As noted in LTC 086-2020, the Homeless Outreach Team worked with the Florida Department of Transportation (FDOT) to clear the homeless encampment located beneath the 63rd Street Bridge. On February 13th, outreach staff assisted FDOT with the closure and ensured that no trespass signage was posted to ensure future enforcement. On February 18th, FDOT provided area maintenance.

Marchman Program
The Marchman Program is administrated by the Miami Beach Police Department. This initiative utilizes the Hal S. Marchman Alcohol and Other Drug Services Act to enable the police to provide court-enforced addiction treatment to homeless persons facing alcohol addiction. After identifying viable program candidates, the Police Department submits a court request to intervention to enable the client to enter a 90-day involuntary treatment facility. That action typically yields the following outcomes:
1) The client enters treatment, completes the 90-day requirement and awaits re-assessment at the end of treatment for additional services; or
2) The client refuses to enter or accept the treatment facility and is jailed for 90 days, where treatment is administered in-house. This process is a laborious one. Members of our team must go to court on several occasions to petition the judge, follow up on the order, find the client, deliver him/her to court and then deliver the client to jail or the treatment facility. Due to the client’s level of commitment, this process can and has repeated itself several times for some clients.

Of the 12 clients initially selected, seven (7) were either placed in permanent supportive housing or in regular treatment and are pending permanent supportive housing. Many of these clients had been homeless for more than 20 years. This process has become a model for other law enforcement agencies to emulate and replicate within their own agencies. Furthermore, the city has partnered with Thriving Mind South Florida to facilitate treatment beds which are different than traditional shelter beds.

Administration Recommendation: Since the Police Department is still in the process of procuring the additional treatment beds funded in the FY 19/20 budget, the Administration recommends maintaining existing levels until performance data can be reviewed.

Lazarus Program
The homeless population experiences a high incidence of mental health (including schizophrenia, bipolar disorder, and depression, among others) and addiction issues. According to the National Alliance on Mental Illness (NAMI), 20.1% of people experiencing homelessness in the U.S. suffered from a serious mental health condition.

In March 2019, the city launched the Camillus House-Lazarus Pilot Program to serve 10 chronically homeless participants with persistent mental illness which contributes to their personal homelessness. Camillus House engages clients in the field, assesses their medical needs, pursues the administration of appropriate medications, and works with the client to pursue and secure permanent housing. This program focuses on continuous client engagement, medication management, when applicable, and a contractual benchmark of achieving shelter and/or permanent placement for a minimum of 30 consecutive days.

The city provided Camillus House with 26 referrals, a pool of sufficient size to acknowledge the inherent difficulties in engaging this population. Of these referrals, six (6) candidates were subsequently rejected because Camillus House staff was unable to consistently locate the individuals.

The program has been able to provide placement to four persons. One participant was housed through permanent supportive housing and is currently receiving wraparound services through Camillus House-ACT Program. As of this writing, one participant remains in shelter since December 2019. Another participant was in shelter for one week, relapsed to the streets and subsequently relocated to family. In January, one participant resided in shelter placement intermittently for more than six months; however, she ultimately reverted to homelessness and is currently waiting for an appropriate shelter bed to become available for re-placement at Camillus House.

The program has been able to provide seven medical assessments in which four participants have consented to receive psychotropics, three of which remain on medication. The administration of psychotropics requires consistency of administration which is difficult to achieve when clients cannot be located or when staffing issues arise for Camillus House. The Lazarus Program is currently not staffed to provide medication management during weekends and holidays. Staff has addressed with Camillus House its concern regarding the consistent administration of medication. Camillus House has subsequently revised its programming to ensure that clients are provided weekend doses for self-administration.

Administration Recommendation: The program has proven effective for those who have been stabilized and subsequently housed. The Administration recommends maintaining existing service levels.

Street Outreach
Homelessness is rarely caused just because a person loses their housing. Homelessness, as demonstrated through our client interactions and service histories and reported by Homeless Hub, is the culmination of a series of behaviors and events such as loss of employment, addiction, family disintegration, criminal behaviors, reticence to abide by society’s rules and expectations, lack of savings/financial resources, mental illness, etc. The city’s current strategies and services balance the need to end homelessness with the individual’s right to self-determination and independence. In our community, however, our homeless population is comprised of primarily transient, single males who tend to be more resistant to engagement. While males still represent the vast majority of homeless in our community, the number of single females is showing growth as a sub-group.

Our community leads the county in its municipal efforts to address homelessness and curb its impacts. As one of only two municipal teams in the county, our city is the only municipality that staffs a Homeless Outreach Team (HOT) and operates a walk-in center.

