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02.08.24 Study Session Agenda M ayor Aaron Brockett Council M e mbe rs Taishya Adams Matt Benjamin Lauren Folkerts Tina Marquis Ryan Schuchard Nicole Speer Mark Wallach Tara Winer Council Chambers 1777 Broadway Boulder, CO 80302 February 8, 2024 6:00 PM City M anage r Nuria Rivera-Vandermyde City Attorne y Teresa Taylor Tate City Cle rk Elesha Johnson ST UDY S E S S ION BOULDE R CIT Y COUNCIL Update on Homelessness Strategies 210 minutes (60 presentation, 150 discussion) 4:00 hrs City Council documents, including meeting agendas, study session agendas, meeting action summaries and information packets can be accessed at https://bouldercolorado.gov/city- council/council-documents. (Scroll down to the second brown box and click "I nformation Packet") This meeting can be viewed at www.bouldercolorado.gov/city-council. Meetings are aired live on Municipal Channel 8 and the city's website and are re-cablecast at 6 p.m. Wednesdays and 11 a.m. Fridays in the two weeks following a regular council meeting. Boulder 8 TV (Comcast channels 8 and 880) is now providing closed captioning for all live meetings that are aired on the channels. The closed captioning service operates in the same manner as similar services offered by broadcast channels, allowing viewers to turn the closed captioning on or off with the television remote control. Closed captioning also is available on the live HD stream on Boulder Channel8.com. To activate the captioning service for the live stream, the "C C" button (which is located at the bottom of the video player) will be illuminated and available whenever the channel is providing captioning services. The council chambers is equipped with a T-Coil assisted listening loop and portable assisted listening devices. I ndividuals with hearing or speech loss may contact us using Relay Colorado at 711 or 1- 800-659-3656. Anyone requiring special packet preparation such as Braille, large print, or tape recorded versions Packet Page 1 of 85 may contact the City Clerk's Office at 303-441-4222, 8 a.m. - 5 p.m. Monday through Friday. Please request special packet preparation no later than 48 hours prior to the meeting. I f you need Spanish interpretation or other language-related assistance for this meeting, please call (303) 441-1905 at least three business days prior to the meeting. Si usted necesita interpretacion o cualquier otra ayuda con relacion al idioma para esta junta, por favor comuniquese al (303) 441- 1905 por lo menos 3 negocios dias antes de la junta. Send electronic presentations to email address: CityClerkStaff@bouldercolorado.gov no later than 2 p.m. the day of the meeting. Packet Page 2 of 85 C OVE R SH E E T ME E T I N G D AT E F ebruary 8, 2024 ST U D Y SE SSI ON I T E M Update on Homelessness Strategies P RI MARY STAF F C ON TAC T Vicki Ebner/Operating and Homelessness Strategy Sr Manager AT TAC H ME N T S: Description Study Session Update on Homelessness Strategy Packet Page 3 of 85 STUDY SESSION MEMORANDUM TO: Mayor and Members of City Council FROM: Nuria Rivera-Vandermyde, City Manager Jeff Cahn, Interim Presiding Municipal Judge Teresa Taylor Tate, City Attorney Chris Meschuk, Deputy City Manager Mark Woulf, Assistant City Manager Steve Redfearn, Interim Police Chief Michael Calderazzo, Fire Chief Kurt Firnhaber, Housing and Human Services Director Joe Taddeucci, Utilities Director Ali Rhodes, Parks and Recreation Director Cris Jones, Community Vitality Director Joanna Bloom, Deputy Utilities Director Chris Reynolds, Deputy City Attorney Carl Castillo, Chief Policy Advisor Vicki Ebner, Operations and Homelessness Strategy Senior Manager Megan Newton, Homelessness Policy Advisor Daniel Reinhard, Senior Data Analyst Nicolia Eldred-Skemp, Senior Data Analyst Lynette Badasarian, Homelessness Program Manager DATE: February 8, 2024 SUBJECT: Study Session on Homelessness Strategy EXECUTIVE SUMMARY Annually, the Housing and Human Services (HHS) department updates the council to keep them informed about ongoing activities, trends, and initiatives aimed at addressing homelessness. This update is focused on providing council timely information related to the overall approach to addressing homelessness and related impacts in advance of City Council’s retreat in April. The first issue discussed is the programs and strategies that address homelessness and assist individuals out of homelessness. The second is a cross-agency proposal on an Study Session Update on Homelessness Strategy Page 1 Packet Page 4 of 85 approach referred to as High Utilizers and expanded programs that could address and support this unique set of residents. The third is an update on the cross-departmental work of the Safe Management of Public Spaces team. Council questions and discussion will focus on funding priorities and next steps for this work. Homelessness Programs Update The City of Boulder’s strategy to address homelessness was adopted by council in 2017 and follows national best practices in an effort to end homelessness. Since 2017, heightened collaboration and coordination amongst different stakeholders, aiming to innovate and facilitate successful exits from homelessness, particularly for those deemed challenging to house, is a hallmark of the region approach. The city's engagement in addressing homelessness extends beyond direct service provision; it actively participates in Homeless Solutions for Boulder County (HSBC), a collaborative effort involving the City of Boulder, City of Longmont, Boulder County, and local housing authorities. Additionally, Metro Denver Homeless Initiative (MDHI), the Continuum of Care (CoC) for the Front Range region, is a valuable partner and participates in the executive committee of HSBC and ensures that HSBC works in coordination with regional initiatives. MDHI also provides input on national best practice in this work and funding trends that support this work. Over the past four years, amidst evolving challenges related to the impacts of COVID on the community, Boulder has established numerous new programs and strategies to expand supportive pathways out of homelessness. Staff continuously assess and evaluate programs and services implemented in other communities to inform local initiatives. Several of these new approaches and early data are shared in this memo. Additional discussion points include an overview of recent data, current housing, sheltering, mental/behavioral health, and various programs and services led by the city’s nonprofit partners. There is also an expanded section on efforts related to family homelessness. High Utilizer Program In the fall of 2022, city staff began holding regular meetings with representatives from organizations that provide services to adults experiencing homelessness in Boulder who are the highest utilizers of the criminal justice, human service, and healthcare systems. This staff-initiated effort was in response to increasing concerns over the impacts associated with this population. Specifically, high utilizers place a disproportionate strain on organizational budgets, put themselves in situations which jeopardize their health and wellbeing and create threats to public safety. This interagency collaboration later formally transitioned to the Interagency Taskforce on Boulder’s Unhoused High Utilizers. The taskforce’s work has resulted in an extensive and unprecedented amount of information sharing allowing for the development of a list of high utilizers and improvements in care coordination and services for individuals who frequently fall through the cracks. The taskforce has identified system gaps and had some success connecting individuals with already existing programming. Study Session Update on Homelessness Strategy Page 2 Packet Page 5 of 85 Last summer, the taskforce developed a framework for a program that could address the impacts of individuals that have the most frequent encounters with the criminal justice system (i.e., police, prosecutors, courts, jails). There is significant overlap between high utilizers of the criminal justice system and other community services such as healthcare and emergency services, and leaders in the healthcare industry are actively involved with the taskforce. Staff hope to use this opportunity to gauge council’s interest in the city continuing to explore the proposed program as well as the city’s role in implementing such a program. Achieving policy direction will be essential given that decisions have not yet been made on how the proposed program would be funded or fully implemented. Should this program move forward, the taskforce will actively pursue funding from a variety of sources including state and federal government, health foundations, philanthropic organizations, and private concerns. Safe and Managed Public Spaces (SAMPS) It is impossible to separate discussions on homelessness from discussions on managing public spaces. Recognizing this connection, it is not the goal of the SAMPS team to solve homelessness nor is SAMPS considered a homelessness strategy. However, it is important to update council and community on the work of managing the city’s public spaces. The Safe and Managed Public Spaces (SAMPS) team was established as a pilot program in 2021 to address barriers to safe and welcoming public spaces. Three key considerations were made to the work: 1. In-source campsite clean-up and utilize a dedicated operational team; 2. Ensure compassionate communication with and outreach to unhoused campers; and, 3. Develop programming to increase visitor and community experience in public spaces. The SAMPS team is comprised of the following work groups: • Operations and Abatement • Urban Park Rangers • Downtown Ambassadors • BTHERE Outreach • Dedicated Boulder Police Support • Data, Analytics, Legal, and Communications Unsanctioned camping in Boulder and other cities is increasing nationwide. SAMPS has made a positive impact on conditions along creek corridors and in other public spaces across the city. There is growing evidence that the 2023 increase in operational team size has led to improvements. Nevertheless, the need for a continuous, coordinated and adaptive response by SAMPS to evolving circumstances persists. There continues to be evidence that, without the work of the SAMPS team, there would be more unsanctioned camping and significantly more trash and debris in the community’s public spaces. Study Session Update on Homelessness Strategy Page 3 Packet Page 6 of 85 Due to timing constraints, staff will not present specifically on the SAMPS work, but are available to answer questions related to this important program. System Gaps and Funding Priorities While Boulder has a robust and holistic response to homelessness, gaps and challenges still exist. Particular gaps exist in addressing high utilizer populations, targeted mental and behavioral health treatment and housing options, and the amount of permanently affordable housing units, particularly for those who have more challenges. As outlined in the 2024 Budget process and discussed at the January 18 council meeting, resources, especially ongoing funding, are extremely limited at the city. It is critically important to prioritize desired outcomes of investments and the supporting programs. As such, staff has developed a succinct set of funding priorities to help guide work plans, policy discussions, outside funding pursuit, and budget planning: 1. Residential and/or voucher-linked mental and behavioral health care expansion with regional partners. 2. Support of programs with expiring temporary funding: a. Winter and family hotel sheltering b. Day Services Center additional services (mental/behavioral health, case management, navigation) c. Respite services d. Older adult rental assistance. 3. Continued creation of additional permanently supportive housing units. 4. Advancement of High Utilizers Program development with regional partners. Questions for Council 1. Do you have questions or feedback on the overall homelessness strategy and/or system gaps as outlined in the memo? 2. After considering the overall approach to homelessness, including High Utilizers, does council have questions or input on the funding priorities to address identified program gaps? 3. Does council have questions or need additional information related to the High Utilizers Program? 4. Does council support the continued efforts to formally develop and seek funding for a High Utilizer program with the city’s regional partners and through philanthropic support? Study Session Update on Homelessness Strategy Page 4 Packet Page 7 of 85 HOMELESSNESS STRATEGY Boulder has felt the impacts of a rise in national homelessness in a post-COVID world; the number of people nationally using shelters and living unsheltered has increased, the degree of vulnerability faced by people living outside is unprecedented, and staffing shortages in mental/behavioral health and social services fields have compounded the challenges the system faces in exiting people from homelessness. While homelessness, in general, is primarily an economic issue – people cannot afford to rent – chronically homeless individuals have additional challenges that impact their ability to weather economic conditions. Chronic Homelessness is defined as a lengthy period of homelessness combined with one or more disabling condition, and the longer time that someone spends living unsheltered, the higher the likelihood is that the person will also suffer from substance use disorder. As a result, a key subset of people that the homelessness response system aims to serve requires creative housing and service provision. To that end, the city and its partners focused its efforts over the past year to implement a tapestry of services such as Building Home (peer support and housing retention services), enhancing a unit acquisition program, strengthening local voucher programs, developing unique services for high utilizers of the criminal justice system, planning for the opening of a Day Services Center, securing funding to add respite services to sheltering, and increasing coordination amongst the various outreach and case management services provided within the city. In addition, HHS was awarded grant funding to add mental and behavioral health services including medically assisted treatment and counseling to the Day Services Center, as well as thirty housing vouchers coupled with intensive tenant supportive services (one case manager to every 15 clients). National Landscape After steady declines from 2010 to 2016, homelessness in America has seen an increase, and Colorado has also seen a significant increase over that time. More individuals are experiencing it in unsheltered settings, such as encampments. In December 2023, HUD released the 2023 Annual Homeless Assessment Report (AHAR), Part 1, which provides estimates of homelessness in the United States. The 2023 report estimates that approximately 653,100 people were experiencing homelessness on a single night in 2023, which was the highest number of people reported by HUD since 2007. The increase was shown across all categories of homelessness, including a 16% increase in families experiencing homelessness. According to the report, unsheltered homelessness increased by 20% (39,598 more people) between 2022 and 2023, and sheltered homelessness rose seven percent. Six of every 10 people experiencing homelessness did so in an urban area (59%), with more than half of all people counted in the Continuums of Care (CoCs) that encompass the nation’s 50 largest cities (53%). The remaining four of every ten people who experienced homelessness were located in largely suburban areas (23%) and largely rural areas (18%). These patterns hold across people experiencing both sheltered and unsheltered homelessness. More than one in five people experiencing homelessness on a single night in 2023 were age 55 or older. More than 98,000 people experiencing homelessness were aged 55 to 64, Study Session Update on Homelessness Strategy Page 5 Packet Page 8 of 85 and almost 39,700 people were over age 64. Nearly half of adults age 55 or older (46%) were experiencing unsheltered homelessness in places not meant for human habitation. Among people experiencing homelessness, 61% were staying in sheltered locations, while 39% were staying in unsheltered locations. About one-third (31%) of all individuals experiencing homelessness reported having experienced chronic patterns of homelessness, or 143,105 people. This is the highest number of individuals experiencing chronic patterns of homelessness counted in the PIT count since these data were first reported in 2007. Two thirds of individuals experiencing chronic patterns of homelessness, or almost 93,000 people, were counted in unsheltered locations. This is also the highest number recorded. Most people experiencing homelessness were individuals, making up 72% of people experiencing homelessness. Local and Regional Picture In Colorado, the trend is similar. According to the National Alliance to End Homelessness, Colorado continues to be one of the higher-growth states for homelessness. While not reaching the level of the west coast or New England, Colorado continues to see growth in both sheltered and unsheltered individuals. The chart below reflects the states with the highest and lowest levels of unsheltered homelessness. Percentages are calculated as the percentage of the state’s number of people experiencing unsheltered homelessness compared to the state’s total number of people experiencing homelessness. For example, California reports a total of 181,399 people experiencing homelessness, 123,423 (68%) of whom were experiencing unsheltered homelessness. For context, Colorado’s percent of unsheltered homelessness is 32.9% (14,439 total; 4,745 unsheltered). Figure 1: States with Highest and Lowest Rates of Unsheltered Homelessness (HUD 2023 AHAR) Colorado has experienced a significant increase in people experiencing homelessness, similar to many western states. The Point in Time (PIT) count completed on a single night in January 2023, showed 14,439 individuals experiencing homelessness in Colorado, with 9,065 people experiencing homelessness in the Front Range. Study Session Update on Homelessness Strategy Page 6 Packet Page 9 of 85 Figure 2: States with the Largest Changes in Homelessness Rates (HUD 2023 AHAR) This correlates with increases in the general migration of people to the Front Range, as people – whether unhoused or not – move to areas that they perceive to have more economic opportunities. The impact of immigration is also felt in both the overall growth of Colorado and in Front Range shelters (migrant inflow impacted the 2023 Point in Time Count for Denver). Figure 3: Immigration as a Component of County Population Growth (Joint Center for Housing Studies Harvard) The 2023 PIT results for Boulder County show a total of 839 people countywide (including sheltered, unsheltered, adults, and families) experiencing homelessness in January. Sheltered homelessness represented 48.6% of the total. Of the 839 people Study Session Update on Homelessness Strategy Page 7 Packet Page 10 of 85 counted, 243 individuals were experiencing unsheltered homelessness, with 142 counted specifically within the city of Boulder. The Summer Point in Time Count – discussed later in this document – provides a summertime snapshot of people living unhoused in Boulder. While there has been an increase in homelessness in the front range, the summer PIT indicated that there was no increase in individuals experiencing homelessness from January to July of 2023. The 2024 Point in Time Count was held on January 23, and results are not available at this time. Unsheltered homelessness in Boulder is fluid; meaning, that while approximately a third of the people living unhoused in Boulder have been in the community for a significant period of time, the majority of people living unhoused are coming to and leaving the community with regularity (as documented through Coordinated entry screening). While the longer-term residents typically have at least one case manager who has been working to end the person’s homelessness, many have recently come to the community. As shown in studies conducted by various entities including the Houston Police Homeless Outreach Team, because it takes about 17 interactions with a person to effectively engage with services, this fluidity of homelessness, particularly unsheltered homelessness, can create challenges for outreach workers and hide what successes the homelessness response team has had in exiting people from homelessness. Nevertheless, the countless examples of people who have lived unsheltered for a significant period finding and keeping stable housing after sustained and persistent outreach make the outreach process a valuable tool in working with the unhoused. ANALYSIS Homelessness Strategy and Local/Regional Collaboration Homelessness Strategy In 2016, members of the community, local nonprofits, the faith community, and staff participated in a consultant-led strategy planning process. From that process, the city’s Homelessness Strategy was adopted by council There are six key components of the Homelessness Strategy, including: • Expanding pathways to permanent housing and retention. • Supporting access to basic services as part of a pathway to self-sufficiency and stability. • Supporting access to public information about homelessness and community solutions. • Expanding access to programs and services to reduce or prevent homelessness. • Supporting an efficient and effective services system based on best practices and data. • Creating welcoming and safe public spaces. The Homelessness Strategy is designed to be a holistic response to Boulder’s unique homelessness issues and challenges, focusing on ending homelessness through supported, permanent, and measurable exits from homelessness. As such, the Homelessness Strategy Study Session Update on Homelessness Strategy Page 8 Packet Page 11 of 85 is aligned with the philosophy of Housing First. Housing First is a national best practice and has been subjected to extensive peer reviewed analysis. The Housing First philosophy centers on providing people with permanent housing quickly and supporting them with services as needed. Housing First recognizes that a person can more successfully address other aspects of their well-being (i.e., employment, health, mental health, education, addiction) once they are stably housed. These programs do not require sobriety or completion of other programs prior to securing housing. Housing First is an over-arching philosophy that guides all programming; it is not a particular program. It is a nationally recognized approach that is has grown in acceptance as, per the National Alliance to End Homelessness notes, “[c]onsumers in a Housing first model access housing faster and are more likely to remain stably housed.” The Housing First philosophy is not “housing only”. Housing focused programming only works with accompanying supportive services before, during and after housing placement. Rather than not addressing a person’s needs who is perhaps not ready or able to access housing, it guides all engagement toward encouragement of actions that would ultimately lead to housing. Under this philosophy, shelters are therefore not seen as solutions to a person’s homelessness but rather tools to provide basic needs and to connect people to services that aim to end someone’s homelessness. Housing First programs share critical elements: • A focus on placing and sustaining people experiencing homelessness in permanent housing as quickly as possible without time limits; • A variety of services delivered following housing to promote housing stability and individual well-being on an as-needed and as-desired basis; and • A standard lease agreement for housing as opposed to mandated therapy or services compliance. An important way in which the goals of the Homelessness Strategy are met is in the provision of critical services that are provided “in the field”, meaning that someone can move directly from unsheltered homelessness to housing without ever opting to use a shelter. These services are designed to encourage people living unhoused toward stable housing, and many of these services meet people where they are and help them with their “pre-housing needs”. Multiple outreach workers, navigators and case managers help ensure that individuals have all their required documentation such as identification, have connections to mental and physical health resources, have access to basic needs (i.e., food, water, clothing) and understand their sheltering options. Attachment A provides a glossary of many of the terms associated with homelessness. Homeless Solutions for Boulder County Homeless Solutions for Boulder County (HSBC) was created in 2017 to provide a regional coordinated approach to addressing the needs of individuals experiencing homelessness. HSBC includes the involvement of multiple government entities including Boulder County and the cities of Boulder and Longmont, public housing authorities, Boulder County Public Health, Metro Denver Homeless Initiatives (MDHI), and nonprofits working to impact homelessness. While the two City Councils and County Study Session Update on Homelessness Strategy Page 9 Packet Page 12 of 85 Commissioners give policy directives, county commissioners appoint the members of the executive board from staff-level leadership of the governmental participants. By having a coordinated regional approach, HSBC is able to utilize data and best practices to leverage resources towards proven strategies that positively impact homelessness outcomes. Guided by the executive board, HSBC addresses issues with the assistance of a number of subcommittees and workgroups. Most notable of these is the Policy Implementation Team, comprised of governmental policy advisors and high-level staff members, who act to implement policy and who coordinate the