El Dorado County, Calif.
Opportunity for Change
El Dorado County is a large geographical county located along the Sierra Nevada Mountains on the California and Nevada border. Due to the underlying causes of homelessness, poverty, unemployment, substance abuse and mental health problems, even relatively rural counties have significant numbers of often-unseen homeless. A 2011 survey of the homeless population in El Dorado County found that on any given night, an average of 322 people are homeless or without stable housing. El Dorado County had two residential facilities in its county seat (Placerville), but none in the basin area, where there is a large transient population. Recognizing that many of these individuals also had a serious mental illness and/or substance use disorder, El Dorado County Mental Health sought and obtained funding to develop and maintain transitional housing opportunities for this population.
El Dorado County’s Model
In July 2015, El Dorado County Mental Health opened a new transitional housing unit in South Lake Tahoe to better meet local mental health needs. Funded through state Mental Health Services Act (MHSA) dollars, the transitional housing site (also known as a t-house) provides a supportive living environment and services for mental health clients who need help transitioning to stable, independent living.
Building on that resource, in September 2015, Mental Health opened a t-house specifically for individuals with the most acute mental health needs who are also involved in the criminal justice system through the Behavioral Health Court or probation – the only t-house in the county with a specific focus on this population. Once admitted to the house, individuals are assigned an intensive case management team that provides full services to help people get back on their feet.
This house was funded through a state Mentally Ill Offender Crime Reduction Act (MIOCRA) grant with additional funding from the county, Medi-Cal (California’s Medicaid program) and MHSA. Up to six people (men and women) at a time can live at this t-house, which provides a supportive community environment, mental health professionals and services, such as wellness groups, medication management and classes in basic life-skills (cooking, cleaning, and managing other household responsibilities). Residents are also encouraged to explore college classes and volunteer opportunities and are assisted with job searches once they are stable.
Potential residents of the t-house are pre-screened by Mental Health staff and must meet eligibility requirements before moving in, including Medi-Cal eligibility. Residents must agree to participate in the program structure and treatment plans, and attend their required appointments. They must also agree to live drug-free and actively work toward their goals. Residents pay a $500 per month treatment fee and contribute $35 per week for group meals that are supplemented by faith-based organizations and food pantries. SSI and SSDI benefits are used for the treatment fees. Case managers assist residents in applying for Medi-Cal, which allows the individual to receive mental and other health services. Most residents can expect to stay approximately six to twelve months, with the goal to ultimately find independent housing and live on their own.
Residents sign a release form when they move in to allow Mental Health to talk with Behavioral Health Court and Probation staff about their treatment plan. The Intensive Case Management team at the house meets weekly to discuss clients in the t-house and monthly with the Behavioral Health Court to ensure compliance with any regulations and conditions of the house.
“There is a mental health crisis in today's society,” says El Dorado County Supervisor Sue Novasel. “El Dorado County is working to address the issue by transitioning mental health patients from our jails and into normal living conditions. A critical component for productive treatment is housing, where individuals and groups can feel safe, settled and secure, and where they can maximize their opportunities for success. Transitional housing gives all concerned a chance to turn crisis into care.”
Successes and Outcomes
El Dorado County is just at the beginning stages of implementing these housing units and providing the case management and services to their residents. They hope to be able to show success in terms of accessing and maintaining treatment services, gaining employment, obtaining permanent housing and successfully transitioning to independence. By working with the courts, they are also hoping to reduce recidivism and violations of probation so that fewer individuals are being arrested and returned to the jail.
Sabrina Owen, LMFT
Manager Mental Health Programs, South Lake Tahoe
 U.S. Census Bureau, State & County QuickFacts. http://quickfacts.census.gov/. Accessed November 24, 2015.
 Average Monthly Inmate Population for the past 12 months (Include those housed at other facilities for whom you are responsible; Excluding inmates we are housing for others). Data provided by Captain Jackie Noren, El Dorado County Sheriff’s Department, December 17, 2015.
 Includes both Placerville and South Lake Tahoe county jails. El Dorado County Sheriff 2014 Annual Report http://www.edcgov.us/Sheriff/2014_Sheriff_Annual_Report.aspx
 El Dorado County Homeless Count and Survey Results, January 2011. https://www.edcgov.us/Government/HCED/2011_Homeless_Count_Results.aspx