Needs of Special Populations
Older Adults and Persons with Functional Limitations
The proportion of the
population of older adults is increasing, especially the very old. In Seattle,
the number of people age 75 and older increased 5.3% between 1990 and 2000, and
now makes up almost 7% of the City’s total population. Many in this older age group have increasing
physical, social, and psychological limitations. With the help of support services,
many will be able to remain in their homes, if their homes are accessible for
themselves as well as their caregivers. While home modifications are an option
to “aging in place”, others may need to move to some other housing arrangement
such as assisted housing which also needs to be accessible and affordable.
In 2001, “approximately 33
% of senior households who are 62 years of age and older earn less than $34,999
per year (about 60-65 % of the area’s median income.)” [An Analysis of the Senior Housing Market
in Seattle, Washington, Prepared by
Novogradac & Company, LLP, for the Seattle Housing Authority.]
Given the increasing
expense of housing, especially rental housing in the Seattle market, subsidies,
and especially Section 8 vouchers will be required in order for older adults to
continue to afford to live in our community.
Unfortunately, under current reduction proposals to the Section 8
voucher program, the City of Seattle could lose as much as $19.5 million in
voucher subsidy funding by 2009. This
could mean as many as almost 2000 families would no longer be assisted. [Center
on Budget and Policy Priorities: Local Effects of Proposed Cuts in Federal
Housing Assistance Detailed, Washington, March 17, 2004.]
The Seattle Housing Authority (SHA) is the primary
provider of housing for low-income elderly persons. Many SHA buildings – built over 20 years ago for elderly tenants
– are now home to tenants whose average age is 74 years. As these residents age
in place, they increasingly need specialized support and medical services. Also, as these tenants age and their service
needs increase, service managers and supports may need to be in place in order
for them to remain as renters.
The trends occurring both in the demographics of the
aging population as well as the resources to meet their special needs are:
Ø As of July 2004, there will be a further reduction in
the State’s nursing home “bed-to-population ratio from 45 beds per 1,000 to 40
beds per 1,000 population age 65 or older.” (Dept. of Health Expedited Rule
Making: WAC 246-310-010 Certificate of Need Definitions.)
Ø Short of nursing home beds and adult family home
arrangements, seniors will need a range of non-institutional housing
alternatives that provide affordable and accessible independent living
arrangements, home sharing, and assisted living.
Ø
In any of these housing
developments, provision must be made for supported service components that can
accommodate space for service
managers arranging in home personal care and COPES (Community Options Program
Entry System), which serves nursing home-eligible clients who, with appropriate
community supports, can be served at home or in some other community-based
living arrangement. Space will also be required for meal
programs; a variety of “healthy aging” components such as exercise, both indoor
and outdoor, including gardening and walking; as well as opportunities for
socialization.
·
A variety of chronic
disease processes flow from isolation or being “home bound”. “Healthy Aging” interventions are proving to
have statistically significant impacts on a variety of these chronic
diseases. These interventions and
provisions for the space to provide them are essential in this era of rapidly
declining resources for both chronic and acute care needs.
Ø Provision must be made for those persons with
developmental disabilities who themselves are now aging and still are being
cared for by their aging parents. They
and their parents will need supportive services, possibly including space for
care attendants. There are rapidly
declining “institutional” options for this population. The recent closure of beds at Fircrest is
indicative of further trends.
Ø There is a significant growth in the population of
grandparents caring for grandchildren. Grandparents may have to leave “senior
only” housing or move from a smaller apartment to units with more
bedrooms. It often means a sudden drop
in their personal resources to meet this caregiving challenge. Assistance with housing voucher support will
need to be available, as well as service components that meet the needs of both
the aging grandparents as well as the displaced children.
Planning for the future
How is the variety of
emergent needs to be addressed? How
will Seattle provide housing that is affordable, accessible and will allow the
aging population to age in place as well as prevent displacement of persons of
any age who find themselves in need of accessible housing? How can housing be developed that meets the
changing care needs of all the populations that must be served regardless of
age? Planning for “inclusion” rather
than “segregation” must be the norm.
All new
construction and remodeling of existing housing stock, especially when it is
developed using public funds, should incorporate application of the principles
of Universal Design (UD). Given the
anticipated growth of the 65 and older population beginning in 2011, it is more
cost-efficient to plan and build and/or remodel now in anticipation of the
increased need for inclusively-designed housing. These principles are not a euphemism for “accessible” design or
meeting the ADA required codes but rather are principles of good design that
create an enabling environment for all.
Using UD
principles to design new housing would:
Ø
Allow the future
generations of older adults to age in place, since their living spaces will
already be accessible and visitable.
Ø
Create accessible
housing as a matter of course rather than as the exception.
Ø
Funding incentives for
creating universally designed housing and environments should be implemented.
Ø
Cut down on the cost of
public resources required for extensive home modifications.
Ø
Prevent housing units
from being designated as set aside units that are ADA-certified units. All units are accessible and do not sit
empty, waiting to be rented or purchased by a person with disabilities.
Planning and development must
also address the entire built environment in order to accommodate the housing
and mobility needs of all ages. Incorporating principles of “Active Living by
Design” into housing and community development projects will help us build a
healthy community.
People with Developmental Disabilities
In
January 2004, 7,990 persons in King County, 4,075 adults and 3,915 children,
were enrolled with the Washington State Department of Social and Health
Services Division of Developmental Disabilities (DDD) due to mental
retardation, cerebral palsy, autism, epilepsy, or other neurological
impairments. The number of persons
served by DDD is increasing at an annual rate of six percent.
The majority of adults with Developmental Disabilities
(DD) living in King County have extremely low incomes from employment and/or
Supplemental Security Income (“SSI”).
Some families with children with DD also have extremely low incomes, which
is often due to the additional care needs of their disabled children.
Adults with Developmental Disabilities
The
King County Developmental Disabilities Division (DDD) has a caseload of 4,075
adults. 1,387 live in Seattle and
2,688 live in King County outside Seattle.
According
the 2004-05 King County DDD Housing Plan, 1,468 adults with DD living in King
County receive residential services in housing. Four hundred of these persons live in private market housing and
pay more than 50% of their income for rent and utilities. Forty-three of these 400 persons live in
Seattle.
In
addition there are 2,340 adults on the DDD caseload in King County who do not
receive residential services, many of whom have need for affordable
housing. These individuals live with
family members or guardians, or independently in the community. Many of these adults are living with aging
parents who can no longer provide the care necessary to support their adult
children with disabilities. These
individuals can live successfully in the community with support systems that
are appropriate to their needs, which can include a combination of case
management, family, friends, or paid support providers.
In
addition, there are currently 217 people with DD living at Fircrest Institution
in Shoreline. The Washington State legislature
mandated the downsizing of Fircrest during the 2003-05 state biennium, and will
likely mandate its closure during the 2005-07 biennium. DDD estimates that approximately 115 people
who are currently living at Fircrest will need affordable housing in the
community in Seattle and King County between now and 2007.
In
the Office of Housing’s portfolio, there are 70 permanent housing units in
scattered sites for persons with developmental disabilities. The majority of these units are in single
family homes. Forty-three (43) of these
units are dedicated for formerly homeless persons.
The
King County Housing Access and Services program (HASP) has issued 300 vouchers
since the year 2000 to adults with DD in King County, and continues to issue
vouchers each month. In 2002, the
Seattle Housing Authority issued 60 vouchers, through its special voucher
program to persons with DD, but has not issued any additional vouchers since
then.
Families with Children with Developmental Disabilities
Of
the 3,915 children on the DDD caseload, 1,251 live in Seattle and 2,664 live in
King County outside Seattle.
The housing need of families with children with DD has
yet to be effectively documented.
Although the majority of the DD-related units in the Office of Housing’s
portfolio are for single adults, there are seven units for families with
children who have developmental disabilities.
