in all 58 counties, we have housing support services in the three bundle available for individuals. 642 housing-related community support providers have been stood up in the first year of CalAIM and a little over 29,000 members receiving those community supports across the state.

We're also really happy to see that we were able to scale up 32 community or recuperative care centers in 42 counties prior to CalAIM, we had a very small footprint of these recuperative care centers. So we're really happy to see that expanding now. This is just the beginning. This type of massive transformation and growth will take many years to fully implement. But we're really happy with some of these early expansions within the first year.

Also, though, if it's anything new and this big and this transformative, we have to go around the State of California and talk to people. We had provider feedback loops. Director Baass and myself have been going around the State of California on a statewide listening tour, figuring out what's working with this, what's not something this big, transformative, and new for healthcare system. We know that we are going to have to tweak and iterate this as we go, and we are committed to doing that.

And we have had a lot of feedback. Some of the early challenges that we're hearing from people on the ground is that we are hearing that there is, and we've heard on this call, if we're paying for transition services, we don't pay for housing. But that connection to those housing, permanent housing services, is really something that is a focus. And I think there was a lot of great energy and investments being made for us to forge that. But we'll be critical.

There's also a scarcity of infrastructure and resources in certain parts of the state where we may have resources in Los Angeles with Bay Area or even some of our Orange County and other areas. We have parts of the state with little to no infrastructure or providers who are doing this today. And so we are building that infrastructure through this, but it will take time. We also are identifying that there are some policy alignments we need to do with our managed care plans.

Managed care plans are approaching this differently. Those are easy administrative pieces that we can clearly look into quickly to make sure that we are providing guidance from the state to our managed care plans. We also need to work on data sharing, standardization, and we have a lot of pieces moving in that way. I think what you would see is that I'll kind of walk through some of the investments that we're doing. We know this is big.

We're engaging with people who historically have not participated in Medicaid or providing sometimes health-related services. And that's from the eyes of the Federal Government, is what these are. And so we've invested a large number of dollars around PATH and IPP, and I'll walk around some of these early investments. We are also really focusing on institutionalizing this across the system. And what I mean by that is in this first year we were so focused on getting things up and running.

Now we need to make sure all of the various people across the full continuum understand what the benefits are, how to refer to them, and how to make sure that we close those loops. So that's this next phase of education. We're doing extensive technical assistance across and we are focusing our next round of incentives around making sure, we are educating providers across that continuum with our social service partners to make sure people are getting those appropriate connected points across the State of California.

We're also working to standardize and streamline a number of our various pieces, as I mentioned a few seconds ago. And we're also focusing on increasing access to street medicine services while someone is still experiencing homelessness. We need to ensure that they're getting access to care. It's actually building a significant amount of trust with those individuals to be able to make those connections and to be able to do that. And I'll tell you some of the ways in which we're doing that.

I want to focus, though, on PATH because it is one of the biggest pieces. It was $1.8 billion that was approved, including drawing down 50% of that from the Federal Government to be able to expand the infrastructure across the State of California. These dollars are just starting to roll out. So those initial provider expansions that we talked about, that's even before these infrastructure and capacity grants are going to be going out across the State of California. There's three main components to PATH.

The first one is collaborative planning groups, so making sure locally all the right people are at the table having conversations around where the investments are needed. We are also funding that fully with state dollars to have those collaborations for people to join and to make those plans. We are also funding direct grants, so tangible grants, to providers who need those services.

And then we have rolled out what we're calling a technical assistance marketplace, where we have brought significant vendors to the table across the entire State of California to inform community-based organizations who don't maybe know how to bill Medi-Cal or get these types of services, to provide them direct technical assistance, be able to make those system changes, process changes, to be a partner for us, and to join to expand these services.

In January of this year, we announced $119,000,000 in funding to 98 organizations for that first round of PATH. PATH is a four-year, five-year technically, initiative that will get those. Out of those 98 organizations, 78 of those organizations were focused on housing and homelessness services. Because we know this is the immediate crisis before us, so we wanted to ensure we were really focused on those particular services.

Additionally, 67 were awarded ECM focused on individuals with serious mental illness to make the connection to those various pieces, because we also think that is really, really critical. And we were happy to see some gap closure where we would like to see more around recuperative care and other pieces. We had 10 approved applications in day habilitation programs, one of the lowest pickups of community supports so far, and 12 for sobering centers. Again, one of the lowest pickups that we had to date in regards to expansion.

We will also be awarding another 41 entities, approximately 100 million, probably close to March. We're just finalizing those various awards. When it comes to the CalAIM incentive program, a few pieces I wanted to note, and I know Secretary Ghaly mentioned this, so I want to make sure I reinforce it. This is a separate incentive program for the broad Medicaid CaliAIM program.

But one of the pieces we specifically had people focusing in on is reporting individuals who identify as Black or African American and how we are closing those disparities. Because we know within housing and homelessness there is a higher proportion. In fact, for Black and African Americans. In our program, we have about 7% enrolled in Medi-Cal population, yet 30% to 40%, I think it sits around 39% dominantly are in the homeless population.

We're happy to see our numbers coming in and incentivizing that disparity gap with 22% of our individuals on enhanced care management being Black or African American, and 33% of our community supports are going to Black and African American individuals. We just released a fact sheet on our website where we are breaking down all of our enhanced care management and community supports by race, ethnicity, age, and various factors. So there is transparency around where these dollars are going and how we are connecting that.

We also have rolled out a $1.3 billion incentive program around housing and homelessness, really focused on making sure that full capacity and infrastructure is there, building those partnerships that are so critical and really the focus of reducing and preventing homelessness. All of our managed care plans were responsible for participating in the local homelessness plans, as well as submitting their own in regards to the investments they will make to make sure that the investments on the Medicaid side are also being infused into the system.

They were required to work with their continuums of care and their regional partners to do that. They also had to submit investment plans, how they were going to invest actual dollars, and we were able to see 719 investment activities, including housing infrastructure, sometimes paying for direct rental subsidies, as well as direct support. 102 of those investment plans included dollars going to those continuums of care who also are showing a shortage of dollars on that side, and then 101 outreach capacity grants going to street medicine providers.

So really expanding those pieces. I want to touch base quickly on street medicine because I know we're short on time, so I want to get through those pieces. We have sent out extensive guidance around street medicine specifically to make sure people understand how to be reimbursed for it. We actually identified through conversations with our legislative partners that we were also typically denying claims when it came to street medicine that was not intended.

We have updated our system comprehensively to make sure that you can provide and be reimbursed for street medicine, updating many of our codes so that a place of service of mobile unit shelter is reimbursable. We also released guidance to our managed care plans so they understand how to be reimbursing for those services, as well as how to streamline access to street medicine services. We have this thing called delegation in California, creates a lot of barriers.

