Trends in Chronic Homelessness among Single Adults in Hennepin County 2016 MCH Annual Conference, October 11, Mayo Civic Center Adapted in part from a Humphrey School of Public Affairs Capstone Project, Spring 2016, “Analyzing chronic homelessness in Hennepin County” by Candice Cheng, James Chege, Tian Qiu, Adam Wahlberg and Capstone Advisor: Dr. Maria Hanratty

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How is Chronic Homelessness Defined? Chronic Homelessness= disability and… Continuous Homelessness: A person has spent at least one night in shelter for each of the past 12 months. OR Episodic Homelessness: A person had four episodes of homelessness in the past three years, with months adding up to 12 Old definition did not require 4 episodes to equal 12 or more months

“Although chronic homelessness represents a small portion of the overall homeless population…this population consumes more than half of services.” Source: Substance Abuse and Mental Health Services Administration

Homeless Population, Hennepin County, 2004-14 (New federal definition of chronic homelessness, 30 days episode gap) 11,346 10,229 7,858 5,430 5,294

Chronic Homeless Population, Hennepin County, 2004-14 (New federal definition of chronic homelessness, 30 days episode gap) Continuous & Episodic Episodic Only Continuous Only

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We Applied The Old Federal Definition 65% reduction New Federal Definition

Number of Homeless Episodes in Three-Year Time Interval (30 day episode gap)

Length of Longest Spell (days)

Demographics

Demographics: By Age 2012 to 2014

Demographics: By Gender 2012 to 2014

Demographics: By Race 2012 to 2014

Demographics: Education Level 2012 to 2014

Health Service Use

“Approximately 30 percent of the chronically homeless population has a serious mental illness.” Source: Office of National Drug Control Policy

Mental Health Inpatient 2012 to 2014

Mental Health Outpatient 2012 to 2014

“…around two-thirds [of the chronically homeless population] have a primary substance use disorder or other chronic health condition that create major difficulties in accessing and maintaining stable, affordable, and appropriate housing.” Source: Office of National Drug Control Policy

Emergency Room 2012 to 2014

Chemical Dependency- Inpatient 2012 to 2014

Chemical Dependency- Outpatient 2012 to 2014

Prison & Detentions

Number of prisoners released from prison in the United States: 150,000 in 1972 “Many individuals leaving the criminal justice system are unable to obtain access to housing and as many as 45 percent return to homelessness.” Sources: U.S. Department of Justice and Office of National Drug Control Policy

Prison 2012 to 2014

Detention (incarceration excepting prison) 2012 to 2014

Policy Recommendations from Capstone Target the needs of chronic homeless by episodic and continuous homelessness sub- populations. Target shelter users who consume highest percentage of services: Those who use detention. Those who use mental health & emergency services. Emphasize broad primary stakeholder collaboration between Hennepin County and incarceration and mental health systems. Follow up research on pattern of service use based on different definitions. Continued exploration of data using sensitivity analysis.

Next Steps in Hennepin County New cohort of chronically homeless single adults identified meets definition with shelter use 2013-2016 649 met that definition – 571 matched to county data systems

Demographics Disproportionately age 45-64, 78% male 40 were age 18-24, 16 were over age 65 – small numbers but concerning People of color – 55 percent African American, 6 percent Native

Use of income supports Most received some kind of income support

Involvement with Criminal Justice More than half had at least one booking in Hennepin County jail

Use of Health Care 80% had an emergency department visit Half of the visits were for Mental Illness or Substance Use Almost one quarter had an inpatient hospital stay Most inpatient hospitalizations were for mental illness or substance use

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