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HomeMy WebLinkAboutChapter VI Homeless and SpecialVI. HOMELESS AND SPECIAL NEEDS ASSESSMENT INTRODUCTION This section describes the nature and extent of homelessness, addressing separately the need for facilities and services for homeless persons and families with children (including sub- populations). A. HOMELESS NEEDS 1. Extent of Homelessness The Kern County Homeless Collaborative conducted its first ever censuses of the homeless population with a Point in Time Homeless count on January 30, 2003. The purpose of the study was to count as many unduplicated homeless individuals and families as possible residing in the county at a given point in time. Two methods were employed to count the homeless population, including a shelter survey and street outreach count of persons without shelter. Teams of outreach workers visited more than 400 locations countywide. The total count for unduplicated homeless persons was 1,618, including 1,002 sheltered and 616 unsheltered persons. Although this initial survey did not distinguish between the homeless persons in the county areas and those within the City of Bakersfield, further efforts of this type will attempt to gather this detail data, (CoC 2003). The Kern County Homeless Collaborative conducted a sampling survey of the homeless population on March 26, 2004. The goal of the sampling was to interview at least 10% of the 1,618 homeless individuals identified during the previous January 2003 Homeless Census Count. The new 2004 survey information would 250000 be utilized to identify the needs and percent of the chronic homeless. The 200000 survey team encountered 200 sheltered and non- 150000 2002 sheltered homeless 2003 individuals. Of this figure, 2004* 100000 10 individuals refused to complete the survey, 50000 dropping the count to 180 completed surveys. The 0 data collected reflected the CounselingMealsBedsShowers** characteristics of the CounselingMealsBedsShowers** homeless population 330692131078205744536 2002 residing within the City of 697682267709500961385 2003 Bakersfield, (KCHC survey 7067424779010830073064 2004* 2004). The survey results have helped better identify the chronic homeless and the potential needs of the general homeless population. Of the 2004 surveyed population 69.5% were found in shelters and 30.5% were street interviews. The major racial/ethnic categories were 48.9% White, 20.8% Hispanic and 15.2% Black. Surveyed males represented 73.9% and females 26.1%. The average age of first time homeless was 32 years. The average age of the homeless population surveyed was 42 years. City of Bakersfield Consolidated Plan 2010 VI-1 May 2005 The response for “last time housed” or “not experiencing homelessness” was 47.3% for less than one year, and over 50% indicated being homeless for greater than one year. Of the total individuals experiencing greater than one year of homeless ness compared to the total surveyed population base, 147.7% had been diagnosed within the past 60 days with a mental health problem. In addition, 22.8% had been prescribed medication for an emotional or metal health problem, 8.4% admitted having an alcohol problem and 13.2% admitted to having a substance abuse problem. These figures point to the severity of associated conditions and potential high percentages of chronic homelessness in the City of Bakersfield as well as countywide, (KCHC survey 2004). 2. Subpopulations There is an immediate need to increase shelter space for the general population of homeless as well as for all subgroups. a. Mentally Ill Kern Linkage, a specialized division of the Kern County Department of Mental Health Services, provides outreach, counseling, and other related services to both the sheltered and unsheltered homeless who are severely mentally ill, as well as the severely mentally ill with a dual diagnosis of alcohol/other drug addiction. Kern Linkage receives FEMA funds, County of Kern ESG funds and State HCD Emergency Housing Assistance Program (EHAP) dollars to provide shelter vouchers and places clients in appropriate housing when it is available. b. Victims of Domestic Violence The Alliance Against Family Violence and Sexual Assault (Alliance) has been providing an emergency shelter with capacity of 36 beds for several years. Alliance provides services to both sheltered and unsheltered victims but their primary client base has some form of shelter. Victims of domestic violence and their families receive enhanced case management services as they make the transition from an emergency shelter environment to a stable living and financial situation. In 2003, Alliance staff provided assistance to 3,963 unique domestic violence victims and 628 unique sexual assault victims. According to a September 2002 article by the National Coalition for Homeless, domestic violence is a factor causing homelessness, “nationally,” approximately, half of all women and children experiencing homelessness are fleeing domestic violence, (Zaza, 1991, National Coalition Against Domestic Violence, 2001). c. Alcohol and/or Drug Abuse Alcohol/other drug addicted homeless often find shelter at the Bakersfield Rescue Mission or the Bakersfield Homeless Center. Although some counseling services are available on site there is currently no facility designed to meet the specific needs of substance-abusive clients. A detoxification center and establishment of a sober living facility have been identified as immediate needs for this particular subpopulation. The chart below identifies the growth in major sources at the Bakersfield Rescue Mission. These numbers point to the need for a modern all-encompassing homeless shelter with detox center. d. HIV/AIDS and Related Diseases The Kern County AIDS Consortium has identified supportive housing and emergency special service facilities for persons with HIV and AIDS related diseases as primary needs in this community. The Green Gardens, a Shelter Plus Care project which City of Bakersfield Consolidated Plan 2010 VI-2 May 2005 includes 10 SRO units for homeless persons with AIDS and related diseases, was completed in May of 1999. e. Veterans The Kern County Veterans Service Department Veteran’s Assistance Foundation and the Veterans Administration sponsors a 4-day event which provides veterans throughout the county with access to services offering medical and dental care, assistance with benefit applications, housing, admission to addiction treatment programs and job training. Attendance ranges from 180-200 veterans. f. Family Homelessness Family Homelessness seen as a growing trend: The Bakersfield Homeless Center (BHC) is a full service homeless program operating 24-hours a day, year round that offers emergency shelter, food, and other basic necessities in conjunction with a comprehensive supportive services program. It is the only shelter in Bakersfield and Kern County that provides services to homeless families. Family homelessness is continuing to increase. In the last fiscal year, BHC provided services to more than 1,200 families with 2,600 children, an increase of 73% more families than the year before. In 2003, BHC provided more than 45,000 bed nights of shelter and 187,000 hot meals to homeless families and individuals. Their rise in numbers is documented in the chart below. Type Assistance1999/00 2000/01 2001/022002/032003/04 # Meals Served 86,450 117,095 164,950 166,071 187,090 # Person Days of Shelter 32,806 42,159 34,350 47,459 45,595* # Persons Receiving Case No data No data 2,338 1,068 1,499 Management # Children in Day Care 217 253 450 816 876 # Persons Receiving Medical/Dental 1,274 1,259 250 937 1,335 Care # Persons Placed in Housing 52 102 450 569 585 # Job Placements 99 118 75 188 483 # Persons Obtaining Public Benefits 212 243 500 310 1,060 These numbers are expected to rise and seem consistent with the trend. The BHC Family Service Center is currently operating at full capacity. BHC, in collaboration with the California State University, Bakersfield, will begin construction of the New Family Learning Center and administration headquarters in the early half of 2005. The new facility will allow BHC to extend more educational opportunities to homeless families. It will feature computer access for students, GED and literacy classes, parenting classes and support groups. g. Others The Kern County Homeless Collaborative has identified the need for an "after care" facility for homeless persons who have been hospitalized and released, but still require a level of rest and medication, meals, etc., that are not a part of the typical services provided at the shelters. If there is no such facility, these "recuperating" homeless often find themselves back in the hospital because of relapses or other complications associated with the environment in which they have attempted to recuperate from their illness and/or injuries. City of Bakersfield Consolidated Plan 2010 VI-3 May 2005 Clinica Sierra Vista (CSV), “Rest and Recovery (R& R)” currently provides services to homeless people who are recovering from an illness, but are not sick enough to remain in a hospital if there is a place for them to go for additional recovery time. This is a HUD funded program. 3. Needs of Persons Threatened with Homelessness A possible measure for gauging the at-risk population is to identify the severely cost- burdened household population and ascertain what percentage of that group lack an adequate family or social support network. Based on the 2000 Census information, approximately 63% of low-income households and 68% of the extremely low-income households had a severely cost-burden on housing. It is difficult to determine who lacks an adequate support network but a conservative estimate of 10% of the severely cost-burdened group could find themselves homeless. Persons with HIV disease are also at risk of becoming homeless. Therefore, it is conceivable that a large number of people may become homeless in the future should their financial situations change. Some of the major reasons leading to homelessness include: substance abuse, domestic violence, eviction, loss or reduction in tenant or owner income, and cuts in public assistance (such as a decrease in TANF – Temporary Assistance to Needy Families and SSI/SSP). In addition, individuals that are released from penal, mental, or substance abuse facilities with no adequate support follow-up may find themselves without immediate housing. 