So we actually developed a work group where we worked along street medicine providers and managed care plans to develop guidance and re-release that. We also released guidance in regards to how to make it easier to enroll people experiencing homelessness into Medi-Cal. And we also are making changes in regards to provider enrollment, so there is no longer a brick and mortar requirement in order to be an enrolled provider. So we've really tried to do many of those investments. I look forward to any questions that you may have later in this panel.

Thank you. Do you have any additional comments you would like to make?

I was just going to provide an overview.

Sure.

Okay, thank you, chairs. I was asked to give a quick overview of HHAP and ERF, which are two grants administered by Cal ICH. So HHAP, the first one, that's the Homeless Housing and Assistance Program. It was launched in fiscal year 19-20. It provides flexible funding, one-time funding over five years to our big cities, all 58 counties, and the 44 continuum of care jurisdictions.

So, for example, a HHAP recipient can use these funds in tandem with a home key site, the capital to provide the operating subsidy, to provide and activate units for folks who are homeless to enter and have stable permanent housing. The third round of HHAP was last year, that's fiscal year 2021-2022. And it included another $1.0 billion in flexible funds, again over a five-year period. And it also had a set aside for tribal nations in round three.

The third round also required applicants to submit in their application an outline of local needs, what other resources they were leveraging with the HHAP funds performance goals, strategies to meet these goals, including strategies to really think about overrepresented populations, and racial equity goals for all of their performance goals.

And as round three resources now are flowing into communities, we are in the middle of reviewing round four, which is another $1.0 billion again over five years, which also comes with performance goals, which we'll be tracking in 2025. As with round three, we continue to be very intentional and to make sure that this is an opportunity for folks to leverage other sources of funds and really build capacity and regional collaboration. So that's HHAP round 3 and 4. Now I'm going to move to encampment resolution fund.

So these were first established in fiscal year 2021-22 and it's really designed to help local communities use these funds to engage people living on the street, whether it's in vehicles, encampments, in tent communities, and help them find the services they need, navigate to housing, and place them on a pathway to safe, affordable housing. The initial fund was $50 million last year, very, very oversubscribed. And so, fortunately, thank you, Legislature, the 2022-23 budget augmented that fund with $700 million over the next two fiscal years.

So with this infusion of funds, we were able to go back and look at the oversubscribed applicants and provide another infusion of folks who applied in round one. Round two is now open. It opened in December 1, and we will be taking those applications on an over the counter basis. And as June 30 approaches, we will be closing that round two application.

Now I'm going to move to proposed investments, HHAP round five in spite of a very difficult fiscal environment, the governor's proposed budget maintains another $1.0 billion for a fifth round of HHAP. If you look at the framework, there is something in their language where the Administration looks forward to working with the Legislature to really think about how accountability can be enhanced, including focusing HHAP round five on particular activities such as encampment resolution home key operating sustainability and community assistance, recovery and empowerment act housing supports.

So we look forward to partnering with the Legislature on that effort with round five of HHAP. And then finally, as I mentioned, there is a round three in the proposed budget, and so that will be $400 million for a third round of encampment resolution fund. So, all told, we are really hopeful that these funds that are coming will continue to enhance local communities and help them really leverage all the different pots of money, all the different players that help people come off the streets into safe, stable housing and look forward to any questions you might have.

Thank you very much.

Hi, everyone. I promise you there's a lot more I would love to share. I can give you lots of numbers, but I'm going to distill what I would have shared into three big points I'd love you to take away from HCD. First, HCD funds, homelessness, and extremely low-income units in all of our programs, it's not just Homekey, it is not just this targeted approach. We target our scoring and investments so the best projects get funded.

Our affordable housing and sustainable communities program funds homeless and permanent supportive housing, and on down the line. Happy to elaborate if you have questions. Two. We are building the capacity and increasing that capacity at local level in terms of supply. With all these investments that we've done since 2018, $13 billion awarded since then, approaching 10,000 units already built and created from those investments, standalone units just from the HCD programs alone, 22,000 in construction right now, 23,000 awarded in the pipeline.

So we are right on the precipice of realizing some of those gains, building that capacity in the communities. More to be done, sure. But those are coming online and we're going to see those investments pay off. Three, the investments we make are long term and multigenerational. It's been mentioned our affordability covenants. We do not talk about that enough or we do not understand it enough. 55 years of affordability.

So that's a one time investment up front, but we're serving easily seven households over the term with normal unit turnover over the course of that investment. So when you think about what our cost benefit is, here we are serving hundreds of thousands of Californians now and in the future, just from the housing already in our pipeline, from the invest that 13 billion in investments that we've made so far. I'm going to stop there. I'm sure you have lots of questions. Lots I'd love to share, and I'd love to do that here or offline if you guys need to.

Sure. We'll now open up to the floor to questions from members, colleagues. Do you have any questions? Chair Wicks and then Petrie-Norris.

Great. First, for HCD, how many projects was HCD oversubscribed by in the last supernova?

So we were able to fund 72 projects. All told, we got at the initial stages around 200 and 4250 applications. Some of those did not meet the threshold, but it gives you a little bit of sense of the oversubscription. We're able to deploy about 700 million in funding, and I think, all told, probably at least two to 3 billion in requests.

So there's a lot of demand still.

There's absolutely a ton of demand.

Okay, next question for Ms. Cooper. And I'd asked this in a previous panel, but in the statewide homelessness assessment report, there was mention that the counties had the option of pairing or augmenting certain programs with realignment funds, MHSA, and behavioral health-related federal block grants. I think it was 17.3 million for 2018 and 2019, as well as they could leverage medical funding. I think that was 11 billion as of August 2022. Just with regard to those funds, can you provide more details on that?

How are realignment dollars being used at the local level? Right now to address homelessness? And are those dollars specifically for people experiencing or at risk of homelessness or generally for lower income people who need mental health services?

Sure. So happy to address that. There's a few places where DHCs is specifically investing dollars, so Director Johnson actually mentioned some of those, the behavioral health continuum infrastructure grants. So we are building brick and mortar both mental health and substance use disorder facilities across the entire State of California, including mobile crisis services, was one of the first grants, and many of those awards are going to our county partners to build that infrastructure, especially those early grants, around initial planning dollars.

That's a $2 billion investment, and that is one direct way that they could be maximizing some of those funds to do those pieces. The other piece is around the bridge housing dollars. So bridge housing is $1.5 billion that will be going out, and that is specifically dollars going towards individuals who are experiencing homelessness, who have a serious mental illness.