work of other work groups. Another key work group is the Housing Exits workgroup, which is tasked with developing strategies to increase housing opportunities for people experiencing homelessness. In June of 2023, HSBC brought community providers from across the county together to participate in a listening session regarding system design. Agencies were asked to identify both strengths and gaps in the system as well as identify programming and interventions they would like to see. Feedback from that session will be used by HSBC partners when determining funding priorities and additional programming. These sessions, along with learning sessions, will be held multiple times a year to continue regular system review as well as coordination and collaboration. During its annual retreat, HSBC leadership requested an evaluation of programs, processes, and the system itself. This evaluation was also requested by council during its January 2023 retreat. Boulder County is currently in the process of identifying an evaluator to begin this work in the next month. This evaluation will assess the effectiveness and impact of HSBC’s approaches and evaluate HSBC’s strategy against national best practice. Since implementing this strategy in 2017, this will be the first comprehensive, outside evaluation of this work. Collaborative Funding A key efficiency of a collaborative system such as HSBC is the ability of the system to target and focus funding across organizations. In many cases, county funds are used to fund one aspect of a program and city funds are used for other parts of that program; in other cases, county funds and city funds are used to fund separate programs. An example of combined funding for a program is Coordinated Entry. County funds are used for personnel costs, and city funds are used for direct client assistance and the BTHERE program. An example of targeted funding is that the county funds the rapid rehousing program while the city provides for a locally funded permanent supportive housing (PSH) vouchering and case management program. Examples of the combination or targeting of funding are shown in the discussion of initiatives later in this document. In addition, both the county and city assertively solicit funding from State and Federal resources. For example, the city was able to secure funding for additional mental and behavioral services within the Day Service Center, a Respite Center, PSH vouchers, and additional resources for housing retention. Moreover, funds received by the city from the American Rescue Plan Act of 2021 (ARPA) were used to establish the Building Home program (peer support and a housing retention team) and to support winter shelter expansion needs. In general: Study Session Update on Homelessness Strategy Page 10 Packet Page 13 of 85 Figure 4: Funding by Program Level Continuum of Care, Metro Denver Homeless Initiative, and Built for Zero A Continuum of Care (CoC) is a regional or local planning body that coordinates housing and services funding for families and individuals experiencing homelessness. In 1995, the US Department of Housing and Urban Development (HUD) began to require communities to submit a single application for McKinney-Vento Homeless Assistance Grants in order to streamline the funding application process, encourage coordination of housing and service providers on a local level, and promote the development of Continuums of Care (CoCs). A CoC is intended to provide a more strategic system by providing unhoused individuals with housing and services appropriate to their range of needs. Metro Denver Homeless Initiatives (MDHI) acts as the planning body for the CoC on behalf of the seven-county Front Range region, and Boulder is a member of this CoC. In March 2021, MDHI adopted the Built for Zero methodology as an approach to regional coordination on homelessness. Built for Zero works primarily with CoCs across the nation and uses data to help inform solutions to end homelessness. Boulder County provides a staff member to represent the countywide HSBC collaborative in this work. Through the Built for Zero work, in summer 2022, Boulder County became the first of the nine Metro Denver subregions to complete a quality score card and to achieve quality data for all single adults experiencing homelessness. HSBC is also working towards being a part of the “Last Mile Cohort” for reaching functional zero for veterans experiencing homelessness. Functional Zero is reached for a population when the number of people experiencing homelessness at any time does not exceed the community’s proven record of housing at least that many people in a month. The Last Mile cohort is for teams with strong collaboration, commitment, and will drive reductions toward the functional zero threshold for one population experiencing homelessness. These Study Session Update on Homelessness Strategy Page 11 Packet Page 14 of 85 communities have strong structures in place to support their system in the enhancement of strategy prepared to focus on the Last Mile. Within Last Mile, the work is centered around strengthening structures and processes in place to sustain progress that scales across population focuses, accelerating positive exits, and preventing new experiences of homelessness. This cohort centers system sustainability throughout the work to equip communities to create a system that makes homelessness rare, brief, and non-recurring. Outcomes and System Effectiveness Outcomes vary depending on the type and level of service, but generally all services – from outreach to case management – are geared toward ending a person’s homelessness and maintaining their housing. As Boulder is impacted by state and national homelessness trends, it is difficult to unilaterally establish a performance target such as “reduce homelessness by 20% over the next five years”. As shown in this memo’s discussion of the national landscape, homelessness is growing at unprecedented rates. The HSBC system has an inflow-outflow average of about 29-30% (meaning, about 30% of the total number of people who enter the Boulder homelessness response system exit from homelessness), which is a comparatively good system response, but translates to a situation where significantly more people enter into Boulder homelessness every day. One key outcome that staff monitor is the retention rate of people who are housed by the system. A benchmark target is approximately 75% (meaning, 75 out of 100 people placed in housing have remained stably housed for over a year). The system in Boulder generally achieves this goal, and some programs can have retention rates of 90-95%. Target rates can vary by program, especially when a program is designated to help people who have the most challenges to housing stability. Contracts for specific programs have different outcomes and measures. Output measures can range from the number of unique interactions to the number and type of peer-led programming is offered to clients. Some of the metrics and achievements by partner organizations are discussed by program below. Service Innovations Boulder, either through council directive or through grant funding, has worked to create new and innovative programming. Six new programs have begun over the last eighteen months in the City of Boulder: Building Home Providers have found that many vulnerable individuals who have been experiencing chronic homelessness for several years struggle to maintain their housing. Building Home is a city initiative funded through American Rescue Plan Act of 2021 (ARPA) funds. Building Home is designed to improve housing retention for people within Permanent Supportive Housing (PSH) units, reduce feelings of isolation for people who have been recently housed, and to build community for people who have formerly experienced chronic homelessness. The intention of the program is to match individuals with lived Study Session Update on Homelessness Strategy Page 12 Packet Page 15 of 85 experience in homelessness to people who will soon be housed or have recently been housed through PSH resources. In addition to peer support services and a housing retention team designed to provide multi-disciplinary support to very vulnerable PSH residents, Building Home services will also include daytime programming designed to assist in socialization, housing program navigation, and life skills. Focus ReEntry was awarded the contract for Peer Support and Daytime Programming, and Boulder Shelter for the Homeless (BSH) was awarded the contract for the Housing Retention Team. Both programs started operating in the first quarter of 2023. In 2023, 31 individuals have been served by the Housing Retention Team, and 31 people have received individualized peer support services. Peer support specialists have also led five classes for individuals living in permanent supportive housing in the community and taken multiple trips to explore the local community. Moreover, the Housing Retention Team initiated a community art group specifically for clients residing in Lee Hill. Participants for this program are identified by a collaboration of shelter staff, outreach staff, and housing case managers who recognize individuals requiring extra support to sustain housing. Despite being a recent initiative, the program has demonstrated positive results. Among the clients engaged in the program, 95% have effectively maintained their housing. Boulder Shelter for the Homeless Acquisition Program People experiencing homelessness who have lengthy criminal histories face difficulty in obtaining rental housing. Landlords are often unwilling to lease to people with lengthy backgrounds, and many are not allowed to rent to registered sex offenders. BSH has recently purchased 12 individual units to assist this population. This program removes the barrier of dependency on a landlord system and provides housing options for some of the community’s highest system utilizers. These units are accompanied by case management services. Since the implementation of the program in 2022, thirteen individuals have been housed. All individuals housed through the program had lengthy histories of experiencing homelessness, significant criminal histories, and experienced many barriers to accessing safe and affordable housing. Twelve individuals from the program have retained their housing and are actively pursuing their designated objectives, while unfortunately, one participant passed away while in the program. BSH was also recently successful in an application to the State of Colorado and awarded dedicated housing vouchers to pair with these housing units. Respite Center This year, the city was awarded $2,000,000 in Transformational Homelessness Response Grant (THR) funding through the State of Colorado Division of Housing (DOH) to provide respite care for people experiencing homelessness. This grant was made possible through state ARPA funding, and the award funds the project over the course of two years. Study Session Update on Homelessness Strategy Page 13 Packet Page 16 of 85 Respite care is defined by the grant as short term, recuperative care for people experiencing homelessness who can perform all activities of daily living independently but require assistance with minor procedural care such as wound care and dressing changes or short-term oxygen use following discharge from the hospital. While respite care is not skilled nursing care, contagious disease isolation, physical therapy, or hospice care, it provides a pathway for hospital or clinic discharge with 24/7 support that does not require people to recover on the streets. The specific goals of the Respite Center include: • Reducing morbidity and mortality of unhoused individuals who are discharged from the hospital or a clinic. • Beginning the process of housing placement or long-term care for residents who are transferred to the Respite Center. • Reducing hospital readmission rates, calls to emergency services or law enforcement for non-emergency services, and the strain on the sheltering system with clients whose needs they cannot meet. Housing and Human Services staff are working on implementation of services with Boulder Shelter for the Homeless with a goal to commence these services by Spring of 2024. Tribe Recovery Methamphetamine (meth) addiction has been identified as one of the largest challenges to housing individuals experiencing homelessness. Landlords will not lease to people with histories of or known addictions to meth. There is a high public health risk associated with smoking meth, and the related damage to apartment units is associated with high remediation and rehabilitation costs. A sober living task force was convened and provided recommendations to HSBC in early 2021. This task force was comprised of representatives from justice services, County and local municipalities, service providers, and individuals with lived experience in homelessness and addiction. The task force provided recommendations to the HSBC Board around what would be necessary to include in a project that would address treatment for substance use disorders, primarily methamphetamine addiction, for individuals experiencing homelessness. HSBC designed a program to build capacity for accessible recovery home options to support individuals with substance use disorders who are experiencing homelessness and secured resources to stand up this program. Boulder County was awarded a 3-year contract in the amount of $899,902 through the Bureau of Justice Assistance (BJA) to provide operational support for Project Recovery. Project Recovery began providing outpatient services to individuals at Boulder County’s campus in the 4th quarter of 2022. In October of this year, Tribe Recovery, the organization chosen by Boulder County to provide Project Recovery services, secured a more permanent space in the community to continue to provide these outpatient services. Project Recovery has been providing the following services to individuals in need: Study Session Update on Homelessness Strategy Page 14 Packet Page 17 of 85 • Individual and group therapies in alignment with national standards and best practices • Trauma treatment (more specifically EMDR-Eye Movement Desensitization and Reprocessing, which is a national best practice intervention for trauma) • Medically Assisted Recovery (MAT) services • Sobriety monitoring • Peer navigation • Case management services to ensure a client’s basic needs are met as well as connection to additional resources such as workforce, Alcoholics Anonymous, Narcotics Anonymous, etc. The City of Boulder was the primary funder for the purchase of the first Project Recovery residential recovery home in Boulder, through the Affordable Housing Fund (Boulder County also contributed additional funding for a second home for treatment services). The first Boulder recovery home is currently operating and providing residential services to ten individuals. Boulder Shelter for the Homeless/Boulder Community Health Partnership Boulder Shelter for the Homeless (BSH) and Boulder Community Health (BCH) have created a partnership with the goal of connecting unhoused high utilizers of the hospital’s emergency department with housing and supportive services to reduce the individual’s reliance on emergency services. Individuals are referred from the hospital to the Boulder Shelter for the Homeless (BSH) case manager who immediately begins working with the individual, connecting them to services and assisting with obtaining housing. From July 1, 2022, to June 30, 2023, the BSH case manager engaged with a total of 39 clients. The level of engagement varied from meeting with them once to working with a client all the way to moving them into an apartment. During that period, 12 people were placed into housing, with 3 pending move in. For the 12 individuals who have transitioned into supportive housing, BCH reports that their utilization of BCH emergency department services has decreased by 84%, and BCH reports a 63% reduction to acute care admissions for these individuals. The length of hospitalization stays for those newly housed individuals reduced by 70% as patients were now able to access the level of care needed to safely discharge from the hospital. This program helps demonstrate the improved impact and outcomes of targeted individualized services for high system utilizers and the benefits of coordinated and collaborative partnerships. High Utilizers People who are experiencing unsheltered homelessness are highly correlated with high usage of community services, including emergency room visits, mental health services, interactions with jails and the legal system, and use of Police resources and ambulance services. Boulder initiated a collaborative effort in 2022, leading a multi-organizational Study Session Update on Homelessness Strategy Page 15 Packet Page 18 of 85 team to address homelessness for high utilizers. The primary goals are to share data, coordinate services, and address housing gaps for this population. The Interagency Taskforce has developed a proposal that is focused on connecting high utilizers with non-traditional supportive housing and offering comprehensive services including peer support, case management, and treatment. This proposal marks the initial step in an ongoing process to transition individuals out of homelessness. Further details on high utilizers will be discussed later in the document. Centering Racial Equity MDHI has stated that an end to homelessness in Metro Denver will require the region to continuously analyze the inequities that can be both the cause of someone's homelessness and their barrier to resolving it. One statistically significant disparity that has remained consistent across data sources over time in both the national statistics as well as local data is the overrepresentation of Black, American Indian/Alaska Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI), and multiracial people experiencing homelessness. In an effort to move these community conversations forward, MDHI hired C4 Innovations, a consulting agency dedicated to building racially equitable systems through process improvement, to look deeply at racial inequities in the Metro Denver coordinated entry system. MDHI also formed the Results Academy, a group of community stakeholders including people of color and individuals with lived expertise, to create an action plan for the redesign of coordinated entry. Boulder partners are engaged in this ongoing work. HSBC and HHS staff also analyze the impact of changes to programs on people of color, people with lived experience, and people facing bias due to sexual orientation or gender nonconformity. HHS also uses the Racial Equity Instrument when embarking on new initiatives to ensure that new programming will either remove barriers caused by systemic racism or to not create any unintended barriers. The following information and data were presented in the council update in September 2023 and has not undergone any updates or revisions. Further updates are expected to be available later this year. Study Session Update on Homelessness Strategy Page 16 Packet Page 19 of 85 Figure 5: HSBC CE Screening - Ethnicity at System Entry, People Reporting New to Homelessness Figure 6: CE Screening Data - Gender at System Entry, People Reporting New to Homelessness Study Session Update on Homelessness Strategy Page 17 Packet Page 20 of 85 Figure 7: CE Screening Data - Race at System Entry, People Reporting New to Homelessness Entry Point Services Accessing homeless services in Boulder County is designed to be low barrier and can be accomplished in multiple ways. Using a brief assessment, Coordinated Entry is the initial step in determining individual’s needs and connecting them with appropriate resources including emergency shelters, diversion, and reunification. For individuals who may not be ready or able to access Coordinated Entry, Boulder has expanded resources into the field to meet people where they are at. This has been accomplished through the highly coordinated efforts of programs and services providing both outreach and navigation services. Coordinated Entry Local Coordinated Entry screening (CE) is the front door for sheltering and case management services within Boulder County. CE is a quick screening process that identifies the best match between people and available services. Through CE, people can be referred to case managed programs such as Shelter Services or Diversion and Reunification services. CE screening also refers people to other assistance outside of the HSBC system, if such referral would better meet a person’s needs. This can include youth shelters, domestic violence shelters, or other targeted interventions. The number of individuals being screened through CE increased in 2023. There were 1,169 people screened in 2020, 968 people screened in 2021, 1,108 people screened in 2022, and 1,146 people screened through November of 2023. Study Session Update on Homelessness Strategy Page 18 Packet Page 21 of 85 Figure 8: CE Screenings 2/1/20-11/30/2023 Generally, people who access CE are new to homelessness or to Boulder County. Information gathered by outreach workers shows that approximately 2/3 of people camping in public spaces have been screened through CE. In 2023, 50% of individuals screened through CE report to have been in Boulder County less than 30 days, and a total of 62% of individuals screened through CE have been in the community for less than six months. Figure 9: Countywide CE Screening - Prior Situation for People Reporting to be Newly Homeless Knowing that CE is focused on people newly experiencing homelessness or new to Boulder, it is not surprising that CE data shows a higher level of people reporting shorter lengths of homelessness than was reported in the summer PIT. However, the CE data does provide important information about each person’s situation. The system also sees a Study Session Update on Homelessness Strategy Page 19 Packet Page 22 of 85 large number of people who have been screened through CE in the past but who either stabilize or do not seek any further services. Figure 10: CE Screening Data - Accessing Services Data collected through CE is used to identify gaps in service delivery, evaluate existing programming and make system decisions. While Boulder is one community attempting to resolve a national homelessness crisis, it can be helpful to study where people are from and how long they have been experiencing homelessness. Boulder and HSBC work with other communities within the Greater Denver Continuum of Care to coordinate services. Outreach Coordination Boulder has a highly coordinated and efficient outreach system. Evidence-based best practices show that strong street outreach efforts create a sense of community among people experiencing unsheltered homelessness. It is the sense of community and connection, coupled with coordinated case management services, that helps to successfully house individuals experiencing unsheltered homelessness. Outreach workers can build rapport and provide the bridge to resources with people who might not else have been engaged in services. Agencies and programs in Boulder who are a part of the outreach and navigation system meet weekly to share information, coordinate services, and reduce duplicative efforts. Agencies providing outreach and navigation services to individuals, living in unsheltered situations, work together to make sure the services provided are coordinated and effective. Some of the agencies that regularly participate in this work are Boulder Shelter for the Homeless (BTHERE & BCH high utilizer partnership case manager), Boulder County Criminal Justice Services (Behavioral Health Assistance Program), Clinica (Street Medicine Team), Boulder Police Department (Homeless Outreach Team), Focus Reentry, and Boulder Municipal Court. Study Session Update on Homelessness Strategy Page 20 Packet Page 23 of 85 This group also coordinates regularly with Boulder partners who provide basic needs services such as Deacon’s Closet, Harvest of Hope, and Feet Forward as regular meeting spots and consistent places to connect with individuals. The group has shared that often the individuals they are working with have complicated barriers that include a history of chronic long-term homelessness, substance use, mental and physical health barriers, and trauma that requires coordination and collaboration to effectively end the individual’s episode of homelessness and get them connected to long term supports in the community. It is not uncommon for multiple partners to assist an individual through the housing process and to assist in coordinating appointments for both care and housing. BTHERE Boulder Shelter for the Homeless (BSH), as an expansion to Coordinated Entry, can provide citywide street outreach services through the Boulder BTHERE team. The BTHERE team consists of an outreach supervisor and three team members. It is the BTHERE team’s goal to engage with and build relationships with people experiencing homelessness for future connections to housing and other services. The team visits locations with high incidence of camping in public spaces and provides connections to coordinated intake, Diversion and Reunification services, sheltering, housing resources, medical services, mental health services, and assistance with obtaining necessary ID documentation. Since incorporating BTHERE as part of the enhanced Coordinated Entry program with BSH in April 2022, BTHERE has had 2,732 interactions in the field. These interactions include outcomes of assisting 43 individuals with coordinated entry, 13 in-field diversions from homelessness, 54 medical referrals, 54 housing assessments, 149 enrollments in entitlement benefits, and 14 mental health referrals. By completing housing assessments with individuals living unsheltered, BTHERE is able to add individuals directly to Boulder’s by-name lists to be included in the queue for housing resources. BTHERE is also able to provide