City of Sacramento
City Council - 5PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2025-01811 10/21/2025
City County Partnership Agreement to Address Homeless Crisis Update File ID: 2025-01811
Location: Citywide
Recommendation: Receive and file.
Contact: Brian Pedro, Director, (916) 808-7816, [email protected], Department of Community Response
Presenter: None
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. The attached 6-month report provides an update on efforts in accordance with the partnership agreement and covers the time period of January 1, 2025 - June 30, 2025. The last report was presented to the City Council on March 4, 2025.
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.
File ID: 2025-01811 10/21/2025
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 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 report is in accordance with the Council approved City County Partnership Agreement.
Financial Considerations: Not applicable.
Local Business Enterprise (LBE): Not applicable.
Six Month Report: January 1 – June 30, 2025
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 provide 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 January 1, 2025, through June 3, 2025.
City-County Partnership - 6 Month Report - Page 1 of 21 Jan. - June 2025
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.
This reporting period there was changes to the agencies who are actively participating in the coordinated outreach within the city. The city added case carrying outreach workers, contracted through Step Up. Step Up staffing ramped up throughout the reporting period and full staffing of 10 case carrying outreach workers and a field lead was achieved by the end of May. The addition of case carrying outreach workers helps to improve service provision for clients who remain unsheltered.
In addition all other partner agencies continued to operate, including DCR and its contracted Hope Cooperative staff, Behavioral Health Services (BHS) Homeless Engagement and Response Team (HEART), and Community Health Works (CoHeWo).
During this reporting period staff implemented a shift in focus for the HEART staff assigned to the City County Partnership Agreement. HEART teams were assigned a shelter location within the city and provided regular outreach within the shelter in addition to maintaining encampment outreach.
This was intended to provide continuity of care for clients seeking or receiving behavioral health services. While staff expected this would lead to a reduction in the number of engagement attempts completed by the HEART team, the objective was to increase the number of engagement attempts that resulted in assessments, referrals and/or linkages.
Overall staffing remained well above the minimum levels outlined in the partnership agreement.
The agreement obligates a total of 50 staff members to outreach within the city. During this reporting period, a total of 67 staff members were assigned to outreach within the city.
• 16 Alternative RespondersDCR
• 13 Outreach SpecialistsHope
• 11 Case Carrying Outreach Step Up
• 12 HEART WorkersBHS
• 15 CalAIM Funded StaffCoHeWo
City-County Partnership - 6 Month Report - Page 2 of 21 Jan. - June 2025
The Department of Community Response also coordinates the 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 field staff, City Park Rangers, and City Code Enforcement officers. 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). These teams work in coordination with PA teams.
• 14 OfficersSac PD IMPACT
• 3 Code Enforcement OfficersCode
• 1 City Park RangersPark Rangers
•8 TeamsTrash Removal
Deployment
Each geographic zone, as
seen in the map, is
assigned staff from all
participating Partnership
Agencies.
Staff communicate
throughout the day 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.
City-County Partnership - 6 Month Report - Page 3 of 21 Jan. - June 2025
Statistics
During the reporting period partnership and IMT staff responded to 8,718 unique locations and provided 40,844 services to 2,738 unduplicated individuals.
Outreach Services
Type of Service Provided Total Number
General Case Management 27,920
Clothing and Hygiene Care 1,274
Community Resource Referrals 1,120
Transportation 1,388
Behavioral Health Services 772
Food Services 987
Care Coordination 1,755
Vital Documents 1,022
Coordinated Access System Referrals 844
Housing Search/Placement 2,357
All Other Services 1,405
City-County Partnership - 6 Month Report - Page 4 of 21 Jan. - June 2025
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 continues to result in noticeable improvements to the situation in our community.
City-County Partnership - 6 Month Report - Page 5 of 21 Jan. - June 2025
Outreach
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
1/1/25–
6/30/25
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
City-County Partnership - 6 Month Report - Page 6 of 21 Jan. - June 2025
Services
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
1/1/25–
6/30/25
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
City-County Partnership - 6 Month Report - Page 7 of 21 Jan. - June 2025
Shelter and Housing
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
1/1/25–
6/30/25
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
City-County Partnership - 6 Month Report - Page 8 of 21 Jan. - June 2025
Training and Information
6/1/23-
12/31/23
1/1/24-
6/30/24
7/1/24-
12/31/24
1/1/25–
6/30/25
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
City-County Partnership - 6 Month Report - Page 9 of 21 Jan. - June 2025
Sacramento County, Department of Health Services
Division of Behavioral Health Services
BEHAVIORAL HEALTH SERVICES FOR THE UNHOUSED
JANUARY TO JUNE 2025
BUILT UNITS
BHS continues to strategically invest
local Mental Health Services Act
(MHSA) funding, administered by the
Sacramento Housing and
Redevelopment Agency on behalf of
BHS, to combat homelessness among
MHSA-eligible clients. As of June 2025:
- Existing Housing: 461 apartments
across 18 developments are
dedicated to BHS clients, with an
additional 85 units planned as
vacancies arise.