With the idea of those county partners, again, county behavioral health agencies and our tribal partners responsible for putting up those housing, whether it's operating subsidies or housing for individuals experiencing specialty mental health, they'll be able to draw down those dollars. We're actually getting ready to release that RFA this month for individuals to be maximizing those dollars. When it comes to the braided funding side on the realignment as well as the other, we have this thing called full-service partnership within our programs.

Almost every county, if not every single, I think every single county has a full-service partnership program that is around someone experiencing specialty mental health services who also most likely not always has a housing component to it. So they do have to do braided funding. In that particular model, you're going to have services and supports that are reimbursable by the Med-Cal side. And so they should be drawing down those funds.

So they're maximizing those federal dollars while at the same time using the MHSA dollars that are available for housing to make sure that they are augmenting that, to make sure they're operating rental subsidies, whatever may be available for that individual. And then the last one is the community supports and enhanced care management that I was mentioning earlier. We are encouraging many of our county behavioral health partners to be enhanced care management providers and or community support providers because then they can do the whole piece.

It can be a true integrated model for someone who has a serious mental health illness or a substance use disorder because they could do the enhanced care management, which coordinates all of the various pieces across the health spectrum. They could also be doing some of those housing transition support services, tenancy support services and be able to maximize those.

So when you talk about the braided funding, both the realignment and the Medicaid side, it's really about counties building models around individuals experiencing specialty mental health or SUD services to leverage all of those funds that we've made available to them.

Great. And then what efforts are being done to educate cities about CalAIM? I know it's not something they are sort of used to dealing with. What's the expectation of them? How's that going?

Yeah, so we've done a lot of extensive training, to your point, with counties, providers, hospital systems, community-based organizations. We're actually starting a round of technical assistance for cities. They raised their hand and said they would like some specific technical assistance.

So the department is putting together packages where we actually did a scan with our health and human service agencies to understand which cities, especially the large cities, don't even know how to connect with their managed care plan or be connected to the services available to them through the Medicaid side. So we'll be making those connections and we'll be working in the next few months to provide some Ta to those large cities. Thank you.

Chair Petrie-Norris.

Thank you. In a previous panel that highlighted the findings from the landscape assessment, you talked about just how vital rental subsidies are in terms of providing a permanent solution. We leave a ton of money on the table, federal money on the table in terms of Section eight vouchers. Vash vouchers. I know that that's in Orange County.

One of the things that we've been focusing on is how can we do a better job of drawing down those dollars and ensuring that we are able to find homes for individuals that qualify. Do we have a sense, do we know across the state how much federal funding we are leaving on the table because of the underutilization of the vouchers that are available?

I'm sure there is. I don't have it right now, but I can find out and get back to you. And also, just to let you know, some of that is because as I'm sure you know, the landlords sometimes peg their rents just above the section eight payment standards. So that's kind of an issue that is beyond sometimes the control of the housing authority or the nonprofit service provider. So there is more we can do. For example, in some jurisdictions, they provide landlord incentives.

But in spite of that, if you have a mismatch between the actual housing market and then what the federal payment standard is, that's going to be an issue that we actually bring it up with our federal counterparts to see if they have any solutions there. But on the other thing you asked, I can find out and let you know, Chair.

That would be great. I think it would help us all understand the scale of both the issue there, but also really the opportunity in terms of being able to draw more of those dollars down. Okay. And then my second question is sort of at like a meta-level. So I was kind of surprised to learn that the interagency council includes, I think it's 16 different agencies and departments that are all trying to touch different aspects of this crisis. Do we have too many agencies and departments trying to solve this problem? Are there too many cooks in the kitchen? And if so, what do we need to do to rationalize that?

So there are 18 state agencies or departments and two community members, one appointed by the Senate and one appointed by the Assembly. I will say,Cchair, that the California Interagency Council, the State Council that we are talking about is mirrored on the United States Interagency Council on Homelessness. So there is a USIC which includes 19 federal departments or agencies.

And the reason why that is at the federal level, which we are trying to mirror at the California State level, is all of these different agencies, as you heard even with here, are touching different people's aspects of their lives. Right? So I could be a woman veteran, but I experienced domestic violence, and maybe now I am living in my car, but my children have been taken away because of all my mental health issues.

So you can see how one department does not address all the needs when you think about a person-centered approach. So this is why I think at the state, we felt it was important to start building that cross-sector collaboration, what Secretary Ghaly and Secretary Castro Ramirez talked about, connect the dots opportunities. Even here as we are talking, there's Homekey that HCD produces, but there are opportunities with MHSA full-service partnerships to provide the services.

So I think that's what we're trying to build, Chair, which it's going to take a village, because each person's journey to homelessness is so different, and each person's journey out of homelessness is also going to look different, which might involve solutions and programs from multiple state departments. So I don't know if that answers your question, but it's the beginning of thinking through how the state as a whole can really think about helping people who are Californians address their own issues and exit homelessness.

And certainly understand, and to be really clear, I mean, obviously, bringing together all of those agencies, doing the work to connect the dots, ensure that we're taking a coordinated approach rather than having 18 agencies operate in a silo, is certainly preferred. I guess my question was, is there an opportunity for us to streamline some of that work so we have to spend less time connecting the dots? So maybe that's conversation topic for another day. Thanks.

Thank you very much. I want to talk about the housing and disability advocacy program. Funds can be used for case management and connection to additional services as appropriate. How are we doing in the coordination with services from the Department of Rehabilitation to provide employment support?

Thank you. The Housing Disability Advocacy Program, as you probably know, is intended to serve folks that are eligible for disability benefits and also experiencing homelessness or at risk of homelessness. It serves a highly vulnerable population, oftentimes with very intensive needs, oftentimes chronically homeless individuals. And we have found a lot of success in combining it with a set of different programs to make sure that folks are able to attain housing and sustain their housing.

One of the notes that Dr. Johnson mentioned is that 80% of folks that actually are able to have their disability benefits approved are able to retain housing six months after they exit this program, which is a huge testament to success. And as part of that program, there is a case management component that really assesses the person's needs more fully.

In addition to the disability benefit advocacy that takes place to make sure that, for example, if there are workforce development opportunities and programs that could meet that person's need for additional income, that can help them sustain housing down the road, that those connections are made. HDAP just like with any of our programs, local operating grantees are required to coordinate with their coordinated entry system, as well as their continuum of care locally and with other departments.

And so the range of resources available locally is meant by design to be brought to bear to meet that person's need. And that would include workforce development, but also anything else from substance use, mental health, other connections that can benefit this person.