continued support to individuals while they navigate their housing process. With the expansion of services into the field, BTHERE has been able to adjust the way individuals interact with the homeless services system. BTHERE is able to provide a continuum of services in the field, while focusing on the overall end goal of permanent housing. Community Court Community Court is a homeless diversion program run by the Boulder Municipal Court and City Attorney’s Office that focuses on crime prevention by addressing the root cause of an individual’s contact with the criminal justice system. Community Court staff have spent the past two and a half years addressing a range of low-level, non-violent municipal offenses associated with homelessness, such as camping, littering or smoking a cigarette where prohibited. Community Court was established through consultation with The Center for Court Innovation and adheres to the American Bar Association’s Best Practices for Homeless Courts. The program's unique strength lies in its participant- centered and trauma-informed approach, meeting individuals where they are and Study Session Update on Homelessness Strategy Page 21 Packet Page 24 of 85 facilitating trust-building interactions. It does this by partnering with both Trinity Lutheran Church and Grace Commons Church to hold weekly outreach sessions of court at Deacon’s Closet, a local faith-based initiative that distributes resources to Boulder’s unhoused community. The program works with unhoused individuals in the City of Boulder, assisting them with obtaining vital documents, benefits and working towards housing. In 2023, in collaboration with Boulder County and other agencies around the city and county, the program assisted 30 individuals into housing. Once housed, individuals’ contact with the criminal justice system and other emergency services is significantly reduced. The reason for this reduction is simple—it is far less likely that an individual will receive a low-level, non-violent charge if they have a stable and healthy living situation. Community Court has been providing services to the neediest and least-engaged people, and as part of their services, have been working with Naropa Community Counseling Center. A Naropa counselor meets with individuals at every Community Court session. The Naropa counselor meets with individuals to address mental health and substance use issues. Community Court has also reestablished the Homeless Advisory Council, consisting of five lived-experience council members who will provide the court with invaluable insight into the challenges faced by the unhoused. The success of Community Court is a testament to the power of effective collaboration. Over 90% of alternative sanctions such as getting a new identification document or attending a housing appointment are successfully completed, which is a much higher completion rate than traditional community service. The program operates in conjunction with multiple city and county agencies as well as nonprofit organizations. The ability to weave together the expertise of these different entities has been crucial to the program's ability to transition individuals from the streets to stable housing. Point in Time Count The Point in Time (PIT) count is an annual, unduplicated count of people experiencing sheltered and unsheltered homelessness on a single night in January. The PIT count is merely a snapshot in time and not recommended by HUD as a year-over-year comparison due to variations in count methodology, count participation, and weather conditions. Last year, the PIT count was performed nationally on or around January 25th, 2023. The breakdown of data provided by Metro Denver Homelessness Initiative (MDHI) for the city of Boulder revealed 142 unsheltered individuals experiencing homelessness. To determine if there is a variation in the number of unsheltered individuals experiencing homelessness within the city of Boulder during the summer months, the City of Boulder HHS, homelessness service providers, and community volunteers came together to conduct a summer PIT Count on the night of July 26th, 2023. The data for the July 26th count revealed 171 unsheltered adults experiencing homelessness. In previous years, staff has observed an increase in the number of unsheltered individuals during warmer months, where due to warmer weather conditions, individuals choose to Study Session Update on Homelessness Strategy Page 22 Packet Page 25 of 85 stay outside of the congregate shelter settings. The summer PIT surprisingly showed no difference in total number of individuals experiencing homelessness in Boulder compared to the previous January count; however, there was an increase of 23 individuals who were found to be unsheltered and an a corresponding decrease in individuals who were staying at shelters. In Boulder between January and July of this year, in the city of Boulder, the overall number of people experiencing homelessness was essentially unchanged. Figure 11: PIT Count Comparison Mental and Behavioral Health Services Increased mental and behavioral health services have been identified as ongoing needs in the Boulder community, and there is often a direct link between homelessness and mental/behavioral health challenges. In fact, CE screening shows that many people experiencing homelessness face multiple health challenges. Figure 12: HSBC CE Screening Data - Types of Disabling Conditions Study Session Update on Homelessness Strategy Page 23 Packet Page 26 of 85 To improve the way the community addresses these needs, Mental Health Partners has received a grant award to acquire and renovate a new commercial building space to consolidate and expand the organization’s acute care services. The current acute care services and programs provided by Mental Health Partners are provided in two locations: • Warner House: which includes Transitional Residential Treatment Substance Use Services (8 beds) and Respite services (8 beds) • Airport Road Walk-In Crisis Center: which includes Walk in crisis, Living Room, Withdrawal Management, Medication Assisted Treatment, Outpatient Services, care coordination. A new psychiatric urgent care clinic is planned to be added to the Louisville location. The new psychiatric urgent care clinic will include case management, therapy, nursing, and medical providers. The new planned space will consolidate the services above into one location. The items that are most often identified in community assessments, including the Behavioral Health Roadmap, as having inadequate levels of service or are gaps in service provision for the unhoused community are listed below: • Intensive Substance Use Disorder (SUD) treatment – this is a longer-term treatment system, often inpatient. • Medication Assisted Treatment (MAT) – this includes substance use disorder treatment such as methadone for opioid addiction, which is administered by a medical professional on a regular basis. • SUD residential – people experiencing homelessness who are exiting detox, treatment, or correctional units (following addiction-related crime sentencing) often require specialized living environments to maintain sobriety and to stabilize for re-entry to mainstream living. • Withdrawal management – this includes short and long-term detox assistance. • Crisis – walk in crisis care for acute treatment. • Living room model – alternative to hospitalization in a calm and safe environment for someone experiencing a mental health crisis • Assessment – used to determine what type of treatment may be needed. • Navigation – model of support for people living with mental illness who present at primary care with unmet non-clinical needs. • Brief outpatient services– treatment services designed to address a wide range of mental health issues. In addition to the expansion of MHP’s services, the Behavioral Health Roadmap has been completed, and Boulder County is determining the resources and program area next steps for implementation. Sheltering Services Emergency sheltering is an integral piece of Boulder’s homeless response system. Emergency Shelters are intended to provide an immediate crisis response for individuals with the goal of quickly connecting them to long term housing resources. Sheltering services are not intended to be permanent solutions to unsheltered homelessness; but, rather, they are the tool through which case managers and service providers can engage with people to find permanent housing and stabilization services. Study Session Update on Homelessness Strategy Page 24 Packet Page 27 of 85 Boulder Shelter for the Homeless Boulder Shelter for the Homeless (BSH) has the capacity to serve 160 individuals nightly. BSH takes a housing focused approach which prioritizes breaking the cycle of homelessness by focusing on any available assistance and intervention that leads to a stable place to live. The shelter provides individuals with meals, case management, counseling services, and medical care. BSH has seen an increase in the number of beds used nightly over the past two years. Traditionally, BSH experiences more turn aways during colder weather, but the rate of turn away was actually higher in the summer months of 2023 than in the last months of the year. During the 2022-2023 winter weather season (October-April), BSH had 39 days of turn aways, equating to 278 individuals being turned away due to capacity during that time. This is a 57% increase in turn aways for capacity from winter 2021-2022 season to winter 2022-2023 season. As there is no identifiable correlation to events such as weather, more analysis over a longer period of time is needed to attempt to identify causes and to determine if this is an isolated increase or a continued trend. Through the current process to update the BSH management plan, a proposal is being put forward to increase the daily bed count from 160 to 180. This change is being proposed with other adjustments to the Management Plan with the addition of day services. Figure 13: BSH Turn Aways Winter Planning The City of Boulder is partnering with BSH in their continued commitment to support the community for the 2023-2024 winter weather season. This season will run from October 1, 2023, through May 31, 2024. The shelter will provide daytime and/or overnight services when the weather meets critical weather criteria. Critical weather criteria are defined as a National Weather Service forecast of: • 10 degrees or below and/or, • 6 inches of snow or more and/or, • 70 mph winds or more Study Session Update on Homelessness Strategy Page 25 Packet Page 28 of 85 When critical weather conditions are expected, the shelter has agreed to increase overnight beds from 160 to 180 and to remove the Coordinated Entry (CE) requirement. When daytime critical weather is expected, the shelter will stay open for clients to shelter inside until the critical weather passes. Over the past few winter seasons, the City of Boulder has worked with Boulder Shelter for the Homeless (BSH) to provide interim sheltering for clients on track for housing in the form of hoteling in Boulder. Due to diminishing hotel resources and increasing cost, BSH and Housing and Human Services staff are currently looking for capacity to continue the program; however, interim sheltering in the form of hoteling is not a long- term, cost-effective solution therefore, other sheltering opportunities should be explored for the winter weather season. This interim and transitional sheltering currently takes the form of 15 hotel rooms with associated case management and supportive services for clients on the housing track. Currently, 17 clients from BSH are staying in the hotel between November 15, 2023, and March 31, 2024. Not only does this prepare people for housing, but it increases space in the BSH facility during the core winter season. Last year, over one-third of the hotel program participants exited directly to housing. To supplement the opening of the winter weather shelter in partnership with the Office of Disaster Management, an additional 21 clients were sheltered in hotels during the severe weather event from January 12th – 15th, 2024. Day Services Center In 2022, Council identified the development of a day services center as a priority. The goal of the Homelessness Day Services Center is to serve as a location for navigation services - a space that creates a welcoming and inclusive environment where individuals experiencing homelessness can come to engage with service providers in a single location. The center will aim to build a sense of healthy community, meet people where they are on their housing journey, replace unproductive habits with productive habits, and provide participants with a path to housing or assistance. In summer of 2023, the owner of the property initially identified to be redeveloped into the permanent Day Services Center with attached permanent supportive housing at 1844 Folsom St. communicated they no longer intended to redevelop the property for that intended use. HHS staff then continued to explore alternative properties for Day Services Center using the identified priority criteria. In December 2023, HHS and Boulder Shelter for the Homeless announced that the Day Services Center would be located at the shelter’s current site in North Boulder. As of the writing of this memo, a Good Neighbor meeting is scheduled for January 31st to discuss updated operations with neighbors of the site. HHS has also been awarded funding from the state of Colorado Department of Local Affairs to support enhanced operations of the Day Services Center. The expanded Study Session Update on Homelessness Strategy Page 26 Packet Page 29 of 85 operations will encompass behavioral health and treatment services, additional supportive services aimed at bolstering housing retention, and the allocation of thirty supportive housing vouchers. Haven Ridge (Mother House/The Lodge) Mother House has relocated both its transitional housing facility and navigation shelter to a new, larger location in South Boulder. As part of the expansion and relocation of services into a shared location, both Mother House and The Lodge programs will operate under one name, Haven Ridge. Mother House at Haven Ridge, a transitional housing facility, will continue to serve pregnant people, single parents, and their children. The program will be providing transitional housing, employment support, connections to childcare and healthcare, parenting classes, case management, housing counseling, and many other services, all with a focus on self-care and healthy families. The Lodge at Haven Ridge, a navigation shelter, will continue providing safe and healthy spaces for adult women and transgender individuals. This program will continue providing employment counseling, housing counseling, hot meals, connections to healthcare providers, and substance recovery support, all from a safe, welcoming, and inclusive environment. The programs settled into the new location over the last quarter of 2023 and are working to increase opportunities for guests - in terms of both numbers of guests and services available to them - in 2024 and 2025. One of the primary goals for services in future is focusing more resources on on-site substance recovery work and on-site holistic counseling and mental health support. TGTHR TGTHR’s Homeless Youth Shelter, the Source, is available for up to 16 young people between the ages of 12-21 to stay nightly. Youth staying at the shelter receive employment assistance, access to education programs, long-term housing navigation, support and inclusivity groups, family coaching services, life-skills development, mental and physical wellness support, and an array of individual and group activities. The goal of the shelter programming is to reduce youth homelessness with a continuum of care that moves youth from the streets or in the shelter towards stable, long-term housing and/or family reunification. TGTHR recently received funding that will be used to renovate the Source’s current space to both improve and expand services. Sanctioned Camping/Safe Outdoor Spaces/Alternative Sheltering Sanctioned camping sites began in communities as an alternative to sheltering for individuals who were unwilling or unable to live in congregate settings. In response to Covid-19 precautions and lack of sufficient shelter space, communities began looking for alternatives to congregate sheltering options, and the number of alternative sheltering Study Session Update on Homelessness Strategy Page 27 Packet Page 30 of 85 interventions began to grow. Communities began standing up alternative sites using varying structures. Hoteling, ice fishing tents, pallet shelters, and tiny homes were the most commonly used to create alternative sheltering sites. Many of these sites have been funded using American Rescue Plan Act (ARPA) funding matched with other government and private funding sources. Housing and Human Services staff have assessed programs in other communities to explore what these programs entail. Further detail about staff analysis, including potential sites, configurations, and cost estimates, can be found within the January 18, 2024 City Council Agenda. Housing The solution to homelessness begins with housing. By connecting people experiencing homelessness to housing and services, they have a platform from which they can address other areas that may have contributed to their homelessness such as employment, health, and substance abuse. Permanent housing with connection to services has been shown to be the most successful intervention for solving homelessness. Housing Exits Between December of 2022 and November of 2023, the system has seen 338 exits out of homelessness into stable housing. Of those who exited the system, 218 people entered into permanent housing, twelve people were reunified with their families or support systems, 104 people were diverted from the homeless system all together, and four people were able to resolve their homelessness in another way. Many of these exits into housing were facilitated by housing vouchers that are provided by multiple funding streams. Boulder Housing Partners and Mental Health Partners (MHP) manage vouchers from HUD, Colorado Department of Housing (DOH), and City of Boulder funded vouchers. These vouchers are then paired with supportive services provided by BSH, TGTHR, and MHP. In an effort to best utilize valuable permanent supportive housing resources, HSBC implemented Move On/Move Up strategies. Move On strategies are a part of HUD’s strategic priority to end homelessness. HUD encourages communities to implement Move On strategies in communities for clients in permanent supportive housing (PSH) who may no longer need or want the intensive services offered in PSH but continue to need financial assistance to maintain their housing. This frees up housing that includes more intensive services for individuals in need who are entering the system. The system continues to benefit from Rapid Re-Housing funding from the state and federal governments. This funding is best utilized for people who have resolvable housing crises rather than for people experiencing chronic homelessness. In some cases, people who have not been able to stabilize under a Rapid Re-Housing program may “move-up” to an Emergency Housing Voucher. Study Session Update on Homelessness Strategy Page 28 Packet Page 31 of 85 In the same time period where there were 338 exits from homelessness into housing (December 2022-November 2023), there were 1,248 individuals screened through Coordinated Entry. The ratio of persons exiting the system compared to individuals entering the system was 27% between December 2022 and November 2023. It is important to note that these are often different individuals, as many people entering the system require more than one month of service to achieve housing. These figures include exits across the county and are not limited to the City of Boulder. Figure 14: Exits from Homelessness by Year Future expansion of units for PSH will primarily come through new development. In early 2024, a new housing development, Bluebird, was completed on 30th street and Mapleton, with 40 apartments and is similar in approach and services to that of Lee Hill. In January, 40 individuals transitioned into these residences, with many coming from shelters, and a notable portion successfully moving directly from unsheltered situations. In mid-2025, a similar development will be completed in Longmont that will include 55 units of PSH. Local Voucher Program In 2018, the City of Boulder began providing funding to Boulder Housing Partners to fund 48 local housing vouchers, with supportive services contracted out to Boulder Shelter for the Homeless. These vouchers serve individuals who have long histories in Boulder and are often not prioritized for other housing programs. The program has served 78 individuals since it began. All 78 individuals served by the program experienced multiple barriers to housing before being matched to the program. Of the 78 individuals served, nine people are survivors of domestic violence, all have at least one disability, 59 people report co-occurring disabilities, and 25 people report three disabilities. Of the 78 individuals served, three (4%) have returned to homelessness. Of the current clients, 100% are enrolled in Medicaid, 100% are enrolled in SNAP benefits, and 65% have income. Study Session Update on Homelessness Strategy Page 29 Packet Page 32 of 85 BSH staff shared the following story of participants in the program. ‘Mandy’ and ‘Sam’ entered the COB voucher program as a couple. They were living under the foothills and goose creek overpass, and both were addicted to heroin/opioids. With the help of their housing case manager, once housed, both entered methadone treatment, started getting mental health and physical health care, and both got jobs. They were eventually able to get their kids back, and in August graduated out of the program with a mainstream housing voucher. Family Homelessness For families struggling to afford rent and other household expenses, and for city staff and organizations serving them, 2024 will continue to pose significant challenges. The challenges include consistently high demand for rental assistance and eviction-related legal services to help prevent homelessness, and high demands for funding and staff support to shelter families already experiencing homelessness. Nationally, the number of families experiencing homelessness is on the rise. The chart below compares sheltered and unsheltered families on the night of the 2023 Point in Time Count. While most families experiencing homelessness are sheltered, the rising number creates a burden on sheltering and prevention intervention options. Figure 15: 2023 Point in Time Count of People in Families with Children Experiencing Homelessness Study Session Update on Homelessness Strategy Page 30 Packet Page 33 of 85 In Colorado, families experiencing homelessness make up a larger percentage of the total number of people experiencing homelessness than in many other states. As evidenced on the local level, more and more families living in the city and within Boulder County are increasingly struggling to make ends meet. The chronic challenges of unaffordability compounded by higher costs of food, utilities, transportation, health care and childcare are putting more families on the edge, experiencing the burden of a widening income gap. The amount of annual income for a three-person household at 30% AMI for a three- person household is $33,870 (at the 2023 rate) yet the Colorado Center for Law and Policy estimates in its Self-Sufficiency Standard report that a single parent with two small children living in Boulder County would need more than $99,000 to be financially self-sufficient. According to the Emergency Family Assistance Association’s 2023 Community Wellbeing dashboard and observations by city HHS staff and other nonprofit agencies, the number of families with low-income is rising; Boulder will see a significant and growing portion of its families with elevated needs for assistance. Figure 16: Family Homelessness by State Compared to Total (2023 Point in Time Count) Not every family experiencing extreme or very low income is at risk of homelessness; however, understanding the gap between actual family incomes and that which is required to obtain financial self-sufficiency can help the city and its regional partners serve families in need. In 2023, the Boulder County Family Resource Network – comprised of county and municipal human services departments, family resource center agencies and other organizations serving low-income families – put in place a rental assistance subcommittee to specifically focus on the skyrocketing demand for rental assistance. No agency, including the city, has been able to fully meet the demands for assistance, with adequate funds. There are many root causes of family homelessness, including changes in family structure, domestic violence and economic hardship, and the high cost of living in Boulder. Exacerbating families' struggle to afford rent and other household basic needs, is the COVID-19 public health emergency unwind that in May 2023 reduced the amount Study Session Update on Homelessness Strategy Page 31 Packet Page 34 of 85 of assistance through the Supplemental Nutrition Assistance Program (SNAP) and Medicaid eligibility. This is an example of increased financial burdens on families which can impact housing insecurity. The effects of homelessness on families, particularly the long-term implications for children, are devastating. Children face frequent instability and dislocation, with lost school days and greater health and behavioral problems due to the physical environment and emotional strain. Hunger, poor nutrition and developmental delays are more prevalent. Periods of homelessness have lasting effects on children, affecting school readiness, school performance, and their long-term ability