DDD notes that many of these children will need affordable or subsidized
housing as they reach adulthood. DDD is
currently developing a waiting list of families who are homeless or in need of
affordable housing in order to begin to document this need.
Dual Diagnosis - Persons with Mental Illness and Developmental Disabilities
In
2003, the King County Regional Support Network provided services to 2,393
persons who had a dual diagnosis of mental illness and a developmental
disability; 203 or 8% of these persons were homeless in 2003. This number likely includes some duplicated
counts of persons with DD served in the DESC shelter.
Homelessness among Persons with Developmental Disabilities
The
Downtown Emergency Service Center (DESC) in Seattle provided shelter to 95
persons with DD in 2002 and 77 persons with DD in 2003.
In
2003, The ARC of King County served 25 persons with DD who were at risk of
homelessness through its Survival Services Program, which included ongoing case
management and housing stabilization assistance.
The
Seattle-King County Coalition for the Homeless Families Committee reports
serving increased numbers of families with DD parents and families with
children with DD in King County shelter and transitional housing programs. According to the 2003 One Night Count
conducted by the Coalition, 59 individuals in shelters and transitional housing
programs were reported to have a developmental disability. Because many of these programs are not
staffed to provide services to meet the unique needs of these families, they
face additional challenges to overcoming homelessness.
People with Mental Illness and/or Substance Abuse Disorders
Data shows that homeless
people with mental illness and/or substance abuse disorders living in King
County congregate primarily in Seattle’s downtown core. Evidence includes the following:
·
The 2003 One
Night Count found 1,899 homeless individuals actually living on the streets in
King County. Of those 1,728 (91%) were
in the downtown Seattle area. In
addition, 78% of the homeless persons in shelters or transitional housing on
that night were in Seattle.
·
According to
the One Night Count survey, the most frequently cited disabilities among people
who are homeless are mental health and chemical dependency. 50% of those who responded indicated that
they had problems with substance abuse, mental health or both.
·
The King
County Crisis Clinic’s Information Line reports that in 2003 they received
14,963 calls from individuals who identified themselves as being homeless. 4,539 (66%) out of the 6,844 callers who
gave geographic information were from Seattle.
·
Sixteen
percent (4,322) of the individuals receiving services from the publicly funded
mental health Regional Support Network were homeless at some point during 2002. More than 30% (1,222) of the individuals served at King County’s
behavioral health crisis triage center during 2002 reported being currently
homeless.
·
An estimated
28,650 low-income adults in King County are chemically dependent and in need of
treatment in any given year. Between
12,000 and 18,750 of these individuals are both mentally ill and chemically
dependent, yet fewer than 10% of these individuals receive the mix of services
they require to promote stabilization and recovery. Data from the Seattle/King County Health Care for the Homeless
Network (HCHN) indicates that 22% of their clients need chemical dependency
treatment.
Despite access to the
resources described above and local successes in expanding the array of housing
and support service resources dedicated to serving homeless populations, HCHN
and the one night count continue to document a steadily increasing population
of chronically homeless adults in the Seattle area. There remains a significant gap in housing stock for the
chronically homeless population, and insufficient capacity in the treatment
service system to absorb those individuals not yet linked to mainstream
entitlements that often present the most significant service needs. The Seattle/King County’s 2002 Continuum of
Care planning process identified an unmet need/housing gap of almost 2,500 shelter
beds and housing units. The absence of the service intensities
required to successfully house chronically homeless adults creates yet another
barrier to accessing the limited housing that does exist. Without such service supports, many of the
individuals who are chronically homeless either remain unable to access
existing housing or experience ongoing or cyclical episodes of homelessness.
Models for Addressing Need
Individuals who
are chronically homeless present a particularly challenging set of housing,
service and treatment needs as they struggle with a range of illnesses and
disabilities that present great difficulties with regard to personal stability,
accomplishing basic tasks of daily living, and accessing and maintaining safe,
decent and affordable housing. Recent
research has made clear that the provision of supportive housing, combined with
appropriate treatment and supports, can help to provide a foundation upon which
individuals with histories of chronic homelessness can begin the journey into
recovery and attain the personal stability that is essential to regaining
control over one’s life. In addition, it is known that the provision of
housing, by itself, or the delivery of intensive supportive services in
isolation from housing are both insufficient to promote stability over time for
most individuals struggling with homelessness, mental illness, and co-occurring
disorders such as substance use disorders, developmental disabilities, and
HIV/AIDS or other chronic health problems.
The U.S. Interagency Council
on Homelessness identifies Housing First strategies as one of the “new
technologies that exist to move chronically homeless people off the streets and
keep them housed.” The approach entails
moving chronically homeless people as quickly as possible into long-term housing
and applying adequate service and treatment supports to allow them to succeed
there. It is a different approach than
those requiring homeless persons to reach stability prior to gaining access to
housing.
Significant cost
savings can be realized through this model. A recent research study in New York
City collected data on 4,679 homeless people with severe mental disorders
placed in supportive housing and compared their service use patterns to system
utilization prior to housing placement.
The study demonstrated that expenses related to shelters, public and
state hospitals, Medicaid funded services, VA services, and state and local
prisons and jails could be significantly reduced when supportive housing was
provided. Prior to placement the
average cost per person per year across all systems was $40,449; post-placement
this cost was reduced to $17,277 – an estimated total savings of $16,282 per
person per year.
With experience gained
from a range of programs that work to house populations experiencing chronic
homelessness, Seattle/King County communities have developed a strong track
record in demonstrating the impact of housing linked with supportive services
in reducing chronic homelessness.
Housing funded by federal, state and local funds such as McKinney,
HOPWA, CDBG and HOME, Transitional Housing Operating and Rent (THOR), the
Washington State Housing Trust Fund, etc., and services funded by Medicaid,
Mental Health and Chemical Dependency Block Grants, HRSA/HCH and demonstration
programs such as the 5-year ACCESS Project have historically been successfully
braided into supportive housing initiatives specifically targeting chronically
homeless individuals. Examples of such
programs include Seattle’s two Safe Haven facilities for persons with severe
mental illnesses and co-occurring substance use disorders (Harbor House and the
Kerner-Scott House), transitional and permanent supported housing for chronic
public inebriates (e.g., the Wintonia and Westlake projects) and persons with
mental illness (e.g., the Union and Morrison Hotels) and specialized
service-enriched housing targeting individuals living with HIV/AIDS who have
histories of homelessness, mental illness and substance use disorders, (e.g.,
the Lyon Building).
Service Delivery System
King County.
The King County Department of Community and Human Services (DCHS) Mental
Health, Chemical Abuse and Dependency Services Division (MHCADSD) has the
primary responsibility for the service delivery system. Services include individual, family and group
therapy, case management, emergency/crisis intervention, medication management,
vocational assistance and training, and assistance with housing and other
supports. MHCADS is responsible for assuring that the needs of project clients
are met as they transition to mainstream mental health services and/or
substance abuse services.
MHCADSD has as its stated mission the following, “To improve the
quality of life in King County by providing services and supports to
individuals, families and communities affected by mental illness and/or
substance abuse or chemical dependence.”
MHCADSD’s core values include the following priorities:
·
To offer outreach,
engagement and specialized services which address the unique needs of
underserved populations, including ethnic and sexual minorities, persons with
disabilities, persons who are homeless and individuals in late-stage illness.
·
To ensure clients have
access to a continuum of services and housing, including integrated services
for clients with multiple needs.
·
To provide services to
individuals and families that are informed by research, evidence-based practice
guidelines and nationally recognized standards of care.
·
To encourage the
provision of services that are designed in collaboration with the individual,
are clinically and culturally appropriate and attempt to meet the array of
supports needed for a person to achieve the highest possible quality of life
while residing in an appropriate setting.
City of Seattle. The City of Seattle Office of Housing has a number of priorities
concerning the development of rental housing for persons at or below 30% median
income as well as service-enriched housing for persons that are homeless and/or
disabled.