4. Continuum of Care System - Facilities and Services for the Homeless and Persons Threatened with Homelessness a. The Vision The vision of the Continuum of Care community is the development of a comprehensive homeless service system that ensures homeless individuals and families can move from homelessness to self-sufficiency, permanent housing, with or without supportive services. Strategic goals have been developed in order to accomplish that vision. The Continuum of Care has developed a tripartite strategy involving preventing homeless and repeat homelessness through increased access to mainstream resources; developing increased housing resources for chronically homeless people and their families; and proving early, intensive intervention for people who are chronically homeless. This strategy also recognizes the need to coordinate services and facilities available to the homeless. b. Gap Analysis Kern, like other counties across the nation, has been severely challenged to meet the almost overwhelming needs of increased numbers of homeless individuals and families. Although the planning and basic framework for a comprehensive continuum of care is largely in place, many gaps exist in the present countywide service system (see chart below). Continuum of Care Housing Gaps Analysis Chart Current Under Unmet Inventory in Development Need/Gap 2004 in 2004 Individuals Emergency Shelter 330 12 150 Beds Transitional Housing 537 0 150 Permanent Supportive Housing 167 6 250 City of Bakersfield Consolidated Plan 2010 VI-4 May 2005 Total 1,034 18 550 Persons in Families With Children Emergency Shelter 170 40 80 Beds Transitional Housing 230 0 250 Permanent Supportive Housing 50 35 125 Total 450 75 455 Major gaps cited in most studies are: 1) non-medical detox facility; 2) increased shelter space for general homeless population and all subgroups, particularly families (see table below); 3) additional transitional housing programs countywide; 4) additional permanent supportive housing for special subpopulations such as the mentally ill; 5) additional supportive services for both the general homeless population and subgroups; and 6) collaboration with developers and property management companies. Primary supportive service needs include case management, medical and dental care, mental health treatment, substance abuse counseling, budget assistance, vocational counseling, and aftercare. Continuum of Care Homeless Population and Subpopulations Chart Part 1: Homeless Population Sheltered Unsheltered Total Emergency Transitional 1. Homeless Individuals 347(N) 342(N) 536(N) 1,225(N) 2. Homeless Families with Children 52(N) 58(N) 13(N) 123(N) 2a. Persons in Homeless Families 171(N) 177(N) 80(N) 428(N) with Children Total (lines 1 + 2a) 518(N) 519(N) 616(N) 1,653(N) Part 2: Homeless Subpopulations ShelteredUnshelteredTotal 1. Chronically Homeless 158(S) 123(S) 281(S) Optional for 2. Severely Mentally Ill 86(N) Unsheltered 3. Chronic Substance Abuse 227(N) 4. Veterans 21(N) 5. Persons with HIV/AIDS 11(N) 6. Victims of Domestic Violence 30(N) 7. Youth (Under 18 years of age) 215(N) c. Prevention Strategies People who are chronically homeless are often eligible for public system of care and assistance. These include mental health, public health, welfare, and veteran’s systems, as well as the criminal justice and child protective systems. The Kern County Homeless Collaborative estimates in its 2003 and 2004 Continuum of Care SHP Applications that 66% of the chronically homeless individuals are eligible for mainstream benefits such as Social Security, SSI, Veteran’s benefits or other income and services. Part of the Continuum of Care strategy is to ensure these eligible individuals receive the financial benefits and metal health services for which they qualify. d. Developing Increased Housing Resources Due to the housing shortage in the City of Bakersfield, where only the most qualified rental applicants are accepted, finding housing is problematic for the homeless individual. The City of Bakersfield through the assistance of the homeless service providers has listed its’ specific homeless objectives to combat chronic homelessness, City of Bakersfield Consolidated Plan 2010 VI-5 May 2005 the support and development of emergency transitional and permanent housing (see Table below). The Kern County Homeless Collaborative has developed a two-fold strategy to increase the stock of subsidized and permanent supportive housing and increase access to existing housing. HUD Table 1C Summary of Specific Homeless/Special Needs Objectives (Table 1A/1B Continuation Sheet) Performance Expected Actual Measure Units Units Objective Number/Specific Objectives Homeless Objectives H-1 - Service providers contacting and assessing the Homeless Clients 500 per year needs of homeless individuals and families. 5 year total = 2,500 H-1 - Service providers providing case management Homeless Clients 50 per year to homeless individuals and families. 5 year total = 250 H-2 - Expand existing shelter or development of new Shelter Beds 10 per year shelter space for homeless individuals and families. 5 year total = 50 H-3 - Develop additional transitional housing units to Transitional Units 4 per year benefit homeless individuals and families. 5 year total = 20 H-4 - Assist service providers with the placement of Homeless Client 5 per year homeless individuals and families into permanent 5 year total = 25 housing units. H-4 - Assist with the development of a permanent Permanent Units 1 project housing project to benefit homeless individuals and benefiting 25 clients families. by year 5 H-5 - Assist homeless individuals and families to Supportive 100 per year have access to supportive services, may include the Services 5 year total = 500 expansion of existing service or development of new service. Special Needs Objectives S-1 – Support the development of affordable units for Units 20 per year elderly and frail elderly. 5 year total = 100 S-2 – Support the development of facilities to provide Beds 10 per year housing for the severely mentally ill. 5 year total = 50 S-3 – Support the development of least restrictive Units 10 per year housing for the developmentally disabled. 5 year total = 50 S-4 – Support the development of accessible housing Units 3 per year units for the physically disabled. 5 year total = 15 S-5 – Increase the number of beds available to Beds 4 per year persons with alcohol or other drug addictions. 5 year total = 20 S-6 – Support the development of units for persons Units 8 per year with HIV/AIDS. 5 year total = 40 S-7 – Assistance for affordable housing units for Vouchers 10 per year Single-Head of Household with rent subsidies. 5 year total = 50 S-8 – Support the development of affordable housing Beds 2 per year beds with services for transitional age youth coming 5 year total = 10 out of foster care. Increasing Stock of Subsidized and Permanent Supportive Housing – This strategy includes the Collaborative’s support and promotion of low-cost housing development projects. The Collaborative supports low-cost permanent housing projects through City of Bakersfield Consolidated Plan 2010 VI-6 May 2005 HUD’s Supportive Housing Program. Technical workshops have been held educating developers on funding options for Single Room Occupancy (SRO) and there is continued support for the HACK special needs Section 8 vouchers certificates. Increase Access to Existing Housing – The Kern County Homeless Collaborative has developed a collaborative relationship with property owners and management companies where once a homeless individual has been placed in permanent housing, intensive case management is done in order to ensure the individual has the support necessary to avoid losing their housing. Property owners are more willing to rent to potentially problematic tenants when they know a case manager will assist with possible issues that may arise. e. Early and Intensive Intervention The final component of the overall strategy is an assessment of the discharge plans of local residential facilities and programs to provide technical assistance to help implement or improve discharge plans as needed. Homeless individuals in shelter or transitional housing facilities, as well as medical or penal institutions must be helped to exit homelessness as quickly as possible through a housing first approach and linking them to services. 5. Fundamental Components in the Continuum of Care System The fundamental components in the Continuum of Care System include Prevention, Supportive Services and Outreach/Assessment. a. Prevention Services in Place: Addressing the needs of individuals and families before they become homeless has proven to be an effective strategy in preventing homelessness. Within the City of Bakersfield there exists an array of comprehensive services that provide a safety net for individuals and families. The key strength of the safety net system is easy access (walk-in, knowledge of existing resources, quick response, with complete and sustained assistance in order to remove client experienced barriers). The available services and providers include: Program & Provider Available Service(s) ? Financial Assistance Kern County Department of Human Services General Assistance & Temporary Assistance to Needy Families (TANF) State Economic Development Department Unemployment ben3efits & disability benefits Community Action Partnership of Kern Utility Payment Assistance U.S. Social Security Administration SSI/SSDI Veterans Administration Disability and other benefits State Vocational Rehabilitation Subsistence benefit funds while training Bridge Builders Representative payee services Around the Clock Representative payee services ? Emergency Food Service Kern County Department of Human Services Food Stamps & Food Vouchers Community Action Partnership, Food Bank Food Baskets, Pantry Program (25 sties) Community Action Partnership, Food Bank Food Distribution Program (73 sites) Bakersfield Gleaners Food Baskets Bethany Services Food Baskets HOPE Center Food Baskets City of Bakersfield Consolidated Plan 