Thank you for that. Care court implementation. How are we making sure that it's interacting with our existing safety net? Right? Making sure that they have full access to all the various services while they're there. Or within the care court process or even after the process, right?

Yeah. So this is Jacey. I'll be happy to answer that. So we are currently working on some guidance and technical assistance for our county. Mean, one of the things about CARE Court, while there is a full structure around a care plan evaluation and building those pieces, it is centered on the very large benefits that we have within California. So California actually has a pretty comprehensive list of both specialty mental health or substance use disorder services and the county will be responsible for.

Once an individual has a petition go through the entire process and deemed eligible for care court and a care plan is then created. It is built on the basis of all of the existing services that are available, including then if someone is experiencing homelessness, of course, to build a plan around that housing and then to connect with all of those services that are available both at the county level or through the Medicaid side or our social service partners or the others mentioned here today.

So I think it is really just leveraging the full benefit that we have, but putting in the full structure around that process of the petition, the identification, the evaluation, but really all of the services and supports that are going to be provided to an individual in CARE Court are currently available through Medicaid today and or MHSA. The other braided funding that was mentioned or those block grants, we have various federal block grant dollars that we put out to our county partners. It's just about leveraging those with an individual in a care plan.

Thank you for that. Now we've been throwing the kitchen sink at all these things, right? But that also means we have several programs, different places like rapid rehousing or housing navigation services. There's different populations we're trying to serve. We have CalWORKS, foster care, the whole deal. Do we need these different programs or is it time to start thinking about consolidation? Right? We always talk about a best practice is creating one-stop shops.

If you go to one program, you should have access to all the range of different programs no matter where you enter into the system. Any thoughts about the need to begin to start collapsing some of these programs and to not create so many silos, especially in regards to the issues of sharing information and those type of barriers we continue to see.

I'll start. Others might have opinions on this too, but I would just say to your point of the kind of one-stop shop concept that is part of the development and growth of embedding the housing navigation and the supports within our existing program.

So whether it's families experiencing poverty in CalWORKS or it's again, goals of keeping families together through family reunification in the child welfare system, what we recognized in doing that work, and again with our county partners, but whether they be social service agencies or community-based organizations, is that the ability to meet the full array of needs of the individual is critical. That whole person and person-centered philosophy.

So I would say that we are kind of taking the perspective of being able to do that, integrating within our programs that are population-focused and specific. But we're also, I think, to other examples provided, making sure that our program administrators have a sense of the connection points that they can make, whether they grow capacity to be able to do more in some of the examples that you heard, but also how we're bringing those pieces together locally.

So I would again say that we are being intentional through the work of the Interagency Council on Homelessness or departments in the locals, the local communities, thinking through how, again, to your point, no matter where someone's entering, they're getting connected to the robust array that we have built together that really is unlike any other in the country. So others might have more to add.

Well, maybe I'll speak to, as a department who has consolidated recently some of our programs per legislation from this body, maybe just a couple of reflections, we have combined four of our major multifamily housing programs into that supernova that was referenced earlier. I will just say there are still statutory obligations within those programs to consider.

And maybe just an observation, some of those subpopulation-targeted programs are harder-to-serve populations, and when you do some of that consolidation, you might see easier-to-serve, quote-unquote, populations get the bulk of the applications. So to the degree I know the Legislature, over time voters have approved overtime bonds for specific programs to serve subpopulations, and we have consolidated, in the case of the supernova programs to serve farm workers and veterans within that supernova.

But of course, you still need developers and providers to provide those types of unique services and housing to those subpopulations, where those sources are coming from. So it's a good question. I think it's a good goal. We have, I hope, tried to lay out some of that groundwork of how it can be done. It's a constant, continuous improvement effort.

But we need to be mindful that sometimes those sources, whether they be federal or state, are coming with some strings and some ties that are put on by the legislation or that budget act that we still need to adhere to. So it doesn't necessarily reduce the complexity in all cases to consolidate. But I do think the timing and efficiency of offering those dollars together is, I hope, helpful within at least our part of that integrated solution. When we're talking about housing production, you.

Do bring a good point, and I think this is an issue we learned during the pandemic that streamlining and efficiency sometimes creates disparities and disproportionality. And so it may not be the solution is not always what's the easy way to do something, right, and making sure that we are taking the time out to sometimes do the long way around in order to make sure everyone's captured. Which brings me to my last question. Out of all these programs and all the different people that we're serving, is there a population we're still missing?

I would just stress we're really excited about the BH bridge housing dollars because while there is a lot of housing being brought up, especially even permanent housing, we're still really struggling on the Medicaid side of finding placement or individuals willing to take people with serious mental health issues or substance use disorder issues. And so we're really excited about a number of models, initiatives, and pieces that are being focused on.

While there is a lot of focus there in working on getting those services, having placement opportunities for those individuals continues to be a struggle is one of the largest things. Even just housing placement is a struggle right now. Someone experiencing serious mental illness or very complex substance use issues, it is even harder to find placement for those individuals.

And so we're doing a lot of thinking around what are the models or the braided funding that we need to do to really address that issue, because it is going to continue to be an issue. We can't just focus on housing individuals who have easier placements, so we are going to have to do more.

We're hoping things like care court or these other fundings, the BH bridge housing dollars that are going out, or the behavioral health continuum or the dollars that we're partnering with our social service agencies on will help some of those. But we're at the very early beginning stages of that and we need to see those models going into place to really be able to have an impact on some of the population, a subset of the population, not the whole. But I still think a lot of work to be done there.

Anyone else, any other populations that we might be missing, like our Trans community, right? Sometimes they need special housing and accommodations because of other cultural norm reasons, right? Any other populations?

The only thing I'll add is that part of the ways in which we too are asking that question is being in community, and you've heard a number of panelists speak to that today. I mean, when we're talking about both talking to program administrators, but also people experience it, it's the difference of the ability for some people to take up the offer of housing.

We, for example, just worked in collaboration with partners here with the recent floods and really targeted efforts in counties who were impacted the greatest on how we were going to support really connecting unsheltered and our unhoused neighbors to that temporary housing, or even permanent, should that be an option. And the ability to have dog food, have a place for animals, it makes all the difference in the world of being able to make that a real offer that an individual can accept.

So what I would say is that where you see our emphasis as a state is informed through both our data and our evidence, but it's also through the communities experiencing the problem so that we can also answer the question that you just raised.

Thank you for that. Any additional questions, colleagues? If not, thank you all very much. And now I'll hand the gavel to Chair Petrie-Norris. Take us home.

