City of Sacramento
City Council - 2PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2025-00555 3/4/2025 Discussion Item 15.
City County Partnership Agreement to Address Homeless Crisis Update [Oral Report] File ID: 2025-00555
Location: Citywide
Recommendation: Receive and file.
Contact: Mario Lara, Assistant City Manager, (916) 808-8526, [email protected], Office of the City Manager
Presenter: Brian Pedro, Director, (916) 808-7816, [email protected], Department of Community Response
Attachments:
1-Description/Analysis
2-Six Month Report
Description/Analysis
Issue Detail: The crisis of unsheltered homelessness is one that impacts our entire community, both those experiencing homelessness and the broader community of housed residents, businesses, and neighborhoods. Over the past several years, the City and County have made significant investments to increase the availability of shelter, services and permanent housing for people and families experiencing homelessness.
On Dec 6, 2022, the City and County entered into a legally binding partnership agreement memorializing the respective roles of each agency to address the homelessness crisis. This oral report provides an update on efforts in accordance with the partnership agreement. The last report was presented to the City Council on September 17, 2024.
Policy Considerations: The City County Partnership Agreement furthers local coordination in response to homelessness, enhances existing sheltering and navigation efforts, is in alignment with the Sacramento Regionally Coordinated Homelessness Action Plan, and fulfills key requirements of the Emergency Shelter and Enforcement Act of 2022.
Economic Impacts: Not applicable.
Environmental Considerations: This report is not a project pursuant to the California Environmental Quality Act (CEQA). This report is an informational item only to provide a status update on the City
File ID: 2025-00555 3/4/2025 Discussion Item 15.
County Partnership Agreement. No action is being taken in connection with this status update. As there is no potential for this oral report to result in a direct physical change in the environment or a reasonably foreseeable indirect physical change, this report does not qualify as a “project” under CEQA. (See CEQA Guidelines 15378(a).)
Sustainability: Not applicable.
Commission/Committee Action: Not applicable.
Rationale for Recommendation: This status update is in accordance with the Council approved City County Partnership Agreement.
Financial Considerations: Not applicable.
Local Business Enterprise (LBE): Not applicable.
Six Month Report: July 1 – December 31, 2024
Homeless Services
Partnership Agreement
City of Sacramento &
Sacramento County
Overview
This report shall be given to the City Council and County Board of Supervisors on a six- month basis. The purpose of this report is to provide regular updates on City-County partnership agreement as well as data related to the success and challenges regarding the response to homelessness within the City of Sacramento. The information reflected below is current to the reporting period of July 1, 2024, through December 31, 2024.
Encampment Outreach and staffing
The Department of Community Response (DCR) is the lead agency in identifying and assessing encampment locations and deploying resources. Teams are deployed in a multidisciplinary approach to specific geographic zones within the City of Sacramento.
The partner agencies currently operating within the agreement are DCR and its contracted Hope Cooperative staff, Behavioral Health Services (BHS) Homeless Engagement and Response Team (HEART), and Community Health Works (CoHeWo).
Each of the five identified geographic zones is assigned staff from all partner agencies, providing a comprehensive approach to connecting unhoused community members to resources and ensuring public health and safety. The staffing is as follows:
The City of Sacramento also dispatches Incident Management Team (IMT) resources to provide outreach and services while also ensuring compliance with City Codes and California State Laws. IMT units are primarily comprised of staff from Sacramento Police Department’s IMPACT team, DCR outreach staff, City Park Rangers, City Code Enforcement officers and City Fire Department Street Overdose Response Team (SORT).
DCR staff assigned to IMT units focus on referrals to the City’s rapid placement sites, the Outreach and Engagement Center (OEC) and Roseville Road Campus (RRC).
• 26 Encampment WorkersDCR/Hope
• 12 HEART WorkersBHS
• 15 CalAIM Funded StaffCoHeWo
• 14 OfficersSac PD IMPACT
• 3 Code Enforcement OfficersCode
• 1 City Park Rangers Park Rangers
Statistics
During the reporting period partnership staff responded to 3,879 unique locations and provided 40,118 services to 2,348 unduplicated individuals.
Outreach Services
Type of Service Provided Total Number
General Case Management 24,458
Clothing and Hygiene Care 2,352
Community Resource Referrals 1,539
Transportation 1,242
Behavioral Health Services 876
Food Services 1,703
Care Coordination 1,951
Vital Documents 1,428
Coordinated Access System Referrals 1,252
Housing Search/Placement 1,852
All Other Services 1,465
Deployment
Each geographic zone, as
seen in the map, is
assigned staff from all
participating Partnership
Agencies. Staff
communicate within their
zone to ensure
encampment residents are
linked to the appropriate
service/agency to best
serve his/her/their needs.