Like much of the country, homelessness continues to concern our residents. According to the 2019 City of Miami Beach Resident Survey, our residents have ranked homelessness as their highest priority.

The city’s homeless outreach team is comprised of nine (9) members (one program coordinator, one client services specialist, one outreach specialist, and two part-time and four full-time caseworkers. The city conducts proactive daily outreach as well as in response to eGov and other requests. In addition to city staff, street outreach is also conducted by HOPE in Miami-Dade (which hires sheltered, homeless persons to engage the homeless remaining on the streets) and Camillus House. In addition to street outreach, the city provides mobile services every Friday from 9:30am to noon at the Miami Beach Regional Library, a location that experiences a significant homeless presence.

The city’s walk-in center is open Monday through Friday, excluding legal holidays, from 7:30am to 3:30pm and the homeless hotline is manned 7:30am to 4pm. The police department, which is staffed 24 hours a day, is provided with five shelter beds daily for after-hours and Pottinger-related placements at The Salvation Army, the city’s sole emergency shelter provider that enables placement of families and adults. Any homeless family with children seeking services after hours triggers activation of the Homeless Outreach Team on overtime to assess and place the family in shelter or hotel, as appropriate. This ensures that no child spends the night homeless in our city.

In order to access shelter in Miami-Dade County, persons must be assessed by a homeless outreach team who must certify that the person meets the HUD definition for homelessness. There are four federally defined categories under which individuals and families might qualify as homeless:
1.Literally homeless;
2.Imminent risk of homelessness;
3.Homeless under other Federal statutes; and
4.Fleeing/attempting to flee domestic violence.

Once assessed and approved for placement, the homeless client is referred to shelter which, in turn, must provide consent for placement. Shelters have the right to decline services to persons who have been served previously and exhibited violent behavior or violated shelter rules. In anticipation that homeless clients may be prohibited from accessing specific shelters, the city contracts with three shelter providers to enable as many placement options as possible to minimize the number of people who cannot be served because of prior actions/behaviors.

In FY 18/19, 1,480 people in the city self-identified as homeless through direct encounters with HOT and police. Of these, 1,411 or 95.33% were directly engaged by the Homeless Outreach Team and 69 or 4.67% were engaged solely by police usually in the form of a referral for services or a direct placement into shelter. The chart below encapsulates the city’s homeless population last fiscal year as well as their service outcomes and reiterates that, while services are offered to all, only a sub-set of the population avails itself to them. (See Exhibit A)

While the vast majority of the city’s homeless population became homeless elsewhere and migrated to our city, the mean length of stay for those clients who subsequently sought relocation services was 27 days. In addition, an important factor that influences housing and employment outcomes is the degree of criminality within this population. In FY 18/19, 76.28% of the population had a criminal history prior to engagement by the HOT team. Of greater concern is that 43.9% of clients had a history of violent criminal offenses.

Current staffing levels have enabled the provision of services to clients in both proactive and reactive ways. In terms of intensity of service provision, the mornings are overwhelmingly the most effective time of day for people to accept services. This is in large measure because HOT’s outreach strategy capitalizes on the data collected during the morning count to target its resources in locations with the greatest overnight homeless density.

What is of overriding value in the data is the sheer number of homeless persons who are approached, offered assistance and subsequently decline these services. This underscores the nature of our homeless population including their reluctance to engage and, far more importantly, the lack of urgency on their part with regards to their homelessness. Please note that unemployment in our county was 1.8% in December 2019, a low threshold that is counter-indicative to a causal effect of homelessness.

From a capacity standpoint, the city currently purchases 57 shelter beds and has access to up to 40 additional beds managed by the Miami-Dade County Homeless Trust. With this existing bed inventory, the city experienced an average of six shelter bed vacancies per day. In turn, the capacity for outreach was limited to the six beds available. This number does not factor the placement of families in hotel when there was no availability of shelter beds for families. All families are directly case managed by HOT while in hotel and served with a rapid-rehousing model whenever possible. Please note that the city experienced an influx of families in December resulting in as many as four families in hotel at the same time. Since October 1, 2019, the city has placed eight families in hotel.

From an efficacy standpoint, the city has reduced homelessness by 25% since FY 15/16 despite the inherent fluctuations among this population. (See Exhibit A)

Administration Recommendation: The Administration contends that the existing HOT staffing level and shelter capacity are appropriate given the size and nature of the city’s homeless population.


Homeless Trust funding
The Administration is pending execution of the agreement with the Miami-Dade County Homeless Trust for funding that was approved at the October 2019 Commission meeting. The Board of County Commissioners approved the receipt of the funds in their February 20th meeting.
Administration Recommendation: The Administration recommends maintaining existing levels until performance data can be reviewed.