Tuesday, September 29, 2009

CityWatchLA - Support & Housing Cheaper than Jails & Hospitals

CityWatch, Sept 29, 2009
Vol 7 Issue 80

Construction is finally underway for Hollywood's new Homeless Healthcare facility, located at Hollywood and Van Ness. The property has been empty and dormant for years so the community is anxious to see the 32,000 square foot, state-of-the-art LEED facility completed as soon as possible. The project is Prop F funded with a budget of $30 million and plans call for sustainable innovations such as a "green roof" which will set new standards for City of Los Angeles properties.

The Hollywood Homeless Healthcare facility will not only provide primary medical services to those in need, it will service the patients at their home, or in the case of the homeless, at the location in which they find themselves in need. Also known as Fire Station #82, the three story Regional Fire/Paramedic Station will be large enough to house 16 firefighters per shift. The new fire station replaces the smaller Bronson station which is staffed with four firefighters and two Firefighter/Paramedics at all times. Occupying a tad over 7000 square-feet, the single-bay station requires the firefighters to jockey equipment on a regular basis. Opened in 1951, the old Fire Station #82 predates the 101 Freeway by three years.

Since then, the demands of Hollywood have changed dramatically and FS #82, which is responsible for nearly 2 square miles of Hollywood, all the way into Griffith Park and up to the Hollywood sign, now handle a busy mix of high density residential and commercial properties along with undeveloped hillside and urban wilderness.

Through it all, the Hollywood Fire Department finds fully 40% of its assets dedicated to the medical needs of the homeless population. With little or no access to traditional healthcare, the homeless population typically allows medical needs to progress to the point of "emergency" at which the Fire Department provides immediate primary medical care.

Transporting the homeless patient to one of the local hospitals, of which there are many (healthcare is now the largest employer in Hollywood, recently passing the entertainment industry, ironically making Hollywood the Healthcare Capital!) the FD typically must return to repeat the duty when the indigent patient is unable to access followup treatment for whatever medical problem started the cycle.

During the development of the proposed Villas at Gower, which would provide permanent supportive housing along with medical and rehabilitative services, Capt. Fry of the Hollywood Fire Department reiterated the need to spend wisely on the medical needs of the homeless and pointed out that it's cheaper to plan ahead and to invest in solutions than to ignore the homeless and then to rely on the more expensive and inefficient attention that the Fire Department can offer, which is basic at best and falls far short of providing a long term solution.

Dennis Culhane, University of Pennsylvania Professor of Social Welfare Policy, has written extensively on the subject of permanent supportive housing for the homeless and has demonstrated that it is more expensive to ignore the homeless than to invest in solutions.

For those of you more likely to read Esquire Magazine than medical journals, Professor Culhane was featured in the 2005 Genius Edition as one of the brightest minds in our country for his work developing and promoting long term solutions to habitual homelessness.

In simple terms, Culhane demonstrates how the current system incentivizes shelter entry, and in some cases, long shelter stays, instead of prevention. Current funding paradigms encourage prolonged transitional housing with no demonstrated benefit. He contrasts this with the "Housing First" model that has been very successful in areas with significant populations of chronic homeless, sometimes using rehabilitated hotels as the facility and addressing community blight and homelessness at the same time.

In the Los Angeles area, there are several architectural firms who have made a name for themselves designing Supportive Housing facilities, including Killefer Flammang Architects, Koning Eizenberg, Pugh + Scarpa and Lorcan O’Herlihy Architects.

Developers such as the Skid Row Housing Trust, A Community of Friends and Step Up on Second typically cobble together funding and rely on the star power of the Architects to come up with facilities that they can position as sustainable, innovative architectural assets to combat the resistance they sometimes encounter from the community when the subject of housing for the chronic homeless is brought up.

Through it all, the funding has to appear and the development team has to break ground and in Hollywood there are a few success stories but there are a lot of failures.

As the dirt lot on Gower sits empty, waiting for A Company of Friends to break ground for the Villas at Gower, Step Up on Second is poised to remodel Hollywood's former Galaxy Hotel on Vine, creating 44 modern efficiency apartments offering permanent housing and social services for the mentally ill homeless in Hollywood.

The solution is four-part, requiring a strong funding partner, a strong development partner, a strong operational partner and incredible political will. It takes four out of four. When we find the team that can deliver all four, we should grab them and give them our full support!

(Stephen Box stands vigil on the City of Angels and writes for CityWatch. He can be reached at Stephen@ThirdEyeCreative.net) ◘

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