to break the intergenerational poverty cycle. Boulder County HHS, EFAA Short Term Housing, Safehouse Progressive Alliance for Nonviolence (SPAN) and Safe Shelter of St. Vrain Valley (SAFE) all provide housing support to families experiencing homeless. In 2022, these agencies supported an estimated 200 households experiencing homelessness with temporary shelter, case management, housing navigation and deposit and rent assistance; while city staff have not received 2023 data from these agencies, the numbers will likely have increased. Framework for Collaboration for Family Homelessness Prevention and Services Fortunately, there exists a tight, collaborative network of nonprofit, governmental and school district agencies working collectively to understand, identify, and help address family homelessness in Boulder County. The Boulder County Family Resource Network, a countywide governance structure comprised of 30 nonprofit, school, and government safety net providers, established the Family Homelessness Subcommittee in 2018 as a forum for collaboration and to better integrate the system of services for families at risk of and going through episodes of homelessness. Goals of the Subcommittee include: • Ensuring that no family is living unsheltered; • Identifying and implementing effective prevention methods to help families avoid homelessness; • Shortening episodes of family homelessness by providing resources that enable families to safely reenter permanent housing as quickly as possible; and • Link families to the benefits, supports, and community-based services they need to achieve and maintain housing stability. These agencies provide a wide array of services to families at risk of and experiencing homelessness. Most agencies involved in the subcommittee offer supportive services other than housing services to community members, including systems navigation, food, utility, and rental assistance, as well as other basic needs support in areas like transportation, childcare, and medical assistance. For families that have lost their housing, there is a continuum of services available. Emergency vouchers for hotels/motels may be provided for families to provide immediate safety and shelter for unhoused families. Families also have access to two local domestic violence shelters. Short term and transitional housing, usually combined with case management, children’s programming and other services may also be available to provide temporary housing (between 3 months and 2 years). Study Session Update on Homelessness Strategy Page 32 Packet Page 35 of 85 Members of the Family Homelessness Subcommittee include Boulder County Housing and Human Services, Boulder County Public Health, City of Boulder Housing and Human Services, City of Longmont Human Services, Emergency Family Assistance Association (EFAA), OUR Center, Sister Carmen Community Center, SPAN, Safe Shelter of St. Vrain Valley, and McKinney-Vento Liaisons of Boulder Valley and Saint Vrain Valley school districts. Family homelessness is primarily served through homelessness prevention assistance and through sheltering. While some families need intensive and long-term supportive housing and services that address significant mental and behavioral health, most families require short-term assistance in order to stabilize. The most effective and least disruptive intervention for family homelessness is preventing it from happening in the first place, and substantial resources are dedicated for this purpose. In addition to homelessness or eviction prevention, the City and County invest in funding partnerships with a variety of nonprofit partners who aim to improve the economic mobility of families who are struggling. Emergency and temporary sheltering are critical to keeping families together, reducing impacts on children, keeping families in supportive communities, close to social safety net services. Family sheltering in Boulder County takes the form of either sheltering for victims of domestic violence or non-congregate options (i.e., hotels, single room occupancy). The community made the decision to not create a family shelter to reduce the trauma on children associated with living in a congregate shelter. In 2023, the Family Resource Network created a Rental Assistance subcommittee to focus on the unique, high demands for this service across the county. Members include staff from Boulder County Housing and Human Services, City of Boulder HHS, City of Longmont Human Services, EFAA, the OUR Center and Sister Carmen. The groups maintain a new internal rental assistance dashboard to track how rental assistance funds are being spent and note where the lack of funds or adequate staffing capacity is limiting the system’s ability to respond. Keep Families Housed Funded in part by the city’s Human Services Fund (General Fund) and administered by the Emergency Family Assistance Association (EFAA), Keep Families Housed served 611 Boulder families during the 2023 fiscal year and has already assisted 423 families in the first five months of Fiscal Year 2024. By comparison, EFAA served 330 Boulder families in Fiscal Year 2022. Even with additional funding received by the city, EFAA expects to run out of Keep Families Housed funding before its 2024 fiscal year ends in June 2024. EFAA is currently working to forecast the expected 2024 gap and is in communication with city HHS staff and other partners about the situation. EFAA has significant wait times across its family homelessness services. Currently, there is an approximate two-month wait to get into short-term and transitional housing and a one-to-two month wait time for rental assistance, unless the participant has a 10-day eviction notice. Study Session Update on Homelessness Strategy Page 33 Packet Page 36 of 85 EPRAS The city’s Eviction Prevention Rental Assistance Services program (EPRAS) has directly served 927 clients with rental assistance, legal services or mediation between Feb. 2022 and Aug. 2023. Of those served, 413 shared that they have children in the household; this may be an underreported figure as 386 clients did not provide any information about family composition. EFAA also serves tenants at risk of eviction through funds provided by the city's EPRAS program for tenants at the initial stages of an eviction process but not yet facing eviction court. Family Outreach Coordination The city HHS’ Family Outreach Coordinators continue to assist families experiencing housing insecurity, by helping to pay basic needs expenses and service navigation in coordination with BVSD and nonprofit organizations. During the 2022-23 School Year, the Family Outreach Coordinators have assisted 69 families and distributed more than $30,000 in financial assistance. Staff estimate that all families assisted so far in 2024 are experiencing housing insecurity. Additional HHS Programs and Investments Including affordable housing programs, support for manufactured housing community residents, the Food Tax Rebate, innovative projects like the Elevate Boulder guaranteed income project, grants to nonprofit agencies serving low-income community members (e.g., EFAA, food distribution organizations, health service agencies and other programs providing assistance and free or subsidized services) - are all helping families make ends meet. Preventing families from becoming homeless is time-and-resource-intensive work. When successful, it also prevents further disruption, stress and generational trauma on parents and children. The city and its partners also collaborate to care for families already experiencing homelessness. Education Programs McKinney-Vento Education Program (McKinney-Vento) is a federal program that provides children and youth in households experiencing homelessness (as defined by the Department of Education) with protections and services to ensure they have equal access to a free and appropriate public education. The program aims to remove educational barriers for children and youth experiencing homelessness and also funds supplemental academic support services. The Boulder Valley School District (BVSD) continues to report high levels of housing distress and instability in Boulder. BVSD’s McKinney Vento programming for homeless school children in schools in the city of Boulder shows a 66% increase year after year in the number of children living in homelessness. From July 1 to December 31, 2023, 348 students attending schools in Boulder have qualified for McKinney Vento services compared to 210 for the same time period in the 2022-23 school year. Study Session Update on Homelessness Strategy Page 34 Packet Page 37 of 85 Family Hoteling Family Hoteling is provided through EFAA and the Safehouse Progressive Alliance for Nonviolence (SPAN), supported in part with funding from the city in 2023. Emergency Family Assistance Association (EFAA) has received a small amount increased funding, which has enabled the organization to address the hotel needs of families with children. However, this need continues to grow, and the Family Homelessness Subcommittee of the Family Resource Network has been coordinating to identify and target funding for this need. The table below compares EFAA’s hotel program outputs for the last three years. Figure 17: EFAA Hotel Program Challenges As with all homelessness responses, the response to family homelessness has several challenges. Chief amongst these is that funding is not currently sufficient to meet the demand. The demand for EPRAS assistance is exceeding annual revenues, and funding will not be sufficient if this demand level continues. The unwind of Boulder County’s Emergency Rental Assistance Program (ERAP) means that there is currently far less funding available countywide for rental assistance that can help keep families housed. Unless and until sufficient new sources are identified, this will undoubtedly impact the governmental and nonprofit agencies. The emergency infrastructure set forth with the COVID-19 pandemic has been dismantled, and this will create greater cost burdens on families when it comes to food and health care. This is true for families who are already extremely low-income and for an expanding number of families who are food insecure and may experience a benefit cliff. Agency staff members are struggling to keep up with demands. This is felt through increased requests for assistance and a general higher level of need. This higher level of need translates to a longer amount of staff time necessary to address needs and an increased overwhelming/burnout of staff members. There are limited options within the city and county for rehousing and temporary shelters. Post COVID, hotels are back to low vacancy levels. This, and the overall low number of affordable hotels particularly in Boulder, means that families need to relocate outside of their supportive communities. Follow Up from January 18 Meeting During the City Council meeting on January 18th, Council members raised various questions that staff have been working to address. In this update, staff has provided responses to some of these inquiries, and staff anticipate providing comprehensive answers to the remaining questions during the scheduled study session on February 8th. Study Session Update on Homelessness Strategy Page 35 Packet Page 38 of 85 Cost Effectiveness and Trade Offs At the January 18, 2024, meeting, staff discussed the constrained financial outlook of the city and showed that any new initiatives would require some level of trade off. This trade off would be the elimination of a program or programs that are currently providing services in the community. At the time of the meeting, staff shared the associated costs of several key Housing and Human Services programs (General Fund). Staff was in no way recommending the elimination of these programs, and any further discussion of trade-offs would have to include other city initiatives. As part of the discussion, members of council requested a deeper understanding of the costs per program participant for some of the proposed trade-offs and for other homelessness services. One challenge with providing a straight comparison of dollars per client across a variety of programs is that it does not address the intensity of services provided, the impact to the community if such services were not provided, and the comparative benefit to the program participant. For example, a small portion of funding from the Human Services Fund might go to a youth program, allowing for a number of underrepresented youth to attend a cultural event. While the program’s goals are indeed worthy and the cost per program participant would be low, it does not compare to a clinician providing intensive crisis mental health services or case management services across a year to a very vulnerable person. With that understanding, below is a table showing the basic costs per clients for some key assorted programs: Program People Served Cost Per Person Housing Vouchers with support services 48 $20,914/year BSH Sheltering (annual beds used) 54,819 $55/person/night CIRT 2,214 $370/encounter Human Services Fund 8,813 $300/person Figure 18:Select Program Unit Costs The local permanent supportive housing program (Housing Vouchers) includes two costs – rental assistance and case management services. Council approved an increase to the Boulder Housing Partners (BHP) contract to allow BHP to maintain adequate rental assistance for the 48 units, in the face of increasing rents. The case management part of this contract is currently underfunded, as personnel expenses have also continued to rise. Funding from the Navigation Center Grant will aid in supplementing this service. Boulder Shelter for the Homeless (BSH)’s cost per client includes all of the things that make housing focused sheltering work. This includes operational staffing, food, laundry, navigation specialists, Coordinated Entry, and other associated services. The City of Boulder funds approximately 30% of these costs. BSH averaged 150.2 clients/night in 2023 and had 1,595 unique clients. In 2023, the Crisis Intervention Response Team (CIRT) had roughly 2,214 service encounters. This includes crisis response, case management, follow-up, consultation over the phone, and other interventions. These service encounters are not unduplicated clients. Study Session Update on Homelessness Strategy Page 36 Packet Page 39 of 85 As CARE was implemented in Dec. 2023, it is too new to effectively measure. This is high-intensity work with licensed behavioral health clinicians that might spend multiple hours de-escalating someone, assessing them for suicide risks or other life-threatening issues, speaking with family members and determining the safest options for their next steps. As licensed clinicians, they are also required to spend significant time on clinical documentation of calls. In addition, case managers might spend multiple hours with someone accompanying them to appointments, working through benefits applications, and other duties. It should be noted that CIRT was not fully staffed for most of the year, which in some cases reduced the number of calls to which the program could respond. Finally, both CIRT and CARE have planned professional evaluations in progress this year. In 2024 the city is providing approximately $2.55 million in Human Services Fund grants to 50 programs. As staff are currently in the process of finalizing grant contracts and do not have exact client numbers for each program, the total number of clients listed for funded programs is roughly 8,500 city community members from infants to older adults; for services that are highly intensive and high-cost (e.g., Keep Families Housed) to lower-cost per person. Staff do not have the ability to know how many people participate in or benefit from multiple programs, so the 8,500 people served is not considered a total of unique clients. Community First Village The Community First Village (CFV) is a microhome community operated by Mobile Loaves and Fishes, in Austin, TX, made up of 350 homes covering 51 acres of land that serves individuals formally experiencing homelessness. CFV has been awarded a substantial allocation of American Rescue Plan Funding from Travis County and is currently undergoing an expansion from 350 homes to more than 1,300 homes over the next seven years. In 2023, the Travis County Housing Authority, City of Austin Housing Authority, and ECHO the local Travis County CoC, requested approval from HUD for a variation to housing quality standards (HQS) inspection criteria to allow for microunits as an acceptable housing type. The request enables micro-units with separate communal bathrooms and kitchens to qualify as Single Room Occupancy units. This variation was approved by HUD. This waiver has not been applied to pallet shelters and would not be available to any housing intervention that is not intended to be permanent. The microunits are considered permanent housing and require that each individual sign a lease. Waiving Electrical Codes and Individually Built Pallet Structures: Council requested staff to look specifically at approaches to reduce infrastructure cost by using other approaches for running electrical to tents or pallet shelters that could be waived from building codes. Staff reached out to the chief building official for the city and received the following input: The electrical code, temporary uses are limited to 90 days by article 590.3 of the 2023 national electric code. There is no ability to waive or modify the NEC as this code is set Study Session Update on Homelessness Strategy Page 37 Packet Page 40 of 85 by the state of Colorado and the city is required by statute to enforce the state minimum code. The consequence of the city ignoring this would be that the state would take over enforcement of the electrical code within the city. Another aspect of this approach of running electrical cables on the ground is that having above ground electrical feeders (temporary or not) would be incredibly unsafe and vulnerable to theft. Permitting pallet structures can be accommodated easily, even though these structures do not comply with the 2018 IRC or IBC. They are engineered to a uniform standard and can have a simple engineered tie down system to resist local wind loads. On the other hand, individual site-built structures would need to be individually reviewed and inspected for compliance, adding significant time delays and regulatory hurdles. The building staff can readily expedite any permits that such an initiative would require and could have them processed, reviewed and issued within a few days. However, the time to implement the infrastructure would be based on the design, selection of a contractor and implementation of the site work. NEXT STEPS Unfunded Programs With the availability of federal funding through the American Rescue Plan Act of 2021 (ARPA), the city was able to launch several new initiatives and pilot programs. These funds – whether in the form of local funding or in competitive grants solicited from the state – will expire within the next two years. At this time, no funding has been identified to sustain the programs beyond the end of these funding sources. Staff believe that these programs have shown merit and helped to fill gaps in the city’s response to homelessness. These programs were established to address key challenges faced by communities most impacted by COVID-19, including the unhoused. Programs set to sunset and associated funding amounts are: Figure 19: Unfunded Initiatives In the chart above, all programs, with the exception of the Older Adult Services Rental Assistance program, are run through contractual agreements with local nonprofits. Program Annual Amount Funding End Date FTE Internal/ Contract Building Home Retention Team 309,000$ 12/31/2025 3 Contract Building Home Peer Support 206,000$ 12/31/2025 3 Contract DSC Peer Support 155,619$ 12/31/2024 2 Contract DSC Housing Retention Team 167,375$ 12/31/2024 2.1 Contract DSC Mental/Behavioral Health 306,296$ 12/31/2024 3.2 Contract Respite Services 978,500$ 12/31/2025 11.5 Contract Winter Weather Shelter Expansion (Bridge Housing Hotels) 2024 120,900$ 3/31/2024 1 Contract Winter Weather Shelter Expansion (Bridge Housing Hotels) 2025 201,500$ 12/31/2025 1 Contract OAS Rental Assistance 26,000$ 12/31/2024 0 Internal Family Hotel Assistance 60,000$ 12/31/2024 0 Contract 2,531,190$ 26.8 Study Session Update on Homelessness Strategy Page 38 Packet Page 41 of 85 Through the 2025 budgeting process, council will need to look at overall budgeting trade- offs if they wish to continue to fund these programs totaling $2.5 million. Staff is uncertain if they will be able to support these programs in the future with additional outside grant resources. In the case of winter weather shelter hotels, funds were only allocated to provide this service through the 2023-24 season (Mar. 31). To provide this service during the 2024-25 season as well as Nov.-Dec. 2025, funding would need to be allocated in the amount of $322,400. The city received significant grant funding for the Day Service Center (DSC) and the Respite Center. The DSC funds will be used to create a second housing retention team, augment the peer program, and to add much needed mental and behavioral health services to the DSC. The grant is for a one-year period, and the grant for the Respite Center is for a two-year period. As shown earlier in the document, the Building Home program has shown strong performance in meeting the challenges faced by people new to housing programs. System Gaps While Boulder has a robust and holistic response to homelessness, gaps and challenges still exist. As discussed below in the proposal from the Interagency Taskforce on Boulder’s Unhoused High Utilizers, there is a subset of people experiencing homelessness that have little to no housing/treatment options and who have disproportional impact on community services. Across the board, there is a need for targeted mental and behavioral health services, particularly those with residential components, that address the unique needs of people experiencing homelessness. Boulder’s housing gap is in two forms: structure (type) and amount. Because Boulder is heavily dependent on site-based vouchers for PSH, Boulder is highly dependent on landlords. The collaborative efforts of Boulder and its partners have led to success in housing many people through traditional methods. As the system moves toward housing more challenging people, there are more people who have qualified for vouchers but who cannot qualify for leases in scattered sites. Moreover, Boulder does not have the available funds or land or unit availability to do some of the activities done in other cities such as purchasing hotels that have passed their useful life to repurpose as single room occupancy units or create large and spread-out villages. Boulder also does not have a wide portfolio of single-family homes that could be used for people who need a setting more like a group home. While Boulder has done an outsized job in creating affordable housing, especially compared to other cities Boulder’s size, the community still lacks enough units that can be used as PSH, particularly for those who have more and more challenges. The recent opening of the Bluebird property was so important because it allowed for 40 program- Study Session Update on Homelessness Strategy Page 39 Packet Page 42 of 85 based, or centralized, PSH units. Not only bringing housing to 40 of the community’s hardest to house, it mitigates impacts to other community residents. Funding Priorities Should additional funding be located, staff recommend prioritization of interventions in the following way: • Additional mental and behavioral health funding in partnership with Boulder County, Mental Health Partners, and Boulder County Public Health. This should either be provided in a residential context that is available to people directly from unsheltered homelessness or be combined with a housing unit/voucher provided to the person once the treatment is completed. • Supporting the unfunded programs listed above that are set to sunset with ongoing funding of $2.5 million. • Creation of additional housing units, particularly those that address structural issues within the PSH system. • More intensive support programs such as described in the High Utilizer program later in this document. In a constrained financial environment, staff believe that funds should be prioritized for interventions that have the most ability to impact identified service gaps. Staff also recommend programming that will end a person’s homelessness and which will help the individual maintain their housing. Programs such as Building Home fill one of the largest gaps in the continuum of services provided to unhoused people in Boulder. Often, people who have significant mental health issues and/or who have lived unhoused for long periods of time face crushing feelings of isolation. This can lead to self-limiting decisions such as moving others from the street into their apartments, worsening of addictive behaviors, hoarding and anti- social behavior, or the need for expensive drug remediation in units; leading to eviction or unit abandonment. When these very challenged individuals return to homelessness, it can require an outsized intervention to stabilize them, often at a much higher cost. By providing peer support and a dedicated team of professionals to identify and assist individuals before they are evicted, the program helps to not only de-escalate issues the individual faces, but also to mitigate disruptive behavior in apartment communities. Staff recommend housing, in various forms including projects such as the High Utilizer program, to reduce the likelihood of people who have qualified for vouchers remaining on the street. A project-based development such as Bluebird provided 40 additional units at a one-time city investment of $3 million. This city investment is then matched with state and federal