2010 VI-7 May 2005 Program & Provider Available Service(s) St. Vincent De Paul Food Baskets Numerous Churches (throughout City) Food Baskets Salvation Army (5-9 throughout City) Food Baskets Community Action Partnership, Food Bank Food Baskets & Single Serving Items ? Housing Assistance Bethany Services – Bakersfield Homeless Aftercare program to prevent repeat family Center homelessness Community Action Partnership of Kern Temporary Housing Voucher Community Action Partnership of Kern Rental Voucher Clinica Sierra Vista HOPWA – Vendor Voucher Clinica Sierra Vista Emergency rent and utility assistance to person with HIV/AIDS Griffin’s Gate Casa De Amigos Transitional housing, SLE for Dual Diagnosed Individuals Housing Authority of the County of Kern Section 8 Housing Assistance Kern County Department of Human Services Temporary Housing Voucher Kern County Department of Human Services Shelter Voucher – Homeless Assistance Program Kern County Mental Health – Rural HOMES Provides housing placement and support in rural areas to prevent repeat homelessness. Kern County Mental Health – Kern Linkage Temporary Housing Voucher for some individuals pending an assessment for services Kern River Valley Family Resource Center EFSP rent vouchers Independent Living Center Emergency Voucher Salvation Army EFSP Vendor Boucher, rent and utility assistance St. Vincent DePaul Rent assistance based on available funds. ? Crisis Prevention Assistance Alliance Against Family Violence Crisis hotline (including 800 toll free number) for domestic violence and sexual assault victims. Provides callers with immediate peer counseling, advocacy and referrals. Community Action Partnership of Kern HELPLine Information and Referral Specialists respond to calls for all types of assistance. Callers are referred to specific service agencies. City 911 911 operators respond to emergency calls for assistance. Emergency services are immediately dispatched. Kern County Mental Health 24-hour 800-Crisis Line. Hotline workers respond to crisis calls from clients, caregivers family and/or significant others, providing guidance to resolve problems and may intervene at safe community sites on a limited basis. 23-hour walk-in Crisis Solution Unit (CSU), including observation, assessment, and counseling. Independent Living Center Responds to crisis calls from consumers, hospital and nursing home discharge planners; provides referrals and assistance locating permanent housing and implementing IHSS or other in-home care providers. City of Bakersfield Consolidated Plan 2010 VI-8 May 2005 Program & Provider Available Service(s) Kern Medical Center Crisis Case Management Outreach (CCMO) Emergency Room (ER) b. Supportive Services : Services in Place Supportive services offered in the Continuum of Care system provide needed assistance to individuals and families as they seek to obtain self-sufficiency and maintain their own individual independence. The key services are case management, social services, resource and referral, and direct treatment services. The Kern County system of care involves many different programs offering supportive services. The client foundation that integrates service is case management. Case management is designed to help the client negotiate through the often times confusing array of services to identify, access and enroll in the specific services needed to realize client goals. The obtained services help individuals to build self-reliance. Case management provides client stability through an individualized plan that generally identifies mutually agreed upon goals and specific action steps needed to reach their goals. Clients are required to take action. Case management services are found through out the established system of care. The Alliance Against Family Violence and Sexual Assault (Alliance) provides case management services to women involved in or escaping domestic violence situations. They also provide services to sexual assault survivors. The Alliance services include battered women’s shelter and a toll-free countywide hotline that operates 24 hours per day. Women experiencing domestic violence or sexual assault may call anytime and speak to a trained crisis intervention specialist about their issues. This hotline often receives calls from women who have become homeless because of their attempt to escape an abuser. Women and their children are accommodated at the battered women’s shelter or other emergency shelter providers through partnerships between the Alliance and other providers such as Bethany Services - Bakersfield Homeless Center. Once women have been referred to the Alliance by another provider or make contact via the hotline, they become eligible for a range of services, including counseling for victims and children, case management and legal advocacy. Such advocacy assists women in securing restraining orders against abusers as well as educational services on other options. Case management services include assistance with job and housing placement, securing TANF, GA, MediCal, Social Security, SSI, or other benefits, childcare, transportation, and many other services. Throughout Kern County, case management and advocacy programs comprise a range of models. They include: casual linkage, shelter and residential based, intensive program based, and housing first models. These various programs provide individualized assessment, service planning, crisis intervention, long-term follow-up, and rigorous individual and systems advocacy for homeless people in Kern County. Case management and advocacy programs are provided by Bakersfield Homeless Center, Bakersfield Rescue Mission, Kern Regional Center, Kern County Mental Health, Alliance Against Family Violence and Sexual Assault, Clinica Sierra Vista Respite Care Program, Community Action Partnership of Kern, DHS-Child Protective Services, Greater Bakersfield Legal Assistance, Independent Living Center of Kern County, Aging and Adult Services, and a comprehensive network of more than 20 geographically based neighborhood partnerships. City of Bakersfield Consolidated Plan 2010 VI-9 May 2005 Outreach, case management, and advocacy programs provide the traditional, direct, and individualized link to mainstream supports and resources as well as targeted homeless programs. Countywide staff from these programs does the footwork of bringing homeless individuals into “the system” and ensuring that they succeed in receiving any and all benefits for which they are entitled. They also provide individually tailored service planning and goals development for homeless individuals and families to determine what led to their current homeless status and which supports are necessary to decrease the likelihood that they will find themselves homeless again in the future. Kern County has a highly developed system of both formal and informal networking and collaboration among these programs and direct service staff. Staff members from programs across the county regularly convene meetings to problem solve difficult cases. These are usually cases where homeless people would simply “fall through the cracks” of a traditional provider system. Program & ProviderAvailable Service(s) Alcohol and drug abuse treatment • AA/NA Substance abuse treatment. Bakersfield Rescue Mission Men/Women’s 12-month substance abuse program. Citizens for Betterment of Community & Country Men/Women’s substance abuse recovery Community Service Organizations Casa De Amigos Substance abuse residential treatment Ebony Counseling Outpatient drug abuse counseling Griffin's Gate Transitional Housing, SLE for Dual Dx Individuals Kern County Mental Health Dual Diagnosis Integrated mental health/substance abuse Program services for dually diagnosed homeless persons including medication therapy, counseling, case management and contract detox, residential treatment and recovery services. Provides screening and referral to substance abuse treatment providers, and community resources. Kern County Mental Health Behavioral Health Provides 90-day substance abuse recovery ServicesPsychiatric Alternative Response treatment for mentally ill persons and paroles. (PAR Kennemer) Restoration Village - Hannah’s House Provides 12-step substance abuse program for women with children, relapse prevention, anger management, drug education and counseling. Restoration Village- Fred’s Program Provides 12-step recovery program and housing for men. Teen Challenge Substance abuse treatment for men and women. Tabitha’s House Ministries Substance abuse treatment for women. Mental Health Treatment • Alliance Against Family Violence Domestic Violence and sexual assault counseling for women and their children. Citizens for Betterment of Community & Country Women’s substance abuse counseling. Restoration Village - Hannah’s House Provides individual and group counseling for substance abuse. Kern County Mental Health Department Crisis Mental Health Services Kern County Mental Health - Kern Linkage Homeless, AB 3024, and Dual Diagnosis Program programs; multi-disciplinary treatment teams City of Bakersfield Consolidated Plan 2010 VI-10 May 2005 Program & ProviderAvailable Service(s) offering assessment, medication therapy, group and individual counseling, case management, contract temporary housing and residential treatment, life skills training and supportive housing services to homeless mental health consumers and their families Kern County Mental Health System of Care Outpatient mental health clinics in all 11 geographic regions of the county, offering full array of mental health treatment and case management services to severely mentally ill adults and emotionally disturbed children and their families. KCAN (Kern Consumer Action Network) Consumer peer support, mentoring, recreational and social activities Case Management • Alliance Against Family Violence Serves victims of domestic violence and sexual assault. Bakersfield Rescue Mission Homeless Serving individuals and families with Intervention Center referrals and social services. Community Action Partnership of Kern Variety of services including referrals and advocacy. Bethany Services – Bakersfield Homeless One-stop shop providing emergency services Center (food clothing, jobs, mail and phone service). Family Services