With the recent
implementation of a new initiative called Taking Health Care Home funded by the
Robert Wood Johnson Foundation and Gates Foundation, with oversight by the
Corporation for Supportive Housing, the Office of Housing is leading strategic
planning efforts to support the development of permanent supportive housing for
persons that are chronically homeless and disabled. This initiative is in partnership with AIDS Housing of Washington
and King County Mental Health and Chemical Dependency Services Division and
will seek to create over 260 units of permanent supportive housing in the
Seattle/King County area over the next two years. The Office of Housing is committed to creating housing that will
serve the population described in this project to support them to obtain and
sustain permanent supportive housing in a “Housing First” approach.
State of Washington. In April 2004, leadership from throughout Washington
State formed the Washington State Policy Academy on
Chronic Homelessness. This group
includes strong representation from King County, including leadership
from King County MHCADSD and the City of Seattle. One of the priorities listed in their plan is to “make the case
for increasing the priority to serve individuals who are chronically homeless.” The plan also calls for enhancing the
linkages between services for this population and housing.
In August 2004, the U.S.
Health & Human Services Department announced grant funding for substance
abuse treatment. The state of Washington was awarded $7.6 million per year for
each of three years, for a total of approximately $22.8 million. The state
plans to utilize its Access to Recovery grant to provide clinical drug and
alcohol treatment and recovery services to low-income individuals in crisis who
are involved with Child Protective Services, shelters and supported housing,
medical clinics, and community detoxification programs. The program will offer
a full range of treatment services and increase the number of providers trained
and qualified to offer recovery services.
King County Committee to End Homelessness (CEH). The
CEH brings together key community and government leaders to establish
priorities designed to move our community toward ending homelessness in the
next ten years. The CEH plan calls for
“linking mainstream systems such as housing, employment, mental health,
education, chemical dependency, and criminal justice to services for homeless
persons.”
Other Partnering Agencies. Within the King County mental health and substance
abuse treatment network, the Downtown
Emergency Services Center (DESC) is
the only agency that has as its primary focus services to the chronically
homeless adult population. Founded in
1979, DESC offers two main sets of services: their Clinical Program provides
state-licensed mental health and substance abuse treatment and their Housing
Program implements a residential continuum including emergency shelters and
transitional and permanent supportive housing.
In 2002, DESC’s emergency shelters served over 9,000 unduplicated
people; clinical programs served over 800; and transitional and permanent
housing projects served over 400.
DESC’s ability to house
persons with serious mental illness and substance abuse disorders is greatly
enhanced by having licensed mental health and chemical dependency treatment
services within the same organizational structure. The DESC Clinical Program has provided state-licensed mental
health services since 1980, and now provides homeless persons with mental
illness and chemical dependency disorders with comprehensive care that includes
street outreach and engagement, case management, short-term and long-term care,
and chemical dependency services. From
1994 to 1999, DESC was a participant in ACCESS, a five-year national
demonstration project funded by the Department of Health and Human Services
through the Substance Abuse and Mental Health Service Administration. After the ACCESS project ended, DESC was
selected to be the sole vendor of mental health outreach and engagement
services countywide through the Homeless Outreach, Stabilization and Treatment
(HOST) project funded by King County.
Outreach and engagement
specialists of DESC’s HOST project target unsheltered individuals who are
typically chronically homeless and have a severe and persistent mental illness
or co-occurring disorder. While some clients are approached directly while on
the street, engagement for others is initiated by a referral to DESC from
concerned citizens, jails, Washington State Department of Health and Human
Services (DSHS), the mental health court, hospitals, the Harborview Medical
Crisis Triage Unit, public libraries, family members, and other mental health
professionals, shelters, and drop-in centers. HOST staff connect people to
other DESC services, including the day center, emergency center, safe haven,
and intensive case management services. Or, depending on an assessment of the
client’s need, a referral is made to a more appropriate provider.
DESC began providing
supportive housing in 1994, and now provides an array of housing project types
for homeless single adults with disabling conditions, primarily severe and
persistent mental illness and substance use disorders. DESC operates the Morrison Hotel (205
units), the Union Hotel (52 units), the Lyon Building (64 units), and the Kerner-Scott
House (25 safe haven beds and 15 permanent units). In addition to these specific housing projects totaling 361
units, DESC utilizes 75 Shelter Plus Care subsidies for persons with mental
illness and 55 Section 8 set-aside vouchers for persons with disabilities.
Established in 1985, the Seattle-King County Health Care for the
Homeless Network (HCHN) program evolved into its present administrative
structure whereby Public Health - Seattle & King County acts as the federal health
center grantee under the Health resources and Services Administration (HRSA) –
Bureau of Primary Health Care. Services
are provided in numerous health department clinics, community-based agencies,
and Harborview Medical Center’s Pioneer Square Clinic. whereby Public Health - Seattle & King County subcontracts HRSA grant
funds to 12 community partners to deliver care to homeless people in a variety
of community sites such as shelters and day centers. HCHN also funds the 22-bed Medical Respite Program, operated by
Pioneer Square Clinic, which serves high numbers of chronically homeless with
disabling conditions.
The Pioneer Square Clinic of Harborview Medical
Center provides primary health
care and treats acute problems for adult patients residing in the downtown
Seattle area. This neighborhood clinic
has been in operation for over 20 years.
The clinic specializes in services for homeless and low-income residents
of the downtown community. The clinic
staff includes physicians, nurses, psychiatrists, mental health practitioners
and social workers. The clinic is an
outpatient site of Harborview Medical Center and the full services of
University of Washington Medicine are available for specialty services or
hospitalization.
The Mental Health Chaplaincy is an outreach
and engagement program for the most difficult and most vulnerable mentally ill
street homeless people. The program uses a four-phase model to working with
homeless individuals—approach, companionship, partnership, and mutuality—in
order to build and share a relationship with clients. In practice, outreach
workers spend time with homeless people on the street, becoming part of their
everyday experience, becoming familiar to them, and offering companionship. The
Mental Health Chaplaincy works with
Harborview Mental Health, local emergency rooms, Downtown Emergency Service
Center, and the Health Care for the Homeless Network.
Evergreen Treatment Center’s REACH Project targets homeless chronic
public inebriates and other drug abusers. REACH staff receive referrals from
the Dutch Shisler Sobering Center, where they are co-located, or conduct
outreach on the street. Eight case managers with caseloads of about 20 people
each work with these individuals to link them to support services and move them
into appropriate housing. REACH case managers facilitate applications to the
state’s publicly subsidized chemical dependency treatment program (Alcohol Drug
Abuse Treatment and Support Act) and other mainstream services, and they make
placements in various housing programs for their clients.
Pathways Home, a McKinney-funded services only project,
promotes housing stability for homeless families experiencing serious, multiple
barriers to care by partnering with parents to provide family-centered,
child-focused health and behavioral health services. The services include:
outreach and engagement services, case management, nursing care, primary
medical care, psychiatric care, mental health and substance abuse counseling
services, assistance with securing permanent housing, and securing linkages
with mainstream, community-based services. Pathways
Home identifies homeless families by referrals from other programs and the
Seattle Police Department’s Community Service Officers, and from staff visits
to clinics, day centers, and shelters. Though not as common, some families are self-referrals
as a result of hearing about the program from another homeless family.
Additionally, Pathways Home staff visit families
self-paying in hotels and motels to try to engage them in the Continuum of Care
system. Each family is evaluated for their income sources, healthcare coverage,
and use of mainstream services in additional to their specific housing, social
and health needs. For those clients who are eligible for services by not
utilizing them, the team will support the application process for the client in
whatever form necessary. This ranges from providing transportation to an
appointment to accompaniment and completion of forms for those who lack the
capacity to do so. Case managers serve as advocates for the clients during the
application process and monitor it closely.