Well, thank you, Chair Jackson, and we are grateful to welcome up our panelists for our final panel, which will focus on accounting perspective. We're being joined by Emily Halcon, who is the director of the County of Sacramento Office of Homeless Initiatives, and Elizabeth Ben-lshai, who is joining from the Los Angeles County Office of Homeless Initiatives. I'll go ahead and let you all jump into your comments. Thank you both for being here.

My apologies. Thank you for having me. My name is Emily Halcon. I'm the Director of the Department of Homeless Services and Housing here in Sacramento County and really appreciate the opportunity both to listen to the past conversation and provide a little bit of local context. I'm going to go very quickly. I know that you've had quite a long morning.

I just wanted to lift up as somebody who works in the local space and has for many, many years in homelessness, in addition to seeing the rising numbers, which you've quite a lot. You talked quite a lot about today. We every day deal as well with the rising and continual community frustration with the perceived lack of solutions, and over the past few years, a dramatic increase in the community's interest in enforcement as one of the options which makes our work challenging.

I live in the social service world. I'm sure you do as well. And so we are really tasked with balancing this effort to both keep our eye on the prize of long-term solutions, which is housing. I heard that repeated over and over again, but also being responsive to our constituents. And those constituents mostly are concerned with the crisis in front of us.

So I want to lift up two things that are working in Sacramento on the crisis end and then maybe end with some housing things. Some of the things that we have been doing over the past few years, which we are seeing changes. It's not enough and it's not scalable, is developing and standing up, multidisciplinary case-carrying outreach teams that consist of traditional navigators, behavioral health clinicians, peer navigators, and soon to be some additional outreach support funded through CalAIM.

So thank you so much to the state for that. These groups are able to work in targeted encampments with extremely vulnerable folks, but their work is a marathon, it's not a sprint. Sometimes they're in encampment for four weeks, six weeks, eight weeks, just to develop a rapport. And at the back end, if they don't have someplace to refer into, it's constantly a cycle.

Additional challenges with that is balancing, again, this approach where we want to be in there and deeply servicing folks with the community's expectations, it's going to result in a clearing of encampments, which often is not the case. The second thing that we really are scaling up here, partly a result of our work through COVID and the Project Roomkey program, is shifting our focus into non-congregate shelters. We're constantly battling against the perception that there's people who are, quote-unquote service resistant.

And while that may be true what I would like to reframe is that they're resistant to what we've been offering. So how can we reframe that in the sheltering model? We're seeing a lot of success with non-congregate shelters. The county has. We have about 500 to 600 beds under development now.

The biggest challenging, of course, is siting. I heard some colleagues earlier today talk about NIMBYism, and that could not be more true when you're trying to site a shelter anywhere near where anybody lives. And the time to develop while we are looking at alternative structures and tiny homes and sleeping cabins, it is quicker than sticks and bricks, but is not quick enough for the crisis that we're under. And then again, balancing this. How much are we spending on shelter development? It's a lot.

Shelters are very expensive to build. They're very expensive to operate. And balancing that with what we know is a real solution is housing. So a couple of things on housing I'd like to lift up and leave you with is what we need and what I'm hoping to get out of some of the partnerships with the state. I've heard it again, I want to echo it. We do need ongoing sustainable funding.

We appreciate and love all the state one-time investments, but this is not a one-time problem. And we're being asked to transform systems, and systems take long time to transform, and so the funding needs to align with that. HAPP has been really great at allowing us to pilot some new initiatives, and now we need sustainable funding to keep those going. I couldn't echo more what I heard Ms. Cooper talk about with integration with CalAIM, and we are excited about those opportunities.

We are one of two counties in the state who have geographic managed care, and so we have five managed care plans who are all working in this space and have been amazing partners, and we're looking to integrate CalAIM more systemically into the homeless system of care. I'd love to be a day soon where every time you walk into a shelter, the first thing that happens is you're enrolled in CalAIM. The first thing that an outreach worker does for you is enroll you in CalAIM.

And that means both that our system needs transform, but the Medi-Cal system has to be ready to pivot with that. And so, thinking from our managed care plan partners, how do we make sure those ECM and community support providers are fully engaged in homeless systems of care? Entering into our homeless management information system, staffed with the right capacity and competencies to do this work? It's very different than clinical work.

When you're on the side of a parkway or under a bridge, and that funding aligns with the depth of service that we're asking them to do. And then finally, I did hear quite a bit and would like to echo again housing subsidies and really excited that the Governor's Budget includes a possibility for CalAIM to be a player in this. In Sacramento County, we've invested $10 million, again, one-time funding, but $10 million to stand up a landlord engagement and assistance program.

And we know that will make a difference for a lot of folks. I heard a question in the last panel about voucher holders. When we were standing this up, we did a one-time, point-in-time count of our community queue of folks experiencing homelessness.

It was in July of last year, and I think at that time we counted about 300, almost 400 people sitting on our queue who are literally homeless, who also have access to a subsidy, whether it be a housing choice voucher, an emergency housing voucher, a voucher subsidy program from our continuum of care. So our landlord engagement program should help mechanize, should help incentivize landlords to help move those voucher holders off quicker. And I think that's an opportunity with CalAIM as well.

But I do want to leave with saying that those are great programs. We need to stand them up, we need to create some more flow out of our system. But some of these subsidy programs are short-term, 6 months, 12 months, 18 months. And we are seeing the aging of our population on the streets.

We are seeing chronicity increasing, we are seeing chronic illness rising, and we are seeing people come into our shelters who aren't ambulatory, can't deal with their ADLs, and we need a housing exit for them as well. And so development is necessary. How we think about permanent supportive housing and the supportive services. I know that there's been conversations in different areas about can we project base CalAIM services so that it can then become the mechanism that permanent supportive housing can be serviced.

So I appreciate your time and happy to answer any questions.

Thank you.

Good afternoon. My name is Elizabeth Ben-Ishai. I'm the Director of Housing and Intergovernmental Relations for the Los Angeles County Homeless Initiative. Thank you so much for having me here today. Trying to make this work. There we go. So in my remarks today, I'll provide some background on the Homeless Initiative and our approach to addressing homelessness, share an overview of the L.A. County state of emergency on homelessness, review our annual investments in homeless programs, and describe our county's partnerships with cities and councils of government.

I'll also provide a brief overview of L.A. County's use of state homeless funds and describe some of the challenges we're experiencing and recommendations to mitigate those challenges. And I'll try to do that fairly quickly. So in 2015, the Los Angeles County Board of Supervisors created the Homeless Initiative, charging it with creating a strategic plan to address homelessness. The plan was developed with extensive community and stakeholder engagement, and ultimately, the voters of L.A. County approved a quarter.