component Provides daycare, and linkage to housing, employment, dental care, medical treatment and advocacy. Clinica Sierra Vista Referrals to food, shelter, benefits. Community Connections Resource and referral for families. NEEDS Center Resource and referral services, 24-hour helpline. Kern County Mental Health Provides information & referral through the HELP+ Team and direct services to homeless and at-risk homeless. The MET Team is a c risis team that responds to individuals who are suicidal, homicidal, gravely disabled, actively psychotic, or simply in danger. Administers medications. Kern County Mental Health - Kern Linkage Homeless treatment teams provide intensive Program case management including benefits assistance, housing placement and linkage with supportive services. Kern County Mental Health Benefits Acquisition Trains other mental health case managers Team (BAT) across the county about various benefit systems, including eligibility and application processes. Will offer this service to CoC case managers in this coming year. Network for Children, Family Resource Centers Assessment, referral and linkage. Independent Living Center Comprehensive assessment and case management for disabled homeless persons. Kern County Office on Aging Adult Protective Services and case management for frail and low-income elderly. Maintains a list of In-Home Support Service workers to assist individuals in their home. City of Bakersfield Consolidated Plan 2010 VI-11 May 2005 Program & ProviderAvailable Service(s) Salvation Army Provides information & referral, food and clothing, some transportation vouchers, residential recovery treatment assistance, and other services to those in need including children, youth and women. AIDS Related Treatment • Bakersfield AIDS Project Advocacy, outreach, linkage, basic necessities, support for families. Clinica Sierra Vista HIV/AIDS - Client advocacy - Kern Lifeline Project Independent Living Center HIV/AIDS - Client assistance and advocacy. Kern County Health Department HIV testing, treatment and linkage to services. Kern County Mental Health HIV Program for mental health consumers. Kern Medical Center HIV/AIDS treatment services. Education • Alliance Against Family Violence and Sexual Provides career /education assistance for Assault victims of domestic violence. Bakersfield Adult School Provides basic education programs, GED, ESL and vocational programs. Career Services Center/Employers’ Training Provides career counseling, training and Resource educational assistance throughout Kern County. Kern Literacy Project Provides literacy for adults. State Vocational Rehabilitation Educational vocation services. Employment Assistance • Bakersfield Rescue Mission Job counseling and referral service. Career Services Center/Employers’ Training Provides employment and job counseling Resource education assistance throughout Kern County. Independent Living Center Paid Mentoring Services. Kern County Department of Human Services Welfare to Work program. Kern County Mental Health All Aboard/On Track Provides vocational counseling, job preparation and placement, and job coaching for mental health consumers. Kern County Mental Health AB 2034 Program Job preparation, placement and coaching for . homeless mental health consumers Proteus Inc. Provides employment and job counseling education assistance. Farmworker program. Life Skills • Community Support Options (CSO) Assists persons with developmental disabilities on how to live independently. Hope with Helping Hands Basic life skills for homeless adults. Independent Living Center of Kern County Provides peer support, independent living skills training, housing search assistance, benefits assistance, referrals to permanent housing, advocacy, home accessibility information, mobility training, food and bus vouchers. Kern County Mental Health Life skills curriculum for homeless mental health consumers, including budgeting, shopping, domestic skills, self-care, medications, symptom monitoring, interpersonal skills. NEEDS Center Home & money management, child care skills, job search, and after care for residents. City of Bakersfield Consolidated Plan 2010 VI-12 May 2005 Program & ProviderAvailable Service(s) Child Care • Bethany Services - Bakersfield Homeless Provides child care to center homeless Center families. Community Connections for Child Care County resource and referral agency for child care assistance. Community Action Partnership of Kern Provides child care services to needy families. Operates migrant child care services, Head Start, State Funded Preschool and General Child Care programs. Transportation • Golden Empire Transit Provider of public transportation for county. Various Homeless Service Providers Provide transportation for client access to Services. (HELP+, Salvation Army, Bakersfield Police Department, St Francis Catholic Church). Community Action Partnership of Kern Provider of public transportation for eligible homeless clients. Health Care Services • Clinica Sierra Vista Mobile services for medical/dental treatment for the homeless.Clinic services for medical, lab, and x-rays at locations throughout Kern. Community Action Partnership of Kern Provides health assessments, primary medical care, including limited prescription medications. Kern Medical Center Serves Medically Indigent Assistance (MIA). Kern County Department of Human Services Provides medical services - MediCal program. Kern County Mental Health Provides medication hotline information after hours assistance to resolve mental health medication issues. National Health Services Provides health care services across Western Kern, including primary medical care and limited prescription medications. Basic Needs Assistance • Bakersfield Rescue Mission Provides meals, clothing, hygiene kits, showers, and lockers for homeless individuals. Bethany Services - Bakersfield Homeless Provides emergency services food, clothing, Center mail & phone message service, and furniture to homeless men, women and children. HOPE Center Food, clothing, hygiene items, furnishings, gas. Saint Vincent De Paul Provides food, clothing, information and referral to community services for needy individuals and families. Valley Catholic Charities Provides a range of food, clothing and mail services to the homeless. Veterans Assistance Foundation, Inc. Provides benefits assistance, counseling and a range of supportive services for veterans. Kern County Veterans Services Department Assists veterans with medical, housing, public benefits and other needs. c. Outreach/Assessment Services in place: People enter the homeless service system through a variety of methods. Street outreach workers and law enforcement representatives identify many of the chronic homeless. Families and others experiencing “episodic” homelessness are often referred through the Department of Human Services, city and county school City of Bakersfield Consolidated Plan 2010 VI-13 May 2005 systems, various neighborhood partnership groups, health care providers and domestic violence providers. Other identification is done through self initiated contact; during 2002 more than 3,000 homeless individuals and families were identified when they called the HelpLine Information & Referral program. These callers were referred to both mainstream resources and traditional homeless providers. A variety of assessment and case management services are provided by the system of care to identify homeless individuals and families needing assistance. Assessment is conducted to determine access to mainstream services such as Medi-Cal and Healthy Families health insurance programs, TANF, Veteran’s Benefits and Health Care, SSI and Social Security, and job training services. Case managers and other homeless service providers assist clients in applying for these benefits whenever they appear to be eligible. In addition, the system of care contains case managers that specialize in working with veterans, people with HIV/AIDS, domestic violence survivors, people with mental illness, and substance abusers. In addition to case management and mainstream services assessment, county service providers continue to maintain an aggressive outreach and assessment service linkage protocol, spearheaded in the outlying county areas by the HELP+ team. The HELP+ Program (funded with SHP and other funds) has outreach workers stationed in outlying areas who continuously and assertively seek out people who appear to be homeless. They approach people and, in the course of conversation, assess their problems and offer referrals to sources of help of any kind. Homeless individuals and families are linked to voucher housing if they are requesting mental health services. Once voucher housing is obtained, County Mental Health Department or other providers evaluate them for services. They are then re-evaluated regularly by HELP+ for ongoing needs as long as their whereabouts remain established. HELP+ provides extensive follow-up, creating a great deal of contact with individuals who are homeless, partner agencies, County departments, local efforts by the Faith Community, Sheriff sub-stations, and by responding to merchants in all of the downtown areas of the County. For example, in the 2003 program year, over 20,000 community and service contacts were made in this manner. They identified 2421 individuals and families needing assistance that fit the Stewart-McKinney definition for “homeless”. This contact and follow-through is the key to giving people the opportunity to take care of some of their problems so they can end their homeless status. In addition, the Independent Living Center of Kern County (ILCKC), funded in part by SHP, provides outreach to individuals with disabilities of all types throughout the county. ILCKC Homeless Specialists provide a unique understanding of the needs of homeless persons with physical, sensory, cognitive, and developmental disabilities as well as those with HIV/AIDS and psychiatric disabilities. These Homeless Specialists operate as outreach workers in Bakersfield and other Kern cities, covering parks, riverbanks, and other areas homeless people frequent. ILCKC offers bilingual English/Spanish speaking Homeless Specialists, and collaborates with all other KCHC