One recent afternoon, two outreach workers strolled along Venice's Ocean Front Walk in search of homeless people most in danger of dying on the streets.
Lured in part by their promise of a $5 McDonald's gift card, Rachel Rochella Lowe, 53, stood by a beach bathroom for several minutes answering questions from Eddie Banda, the stocky, tattooed outreach coordinator for St. Joseph Center.
Had she ever been diagnosed with liver disease, diabetes or cancer? (Yes.) Had she ever abused drugs or alcohol? (Yes.) How often in the last three months had she visited the emergency room? (Maybe 15 times.)
A man named Robert, sitting on a blanket under a palm tree across from diners at the Sidewalk Cafe & Bar, said he had been homeless for less than a year after living at Atascadero State Hospital, which treats criminally mentally ill people.
Throughout Venice, scores of people with similar stories sprawl in alleyways, on blankets under palm trees and near the canals in cardboard boxes. Many are addled by mental illness, drugs or alcohol. Some have life-threatening ailments.
And St. Joseph Center, a Venice-based social service agency that has served poor and homeless individuals for more than 30 years, wants to find them before it's too late.
That is why dozens of volunteers and social workers fanned out for three nights earlier this month to survey the community's street denizens. With a grant from Los Angeles County, the agency plans to crunch the data and identify the 40 most vulnerable individuals. The next step will be to use Section 8 vouchers provided by the Los Angeles Housing Authority to house them and provide supportive services to help them overcome addictions and other physical and mental issues.
The Venice Chronic Homeless Intervention Project is based on a model developed in 2005 by Common Ground, a New York agency that substantially reduced homelessness in Times Square. It follows the successful rollout of similar programs in downtown Los Angeles' skid row and Santa Monica that have housed and treated more than 100 men and women.
In many cities, the "housing first" approach is replacing the previous practice of contacting "as many people as possible to let them know you're there," said Julie DeRose, who directs homeless programs at St. Joseph Center. Experts on homelessness are realizing that it is far easier to resolve addictions and other issues when people accustomed to the harsh life on the streets have a stable place to sleep and shower.
"Project 50 in skid row is a pilot program that has proven to be very successful," said Los Angeles County Supervisor Zev Yaroslavsky, who has committed $724,000 from his district's funds over the next two years to pay for supportive services for the 40 participants in Venice.
Buoyed by the successes in downtown L.A. and Santa Monica, Yaroslavsky and others are aiming to house 500 long-term homeless people countywide. The program, he said, is expected to reap substantial savings for the county in costs for emergency medical care and incarceration. Once chronically homeless people have a roof over their heads, he said, visits to the emergency room and time in jail plummet.
The overnight surveys in Venice helped put St. Joseph Center personnel in touch with people who had eluded previous outreach efforts.
"I was struck by the depth of the problem and encouraged that we have a program that maybe can make a difference," said Va Lecia Adams, St. Joseph Center's executive director.
Between 3 and 6 a.m. on May 18, 19 and 20, teams of staff members from local nonprofit groups and government agencies, along with community volunteers, visited areas where long-term homeless people tend to sleep. In the most dangerous spots, Los Angeles police officers accompanied the teams.
Using a questionnaire developed by a Boston doctor with expertise in treating homeless people, the volunteers surveyed and photographed more than 200 men and women, asking how long people had been homeless and whether they had been diagnosed with physical or mental illnesses.
The data will ultimately produce a "vulnerability score" that St. Joseph Center will use to identify the 40 most in need -- those on the streets the longest, perhaps, or those with dire ailments, such as the man who must visit a dialysis center every day. Starting July 1 or so, participants will be housed somewhere in the city and provided with intensive services. The agency anticipates that 25 will be housed in the program's first year and 15 in the second.
Naomi Levi, Banda's assistant, said of the most vulnerable homeless people tend to be the most resistant to the kinds of services the center provides.
She and Banda were pleasantly surprised by how many people agreed to answer questions, both in the nighttime surveys and on a recent afternoon.
At the boardwalk's edge, a man in a dark hoodie perched cross-legged on a patch of grass. He told Levi that he had recently gotten out of federal prison after serving six years for bank robbery.
Whether he, Robert or Rachel Lowe will rank among Venice's 40 toughest cases remains to be seen.
But some time soon 40 of Venice's most fragile street people will begin moving into apartments and counseling with social workers.
"You can't put a price on taking them off the streets," Yaroslavsky said. "It's the first step toward helping them reclaim their lives."