I'm sorry to interrupt, just maybe lower your microphone a little. I just want to make sure that the folks watching from home can also hear.

Yes. So the voters of L.A. County approved a quarter-cent sales tax that generates more than $500 million annually and is used to implement the strategic plan. The Homeless Initiative works with county departments and agencies, city governments, and more than 100 community-based service providers to implement programs across a range of areas, including prevention, outreach, interim housing, permanent housing, and supportive services. So since the inception of Measure H a bit over five years ago, the system has made significant progress.

We've placed over 87,000 people into permanent housing, more than 118,000 people into interim housing, such as shelters or temporary motel rooms, and we have prevented almost 23,000 people from becoming homeless. Now, despite these successes, we clearly are still in a crisis.

This is driven from our perspective, in part by the inflow into homelessness, which has continued to grow, as you've heard from other speakers today, and by the growing number of people who become homeless and then struggle to exit the system, remaining within it for at least six months in the course of a year. And we view these individuals and families as persistently underserved. As persistently underserved people struggle to resolve their homelessness, many get stuck in interim housing and with beds full as a result, unsheltered individuals are unable to move off the streets into interim housing

This is driven by what we understand as an exit gap, insufficient options for people experiencing homelessness to exit the system into permanent housing. As this slide shows, an ideal system would have five permanent housing exits for every one shelter bed. But in L.A. County, we have a one-to-one ratio, which leads to poor system flow.

So to try to address the continued growth in homelessness, and despite our major efforts to stem it, the HI recently revised and refreshed its strategic plan. Once again, drawing on community engagement, research, and data. In April of 2022, our board approved a new framework to end homelessness in L.A. County. The new framework operates across five pillars, coordinate, prevent, connect, house, and stabilize.

Most crucially, the new framework involves three key partners, our homeless rehousing system, our mainstream county systems, and our partnerships with 88 cities and seven councils of governments in the regions. Each one of these plays a critical role in addressing our current crisis.

So just to take a look at those different roles, we are really looking to our mainstream systems, and that includes our health, public social services, probation, and more to quickly identify and prioritize at-risk households who are experiencing housing crises when they engage with the county system. And this should help to reduce inflow into homelessness. We're looking to our homeless rehousing system to focus primarily, but not exclusively, on those persistently underserved individuals and families who need more intensive interventions.

And finally, we are seeking to build our collaborations with cities and COGS or councils of governments with the goal of increasing the supply of permanent housing and working together to resolve encampments by moving their occupants into housing. And I'll come back to those partnerships in a little bit. So our new strategic plan has already begun to drive change within our homeless service system. But on January 10 of 2023, our Board of Supervisors took another step to respond to the crisis we're experiencing.

The board unanimously adopted a motion to proclaim a local emergency for homelessness. This came less than a month after Mayor Karen Bass declared a local emergency for the City of Los Angeles. The local emergency proclamation provides our office and other county departments with increased authority to take steps to expedite and streamline creation of housing, expanded services, more effective and efficient use of funds, and other administrative processes that will allow the county to be more nimble and responsive across the board.

Last week, the board adopted three missions that reflect the strategic focus of the emergency declaration and prioritize unsheltered people experiencing homelessness. The first mission, encampment resolution in partnership with local jurisdictions. Through this mission, the county will collaborate with cities, COGS, and unincorporated areas to develop plans to resolve encampments through connections to interim and permanent housing and supportive services. Second mission focuses on housing.

We will increase interim and permanent housing placements by working in more streamlined collaboration with local partners and stakeholders to reduce time in interim housing, increase exits to permanent housing, and streamline permanent housing production. And the third mission, focused on mental health and substance use disorder services, will provide the needed mental health and substance use disorder services to unsheltered and sheltered people experiencing homelessness.

So, four weeks after the county declared a local homelessness emergency, the board also approved the homeless initiative's $609.7 million fiscal year 2023-24 budget. That's our largest annual investment to date. The budget will help fund a heightened focus on the three key missions that I mentioned in collaboration with cities and other local partners. So this slide shows a high-level breakdown of L.A. County's homelessness budget this fiscal year 22-23 and for the upcoming year 23-24.

I want to draw your attention to the fact that funding dedicated to interim and permanent housing included in the house row grew by 10% year over year. Programs funded under the house category primarily provide supportive services and rental subsidies rather than funding capital costs. Three-quarters of L.A. County's total budget each year goes to support interim and permanent housing solutions.

This year's budget includes a 26% increase in the number of permanent supportive housing intensive case management service slots, taking us from 17,500 slots to more than 22,000 slots, and an 18% increase in the number of time-limited subsidies, also known as rapid rehousing, taking us from 1,400 slots to 1,700 slots. While the state homeless housing assistance and prevention, or HHAP funding is very valuable to L.A. County, it constitutes only about 12% of L.A. County's fiscal year 22-23 budget and 14% of the budget for next year.

The figures on this slide do not include funding from several other state one-time grants. For example, it excludes the following: state home key awards and local matching funds, one-time CDSS homeless funding increases that will sunset in 2425, encampment resolution grants as well as others. And I'll discuss some of these one-time state grants shortly. I want to return now to our partnerships with cities and councils of governments. This is something that's very important to the Board of Supervisors and the county in general.

We have been working to strengthen our partnerships with the 88 cities and seven councils of governments over the past year. We have been working hard to improve our communication and collaboration with city and COG partners and look forward to growing this work together. To fuel this joint work, we are investing significant funds and efforts that will allow local jurisdictions in L.A. County to build on the work of our homeless services system in ways that are relevant to their community's needs.

These include more than $130,000,000 over the next several years to fund homeless services and housing programs initiated by local jurisdictions and to collaborate on encampment resolution, as well as to sustain operations at city or COG-created interim housing sites. So, as far as our use of state funding goes, the county has prioritized its HHAP rounds 1, 2, 3, and 4 funding as follows.

60% of our HHAP funds have been prioritized to fund the significant annual growth and costs of the county's permanent supportive housing portfolio. Each year as the county brings additional PSH units online to meet the growing need for these units among our homeless population with acute health and behavioral health needs. The county needs to Fund these additional units with a combination of local, state, and federal resources, and HHAP has been critical to meet this need.

About a quarter of our funds have been prioritized to fund existing and new interim housing beds and 11% for housing services for transition-age youth. The Governor recently stated his intent to pursue statutory changes to prioritize future rounds of HHAP funding for specific activities such as encampment resolution, home key operating costs and CARE Act housing supports. Proposed budget trailer bill language released by the Department of Finance also includes these priorities.

While these efforts are important to L.A. County, they are only part of the broad range of programs that the county must fund to comprehensively address the local homeless and housing crisis. The county works to effectively braid together the dozens of local, state, and federal funding streams it receives to support its entire homeless rehousing system.