- Future Developments: 115 new
apartments are planned across 5
properties from 2025 to 2027. These
additions will expand the BHS
Permanent Supportive Housing
Portfolio to a total of 661 dedicated
apartments across 23
developments, resulting in a 25%
increase in PSH units.
OVERVIEW
Serving Sacramento County’s unhoused residents remains an ongoing, primary priority for the entire continuum of the service delivery system, including adult CORE (Community Outreach Recovery Empowerment), youth FIT (Flexible Integrated Treatment), and Substance Use outpatient programs; Full Service Partnership Programs; and crisis programs, such as the Mental Health Urgent Care Clinic (MHUCC), Crisis Receiving for Behavioral Health (CRBH), Crisis Residential Programs (CRPs), Crisis Navigation Program (CNP), Community Support Team (CST), Community Wellness & Response Team (CWRT), and Crisis Respites.
DESCRIPTION
Sacramento County’s outpatient mental health system provides specialized, accessible, and coordinated behavioral health care designed to support individuals experiencing homelessness. Our comprehensive approach integrates trauma-informed, culturally responsive mental health services with robust housing navigation and case management. Services include crisis intervention, counseling, psychiatric medication support, substance use disorder treatment, peer support, and flexible funding to prevent, divert and help resolve homelessness. Behavioral Health Services are delivered through community-based outpatient clinics and field-based outreach teams. By working closely with housing providers, shelters, and homeless service organizations, our outpatient programs aim to stabilize individuals’ mental health, facilitate connections to permanent supportive housing, and ultimately break the cycle of homelessness.
The Homeless Engagement and Response Team (HEART)
HEART is 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.
HEART has 4 areas of concentration:
Shelter Team – Clinicians and Peer Support Specialists are present at local shelters to provide services. Approximately 33% of the shelters are within the city limits.
City Partnership Agreement – Clinicians and Peer Support Specialists partner with City Street Outreach teams and provide services to individuals residing in encampments and city shelters.
Greater Sacramento County – Clinicians and Peer Support Specialists provide services to individuals in the unincorporated County, including outreach to individuals in the American River Parkway area and surrounding cities.
Community-Based Referrals – Services provided to individuals who have received a HEART referral from the community over the phone or electronically.
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.
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Behavioral Health Bridge Housing (BHBH)
Sacramento County received $43 million in the Round 1 BHBH grant through fiscal year 2026-2027. Sacramento County was also awarded Round 3 BHBH grant funding in the amount of $15 million, also through fiscal year 2026 -2027.
The Sacramento County BHBH program provides short- to mid-term interim housing for individuals experiencing unsheltered chronic homelessness who have serious mental illness or substance use disorder. A variety of interim solutions are offered including sleeping cabins, sober living environments, a renovated hotel and via the purchase of an apartment complex. The current bed count is 248. For Fiscal Year 25/26, BHS will add 80 beds at the new Watt Safe Stay and convert 30 existing BHBH beds to BHSA-funded Permanent Supportive Housing. This results in a net increase of 50 beds. In addition, 29 Sober Living Environment (SLE) beds will be added through SUPT’s open enrollment pool.
When all projects are completed by July 2026, BHBH will operate a total of 327 int erim beds.
The program prioritizes stabilization through immediate shelter combined with linkage to our outpatient system for mental health and substance use services and supports. HEART serves as the front door accepting referrals, establishing eligibility, and coordinating placement. BHBH also offers flexible funding to meet individual needs, such as necessities, transportation, and move-in costs, to help clients successfully transition from temporary housing into permanent supportive housing solutions.
OUTCOMES – JANUARY TO JUNE 2025
From January 1 to June 30, 2025, 1,569 residents who were unhoused were referred to County Behavioral Health Services and 1,080 individuals (68.8%) were successfully admitted and linked to services.
