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Caring for Homeless Mentally Ill : Innovative Program Has Cities Competing for Funds

December 19, 1985|ALLAN PARACHINI | Times Staff Writer

In an unprecedented joint venture linking a large private foundation and the federal government, the nation's 60 largest urban areas are being asked to compete for more than $100 million in new funds to help resolve one of the most intractable dilemmas facing American metropolises--the plight of the homeless mentally ill.

Its sponsors say the program, announced Wednesday, will attempt to establish coordinated treatment centers where mentally ill homeless people can receive long-term therapy and drugs they may need to control their symptoms, as well as decent housing, welfare assistance if needed and assurances their personal safety will be preserved.

Program organizers say the $103 million that will be spent is intended to beget basic changes in the way services are provided to the homeless mentally ill nationwide, a population that may number in the hundreds of thousands and possibly in the millions. The program is designed to spawn prototype local organizations that would enjoy total political and jurisdictional freedom to strip away bureaucratic delay and set policy to be observed by other agencies from police departments to welfare bureaus.

Grant, Subsidies

The program has been provided $28 million from the Robert Wood Johnson Foundation, which enjoys a national reputation for inducing major changes in the health-care system, and a $75-million in rent subsidies from the U.S. Department of Housing and Urban Development to provide housing for mentally ill street people.

Winning cities will get cash grants and loan commitments to establish local agencies to deal with the homeless mentally ill and finance innovative housing programs for them. That money will come from the foundation, while the government will provide Social Security assistance and $75 million from HUD to help guarantee stable housing for patients for as long as 15 years.

The project is co-sponsored by the foundation and HUD, as well as the National Governors' Assn., the U.S. Conference of Mayors and the National Assn. of Counties. The advisory committee includes a range of experts, from the director of the National Institute on Mental Health to Dr. H. Richard Lamb, director of community psychiatric services at County-USC Medical Center.

The eight winning urban areas will receive direct cash grants of up to $2.5 million each and, at the same time, the U.S. Social Security Administration will provide local caseworkers to speed procedures to permit homeless mentally ill people to qualify for federal disability benefits. The Robert Wood Johnson Foundation will also provide low-interest loans of up to $1 million to each winning agency to buy or renovate housing for the mentally ill.

Unveiled at Press Conference

The new program was unveiled at a Washington press conference. In interviews, however, members of the advisory committee that organized it agreed that local politics and turf warfare in the largest of the 60 big cities may make it almost impossible for municipalities with the most extensive need to qualify for the new funds.

The doubts were voiced for cities like Los Angeles, Chicago and New York, which will compete with other cities of 250,000 population or more for a maximum of eight grants. Because comparatively smaller metropolises operate on a smaller scale, program planners believe political difficulties there are more manageable and amenable to compromise and solution than those of larger locales.

Applications must be filed by mid-May of next year with the winners to be announced in November. Sources on the advisory committee, speaking on the condition they not be identified, said they feared that politics--typified by the conflicting ambitions of Mayor Tom Bradley and Gov. George Deukmejian--may doom hope that the nation's largest cities can participate.

In New York and Chicago, similar conflicts exist between state and city or county governmental entities.

At least one local organization, the Skid Row Development Corp., predicted, however, that political problems can be resolved in Los Angeles and that a local group will be able to start work on such a program here.

Some members of the advisory committee held out hope that one of New York's five boroughs could emerge as a winner. In California, Los Angeles and San Francisco are thought to be long-odds choices, with San Diego seen as a promising contender. Other eligible cities here include Long Beach, San Jose, Fresno, Sacramento and Oakland.

But even if the largest cities don't qualify for the demonstration grant money, said program director Dr. Miles F. Shore, "the hope is we will have eight imaginative new ways of organizing things that can be demonstrated in sufficiently large cities so people can take a look and adapt them (elsewhere)."

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