In a single day a chronically homeless individual may elicit seven or more responses from various City departments, but a one-of-a-kind data sharing application has allowed the City to slice those numbers dramatically and get people the help they need.
For example, a chronically homeless individual could trigger a fire department ‘man down’ call for being on the ground and unresponsive, a police call for engaging in an altercation, a response from a homeless outreach team for camping in public, another fire department call for a medical emergency, and so on. Each department will respond to an acute concern, but traditionally has not had the capacity to address the overall problem or coordinate interdepartmental interventions.
The Santa Monica Connect App changed that. This unique data sharing platform was created in partnership with Akido Labs and allows police officers, firefighters, human services staff, and homeless service providers to share real time information on around 120 of the highest utilitzers of the City’s emergency response systems.
This information sharing allows for more timely and informed responses that can prevent individuals from generating repetitive calls for service and frequent police encounters.
“Prior to the Connect program, these services were all working with pen and paper, sharing printed pictures of patients during scheduled case conferencing meetings and asking if others had seen them. This significantly slowed down collaboration and coordination across these services so much that it was starting to become ineffective,” said Dr. Karthik Murali, head of Public Health for Akido Labs.
The Connect application, on the other hand, pulls realtime data from each of the department’s respective response tracking systems and automatically populates homeless utilizers’ profiles with information from every call for service they generate. Because the application pulls information from data that each department is already internally recording, it does not place any additional demands on emergency responders or service providers.
The application was first piloted for a 10 month period in 2019. During this time the police department saw a 33 percent decrease in encounters with homeless high utilizers of the 911 system and 37 percent fewer arrests of these individuals. The fire department also saw a 27 percent reduction in calls for services related to individuals experiencing homelessness.
The partnership with Akido was spearheaded by Santa Monica Chief Information Officer Joseph Cevetello, who was acting on instructions from former City Manager Rick Cole to develop a data tracking system to eliminate inefficiencies in the City’s homelessness response model.
“He [Cole] said, ‘here’s the challenge: Santa Monica probably spends more than any other municipality in California on support for those experiencing homelessness… but I’m not sure that we get the best outcomes we can… not only am I not sure, I don’t know, and the reason why I don’t know, is because we have various groups who respond to homelessness and there’s not a lot of information sharing going on between them,” said Cevetello.
For over twenty years, Santa Monica has targeted a population of chronically homeless individuals with the highest barriers to accessing help for intensive attention from outreach workers. The City was doing this long before it was adopted as a best practice by the County of Los Angeles.
To this day, the City maintains a list of the highest need individuals who generate the greatest number of 911 responses and matches them with a case worker from a homeless service provider. Currently, The People Concern’s Homeless Multidisciplinary Street Team manages the bulk of these clients and through the practice of relentless engagement, seeks to connect them to the services they need to transition off of the streets.
Although this type of engagement is a longstanding practice, prior to the Connect application tracking down these individuals was like throwing darts while blindfolded.
“In the olden days if you couldn’t find your client at the regular outreach location, service providers would go searching up to ten different locations,” said Brian Hardgrave, Human Services senior analyst.
This included looking at the LA County Sheriff’s Information Center to see if their client had been arrested anywhere or cold calling emergency rooms in hope that a sympathetic nurse or social worker would be willing to let them know if their client was hospitalized. Locating hospitalized clients was especially challenging as there are multiple emergency rooms in the area and they will often log homeless patients as ‘Trauma Johnny’ or ‘Trauma Jane’ if they are unconscious or in need of urgent medical attention upon arrival.
With the Connect application, case managers receive a notification when the fire department is transporting their client to a hospital. The case manager can then visit the emergency room and try to connect their client to appropriate long-term care.
“Something like a seizure related to an alcohol withdrawal, it may be an imminent medical issue, but the treatment they need is long-term substance abuse intervention that is not going to be provided by the ER,” said Zachary Coil, The People Concern program director. “We’ve been able to go to the ER… see the person and we’ve been able to make calls for treatment or advocate for a detox [program].”
Case managers are also notified if there is a firefighter EMT call where their client refuses transportation to the hospital. If the case manager is working at the time of the incident, they can then visit the scene and try to generate a different response.
“We’re able to follow up with one of the Venice Family Clinic providers we’ve worked with, or our psychiatrist, or just go and see them and take them ourselves to the hospital, so we’re able to help them get their medical needs met that they refused emergency transport for,” said Coil. “That’s been extremely successful for some people.”
By enabling case managers to be at the right place at the right time, the application provides the opportunity to leverage an emergency encounter into an opportunity for service delivery and, ideally, a longer-term care intervention.
A similar phenomenon takes place through the police department data shared on the Connect platform. Case workers are notified when their clients have a police interaction or when they are arrested, and can then come meet them in jail.
“Each time they [homeless high utilizers] are in custody, case workers can plan for what’s next, whether it’s treatment or a housing option,” said Thomas Mastin, officer in charge of SMPD’s Homeless Liaison Program. “That’s why you saw a decrease in the amount of arrests.”
Mastin also said that this can be a good opportunity for case managers to work with clients who have substance abuse issues as they sober up and become more lucid while in custody.
These in jail interventions have been happening less frequently during the pandemic as the County enacted a temporary zero bail policy for many low level offenses in order to reduce density in jails. However, Mastin expects these interventions to become more frequent as the emergency bail schedule expires on July 1. In general, he is a big supporter of the Connect application and an advocate for creating stronger connections between the police department and service providers.
“Getting that information channeled to caseworkers really can be a big money saver and time saver for the City in general, for the police department, for the fire department, even for our hospitals,” said Mastin. “Money like this is well spent when you can coordinate that service to reconnect people to those social services that law enforcement can’t provide.”
Although the Connect application has all of these benefits, the City was initially hesitant to partner with Akido to develop the platform due to the highly sensitive nature of the data it shares. For example, a lot of the health data collected during a fire department EMS call is protected under HIPAA, while most of the police department’s criminal justice data is similarly confidential.
Akido Labs was able to ensure the Connect app abided by these privacy laws by working closely with the City Attorney’s office and developing an interface that displays different information depending on who is signed in.
“If you’re a cop, you’re going to see all the criminal justice data, but you’re not going to see all the HIPAA data. If you’re a community service provider, you’re not going to see any of the criminal justice data that you shouldn’t be seeing… the protections are in place as part of the platform itself,” said Cevetello.
The innovative nature of the SM Connect app and the impressive outcomes generated for Santa Monica are now gaining widespread attention. Several other municipalities are in talks with Akido about developing a similar program and this August both the City and Akido will be recognized as a winner of CIO Magazine’s CIO 100 Awards.
The US CIO 100 awards, which are currently in their 35th year, recognize 100 organizations for their IT innovation and leadership. According to Cevetello, Santa Monica is the only municipality to receive a CIO 100 award this year, as for the most part they are awarded to organizations in the private sector.
Clara@smdp.com