Additionally, staff can
communicate potential
compliance action to help
prevent loss of client
connection.
Behavioral Health Services for the Unhoused:
July – December 2024
Overview
Serving Sacramento County’s unhoused
residents remains an ongoing, primary priority
for the entire continuum of the service delivery
system, including adult Community Outreach
Recovery Empowerment (CORE), youth
Flexible Integrated Treatment (FIT), and
Substance Use outpatient programs; Full
Service Partnership Programs; and crisis
programs, such as the Mental Health Urgent
Care Clinic, Crisis Receiving for Behavioral
Health, Crisis Residential Programs, Crisis
Navigation Program, Community Support Team,
Community Wellness & Response Team, and
Crisis Respites.
Description
Culminating in Summer, 2023, BHS completed
the redesign of the entire County outpatient
system to be more responsive to the needs of
the entire community, including a heightened
focus on the needs of the unhoused. For
Substance Use, the Medi-Cal Organized
Delivery System was implemented in Summer,
2019. For youth, the FIT programs were
implemented in 2019, and for adults, the CORE
programs were implemented in Summer, 2023.
Most substantively, the CORE programs
expanded to 11 locations geographically spread
out across Sacramento County. Each site
IMPACT
➢ Outreach and Engagement
➢ Linkage to services
➢ Crisis stabilization, promoting
recovery, and optimizing
community functioning
➢ Decrease criminalization of mental
health and homelessness
➢ Access to flexible housing funds
➢ Eligibility for Mental Health
Services Act Permanent
Supportive Housing units.
BUILT UNITS
Sacramento County Behavioral
Health Services (BHS) has invested
Mental Health Services Act (MHSA)
funding administered by the
Sacramento Housing and
Redevelopment Agency to address
homelessness for MHSA-eligible
clients.
As of December 2024, 401 apartment
units across16 developments are
dedicated to MHSA tenants. An
additional 85 units will be added as
vacancies occur.
There are 175 new units in the
pipeline across 7 properties planned
in 2025 – 2027. This will grow the
BHS MHSA Housing Portfolio for
Permanent Supportive Housing to
661 dedicated apartments at 23
developments.
includes a walk-in, peer-operated Community Wellness Center providing resources, such as showers, laundry, food, substance use resources, groups, and many other services designed for each locations surrounding community.
The Homeless Engagement and Response Team (HEART), staffed with clinicians and peers, conducts outreach and engagement with unhoused residents with the goal of linking individuals with the most appropriate behavioral health services.
Sacramento County Behavioral Health Services Outreach,
Referrals and Linkages for Unhoused Individuals
July to December 2024
HEART Specific Outreach
➢ From July to December 2024, the HEART team(s) made 1,607 outreach attempts to unhoused individuals in Sacramento County. Of those:
o 1,446 (90.2%) were done within city limits by the Co-Deployed outreach team
o 157 (9.8%) were done in the Greater Sacramento Area
HEART Referrals to BHS
➢ The HEART team(s) made 342 referrals to Sacramento County Behavioral Health Services (BHS)
Note: an individual could have multiple referrals within the timeframe to multiple types of services (i.e. mental health and/or substance use programs)
HEART Linkages to BHS
➢ Of the 342 unhoused individuals referred to BHS by HEART, 171 were linked to BHS services
o Over 65% (66.6%) of the individuals linked came from referrals from the Shelter (33.9%) and City Partnership Agreement teams (32.7%)
Note: linked is defined as receiving at least one service at a Sacramento County BHS service provider
HEART Referrals by BHS Program Type/Modality
HEART outreach teams made 342 referrals to BHS programs ➢ With the exception of MH outpatient, the City Partnership Team made the most referrals overall
➢ Of the 342 referrals HEART made to Sacramento County BHS, o The majority were to mental health outpatient programs (83.9%)
HEART Linkages by BHS Program Type/Modality
Of the 342 referrals HEART outreach teams made to BHS:
➢ 171 unhoused individuals were linked to a service provider within BHS o With the exception of MH outpatient, most of the linkages occurred as a result of a referral from the Partnership Agreement team o While MH outpatient had the most referrals, the percent linked was just under 50% (48.4%)
o MH Full-Service Partnerships only had 32 referrals, but 94% of those individuals were successfully linked
Other BHS Referrals and Linkages
(does not include HEART referrals/linkages)
➢ From July to December 2024, 1,360 unhoused individuals were referred to Sacramento County Behavioral Health Services by other sources (i.e. CORE outreach teams, Mental Health Urgent Care Clinic,walk-ins etc.)