During the same period, efforts specific to HEART included:
• 1,612 outreach attempts to individuals who were unhoused • 349 individuals screened for BHS services
• 320 individuals referred to County BHS programs
• 178 individuals linked to and served by County outpatient programs • 110 individuals enrolled in HEART over the last year were sheltered in the Behavioral Health Bridge Housing program (BHBH) during the reporting period
Sacramento County, Department of Health Services
Division of Behavioral Health Services
HEART Outreach, Referrals and Linkages – January to June 2025
HEART Outreach and Outreach Attempts
Data from Co-Deployed and Greater Sacramento areas includes outreach attempts reflected in the graph below
➢ There were a total of 1,612 outreach attempts provided during the reporting period
➢ City Partnership accounted for over 73% of outreach attempts
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Referrals By HEART Areas Of Concentration
➢ There were 320 unduplicated individuals referred to various BHS programs during the reporting period, for a total of 411 referrals
➢ The City Partnership Team accounted for the largest share of referrals (36.3%), closely followed by the three-person Shelter Team (just over 35%). This outsized impact underscores both the accessibility and engagement readiness of individuals living in shelters, where clients are easier to find and consistently reachable for service engagement. ➢ 64 (20%) individuals had more than one referral to mental health and/or substance abuse treatment during the reporting period
Note: Total referrals are higher than unduplicated individuals as some individuals receive multiple referrals from different sources
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Referrals by HEART Areas Of Concentration to BHS Program Type
Of the 411 referrals HEART made to Sacramento County BHS,
➢ Most referrals were to mental health outpatient programs (76.6%), followed by FSPs at just under 12%. In both programs co-occurring conditions are addressed.
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Linkages by HEART Areas of Concentration
Of the 411 referrals made to BHS by HEART, 195 (47.4%) resulted in linkage to BHS services. Note: individuals may be referred to multiple programs.
➢ Nearly 70% of successful linkages came from the City Partnership Team (36.4%) and the three-person Shelter Team (33.3%). This demonstrates how the shelter setting provides consistent opportunities for engagement, where clients are easier to locate and staff can reinforce readiness through reminders, encouragement, and coordination with providers.
➢ 178 (55.6%) unduplicated individuals were linked to a mental health and/or substance use prevention program
Note: linked is defined as receiving at least one service at a Sacramento County BHS service provider
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Linkages by HEART Areas of Concentration to BHS Program Type
➢ 195 referrals resulted in a linkage to a service provider within BHS
➢ Mental Health Full-Service Partnerships were effective in connecting people to care, with nearly three out of four referrals successfully linked to services
➢ Almost 50% (46%) were successfully linked to mental health outpatient programs .
Sacramento County, Department of Health Services
Division of Behavioral Health Services
BHS Referrals and Linkages (excluding HEART referrals/linkages) January to June 2025
Unhoused Referred to BHS by Housing Status
➢ From January to June 2025, 2,225 referrals were made for 1,569 unhoused individuals to Sacramento County Behavioral Health Services by other sources (i.e. CORE outreach teams, Mental Health Urgent Care Clinic, FIT and CORE walk-ins etc.)
➢ 434 (27.7%) individuals received more than one referral during the reporting period
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Unhoused Linked to BHS Services
➢ 1,080 (68.8%) unduplicated individuals actively engaged and received service(s) in a BHS mental health and/or substance use program
➢ Just over two-thirds of unhoused individuals were linked to BHS services
Sacramento County, Department of Health Services
Division of Behavioral Health Services
Unhoused Linked by Program Type
➢ From January to June 2025, 1,080 unhoused residents were linked to behavioral services
➢ Just under 45% of unhoused adults received services at a mental health outpatient facility
➢ Just over 20% received residential services for substance use Note: linked is defined as receiving at least one service at a Sacramento County BHS service provider
Sacramento County, Department of Health Services
Division of Behavioral Health Services
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, a nd 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 support.
As of the end of June 2025, the contracted capacity in FSP programs was 3,071. From January to June 2025, the FSPs served 2,913 (95% of total capacity) unduplicated individuals. The data below indicates the number of individuals served by housing status as of June 2025.
Full-Service Partnership Current Housing
Of the 2,913 individuals served in FSPs,
➢ Most clients (73.7%) are in stable housing, demonstrating the effectiveness of Full-Service Partnerships (FSPs) in helping people with the most complex needs secure permanent housing. • During the reporting period,181 individuals were placed in housing and 1,965 were already living in housing
➢ Another 14.1% are in bridge or shelter settings, reflecting progress for individuals who may not yet be ready for independent housing but are engaged in care and moving along the housing pathway. ➢ About 9.2% remain unsheltered. This group often faces multiple barriers: long histories of homelessness, untreated health or behavioral health conditions, or difficulty maintaining tenancy. For some, readiness for housing takes time, and the lack of motels and affordable units and landlords willing to rent to high -need clients makes immediate placement challenging even with intensive support.
➢ 3% of clients did not have a housing status indicated in the electronic health record