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AB 2034 (Assembly Bill 2034) Integrated Services to the Homeless Mentally Ill

March 31, 2003

REACH Building - ExteriorREACH Building - ExteriorBy Gary Hubbard, MFT, Administrator San Diego REACH

Three years ago, California Assemblyman Darrell Steinberg became aware of the increasing number of homeless gathering at a Sacramento faith-based agency serving the homeless. Assemblyman Steinberg decided to delve into the problem and look for possible solutions. After some investigation, he learned that many of these individuals were mentally ill and that the homeless mentally ill in particular had difficulty accessing services, thereby trapping them in a cycle of homelessness. Often they would fall through the cracks due to the transient nature of their lives, the symptoms and consequences of their mental illness, and the unwelcoming nature of government bureaucracy.

Addressing the Problem with a Integrated Approach
In response, Steinberg worked in conjunction with the California Department of Mental Health to develop Assembly Bill 34 (AB34). Born in 1999, AB34 was a pilot project to provide integrated services to the homeless. Sacramento, Stanislaus, and Los Angeles Counties became the pilot sites for this innovative approach. This pilot was so successful in lowering hospitalization, incarceration and homeless episodes the program was expanded to more than 30 counties in late 2000 as AB 2034. Data collection by the pilot programs demonstrated the success of the services being provided.

Telecare Corporation has become a recognized leader in providing AB 2034 homeless services and is the largest single provider of these services in the state. Telecare Corporation serves the homeless mentally ill in Los Angeles, Santa Barbara, San Mateo, Stanislaus, Ventura and San Diego Counties. Each program has unique characteristics that model the individual needs of the county they serve.

REACH Building - LobbyREACH Building - LobbySan Diego REACH (Reaching Out and Engaging to Achieve Consumer Health) is unique in that it is a large collaboration of providers working together to meet the needs of the homeless mentally ill in downtown San Diego. This collaboration has brought together outreach, case management, psychosocial rehabilitation, psychiatric, medical, dental, vision care, and housing providers plus law enforcement and probation to meet the needs of the whole person.

AB2034 in Action
In the San Diego project, Telecare Corporation provides outreach and case management services.  Starting December 26, 2000, REACH staff outreached over 1600 persons and enrolled over 250 members in 6 months. Case managers met the homeless where they were and carried a "do whatever it takes" attitude of engagement to build trust. Often prospective members were outreached, enrolled and housed all within the same day. Others were more challenging, taking months of daily contact before they would allow our staff to assist them. After enrollment, members were offered a variety of services provided by the project such as housing, food assistance, bus passes, psychiatry and free medical, dental and vision care. The case manager meets regularly or as often as needed with each member to assure that services are reaching the member.

The Results
Few mental health programs can point directly to how well their services are working. However, AB 2034 programs are required to collect data in several major domains and can demonstrate their effectiveness.  In San Diego for instance, homeless episodes have been decreased by 88%, incarcerations by 60%, and hospitalizations by 51%. Due to similar results statewide, the integrated services program is being considered as a model for the way adult mental health services should be delivered.

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