Youth and Young Adults
Definition of a Homeless Youth or Young Adult
Homeless
youth services in Seattle are intended to serve young people between the ages
of 12 and 24 who are without a safe, stable place to sleep and not living as
part of a family with a responsible parent figure. Homeless youth under age 18
who are served in homeless youth programs most often have experienced multiple
failures of foster home placements.
Young adults come to homelessness under a variety of circumstances. They generally have experienced significant
trauma and disruption in normal developmental processes, resulting in a lack of
basic life skill competencies, and frequently appear to experience failures in
programs. An estimated 820 youth and young adults are
homeless in Seattle at any one time.
The Number of Homeless Youth and Young Adults in
Seattle
This point-in-time estimate is based on data collected
from shelter/housing programs, case management and drop in day-center service
providers. This data has been updated
through phone surveys of providers during 2003. During this period, 976 youth were reported in service at any one
time. Adjusted for duplication, an
estimated 820 homeless youth and young adults were in service. This number is used in Seattle as the most
accurate point in time count of homeless youth and young adults, because it
includes more sources of information than the One Night Count. The One Night Count is used in our McKinney
application and in the Nature and Extent of Homelessness section of this
document because it includes data on all homeless populations including
youth. The One Night Count in 2003
counted 42 youth, 186 young adults, 13 minor youth with children, and 105 young
adults with children in Seattle shelter and transitional housing programs, plus
51 minors alone on the street and 67 young adults living in squats, for a total
of 464 youth and young adults homeless in Seattle on that night. The difference between the One Night Count
and the estimate of 820 is due to the fact that in the One Night Count, young
adults on the street were not counted separately from older adults (total
1,677) and youth and young adults not visible on the streets, but using drop-in
or case management services were not counted.
Demographic Data on Homeless Youth and Youth Adults
Two
sources of unduplicated demographic data on homeless youth and young adults
exist. While these do not represent a complete, unduplicated count of all
homeless youth in Seattle, they do provide valuable information about the
demographics, challenges and needs portrayed by Seattle’s homeless youth
population. The first is Health Care for the Homeless Network (HCHN), which
provides health services to homeless people in several community clinics. In 2003, 427
homeless youth who were living on their own (not as part of a family) were seen
in Health Care for the Homeless clinics.
The other source of data is the PRO-Youth program, which provides case
management services to homeless youth throughout King County. In 2003, 428 new youth were enrolled in
services by PRO-Youth case managers.
The amount of duplication between the two sources is unknown. The following demographic data were
collected for these youth and young adults from these two sources.
|
Prior Living Situation of the Homeless Youth, Young
Adult Population
|
|
|
HCHN
|
PRO-Youth
|
|
Location
|
Number
|
Percent
|
Number
|
Percent
|
|
Non-housing (street, park,
car, bus station, etc.)
|
35
|
8%
|
127
|
30%
|
|
Emergency shelter
|
57
|
13%
|
96
|
22%
|
|
Transitional housing for
homeless persons
|
40
|
9%
|
10
|
2%
|
|
Psychiatric facility
|
0
|
0%
|
0
|
0%
|
|
Substance abuse treatment
facility
|
5
|
1%
|
0
|
0%
|
|
Hospital
|
2
|
0.5%
|
0
|
0%
|
|
Jail/prison
|
10
|
2%
|
1
|
0.2%
|
|
Domestic violence situation
|
0
|
0%
|
7
|
2%
|
|
Living with
relatives/friends
|
41
|
10%
|
114
|
27%
|
|
Rental housing
|
0
|
0%
|
14
|
3%
|
|
Other/Unknown/info missing
|
0
|
0%
|
59
|
14%
|
|
Total
|
427
|
100%
|
428
|
100%
|
|
Race and Ethnicity of the Homeless Youth, Young
Adult Population
|
|
|
HCHN
|
PRO-Youth
|
|
Ethnicity
|
Total
|
Percent
|
Total
|
Percent
|
|
Hispanic or Latino
|
20
|
5%
|
36
|
8%
|
|
Non-Hispanic or Non-Latino
|
407
|
95%
|
392
|
92%
|
|
Total
|
427
|
100%
|
428
|
100%
|
|
Race
|
Total
|
Percent
|
Total
|
Percent
|
|
American Indian/Alaskan
Native
|
30
|
7%
|
14
|
4%
|
|
|
Asian
|
7
|
2%
|
15
|
4%
|
|
|
Black/African American
|
64
|
15%
|
108
|
27%
|
|
|
Native Hawaiian/Other
Pacific Islander
|
2
|
0%
|
2
|
1%
|
|
|
White
|
266
|
62%
|
178
|
45%
|
|
|
Other/Multi-Racial/unknown
|
58
|
14%
|
111
|
26%
|
|
|
Total
|
427
|
100%
|
428
|
100%
|
|
|
|
|
|
|
|
|
|
|
|
Special
Needs of the Homeless Youth, Young
Adult Population
|
|
Type
|
HCHN
|
PRO-Youth
|
|
Mental illness
|
224
|
46
|
|
Alcohol abuse
|
*
|
74
|
|
Drug abuse
|
*
|
89
|
|
Chemical/Alcohol
Abuse/Dependence
|
88
|
*
|
|
HIV/AIDS and related
diseases
|
*
|
5
|
|
STD/HIV/AIDS
|
59
|
*
|
|
Developmental disability
|
12
|
4
|
|
Physical disability
|
0
|
8
|
|
Abuse Issues
|
37
|
*
|
|
Domestic violence
|
*
|
22
|
|
Total
|
420
|
248
|
*Each Data System collected data in
slightly different categories
Causes and Effects of Homelessness Among Youth and Youth Adults
Most studies conducted on issues of youth
homelessness include data on the family history profile of the youth. All document strong associations between
negative childhood experiences and homelessness,
and high incidences of abuse, neglect, sexual abuse, parental substance abuse,
and other family disorganization.
While youth often leave unpleasant and hazardous
circumstances for the street, once there, risks increase, and prospects for a
successful future diminish rapidly. The
lifestyle of youth on the street is “characterized by violence and deprivation
– physical and sexual abuse, sexually transmitted diseases, unintended
pregnancies, substance abuse and mental disorders.” Victimization rates on the street are very
high, along with difficulty in meeting basic needs, risky sexual behavior, drug
and alcohol abuse, criminal behavior,
infectious diseases, and depression and suicide. Youth are regularly subjected to extreme stress and trauma while
living on the street.
Several national studies also document the fact that a
large proportion of homeless youth are on the run from government placements or
are former foster children. In Seattle, the Washington State Department
of Social and Health Services reported 52 youth on the run from placement in
Region 4 (King County) on February 4, 2002.
Even more homeless youth in Seattle are estimated to be on the run from
foster care, because they come here from other regions.
Service Needs of Youth and
Young Adults in Seattle
Youth
have different needs relative to their status as minors or adults and relative
to their developmental stages, special needs, and street experience. The service approach needs to be different
for youth under age 18, especially if they have been on the street for a
relatively short time. In these cases a priority is placed on minimizing the
youth’s exposure to the street.
Residential services and support for returning to family or foster care
are the first choice. However some
youth, even at a very young age, are not able to engage in or be successful in
foster care or residential programs, most often because of mental health or
chemical dependency issues. These youth
need intensive case management, advocacy to help them obtain needed services,
and support for maintaining health and safety until they are stabilized or
mature enough to successfully engage in transitional services.
Young
adults present a range of needs. Many
are developmentally ready to succeed in transitional services, but face
eligibility challenges because of a criminal history, lack of identification,
lack of awareness of resources, or age.
Others have severe mental health issues and chemical addictions that
prevent them from meeting the requirements of most programs. Another group of young adults have less
obvious mental health challenges, but are not developmentally prepared to take
on the challenges of responsible independent adulthood. Outreach, information
and referral services, and case management assist the entire range of youth in
taking whatever the next step may be for each of them toward stable
housing. Many youth are fearful of
services, and very minimal contact by outreach workers with provision of basic
needs like food and hygiene supplies is the first step in engagement. Others need intensive support for accessing
services to meet multiple needs, while many require help with completing their
education, gaining job readiness and independent living skills to work toward
independent housing.
A
comprehensive continuum of services is needed to meet the diverse needs of
youth and young adults. Outreach, case
management, shelter and transitional housing services are the services required
by most youth in both age groups. The
majority of these young people also require one or more supportive services
such as mental health counseling, chemical dependency treatment, specialized
educational support services, and employment services. With the appropriate mix of services, nearly
all homeless youth and young adults can successfully move out of the homeless
assistance system, many into successful independence, others into mainstream
social service systems. Besides
supporting the service continuum, efforts to close the door to homelessness by
working with mainstream systems – child welfare/foster care, treatment,
juvenile justice) through discharge planning and transitional services must be
part of the overall plan to end
homelessness.
Housing Needs of Youth and Young Adults in Seattle
Homeless youth and young
adults often require substantial preparation prior to being able to enter
transitional or permanent housing.
Issues related to the high degree of trauma, disorganization and
arrested development highlighted above along with substance abuse, mental
health, sexual orientation, cultural identity, developmental disabilities and
criminal history are major barriers to housing stability that transitional
housing programs are presented with among the youth who apply for service. Currently most transitional housing
programs for youth and young adults are designed to meet the developmental
needs and skill deficits common among homeless young people, but few are able
to work with youth who are chemically dependent, mentally ill, or unable to
successfully work at a paying job or attend school.
In a 2000 survey of homeless
youth service providers, workers who referred youth to shelter and transitional
housing said the most common barriers to youth entering a program were that the
maximum length of stay allowed was too short to be useful to the youth and that
youth were denied service because of a criminal history or drug use. In addition, transitional housing programs
are unable to accept pregnant youth due to liability insurance issues. Housing providers said that the most common
reason for turning away youth was that their programs were not designed for the
issues presented by the youth being referred. Providers, committed to providing a safe
environment for all residents, are forced to bar or evict the most needy and
challenging youth due to substance abuse or behaviors resulting from mental
health issues, without the ability to refer these youth to alternative, safe
housing situations.
PRO-Youth case managers
report that the geographic location of services is a barrier to many of these
youth, especially young women of color. The PRO-Youth case management team has
identified the need for transitional housing in more communities in
Seattle. Currently, the majority of
transitional housing is north of downtown Seattle, in the U-District, Sand
Point, and Greenwood. Youth struggling
with housing in other neighborhoods are often reluctant to go someplace unfamiliar
or culturally uncomfortable and will remain near “home”, couch surfing and
relying on predatory adults. Pregnant
and parenting girls and young women are particularly reluctant to move to
unfamiliar neighborhoods for housing.
By state licensing rules,
youth under age 18 must be housed separately from those over 18. Under some circumstances appropriate
separation can be licensed within the same building. Licensing considerations provide a higher level of complexity and
expense in programming for minor youth, however many of the standards imposed
by licensing are based on the specific needs of young people which are present
in the young adult population as well.
For all of these reasons, there is a need for a range of specialized
services connected to transitional housing as well as services to prepare youth
to enter housing and utilize it successfully.
Mental Health Service Needs of Youth and Young Adults in Seattle
Histories
of trauma experienced by troubled youth and young adults translate into
significant needs for mental health services.
The 2000 service gaps analysis estimated that 160 youth at any one time
might seek mental health services if available. Currently, one community clinic has a part time psychiatrist who
assists with medication prescription and management for mentally ill
youth. One additional mental health
specialist will provide services to homeless youth in the coming year as a
result of a new grant. Access to most
other mental health services requires enrollment in medical assistance. This poses a significant barrier to homeless
youth, who have difficulty meeting the documentation requirements. The gap for mental health services is
approximately 115 youth. In the absence of easily accessible mental
health services, advocacy is required by other providers working with youth to
connect them with resources and assist them in managing their lives with
minimal services.
Chemical Dependency
Treatment Needs of Youth and Young Adults in Seattle
A large
percentage of homeless youth are affected by drugs and alcohol, as indicated in
a local Seattle study. In 2003, 38% of youth enrolled in PRO-Youth
were identified as in need of chemical dependency services. There is currently only one Chemical
Dependency Specialist providing services to homeless youth and only 30 beds of
inpatient chemical dependency treatment available for youth under age 18. Other resources for chemical dependency
treatment are very scarce. Youth must
wait months to get into treatment from the time they request it. The realities of street life and addiction
prevent most from maintaining a commitment to attending treatment for extended
periods of time. In the absence of easily accessible
chemical dependency services, advocacy is required by other providers working
with youth to connect them with resources and assist them in managing their
lives with minimal services.
Case Management Needs of
Youth and Young Adults in Seattle
As
described above, many homeless young people are not eligible for housing
programs because of chemical dependency, mental health issues and criminal
histories. In addition to providing
advocacy and support to youth in accessing services and coping without needed
services, intensive case management services are also effective with many of
these youth in reducing the negative impacts of life on the street, completing
their education, obtaining jobs or public benefits and moving off the streets
into shared or independent housing.
Seattle currently has 20 case managers serving about 500 youth. This leaves a gap of 150 youth who are not
able to access case management services.
Outreach and Engagement
Needs of Youth and Young Adults in Seattle
Outreach
serves two purposes in the homeless youth population: information and
engagement. In order for youth and
young adults to access services they must know what services are available and
how to use them. Most young people have
limited experience in seeking services, therefore homeless youth find it
difficult to get accurate information about services. Some youth are reluctant to become involved in services because
of previous bad experiences and/or unfavorable comments about services they
might hear from others on the street.
Outreach workers can meet youth where they congregate, provide accurate
information, transportation to service sites, and develop trust by
demonstrating a genuine interest in helping and ability to provide useful
resources. Drop-in Centers provide
low-barrier access to basic needs enabling workers to engage youth in transitional
services.
Summary
of Housing and Service Gaps
|
Homeless Youth and Young Adults Need: Gaps Chart
|
|
|
Estimated
Need
|
Current
Capacity
|
Unmet
Needs/Gap
|
|
Youth Shelter
|
20
|
3 beds
|
17 beds
|
|
Youth Transitional Housing
|
90
|
35
beds
|
55 beds
|
|
Young Adult Shelter
|
60
|
33
beds
|
27 beds
|
|
Young Adult Transitional Housing
|
130
|
71 beds
|
59 beds
|
|
Young Parent Transitional Housing
|
70
|
16 beds
|
54 beds
|
|
Case Management
|
650
|
20 case
managers
500 youth
|
12 case
managers
150
youth
|
|
Mental
Health Services
|
160
|
1 PT Psych., 1 MHS
45 youth
|
6 MH Specialists
115 youth
|
|
Chemical
Dependency Treatment
|
160
|
1 CD Spec.
25 youth
30 <18 beds
|
5 CD Specialists
135 youth
26 young adult treatment beds
|
|
Outreach/drop
in
|
640
|
Three street outreach teams based
at drop-in centers
|
New outreach strategies needed
to reach youth of color. Mobile van
outreach needs to be restored.
|
Source: City of Seattle
Human Service Department 2000
Gaps Analysis Chart
The methodology for determining the unmet needs or
gaps in services in the above chart is included in footnotes. This methodology is based on a homeless
youth and young adults community planning process conducted in 2000 and updated
annually since then. The above chart
provides greater detail and reflects more in-depth planning for this special needs
population of youth and young adults than the data prepared for all homeless
populations for the Continuum of Care Plan.
As a result, these gaps estimate are higher than those shown in the
Continuum of Care Plan.
Service Strategy
Seattle
has worked to develop a comprehensive continuum of care for homeless youth and
young adults that starts with prevention efforts,
includes outreach and emergency services to meet basic needs, and ultimately
leads to permanent, stable, affordable housing. The City has worked with youth, providers and other systems,
including mental health and chemical dependency agencies, to continually
develop more comprehensive and effective services for homeless youth and those
at risk of homelessness. Resources in
many needed areas still fall far short of the demand, and the City has worked
to develop capacity through coordinated, outreach-based case management
services, to bridge the gap for young people so they remain safer, healthier,
and better prepared to take advantage of services and housing opportunities when
they become available. Homeless
youth services programs provide creative outreach, case management, emergency
shelter, referral and support to assure that homeless youth and young adults
access the necessary level and types of service to effectively transition off
the street and into safe and stable housing and, at maturity, permanent
housing. Neighborhood-based
multi-service centers act as hubs for offering outreach, case management,
meals, employment and training, GED classes, health care, substance abuse and
mental health counseling, AIDS prevention and harm reduction services. Community Development Block Grant and
Emergency Shelter Block Grant funded services play an important role in
supporting emergency and transitional services in the continuum of care for
youth and young adults that is primarily funded by the City General Fund and
McKinney resources with significant assistance from the faith community.
PEOPLE WITH HIV/AIDS AND THEIR FAMILIES
Characteristics of the
HIV/AIDS Population
According to Public Health –
Seattle & King County, an estimated 8,400 individuals are living with
HIV/AIDS in King County, with 400-500 new HIV infections occurring each
year. The biggest increases in new
infections are among people of color, women, young adults, and recent
immigrants. Similar to most other areas
of the country, HIV/AIDS has disproportionately affected African
Americans/Blacks and Hispanics/Latinos.
An estimated 750 women are
HIV-positive in King County, which includes women who have not been diagnosed
and a small number who have tested positive but have not been reported. Women represent nine percent of the total
HIV/AIDS cases, which has increased over recent years and is expected to
continue increasing. The racial
disparity is even greater among women compared to men. The rate is thirteen times higher for
African American/Black women than White/Caucasian.
Other key facts for
Seattle-King County include:
- An estimated 1,000 youth and young adults (ages
13-24) are HIV infected.
- Seventy percent of the people living with
HIV/AIDS are men who have sex with men.
- An estimated 10 % of the HIV-infected residents
of King County were born outside of the United States.
Critical Issues for People
living with HIV/AIDS
Increasingly, people living
with HIV/AIDS also have substance use or mental health issues that may or may
not be combined with homelessness.
People with both substance use issues and mental illness are at a
greater risk for HIV/AIDS, are overrepresented in the homeless population, and
experience more barriers to housing and health care. Substance use and homelessness are also closely associated with
incarceration and involvement with the criminal justice system. Particularly as people with HIV/AIDS live
longer lives, incarceration is a growing concern.
Appropriate services and
housing for people with histories of homelessness, mental illness, substance
use, and/or incarceration can make a critical difference in improving health
and quality of life. For example, housing
stability is often necessary for a person living with HIV/AIDS to gain access
to health care and adhere to treatment regimens. Individuals who have had histories of substance use, mental
illness, and homelessness often need ongoing support services in order to
maintain stable housing.
People living with HIV/AIDS
who have low incomes face the same challenges as other people with low incomes,
and they frequently turn to the same resources to meet their housing and
services needs. Clearly, people with
disabilities who depend on SSI – equivalent to just 17 % of the median income
for an individual in 2004 – have even fewer housing choices. The Fair Market Rent for a one bedroom
apartment in Seattle is $843 per month; $279 more than the monthly SSI income
of $564.
Many individuals and families
are forced to make critical choices when their income is not sufficient to meet
their basic living needs. It may mean
fewer meals, no health care, loss of utilities, overcrowded housing, or eviction. For people living with HIV/AIDS who have low
incomes, these choices can have a serious effect on their health status.
Resources to Address
Housing Needs for People living with HIV/AIDS
Seattle-King County has a
well-developed continuum of AIDS-dedicated housing and services which has evolved
over the last 10 years. It includes 106
independent and supported transitional housing units, 369 permanent independent
units, 18 assisted living beds, and 35 skilled nursing beds. Developments for
families are coming on-line in 2004 and 2005.
The priorities of the Housing
Opportunities for Persons with AIDS program (HOPWA), administered by the City
of Seattle Human Services Department, are to prevent homelessness and promote
housing stability. HOPWA-funded programs
serve more than 500 people per year in King and Snohomish Counties through
rental assistance, permanent housing development, set-aside units, services
enriched housing, adult day health, and assisted living.
Despite the resources
available through the continuum, some notable gaps are emerging. Clients with personality disorders and other
mental health issues are difficult to successfully house and require additional
time and energy from case managers and service providers. There are few housing options available for
individuals exiting the criminal justice system, or for those who have poor or
no credit. People without legal status
cannot be served by most of the housing programs that receive funding from
HUD. Increasingly, new clients are
presenting with language and cultural barriers that are difficult to address
through the AIDS housing and service system.
Further, the existing AIDS
housing inventory is prioritized for people disabled by AIDS with incomes below
50 percent of median. There are very
few housing resources for low income people who are HIV positive and not
disabled by AIDS.
The 2004 Seattle-King County
HIV/AIDS Housing Plan, available in summer of 2004, will provide in-depth
information on housing needs, gaps, barriers, critical issues, and
recommendations.
Victims of Domestic Violence
Domestic violence is a
widespread social and public health problem that affects not only the victims,
the perpetrators, and their children, but the entire community. Each year, domestic violence impacts
thousands of families in Seattle. In
2002, the Seattle Police Department responded to 12,483 domestic
violence-related calls for service.
However, national research suggests that the problem touches many more
families than these data indicate. The
National Violence Against Women Survey
found that nearly 25% of US women and 7% of men reported that they were raped
and/or physically assaulted by a current or former spouse or partner at some
time in their lives. Based on this
research, it is estimated that approximately 66,000 female Seattle residents
will be physically and/or sexually assaulted by their spouse or intimate
partner at some point in their lives.
There is a broad consensus
about the behavioral definition of domestic violence among researchers and
service providers nationally and internationally. The American Bar Association
provides the following definition of domestic violence:
Domestic
violence is a pattern of behavior that one intimate partner or spouse exerts
over another as a means of control.
Domestic violence may include physical violence, coercion, threats,
intimidation, isolation, and emotional, sexual or economic abuse. Frequently,
perpetrators use the children to manipulate victims: by harming or abducting
the children; by threatening to harm or abduct the children; by forcing the
children to participate in abuse of the victim; by using visitation as an
occasion to harass or monitor victims; or by fighting protracted custody
battles to punish victims. Perpetrators often invent complex rules about what victims
or the children can or cannot do, and force victims to abide by these
frequently changing rules.
Domestic
violence is not defined solely by specific physical acts, but by a combination
of psychological, social and familial factors.
In some families,
perpetrators of domestic violence may routinely beat their spouses until they
require medical attention. In other
families, the physical violence may have occurred in the past; perpetrators may
currently exert power and control over their partners simply by looking at them
a certain way or reminding them of prior episodes. In still other families, the violence may be sporadic, but may
have the effect of controlling the abused partner.
Unlike other assailant-victim
situations, the batterer has a deep personal knowledge of the victim’s
lifestyle, needs, and vulnerabilities, and may have unlimited access to the
victim, and the victim’s children, friends, and family members. This puts the victim at grave risk. She is often terrified of the batterer, and
cannot speak openly about the violence because of her fear of a broad range of
potential negative consequences. This
fear is quite realistic and is based on her experience of the behavior and
threats by the batterer. The
consequences of disclosing the violence may include further violence by the
batterer as “punishment,” loss of custody of her children, further isolation
from supportive friends and family members, loss of her home, loss of child
support, loss of public benefits, and other essential resources. This fear greatly enhances the batterer’s
ability to control and to abuse her.
When a woman leaves an
abusive relationship, she often has nowhere to go. Across the United States there are now several hundred
confidential shelters for victims of domestic violence. Because of the level of lethality, many
victims have to flee their immediate jurisdiction and go to a confidential
shelter in another county or state. 2002 data
from the four confidential domestic violence shelters in King County reflect
this pattern:
|
2002 Data-King County DV Data Base
|
New Beginnings Shelter (Seattle)
|
Catherine Booth House Shelter (Seattle)
|
Eastside Domestic Violence Program (Bellevue)
|
Domestic Abuse Women’s Network (Kent)
|
Total
|
|
New Intakes 2002
|
81
|
76
|
59
|
106
|
322
|
|
Residence at Intake-Seattle
|
42%
|
36%
|
29%
|
31%
|
|
|
Residence at Intake-North KC
|
4%
|
1%
|
0%
|
3%
|
|
|
Residence at Intake-South KC
|
19%
|
21%
|
26%
|
41%
|
|
|
Residence at Intake-East KC
|
5%
|
3%
|
19%
|
9%
|
|
|
WA State-out of KC
|
20%
|
27%
|
25%
|
10%
|
|
|
Out of State
|
11%
|
12%
|
2%
|
6%
|
|
|
|
101%*
|
100%
|
101%*
|
100%
|
|
*Totals more than 100% due to rounding
During 2002, for every
domestic violence victim served by a local domestic violence shelter in King
County, 11 other women were turned away.
Transitional housing for
survivors of domestic violence is also limited. In Seattle there are only 47 units of transitional housing with
specialized support services.
Many studies demonstrate the
contribution of domestic violence to homelessness, particularly among families
with children. A 1990 Ford Foundation
study found that 50% of homeless women and children were fleeing abuse. In addition, 46% of cities surveyed by the
U. S. Conference of Mayors identified domestic violence as a primary cause of
homelessness. In the City
of Seattle, only 5 percent (or 79-81) of the facility-based emergency shelter
beds are available for women with children.
Issues That Impact
Homelessness of Victims of Domestic Violence
Safety – Shelter provides immediate safety to battered women
and their children and help women gain control over their lives. The provision of safe emergency shelter is
thus a necessary first step in meeting the needs of women fleeing domestic
violence. To assure the ongoing safety
of these women, the shelters should provide or facilitate access to services
that help the women develop and implement safety plans.
Mental Health – Women who have experienced domestic violence also
experience high levels of physical and mental health problems. For example, the Passaic County (New Jersey)
study
found that 54% of the currently abused women stated that they were depressed
and a similar study found the over 11% were suffering from acute
depression. Mental health problems
compound the difficulties the victims of domestic violence have with accessing
and maintaining safe housing. Effective
emergency and transitional housing for these women includes case management and
access to services that help them establish stability
Employment – Recent studies (see footnote 28) document that
abused women do seek employment but are not able to maintain it because of
interference from intimate partners.
This affects their ability to maintain housing over the long term. Program designs to support housing for
abused women must include strategies to deal with abusers who interfere with
her capability to hold a job, or participate in work-training programs, and
thus afford stable housing over time.
Mental health and other issues frequently make it difficult for survivor
to actively seek work: according to
2002 data from the four confidential shelters in King County, an average of 30%
were not in the job market and 23% were unable to work.
Financial and Housing
Practices and Policies – An abusive
partner creates barriers to securing affordable housing when he wreaks havoc on
a battered women’s credit history, leaves her with poor landlord references,
and impedes access to the joint financial resources of the relationship for
security or utility deposits.
The federal Department of Housing and Urban Development’s “one strike policy”
for eviction also creates a hardship for victims of abuse. In many parts of the country victims of
domestic violence are being evicted if the police are called to their housing
unit too many times (Griffin, 1999; Renzetti, 2001). Solutions to many of these situations will
involve legislative or regulatory action.
Refugee and Immigrant Population Groups
According to the Brookings
Institution Center on Urban and Metropolitan Policy: “At the turn of the 21st
century, understanding the characteristics of growing foreign-born populations
is central to understanding the social, economic, and political dynamics of
cities.” Nationwide, the U.S. Census
identified 31 million foreign-born persons representing approximately 11% of
the total population living in the United States. This compares rather
dramatically to the 1970 census which identified approximately 5% of the total
population as foreign-born.
Seattle has been a portal of
entry for thousands of refugees and immigrants in the past three decades. The
city is also a popular destination for many secondary migrants attracted to its
diverse cultural and social environment as well as the presence of family
members who provide the needed social support conducive to their assimilation
into U. S. life.
Seattle ranks in the top
third of large U.S. cities with foreign-born populations. Of a total population
of 563,374 in the city, 94,952 are foreign-born or one foreign-born resident
for every six residents born in the United States. Seattle’s foreign-born population
grew from 67,736 in 1980 to 94,952 in 2000, a 40.2% increase.
Over half of Seattle’s
foreign-born residents or 44,334 persons have become naturalized U.S. citizens,
the second highest among 23 largest cities in the Brookings Institution study. Approximately
55% of all immigrants are from Asian nations, although significant numbers have
also arrived from Europe, Africa, and Latin America nations.
The state of Washington has
the fourth largest number of refugees in the country, of which approximately
66% live in King County. The Refugee and Immigrant Assistance unit in the state
Department of Social and Health Services estimates that approximately 80,000
refugees currently reside in the greater Seattle area. Southeast Asians comprise 48%, or the
largest percentage, of the County’s refugee population. However, a growing
segment of this population is from East Africa, which represents about 13% of
the refugee population. They include refugees from Ethiopia, Eritrea, Somalia,
and Sudan. Eastern Europeans make up
31% of the refugee population in King County; however most are concentrated in
south and east King County. Less than
10% of the refugee population is from the Middle East.
Refugee Populations in
Seattle/King County
|
|
Region of Origin
|
Number
|
Percent
|
|
SE Asia
|
35,196
|
48%
|
|
Eastern Europe
|
25,509
|
34%
|
|
Eastern Africa
|
9,291
|
13%
|
|
Middle/Near East
|
4,079
|
6%
|
|
Total
|
74,075
|
100%
|
Source: 2000 U.S. Census
The more stringent screening
of foreign arrivals to the U.S. following 9/11 is reflected in the decreased
number of refugees admitted for resettlement in recent years. The admission ceiling set by Congress for
new refugee arrivals was radically reduced when it was dropped from 70,000 in
2001 to 27,000 in 2002. In 2001, only
27,180 were actually admitted. Refugee
admissions increased dramatically when 20,529 were admitted during the first
six months of 2003. Of this number,
31.5% were from the former Soviet Union, 31.9% were from Africa, 16.6% from the
Near East, 6.9% from Asia, and 1.2% from Latin America.
|
2003 Refugee Arrivals in Seattle/King County
|
|
Country of Origin
|
Number
|
Percent
|
|
Former USSR
|
766
|
72%
|
|
Iran
|
72
|
7%
|
|
Somalia
|
56
|
5%
|
|
Ethiopia/Eritrea
|
49
|
5%
|
|
Vietnam
|
33
|
3%
|
|
Liberia
|
20
|
2%
|
|
Bosnia
|
19
|
2%
|
|
Afghanistan
|
18
|
2%
|
|
Sudan
|
7
|
1%
|
|
Iraq
|
6
|
1%
|
|
China
|
1
|
0%
|
|
Total
|
1,058
|
100%
|
Source:
Public Health-Seattle & King County, Refugee Screening Information, April
2004
Seattle-King County resettled
1,058 refugees in 2003 of which 72% were from the former Soviet Union; 2% from
Bosnia; 13% from Ethiopia, Eritrea, Sudan, Somalia, Liberia; 10% from
Afghanistan, Iran and Iraq; and 3% from Vietnam.
Welfare Profile of Refugee and
Immigrant Communities
In the current tight labor
market, there are refugees and immigrants who need assistance from government
programs such as the Temporary Assistance for Needy Families (TANF) and the
Refugee Cash and Medical Assistance (RCMA) programs.
|
Limited English Proficient (“LEP”) Adults on TANF or
RCMA
in Seattle/King County
|
|
Language
|
Number receiving TANF
|
Number receiving RCMA
|
|
Russian
|
667
|
120
|
|
Somali
|
324
|
27
|
|
Vietnamese
|
216
|
3
|
|
Spanish
|
116
|
1
|
|
Cambodian
|
49
|
|
|
Farsi
|
54
|
4
|
|
Laotian
|
13
|
4
|
|
Others
|
731
|
146
|
|
Total
|
2,170
|
301
|
Source: Department of Social and Health Services,
Economic Services Administration, March 2004
Data from the State
Department of Social and Health Services showed 2,170 refugee or immigrant
households enrolled in TANF and 301 households in the federal RCMA in March
2004. Of those on TANF, 30% were Eastern European, followed by 15% Somali and
9% Vietnamese. Those on the RCMA program were predominantly Eastern European
families (40%) followed by Somalis (9%). The state’s ESL and employment
training programs served 953 refugees in 2003.
Emergency Shelter and Publicly Assisted
Housing
Though community nonprofit
agencies which serve refugees and immigrants report that many refugees reside
in public housing in Seattle, the local Housing Authority currently does not
compile data on the number of refugees and immigrants on its waiting list or
occupancy list.
However, the Annual One-Night
Count in October 2003 conducted by the Seattle-King County Coalition for
Homeless provides a snapshot on the number of refugees and immigrants who
utilized emergency shelters or transitional housing units. The study concluded
that, on any given night, approximately 9.9% of homeless persons are refugees
or immigrants from Africa and 9.7% are Hispanic/Latino. The One Night Count of
Hispanic/Latino persons may include undocumented immigrants. However, providers believe that the numbers
recorded for this population group do not accurately reflect the actual number
of Spanish speakers who are homeless on any given night. Agencies which serve primarily
Spanish-speaking persons report that a large number of their clients are
undocumented and do not go to emergency shelters because of apprehension about
requests for documentation about their INS status.
These providers report that
most Spanish-speaking homeless people do not like to go to places where they
are not in the majority and instead prefer to sleep under bridges within
clusters of homeless Latinos. Providers
cite difficulties in finding affordable housing for large Latino families and
the inability of these Spanish speakers to access other mainstream services
because staff do not speak Spanish.
Agencies report that they are
unable to serve increasing numbers of Spanish-speaking single men who need
housing services. Many simply provide a
hot meal at noon and referrals to hygiene and shelter services. One service provider suggests establishing a
shelter for primarily Spanish-speaking persons.
The One Night Count found 707
refugees or immigrants utilizing shelter services or 19.6% of the total number
of 3,595 persons in shelters. Of this number, 480 were new arrivals in the U.S.
and 411 had limited English speaking capabilities. Languages spoken included
Spanish, Somali and other African dialects and a few Asian dialects. It was
noted that refugee families seeking shelter were comprised of many family
members.
Being able to house large
refugee or immigrant families, along with bilingual and culturally competent
services, is an emerging need in the system of services for homeless people. Of
refugees enrolled in TANF and RCMA programs, 51% have families of four or more
persons. The “Needs and Gaps” section of the 2002 King County Refugee Service
Delivery Plan identified transitional and permanent housing as a need,
especially for large families.
Healthcare for the Homeless special needs data is
based on health problems identified during clinic encounters. PRO-Youth special needs data is based on
needs identified at initial contact – considered highly under reported.
Burt, M. R. (1998). Demographics and Geography:
Estimating Needs. National Symposium on Homelessness Research: What Works?
Washington, DC. October.
De Rosa CJ; Montgomery SB; Kipke MD; Iverson E; Ma JL;
Unger JB. (1999). Service utilization among homeless and runaway youth in Los
Angeles, California: Rates and reasons. Journal of Adolescent Health 24(3),
190-200.
Fest, J. (2001). Understanding Street Culture: A
Prevention Perspective. The Prevention Researcher 8(3), 8-10.
Kufeldt, K., Durieux, M. & Nimmo, M. (1992).
Providing Shelter for Street Youth: Are We Reaching Those in Need? Child Abuse
and Neglect, 16, 187-199.
The students in the course Health Services 523:
Community Health and Needs Assessment. (2000, Spring). Needs Evaluation of Street Teens Final
Report. Seattle, WA: University of Washington School of Public Health and
Community Medicine
Ringwalt, C. L., Greene, J.
M., Robertson, M. (1998a). Risk Behaviors, Negative Familial Experiences, and
Institutional Placements Among Throwaway Youth. Journal of Adolescence, 21:
241-252.
Robertson MJ. (1990). Characteristics and Circumstances
of Homeless Adolescents in Hollywood. Berkely CA: Alcohol Research Group.
Smollar,
J. (2001). Homeless Youth in the United States, Prevention Researcher V.8#3.
Whitbeck, L. B. & Hoyt, D.R. (1999). Nowhere to
Grow, Homeless and Runaway Adolescents and Their Families. New York: Walter de Grueter, Inc
Greene, J.M. (1995). Youth with Runaway, Throwaway, and
Homeless Experiences: Prevalence, Drug Use, and Other At-Risk Behaviors, Volume
I (Report); and Volume II (Appendixes). Silver Spring, MD: National
Clearinghouse on Families & Youth.
Interfaith Task Force on Homelessness & Real
Change/First Things First (2003). A Walk Through the Revolving Door of
Homelessness in King County.
Preliminary Findings, Impacts, Opportunities, and Recommendations. Seattle,
WA.
[19] Meyers, R. & Shaw, M.E. (2000)
It Takes More than Shelter: Vacancies in residential programs for homeless
youth. Seattle, WA: Seattle-King County Coalition for the Homeless Youth and
Young Adult Committee and City of Seattle Human Services Department, Division
of Family and Youth Services.
[20] PRO-Youth Case Management Team
(2004). Information from discussions at monthly County-wide case management
team meetings. Seattle, WA
City of Seattle Human Services Department (2000).
Homeless Youth in Seattle/King County: Service Gaps Analysis. Seattle, WA.
Paradise,
M. & Cauce, A.M. (2003). Substance Use and Delinquency During Adolescence:
A Prospective Look at an AT-Risk Sample. Substance use & Misuse, 38, Nos.
3-6: 701-723.
Greene, J.M. &
Ringwalt, C.L. (1997). Substance Use Among Runaway and Homeless Youth In Three
National Samples. American Journal of Public Health 87(2), 229-236. continued…
(note 16 cont.) Robertson,
M., Koegel, P. and Ferguson, L. (1989). Alcohol Use and Abuse Among Homeless
Adolescents in Hollywood. Contemporary Drug Problems, 16, 415-452.
City of Seattle Human Services Department (2000).
Homeless Youth in Seattle/King County: Service Gaps Analysis. Seattle, WA.
The numbers for Mental Health, Drug/Alcohol and Dual
Diagnoses services represent expected demand, if services are appropriate and
easily accessible to homeless youth.
Expectations are that 20% of the total population (800) would use Mental
Health Services, 20% would use Drug/Alcohol Services and 20% would use a
combination of the two services (Dual Diagnoses).
The numbers for Mental Health, Drug/Alcohol and Dual
Diagnoses services represent expected demand, if services are appropriate and
easily accessible to homeless youth.
Expectations are that 20% of the total population (800) would use Mental
Health Services, 20% would use Drug/Alcohol Services and 20% would use a
combination of the two services (Dual Diagnoses).
Average number in service through Drop In Centers at
any one time. Number of centers is
adequate, additional services are needed but are described under “Case
Management,” “Mental Health Services,” and “Drug/Alcohol Services.” Number
currently served by outreach plus estimated number of known undercounted
groups.