funding to subsidize rent and case management services. Additionally, several of the people moving into Bluebird are participants in the Building Home program. As the amount of and toxicity of drugs in encampments continues to grow, the need for additional detox and treatment beds is critical. As mental and behavioral health are most aligned with Public Health, Mental Health Partners, and Boulder County, staff Study Session Update on Homelessness Strategy Page 40 Packet Page 43 of 85 recommend that city involvement would be in the acquisition of housing and/or support of the residential components of any such programs. Near Future Next Steps HHS continues to work toward the opening of the Day Services Center and the Respite Center while monitoring new initiatives such as Building Home and the Shelter Unit Acquisition Program. HHS also continues to work on homelessness prevention, sheltering, housing retention and housing security through services and investments and is committed to cross-departmental and cross-agency work to continue and improve collaboration. The HSBC system evaluation will be conducted during 2024. HIGH UTILIZERS PROGRAM Who Are High Utilizers Boulder has a robust continuum of services to aid people experiencing homelessness with the aim of ending their homelessness. As the homelessness experience is not monolithic, the city and its partners target services to the unique experiences faced by people. In many cases, mental health and substance use disorders become more acute during a person’s time experiencing homelessness. This often has other consequences: a distrust of outreach, law enforcement, and service providers and a criminal history. Their criminal history can preclude them from qualifying for leases under traditional homelessness exit programs, and the frequency or length of incarceration can also significantly reduce their ability to qualify for traditional housing programs. People who are frequently accessing community services (whether voluntarily in the case of most healthcare or involuntarily in the case of emergency and criminal justice services) are termed “high utilizers”. The proposed program focuses on this subset of high utilizers because the largest community and individual impacts are aligned with criminal justice system-involved high utilizers. There is a significant overlap between high utilizers of the criminal justice system and high utilizers of other community services, with the greatest usage in healthcare and emergency services. For example, in 2022, approximately 20 percent of Boulder’s 45 highest utilizers of the criminal justice system were found to also be high utilizers of the Boulder Community Health Emergency Department. Many of the high utilizers of the criminal justice system are incarcerated frequently and are not accessing healthcare services while in jail, but case workers often see high utilizers ebb and flow between the criminal justice and healthcare systems depending on when they are in jail or unsheltered in the community. While leaders in the healthcare industry are actively involved with this taskforce, privacy protections mean that sharing by-name data between healthcare providers and the other members of the taskforce presents certain challenges. These high utilizers: • Place a disproportionate strain on organizational budgets – On average, staff estimate that responding to these individuals currently costs the community Study Session Update on Homelessness Strategy Page 41 Packet Page 44 of 85 between $48,000 and $67,000 annually for criminal justice system costs and an additional $17,000 per year for Boulder Community Hospital emergency department and ambulance costs. • Find themselves in situations which jeopardize their health and safety – These individuals are at risk of serious health issues or loss of life due to uncertain weather, public health risks (disease, contamination of living spaces) as well as being victims of crime, as campsites often attract more serious crimes such as drug distribution, rape, and assault. • Threaten public safety and impact public spaces – These individuals often draw the most attention in public spaces and often perpetrate nuisance violations, violent and property crimes, increase wildfire risks, and engage in behaviors that can negatively impact or endanger wetlands or other sensitive and ecologically important natural areas. Currently, there is no approach in Boulder customized to meet the unique needs of high utilizers. Interventions for a high utilizer’s needs require a complex set of responses that are targeted to the unique reasons that such individuals are not successful in traditional or locally provided homelessness responses. The interventions proposed in the proposed program, described later in this memo, respond to people at the very highest level of need across multiple strata: housing, substance use disorders, engagement, support needs, and mental health issues. The figure below illustrates this point by placing the high utilizers on a spectrum of complexity of needs and services. Figure 20: Client Needs and Existing Program Continuum High Utilizers of the Criminal Justice System In August of 2022, the taskforce established a baseline list of the highest utilizers of Boulder’s four criminal justice system agencies (Boulder Police, Boulder Municipal Study Session Update on Homelessness Strategy Page 42 Packet Page 45 of 85 Court, Boulder County District Attorney’s Office, Boulder County Jail). Each agency was asked to determine which individuals had the greatest impact on its system. The following criteria were established: • Police - The top 20 percent of individuals who were cited/arrested five or more times and had police contacts in the last year. • Municipal Court – Average of five or more municipal cases/year with at least some cases in the last year. • Jail – The top 25 highest number of jail bookings each year with at least some bookings in the last year. • District Attorney – Five or more open cases with the Boulder District Attorney’s Office. Using the additional criteria that an individual needed to be a high utilizer of at least two of the four agencies and needed to be unhoused, 45 individuals made it onto a baseline list, referred to in the rest of this memo as the “baseline list”. The high utilizer list was updated in June 2023 using the same methods. Figure 2 below shows the overlap between point-in-time lists. The following section contains some highlights about the individuals on the high utilizer list. Unless otherwise specified, analyses were conducted for the 46 individuals on the baseline list created in August 2022. • What are the demographics of high utilizers? The average and median age of individuals were 40 years old; 87% were male; 87% were White, 6.5% were Black, and the remaining 6.5% were other races. • Only one of the 45 baseline high utilizers was known to be staying at Boulder Shelter for the Homeless at the time of the analysis. • Forty-one percent of the baseline high utilizers had been contacted during encampment management activities. • Slightly less than one-quarter of individuals were somewhere in the housing process at the time of the baseline analysis (either on a housing list or matched to housing). Note: As of December 2023, the High Utilizer Operations Team is working from a list of 39 criminal justice high utilizers. This includes the 31 individuals formally identified using the high utilizer list methods, plus 5 baseline high utilizers who are benefitting from continuity of care from the group, and 3 ‘emerging’ high utilizers identified since the last list update. 31 August 2022 Baseline List Only 15 Both Lists 16 June 2023 List Only Figure 21: Number of Individuals on Each Point-in-Time Criminal Justice High Utilizer List Study Session Update on Homelessness Strategy Page 43 Packet Page 46 of 85 • Many of these individuals have mental health and/or substance use concerns that make traditional housing options with limited case management support difficult and unlikely to succeed. What types of charges do high utilizers have? • Criminal Justice High Utilizers have a high number of touch points with each system over several years. On average, high utilizers from the baseline list had: o 34 Police citations/arrests between 2018 and 2022. o 29 Municipal Court citations between 2019 and 2022. o 15 cases with the District Attorney’s Office between 2021 and 2022. • The majority of high utilizers had some felony charges (80%) and charges related to trespassing/camping (80%), theft/burglary/shoplifting (70%), drugs and/or a substance use disorder flag (59%), and/or assault (54%). How do these criminal justice high utilizers interact with the healthcare system? • Approximately 20% of the criminal justice high utilizers were also high utilizers of the Boulder Community Health Emergency Department (12 or more Emergency Department (ED) visits in a year). • Eighty percent of the high utilizers had at least one ambulance trip with American Medical Response (AMR) in a five-year period between 2018 and 2022, but only 14% had a high volume of utilization (having an average of five or more trips per year). • Approximately one-third of the 61 high utilizers on both list updates were active patients at Clinica Family Health (seen in the past 18 months) and another 43% of the high utilizers were patients more than 18 months ago. • Less than 20% of the high utilizers were active clients with Mental Health Partners at the time of the analysis. • Twenty-four percent of the high utilizers had some interaction with the City of Boulder’s Crisis Intervention Response Team (CIRT) since the program launched in 2021. None of these high utilizers have ever engaged in CIRT case management, follow up, or resource navigation with the team. Nearly all of the individuals who had in-person contact with CIRT were intoxicated and many were one-time contacts with the team. Interagency Taskforce on Boulder’s Unhoused High Utilizers As previously reported, including in an Information Item included in council’s September 7, 2023 packet, the city convened an Interagency Taskforce on Boulder’s Unhoused High Utilizers currently composed of representatives from the following organizations: • American Medical Response of Colorado, Inc. • Boulder Community Health • Boulder County o Boulder County Commissioners’ Office o Boulder County Community Services Department o Boulder County Sherriff’s Office • Boulder Shelter for the Homeless • City of Boulder Study Session Update on Homelessness Strategy Page 44 Packet Page 47 of 85 o City Attorney’s Office o Boulder Fire Rescue o Boulder Municipal Court o City Manager’s Office o Boulder Police Department o Housing and Human Services Department • Clinica Family Health • Focus ReEntry • Mental Health Partners • Twentieth Judicial District / Boulder County o District Attorney’s Office o Division of Probation Services The mission of the taskforce is to reduce “the impact of unsheltered homelessness on community resources through data-rich inquiry, individual-based solutions, and advocacy for innovative responses.” The effort operates in furtherance of the following principles: • Unsheltered homelessness is an unacceptable threat to the safety of community members, public safety and healthcare professionals, and to the individuals experiencing it. • Proposed solutions are evaluated through an equity lens to ensure that past injustices are not compounded by taskforce actions. • Each individual should be treated with respect, fairness, and dignity. This recognizes each individual’s rights while encouraging engagement with the organizations that can end their homelessness. • While solving unsheltered homelessness is unlikely, endeavors are made to make data-informed and meaningful changes to the lives of those who are most impactful to and impacted by the system. The taskforce focuses on individuals who are unhoused within the City of Boulder but who have relied on the services of several agencies, including those beyond the city boundaries. The taskforce to date has focused on the City of Boulder, given that data shows 70 percent of individuals experiencing homelessness and going through Coordinated Entry screening in Boulder County are in the City of Boulder (since 2020). Nevertheless, if the effort is proven successful, it is the hope that it can establish a replicable model that could be used in other cities. The taskforce is divided among a Leadership Team and an Operations Team. The focus of the Leadership Team is on advocacy, serving as liaisons with elected officials, strategic decision making, resource identification/budget development, interorganizational alignment and executing data sharing and agreements. It functions as the policy development team with direction given to the Operations Team while encouraging and supporting collaboration, cohesion, and data sharing between the agencies/organizations. It also makes budget and staffing recommendations, subject to council/ Commissioner/ Organizational Board approval, as necessary. The following is a list of the members of the Leadership Team: Study Session Update on Homelessness Strategy Page 45 Packet Page 48 of 85 • Grant Besser, BCH Vice President of Community Health & Engagement and BCH Foundation President • Robin Bohannan, Boulder County, Community Services Director • Jeff Cahn, City of Boulder Municipal Court, Interim Presiding Judge • Mike Calderazzo, City of Boulder Fire Chief • Carl Castillo, City of Boulder, City Manager’s Office, Chief Policy Advisor • Michael Dougherty, Colorado 20th Judicial District, District Attorney • Vicki Ebner, City of Boulder Housing and Human Services, Operations and Homelessness Strategy Senior Manager • Nicolia Eldred-Skemp, City of Boulder, Housing and Human Services, Data Senior Analyst • Kurt Firnhaber, City of Boulder, Housing and Human Services, Director • Paloma Gilman, Colorado 20th Judicial District, Probation Supervisor • Jeff Goetz, Boulder County Jail, Division Chief • Curtis Johnson, Boulder County Sheriff • Adam Kendall, Colorado 20th Judicial District, Chief Deputy District Attorney • Jennifer Leosz, Mental Health Partners Co-CEO • Claire Levy, Boulder County, Commissioner • Monica Rotner, Boulder County, Community Justice Services, Division Manager • Simon Smith, Clinica Family Health, President and CEO • Anjali Nandi, Colorado 20th Judicial District, Chief Probation Officer • Megan Newton, City of Boulder, Housing and Human Services, Homelessness Policy Advisor • Steve Redfearn, City of Boulder Interim Police Chief • Nuria Rivera-Vandermyde, City of Boulder, City Manager • Chris Reynolds, City of Boulder, Deputy City Attorney The Operations Team makes recommendations to the Leadership Team. It is focused on case coordination, data analytics and prioritization, resource gap identification, measurement, reporting, communication, infrastructure tool development, alignment with service providers and data sharing agreement preparation. It implements policy decisions from the Leadership Team, ensures that operations are efficient and effective, develops tools to identify the highest utilizers and targets solutions to identified individuals, prepares reports, documents, presentations and manages/coordinates the work of sub- groups. There are currently three sub-groups on the operations level – Operations, Legal, and Data teams. The Operations Team consists of a mix of direct service providers and subject matter experts across 14 different agencies and departments. The Operations Team has been meeting twice a month since early 2023 to identify top system gaps and potential interventions, develop the initial Proposed Program and budget, advise the Leadership Team on top priorities for work, and conduct care coordination efforts for the list of high utilizers using the existing resources available to the collective teams. The Operations Team has achieved some initial success just from having a wide range of service providers in the same room that are dedicated to this work. For example, law Study Session Update on Homelessness Strategy Page 46 Packet Page 49 of 85 enforcement and healthcare partners are now able to quickly alert relevant staff after contact with an individual, so that care coordination and resource assignment can happen with a quicker turnaround. Operations staff use collective resources for creative brainstorming about some of the trickier cases and have established additional policy and resource connections for future work. The Legal Team consists of legal, security, and privacy experts across eight agencies and departments. This team developed a multi-agency MOU, executed in November 2023, that allows data and resource sharing across participating agencies as well as a multi- agency client Release of Information (ROI) that allows greater efficiencies for case coordination and fewer administrative burdens for clients. The Data Team consists of data experts across six agencies and departments who have subject matter expertise in data analysis, program evaluation, technology innovations, and content expertise related to this work. The Data Team members have been refining definitions for high utilization of system services, analyzing utilization data, drafting metrics of success, and identifying future data-oriented collaboration opportunities that will help streamline this work. Proposed Program The taskforce Leadership Team endorsed a proposed program to reduce the impact of the 45 individuals on the baseline list of high utilizers of the criminal justice system. They have also begun initial conversations aimed at garnering political and funding support from various entities for that initiative (see Attachment B, summary of individual endorsements). The proposed program was developed in alignment with best practices identified by the Corporation for Supportive Housing’s (CSH) FUSE model for frequent users of justice and hospital systems who are experiencing either literal homelessness or chronic homelessness. It would create a countywide, unified team of professionals dedicated to working with high utilizers to limit community risk, reduce the impact on community resources, provide support for individual clients, and house the hardest members of the community experiencing homelessness. It follows the best practices in equitable, inclusive, and trauma-informed housing with wrap around services to set high utilizers up for success and support landlords who want to help. Operational Staffing Employees will consist of both full-time (FTE) and part-time (PTE) employees whose primary focus is the single adults who have been identified as Criminal Justice High System Utilizers in Boulder County. • Medical Team - A team consisting of one PTE Mental Health Nurse Practitioner (MHNP), or Advanced Registered Nurse Practitioner (ARNP) will provide medical level treatment and referrals, medication orders, and communicate with hospital and treatment center staff. They would work with the assistance of one PTE Medical Assistant/Medical Technician for record keeping and client management for provider. • Behavioral Health Team - A behavioral health clinical team with one FTE Licensed Clinical Social Workers (LCSW) or Licensed Professional Counselor Study Session Update on Homelessness Strategy Page 47 Packet Page 50 of 85 (LPC) who will provide support for behavioral health and substance misuse services and work with hospital staff to arrange behavioral health treatments for clients. The clinical nature of this staff could oversee the direct supervision of a team of four FTE Master of Social Work (MSW) Case Managers. The MSW case management team will support the clients with housing and associated wrap around services required for successful housing retention. The case management team would have experience with unhoused clients in the criminal justice system. • Peer Support - In addition to the clinical and case management staff, two FTE Peer Support Specialists with lived experience in homelessness and/or mental health, and/or substance misuse who would build rapport with clients to foster relationships with the clinical case management team. Housing-Related Components • Housing - In addition to annual FTE and PTE operational staff, a one-time cost would be incurred during the ramp-up of the proposed program. A one-time investment of ten housing units would be reserved for the high utilizer clients with connection to wrap around support services provided by the operational support teams. A set aside of forty-five housing vouchers each year would assist in placement of high utilizers in housing, either in the acquired ten units or in other housing sites with wrap around services provided by the operational staffing team. • Bridge Housing - To aid in the document procurement and possible costs necessary for assisting a client’s successful transfer to housing, a fund would be set up that can be used to assist in costs associated with this process. In addition to the document and testing fund, case managers could provide bridge housing in the form of hoteling for 30 days for high utilization clients while they prepare for housing openings. • Remediation Fund - Considering the risks associated with high utilizers and methamphetamine contamination, a landlord remediation fund would be set up for qualifying remediation costs associated with high utilizer methamphetamine contamination of PSH apartments. The fund would only be available to property owners who place one of the forty-five high utilizer clients and proper documentation must be presented to show connection to the client. Budget Start-up costs, including operational staffing, one-time housing acquisition, housing vouchers, bridge housing, program staffing centered on behavioral and mental health, one-time robust program evaluation, and the creation of a landlord insurance fund to support a minimum of forty-five high utilizers of the criminal justice system in Boulder, is estimated to total $4,975,500 for year-one, $2,000,500 for year-two, and $1,925,500 for every year thereafter. Estimates were developed by the Operations Team, given their understanding of the level, scope, and costs of the various components of the program proposal. Study Session Update on Homelessness Strategy Page 48 Packet Page 51 of 85 ANALYSIS Homelessness is Associated with High Utilization of Public Services People experiencing homelessness are more likely to interact with the criminal justice system due to a high volume of citations or arrests for low-level offenses like loitering or sleeping in parks. Many people experiencing long-term homelessness are trapped in a homelessness-jail cycle, rotating in and out of jails, emergency rooms, and detox facilities. Studies have indicated that unhoused individuals with concurrent mental and substance use disorders have more frequent use of emergency department and inpatient hospital services. This can often lead to high rates of 30-day hospital readmissions and can exacerbate chronic medical illnesses. High Utilizers Are Costly for Taxpayers Jails are often used to house people with mental health needs when mental and behavioral health community resources are not available. Los Angeles previously reported spending approximately $51,000 per individual per year for the “most costly 5%” of their 148,815 unhoused individuals for a variety of social service and criminal justice services. Denver previously reported spending an average of $7.3 million per year to provide safety net services to 250 people experiencing long-term homelessness, or $29,200 per individual per year just for services. Data from the baseline list in Boulder also illustrates that responding to these individuals currently costs local criminal justice agencies between $48,000 and $67,000 annually. Utilization and cost estimates were calculated for four individuals experiencing unsheltered homelessness on the baseline list who had high levels of interactions with the criminal justice system in 2022. One individual had one municipal court citation, 20 unique police reports, 11 summons to court, six custodial arrests, 22 open cases with the Boulder County District Attorney’s Office, 10 jail bookings, and spent 301 nights in custody. This individual cost the Boulder city and county criminal justice agencies at least $67,000 in 2022. Factoring in the cost analysis of the three additional high utilizers put an average criminal justice services cost of $48,000 per year, just for estimated costs to the Boulder County Jail and Boulder Police (cost estimates were not feasible for Boulder Municipal Court or the District Attorney’s Office at this time). Factoring in the minimum Boulder Community Health (BCH) emergency department cost for high utilizers with Colorado Medicaid coverage and additional costs of ambulance trips and hospital treatment for acute medical needs, a typical unhoused healthcare high utilizer would cost the hospital and ambulance at least $17,000 for one year of services. Proposed Program Likely Less Expensive Than Status Quo Costs for programs with high levels of case management support, with low ratios for case workers and housing - that reflect the high needs of the high utilizer population - are generally higher than a typical permanent supportive housing (PSH) program. The taskforce’s proposed program assumes that individuals will rotate in and out of the program as their support needs decrease over time. This assumption aligns with a comprehensive study in England of unhoused criminal justice high utilizers; they Study Session Update on Homelessness Strategy Page 49 Packet Page 52 of 85 found that the costs of Housing First program were twice as high in the first month compared to month 12. In Seattle, costs averaged $29,388 per year per individual for housing and public services utilization for individuals with severe alcohol problems who were enrolled in a housing program. Sacramento conducted hypothetical cost analyses to provide integrated care with supportive housing and treatment to 2,000 unhoused individuals over five years, and estimates came out to $25,500 per individual per year, or only $5,100 per individual per year when factoring in cost savings from reduced criminal justice and healthcare interactions. Converting High Utilizers into Lower Utilizers The Frequent Users Service Engagement (FUSE) model has found successes in cities across the nation with keeping participants housed and reducing utilization of services. In New York, 86% of FUSE program participants remained housed after two years and they spent 40% less time in jail than a comparison group. 