After years of planning, in Fall 2020, Franciscan Workers received funding from the State of California through the Monterey/San Benito Counties Coalition of Homeless Services Providers and the City of Salinas to create a social/medical/mental health team of professionals to bring what chronically unsheltered consumers really nneed: help that comes right to their encampment. This de-institutionalized service model will be another facet to the Dorothy’s Place Streets To Homes program, already recognized for their expertise with chronically unsheltered consumers.
Goal: Creation of a street outreach team to visit Salinas’ encampments with the purpose of gaining trust in chronically unsheltered clients, providing for basic social, medical and behavioral needs, and Hepatitis C testing and treatment, case management and housing navigation with the goal of assisting clients into shelters and housing.
The social component of the team consists of a peer-level community health worker (CHW locates encampments, tracks client locations, conducts CARS (coordinated entry) assessment and HMIS intake, provides for basic needs and transportation), a social worker (works with each client individually to create a personal recovery plan with ten domains of risk and strength that include health, income and housing) and a housing navigator (assists with housing eligibility, accompanies to housing appointments, works with landlords and updates housing availability). Social workers are aided by Housing Authority Homeless Preference Section 8 vouchers through a special Memorandum of Understanding. Dorothy’s Place and Central Coast Center for Independent Living (CCCIL) partner to perform these functions (CCCIL is proposing in a separate application). Food support for clients is performed by Dorothy’s Place.
The health component of the team consists of a paid medical Physician Assistant (P.A.) with strong psychiatric experience assisted by volunteer registered nurse interns from CSUMB’s Public Health Nursing program, a Hepatitis C testing and treatment partnership from Access Support Network (ASN) and Clinica de Salud (CSVS), and a volunteer M.D. that will supervise the P.A. and review/collaborate on medical/mental health case files, with limited capacity to join the team on encampment visits.
Equipment: Team will have a van for transportation, driven by the CHW. Health team will have a basic medical diagnostic set (stethoscope, BP cuff, etc.) CHW, social worker, housing navigator and clinicians will use laptops or tablets with WiFi to record client data (RISE)/patient records (EPIC). CSVS will make their mobile health clinic available for encampment visits as a blood-draw site, with a phlebotomist from ASN, possibly with Hep C testing equipment.
Supplies: team will be supported with office supplies (case note files), medical supplies (first aid, basic antibiotics, antifungal, inhalers), and client incentives (blankets, socks, gift cards, etc.)
Rental subsidy: Housing Authority for the County of Monterey (HACM) is our subsidized housing partner. Both Dorothy’s Place and CCCIL are bound by agreement with HACM and have access to Homeless Set Aside (homeless preference) Housing Choice vouchers (Section 8).
Rental assistance: First/last months’ rent and deposits are proposed in a separate application (CCCIL).
Salinas Police Department HOT officer: Our chronically unsheltered population, especially in urban areas, develops and maintains their own economy and policy structure in order to survive brutal conditions. Although personal income can come from employment, it often comes from submission to gang-operated drug sales and sex work, governed by the harsh and life threatening policy enforcement of organized crime.
Even legitimate employment income and disability income is “taxed” by the street economy through payments for “protection”, and gang enforcers routinely patrol encampment areas. In order for unsheltered people to work toward independent housing, they may need police help to extricate themselves from street life, or at minimum, a conduit of information that will help overcome fear of moving on. The Salinas Police Department Homeless Outreach Team officer (HOT officer) is that conduit of information and a law enforcement advocate for people that wish to move out of crime-involved encampment environments. Discretely, with the aid of the social workers, the HOT officer can provide both motivation and practical help for unsheltered people to seek and cooperate with social and health assistance. Our integrated team will also be available as a resource for the HOT officer when, in the field, the officer finds that they need to connect their unsheltered citizen with needed social and health supports. The team would operate Monday-Friday, with exceptions made for clients that require attention on weekends.
Social component
– 2 Community Health Workers (Dorothy’s Place)
– 2 BA-level social workers (Dorothy’s Place)
– BA-level case manager/disability specialist (CCCIL)
– BA-level housing navigator (CCCIL)
Health component
– Physician Assistant (contracted from Monterey County Health Department)
– Registered nurse interns from a Public Health Nursing program (CSUMB Nursing)
– Phlebotomist from ASN’s Hep C program
– Additional personnel from ASN/CSVS
– M.D. supervision for the P.A. (Dorothy’s Place volunteer)