partners in linking homeless individuals to both mainstream services and specialized homeless services. ILCKC provides limited shelter vouchers for disabled individuals who need a supported living environment or have other specialized needs due to their disability status. They provide regular workshops to consumers on how to access benefits such as social security, veteran’s benefits, food stamps and City of Bakersfield Consolidated Plan 2010 VI-14 May 2005 others. These workshops include technical assistance in completing benefits applications if necessary. d. Past Accomplishment th The Kern County Homeless Collaborative, Continuum of Care System is in its 8 year and continues to improve in its accomplishments and effectiveness in making a difference in the lives of the homeless population and the community as a whole. Consensus building and a true collaboration of unified stake holders, composed of City and County government agencies, numerous non-profits, private agencies, private businesses, individuals, and consumers of the homeless services have helped shape an effective Continuum of Care system to help in the fight against homelessness. Some major accomplishments of the Collaborative are as follows: Transportation Advocacy: The Collaborative established public meetings with the local Golden Empire Transit (GET), primary public transportation provider, to address transportation issues for creating routes that provide easy access to homeless individuals. GET agreed to become a member of the Collaborative and to work towards bus stops that are safer and closer to homeless individuals. Also, the discussion involved CalTrans and local KernCOG for route locations that require long-term planning. Homeless Court: The emergence of the Homeless Court out of the Veteran’s Stand- down, has evolved into a successful program for resolving many legal issues that create barriers for homeless individuals trying to obtain self-sufficiency. The program has more than doubled in size and frequency. Mainstream Benefits Training: On March 24, 2004, the KCHC held its first annual training for case managers in hopes of helping professionals to assist homeless clients in obtaining benefits. Nearly 50 staff and residents, including homeless individuals and consumers from a total of 19 agencies and community groups received training from California Employment Development Department, Clinica Sierra Vista, Kern County Department of Human Services, Kern County Mental Health System of Care, Social Security Administration, and Greater Bakersfield Legal Assistance. River Sweeps: Collaboration began last year with the Bakersfield Police Department to assist homeless persons during river sweeps. It has been expanded to include coordination with the Kern County Sheriff on sweeps of homeless encampments in unincorporated areas. HELP+ outreach assists homeless persons affected with referrals, transportation and protection of their belongings. Licensed Child Care: Opening of a new Family Services Center at the Bakersfield Homeless Center that provides long awaited licensed quality child care services for homeless center clients. Housing Development Conference: Sponsorship of a daylong housing development conference for increasing affordable housing units in the City of Bakersfield provided engagement between housing stakeholders, such as developers, non-profits, local City and County Community Development staff and housing representatives at the State level to discus potential programs for implementing successful permanent housing projects. City of Bakersfield Consolidated Plan 2010 VI-15 May 2005 HMIS Award: The KCHC was awarded 2003 SHP funds to implement an HMIS system and is on the verge of contracting with a software vendor. So far 14 agencies have agreed to participate, accounting for 75% of all homeless beds in the county. B. POPULATIONS WITH SPECIAL NEEDS Certain segments of the population may have more difficulties in finding decent, affordable housing due to their special needs. In Bakersfield, these "special needs" groups include the elderly and frail elderly, severely mentally ill, disabled persons, female-headed households, large households, persons with AIDS and related diseases, persons with drug and/or alcohol addiction, and transitional age youth. Many of these households have physical and mental impairments that restrict mobility and employment. Per the U.S. Census 2000, it is estimated that about 15,500 households in Bakersfield are in this category. This section discusses the special housing and supportive service needs of these populations. In this section, where affordable housing is mentioned, affordable and accessible housing is implied. 1. Elderly and Frail Elderly The population over 65 years of age has four main concerns: 1) Income: People over 65 are usually retired and living on a fixed income; 2) Health Care: Because the elderly have a higher rate of illness and dependency, health care and supportive housing is important; 3) Transportation: Many seniors use public transit. However, a significant number of seniors have disabilities and require alternatives to public transit; and 4) Housing: Many live alone and rent. These characteristics indicate a need for smaller, lower cost housing units with easy access to transit and health care facilities. The Independent Living Center of Kern County endorses universal design and construction of these smaller units so that as the population ages, the units can be adapted to meet the residents' changing needs, with ease and less expense. According to the 2000 Census, there were an estimated 21,681 elderly persons (65+ years of age) in the City of Bakersfield, representing 8.8% of the total population. Of these, approximately 43%, or 9,415 were considered "frail" elderly persons (persons with one or more limitations to daily activities, defined in Census as persons with work or self- care/mobility limitation.) According to HUD, an estimated 2,156 elderly households in the City were lower income households in need of housing assistance. Assuming the same proportion (43%) of these elderly are frail, it can be estimated that 813 of Bakersfield's low- income elderly households were frail elderly in need of housing assistance. Services and Facilities Available Housing needs of the City's elderly can be addressed through housing programs for assisted senior rental housing, rental subsidies, down payment assistance, and housing rehabilitation assistance. The housing needs of the elderly and persons with disabilities who require supportive services include - in addition to architectural design features that accommodate physical disabilities - access to health care, grocery stores, pharmacies, and a convenient, economical means of transportation. Location, planning and design of these facilities should enhance social communication and independence. Subsidized Housing: Bakersfield currently has seven subsidized elderly housing projects specifically targeted for the elderly: Plaza Towers; Sunny Lane Village; St. John's Manor; Park Place Senior Living; Canyon Hills Senior Housing; Lowell Senior Apartments; and California Avenue Senior Housing Project. Combined, these developments contain 683 housing units for seniors who are capable of living independently. City of Bakersfield Consolidated Plan 2010 VI-16 May 2005 Licensed Residential Care Facilities: According to the California Department of Social Services, there are 46 licensed residential facilities catering to the needs of the elderly in Bakersfield. Combined, these 46 facilities have a capacity of 1,002 beds. Many of these facilities can accommodate non-ambulatory residents. Some of the larger facilities include: Rosewood, 220 beds; Laurel Springs, 150 beds; Redwood Village, 99 beds; The Hallmark , 70 beds; and Hearthstone, 87 beds. Adult Day Care: Another care option for the elderly is the use of adult day care facilities. In the City, there are 9 facilities with a capacity of 724 persons that provide this service. Support Services: In addition, some support is available to persons who live independently. Homemaker and home health care services provide in-home personal and medical services to the elderly. The majority of these services are provided through the private sector. However, the Kern County Department of Human Services does provide limited homemaker services to the elderly and the County Health Department will make some basic medical calls to elderly households. Aging and Adult Services Department: The Aging and Adult Services Department has four divisions: 1) Protective Service; 2) Care Programming; 3) Social Programs; and 4) HSS Public Authority. Protective Services serves individuals at risk physically and/or mentally, who may be vulnerable to abuse. The Care Programming division provides in-home supportive type services, such as light housekeeping, shopping and personal care designed to promote independence by assisting clients to remain in their own homes, and preventing premature or undesired placement in care facilities. The Social Programs division serves as the point of entry to all the services of the agency, assisting seniors in identifying programs and services to meet their specific needs. The HSS Public Authority provides accounting, contract, and computer management support. Service delivery continues from the three separate locations of the agencies involved (e.g. Human Services, Mental Health and Office on Aging). The table below summarizes the programs currently available through the Aging and Adult Services Department. Kern County Aging and Adult Services Department Program Summary Senior Citizens Information & Referral helps seniors identify programs and services to meet their specific needs. This service is free. Health Insurance Counseling & Advocacy Program provides free assistance with Medicare problems and other health insurance issues for seniors and disabled adults. Senior Nutrition Program provides a nutritious lunch in a group setting at locations throughout Kern County. Home Delivered Meals are available to those with medical conditions that do not allow them to visit a group meal site. Brown Bag Program provides surplus fruits, vegetables and other food products to eligible seniors. Legal Services are