77% of Denver Social Impact Bond participants remained stably housed after three years in the supportive housing program. Studies show that simply being housed results in decreased substance use, decreased criminal justice interactions, and increased housing stability even with presence of mental disorders. Seattle unhoused individuals with severe alcohol problems had reductions in daily drinking just from being housed without any additional alcohol treatment. Local analyses of previously unhoused high utilizers in Boulder also demonstrate that criminal justice interactions drastically decrease after being housed. Three individuals were identified as previous high utilizers of both the Boulder Police and Municipal Court systems (average of 5 or more citations or arrests per year) and were all housed in Boulder between 2022 and 2023. Local criminal justice interactions dropped by 87% after obtaining housing (from an average of 18 annual arrests and citations per person to an average of 2 annually after housing). One of these high utilizers averaged 20 arrests and citations per year in Boulder between 2006 and 2022, including charges such as possession/ consumption of alcohol in public, trespassing, physical harassment, assault, and detox holds. Since being housed 16 months ago, they have only received 2 arrests/citations. Similarly, an early 2023 analysis of 63 unhoused individuals with Municipal Court interactions showed these individuals had an average of 41 Municipal Court cases per person before being housed, compared to an average of 0.2 cases per person after housing. Supportive housing and case management programs for unhoused populations across the nation have led to significant declines in emergency department visits and inpatient admissions as well as reduced emergency department costs. In Boulder, a recent partnership between BCH and Boulder Shelter for the Homeless has shown early successes in housing vulnerable healthcare high utilizers. To date, BCH has referred 54 of their high utilizers to Boulder Shelter for the Homeless, and housing was secured for 13 individuals. Housing had a nearly immediate impact on reduction to inappropriate use of Emergency Department services, with a 74% decrease within the first three months of housing. Additionally, utilization of Emergency Department services for alcohol intoxication encounters brought in by law enforcement was reduced by 36% Study Session Update on Homelessness Strategy Page 50 Packet Page 53 of 85 after housing. These types of service utilization reductions have huge potential cost savings for the local healthcare system. Expected Public Service Cost Reductions Providing housing and support to criminal justice high utilizers who are experiencing homelessness can result in significant cost savings to public and private services, but exact savings vary by program. Some estimates for cost savings for PSH programs that were tailored for high-needs individuals saved between $6,000 to $36,900 per individual each year. Approximately half (or nearly $7,000) of the total annual per person cost of Denver’s Social Impact Bond program were offset by reductions in other public services. Unhoused individuals with severe alcohol problems in Seattle saw a 53 percent reduction in public services costs (including jail, shelter use, medical services) after housing just in the first six months compared to individuals on a housing wait list. In a New York supportive housing initiative serving unhoused individuals with severe mental illness, cost savings across eight public systems, including the judicial and medical sectors, dropped so much after housing placement that the $17,000 annual program cost per unit was nearly offset. The cost of doing nothing and working within the limited housing and case management resources the City and County have at their disposal is still a high cost to taxpayers. The proposed program estimates costing approximately $42,800 per individual per year to provide wraparound supportive services and housing (ongoing costs for Year Two onward, removing one-time housing acquisition and program evaluation costs), which could lead to cost savings of up to $5,000 per person for a typical criminal justice high utilizer. Proposed Program Not Expected to Attract New High Utilizers The proposed program is not expected to attract new individuals to the city and/or unintentionally encourage the existing unhoused population in Boulder to become high utilizers. In order to make it on to Boulder’s high utilizer list, which will be used to identify and prioritize participation in the proposed program, an individual would have needed to accumulate a high volume of criminal justice interactions in two or more of Boulder’s systems. Existing case management and supportive services staff have attested that individuals on the high utilizer lists have been unhoused in the Boulder area for a long enough period of time that staff know these individuals by name. The proposed program is considering applying additional criteria of length of time an individual has been unhoused in the Boulder area to ensure that participants are truly long-term high utilizers of Boulder services. Metrics to Evaluate Effectiveness of Proposed Program The primary metric used to evaluate the effectiveness of the proposed program will be decreased utilization of services. Utilization data will be analyzed from organizations participating in the taskforce, although exact definitions of utilization will vary across systems. Additional planned metrics of progress and success include: • Increase in length of time housed • Increase in engagement with case management and supportive services Study Session Update on Homelessness Strategy Page 51 Packet Page 54 of 85 • Decrease in total nights in jail • Decrease in number of jail bookings • Longer period of time between police contacts and jail bookings • Decrease in number of police, DA’s Office, and municipal charges • Decrease in severity of police, DA’s Office, and municipal charges • Increased compliance in connections with probation officer • Decrease in utilization of Emergency Department visits • Decrease in utilization of ambulance services • Increased participation in mental health and/or substance use treatment • Increased participation in primary and preventive care services NEXT STEPS With direction from council, and in coordination with taskforce members, city staff will develop a strategy to secure funding for the proposed program. This will include an analysis of the potential to reallocate existing funding and to continue the conversation on soliciting new funding opportunities from a variety of sources such as the Colorado Department of Housing, health foundations, philanthropic organizations, and private organizations. Staff would then work with taskforce members to secure funding commitments. The following diagram depicts the timeline that staff expects to follow. Figure 22: High Utilizer Program Timeline SAFE AND MANAGED PUBLIC SPACES (SAMPS) BACKGROUND It is impossible to separate discussions on homelessness from discussions on managing public spaces. Recognizing this connection, it is not the goal of the SAMPS team to solve homelessness. Rather, the SAMPS team focuses on ensuring that public spaces are safe and welcoming for all, including people experiencing homelessness. Anyone, regardless of housing status, who is following the usage rules of public spaces, is welcome to use the space. It is in the compassionate approach, particularly in interactions with the Study Session Update on Homelessness Strategy Page 52 Packet Page 55 of 85 unhoused, that SAMPS can contribute to the larger ecosystem that is the city’s homelessness response. Since early 2020, an interdepartmental staff team has applied a strategic approach to safely and compassionately clear camps in public spaces. The aim of the team is to mitigate the impact of camping in floodways, drainageways, and high hazard zones while addressing hazardous materials and conditions in public parks and playgrounds. All work is also centered on the idea that people experiencing homelessness deserve compassion and should be informed of other options to living outside. Teams directly involved are listed below, followed by a brief description of the focus of each team. • Operations and Clean-Up • Urban Park Rangers • Downtown Ambassadors • BTHERE • Dedicated Boulder Police Support • Data, Analytics, Legal, and Communications Operations Team Prior to 2021, all clean-up and public space operational work was accomplished through a contract with a third-party vendor and by city maintenance employees in various departments, such as Utilities, Transportation and Mobility and Parks and Recreation. Upon internal consolidation of this work, a five-person operational crew was created, including a supervisor. In 2023, four additional positions were added to the for a total of nine. This team investigates reports of encampments submitted through Inquire Boulder and prioritizes clean-ups using a framework which considers life safety risk and proximity to schools or residences, among other criteria. The team also supports response to more immediate hazards, such as obstruction of multi-use paths and underpasses. The team is fully equipped with vehicles, dump trucks and other equipment necessary to perform encampment abatement work. This operational team performs inspection, notification, and clean-up activities five days per week, with an average of two days focusing on active campsite clean-up along creek corridors, greenways and in other public spaces. The team works collaboratively with representatives of other city departments and respectfully performs the work with compassion and empathy. Part of the notification process involves providing the people living in the camps with information on available services. The notification process, as well as other aspects, such as uniform system of identification, storage, and retrieval of personal property are guided by standard operating protocols developed by the multi-departmental SAMPS team and city leadership. Clean up is also augmented by a team of Open Space and Mountain Parks. Rangers, who attend to this work in addition to other duties, and partner with the operations and other team members to secure areas. Urban Park Rangers This team of three contributes to the progress of several goals related to safe public spaces, including ensuring access to public spaces is not impeded, that visitors have Study Session Update on Homelessness Strategy Page 53 Packet Page 56 of 85 access to knowledgeable resources on city services, protecting waterways and natural areas, and user perceptions of safety. The Urban Park Rangers also support general Parks and Recreation issues such as dog violations, wildlife harassment, public trespassing, permit compliance, fires, and littering, A recruitment process has begun to hire three temporary employees in May for nine months. The program began operation in June 2022, after careful focus on ensuring appropriate Standard Operating Procedures, communication protocols, and training (such as de-escalation) plans to support this program were developed. Downtown Ambassador Program This program is a partnership program between the Community Vitality department, Downtown Boulder Partnership (DBP) and the University of Colorado (CU). The scope of services for this six-person team includes hospitality, safety, and cleaning-related duties in the service of enhancing visitor experiences in the downtown corridor and University Hill commercial district with support from CU. These duties can include such things as hospitality contacts, business contacts, welfare checks, eliminating instances of graffiti, picking up trash and litter, and cleaning up biohazard waste from humans and other animals. Additional in-kind support is being provided by the City’s Central Area Improvement District (CAGID) in the form of office and storage space and by the Downtown Boulder Business Improvement District (BID) in the form of program management and administration and vehicles and equipment. BTHERE As mentioned earlier in the document, BTHERE (Boulder Targeted Homeless Engagement & Referral Effort) is supporting outreach and engagement efforts for people who are residing in encampments, working closely with the operational team to ensure that campsite residents are informed of available resources during campsite notification processes as well as before or after clean-up activities. The BTHERE is incorporated into the Coordinated Entry (CE) program, the screening program for entry into sheltering services run by Boulder Shelter for the Homeless, allowing for in-field CE screening and diversion/reunification services. Dedicated Boulder Police Department Team Boulder Police Department (BPD) has dedicated a six-member team to support encampment clean-up in addition to, or in some cases, replacing the support that has been provided by the Homeless Outreach Team (HOT)/Mall Unit Sergeant and officers from the Mall Unit. The goal of the essential and dedicated BPD unit is to support the work of the SAMPS team, rather than to issue citations. Similar to the operations team, officers provide a compassionate approach to service and provide information about resources and shelter options. This unit also provides courtesy transports, expedites contact between medical personnel and unhoused individuals, facilitates unhoused service provider outreach efforts, and assists with navigational support through unhoused services in Boulder and Boulder County. Study Session Update on Homelessness Strategy Page 54 Packet Page 57 of 85 Data, Analytics, Legal, and Communications This team provides internal support to the SAMPS team members. All initiatives are grounded in a solutions-based framework and are thoroughly reviewed for compliance with the city’s legal requirements. In addition, the team supports all communications to and from the public while also developing more robust and transparent communications associated with activity and outcome reporting. The team works in an iterative way; identifying aspirational goals and measurements and exploring whether robust measurement is feasible. ANALYSIS The topic of homelessness has proven polarizing in Boulder, with members of the Boulder community expressing opposing and passionately defended opinions about camping, and the people who are camping in public spaces. At the heart of the issue is the balance between protecting public spaces for all people who wish to use them and ending homelessness for the people who most need housing solutions. Substance use and often associated mental health issues not only impact an individual’s ability to obtain or retain housing, but also lead to many of the conditions currently found in Boulder’s public spaces: erratic behavior that can threaten other people in public spaces, improperly discarded drug paraphernalia, unused and/or vandalized public restrooms and human wastes in inappropriate places, hoarding behavior leading to accumulation of intertwined personal belongings and refuse, and increased criminal activity. Current State and Emerging Issues Overview The SAMPS team recognizes that this is ongoing and dynamic work and continues to problem solve around persistent challenges. Below is a discussion of both the issues and various approaches used to address them. Safe Zones 4 Kids In the fall of 2023, Boulder voters approved the Safe Zones for Kids initiative, which prioritizes removal of prohibited items located on city property within a radius of five- hundred feet from any point on a school property line or within fifty feet on both sides of any multi-use path or sidewalk. The initiative was promoted by parents with concerns about encampments and related unwanted behaviors, such as open fires, occurring near and on the way to schools. Although these areas were already highly prioritized for clean- up under prior operations, the Safe Zones designation provides additional emphasis on them. The city has updated the criteria used to prioritize clean-up activities to reflect the Safe Zones changes and the team is currently operating under the new guidance. The team is also evaluating whether signs or other related tools are needed to identify and designate these Safe Zones. Non-tent Items The Operations Team frequently encounters encampment-like activities, such as excessive amounts of belongings and trash spread over a large area within public spaces. When these situations do not involve tents or other shelter structures, they do not violate Study Session Update on Homelessness Strategy Page 55 Packet Page 58 of 85 the camping ban and the team is limited in response options. Nevertheless, the situation affects public spaces and negatively impacts the ability for others to use them. Encampments on Private Property When reported campsites occur on private property and fall outside the city’s operational jurisdiction, staff typically advise private property owners to work with private abatement services to address camping activities. These companies have experience in addressing areas with camping-related impacts and respond accordingly. Although SAMPS encourages reporting of all encampment activity through the city’s Inquire Boulder system to inform operations, the team cannot address these private areas and property owners and community members understandably experience frustration that more cannot be done. Supply Distribution There are independent groups, both formal and informal, that distribute food, sleeping bags and other items to campers. Although well-intended, these distributions can enable unsheltered homelessness, creating a disincentive for some individuals to engage with the coordinated outreach, housing, and sheltering services that are currently available to them and which give them the best chance of housing success. This supply distribution can also work in cross-purposes with operational efforts, as these supplies are a significant contributor to the amount of debris and trash removed from sites, often directly delaying clean-up activities. The soon to be implemented Day Service Center will provide an alternative resource for basic supplies and mental health services and can provide a space for community members and groups to support the unsheltered community in a way that does not disrupt connections to services. This shift will likely not have an immediate or consistent impact on the number of people choosing to disengage with services and camping in unsanctioned areas and the city will continue to find ways to work collaboratively with those wanting to offer help and support to those living unsheltered. Action Plan Overview In early 2023, staff developed an Action Plan to guide, monitor and prioritize activities for the 2023 Program Year in alignment with the established goals of the SAMPS program and with the city’s Sustainability, Equity and Resiliency Plan. The Action Plan includes key metrics, designed to measure issues, outcomes and impacts and takes a “people-focused”, compassionate response to a complex community challenge. Goals The eight SAMPS program goals provide the foundational framework for SAMPS work are to ensure: • No camping in public spaces • Individuals experiencing homelessness are connected to services; • Access to public space and public infrastructure; • Reduction in crime and disorder in designated areas of emphasis; • Visitors have access to knowledgeable resources on city services; • Maintenance crews can safely access critical infrastructure in public spaces; • Waterways are free of contamination; and, Study Session Update on Homelessness Strategy Page 56 Packet Page 59 of 85 • Users of public spaces feel safe and welcoming. The discussion of accomplishments, current activities, data, and emerging issues is presented by goal below. Goal 1: No Camping in Public Spaces • Broaden geographic Footprint of Campsite Clean-Ups. • Increase efficiency of clean-up operations. The expanded team approved in the 2023 budget allowed for clean-up efforts to extend beyond the main drainageway corridors, increase frequency of attention to hot-spot areas, and at times allowed for two separate operational teams that covered a broader geographic area. The expanded team helped city staff from other city departments return to normal operational functions versus being pulled away to address impacts from unsanctioned camping. Weekly operational coordination meetings were established to increase efficiency through discussion of operations and any adjustments needed to respond to adaptive behaviors and allow for quick coordination on emerging issues as they arise. Open Space Rangers, Parks Rangers, the operations team, Boulder Police Department (BPD), Housing and Human Services (HHS), and Communications are represented at this meeting, which allows for a comprehensive response. One of the outcomes of these coordination meetings was the addition of two remotely operated cameras for surveillance of hot-spot areas and fencing in select public spaces to deter and disrupt behaviors, improve response efficiency and to limit access to natural areas for restoration. Both measures supported public space management efforts and will continue in 2024. After performing inspection and assessment of 969 encampments and/or areas with significant debris, 727 cleanups were completed in 2023. Of the 969 encampments, 117 of them were bordering schools, playgrounds, private residence, or within 100 feet of a school bus stop; 259 of them were on school or park property or attached to an occupied private residential property. Of this same total, 117 of them involved the removal of human feces from public use areas, 46 involved the removal of fire rings, 124 propane tanks were confiscated, and the team stored personal property on 130 occasions. Over 264,000 pounds of trash/debris were hauled away from the city’s public spaces including over 2,500 needles requiring safe collection and disposal. Open Space and Mountain Parks (OSMP) Rangers and the operations team partnered to perform 48 cleanups on OSMP lands; many involved hiking long distances and hauling debris down steep inclines and difficult terrain. The operations team also partnered with Utilities Flood Maintenance staff to clear drainageways, culverts, canals, and irrigation ditches. A partnership with Community Cycles helped reuse and recycle bike parts and identified safe disposal methods for hazardous materials including chemicals and batteries. Study Session Update on Homelessness Strategy Page 57 Packet Page 60 of 85 Figure 23: Encampment Inquiry Response System The team will continue to evaluate the effectiveness of operational measures on a weekly and real-time basis and adapt to the continuously evolving behaviors and challenges surrounding unsanctioned campsites. Specific, tactical measures are described under Goal three below. Goal 2: Individuals Experiencing Homelessness are Connected to Services • Understand personal property-related barriers to accessing services. • Ensure connections to services are as efficient and effective as possible. • Mitigate impacts of service limitations resulting in staffing turnover inherent to the type of work being done. • Improve connections, data sharing and communication between SAMPS team members. Goal 2 focuses primarily on the measurement and activities of the outreach components of the SAMPS team. Numerous collaborative activities are designed to provide team members with resources to help people in encampments, and thoughtful activities have been developed to improve the voice of encampment dwellers. This goal includes a distinction between “referral” (letting someone know of a person/agency with which to discuss their situation) and “connection” (active work to solve someone’s homelessness and connection to sheltering/services/pre-housing), with a focus on “connection” rather than “referral”, as this is measurable and is directly attributable to meeting the goal of ensuring “Individuals experiencing homelessness are connected to services”. The subject matter experts in homelessness aided in the development of these strategies and actions, not to create/enhance exits from homelessness but rather to focus on the overlap of the SAMPS and homelessness work. Strategies aim to gain lived-experience input regarding storage needs and increase BTHERE’s ability to make strong connections, beyond referral to sheltering. While BTHERE is already accomplishing some of this work, these actions outline the need to strengthen pre-housing and housing activities through this part of the SAMPS team. The Community Court team works closely with many of the same Study Session Update on Homelessness Strategy Page 58 Packet Page 61 of 85 clients, and once the Community Court is relocated to the Day Service Center, they will have an even greater opportunity to collaborate within the SAMPS structure. Other outreach organizations such as the non-profit Focus Re-entry and Boulder County’s Behavioral Health Assistance Program (BHAP), while not officially associated with SAMPS work, often do their work in coordination with BTHERE, the Homeless Outreach Team, and others, with many of their clients living in encampments. Dedicated BPD staffing has allowed Homeless Outreach Team (HOT) officers to make over 300 