The county and its hundreds of service provider partners already face challenges balancing the various requirements and restrictions that exist across all these different funding sources. So today I want to highlight that the restricted uses the Governor proposes for future HHAP funds will exacerbate that challenge. To date, L.A. County has invested its HHAP resources in a manner that balances our local funding realities, the service needs across our geography, and the investments being made by our partners.

The flexibility afforded by HHAP dollars up until now has made this possible. Homekey has also been a really important investment for our county. Through the first two rounds of Homekey, the state has granted the County of Los Angeles and its co-applicants more than $350,000,000 in Homekey funds to support 24 projects.

To take full advantage of the opportunities offered by Homekey, the Board of Supervisors has set aside more than $300 million in federal ARPA and Cares Act funding to provide the county's capital and operating match for all three rounds of Homekey. The county has also benefited from the encampment resolution grants as a part of our implementation of the emergency proclamation in L.A. County. Addressing unsheltered homelessness is a very high priority.

To this end, we have already invested significant resources in encampment resolution and will be further ramping these up using funding from all levels of government. At the state level, the county was awarded $15 million in round one of the encampment resolution grant program and will pursue funds in round two. Both of these grants support work in Skid Row.

At the federal level, our partners at the Los Angeles Homeless Services Authority, or LAHSA, have been awarded $60 million from HUD's Special Unsheltered Homelessness Grant, 20 million per year for three years, and the county will be working closely with LAHSA to prioritize these dollars. And finally, the county is also investing more than $95 million of Measure H local funding to support encampment resolution.

In addition to the funding sources that I've already mentioned, L.A. County has received numerous one-time funding allocations in two separate tranches that must all be expended by June 30, 2025. These include the CalWORKs Housing Support program, housing and disability advocacy services, HDAP, Home Safe, Bringing Families Home, and more.

As other speakers today have mentioned, I want to draw your attention to the challenges with the one-time state funding and our recommendations to address these. The county is very grateful for the state's leadership on the issue of homelessness and its commitment of funds to support critical programs in L.A. County.

All state homelessness funding to date, though, has been one-time, which means that once it is exhausted, L.A. County and other counties throughout the state will need to either backfill the loss or cut housing and supports for the hundreds of clients, thousands of clients, relying on the housing these states state funds temporarily provided. We strongly recommend that the state commit ongoing funding on a scale commensurate with the scope of our statewide homelessness and housing crisis.

Our second challenge, each separate state allocation grant creates its own separate annual contracting process, which reinforces fragmentation and administrative redundancies. For example, procurement, contracting, and data reporting, and prevents our service providers from scaling up service delivery. I think this is something that you've heard today and seen in some of the data that's been presented. We strongly recommend that the state consolidate these separate, siloed state funding streams and streamline the existing restrictions within each.

The state should instead measure local or and regional outcomes across key performance indicators to ensure local areas are leveraging all their funding to achieve those common system-wide outcomes. Thank you so much for having me today and I'm happy to answer your questions.

Thank you. We'll go ahead and open it up for questions. Chair Wicks.

Thank you. I'll be brief. One, agree with your assessment of the need for ongoing funding, and I will continue to beat that drum. And then the other thing is also agree with the need for consolidating to create a single funding source. I know that's critical and that's just good government. So hopefully we can continue to work on that. The question I had, though, was about Homekey.

I think that's been lifted up over the course of today and other reportings around. A successful program really took advantage of a unique moment, put a bunch of money into it, made it easier to build. If we were to infuse more funds into something like Homekey, is there the supply available in your respective counties to actually convert some of those pre-existing buildings into Homekey projects?

I can speak for Sacramento County. So we've had, I don't know the number, but four or five in the city. We're assuming a couple within the unincorporated county this round, and I do hear all the time about continued interest. So I think the short answer is yes.

Yeah, I would agree. Based on the many, many calls I receive each week from property owners, there's still supply. But I just want to highlight that the biggest barrier for us is the lack of operating funding. So we have the funds to continue to invest and to use the state's capital funding. But our housing authority, the Los Angeles County Development Authority, is close to its cap for project-based vouchers. There's essentially no more vouchers left to project base.

So for this next round of Homekey, we will be looking to use tenant-based vouchers, which has some challenges associated with it. So we really need to continue our advocacy to the Federal Government to increase that cap and allow us to project base more vouchers or to look at state sources for ongoing operating funds for permanent supportive housing.

Right. Which is why the ongoing funding is so important for you.

Absolutely.

Yeah. Thank you.

Chair Jackson.

Thank you very much. You know, we hear a lot about the needs to, or even the criticism that local governments need to better utilize their existing resources to address homelessness. Do you have any thoughts about that criticism?

Yeah, I mean, we agree that we need to do a better job utilizing our mainstream systems to try to prevent homelessness and intervene further upstream to prevent folks from flowing into homelessness. So that's a major focus for the County of Los Angeles, really working closely with our county departments to identify the opportunities to intervene earlier, to utilize existing resources that flow into those mainstream departments to quickly prevent homelessness or quickly rehouse folks who are first encountering our systems.

So we have a lot of different funding sources coming into the county that can be used to address homelessness. We are trying to really get a handle on all of those funding sources and to make sure we're fully leveraging them to do our best work.

Using county mainstream sources primarily to prevent homelessness, but also to intervene when folks become homeless and also to relieve some of the pressure on our homeless rehousing system, which is meant to be a system of last resort, an emergency system, but is extremely overburdened and could definitely use some more support from our mainstream services.

I think the only thing I'd add, I'd agree with that, and we are doing our best as well to coordinate with some of our social service agencies. And I think that those are critical funding sources, but they're really tied to very specific eligibility. You have to have a diagnosed mental health disorder, you have to be CPS involved for some of these streams, and certainly, there's a lot of overlap within the homeless system of care of those social conditions, but it's not 100%.

So as with other counties, I'm sure L.A. County is as well. We're committing a significant amount of General Fund, our ARPA Fund. This is the biggest commitment we've made from our ARPA Fund. So I understand the criticism, and I do appreciate the counties' need to do a better job of braiding our funding sources together.

But I think it's just as important that we have participation external from our cities and from the state and from other places, because sometimes we're actually a little bit more limited on how flexible we can be with some of our mainstream funding sources.

And then lastly, what kind of legal or programmatic tools can this Legislature give you local folks to better address your issues?

Well, I do think everybody has said continual, ongoing funding without changing requirements every year, and new competitions and new procurement requirements would be the first and foremost thing. So a continual stream of funding. I also think, and I'm really heartened to hear some of the efforts that Department of Healthcare Services is leaning into to make CalAIM more accessible.