available to seniors, providing free civil and legal counseling and guidance. Special Circumstance Program provides housing repairs, replacement of essential household furnishings and supplies to elderly and disabled person who are in urgent need. Multi-purpose Senior Services Program offers eligible, frail elderly Medi-Cal recipients necessary services so they can remain at home. Adult Protective Services responds 24 hours a day to reports of suspected abuse, such as financial, physical, abandonment, isolation, neglect, and self-neglect of seniors and disabled individuals. Emergency services provided include emergency shelter, in-home care, meals and provision of basic necessities. City of Bakersfield Consolidated Plan 2010 VI-17 May 2005 Probate Conservatorship is protective care available to individuals unable to resist undue influences, exploitation, and/or unable to provide for their basic needs. The court appoints the Conservator to act as the representative decision maker for medical, financial, and special needs of clients. LPS (Lanterman Petris Short) Conservatorship is protective care available for individuals determined to be gravely disabled due to a mental illness. The Conservator is court appointed for the person and/or estate for a period of one year to secure mandated mental health treatment and to act as decision maker in matters of medical, financial and special needs. Long Term Care Ombudsman investigates and attempts to resolve complaints made by or on behalf of people living in long term care facilities, such as nursing homes, board and care, assisted living, etc. Senior Outreach Assessment Response provides outreach and assessment services to older adults in their homes to determine competency and to develop a plan for improving quality of life. 2. Severely Mentally Ill HUD's definition of severe mental illness includes the diagnoses of psychoses (e.g. schizophrenia) and the major affective disorders (e.g. bipolar, major depression). Also, the illness must qualify as “chronic” meaning that it has existed for at least one year. According to the 2000 Census, only 6% of County adult public mental health clients (about 1,017 persons) live in institutional, inpatient, intensive care, or supervised settings under the general purvey of the Mental Health System of Care. Of the remaining 94% of clients, most live either independently by themselves, with roommates, or with family, in housing situations similar or identical to those used by other, economically equivalent but non- mentally ill Kern county residents. The mental health housing continuum is a sub-system of the public mental health system of care in the community. Components of the housing continuum for mentally ill persons include both the housing options available to this population and the treatment and supportive services necessary to help them live successfully in community housing. Participants in the continuum include: consumers and their families; mental health and social service providers; licensing and regulatory agencies; housing planners and developers; property owners and managers; and the community at large. Severely mentally ill persons require a broad array of housing options appropriate to their needs, preferences, and capability. The various housing needs for this population may vary from the controlled environments of an institution, hospital or nursing home to less restrictive housing such as rooming houses or supported apartments. Additional options include unassisted community housing or independent housing where clients manage their own lives with family support. Services and Facilities Available: Mentally ill persons requiring institutional and inpatient care, although small in number, represent the greatest treatment or cost burden to the County. In 2000, a total of 530 estimated mentally ill adults, were residing in various institutional facilities, including custody settings, state hospitals, nursing homes and acute care facilities. Custody Facilities: Recent years have seen dramatic increases in the numbers of mentally ill persons involved with the criminal justice system. According to the State Department of Corrections, about 9% of all felons serving time in State prisons have a diagnosis of severe mental disability. In Kern County, the Lerdo Correctional Facility has two 16-bed crisis stabilization units which offer specialized treatment for acutely mentally ill men and women. City of Bakersfield Consolidated Plan 2010 VI-18 May 2005 Mentally ill inmates are kept in protective custody settings rather than being housed with the general inmate population. Housing program gaps for this sub-population, as identified in discussion with mental Health Department forensic and jail services staff, include: acute care space (5 to 10 beds) for male inmates in the Lerdo Facility; 6 to 10-bed custody and/or diversion facility for female inmates or probationers with pre-teen children; and a 6 to 10-bed short-term transitional treatment programs, including locked and unlocked facilities, for inmates who can be released early from serving time in the Lerdo Facility. Licensed Residential Care Facilities and Generic Board and Care Homes: These terms are interchangeable for the same type of facility. Over the past three years the numbers of Kern County mentally ill persons living in licensed residential care facilities has increased significantly. There are now 68 adult board and care homes in Bakersfield targeted to mentally ill (ages 18-59) clients, offering a combined total of approximately 680 beds. Although facilities range in size from a minimum of 2 to more than 79 beds, most are small proprietary homes (6 or fewer beds) operated by their owners; only 9 facilities offered more than 20 beds. Room and Board Facilities more properly known as Room and Board Homes: Residents receive 24-hour room and board services, including three meals a day, but are not supervised, transported, or helped with daily living activities by facility staff. There are 24 licensed room and board facilities located in the City of Bakersfield, offering approximately 100 beds. Supported Apartments: Residents live in adjoining one-bedroom apartments around a common yard and community room, with support services provided off-site by County Mental Health Department case managers: 90 unit Green Gardens (HACK administered rent subsidized, HUD Shelter Plus Care transitional housing program for Kern Linkage homeless clients); 20 unit Joshua Tree Apartments, 24 unit Magnolia Tree Apartments; and 6 unit Anne Sippe Clinic – Garden Work House. The above projects are located in the City of Bakersfield. Ideally, another 300 to 400 such single-room occupancy and 1-bedroom apartments are needed to house mentally ill persons throughout the County. 3. Disabled Persons Physical disabilities can hinder access to housing units of conventional designs, as well as limit the ability to earn adequate income. The proportion of disabled individuals is increasing nationwide due to overall increased longevity and lower fatality rates. In 2000, 5,928 residents had a self-care disability, 8,186 a sensory disability, 12,285 a mental disability, and 17,704 a physical disability. Housing for physically disabled persons must not only be affordable but also contain special construction features to be accessible. The location of housing for disabled persons is also important because many such households need access to a variety of social services, specialized disability services, shopping and public transportation lines. Specifically, the majority of individuals with developmental disabilities need housing that is within walking distance of bus lines. In addition to the housing needs of the physically disabled described above, there should be support services designed to meet individual needs. City of Bakersfield Consolidated Plan 2010 VI-19 May 2005 The State Department of Social Services documents group homes for the disabled in Bakersfield based on State licensing. Each group home on the State's list may indicate a preference for the type of disabled person (developmentally, physically, or mentally) to be served by the facility. As shown in the table below, there are 104 licensed residential care facilities serving children, adults, and seniors. Most of the residential care facilities in Bakersfield are small homes serving six or fewer residents. Licensed Community Care Facilities Type of Facility Description No. Capacity Adult Day Care Provides programs for frail elderly and developmentally disabled and/or mentally 25 1,301 disordered adults in a day care setting. Residential Care/Elderly Care, supervision and assistance with 71 1,512 activities of daily living. Social Rehabilitation Provides non-medical care and supervision in Facility a group setting to adults recovering from 1 15 mental illnesses, which temporarily need assistance, guidance, or counseling. Total 104 2,860 Source: State of California Community Care Licensing Division, 2004 a. Developmentally Disabled The State Department of Developmental Services defines a developmental disability as a severe and chronic disability that is attributable to a mental or physical impairment, th which begins before the 18 birthday, is expected to continue indefinitely and present a substantial disability. The disability must be due to one of the following conditions: Mental Retardation, Cerebral Palsy, Epilepsy, Autism, or a disabling condition closely related to mental retardation or requiring similar treatment. According to the Association for Retarded Persons, the nationally accepted percentage of the population which can be categorized as developmentally disabled is one to three percent. Translating this proportion to the City's January 2004 population, approximately 8,390 persons may be considered developmentally disabled in Bakersfield. According to the Kern Regional Center's Client base, approximately one- third of the developmentally disabled live in a community care facility, one-third live in a health care facility, and one-third live independently. Services and Facilities Available: A progression of residential care is also available for persons who are developmentally disabled. Bakersfield ARC (BARC) has identified 14 levels of housing assistance available to the developmentally disabled. A community care facility (Level 1) will provide the most structured care for the developmentally disabled with full medical care and supervision. Level 2 is a highly structured environment for persons with severe behavior problems that prevent daily living. These persons may transition to Intermediate Care Facility Designated Nursing or Level 3. Level 3 is a health facility that provides on-going nursing; a maximum of six beds are allowed in the facility. Similarly, the next type of facility is a Level 4 which is also a small facility with 15 beds or less. Level 4 provides skilled nursing care and some type of on-site rehabilitation services. The lowest level of intermediate care facilities that may serve 50 or more clients is Level 5. Level 5 provides supportive, medical, and personal care services. Level 6 facilities specifically work to teach the developmentally disabled self help skills and basic training. These persons tend to have serious behavior City of Bakersfield Consolidated Plan 2010 VI-20 May 2005 problems and may be non-ambulatory. Level 7 is limited to those persons without any behavior problems and teaches self help skills. The lowest level of these services is Level 8, which provides only general supervision. The next lower level is Level 9 which provides only limited care to the developmentally disabled. At this point there is an important transition to more independent living environments: living with the family Level 10, persons enrolled in independent living programs is Level 11, living on their own but with supportive services is Level 12, living independently is Level 13, and cooperative home ownership is a Level 14. Licensed Residential Care Facilities: There are licensed community care facilities in Bakersfield with capacity for 71 developmentally disabled young persons age 0 to 17 and 317 developmentally disabled adults. However, no board and care facilities are designed for developmentally disabled persons over the age of 60. Services Gaps: According to BARC, there are several service gaps and problems for the developmentally disabled in Bakersfield. One of the primary concerns is a shortage of "least-restrictive" (affordable and accessible) housing for individuals with development disabilities. Current inventories include facilities in which a total of 388 individuals have little choice and permanency and are limited in quality of life by regulations and policies that govern the operation of residential facilities. The emphasis should be placed on providing individuals with permanency and housing in the least restrictive environment where individuals can exercise choice and develop potentials. Currently, there are two room-and-board homes that the Kern Regional Center utilizes for individuals who do not need restrictive supervision and care. One home has capacity for six individuals and the other accommodates four. Thus, there is a shortage of "least-restrictive" housing for individuals with developmental disabilities. Another problem is the lack of transitional living environments which will teach the disabled basic skills so the person could live independently or transition to a lower level of care. It is estimated that a significant percentage of the developmentally disabled could live independently with the appropriate support services. However, the cost of housing also limits persons from transitioning to the independent living environment. With SSI payments of approximately $700/month and market rent in Bakersfield at $500 to $710 for a one-bedroom apartment, the developmentally disabled may be faced with spending well above 30% of their income on housing needs. b. Physically Disabled Persons with an illness or impairment which impedes their ability to function independently are considered physically disabled. In 2000, approximately 17,704 Bakersfield residents are physically disabled. This group normally receives SSI and other government subsidies and represents 50% of the less than median income. Services and Facilities A vailable: Residential opportunities for the physically disabled consist of five options: rehabilitative hospitals, nursing homes, transitional living facilities, board and care facilities, and independent living with home care services. After release from an acute hospital, such as Kern Medical Center in Bakersfield, physically disabled persons can temporarily stay at a rehabilitative hospital to receive intensive rehabilitative treatment. The average stay at this type of facility is 30 days. Persons may need to transfer to nursing homes for continued care or transfer into a transitional living program. Transitional living programs teach physically disabled persons to live independently. If a City of Bakersfield Consolidated Plan 2010 VI-21 May 2005 lower level of supervision is required, persons may transfer to board and care facilities which provide only general supervision to their clients. Ultimately, a person may be able to live independently with home care services. Home care service is a vital link in helping those who are physically disabled live independently. Housing for the physically disabled may require special design and location features. Special needs of households with wheelchair users or semi-ambulatory individuals for example, may require ramps, grab bars, special bathroom design, wider doorways, and lower cabinets. Housing opportunities for individuals with disabilities can be addressed through the provision of affordable, barrier-free housing. Rehabilitation assistance can be targeted toward disabled renters and homeowners for unit modifications to improve accessibility. Accessible housing can also be provided via senior housing development for disabled persons over the age of 62. 4. Single-Headed Households Single-parent households require special consideration and assistance because of their greater need for day care, health care, and other facilities. Specifically, female-headed households with children tend to have lower incomes, thus limiting housing availability for this group. In 2000, Bakersfield had 25,088 single-headed family households, 12,956 of these were female-headed households, 3,572 were living in poverty, as defined by the Census and in need of housing. Services and Facilities Available Affordability needs of female-headed households can be addressed through rental subsidies and the City's housing development assistance program. Housing opportunities for female- headed households with children can be improved through policies that call for the provision of affordable child care and for the location of family housing sites in close proximity to recreational facilities and public transit. State and Federal Assistance Programs: The state and federally funded Temporary Assistance to Needy Families (TANF) operated by the Kern County Department of Human Services, is the primary source of services and help for low-income single parent households. This assistance may be used for school transportation and child care assistance as well as for job training for any TANF recipient. In addition, the Transitional Child Care program provides monies to families who previously received TANF assistance for continued child care support. Transitional Housing: Golden Empire Gleaners, Inc. manages a transitional housing project of 80 units for mothers and their children. Applicants for the program are selected from the TANF program. All applicants must speak English, earned a high school diploma or GED, and children must be of school age. The units consist of one-, two-, and three- bedroom apartments. In addition to providing housing, mothers are required to attend various workshops on job training and basic life skills. Supportive Services: Community Connection for Child Care provides numerous services and programs for children in Bakersfield. The agency refers parents to licensed day care facilities in the area, and also educates parents on how to choose the right day care program for their family. The agency also facilitates numerous programs for low income families, such as job training and counseling. In addition, Community Connection operates "Kids on City of Bakersfield Consolidated Plan 2010 VI-22 May 2005 the Block" which features puppets that are deaf, blind, etc. and allows children to ask questions about their disability. 5. Large Households Large households are identified as a group with special housing needs based on the limited availability of adequately sized, affordable housing units. Large households are often of lower income, frequently resulting in the overcrowding of smaller dwelling units and in turn, accelerating unit deterioration. The 2000 Census reports 9,751 households with five or more members in Bakersfield, representing 16% of the City's total households. Information further indicates that more than 2,498 large family renters were lower income and in need of housing assistance. This illustrates a need for room additions and larger homes for large family households, particularly for larger renter households. Services and Facilities Available There are no services and facilities available specifically for large households. However, the housing needs of large households can generally be accommodated through Section 8 rental assistance and other housing programs which give priority status to Veterans and displaced families due to government/disaster type of actions. 