01/09/2013 - Reflections from the Streets of Hollywood

Recently, I accompanied the VA Greater Los Angeles’ (VA GLA) new Assertive Community Treatment (ACT) team, to observe their work in Hollywood, California.  I wanted to see the team in action, tackling issues on the ground level. Ending Veteran homelessness in Los Angeles cuts across three of my top priorities as Executive Director of USICH:  ending Veteran homelessness, ending chronic homelessness, and reducing all homelessness in Los Angeles.
Pictured L-R: Veteran client, Janell Perez, Barbara Poppe

The ACT team is part of the VA’s Housing First demonstration project.  The team provides case management support to Los Angeles County Supervisor Zev Yaroslovsky’s Project 60. Project 60 (a replication of Project 50) is an innovative partnership between VA GLA, community based non-profit organizations, and the Supervisor’s deputy, Flora Gil-Krisiloff.  Project 60 uses HUD-VASH vouchers from the Housing Authority of the City Los Angeles (HACLA) in order to get chronically homeless and vulnerable Veterans into permanent supportive housing with access to comprehensive, wrap-around services. Supervisor Yaroslovsky provided county funding to support the efforts of the non-profit partners, including Ocean Park Community Center (Santa Monica), Step Up on Second (Hollywood), St. Joseph Center (Venice), and San Fernando Valley Community Mental Health Center (Van Nuys).The Hilton Foundation, working through the Corporation for Supportive Housing brought together financial assistance to help with move-in costs.  Project 60 also collaborates with Hollywood’s Vulnerability Registry as part of the 100,000 Homes Campaign (an initiative of Community Solutions). HACLA has been a strong partner in this effort as well working to streamline the application and inspection processes and working closely with VA GLA to prioritize Veterans who are chronically homeless.

I wanted to see how the VA’s ACT Team contributed to these efforts. Specifically, it seemed that the work being done in Hollywood might be a living example of what USICH has been calling out as the key components of making progress on homelessness:  new strategic investment; re-alignment of existing resources; collaboration across sectors; integration of housing, healthcare, and services; and implementation of evidence based practices. It was an opportunity to see my rhetoric in action.

The day began when Matthew Doherty, USICH Regional Coordinator, and I met the VA team at the Aris Anagos Residential Center, an interim housing program operated by PATH (People Assisting The Homeless). The VA team is composed of Team Leader and Clinical Social Worker, Craig Joyce, psychiatrist Dr. Binyamin Amarami (who joined the team just two months earlier), family nurse practitioner Janell Perez (who had previously worked as volunteer medical missionary and decided to do this fulltime), and Peer Specialist Domenic Delillo.  We were accompanied by Michelle Wildy, VA Chief of Community Care of the Greater Los Angeles Area and HCHV Coordinator for the Greater Los Angeles Area, acting Network homeless coordinator Sharon Elefant, and Paula Berger of the VA who helped document the visit through photography. 
Pictured L-R: Dr. Binyamin Amarami, Step Up on Second staff member, Janell Perez, Barbara Poppe, Craig Joyce, Michelle Windy (back to camera), Matthew Doherty (back to camera)

The first Veteran we met was staying at the PATH Hollywood program following many years of living on the streets. I watched from across the dormitory as Janell Perez checked his vitals and both she and Dr. Amarami engaged with him.  They signaled that it was okay for me to come over and speak with him.  He was social and engaging, but definitely evidencing some paranoid thoughts.  He said that the team had been very helpful and he felt much better staying at the residential center.

As I asked about the next steps, the team emphasized that it had taken many months of active engagement and getting him important health care and medications in order to get him off the streets and into the interim housing program.  They were working to get him into HUD-VASH but the immediate barrier was that he didn’t have a photo I.D. The VA was able to document his identity but he needed photo identification from either the state or Veterans Benefits Administration to meet the HUD requirements. He was unwilling to go to either processing site and have his photo taken.  The team was working with both offices to determine if there was a legal work-around to that requirement. In the meantime, by providing safe interim housing and health care, they were hoping he would continue to improve his well being and someday soon be willing to go for an I.D.  This is one of many examples I encounter that tell the story of how small barriers become big challenges.  But it is with the discovery of these barriers that we can begin to identify ways in which to minimize the challenges faced by those who experience homelessness and get them enrolled into the services that exist to serve them. 

Our next stop was the Hollywood Healthcare Partnership, a community meal and engagement site operated by the First Presbyterian Church of Hollywood.  The open-aired courtyard with tables and the indoor community room provided nice gathering spaces for their guests from the streets of Hollywood to socialize with each other, the volunteers, and the staff from community organizations who drop by. It was clear that the VA team was working hand-in-glove with the other community organizations and the staff from the church.  Together they were connecting with the men and women in their neighborhood to help them find a pathway off the street. The VA team had hoped to connect with a particular Veteran at the program site, but he wasn’t there.  We decided that we would head out to his “campsite” to try and locate him.  Right after we drove away, the VA team leader got a call from the Hollywood Healthcare Partnership outreach worker who said that this particular Veteran had just arrived at the program site.  We turned around and made our way back to the program site. The VA team connected with the Veteran, checking on his health conditions and making plans for him to access the HUD-VASH program and get his own apartment.
Pictured L-R: Barbara Poppe, Amy Quigley - Director, Diaconal & Community Ministries First Presbyterian Church, Michelle Windy

I was encouraged to see all this good work happening in Hollywood. The VA GLA ACT Team and their community partners are showing us firsthand that new strategic investment, collaboration, integration, and using evidence-based best practices are working in places like Hollywood, California.  Investments like VA services and HUD-VASH combined with the re-alignment of existing resources, such as county resources and private philanthropy, are being implemented through a collaboration of faith based, non-profit, and local and federal government partners and are an integration of housing, healthcare, and services that represent the cutting edge of what we know about how we solve Veteran and chronic homelessness. 

Housing First and Assertive Community Treatment are making it possible for Veterans, who have lived for years on the streets, to exit to hope, dignity, and the safety of a home and to begin a path to health, recovery, and wellness.

So yes, it is possible to end Veteran and chronic homelessness, and it is possible to reduce all types of homelessness in Los Angeles and in every community in America. The efforts of VA, along with other federal, state, and local agencies and community partners, are working to make that possibility a reality.  We can do it.

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