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Cecil County Homeless Study 2004-2005

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Cecil County Homeless Study 2004-2005 Powered By Docstoc
					Cecil County Homeless Study
         2004-2005



A SURVEY AND ANALYSIS OF HOMELESSNESS IN
              CECIL COUNTY




              Prepared For:
Meeting Ground, Inc. - Cecil County, Maryland


                 Funded By:
            Citigroup Foundation



                Prepared By:
   Center for Family and Community Life
            Salisbury University

                 May 2005
                                   Table of Contents

List of Tables                                                       3
Preface                                                              5
Introduction                                                         6
Section I – Description of County/Factors Related to Homelessness    7
        A. Demographic Description                                   8
        B. County Population                                         8
        C. Household Population                                     10
        D. Selected Social Characteristics                           10
        E. Selected Economic Characteristics                        11
        F. Selected Housing Characteristics                          14
Section II – Current Services to Homeless                            22
        A. Hospital Services                                         23
        B. Public and Private Non-profit Agency Services             24
Section III - Study Findings                                        33
        A. Provider Survey                                           34
        B. Key Informant Survey                                      43
        C. Survey of the Currently Homeless                          53
Section IV –Summary, Discussion, and Recommendations                71
        A. Summary of Salient Points                                 72
        B. Discussion                                                77
        C. Recommendations                                           78
Section V – Appendices                                              84
        Appendix 1 – Resource Guide                                  85
        Appendix 2 – Cecil Provider Survey Comments                  98
        Appendix 3 – Key Informant Interview Questions              105
        Appendix 4 – Homeless Survey Questionnaire                  110
        Appendix 5 – Interviewer Assessment Form                    132
        Appendix 6 – Personality Assessment Screen Instrument       135
        Appendix 7 – Demographic Characteristics of Respondents     137
        Appendix 8 – Gender Differences in Respondents              139
        Appendix 9 – Patterns of Homelessness                       141
        Appendix 10 – Reasons for Homelessness                      143
        Appendix 11 – Resources and Needs of Respondents            145




                                                                          2
                                      List of Tables

Table 1    Population Growth Rate                                                  8
Table 2    Incorporated Town Population Estimates                                  9
Table 3    Population by Age                                                       9
Table 4    Educational Attainment                                                 11
Table 5    Median Household Income                                                11
Table 6    Median Family Income (Families with “Own” Children under 18)           12
Table 7    GINI Co-efficient 1979–1999                                            12
Table 8    Share of Aggregate Household Income by Household Income Class          13
Table 9    Mean Household Income                                                  13
Table 10   Per Capita Personal Income                                             13
Table 11   Cecil County and State Unemployment Rates                              14
Table 12   Section 8 Subsidized Housing                                           16
Table 13   HUD Fair Market Rents                                                  16
Table 14   Median Sale price of Owner Occupied Properties                         17
Table 15   Percent Residential Sales under $200,000/Median Sales Value            18
Table 16   Housing Affordability Indices                                          19
Table 17   Percentage of Households that Cannot Afford Rental Units               20
Table 18   Renter Households                                                      20
Table 19   Hourly Income Needed to Afford Fair Market Rent                        21
Table 20   Family Annual Income Needed to Afford Fair Market Rent                 21
Table 21   Number of Homeless People Sheltered                                    29
Table 22   Bednights provided                                                     30
Table 23   Turnaway Occasions                                                     30
Table 24   Demographic Characteristics of Homeless Persons Served                 30
Table 25   Comparison of Age Groups of Homeless Served                            31
Table 26   Household Composition of Homeless Served in Cecil County               31
Table 27   Comparison of Household Composition of Homeless Served                 31
Table 28   Comparison by Gender of Adult Homeless Served in Shelters              32
Table 29   Summary of Findings of Provider Survey                                 35
Table 30   Provider Estimate of Homeless Served                                   37
Table 31   Provider Survey – Number Served                                        37
Table 32   Provider Survey – Services Provided                                    38
Table 33   Provider Survey – Unmet Client Needs                                   39
Table 34   Collective Survey findings - Need (weighted)                           40
Table 35   Collective Survey findings - Contributors to Homelessness (weighted)   41
Table 36   Collective Survey findings - Prevention Strategies (weighted)          42
Table 37   Factors Contributing to Homelessness                                   45
Table 38   Unmet Needs and Suggested Solutions                                    46
Table 39   Resources Used by the Homeless in Addition to Shelter                  49
Table 40   Collective Survey findings - Contributors to Homelessness              51
Table 41   Collective Survey findings - Needs of the Homeless                     51
Table 42   Gender and Ethnicity of Respondents                                    55
Table 43   Age of Respondents                                                     55
Table 44   Marital Status of Respondents                                          56
Table 45   Number of Children of Respondents                                      56
Table 46   Child’s Reported Current Status                                        56
Table 47   Education of Respondents                                               57
Table 48   Community Where Interviewed                                            57
Table 49   Current Living Situation                                               58
Table 50   First Time Homeless                                                    58
Table 51   Places Slept in Last Thirty Days                                       58
Table 52   Place Slept Last Night                                                 59
Table 53   Sources of Meals in Last Thirty Days                                   59



                                                                                       3
Table 54       Reasons for Homelessness (weighted)            59
Table 55       First Reason for Homelessness by Gender        60
Table 56       First Reason for Homelessness by Race          60
Table 57       Last Saw a Medical Professional                60
Table 58       Drinking in the Past Month                     61
Table 59       Resource Use                                   63
Table 60       Self-Rating of General Well-Being              64
Table 61       Life Satisfaction                              64
Table 62       Question Accuracy                              64
Table 63       Interpretation of PAS Total Scores             67
Table 64       Interpretation of PAS Element Scores           68
Table 65       Respondents’ PAS-P Total Scores                68
Table 66       Respondents PAS Scores - Individual Elements   69

Cecil County Map – Location of Services                       36




                                                                   4
                                           Preface
In September of 2004, Meeting Ground, Inc. contracted with the Center for Family and
Community Life (CFCL) at Salisbury University to conduct a study of homelessness in Cecil
County. This inquiry was to address specific concerns arising out of Meeting Ground’s
experience as a provider of services to the homeless. Based on these concerns, this study
examines Cecil County demographics, social/economic factors that relate to homelessness in the
county, the service system currently available to the county’s homeless population,
characteristics of the homeless themselves, and finally, examines possible strategies that might
be employed to address the problems that homeless individuals and families continue to face.

To provide a comprehensive assessment of the depth and breadth of the homeless problem in
Cecil County, a multi-method plan was developed which included five different sources of data
including (1) a demographic description of the county and a review of existing data pertaining to
the homeless, (2) a current resource list of services available to the homeless in the county, (3) a
written survey of providers of social services in Cecil County including an estimated number of
homeless served, (4) interviews with 14 key informant community stakeholders and with
previously homeless county residents, (5) comprehensive interviews of 75 homeless men and
women, and concludes with a discussion of the findings and makes recommendations based upon
these findings..

The study was conducted between November 2004 and March 2005 by Center staff and local
data gathers from the Cecil County community. This report is organized by the methodological
elements just described.




                                                                                                  5
Introduction
A word about the definition of homeless—though there are many definitions of homelessness,
this report is consistent with both the McKinney Act and U.S. Department of Housing and Urban
Development’s (HUD) definitions. According to the Federal Government’s Stewart B.
McKinney Act, 42U.S.C.§ 11301, et seq. (1994), a person is considered homeless who “lacks a
fixed, regular, and adequate night-time residence” or who “has a primary night time address that
is: (A) a supervised publicly or privately operated shelter designed to provide temporary living
accommodations … (B) an institution that provides temporary residence for individuals intended
to be institutionalized, or (C) a public or private place not designed for, or ordinarily used as, a
regular sleeping accommodation for human beings.” HUD defines persons as homeless when
they reside in places not meant for human habitation, such as cars, parks, sidewalks, or
abandoned buildings, shelters, or supported/transitional housing.




                                                                                                   6
                Section I

Description of County and Factors Related
             to Homelessness




                                            7
A. Demographic Description
Cecil County is located in a region of the state referred to as the Upper Eastern Shore. It is an
essentially rural jurisdiction that encompasses 348 square miles with 247.0 persons per square
mile. This compares to a statewide average of 541.9 persons per square mile. (Maryland
Department of Planning, Planning Data Services, March 2001)

According to the 2000 Census, a little more than half (52%) or 45,045 of the 85,951 county
residents live in areas described as “rural.” A slightly smaller percentage (48% or 40,906) is
reported to live in “urban” areas. Of that urban population, 12,047 or 29% of the reported urban
population live in “urban clusters.” An urban cluster is defined as a population center of
between 2,500 and 50,000 NOT near an urbanized area. (U.S. Census Bureau, 2000 Census,
Summary File 2 [PCT2]) According to the Maryland Department of Planning (May 2002),
these figures represent a significant shift in Cecil’s urban/ rural population split. While the total
county population increased 20.5% between 1990 and 2000, the county urban population
increased by 198% while the rural population decreased by 21.8%. This compares with an
increase of 17.2% in Maryland’s urban population and a decrease of 17.4% in statewide rural
population.

In 2000, the county had 31,223 occupied housing units: 48% were located in rural areas and 52%
in urban areas as might be expected from the population distribution.

B. County Population
1. Population Growth and Distribution
Exceeding the percentage of growth found across Maryland as a whole (10.8%), Cecil County’s
population grew by 20.5% between 1990 and 2000 (calculated from U.S. Census Bureau-1990,
CPH-2-1, 1990 Census of Population and Housing: U.S. Census Bureau, Census 2000, P.L. 94-
171 Summary File). This percentage of growth ranked Cecil County fifth among Maryland’s 24
jurisdictions.

Recent data based on 2003 population estimates show that Cecil County continued to grow
between 2000 and 2003 at a rate slightly higher than the state. The table below illustrates these
rates of growth for the state and for the county.

                                                Table 1
                                       Population Growth Rate
 Jurisdiction   2000 census         2003 estimates (7/1/03)/ Percent change from 2000
 Cecil          85,951              92,746/ +7.9%
 Maryland       5,296,486           5,508,909/ +4.0%
        Source: Maryland Department of Planning from U.S. Bureau of the Census, Population
               Estimates Branch (April 2004)

Maryland’s Department of Planning projects that by 2010, the county’s population will grow to
101,190, a 17.7% increase over 2000 census figures (calculated from MDP, Planning Data
Services, July 2004). Again, the county rate is higher than the projected statewide growth rate of
10.6%.


                                                                                                    8
The following table illustrates the 2000 census population and 2003 estimates for Cecil County’s
incorporated areas.

                                             Table 2
           Cecil County Incorporated Town Population Estimates, Sorted within County
                           2000 Census and 2003 Population Estimate
Jurisdiction                  July 1, 2003 Population      Census 2000 Population
Cecil County                  92,746                       85,951
Total Municipal Population    24,815 (26.8%)               22,995 (26.8%)
Cecilton                      476                          474
Charlestown                   1,074                        1,019
Chesapeake City               783                          787
Elkton                        13,586                       11,893
North East                    2,753                        2,733
Perryville                    3,705                        3,672
Port Deposit                  672                          676
Rising Sun                    1,766                        1,741
Balance of Cecil County       67,931 (73.2%)               62,956 (73.2%)
Source: Maryland Department of Planning from U.S. Bureau of the Census, Population Estimates Branch
        (June 2004)

Although Cecil County has shown an overall population growth, the percentages of residents
living in incorporated and unincorporated areas within the county has remained essentially the
same between 2000 and 2003. The town of Elkton is perhaps the lone exception to this
observation, showing an increase in the past three years of 1,693 residents or just over 14%.

2. Population by Age
The median age in Cecil County is 35.5 years. This compares with the median age of 36.0
across Maryland. (U.S. Census Bureau, Census 2000, Summary File 1 [SF1])

                                               Table 3
                            Cecil County Population by Age (2000 Census)
          0-4             5-19          20-44          45-64          65+                      Total
         5,957           19,787         31,247         19,965        8,995                    85,951
        Source: MD Dept of Planning, “Demographic and Socioeconomic Outlook,” July 2004

According to the 2000 U. S. Census, 23,789 individuals or 27.78% of Cecil County’s population
are under 18 years of age compared to 25.6% statewide. (Population Reference Bureau, analysis
of data from the U.S. Census Bureau, 2000 Census, Summary File 1) On the other hand, 10.5%
of the county population is age 65 or over compared to Maryland’s rate of 11.3%. Overall, then,
Cecil County residents are currently a little younger than residents across the state.

3. Population by Race
According to the 2000 Census, 93.4% of Cecil County’s population is white (alone); 3.9% is
black (alone), 1.5% is of any other race (alone), and 1.2% is of two or more races. The 2003
population estimates indicate that these percentages have increased slightly (+1.1%) for the
white (alone) population group and decreased slightly (-0.2%) for the black (alone) group.
Hispanic or Latino residents total 1,306 or 1.5% of the county population; this compares to a
statewide Hispanic/ Latino population percentage of 4.3%. (U.S. Census Bureau, Census 2000


                                                                                                       9
[Table P7 and P4] calculated) Combined, the Maryland State Department of Planning indicates
that 7.5% of the county population is “minority,” defined as “anyone who is not ‘Non-Hispanic
white.’” (U.S. Census Bureau, Census 2000 [Table DP1]/ MDP, Planning Data Services)

Although the number of Hispanic or Latino residents appears small, the Census 2000 data on
“language spoken at home” appears to indicate that this is a growing population in Cecil County
(see following section “Language Spoken at Home”).


C. Household Population

1. Household Size and Type
According to the 2000 Census, there are 31,223 total households in Cecil County with an
average household size of 2.71, slightly higher than the state’s 2.61. Of these 31,223
households, family households make up 74.6% (23,290). Of the non-family households (7,933),
persons living alone make up 78.5% (6,225) with 35.9% of those living alone being age 65 or
over. (U.S. Census Bureau, Census 2000 [Table DP-1])


2. Family Households with Children
The 2000 Census indicates that 11,555 family households (49.6% of the 23,290 total family
households) report having in their households one or more of their “own”* children under age
18. Of these 11,555 family households, 8,483 (73.4%) are married couples, and 2,161 (18.7%)
are single female households. (U.S. Census Bureau, Census 2000 [Table DP-1])

*According to the Census definitions, “own” refers to a child under 18 years old who is a son or
daughter by birth, marriage (a stepchild), or adoption. (Population Reference Bureau, “A
Glossary of Census Terms,” July 2001)


D. Selected Social Characteristics

1. Educational Attainment
Cecil County shows slightly lower educational attainment than state figures. As can be seen in
the table below, data indicate that 18.8% of all county residents (age 25 and over) have less than
a high school diploma; this compares with a statewide figure of 16.2% and ranks Cecil with the
tenth highest percentage of non-high school graduates in the state (of 24 jurisdictions). Perhaps
the most striking difference can be seen on the other end of the educational spectrum. Compared
to a statewide figure of 31.4%, only 16.4% of county residents have attained a bachelor’s degree
or above giving Cecil a rank of 18 among the state’s 24 jurisdictions.




                                                                                               10
                                             Table 4
                              Cecil County Educational Attainment
   Population age 25       Percent less than HS HS diploma or above              Bachelor’s degree or
   years and over                diploma                                            above (rank)
   Cecil                          18.8%                 81.2%                        16.4% (18)
   Maryland                       16.2%                 83.8%                          31.4%
       Source: MD Dept of Planning from 2000 Census, SF1, Profiles DP2, DP3 and DP4 (May, 2002)



2. Language Spoken at Home
Of the county’s 80,035 residents, age 5 years and over, 1.1 % or 862 report speaking English less
than “very well.” This percentage ranks Cecil County 21 of 24 jurisdictions in this population
percentage category. Approximately 57% of those reporting language barriers in Cecil County
are Spanish speaking; 33% speak Indo-European languages. (U.S. Census Bureau, Census 2000
[Table DP-2] / MDP, Planning Data Services)

Looking more closely at the issue of language barriers, the numbers of people in Cecil County
who report speaking English less than “very well” have increased by 210 or 32% since the 1990
census; this compares to a statewide increase of 66% in this same category. (U.S. Census,
Census 2000, [Table DP-2])



E. Selected Economic Characteristics

1. Household Income
In 2000, according to the U.S. Census, Cecil County was ranked 13 of 24 jurisdictions in terms
of median household income—just below the state figure. That ranking remains the same for the
most recent 2003 estimates.

                                              Table 5
                                      Median Household Income

           Jurisdiction     1999                                     2003 Estimated
           Cecil            $50,510                                  $53,550
           Maryland         $52,868                                  $59,200
                   Source: Md. Dept. of Planning from 2000 census (June, 2004)




For families with “own” children under age 18 (according to the 2000 U.S. Census definition),
the following chart illustrates the median incomes by family type. As would be expected, it is
clear from these figures that single-parent families have significantly lower incomes than do
married-couple families; this is particularly true of single-mother families.




                                                                                                        11
                                             Table 6
                Median Family Income of Families with “Own” Children under Age 18
Family Type                                             Number of       Median Family
                                                        Families        Income
Families with own children under age 18                 11,886          $55,207
Married-couple families                                 8,916           $64,161
with own children under age 18
Single-mother families                                  2,168           $26,186
with own children under age 18
Single-father families                                  802             $38,017
with own children under age 18
               Source: Population Reference Bureau, analysis of data from U.S. Census Bureau,
                       2000 Census Summary File 3 (Tables P15, PCT39 & PCT40)



2. Household Income Distributions
The Maryland Department of Planning describes household income distributions through use of
the GINI Coefficient. GINI coefficients range from 0 to 1. The closer the GINI coefficient is to
0 the more equal the income distribution among jurisdictional households; the closer to 1.0, the
more unequal the income distribution. The GINI coefficient was named after its creator, Italian
statistician Corredo Gini.

The GINI Coefficient has been calculated in each of the past three decennial census years (1980,
1990, and 2000) with household income distributions of the previous year’s incomes (1979,
1989, 1999). The following chart shows Cecil’s GINI Coefficient and state rank (Rank 1 = most
unequal income distribution) since 1979.

                                              Table 7
                             Cecil County GINI Coefficient - 1979 - 1999
1979 GINI      Rank            1989 GINI       Rank             1999 GINI            Rank
0.3646         14              0.3717          15               0.3702               18
                            Source: MDP, Planning Data Services (August 2002)

Cecil County’s GINI Coefficient, based on 1999 income value, was .3702. This ranked Cecil
18th in the state. Between 1979 and 1999, Cecil County’s GINI coefficient increased from
0.3646 to 0.3702, dropping the county four places in rank (Rank “1” = lowest coefficient). In
other words, this county showed movement toward less equal income distribution during this
time. (MDP, “GINI Coefficients for Household Income Distributions for Maryland’s
Jurisdictions, 1979-1999,” August 2002)

In another measure of household income distribution, the Maryland Department of Planning
calculates “Share of Aggregate Household Income by Household Income Class.” This data is
shown in the following table.




                                                                                                12
                                            Table 8
                              Households for 2000, Income for 1999
                Share of Aggregate Household Income by Household Income Class
                   Bottom 20% of All      Middle 60% of All        Top 20% of All
Jurisdiction       Households             Households               Households
Cecil County       4.9%                   53.2%                    41.8%
Maryland           3.9%                   48.9%                    47.2%
    Source: MD Dept of Planning from 1980, 1990, and 2000 Census household income distributions

These data seem to indicate that the percentage share of aggregate household income is slightly
less skewed toward the top 20% of all households in Cecil County than is found across the state.
Cecil County’s figures have remained fairly steady between 1980 and 2000 showing a 0.1% gain
in aggregate income among the bottom 20%; a -1.1% decline among the middle 60%; and a
0.8% gain among the top 20%. Again, this is in contrast to statewide figure which showed a -
0.3% drop among the bottom 20%; a -3.4% drop among the middle 60%; and a 3.7% gain among
the top 20%.

3. Mean and Per Capita Income
Cecil County evidenced a mean income in 1999 below the state average. According to 2003
estimates, Cecil fell even further behind the state mean income in the ensuing four years.
According to the 2003 estimate, Maryland households have experienced an $11,000 mean
household income increase since 1999, a gain of 16.3% while Cecil County households have
seen a $4,600 increase, a gain of 7.9%. Likewise, Cecil County falls below the state per capita
personal income figure. Both Mean Household Income and Per Capita Personal Income
comparisons between the county and state are detailed below.

                                              Table 9
                                       Mean Household Income
Jurisdiction                        1999                                 2003 Est.
Cecil                               $57,950                              $62,550
Maryland                            $67,450                              $78,450
                             Source: MDP from US Census Bureau (June 2004)

                                              Table 10
                                        Per Capita Personal Income
Jurisdiction                        2000                           2002 (current dollars)
Cecil                               $28,244                        $ 29,078
Maryland                            $34,257                        $ 36,303
                        Source: MDP from US Bureau of Economic Analysis (May 2004)



Based on the U.S. Bureau of Economic Analysis 2002 per capita personal income data, the
Maryland State Department of Planning assigned a ranking to each county in both current and
constant 2000 dollars. Cecil County is ranked 16th among Maryland’s 24 jurisdictions in both.




                                                                                                  13
4. Unemployment
As reported by Maryland’s Department of Labor, Licensing, and Regulation for 2004, Cecil
County (5.8%) exceeded the state unemployment rate of 4.0% for that year. In looking back
over the past five years, Cecil County has consistently had a higher unemployment figure than
the state figure. Data for 2004, however, showed an encouraging drop in county unemployment.
The table below illustrates this data

                                            Table 11
                     Cecil County and State Unemployment Rates - 2000-2004
Jurisdiction      2000           2001          2002         2003           2004
Cecil County      5.5            5.6           6.0          7.2            5.8
Maryland          3.8            4.0           4.4          4.5            4.0
   Source: Maryland DLLR, Civilian Labor Force, Employment and Unemployment—1978-2004:
           Updated January 27, 2005



5. Individuals, Families and Children Living Below Poverty
Because of non-compliance in income-reporting by some individuals, the 2000 Census was able
to determine the poverty status of only 84,648 of the county’s total population of 85,951. Of
these 84,648 Cecil County residents completing the income portion of the Census, 6,066 or 7.2%
live below poverty. This compares with a statewide individual poverty percentage of 8.5%.
When ranked across the state, these individual poverty percentages place Cecil County 14th
(Rank: 1=highest poverty) among the 24 jurisdictions. (MDP from 2000 census, December
2002) This Census 2000 figure shows an overall drop of -0.3% (percentage point change) from
Census 1990 figures. (MDP from 1990 Census (STF3) and 2000 (STF3) Census)

Of the county’s 23,350 families, 1,253 or 5.4% live in poverty (1999 figures). This compares to
a statewide figure of 6.1%. (US Census Bureau, Census 2000 [Table DP3])

Adding the presence of related children under age 18 in a family increases the likelihood that a
family is living in poverty. Across the state, 8.7% of all families with related children under the
age of 18 live in poverty; in Cecil County that figure is 7.9%. (US Census Bureau, Census 2000,
[Table DP3])



F. Selected Housing Characteristics

A larger percentage of Cecil County residents own their own homes than is found across the
state. According to the 2000 Census, of the county’s 31,223 occupied housing units, 75%
(23,404) are owner-occupied while 25% (7,819) are renter occupied; this compares to state
figures of 67.7% owner-occupied and 32.3% renter-occupied. The average county household
size was 2.78 for owner-occupied and 2.52 for renter-occupied units. (U.S. Census Bureau,
Census 2000 [Table DP1]) Of all housing units in the county (both vacant and occupied), the
2000 Census indicated that 90.6% were occupied while 9.4% were vacant at the time of the
Census. Of the vacant units, 1.7% were for rent; 1% were for sale; 0.5% were rented or sold but
not occupied; 4.1% were seasonal, recreational, or occasional use, and 2.1% were categorized as


                                                                                                 14
“other.” (U.S. Census Bureau, Census 2000 Summary File 1, [Table
H1/H3/H4/H5/H10/H11/H12])

1. Renter-Occupied Units
According to the Maryland Department of Planning using 2000 Census data, the median monthly
rent in Cecil County was $617 per month; this ranked Cecil 13th among Maryland’s 24
jurisdictions. The statewide median monthly rent was $689. (MDP from 1990 census [STF3]
and 2000 [SF3] Census)

In tracking how these figures may have changed over time, two views can be presented. Using
data from the 1990 census (employing constant 2000 dollar value across time), the MDP analysis
indicates that monthly rent was shown to have increased an average of $9 per month, ranking
Cecil as14th of Maryland’s jurisdictions in rate of increase. Across the state, however, the
constant dollar value for monthly rent decreased by $11. (MDP from 1990 census [STF3] and
2000 [SF3] Census) On the other hand, simply comparing 1990 and 2000 rental figures in Cecil
County, net decreases were found in the number of units available at rents under $500 (-953
units), and net increases were found in the number of units available at rents over $500 (+2,634
units) with the greatest increase in units available at rents between $750 and $999. (U.S. Census
Bureau, Census 2000 [Table DP-4])

2. Subsidized Housing
Below are two tables illustrating Section 8 subsidized housing availability and the Department of
Housing and Urban Development (HUD) Fair Market Rents in Cecil County. (DHR, “2003 DHR
Fact Pack, Cecil County Snapshot”—most recently available publication)

Section 8 provides rental assistance nationwide to low income families, elderly, disabled, and
handicapped individuals. This program provides financial assistance to eligible families whose
annual gross income does not exceed 50% of HUD's median income guidelines.

Through rental assistance, families are able to live in safe, decent, and sanitary housing they
would not otherwise be able to afford. Section 8 housing is designed specifically for needy
families in small cities and rural communities not served by similar local or regional programs.
People eligible for Section 8 vouchers must rent an apartment at or below the Fair Market Rent
(see [*] below for definition) for the area where they want to live. Vouchers cover a portion of
the rent, and tenants pay the rest—up to 40%, but usually closer to 30% of their gross income.
HUD regional offices may, however, authorize vouchers for rents up to 120% of an area's FMR,
if the need exists.

All federally subsidized housing developments and, if necessary, an additional number of
properties in any given community are to set aside section 8 housing units for eligible tenants. In
Cecil County, three multiple-unit properties set aside a total of 51 units that accept assisted
housing vouchers.




                                                                                                 15
                                                Table 12
                        Section 8 Subsidized Housing in Cecil County
          Assisted Housing and Section 8 Properties
          Multiple-unit General Rental Properties                2
          Multiple-unit Elderly/ Disabled Properties             1
          Total of Section 8 Units                               51
       Note: A portion of the Section 8 properties serving elderly and disabled households listed above is
       considered Section 202 (elderly households) and Section 811 (households with persons living with
       disabilities). These households do not comprise all Section 202 and Section 811 households in this
       jurisdiction.



*Fair market rents (FMR) are gross rent estimates which include shelter rent and utilities costs,
except telephone. In general, the FMR for an area is the amount needed to pay the gross rent
(shelter rent plus utilities) of privately owned, decent, safe, and sanitary rental housing of a
modest (non-luxury) nature with suitable amenities.

The Department of Housing and Urban Development sets FMRs to assure that a sufficient supply
of rental housing is available to those qualifying for housing assistance. To accomplish this
objective, FMRs must be both high enough to permit a selection of units and neighborhoods and
low enough to serve as many families as possible. The level at which FMRs are set is expressed
as a percentile point within the rent distribution of standard quality rental housing units. The
current definition used is the 40th percentile rent, the dollar amount below which 40% of standard
quality rental housing units rent. The 40th percentile rent is drawn from the distribution of rents
of units which are occupied by recent movers (renter households who moved into their unit
within the past 15 months).

                                               Table 13
                                 HUD Fair Market Rents in Cecil County
          Efficiency                             $502
          One Bedroom                            $661
          Two Bedrooms                           $771
          Three Bedrooms                         $1,048
          Four Bedrooms                          $1,266
               Source: US Department of Housing and Urban Development, 2004



3. Owner-Occupied Units
The median monthly owner cost of owner-occupied units in Cecil County was $1,122, again
ranking Cecil 13th among Maryland’s 24 jurisdictions. The statewide median monthly owner
costs were $1,296. (MDP from 2000 Census, [SF1] [Profiles DP2, DP3, and DP4])

In tracking how these figures may have changed over time, two views can be presented. Using
data from the 1990 census (employing constant 2000 dollar value across time), the MDP analysis
indicates that monthly owner costs have increased $123 per month, ranking Cecil 10th in the
state. This increased dollar amount is exactly the same figure as was found statewide. (MDP
from 1990 census [STF3] and 2000 [SF3] Census) On the other hand, simply comparing 1990
and 2000 mortgage status and selected monthly owner costs in Cecil County, net decreases were
seen in the number of units managed at costs under $700 (-2,442 units) and net increases in the


                                                                                                             16
number of units managed at costs over $700 (+7,207 units) with the greatest increase seen in
units managed at costs in the $1,000 to $1,499 range. (US Census Bureau, Census 2000 [Table
DP-4])

The median value of owner-occupied units, according to the 2000 Census, puts Cecil County’s
median value at $132,300; this ranks Cecil County 13th among Maryland’s 24 jurisdictions. The
statewide median value was $146,000 with a range of $69,100 in Baltimore City to $221,800 in
Montgomery County. (MDP from 2000 Census, [SF1] [Profiles DP2, DP3, and DP4]) Looking
back historically, however, it appears as if Cecil County owner-occupied values increased at a
higher rate than many jurisdictions across the state and exceeded the state average increase.
Between 1990 and 2000, the median value of owner-occupied units increased by $8,369 (using
constant 2000 dollar value); this ranked Cecil 8th in the state for amount of increase, while the
state average actually decreased by $2,845. (MDP from 1990 census [STF3] and 2000 [SF3]
Census)

Since 2000, the median sale price of owner-occupied units in Cecil County has continued to
climb. From Fiscal 2000 through Fiscal 2004 (most recent data available), the median sale price
of owner occupied property in the county has increased from $129,000 to $187,500, a 45.3%
increase. In the first quarter of Fiscal Year 2005, which ended in September 2004, Cecil’s
median price jumped to $211,000. Concurrently, in statewide data the median sale price of
owner occupied property has increased from $150,000 to $221,103, a 47.4% increase. In the
first quarter of Fiscal Year 2005, the statewide median sale price increased to $256,000. Cecil’s
two closest neighboring counties, Harford and Kent, show a lower rate of increase than Cecil
County during this same time period. (Maryland State Department of Assessments and
Taxation, Annual reports: 2003, 2004 and SDAT: Residential Sales, 2004, 2005) The table
below illustrates these median sale prices for Cecil County, the state of Maryland, and Harford
and Kent counties, as well.

                                               Table 14
                           Median Sale price of Owner Occupied Properties
                               Fiscal Years 2000-2004 (in thousands)
Jurisdiction       2000      2001       2002      2003      2004     Percent Increase
                                                                     2000-2004
Maryland           $150      $152       $163      $183      $215     47.4%
Cecil County       $129      $134       $143      $165      $188     45.3%
Harford            $143      $148       $160      $171      $195     36.4%
Kent               $125      $124       $126      $139      $168     34.4%
Source: Maryland State Department of Assessments and Taxation, Annual reports: 2003, 2004 and SDAT:
        Residential Sales, 2004, 2005

In both 2002 and 2003 (most recent data available), well over half of all residential housing units
in Cecil County sold for less than $200,000. In 2002, the percentage of residential housing units
with a sales price of less than $200,000 was 73.6% compared with 58% across the state.
However, in 2003, the percentage of residential housing units with a sales price of less than
$200,000 dropped to 61.5% compared with 49.5% across the state. (Maryland Department of
Planning, Planning Data Services from 2002 and 2003 Maryland Property View Sales Data, July
2004) The table below illustrates the percentage of various types of residential units sold in




                                                                                                      17
Cecil County for under $200,000 along with each type’s median sales figure in both 2002 and
2003.

                                             Table 15
                 Percent of Total 2002 and 2003 Residential Sales under $200,000
                         and Median Sales Value by Type - Cecil County
     Year                            2002                          2003
                                     Percent        Median         Percent                 Median
                                     < $200         Sales Value    < $200                  Sales Value
     Single Family                   72.7%          $157           59.0%                   $183
     Townhouse                       96.2%          $104           89.9%                   $120
     Condo                           65.4%          $185           52.4%                   $197
     Mobile Home                     100.0%         $65            100.0%                  $77
     Total                           73.6%          $151           61.5%                   $177
   Source: Maryland Department of Planning, Planning Data Services from 2002 and 2003 Maryland Property
           View Sales Data, July 2004)



4. Affordability
The target percentage of household income (used by the Maryland Department of Planning in
their analyses) to be affordably spent on housing, both rental and owner-occupied, is 35%.
Again, according to MDP using 2000 Census data, it was reported that 23.3% of Cecil County
renters spent more than 35% on renter costs; this ranked Cecil 18th in the state (1=highest
percentage over 35%). The statewide percentage was higher at 27%. Similarly, 14.9% of
homeowners had monthly costs exceeding 35%; this ranked Cecil 14th in the state. The
statewide percentage was higher at 16.1%. (MDP from 2000 Census, [SF1] [Profiles DP2, DP3,
and DP4])

The Maryland Department of Housing and Community Development publishes “Blueprint
Maryland,” a monthly publication that presents information on the state’s housing economy.
“Blueprint Maryland” presents a “Housing Affordability Index” for each county and for the state
as a whole, the most recent Housing Affordability Index (at time of writing) for August, 2004.
In August, the Affordability Index for repeat buyers in Cecil County was 159, signifying the
ability of a typical repeat buyer to afford a house that is 59% more expensive than a median
priced home. The August Affordability Index for first time buyers stood at 108, indicating that
the typical first-time buyer in Cecil County could afford a home priced 8% above the median
priced home available to first time buyers. Compared to state figures for this same month, both
repeat and first time home buyers in Cecil County showed greater capacity to purchase a home at
or above median price than home buyers across the state. These indices significantly vary from
month to month; however, the greater capability of county home buyers, especially among first
time home buyers, appears to be consistent over the ten most recent months of data. The
following chart presents this affordability index for both county and state home buyers from
November 2003 through August 2004.




                                                                                                          18
                                            Table 16
                           Housing Affordability Indices - 2003 – 2004
Month             Cecil County                         Maryland
                  Repeat Buyers    First Time          Repeat Buyers           First Time
                                   Buyers                                      Buyers
8/04              159              108                 111                     75
7/04              139              95                  108                     74
6/04              137              93                  106                     72
5/04              147              100                 113                     77
4/04              155              106                 125                     85
3/04              145              98                  138                     94
2/04              157              107                 140                     95
1/04              149              102                 134                     91
12/03             152              103                 127                     86
11/03             149              101                 135                     92
         Source: Maryland Department of Housing and Community Development, “Blueprint Maryland”
                   (January – December 2004)

Data from the Department of Housing and Community Development indicate that rental units for
low income households in Cecil County, however, may be in short supply. According to
“Blueprint Maryland” (April/ May 2004) , “[d]ata from the Census Population and Housing
indicate that there are only 87 affordable rental units for every 100 extremely low income renters
(statewide). These renters are represented by households whose income falls below 30 percent
of the area median income (AMI). The supply of affordable and available units, on the other
hand, excludes units nominally affordable to specific income groups but occupied by higher-
income households. The supply of affordable and available units per 100 renter households in
the 30% of the AMI groups is 47 units. Applying the supply data to the number of Maryland
households in the 30% of the AMI threshold yields a total rental housing shortage of 76,047
units for extremely low-income households.” (2) In Cecil County, there are 1,566 “extremely
low-income renters” but only 845 units “affordable and available.” This leads to a county
shortage of 720 units.

Another indicator of rental housing affordability has to do with the “housing wage” defined as
the wage a family must earn to afford the average two-bedroom apartment. According to
“Blueprint Maryland,” “[t]he NLIHC (National Low Income Housing Coalition) defines
affordable housing as a household paying no more than 30% of its income for rent. This is an
industry wide standard, as studies show that once a family pays more than 30% of its income for
rent, there is a substantial increase in the likelihood of the family becoming homeless…On
average, 21% of all Maryland households could not afford even an efficiency unit in the county
in which they live without paying more than 30% of their income in rent….It is not just a
problem affecting the poorest of the poor; it also impacts working families with secure jobs and
multiple incomes.” (Maryland Department of Housing and Community Development, “Blueprint
Maryland” January, 2004, pg. 8) According to this Housing and Community Development
analysis of the NHLIC 2003 annual report, Cecil County ranked 16th of Maryland’s 24
jurisdictions in the percentage of households that cannot afford two-bedroom rental units (1=
higher percentage). The following table illustrates the percentages of families who cannot afford
rental units of various sizes in Cecil County, across Maryland and in two neighboring counties,
Harford and Kent.


                                                                                                  19
                                              Table 17
                      Percentage of Households that Cannot Afford Rental Units
                                 in Cecil County and Maryland 2003
                        Zero              One              Two               Three            Four Bedroom
                        Bedroom           Bedroom          Bedroom           Bedroom
    Maryland            21%               26%              37%               47%              56%
    Cecil               15%               20%              26%               38%              49%
    Harford             11%               16%              26%               37%              42%
    Kent                10%               16%              24%               31%              44%
   Source: Maryland Department of Housing and Community Development, “Blueprint Maryland” (January 2004)



While the percentages for Cecil County illustrated above are lower than state averages, they are
consistently at or above those found in its two closest neighboring counties.

In its October 2003 publication of “Maryland: Rental Housing Affordability Index” (most recent
available), the Maryland Department of Housing and Community Development offers further
analysis of the data presented in the NLICH 2003 annual report. The following tables are from
this DHC report and offer comparative data between Cecil County, neighboring counties Kent
and Harford, as well as statewide data.


                                               Table 18
                                       Renter Households - 2003
Jurisdiction                      Renter Households            As Percent of Total
                                                               Households
Maryland                          639,108                      32%
Cecil                             7,819                        25%
Harford                           17,519                       22%
Kent                              2,271                        30%
Source: “Maryland: Rental Housing Affordability Index,” Maryland Department of Housing and Community
        Development (October 2003)



The following tables show the “housing wage and hours per week at minimum wage that would
allow a worker to rent a zero-to-four bedroom apartment at the fair market rent.” To calculate
the housing wage—the wage at which a worker could afford a two-bedroom apartment—the
NLIHC divides the monthly fair market rent by 0.3 to get the monthly affordable wage and then
by four to get the weekly wage and again by 40 to get the hourly housing wage.




                                                                                                           20
                                                 Table 19
                             Hourly Income Needed to Afford Fair Market Rent
                                                  2003
                                      Housing Wage
        Jurisdiction                  Zero        One         Two          Three                    Four
                                      Bedroom     Bedroom     Bedroom      Bedroom                  Bedroom
        Maryland                      $13.36      $15.74      $18,85       $25.31                   $29.72
        Cecil                         $9.65       $12.71      $14.83       $20.15                   $24.35
        Harford                       $11.46      $13.98      $17.08       $22.62                   $25.87
        Kent                          $6.88       $8.48       $11.33       $14.13                   $17.04
                                      Hour per week necessary at Minimum Wage
                                      Zero        One         Two          Three                    Four
                                      Bedroom     Bedroom     Bedroom      Bedroom                  Bedroom
        Maryland                      104         122         146          197                      231
        Cecil                         75          99          115          157                      189
        Harford                       89          109         133          176                      201
        Kent                          53          66          88           110                      132
          Source: “Maryland: Rental Housing Affordability Index,” Maryland Department of Housing and
                  Community Development (October 2003)



The following table shows the same information from a different perspective: annual income. In
Cecil County, an annual income of $30,840 is needed to afford a two-bedroom apartment. This
is 44% of the Cecil’s MSA (Metropolitan Statistical Area) median income.


                                               Table 20
                         Family Annual Income Needed to Afford Fair Market Rent - 2003

                   Number of Bedrooms

                   Family Income                                               Percent of Area Median Income
Jurisdiction        Zero        One        Two        Three       Four      Zero     One      Two      Three    Four
Maryland           $27,789    $32,733    $39,217     $52,645    $61,819      38%      45%     54%        73%     85%
Cecil              $20,080    $26,440    $30,840     $41,920    $50,640      29%      38%     44%        60%     72%
Harford            $23,840    $29,080    $35,520     $47,040    $53,800      35%      43%     53%        70%     80%
Kent               $14,320    $17,640    $23,560     $29,400    $35,440      27%      33%     44%        55%     66%
Source: “Maryland: Rental Housing Affordability Index,” Maryland Department of Housing and Community
        Development (October 2003)



According to the 2000 Census, 4,402 of the 23,350 families in Cecil County report incomes less
than $30,000. This shows that 18.8% of families (as opposed to the percentage of households
depicted in the table on page 16) cannot afford a two-bedroom apartment using 30% or less of
the family income on housing.

Note: For additional information on housing affordability, readers are referred to the National Low Income Housing
Coalition annual study reports: “Rental Housing for America’s Poor Families: Out of Reach” at www.nlihc.org/oor
or the full Maryland Department of Housing and Community Development report at
http://www.dhcd.state.md.us/Website/publications/Publications.aspx



                                                                                                               21
           Section II
Current Services to the Homeless




                                   22
A wide range of services is available to the homeless in Cecil County. These services include
acute care hospitals, shelters, community kitchens, supportive resources such as a food pantry,
and social/addiction/mental health services. (It should be noted that these services are also
available to the needy non-homeless.)

In an attempt to coordinate homeless services in Cecil County, many local providers have
informally organized and meet monthly at the Community Provider Meeting in Elkton. Both
public and private organizations are represented at the monthly meetings. In addition to the
organizations that regularly send staff members to attend the meeting, other local faith based
outreach entities were identified by Meeting Ground Inc. as providers of services to the
homeless. Representatives from both the Community Provider Group and the faith based groups
were interviewed and are included in this discussion.


A. Hospital Services
Two hospitals provide comprehensive health services in Cecil County: Union Hospital in Elkton,
Maryland and Perry Point VA Medical Center in Perry Point, Maryland.

1. Union Hospital
Union Hospital has a 15-bed adult inpatient Psychiatric Unit where Patient treatment and care
focus on psychiatric crisis intervention and stabilization. A psychiatric social worker at the
hospital described members of the homeless population entering the hospital as emergency room
walk-ins, as 911 emergency patients, or as subjects of Emergency Petitions. Many homeless
individuals arrive in the emergency room under the influence of drugs or alcohol. The hospital
staff of trained psychiatric caregivers provides intensive assessment and intervention to diagnose
the illness or condition and determines if hospitalization is necessary. All persons stating they are
suicidal or homicidal are admitted to the hospital in an attempt to stabilize the condition and/or to
allow detoxification, if necessary. Following diagnosis, staff members provide the treatment and
support needed to help patients through their time of crisis, so they can safely transition back to
the community. The length of stay varies depending on whether or not patients have Medicare
Insurance which allows patients to stay in the hospital as long as they are meeting the criteria of
hospitalization defined by Medicare. Uninsured patients, on the average, stay a couple of days to
a week. No one is ever discharged from Union hospital without a place to go. Patients needing
more intensive psychiatric services are transferred to a long term psychiatric facility while others
are referred to emergency shelters. Initially, shelter is sought locally, but if nothing is available,
the search extends to Baltimore, Maryland or to Wilmington, Delaware. Upon discharge,
transportation is arranged for patients to travel to available shelters of their choice.

2. Perry Point VA Medical Center
The Perry Point VA Medical Center provides primary care, comprehensive mental health care,
and specialty outpatient services to Maryland’s veterans. Veterans enter the VA system of care
by calling or dropping by the VA hospital. The first step in providing services is to determine the
eligibility of the veteran. Generally, veterans with honorable discharges are eligible for services.
Non-eligible veterans are typically those with dishonorable discharges or without enough time
spent in military service. Veterans who meet the eligibility criteria are evaluated for medical and


                                                                                                   23
psychological needs. Perry Point VA Medical Center has several programs available to address
the needs of homeless veterans, among them the Domiciliary Care Program and the Substance
Abuse Rehabilitation Treatment Program (SARTP), both of which provide inpatient services,
while the Homeless Coordination Program is community based.

The Domiciliary Care Program helps to rehabilitate homeless veterans through counseling, job
assistance, and home placement. The 50-bed unit provides housing and structure for four months
to give veterans time to develop work routines and to save money toward housing expenses.
Participants in the program, either working or receiving disability income, are required to save
75% of their income for housing.

The Substance Abuse Rehabilitation Treatment Program (SARTP) is a four-month inpatient
program which focuses on drug and alcohol addictions. The goal for veterans who successfully
complete this program is to be discharged to a halfway house, a safe house, or other independent
living arrangement.

The Homeless Coordination Program is a community based service. HCP outreach workers refer
veterans to a shelter, usually in the Baltimore area and then monitor how each individual
accesses the continuum of care. Veterans are linked to services and programs that meet their
individual needs. One Homeless Outreach Clinical Social Worker employed at Perry Point VA
Medical Center observed that services to homeless veterans are currently moving toward long
term care. For example, many homeless veterans entering the service delivery system at Perry
Point are referred to the Maryland Center for Veterans Education and Training (MCVET). The
U.S. Department of Housing and Urban Development declared MCVET the National Model for
seamless services to homeless veterans in 1997. MCVET is a long-term residential facility
designed to treat severe addictions complicated by homelessness, medical problems, and
psychiatric problems. Because of the complexity and severity of these problems, most residents
require one to two years of treatment to establish a foundation firm enough to sustain their
recovery once they leave the program. Stays can last up to five years if necessary. Participating
in comprehensive services at facilities like MCVET enables some previously homeless veterans
to rejoin their communities as productive citizens.

B. Public and Private Non-profit Agency Services

Non-medical services are available to the homeless population in Cecil County through public
agencies and private not for profit organizations. Three public agencies with offices located in
Elkton, Maryland provide or link individuals to various services: the Cecil County Housing
Office, the Mental Health Core Service Agency, and the Cecil County Department of Social
Services. The Cecil County Housing Office administers Section 8 HUD housing assistance to
low-income renters. The Section 8 HUD program is overburdened, so it is difficult for applicants
to get the subsidy; in fact, many people wait for years. The Mental Health Core Service
Agency’s Shelter-Plus-Care program uses available community-based housing, through approval
of Section 8 referrals, to house the chronically mentally ill. This program also provides motel
days for interim placements of the homeless mentally ill. Additionally, a number of private non-
profit agencies in Cecil County offer combinations of services providing not only food and
shelter, but structured strategies for re-engaging with the community.


                                                                                               24
1. Public Agencies
Perhaps the public agency attracting the largest number of homeless families and adults is the
Cecil County Department of Social Services (CCDSS). When families or individuals enter
CCDSS they are greeted by a receptionist who signs them in and directs them to Intake Services.
Those requesting services are seen on a first come first serve basis. Social workers in the Intake
Services department are trained to assess and evaluate the problems presented. These workers
then assess individual and family situations to determine the scope, nature, urgency, and
complexity of their circumstance and seek information for the purpose of assisting applicants in
resolving their problems through:

   !   identifying problems through the interview process
   !   providing crisis intervention/counseling and support services
   !   exploring available resources and limitations in family, friend, community, inter and
       intra-agency environments
   !   assisting families and individuals identify resources which best and most appropriately
       meet their particular needs
   !   reviewing CCDSS agency requirements and limitations to access different resources.
   !   linking families and individuals with selected resources

When working with homeless individuals or families, the first priority is to resolve emergency
food and housing needs. Customers are referred to the Cecil County Help Center and local faith-
based outreach centers for emergency food purposes. Social workers address emergency housing
needs by checking local shelters for openings or by providing a motel placement for one night.
There are always funds available to provide motel placements for families with children;
however, single adults and adult couples are placed in motels only during freezing weather
conditions defined in conjunction with the energy assistance program as the period between
November 1 and March 31. Before customers are eligible for Emergency Shelter Placement
Funds, they must furnish proof of Maryland residency, be without shelter, and lack resources to
provide shelter. The following CCDSS guidelines are followed before awarding a customer a
motel placement:

   !   available to families only
   !   must have a feasible plan in place for remedying their homelessness in a reasonable
       timeframe (generally within one week)
   !   no motel placement for single adults or adult couples - homeless men and women should
       be referred to local shelters
   !   exceptions for freezing weather—November 1 through March 31—to include single
       adults or adult couples without regard to weather conditions
   !   explore and utilize family/friend resources
   !   explore and utilize available shelter space
   !   motel placement only until next business day when customers are to go to Services Intake
       for assessments, at which time they may be assigned a continuing social worker to assist
       in resolving the issue of homelessness
   !   assistance is limited to one time in a 12-month period (maximum $250)




                                                                                                 25
Customers seeking permanent housing or facing homelessness due to rent eviction are subject to
the following guidelines:

   !   limit of one month’s rent (maximum $250) on the condition that payment will prevent
       eviction (court ordered eviction notice required) - families with children must first utilize
       Emergency Assistance to Families with Children (EAFC)
   !   payment of first month’s rent (maximum $250) to enable persons to acquire permanent
       housing
   !   must be able to demonstrate the ability to independently maintain their housing in
       subsequent months
   !   assistance limited to one time in a 12-month period

After emergency food and housing needs are addressed, families and individuals can return to
the front office for assistance with applying for benefits such as food stamps and medical
assistance.

The Cecil County Domestic Violence Shelter and Rape Crisis Center located in Elkton, is a
CCDSS special program which offers services to victims of domestic violence and rape. This
agency offers emergency shelter, food, counseling for battered women and their children, and
motel assistance for men who find themselves homeless as a result of domestic violence.

2. Private Non-profit Agencies
Other emergency and transitional shelters located in Cecil County are run by private non-profit
organizations. Wayfarers’ House, Clairvaux Farm, and George Porter House came into existence
through Meeting Ground, a faith-based organization formed to combat the problem of
homelessness in Cecil County and surrounding areas. Wayfarers’ House, located in Elkton, has
a 16-bed capacity for single women and women with children. Clairvaux Farm, with a 35-bed
capacity, is approximately 15 miles south of Elkton near Cecilton, and provides community
living for individuals and families. George Porter House, with an eight-bed capacity, is also
located in Elkton, and provides transitional group housing for adults, both women and men. This
shelter provides more permanent housing to better stabilize the lives of its residents by allowing
them to acquire resources and skills necessary to become self sufficient.

Residents staying at Wayfarers’ House, Clairvaux Farm, and George Porter House assume
responsibility for chores and participate in decision-making in an attempt to affirm their
importance as individuals as well as to participate as members of a community. New residents at
Wayfarers House and Clairvaux Farm are given 30 days during which to adjust to life and secure
income (employment or public assistance). After 30 days, individuals or families are asked to
make a maximum rent-donation of $100 a month depending on ability to pay and, as much as
possible, to assume a fair share of the cost of purchasing food. Each month, residents sign a
contract outlining their personal goals and the steps they want to take to meet their goals. They
are also encouraged to begin saving money. Meeting Ground has a Residents' Fund and
families/residents may deposit a portion of their monthly income into this escrow account. When
residents are ready to move, they receive all of their deposits plus 10% (annual) interest.

Some residents may need to stay at Meeting Ground for a year or longer. These long-term



                                                                                                  26
residents assume greater responsibility for chores: mowing, doing maintenance, assisting with
menu-planning, grocery shopping, etc. The length of time individuals or families may stay at
Meeting Ground is determined by their individual needs as well as by their willingness to respect
the rules, contribute to the community, and make honest sincere efforts to realize their personal
goals.

The Settlement House (Cecil County Men's Shelter) was founded in the late 1980s to address the
large number of otherwise unserved homeless men in Cecil County. Meeting Ground helped
gather a task force to explore setting up a separate men's shelter. This task force worked for two
years and began as a formal corporation with its own board of directors in 1988. Settlement
House, with a 15-bed capacity, shelters only men. This shelter also acts as a day shelter offering
showers, clothing, blankets, coats, and meals at lunch time, both to residents of Settlement House
and to other homeless persons in the community. Homeless men and women both may access
the day shelter. Residents prepare the noon meal and do household chores, and while residents
do not receive case management services, they must adhere to the shelter rules which include
curfews and bed times.

Several regions within Cecil County have faith-based outreach services which offer regularly
scheduled soup kitchens, clothing, food pantries, motel placements, and referrals to shelters and
social services. In 1999, the Meeting Ground community helped gather a partnership to organize
a weekly community kitchen for Cecil County at the Presbyterian Church in Elkton resulting in.
the Elkton Community Kitchen Program. Every Friday, from noon to 1 p.m., a church or other
group provides lunch for anyone in the community who would like food and fellowship. A
similar program called Hope Place is open to the community on Saturdays between 11 a.m. and
noon at the Perryville United Methodist Church in Perryville, Maryland. The Chesapeake City
Ecumenical Association Outreach provides a monthly soup kitchen service on the last Saturday
of each month. A youth ministry provides the meal, and coats are distributed on site during the
soup kitchen service for any who need them.. Other services provided by the Chesapeake City
Ecumenical Association Outreach are a food pantry and care-package distribution of pillows,
blankets, and daily care supplies housed at Trinity United Methodist Church. Ray of Hope
Mission also conducts a weekly soup kitchen every Friday in Port Deposit

Ray of Hope Mission Center in Port Deposit, Maryland operates with the mission of helping
families and individuals become self-sufficient. The Mission Center makes referrals to connect
individuals and families to CCDSS and other helping agencies. Ray of Hope Mission Center
offers individuals and families access to a Christian library, food pantry, and thrift shop which
sells gently worn clothing, furniture, nursery needs, household items, personal hygiene items,
and over-the-counter medical supplies. Vouchers for clothing, personal items, and medical
supplies are issued free of charge to those who do not have the financial means to purchase these
items. The Outreach Service offers counseling, education, and information for the following:

   !   emergency financial assistance
   !   transient motel lodging
   !   domestic violence
   !   job placement
   !   GED classes



                                                                                               27
   !    free medical care
   !    home financial budgeting
   !    wellness classes
   !    after school tutoring
   !    pastoral counseling

The Immaculate Conception Church Outreach in Elkton, St. Mary Ann’s Episcopal Church
Outreach in North East, and Church of the Good Shepard/ St. Vincent de Paul Society in
Perryville assist individuals and families in need through food pantries and financial assistance to
help with motel placements, utility payments, rent eviction prevention, and prescription
payments.

Five churches support the Beacon of Light Ministries in Elkton. Many of the people helped are
transient—on their way from Point A to Point B—and are stranded for some reason. Beacon of
Light Ministries tries to get them into local shelters or to provide a motel placement. This
organization will arrange transport to the Sunday Breakfast Mission shelter in Wilmington,
Delaware and may also buy bus tickets to get individuals and families to their destination or city
of origin. In addition to financial assistance, food, clothing, and furniture are also available.

Two other services located in Elkton are the Cecil County Drug Awareness Program and the
Oxford House. The Cecil County Drug Awareness Program is run by volunteers with a focus on
drug awareness and prevention through education. The volunteers in this program use an 18-foot
trailer (half concessions and half literature educational materials) to distribute information as
well as food and clothing. The trailer is set up in areas known to have high drug traffic (Ex:
intersection of Booth and Collins in Elkton). Through this program a rapport has been built with
several members of the homeless community living in Cecil County. Many of these individuals
live in camps located behind the Acme Grocery Store and the Good Will store. Volunteers
supply these individuals with food, clothing, sleeping bags, and tents.

Oxford house is a self-run self-supported recovery house. The Oxford House experience
provides a cost-effective way to help individuals recovering from alcohol or drug addiction avoid
relapse by offering a comfortable life without substance abuse. Oxford House operates under
three conditions:

    !   the recovery house must be operated on a democratic basis
    !   the recovery house must be financially self-supported
    !   individuals who use alcohol and drugs must be expelled

A copy of the Help Handbook Resource Guide, listing all community resources available to
residents of Cecil County (with an emphasis on services to the homeless) is located in Appendix
1 on page 82.




                                                                                                 28
3. DHR Directory of Services for the Homeless in Cecil County
According to the Maryland Department of Human Resources Office of Transitional Services
“2005 Directory of Emergency Shelters and Transitional Housing Programs” (updated 12/23/04),
there are currently seven (7) providers serving the homeless with DHR funds in Cecil County.
These seven providers have an 87 shelter bed capacity: 29 emergency shelter beds, eight (8)
transitional shelter beds, and 50 “undesignated” beds. Of these, 22 are designated for battered
women and children only. All services listed in the “Emergency Shelters” Directory include*:

       !   Emergency Shelter
       !   Transitional shelter
       !   Day shelter and meals
       !   Motel placements
       !   Emergency shelter placements or referrals
       !   Referrals to shelters
       !   Counseling
       !   Assistance with applying for benefits
       !   Heating and electric bill assistance
       !   Meals
       !   Food pantry
       !   Clothing
       !   Financial Assistance
       !   Mental health services

(It should be noted that these resources are consistent with the survey conducted as part of this
study

4. Shelter Usage
Because of the difficulties of counting the entire homeless population, Maryland’s Office of
Transitional Services (OTS) gathers information only on those people who have stayed in an
emergency shelter, transitional housing program, or who have been given a motel placement.
Since data gathered by OTS omits those homeless persons who have not participated in the
shelter system, homeless statistics reported by OTS are not meant to be an absolute count, but to
render an approximation of the number of homeless people in Maryland. The numbers reported
might include duplicated counts of people who stayed in more than one shelter.

                                         Table 21
             Number of Homeless People Sheltered in Cecil County - FY 2001 - 2003
 Fiscal Year   Emergency Shelter        Transitional Shelter    Motel Placements               Total
 FY01          411                      177                     299                            887
 FY02          463                      316                     271                            1050
 FY03          232                      266                     305                            803
      Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

According to the DHR Annual Report on Homelessness Services in Maryland, FY2003, “[a]
“bednight” is the most accurate and unduplicated unit of measure to study the use of homeless
shelters. Each night a shelter bed is filled by a person is considered one bednight. If one bed is
used for an entire week, the total number of bednights for the week is seven…Because the
bednight count in unduplicated, it is a more accurate measure of the provision of shelter service


                                                                                                       29
than the number of people served, which may include duplication between shelters.” (7) Despite
this endorsement, the data from Cecil County, as illustrated in the table below, appear to reflect
significant “swings” in bednights reported, calling their accuracy into question.

                                              Table 22
                          Bednights provided in Cecil County - FY2001-2003
Fiscal   Emergency         Transitional    Motel            Total                  Change from
Year     Shelter           Shelter         Placements       Bednights              Previous FY
2001     12872             11630           2007             26509                  -601
                                                                                   Change from
                                                                                   FY01
2002     7688              18970              1188              27846              1337
                                                                                   Change from
                                                                                   FY02
2003     4565              19558              1457              25580              -2266
 Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

According to these same reports, a significant number of people in Cecil County were “turned
away” from shelter or motel placements in Fiscal Years 2001 through 2003. Each time an
individual is refused shelter or a motel placement because of a program’s lack of space or funds,
it is defined as a “turnaway.” This figure may be the best representation on the unmet need for
homeless shelter beds available. However, several providers do not collect turn-away occasion
data while, on the other hand, the degree to which duplication exists in the reporting of turn-
away occasions, as a person or family looks to several shelters before finding a bed, is unknown.
Reported “turnaway” occasions are illustrated in the chart below.

                                            Table 23
                        Turnaway Occasions in Cecil County - FY 2001- 2003
Fiscal Year                    Turnaway Occasions            Change from previous
                                                             Fiscal year
FY01                           390                           -135
FY02                           398                           +8
FY03                           1035                          +637
Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

Demographic characteristics, e.g., age, household composition, gender and ethnicity, are
collected from shelters. Again, these demographic numbers may not total the actual number
served because some providers do not keep demographic data on all of their residents. The
following tables report age and household composition as recorded on those homeless people
who have been sheltered in Cecil County during the two most recent years for which data is
available.
                                          Table 24
Demographic Characteristics of Homeless Persons Served in Cecil County FY 2001 - 2003
                      Age of Homeless Persons Served in Cecil County
Fiscal Year        0-17                18-30                31-60                 61+
    FY01           264                  211                  392                   20
    FY02           269                  145                  448                   12
    FY03           227                  147                  409                   20
Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003




                                                                                                 30
Of the total number of homeless served in Cecil’s shelters during FY 01, 30% percent were 17
years old or younger. In FY02 and FY03, those percentages were 31% and 28% respectively.
The following table illustrates a comparison of county and state data in terms of the percentage
of homeless persons served by age group.

                                          Table 25
     Comparison of Percentage of Age Groups of Homeless Served: Cecil County v Statewide
Jurisdiction               0-17             18-30             31-60                61+
Cecil 2001                29.8%             23.8%             44.1%               2.3%
Maryland 2001             30.9%             20.4%             46.4%               2.3%
Cecil 2002                30.7%             16.6%             51.3%               1.4%
Maryland 2002             22.2%             19.3%             55.5%               2.3%
Cecil 2003                28.3%             18.3%             50.9%               2.5%
Maryland 2003             21.0%             17.7%             58.8%               2.5%
Source: Salisbury University Center for Family and Community Life (2005) calculated from Maryland DHR: Annual Report on
Homelessness Services in Maryland, FY 2001, 2002, 2003


These data appear to indicate that Cecil County serves a somewhat younger population of
homeless than is served across the state. This may be skewed, however, by the number of beds
designated for women and children only.

                                             Table 26
                      Household Composition of Homeless Served in Cecil County
  Fiscal Year             Individuals            Family Members            Percent Families
     FY01                     351                      536                      60%
     FY02                     469                      448                      49%
     FY03                     355                      408                      53%
Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

As with age groups, it is interesting to consider the percentages of families served (as compared
to individuals) in Cecil County. The following table illustrates a comparison of county and state
data in terms of the percentage of homeless persons served by family status.

                                          Table 27
           Comparison of Percentage of Household Composition of Homeless Served:
                                  Cecil County v Statewide
        Jurisdiction                      Individuals                  Family Members
Cecil 2001                                   40%                             60%
Maryland 2001                                65%                             35%
Cecil 2002                                   51%                             49%
Maryland 2002                                68%                             32%
Cecil 2003                                   47%                             53%
Maryland 2003                                69%                             31%
Source: Salisbury University Center for Family and Community Life (2005) calculated from Maryland DHR: Annual
Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

As was the case with age groups, these data appear to indicate that Cecil County serves a higher
percentage of homeless families than are served across the state. The same caution about the
data must be repeated, however. This may be skewed by the number of beds designated for
women and children only.



                                                                                                                     31
The following table compares the percentage of homeless people served in Cecil County shelters
during 2001-2003 to the state average by gender.

                                          Table 28
           Comparison of Percentage by Gender of Adult Homeless Served in Shelters
                                  Cecil County v Statewide
         Jurisdiction                         Men                           Women
Cecil 2001                                    31%                             69%
Maryland 2001                                 59%                             41%
Cecil 2002                                    36%                             64%
Maryland 2002                                 64%                             36%
Cecil 2003                                    53%                             47%
Maryland 2003                                 71%                             29%
Source: Maryland DHR: Annual Report on Homelessness Services in Maryland, FY 2001, 2002, 2003

As is illustrated above, during 2001-2003 Cecil County served a significantly higher percentage
of adult females and fewer adult males each year than the state average. Cecil County’s shelters
served almost twice the number of adult women than men during FY 2001 and 2002. On the
other hand, during 2003, six percent (6%) more adult males were served in shelters. It bears
repeating that these data may be skewed by the number of beds designated for women or for
women and children only.




                                                                                                32
  Section III

Study Findings




                 33
A. Provider Survey
Provider Survey Summary
The survey of providers of services to the homeless in Cecil County was modeled after the Point
in Time (PIT) Survey conducted by the Cecil County Core Service Agency and used as part of
the Continuum of Care application documentation for Housing and Urban Development funds to
serve the homeless. The biggest difference between these two surveys was the length of time
respondents were asked to record their service numbers. In the Point in Time survey, providers
of service are asked how many homeless individuals are served in a given 24 hours period; in
this survey, however, service numbers were recorded over the course of one week beginning
January 24 and continuing through January 30, 2005. It was hoped that this longer time frame
would allow for a more detailed picture of the homeless in the county. The final sections of the
survey gave providers an opportunity to offer their observations and suggestions about the causes
of homelessness and the adequacy and quality of services currently available to the homeless in
the county.

Thirteen (13) of the 14 surveys mailed to providers of services to the homeless in Cecil County
responded to this survey. This represents a 93% return rate, well above the expected rate of
return for a mailed survey. Of those responding, nine (9) were private, non-profit organizations.
Of the four (4) public agency responses received, three (3) were programs administered by the
Cecil County Department of Social Services: the Domestic Violence Shelter of Cecil County;
Services Intake; and Family Investment Administration (FIA).

The following tables present aggregate responses to the survey questions. Additional individual
comments can be found in Appendix 2 of this report as indicated throughout this text. Survey
questions are presented below in italics.


                                       Survey Questions
   1. What provider type are you representing in completing this survey? (Check only one)
          0 a. Private For Profit
          9 b. Private Not For Profit
          4_ c. Public Agency


   2. What type(s) of services are offered by your organization/ agency?
      a) Please check “yes” or “no” by each service type. If “yes,” please answer the
         questions in the columns to the right.




                                                                                               34
                                           Table 29
 Summary of Findings of Provider Survey – Services Provided and Locations Served
Service Type              YES   NO      Whom Do You Serve?          Geographic Area
                                        Place a check under each    Enter the letter of the
                                        type of client you serve    geographic area(s)
                                                                    from the list on the
                                                                    following page
                                        Male      Female Children
Emergency Shelter         7             7         6         6       5I; 1(B,D,E,F,G,H,J)
                                        (1
                                        places
                                        men in
                                        motels)
Transitional Housing      4             2         2         2       2I;1(B,D,E,F,G,H,J)
Permanent Housing         2             2         2         2       2I
Housing Placement         2             2         2         2       1I; 1(B,E,F,G,H,J)
Food Pantry               7             7         7         6       4I; 2E; 2J;
                                                                    1(A,B,C,D,F,G,H)
Meals                     7             6         7         6       3I;2(C,D,E,F,G,H,J);
                                                                    1(A,B)
Clothing                  6             5         5         5       4I; 1(B,D,E,F,G,H,J)
Provide Personal Items    7             7         6         5       4I; 2(D,J);
(ex., sleeping bags,                                                1(A,B,C,E,F,G,H)
blankets, etc.)
Case Management           6             5         5         4       4I; 1(B,D,E,F,G,H,J)
Child Care                1             1         1                 I
Job Training              1             1         1                 1(B,E,F,G,H,J)
Mental Health             1             1         1         1       I
Treatment
Substance Abuse
Treatment
Life Skills Training      4             4         3                 3I; 1D
Other:
Food Stamps               1             1         1         1       I
Medical Assistance        1             1         1         1       I
Temporary Cash            1             1         1         1       I
Assistance (TCA)
Emergency Cash for        2             2         2         1       1(A,C,D,J,I)
electric, heat, eviction,
temp. shelter, meds
Doctor visit              1             1         1         1       1(B,E,F,G,H,J)
Medications               1             1         1         1       1(B,E,F,G,H,J)



Of the seven providers of emergency shelter in Cecil County, four report providing funds for
families and individuals to seek shelter in area motels while others maintain shelter facilities, and
one provider does both. Of those four that report maintaining shelter facilities, one reports
providing shelter to men, women and children; one reports providing shelter to men only, and
two report providing shelter to women and children only. Likewise, of the four who report
providing transitional housing, three maintain transitional housing facilities. Of those, one
reports providing this housing to men, women, and children, one to men only, and one to women
and children only.



                                                                                                  35
The map below shows quite clearly the locations of both public and private non-profit agencies
offering the services discussed above.




                                                                                             36
        b) In far right column of table above, enter the letter indicating what area(s) of the
        county in which you provide services:
            A. Cecilton
            B. Charleston
            C. Chesapeake City
            D. Elkton
            E. Northeast
            F. Perryville
            G. Port Deposit
            H. Rising Sun
            I. All of the above
            J. Other(s): 1(Conowingo, Colora, Calvert, Pilottown); 1(Galena, Earlville)

        c) