Statewide Homelessness Assessment: A Research Series Addressing Homelessness in California

As California’s homelessness crisis has continued to grow, so has the range and scale of efforts to address it. To understand these efforts in greater depth and inform their ongoing implementation, the UC Berkeley Terner Center, UCSF’s Benioff Homelessness and Housing Initiative (BHHI), and Abt Associates collaborated on a research project focused on homelessness in California.

Our findings come from hundreds of in-depth interviews with people experiencing homelessness, government officials, non-profit leaders, front-line workers, and other stakeholders from local homelessness and housing organizations throughout California. We also analyzed quantitative data from local homelessness services, shelter, and housing programs.

The Statewide Homelessness Assessment Report

The California Interagency Council on Homelessness (Cal ICH) submitted a report to the state legislature, Statewide Homelessness Assessment, in February 2023 that assessed state-directed funding to address homelessness over the course of three fiscal years (2018–2021). Produced in collaboration with BHHI, the Terner Center, and Abt Associates, the report presents quantitative findings on: the sources and intended uses of $9.6 billion in state-directed funding designed to address homelessness and the types of interventions supported with that funding. The report also analyzes the characteristics and outcomes of the approximately 570,000 unique individuals served by local homelessness service, shelter, and housing programs, including an estimated 273,000 people served by programs supported at least in part by state funding.

The report is the first in-depth analysis of Cal ICH’s Homeless Data Integration System (HDIS), a powerful tool for understanding the reach and effectiveness of homelessness programs statewide.

Five Recent Trends in Homelessness

Five Recent Trends in Homelessness in California describes the number and characteristics of people experiencing homelessness in CA and documents trends in the available shelter and housing across the state. The patterns presented in the brief underscore the need for sustained resources to address homelessness, ensure equitable service provision, and expand the production of affordable housing.

Distinct Populations Served by California’s Homelessness Programs

Many homelessness programs target specific populations, reflecting their unique circumstances and needs. Leveraging the unique strength of Homeless Data Integration System (HDIS), a statewide aggregation of data collected by local homelessness service, shelter, and housing providers, a series of briefs will examine four populations served by homelessness programs in California: Unaccompanied Children and Young Adults, Older Adults (aged 50 or older), Families, and Veterans. The briefs will describe the characteristics of each population, the distinct kinds of programs serving them, and outcomes at the end of the 2018-2021 period. [include links once it is published]. 

Findings show that some groups have better housing outcomes—such as families relative to adults without children, and veterans relative to non-veterans—demonstrating that solutions to homelessness exist, but programs need to have sufficient funding and targeting to meet specific needs for success.

Understanding CalAIM Implementation

In January 2022, California’s Department of Health Care Services (DHCS) and its local partners began implementation of California Advancing and Innovating Medi-Cal (CalAIM). Using the authority and flexibility provided through two new Medicaid waivers approved by the federal government at the end of 2021, CalAIM seeks to address the upstream factors that contribute to health disparities, including allowing health care dollars to be spent on supportive services that are critical to enhancing the well-being of people experiencing or at risk of homelessness.

However, there are significant barriers to the implementation of CalAIM, particularly as it relates to building stronger connections between the health and housing sectors. In this report, we will describe challenges related to the implementation of CalAIM at the local level drawing from interviews with stakeholders from local government, health and housing-related service organizations, and health care entities within the homelessness response system across CA. We also highlight some of the new initiatives designed to implement CalAIM, how local service providers are accessing CalAIM, and propose policy recommendations to expand the impact of CalAIM. 

Findings show that while there are many challenges and concerns in CalAIM implementation, stakeholders recognize the importance of CalAIM in addressing homelessness. Administrative burdens, system fragmentation, insufficient funding, and need for technical assistance and new data systems present barriers to implementation. Our recommendations in the report help to overcome these barriers.