Program looks to stop the Skid Row to jail pipeline

Jose Garcia waited near the cell block door for his client—a tall man in his 50's dressed in blue pants and a yellow shirt, a variation of the standard outfit on the second floor of the Twin Towers Correctional Facility, the Los Angles County jail system's destination for inmates experiencing mental health problems.

This, Garcia said, was a pretty calm floor—the acuity level of the inmates generally goes up as you climb Twin Tower—and the man willingly sat across a checkers table from Garcia to hear his pitch. 

It was the men's first meeting, a time to establish the basics: the man had been homeless on Skid Row for about three years, yes, he was getting out in a couple weeks, and no, he had nowhere to go. And that's what made him a candidate for the Office of Diversion and Reentry's housing program. 

"Three years on Skid Row, and he's been connected with no services, it's unbelievable," said Garcia, a program manager for Project 180, shaking his head. 

As a condition of observing the program, the L.A. County Sheriff's Department required KPCC to have no direct contact with inmates out of respect for their medical privacy.

If follow-up visits yield what they're designed to, the man will move into temporary housing when he gets out of jail, and then on to a permanent apartment, where his rent will be subsidized by L.A. County, and he'll be visited by a case manager and mental health worker. The big idea is to get him into housing and out of the pipeline that runs between Skid Row and L.A.'s jails. 

"We're really interested in serving the most medically complex individuals who are in our jail and justice system, we know there are a lot of high-need clients," said Corrin Buchanan, interim deputy director of the Office of Diversion and Reentry (ODR). 

The office estimates one out of every five jail inmates is at risk of homelessness when they come out. The program has served about 500 inmates in its first year, but hasn't been able to meet the growing demand. With a private "pay for success" investment, they're poised to massively scale up in the coming months. 

Pay for success is a new concept to L.A. County, but has been used elsewhere to encourage government agencies to innovate by outsourcing some of the financial risk of trying something new to the private sector. In this instance, a group of private investors, including United Healthcare and the Conrad N. Hilton Foundation, has given ODR funds to scale the program to 300 new clients--and if successful, the county pays the investors back. 

The overall goal, Buchanan said, is to reduce the number of people in the justice system who have mental health and substance use disorders.

"We're using supportive housing as a health care intervention," she said. 

The clients, Garcia said, are usually pretty surprised when he explains how the process works. 

"At times I don't think they believe us," he said. "Like you're really going to help us?"

When clients end up back in jail, which has happened for some already, the team reaches out to them again.