6. People with HIV Infection and AIDS This special needs group is the most difficult one on which to gather information. Issues, such as reportability and discrimination, limit the information available on the population infected with the HIV virus. In addition, many individuals are unaware that they have contracted the virus. The Kern County Health Department of Public Title II H IV Needs Assessment 2004 reports that there have been a total of 1,370 reported AIDS cases in Kern County and 527 in Bakersfield, since 1986 with 2003 having the highest percentage of diagnosis at 16.7% and 75% of current cases in Bakersfield. For the total number of cases reported, race/ethnicity of persons with AIDS is 18% Caucasian, 5% African American and 29% Hispanic with 4% Asian, Native American, or Other 44%. Nearly all AIDS cases (93%) involve adult patients, age 25 and above. Eighty-nine percent of adult/adolescent AIDS patients are males. Currently, more than 840 persons infected with the AIDS virus live in Kern County. According to the Kern County AIDS Advisory Board, it is estimated that those persons who are living with AIDS about 64% (321) are extremely low-income and 32% (163) are low- income. The majority of those who are sheltered experience a significant cost burden. The Kern County Title II AIDS Advisory Board's Housing Needs Assessment Executive Summary, 2004, revealed that 45% of respondents likely met the federal HUD definition of very-low or low-income households (based upon reported income and family size). The Kern County AIDS Advisory Board (KCAAB) established goals, priorities of needs and delivery of support services for persons with HIV/AIDS infection in Kern County. At this time the AIDS Housing of Washington, a non-profit agency, is conducting a needs assessment for Kern County that would include input from people living with HIV/AIDS through focus groups and surveys. The results of which should provide more in-depth information. City of Bakersfield Consolidated Plan 2010 VI-23 May 2005 Services and Facilities Available Kern Lifeline Project, run by Clinica Sierra Vista is the only comprehensive AIDS/HIV service delivery program in Kern County. The County of Kern Health Department's Home Community Based Care Pilot Project, a medical model case management program, has a maximum caseload of 15. There is a significant deficit of any other fully developed medical or social services. Due to the scarcity of housing options, people with AIDS often leave the area to seek treatment and supportive services. The issue for Kern County is not so much duplicating on- going efforts, but maximizing limited resources available and strengthening referral and service delivery mechanisms. Medical Care:The primary medical provider for persons with HIV infection and AIDS is the Kern Medical Center, providing both out and in-patient care. Despite the level of medical care available at Kern Medical Center, many HIV patients are forced to find additional medical treatment outside of Kern County. The Kern County Health Department (KCHD) provides extensive services to persons who are HIV positive. As a natural clearinghouse of biomedical information for diagnosis and treatment, the Health Department provides referral services to persons with HIV Infection or AIDS. Additional services available in the County include case management and an AIDS/Drug program. Housing Resources: Homeless persons with HIV or AIDS are eligible for residence at Green Gardens, which is designed for homeless persons including those who have physical, mental or developmental disabilities. Persons living with HIV or AIDS whose incomes are low enough to meet HUD guidelines are eligible to apply for public housing or Section 8 rental assistance available to the general community. In addition, there are now approximately 150 vouchers specifically designated for people with disabilities (physical, mental or developmental disabilities; including those disabled by HIV or AIDS). Individuals may apply for Green Gardens or Section 8 for People with Disabilities (“Special Needs”) vouchers by contacting either the Health Department’s Nursing Case Management or Kern Lifeline’s case management staff for more information, application forms, and assistance with the applications process. For those with no other resources, the Kern County AIDS Advisory Board has established the HOPWA Rental Assistance Program which for approximately 5 or 6 qualifying low-income individuals or families. Clinica Sierra Vista operates Sebastian House, an unlicensed group home for up to four persons with HIV or AIDS. Kern County AIDS Advisory Board: The Kern County AIDS Advisory Board was formed in 1997 to advise the County Board of Supervisors and the Kern County Health Officer on local conditions and the outlook for Kern County based on the national and global experiences with AIDS, including existing and desirable programs and services for persons infected with the AIDS or HIV virus. The purposes of the Advisory Board is to advise the Kern County Board of Supervisors and the Kern County Health Officer on local conditions and the outlook for Kern County based on the national and global experiences with AIDS including existing and desirable programs and services affecting the living and working conditions of and the care for persons who are infected with the AIDS Virus in Kern County and on measures taken or desirable for the prevention of and for control of the spread of HIV. City of Bakersfield Consolidated Plan 2010 VI-24 May 2005 In addition, the AIDS Advisory Board must assure that case management is available within its geographic service area, and the Board must work with case management service providers to ensure a coordinated system of care. The AIDS Advisory Board, in its capacity as a consortium pursuant to the Ryan White CARE Act, makes determinations regarding the disbursement of federal monies. The Kern County Public Health Department, as the Fiscal Agent of the AIDS Advisory Board, prepares and monitors the contracts with each of the community-based contractors to ensure compliance with the contract. The Health Department also acts as a service provider, receiving Ryan White monies for case management services. The amount of Ryan White monies allocated to the Health Department is determined and approved by the AIDS Advisory Board. Each year, the AIDS Advisory Board holds public meetings to establish service funding priorities. Although funding priorities are established each year, they have remained fairly stable over the past several years. Additional HIV/AIDS service providers include private organizations such as the Bakersfield AIDS Foundation and Bakersfield AIDS Project. These organizations provide support services and education for people with HIV/AIDS. A limited amount of emergency housing assistance is available. The foundation provides house and yard clean-up and some hot meals to people who are less able to cook for themselves. 7. Alcohol and Drug AbuselAddiction According to the National Institute on Alcohol Abuse and Alcoholism, one-third or more of clients in publicly funded residential programs are homeless most of the year before entry into treatment. Because no information is available about persons in residential programs, one-third was applied to the estimated city-wide population who abuse drugs and alcohol. As a result, approximately 12,766 adults can be estimated to need supportive housing. The continuum of care for persons with substance abuse problems consists of four levels of assistance, including public inebriate reception centers, detoxification recovery facilities, recovery homes, and outpatient support groups. A public inebriate reception center refers to a 24-hour facility, allowing people to get immediate help without being jailed. A detoxification recovery facility allows persons to stay up to 30 days for detoxification help, and recovery homes allow between 30-90 day stays for persons who need extended assistance. All of these efforts are supported through outpatient support groups, such as Alcoholics Anonymous. A primary need in Bakersfield to help substance abusers is a non- medical detox reception center and a model detoxification program. Services and Facilities Available Supportive Services: Numerous agencies in Bakersfield provide services to alcohol and drug abusers. Kern County Department of Mental Health's Substance Abuse Unit is a major provider of drug abuse services. It also administers most public funding for other community drug and alcohol programs. There are a number of unlicensed recovery and sober living homes in the Greater Bakersfield community such as: the Salvation Army, Victory Outreach, Teen Challenge, and Vinesman Ponderosa. The Kern Linkage Program (KLP) provides services to persons who are diagnosed as both mentally ill and substance abusers. City of Bakersfield Consolidated Plan 2010 VI-25 May 2005 According to the Kern Master Plan Needs Assessment, the most important strategies to reduce substance abuse problems in the Bakersfield area are: 1) better alcohol/drug education in schools; 2) stronger community prevention efforts; 3) stronger criminal justice response for DUIs; and 4) alternative recreation programs for youth. 8. Transition – Age Youth According to the State of California Department of Social Services, Community Care Licensing Division, there were 143 licensed community care facilities in the City of Bakersfield. These included 9 Small Family Homes and 19 Group Homes serving persons under age 18. There are 69 Adult Residential facilities providing care for disabled persons age 18 to 59 years and 46 Residential Elderly facilities providing care for persons age 60 and above. Unlike Adult Residential and Residential Elderly facilities which provide care only for persons with disabilities, Small Family Homes and Group Homes may provide care for children who are not disabled but are wards/dependents referred by the Department of Family Services, as well as children referred by the Probation Department. Upon reaching age 18, children who have lived in group homes as wards/dependents are no longer under protective custody of the state and are not eligible to receive SSI and TANF benefits. There are nine Group Homes in Bakersfield for children referred by the Department of Family Services and the Probation Department; total capacity for these facilities is 86 beds. Upon reaching age 18, residents of these facilities may be at risk of homelessness and need housing as well as counseling in life skills and job placement assistance. Table 1B Special Needs (non-Homeless) Populations Priority Need Dollars to Level Unmet SPECIAL NEEDS SUBPOPULATIONS Address Goals High, Medium, Need Unmet Need Low, No Such Need Elderly High 1,010 100 Frail Elderly High 613 15 Severe Mental Illness High 225 50 Developmentally Disabled High 388 50 Physically Disabled High 50 15 Persons w/ Alcohol/Other Drug Addictions High 1,766 20 Persons w/HIV/AIDS High 188 290 Other TOTAL 290 City of Bakersfield Consolidated Plan 2010 VI-26 May 2005