And so any ways we can support that and echo that would be appreciative, because that may be the most appropriate funding source for the types of things that we're all asking to, because virtually everybody who's experiencing homelessness should be eligible for or already enrolled in Medi-Cal. So any ways that we can make CalAIM a little less complicated, a little more accessible to folks who don't live and breathe medical policy and the medical world would be extremely beneficial.

Yeah, I agree. And we hear from our Department of Health Services that CalAIM is the most burdensome funding source that they're currently using. We're very grateful to have it, but to alleviate some of that administrative burden would be really important. Again, emphasizing the ongoing funding as a part of our emergency declaration response, we are looking really closely at ways that the state might be able to streamline housing production.

So that's an analysis that's ongoing, and we will be looking to the state to help us to expedite housing production as we try to really act in an urgent manner.

Thank you very much, Madam Chair.

Thank you. Just one question for me. So we asked our previous panelists, do we have too many agencies working in this space? Do we have too many programs? And I think I heard you say, yes, we do. Can you just speak to some opportunities that you see for us to more effectively kind of rationalize and streamline some of the programs so that we can get as much money into the hands of our locals to do this work as possible?

Yeah, I mean, I think to the extent that funding sources can be consolidated and aligned, we heard from the LAO that they're all on different reporting schedules and they're on different requirements. So all of that would be extremely helpful as we move forward. I had another thought, but it's escaping me, so I'll turn it over to you.

Yeah, I would echo that on the funding, the funding streams making consolidation as much as possible, but I did want to sort of chime in on, do we have too many cooks in the kitchen. And I would say potentially no. I mean, homelessness really, in my opinion, is a demonstration of so many other issues in our upstream services.

And so I think it's really important to have those departmental leads and those agency leads at the table, because at the end of the day, I work in a county where we have, I don't know, 50 Department heads. I can't think of one Department head in my county who doesn't some way or another, touch homelessness. And not because that's what they're designed to do, but that's because that's how broad and at the breadth.

So I think it's important to have those variety of voices to help us whose day-to-day life is to do that, to reflect how this impacts throughout our state and our county.

Yeah, I absolutely agree with that. Everything from parks to library is involved in homelessness. So I think it's the coordination, and I think the state is really making a concerted effort to have that coordination. But we do want to look at it holistically and make sure that we have all the perspectives involved, but just to try not to create more administrative burden in doing so.

Yeah, absolutely. And I think, with that, just thank you so much for being here today and for the work that you do and look forward to continuing to partner with you as we address this crisis together.

Thank you.

With that, I will pass it back to Chair Wicks.

Well, what a day. We are now going to open up for public comment. I'm not sure if folks are going to want a public comment, but please just name organization. One sentence about your desire here on this issue.

Yeah. Good afternoon. My name is Kevin Aslanian. I'm with the Coalition of California Welfare Rights Organizations, and I would just like to. I've been sitting here for 3 hours, so I have three points. One, consolidation. Consolidation only makes sense if it's an entitlement. Most of the programs that you're talking about, they're not entitlements. That's why we have categorical programs, because they're entitlements. I've heard of programs where they say you could stay here for 30 days.

On the 20th day, they just say you have to leave, no due process. So if you want to do consolidation, make sure it's an entitlement. If it's not an entitlement, then consolidation is basically what they call the Paul Ryan Block Grant Program. And then population missing. The population missing in CalWORKs. Is that what happens is they give you 16 days of temporary homeless assistance. If you're homeless after 16 days, you are gone. You are back in the streets. There's nothing you could do.

They don't even make you automatic referred to the housing support program. They do provide you permitted homeless assistance. In homeless assistance, you can only get it once a year. So I had a family that I helped them get homeless assistance. In February, they got a permit in place, and then in July, the landlord kicked them out to get his nephew back in there.

When they went to the welfare office, they say, sorry, you have to wait till next February, and then you could come back and we could give you homeless assistance. And also about the reporting, the data is done on the computer. We don't see them. All the reports should be available to the public. Thank you very much. Sorry.

Thank you.

Hello, my name is Harrison Linder. I'm here from Leading Age California. I'm also speaking on behalf of Justice in Aging and the United Way of Greater Los Angeles, as well as the State Council on Developmental Disabilities. We're urging you all to support Senate Bill 37, which would create a rental assistance program for older adults on the verge of homelessness. Thank you very much.

Thank you.

Good afternoon. My name is Cody Van Felden. I work with John Burton Advocates for Youth as a youth advocate representing homeless youth and foster youth. I experienced firsthand the consequences of not having a response system for youth homelessness when I discovered I was ineligible for general foster youth services. I am in strong support of establishing HHAP as an ongoing program. Thank you.

Thank you.

Good afternoon. Anna Johnson with John Burton Advocates for Youth and my comment is in relation to the Housing Homeless Assistance and Prevention program. This is the only program that every jurisdiction has something in terms of a baseline for youth. With the youth set aside, it's really our only program, and it's had results. So far, we've seen a 21% decrease in youth homelessness in California because every jurisdiction can help homeless youth for the first time ever.

And we want that to be an ongoing, permanent program that our youth can count on and that we can build year over year. Thank you.

Thank you.

Hi, Justin Garrett with the California State Association of Counties, representing all 58 counties in California. Thank you so much for this informative and comprehensive hearing today, in particular last panel where we got to hear the county perspective on what we're doing that's working on homelessness and what else we need. For CSAC, homelessness is the top advocacy priority this year, and we are excited about the tremendous opportunity that we have before us with interest in the Legislature and Administration to create a comprehensive system.

The recent one time investments have allowed counties to innovate and make good progress. However, meaningful progress on homelessness can only be achieved through the development of a comprehensive system with accountability, clear lines of responsibility, and ongoing funding. So much like the multi-committee approach here today, CSAC has engaged in an association-wide effort to really look at the current system, find the gaps, identify what's working, and make some policy recommendations.

So we're developing a comprehensive plan that's going to look at what's needed on housing, on prevention, on the unsheltered response system, workforce, and data systems. So we look forward to partnering with you, with the Administration, with cities and all of their partners this year, developing a comprehensive homelessness response system. Thank you.

Thank you.

Good afternoon, Assembly Members. My name is Louis Mirante. I'm with the Bay Area Council. Here to echo thanks for your focus on this issue and for this hearing today, but also to urge, I think, more action on housing production generally. Something that we've heard today is that it's really hard to staunch the inflow of homeless folks in California, in large part due to the dramatically higher rents that California has as compared to peer states across the country.