transports in 2023, driving unhoused persons to medical appointments, shelters, court hearings, and other places, such as addiction treatment facilities. Outreach work typically has a high staff turnover. Vacancies in this team can have a deleterious effect on SAMPS operations, and actions are geared toward ensuring that all pieces of the SAMPS team who work with individuals are aware of community outreach efforts on behalf of those individuals and to provide an understanding for operational staff of homelessness response. The BTHERE team is fully filled and is actively participating in client case conferencing. The team has been instrumental in connecting people with a variety of housing and support systems, and they are able to conduct Coordinated Entry screening in the field. During the recent extreme weather, the BTHERE team engaged with people staying outside to encourage sheltering and provided transportation to the overflow shelter. This outreach and transportation effort continued over the weekend to include reconnection with people who had refused sheltering the first evening of the extreme weather. BTHERE data was shared as part of the Bureau of Justice Assistance grant-funded evaluation of police homelessness responses. Figure 24: BTHERE Reporting Dashboard The Homelessness Policy Advisor hosts monthly meetings between outreach and operations teams to problem-solve issues and to educate the various members of the SAMPS team on available resources and client-level coordination. Study Session Update on Homelessness Strategy Page 59 Packet Page 62 of 85 Figure 25: Number of People Residing at Inspected Sites Figure 26: Number of Individuals Contacted by BTHERE Figure 27: Number of Individuals Connected to Pre-Housing Assistance from BTHERE Site Visits Study Session Update on Homelessness Strategy Page 60 Packet Page 63 of 85 In 2024, the team will continue to focus on improvement of communication channels, particularly with the opening of the Day Service Center in Spring 2024. Goal 3: Access to Public Space and Public Infrastructure • Evaluate programs and practices that ensure the provision of access to public space and infrastructure. • Establish criteria for identifying areas which require immediate response due to acute life/safety issues or access to public buildings. This long-term goal is designed to focus on access spaces while also focusing on life/safety risks associated with blocked access. In response to increasing concerns about multi-use path obstruction and encroachment and the danger to everyone involved in possible collisions, the SAMPS team updated the abatement protocol in March 2023 to ensure safe use of multi-use paths. The team was able to use the modified approach when warranted in 2023 to achieve improvements in underpass safety. Similarly, protocol updates were made to address re-occupancy of areas that were almost immediately reinhabited after the operations team performed a clean-up. Increasing the frequency of attention to these areas both deterred camping and reduced the amount of debris removed during clean-up operations. Following the passage of the Safe Zones for Kids ballot initiative, modifications to the abatement protocol were made to update guidance on operational activities. Modifications include updates to the prioritization criteria to allow for increased tools to address areas within 500 feet of schools and within 50 feet of multi-use paths. The team is in the early stages of implementing these changes, which complement already existing operational practices. Urban Park Rangers identified the need to re-establish regular bike patrols in partnership with BPD along creek paths with the goal of consistent visibility (for deterrence) and to educate people camping along creek paths as to the dangers of impeding traffic along these paths. In addition, the Parks team is interested in providing regular pre-storm danger education, specifically about the danger of being in the way of snowplows who may not be able to see unhoused people who are in the pathway. The annual audit of the prioritization framework gives the SAMPS team flexibility in addressing changing conditions. The next update is scheduled for early 2024. This review will happen in conjunction discussions about the emerging and current issues described above, including weather-related challenges and encampments on private property, among others. Goal 4: Reduction in Crime and Disorder in Designated Areas of Emphasis • Evaluate Historical Patterns of Crime and Disorder in Designated Areas of Emphasis. • Maintain Police Support in Designated Areas. Study Session Update on Homelessness Strategy Page 61 Packet Page 64 of 85 The focus of this long-term goal is to address crime and disorder in the community. The Boulder Police Department’s criminologist developed these strategies which allow staff to conduct important evaluations. This is vital for developing informed programs and practices, to include a targeted presence to mitigate criminal behavior and reduce harm. The Boulder Police Department (BPD) has made strides in maintaining police support to the city-identified encampment areas. In 2023, BPD moved the Pearl Street Mall Team and the Homeless Outreach Team to the Atrium Building at 13th Street and Canyon Boulevard to enable officers to patrol these downtown spaces and engage with members of the community more effectively. This includes: • One patrol sergeant • Six officers for the areas around the Pearl Street Mall • Two non-enforcement Homeless Outreach Team officers to provide navigational support, and courtesy transports for unhoused individuals • Three officers to assist with the City of Boulder teams notifying encampment residents and connecting them with available services and resources As staffing has increased, the Boulder Police Department has been able to fill all vacancies in the Pearl Street Mall Team and will soon fill the remaining vacancy in the notification team. This staffing has meant that officers are able to perform tasks such as engaging with local businesses and proactively working to prevent crime, consistent with the Reimagine Policing Plan. Staffing also allowed two mall team officers to proactively identify and arrest someone distributing a significant amount of drugs in an encampment area, within 1,000 feet of a school. This work prevented harm to the surrounding community and is an example of how BPD is working to get drugs off the street, an important police focus given the drug overdoses observed this past year in encampment areas. In 2023, BPD responded to more than 120 drug overdoses across the city, and 42% of these overdoses occurred in encampment areas. Among the overdoses in encampment areas, eight were fatal, and more than half of these encampment overdoses were suspected of involving fentanyl. Naloxone was used to try and save lives in more than 30 overdose incidents near encampments in 2023. This past year, BPD has continued to develop compassionate and creative solutions for addressing circumstances in encampment areas. One example of this is BPD’s continued efforts on a US Department of Justice grant it was awarded to build a coordinated response to homelessness. This has involved surveying dozens of unhoused individuals in encampment areas in the fourth quarter of 2023 to ask why certain areas are selected for camping and what barriers unhoused persons experience to becoming housed. These efforts were facilitated by multiple city and community partnerships and employ a holistic approach for considering evidence-based responses. Multiple peer-reviewed academic studies about the nature of police-unhoused interactions, and the utility of police data for homeless outreach efforts have also resulted from this work. Police-related events, such as reported crime or transportation to alcohol treatment Study Session Update on Homelessness Strategy Page 62 Packet Page 65 of 85 centers, increased overall in 2023 compared to 2022. Circumstances requiring police tend to increase in encampment areas in the summer months and decrease in the winter months. Property crime, such as vandalism and burglary, as well as quality-of-life crimes, such as drug charges and trespassing, increased in encampment areas compared to the rest of Boulder. Figure 28. Count of Police Circumstances in Encampment Areas, 2021-2023 Figure 29. Percent of Police Circumstances across Boulder that occurred in Encampment Areas BPD has additional strategies for further increasing public safety in encampment areas in 2024. First, BPD’s efforts to better track overdose incidents have enabled a more informed police response for overdose hotspots to prevent drug sales and save lives. These strategies will be employed in partnership with the Boulder County Drug Task Force. Second, Stratified Policing, the department’s approach to crime prevention, is being leveraged to address repeat offenders, repeat locations, and repeat targets in encampment areas. By using crime science principles and fostering community partnerships, BPD aims to work with residents, businesses, and community groups to Study Session Update on Homelessness Strategy Page 63 Packet Page 66 of 85 address crime in specific encampment areas where the greatest impact is possible. Lastly, BPD will use the Department of Justice grant to develop evidence-based responses with the help of relevant stakeholders and assess those responses using the SARA framework (scanning, analysis, response, assessment). Goal 5: Visitors Have Access to Knowledgeable Resources on City Services • Fully Implement Urban Park Ranger Program. • Increase Scope of Downtown Ambassador Program. • Improve SAMPS Team Knowledge Base for Visitor Requests/Questions Different from Goal 2, this goal focuses on the primarily non-homelessness resource components of the SAMPS team – Urban Rangers and Downtown Ambassadors. Strategies emphasize presence; personnel development and training; understanding of visitor access to requested information, specific to the Downtown Ambassadors; and enhancing coordination to ensure responsiveness to visitor needs (separate from collaboration on unhoused individuals). Urban Park Ranger Program Positions funded for the Boulder Parks and Recreation (BPR) Urban Ranger program were filled as of December 2022, including three fixed-term, full-time employees. In 2023, the program also included one-time funding for seasonal support. Urban Rangers generally operate seven days a week from 7:00 a.m. to 5:30 p.m. Urban Rangers patrol parks for violations of the Boulder Revised Code, generally related to peoples’ safety and protection of public spaces. Among a wide variety of issues, urban park rangers often handle dog violations, wildlife harassment, public trespassing, permit compliance, fires, and littering. In 2023, Urban Rangers conducted approximately 6,300 patrols, with 1,750 (or 28%) of those along the Boulder Creek Path from Eben G Fine Park through Central Park and Andrews Arboretum. An additional 207 patrols were conducted on the Pearl Street Mall, supporting special events and the Downtown Ambassadors. Urban Rangers made 1,700 enforcement contacts, primarily issuing warnings to educate visitors about appropriate and safe use of public spaces, issuing summons in only 5% of cases. While they can and do enforce the Boulder Revised Code, the Urban Rangers emphasize providing education and building relationships. The rangers work with the public to teach them how to interact with the city’s parks, wildlife, natural resources, and other visitors respectfully and sustainably. Rangers may answer questions about Boulder’s history, natural environment, and city resources. In 2023, Urban Rangers made over 7,000 of these non-enforcement contacts throughout the BPR system. Education is a core service of the Urban Rangers, helping BPD host youth bike rodeos and interacting with Open Space and Mountain Parks (OSMP) Junior Rangers. They also support city staff doing routine work or special projects throughout the parks system and facilities for extra safety measures, traffic control, or de-escalation. Rangers provide extra security for large public events that are hosted in the parks to make sure participants are having a safe and fun Study Session Update on Homelessness Strategy Page 64 Packet Page 67 of 85 time, such as the What’s Up Boulder event in September and the bike registration drive on the Pearl Street Mall in October. Figure 30: Urban Ranger Dashboard Throughout the year, BPR Urban Rangers provided support for events in the Civic Area, such as the Farmer’s Market, Snow Much Fun, Social Streets on 13th, and Arts in the Park. Urban Rangers ensured the area was safe and clean for vendors and contractors to set up and provide patrols during event hours when capacity and timing allowed. Urban Rangers regularly supported SAMPS clean-up activities as backup for BPD and Utilities staff. The rangers participated in both the winter and summer Point in Time counts. For 2024, BPR requested ongoing funding and an expansion of the Urban Ranger program. Due to ongoing pressures on the General Fund, the program was funded only through the end of 2024. This enables the program to maintain its current full-time staffing with the ability to increase high-season (Memorial Day through Labor Day) capacity by hiring three temporary Urban Rangers. The program continues to expand its capabilities in 2024 with additional training and equipment, such as body worn cameras. The program will again seek ongoing funding as part of the 2025 budget process to support this valuable service to the community. Study Session Update on Homelessness Strategy Page 65 Packet Page 68 of 85 Figure 31: Urban Ranger Non-Enforcement Contacts by Type Figure 32: Number of Non-Enforcement Urban Ranger Contacts Study Session Update on Homelessness Strategy Page 66 Packet Page 69 of 85 Figure 33: Top Ten Types of Downtown Ambassador Contacts Figure 34: Number of Downtown Ambassador Contacts Study Session Update on Homelessness Strategy Page 67 Packet Page 70 of 85 Goal 6: Maintenance Crews Can Safely Access Critical Infrastructure in Public Spaces • Ensure that Crews are Aware of and are Monitoring Critical Public Infrastructure. • Explore Methods to Improve Measurement of Barriers to Safe Access. • Identify Methods to Improve Worker Safety in Parks and Public Spaces. Goal 3 addresses community safety, while Goal 6 focuses on the teams who do this and associated work. Strategies work to ensure that crews are aware of and are monitoring critical public infrastructure while exploring methods to improve measurement of barriers to safe access. Strategies and actions under this goal guide work to understand the safety issues faced by SAMPS team members, with an additional goal of reducing staff turnover. The creation and subsequent expansion of the operational team has allowed city staff from other city departments return to normal job functions versus being pulled away to address impacts from unsanctioned camping. This staffing reset has significantly reduced Parks and Recreation operational staff turnover in the past two years and staff report increased job satisfaction and perceptions of safety with the focused operational team and public safety support. Field worker input identified a need for enhanced communications and training to address safety concerns. SAMPS has identified, and staff have begun completing, necessary training, including Hazardous Waste Operations and Emergency Response (HAZWOPER) training, Occupational Safety and Health Administration (OSHA) general industry training, de-escalation skills, bloodborne pathogen certification and other trainings to enhance staff safety. Additional training including trauma informed care and mental health first aid will continue to be vetted and offered in 2024. Goal 7: Waterways are Free of Contamination • Reduce Trash/Hazards in Waterways. • Maintain Stable or Reduce E. coli Trends, Especially During Recreation Season (May – Oct.) with the Recognition that There are Many Sources of Contamination in Boulder Creek. Goal 7 is specific to waterways, and the strategies and actions reflect measurable steps that are within the control of the SAMPS team. Under this goal, staff works to evaluate ideas to mitigate the impact of fecal matter, trash and E. coli. On October 20, 2022, council approved funding for a pilot program to prevent trash and unwanted items from migrating from University Hill and other nearby areas into encampments along the Boulder Creek corridor. In response, staff implemented a pilot effort to provide enhanced trash collection in the student-dense neighborhoods of University Hill and Goss-Grove during spring and fall University of Colorado (CU) move-in/out 2023. Study Session Update on Homelessness Strategy Page 68 Packet Page 71 of 85 During this initial pilot, the city provided 15 large capacity dumpsters throughout the two neighborhoods. Although the dumpsters experienced heavy use, there was not a meaningful decrease in the amount of trash and debris removed from encampments during the same timeframe. Additionally, the operations team was pulled away from its core duties to manage misuse of the dumpsters, such as addressing furniture left outside of the dumpsters. Although a direct relationship between the impact of providing dumpsters and encampment operations cannot be drawn, the pilot program did not work as intended to substantially reduce trash in encampments and the reduction in encampment-related trash removal during the pilot was not commensurate with the cost of providing dumpsters, which was close to $80k. The table below shows tonnage collected during 2022 and in 2023 with the enhanced trash collection program. Figure 35: Volume of Trash Removal Also related to clean waterways, staff continue to monitor E. coli in Boulder Creek monthly throughout the year and weekly from August to October, when E. coli concentrations are historically higher primarily due to low flows and warm stream temperatures. Monitoring data shows that E. coli trends have generally been stable over the past decade. To support meeting this goal, staff have been implementing priority actions and investigations to identify sources of E. coli and mitigate those sources to the extent practicable, as identified in the 2019 E. coli TMDL Implementation Plan. Goal 8: Users of Public Spaces Feel Safe and Welcome • Improve Information Sharing on “Designated Areas of Emphasis”, and Crime/Calls for Service (CFS) Data for Those Areas. • Continue to Improve Site Activation. • Investigate Ways to Change Prioritization Rubric to Highlight High Visibility Areas. • Improve Compliance with Debris/Needle Disposal. SAMPS work requires transparency in reporting and communications, particularly communications related to responsiveness. The focus of Goal 8 is on communication and perceptions of safety, for the community at large and the city’s employees. Site activation – using public spaces for cultural and recreational purposes – was identified as a key method to reduce unsafe activity and to increase perceptions of safety. With the addition of a second operational team, a review of the prioritization rubric is necessary to build confidence in the team’s ability to address high visibility areas, and reducing the incidence of used needle debris protects the community aids in the perception of safety. Study Session Update on Homelessness Strategy Page 69 Packet Page 72 of 85 A new SAMPS dashboard has been created to give a holistic view of the SAMPS program and the interconnection between the various ongoing efforts related to homelessness and public spaces. The dashboard explains the process of how the city receives encampment reports through Inquire Boulder, and how those reports are subsequently addressed by SAMPS. This dashboard is in addition to and complements the data tracking dashboard, which provides weekly and historical statistics about the clean-up work being performed. At the request of Boulder Valley School District, the sharps container near Boulder High School was removed. Staff are currently evaluating use patterns and are determining future container placement. NEXT STEPS Staff will continue to develop the 2024 Action Plan, which will address responses to emerging issues. The 2024 Action plan will be heavily guided by the feedback received at the Field Worker Workshop scheduled for the first quarter of 2024. A portion of the workshop will focus on a review of the prioritization criteria for any needed updates to optimize operations and refine data collection. The team will also consider how best to ensure consistent and relevant data collection to support continued evaluation of the work and specific practices and approaches. In addition, staff will compile an assessment of progress toward stated 2023 strategies and actions. As part of the 2025 budget process, staff anticipate a request to create ongoing funding for the Urban Park Rangers, as the program is currently funded through a one-time 2024 allocation. ATTACHMENTS Attachment A: Glossary of Homelessness Terms Attachment B: Endorsements of High Utilizer Program Proposal Study Session Update on Homelessness Strategy Page 70 Packet Page 73 of 85 Attachment A Glossary of Homelessness Terms and Acronyms Acuity: speaks to the severity of a presenting issue. In the case of an evidence-informed common assessment tool like the SPDAT, acuity is expressed as a number with a higher number representing more complex, co-occurring issues that are likely to impact overall housing stability. Affordable Housing: Any type of housing, including rental/home ownership, permanent/temporary, for-profit/non-profit, that costs less than 30% of a household’s pre- tax income. Alternative Sheltering: Sheltering options outside of traditional congregate shelters. Ex: Safe Outdoor Spaces (SOS), Pallet shelters, micro communities. American Rescue Plan Act of 2021 (ARPA) – funding allocated by the Federal government to cities, counties, and states to address issues causes by the COVID-19 pandemic. At Risk of Homelessness: people who are not experiencing homelessness, but whose current economic and/or housing situation is precarious or does not meet public health and safety standards. Best Practice: A program, activity or strategy that has the highest degree of proven effectiveness supported by objective and comprehensive research and evaluation. Boulder Community Health (BCH): Boulder Community Health is a community owned-and-operated nonprofit health system dedicated to providing local access to high- quality medical care to people and businesses in Boulder and surrounding areas. Boulder Shelter for the Homeless (BSH): A private nonprofit organization that provides congregate, overnight shelter services for men, women, and transgender individuals. BSH is a housing focused shelter and is the main shelter for single adults experiencing homelessness. Boulder Targeted Homelessness Engagement Referral Effort (BTHERE): Outreach designed to meet people experiencing unsheltered homelessness where they are. This service is part of Coordinated Entry and provides a variety of services and information related to housing as well as certain pre-housing activities (connection to benefits, identification, etc.). Bridge House: a local nonprofit that provides basic services to the unhoused and runs job training programs (Ready to Work, Community Table) that include a short-term residential component. Study Session Update on Homelessness Strategy Page 71 Attachment A: Glossary of Homelessness Terms Packet Page 74 of 85 Building Home: consists of Daytime programming, Peer Support, Community Building supports with the aim of increasing housing retention of Permanent Supportive Housing program participants Built for Zero: methodology used by more than 100 cities and counties that have committed to measurably ending homelessness, one population at a time with a focus on comprehensive, real-time, by-name data. Case Management: a collaborative and client-centered approach to service provision for persons experiencing homelessness. In this approach, a case worker assesses the needs of the client (and potentially their families) and when appropriate, arranges, coordinates and advocates for delivery and access to a range of programs and services to address the individual’s needs. Chronic Homelessness: A person experiencing homelessness with a disabling condition who has either been continuously homeless for a year or more or has had at least four episodes of homelessness in the past three years. Clinica: a medical and dental care provider for low-income and other underserved people in south Boulder, Broomfield, and west Adams counties. Collaborative: is the term used to describe loosely affiliated networks as well as more formal partnerships between people working across departments, organizations or sectors. Unlike integration, collaboration does not require formal infrastructure to merge work processes across organizational sites Co-Occurring Disorder (Dual Diagnosis): A diagnosis that describes both a mental health concern and a substance misuse disorder. Continuum of Care (CoC): designed to promote a community-wide commitment to the goal of ending homelessness; to provide funding for efforts by nonprofit providers, states, Indian Tribes or tribally designated housing entities (as defined in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103) (TDHEs)), and local governments to quickly rehouse homeless individuals, families, persons fleeing domestic violence, dating violence, sexual assault, and stalking, and youth while minimizing the trauma and dislocation caused by homelessness; to promote access to and effective utilization of mainstream programs by homeless individuals and families, and to optimize self-sufficiency among those experiencing homelessness. The CoC for the seven-county Front Range area is administered by Metro Denver Homeless Initiative. Coordinated Entry (CE): process that standardizes the way individuals and families at risk of homelessness or experiencing homelessness access are assessed for and referred to the housing and services that they need for housing stability. CE screening is provided at 909 Arapahoe (soon to move to the Day Service Center), and BTHERE can provide CE services in the field. Study Session Update on Homelessness Strategy Page 72 Attachment A: Glossary of Homelessness Terms Packet Page 75 of 85 Day Services Center (DSC): The Day Service Center is a council 2022 initiative that is scheduled to open in spring 2024 at Boulder Shelter for the Homeless. The DSC will provide a co-location for various service providers, basic services, peer services, case management, mental and behavioral health services, Community Court, and other services designed to engage people and encourage housing. Deacon’s Closet: a faith-based supply donation distribution program for people in need. Department of Housing (DOH): State of Colorado department that partners with local communities to create housing opportunities for Coloradans who face the greatest challenges to accessing affordable, safe, and secure homes. DOH supports projects ranging from homelessness prevention to homeownership. Department of Local Affairs (DOLA): a State of Colorado agency that serves as the primary interface between the State and local communities. DOLA provides financial support to local communities and professional and technical services to community leaders in the areas of governance, housing, and property tax administration. Disability/Disabling Condition: According to the U.S. Department of Housing and Urban Development, a person shall be considered to have a disability if the person is determined to have a physical, mental, or emotional impairment that: (1) is expected to be of long-continued and indefinite duration, (2) substantially impeded his or her ability to live independently, and (3) is of such a nature that the ability could be improved by more suitable housing conditions. A person shall also be considered to have a disability or he or she has a developmental disability as defined in the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6001-6006). The term also includes the surviving member or members or any household described in the first sentence of this paragraph who were living in an assisted unit with the deceased member of the household at the time of his or her death. Diversion: assists persons experiencing homelessness with creative solutions to their housing issues, and these services aim to redirect people from temporary shelter toward alternate housing options. Works to divert people from the sheltering system and long term homelessness through assistance such as reunification. Emergency Shelter: Any facility with overnight sleeping accommodations, the primary purpose of which is to provide temporary shelter for the homeless in general or for specific populations of homeless persons. The length of stay can range from one night up to as much as three months. Episodically Homeless: Refers to those who move in and out of homelessness Eye Movement Desensitization Reprocessing (EMDR): is a non-invasive, evidence- based method of psychotherapy that helps victims recover from the effects of psychological trauma through adaptive information processing. EMDR therapy is an Study Session Update on Homelessness Strategy Page 73 Attachment A: Glossary of Homelessness Terms Packet Page 76 of 85 eight-phase trauma treatment that comprehensively identifies and addresses experiences that have overwhelmed the brain’s natural resilience or coping capacity, thereby generating traumatic symptoms and/or harmful coping strategies. Through EMDR therapy, patients are able to reprocess traumatic information until it is no longer psychologically disruptive. Focus ReEntry: nonprofit that was founded to serve the needs of people in the Boulder County Jail before, during, and after their release and reentry into the community. Functional Zero: Functional zero is a dynamic milestone that indicates a community is continuously rendering homelessness rare overall and brief when it occurs, for a population. Harm Reduction: refers to policies, programs and practices aimed at reducing the risks and negative effects associated with substance use and addictive behaviors for the individual, the community and society as a whole. Haven Ridge: helps unhoused and at-risk women and transgender individuals and their children through sheltering, services, and pathways to housing. High Utilizer: an unhoused person that has an outsized impact on community services Homeless Management Information System (HMIS): is an information technology system used to collect client-level data and data on the provision of housing and services to individuals and families at risk of and experiencing homelessness. Each CoC is responsible for selecting an HMIS software solution that complies with HUD's data collection, management, and reporting standards. Homelessness: the state of having no home. HUD defines homelessness as meeting one of four categories: literally homeless, imminent risk of homelessness, homeless under other federal statutes, and fleeing domestic violence. Homeless Outreach Team (HOT): a two non-enforcement officer team that assists with people experiencing unsheltered homelessness. Homeless Retention Team (HRT): a team of Boulder Shelter for the Homeless professionals that aid the case manager and provide a number of additional supports (mental health, medical, etc.) for people who require more services to remain in housing. Homeless Solutions for Boulder County (HSBC): an innovative approach to homelessness that includes multiple government entities including Boulder County and the Cities of Boulder and Longmont, the nonprofits working to impact homelessness, and other external partners. This regional integrated service system combines a coordinated entry process with the provision of timely and appropriate supportive and housing services to assist people in moving out of homelessness and into housing in the most efficient ways possible. Study Session Update on Homelessness Strategy Page 74 Attachment A: Glossary of Homelessness Terms Packet Page 77 of 85 Housing First: a homeless assistance approach that prioritizes providing permanent housing to people experiencing homelessness, thus ending their homelessness and serving as a platform from which they can pursue personal goals and improve their quality of life. Medically Assisted Treatment (MAT): the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery. Mental Health Partners (MHP): community-based provider of mental health and addiction services in Boulder, Broomfield, Lafayette, Louisville and Longmont. Metro Denver Homeless Initiative (MDHI): is the region’s Continuum of Care (CoC) administrator, designated by the US Department of Housing and Urban Development to coordinate Metro Denver’s response to homelessness. MDHI is a collaboration of nonprofit and government agencies, elected officials, nonprofit leaders, and people with lived expertise to bring about an equitable end to homelessness in seven-county Metro Denver. Motivational Interviewing: an evidence-based practice in working with clients that has proven to be successful. In this approach, the service provider allows the client to direct the change rather than telling the client what they need to do. This approach is about having a conversation about change. Pallet Shelter: The brand name of a form of alternative shelter that is shipped on a pallet and assembled on site. Pallet Shelters are customizable with air conditioning, heat, smoke detectors, door locks, window, bed, desk, and meet trauma informed standards for people experiencing homelessness. Peer: an individual with lived experience in homelessness, substance misuse disorder, or mental health disorder and in active recovery who provides supportive services to people experiencing homelessness. People/Person Experiencing Homelessness (PEH): an individual or family who lacks a fixed place of residence. Permanent Housing: Housing which is intended to be the tenant’s home for as long as they choose. In the supportive housing model, services are available to the tenant, but accepting services cannot be required of tenants or in any way impact their tenancy. Tenants of permanent housing sign legal lease documents. Permanent Supportive Housing (PSH): Long-term community-based housing and supportive services for homeless persons with disabilities. The intent of this type of supportive housing is to enable special needs populations to live as independently as possible in a permanent setting. The supportive services may be provided by the Study Session Update on Homelessness Strategy Page 75 Attachment A: Glossary of Homelessness Terms Packet Page 78 of 85 organization managing the housing or provided by other public or private service agencies. There is no definite length of stay. Point-in-Time Count (PIT): Nationwide count of PEH conducted in January who are sheltered and unsheltered. The count is a snapshot in time and not to be used as a measurement of the actual number of homelessness due to variables such as weather, count participation, and methodology can impact outcomes. Project Recovery/Tribe Recovery: aims to end the cycle of incarceration, support the recovery and reentry process, reduce incidences of crime and recidivism, and create a safer community through the creation of substance use recovery homes throughout Boulder County. A collaborative between Boulder County, City of Boulder and Tribe Recovery, the program administrator. Promising/Emerging Practice: A program, activity or strategy that has worked within one organization or more organizations and shows promise for becoming a best practice with long term sustainable impact after scientific testing. A promising practice must have some objective basis for claiming effectiveness and must have the potential for replication among other organizations. Project-Based/ Single Site Housing: housing located in single buildings, typically owned by the housing and support services provider. This type of housing allows staff to provide a high level of supervision and offers the greatest latitude in responding to the challenges of housing its participants. Staff is typically located on-site and can respond immediately to issues that may arise. While this approach minimizes community integration and limits participant choices in housing, it can offer its residents more community support. Rapid Re-housing: Rapid re-housing focuses on moving homeless individuals and families who are living in shelters or on the street as quickly as possible into appropriate housing using many of the same tools used by prevention strategies. Reunification: client-driven case-management approach that seeks to identify and nurture opportunities to allow a person to return to their support network. In Boulder, reunification often involves a short shelter stay while connections to family/friends are being made and it is determined that it is a safe situation. Safe and Managed Public Spaces (SAMPS): city team working to ensure that public spaces are safe and welcoming for all. Guided by compassion and a people-focused approach, the work of the SAMPS team reflects a coordinated, multidisciplinary approach that leverages expertise of community partners to manage the city’s public spaces. Safe Outdoor Spaces (SOS): provides dedicated spaces for tentsor other structures for temporary occupancy. An SOS also provides social services and support facilities for occupants. Study Session Update on Homelessness Strategy Page 76 Attachment A: Glossary of Homelessness Terms Packet Page 79 of 85 Scattered Site Housing: Scattered-site housing is generally defined as low-density housing in buildings (less than 15 units per site) located in economically and racially diverse neighborhoods. The housing is usually provided through private landlords and management companies and tenants are party to standard leases. Except in places with very low vacancy rates and or high rental housing costs, scattered-site housing maximizes choice in housing for housing first program participants. Supported or Supportive Housing: Permanent housing with services. The type of services depends on the needs of the residents. Services may be short term, sporadic, or ongoing indefinitely. Supportive Services: Services such as case management, medical or psychological counseling and supervision, childcare, transportation, and job training provided for the purpose of facilitating the independence of residents. Ten-Year Plan – A strategic planning document developed by a locality, with vigorous encouragement from the federal Interagency Council on Homelessness, with the aim of ending “chronic homelessness” within the specified temporal parameters. See: Chronic Homelessness. Transitional Housing: A program designed to provide housing and appropriate support services to homeless persons to facilitate movement to independent living within 24 months. (HUD definition) Trauma-Informed Care: focused on an understanding of and responsiveness to the impact of trauma. It emphasizes physical, psychological, and emotional safety and enhances wellbeing by empowering individuals to define their needs and goals and make choices about their care and services. Study Session Update on Homelessness Strategy Page 77 Attachment A: Glossary of Homelessness Terms Packet Page 80 of 85 Attachment B Endorsements of High Utilizer Program Proposal Boulder Community Health Individuals experiencing homelessness often face a myriad of health challenges exacerbated by their living conditions, leading to frequent and avoidable healthcare utilization. It has become increasingly evident that addressing the needs of unhoused high utilizers is not only a compassionate endeavor, but also a strategic initiative for Boulder Community Health. Through a comprehensive analysis, we have identified a notable correlation between high- utilizers and increased healthcare costs, including unnecessary emergency medical interventions, long-term inpatient stays, and hospital readmissions. By actively participating in the Interagency Taskforce on Boulder’s Unhoused High Utilizers Initiative, we strive to enhance the well-being of individuals experiencing homelessness as well as contribute to the overall efficiency and sustainability of our local healthcare system, promoting preventative care and long-term health outcomes within the community. This approach aligns with a broader understanding of healthcare that extends beyond clinical interventions to encompass social and environmental factors influencing individuals' health and quality of life. Our commitment to this initiative is rooted in the belief that addressing the unique needs of high- utilizers will not only enhance the quality of care provided, but also contribute to the overall well-being of our community. Dr. Robert Vissers, President and CEO Grant Besser, President, BCH Foundation Boulder County Commissioners’ Office The individuals who have been identified as “high utilizers” have complex needs that existing programs and services are unable to meet. The result is a degree of impact on health care, law enforcement agencies, businesses and people using public spaces that is disproportionate to their numbers. In addition, although high utilizers have been identified based on their impacts to various systems, we should not lose site of the fact that they are people whose lives have gotten far off-track and they are at increased risk of being victimized and needlessly suffering from exposure and from untreated mental health and substance use disorders. Boulder County has long supported evidence-based efforts to provide housing to people experiencing homelessness. With the higher acuity of need that Boulder County and the municipalities in Boulder County have been seeing in recent years, we believe that a renewed effort is needed. The Proposed Program under consideration by the Interagency Taskforce reflects best practices identified by the Corporation for Supportive Housing and would create an interdisciplinary approach to services that is consistent with a housing first model. The program has been successful in other communities. For this Study Session Update on Homelessness Strategy Page 78 Attachment B: Endorsements of High Utilizer Program Proposal Packet Page 81 of 85 reason, Boulder County supports continued efforts to find funding for the program and a location to provide the specialized housing needed. Claire Levy, Boulder County Commissioner Boulder County Sheriff’s Office Throughout the course of my career, both at the Boulder Police Department and the Sheriff’s Office, I have witnessed a small number of people in our community that disproportionately impact the criminal justice system, medical providers and other services. In the past, efforts to address this population have failed to gain traction and make a meaningful difference. The current work being conducted to identify and ultimately address the high utilizers includes a broader multi-disciplinary approach and a stronger commitment to actually try to accomplish meaningful work. I support this effort because we have used a much larger set of data to identify the people who need our attention and I believe that we can take action, assess the progress and then decide whether or not to continue this project. Curtis Johnson, Sheriff Boulder Shelter for the Homeless I am writing in support of the recent efforts to provide a coordinated response and appropriate supportive housing system resources to reduce the impact of homeless individuals who are chronic users of the local criminal justice system – otherwise known as the High Utilizer Task Force. Housing, with associated high intensity case management, peer, and clinical services, is the only known activity that reliably reduces the impact these homeless individuals are having on our community. Data collected by our Muni Court since 2014 conclusively demonstrates that interventions resulting in housing and intensive wrap around services makes our community safer. Efforts in Denver through the Colorado Coalition for the Homeless’s “SIB” (Social Impact Bond) program, which targets a similar population, has had the same results. A variety of studies nationwide have shown that such supportive housing investments are ultimately cheaper than the cost of these individuals remaining on the streets. While this type of programing is resource intensive, it is ultimately an investment in community safety while providing life changing outcomes for the participants and an opportunity to realize cost savings in utilization reduction. As such, the Boulder Shelter for the Homeless is in full support of these efforts. Michael Block, CEO District Attorney’s Office Study Session Update on Homelessness Strategy Page 79 Attachment B: Endorsements of High Utilizer Program Proposal Packet Page 82 of 85 The District Attorney’s Office has worked closely with staff from the City of Boulder and other agencies on the High Utilizer Program. I strongly believe in the High Utilizer Program because it pushes services to those in need and has fostered better information sharing between agencies. Through this work, we have identified approximately 50 people having a disproportionate, negative impact on community safety and well-being, as well as on their own lives. The High Utilizer Program provides these individuals with direct services and, if/when they commit a criminal offense, appropriate consequences as a result of the information being shared through this program. The rule of law must be enforced at every level, including for municipal violations. A failure to address low-level offenses is a failed opportunity to address criminal behavior and to prevent more serious offenses. The District Attorney’s Office examined a one-year snapshot of all felony cases, which revealed that 10 percent of felony cases are committed by individuals struggling with homelessness. The sad reality is that the victims of these offenses, which includes murders and felony assaults, are often homeless at the time of the offense. The High Utilizer Program is an opportunity to directly improve community safety, answer the valid concerns of community members, and improve the lives of those who are unhoused. Also, through this work, we are identifying gaps and wraparound services that can help other community members who are currently homeless. I strongly recommend that this work continue. The District Attorney’s Office is fully committed to it. Michael Dougherty, District Attorney Focus Reentry The individuals who have been identified as “high utilizers” have complex needs that cannot be served by one existing program, but rather need a collaborative approach to assistance. Currently, there is not one collaborative program so these individuals must navigate between partner agencies to get all their needs met, which is difficult at best for most. The result is a degree of impact on health care, law enforcement agencies, businesses and people using public spaces that is disproportionate to their numbers. Though these individuals are identified because of their impact on the community we need to remember that they are people whose lives have been affected by untreated mental health and substance use disorder which puts them at an increased risk of being victimized, suffering from exposure, continued untreated mental health and substance use issues, and getting caught in the ongoing cycle of homelessness and incarceration. Focus Reentry has long supported individuals who are caught in the cycle of homelessness and incarceration. We assist individuals in Boulder County secure housing in a manner that is consistent with the housing first model and designed to help those with barriers to housing such as criminal justice involvement, untreated mental health concerns, and substance use. We have found that the primary reason that people are not successful when they are released from jail is that they are experiencing homelessness, which prevents them from maintaining mental health treatments, refraining from substance misuse, and makes it extremely difficult to comply with court obligations. Molly East Focus Reentry, Executive Director Study Session Update on Homelessness Strategy Page 80 Attachment B: Endorsements of High Utilizer Program Proposal Packet Page 83 of 85 Mental Health Partners Mental Health Partners (MHP) is in strong support of the Taskforce’s work and program proposal. As the community’s safety-net comprehensive behavioral healthcare provider, MHP is acutely aware of the challenges created by housing instability for individuals and communities, particularly when compounded with mental illness and addictions. We see consistently that stable housing is a key to recovery and to breaking the cycle of criminal justice system involvement, emergency department utilization, and other high-acuity and high-cost settings. The Taskforce’s proposal to connect individuals with permanent supportive housing with wraparound services will facilitate engagement in effective care at the right level to break the high utilization cycle, set individuals up for successful engagement in recovery, and build a more equitable community. MHP manages nearly 500 housing vouchers and works directly with a high-acuity population with complex needs related to housing insecurity, serious mental illness, and addictions. We know that services provided in a whole-health and person-centered framework are effective, including permanent supportive housing with wraparound services and engagement supports. MHP’s Housing Team helps approximately 80 individuals successfully attain housing each year, and works with hundreds more in outreach, engagement, and services to maintain housing. And in behavioral health outcome assessments administered across MHP’s outpatient client population, only 22% of clients report feeling satisfied with their housing situation at entry into treatment (n = 5458), increasing to 77% after at least 6 months in treatment (n = 3502). Overall, the Taskforce’s project is a strong match with MHP’s approach to leveraging expertise across partners, capitalizing on each partner’s strengths and bringing a whole health approach with a strong equity lens. Jennifer Leosz, Co-CEO Twentieth Judicial District Probation Department Probation clients can face several challenges in their path to recidivism reduction and behavior change, with homelessness being one of the main impediments. The lack of this important stability factor, especially when it is coupled with unaddressed mental health symptoms, often prevents clients from addressing other basic needs and makes them more prone to substance misuse and criminal justice involvement. Research has shown that being unhoused can substantially decrease one’s chances of successfully completing a community-based supervision sentence. We have seen that even though the County has several programs to address housing for those in need, none of them are equipped or have the right resources to help and support the specific needs that the high utilizer population presents. The 20th Judicial District Probation Department believes that this initiative is a step in the right direction to help those involved in the criminal justice system and lacking housing to acquire one of the most basic needs an individual must have to be Study Session Update on Homelessness Strategy Page 81 Attachment B: Endorsements of High Utilizer Program Proposal Packet Page 84 of 85 ready to address their physical and mental health, reduce their engagement in criminal behavior and take steps to improve their quality of life and the safety of our community. Anjali Nandi, Chief Probation Officer Paloma Gilman, Probation Supervisor Study Session Update on Homelessness Strategy Page 82 Attachment B: Endorsements of High Utilizer Program Proposal Packet Page 85 of 85