➢ Of the unhoused individuals referred, 947 (69.6%) actively engaged and received service(s) in a mental health and/or substance use program
➢ From July to December 2024, 947 unhoused residents were linked to behavioral services
➢ Just under 50% of unhoused individuals received services at an adult mental health outpatient facility
➢ Just over 18% received residential services for substance use
Note: linked is defined as receiving at least one service at a Sacramento County BHS service provider
Full-Service Partnerships
Full-Service Partnership (FSP) programs are recovery-oriented, comprehensive services targeted to individuals who have a severe mental illness often with a history of criminal justice involvement and repeat hospitalizations, who may also be unhoused, or at risk of becoming unhoused. FSP programs are designed to serve people in the community rather than in locked settings. By engaging mental health consumers in their own care and providing services tailored to individual needs, FSPs can reduce costs, improve the quality and consistency of care, enhance outcomes, and, most importantly, save lives.
FSPs provide the full spectrum of high intensity outpatient mental health treatment for children and youth (and their families) living with severe emotional disturbance and TAY, adults, and older adults living with serious mental illness. The full spectrum of services includes permanent supportive housing and flexible housing services and supports.
As of the end of December 2024, the total capacity in FSP programs was 2,758. From July to December 2024, the FSPs served 2,631 (95% of total capacity) unduplicated individuals. The data below indicates the number of individuals served by housing status. Note: The Justice Involved THRIVE FSP opened in late November 2024 and was not at full capacity for this reporting period.
➢ Just over 76% of individuals were housed
➢ Just under 11% of individuals were in shelters or bridge housing ➢ Just over 9% were still homeless on the streets
Partnership agreements
The current Partnership Agreement requires the City and County to meet specific thresholds to satisfy the agreement. The following is a comparison of the Partnership Agreement mandates from the previous reporting period, June 1, 2023, to December 31, 2023, to the current reporting period. Each category in the agreement was rated with a red, yellow, or green color to determine its progress. Red indicates the section has not been met, yellow indicates in progress, and green notes the requirement has been satisfied. The categories assessed are broken out into four categories, each with subcategories which must be satisfied to meet the overall requirements. The categories are:
• Outreach;
• Services;
• Shelter and Housing;
• Training and Information.
At the close of this six-month reporting period the City and County continue to meet all requirements of the Partnership Agreement. The historic agreement has led to a surge in resources being deployed within the City of Sacramento and been a major catalyst in the 41% reduction of homelessness in the Sacramento area as shown in the 2024 Point-In- Time Count.
Outreach
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
10 Encampment teams within the City limits
25 City encampment workers
10 County mental health workers
County MH workers will deploy 67% of work within
the City
15 CalAIM workers to provide ECM/CS services
County staff will conduct Behavioral Health
Assessments/Enrollments
City Will determine the deployment sites for
engagement teams
Encampment team will engage 20 large
encampments a month
Navigate/arrange PEH back to their jurisdiction when
appropriate
Services
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
County shall provide 4 Core Centers within City limits
County shall support a sobering center within City
limits
City & County will refer to care coordination programs
to include Outpatient Treatment, Full Service
Partnerships, and CalAIM ECM and CS
If County FSP program is full, capacity will be added
County to meet State standard for access to SUPT
services
When appropriate County will refer to involuntary
behavioral health programs
Shelter and Housing
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
Within 12 months of agreement County shall open
minimum 200 shelter beds within the County limits
Within 36 months of agreement County shall open
additional emergency shelter site with a minimum of
200 beds
City provide shovel ready site within the City limits the County shall open and operate a minimum 200 bed
shelter
City and County shall fully integrate all emergency
shelter beds into CAS to the extent possible
City and County shall finalize an affordable housing
plan
County agree to seek additional funding to directly
fund or reimburse County
Training and Information
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
County shall provide Mental Health First Aide training
to City
County Shall provide Public Health education to
shelter operators
County advise City staff on process for accessing
County programs
City & County shall track and share information and
data
County shall provide City staff with 5150 training
County shall provide Mental Health First Aide training
to City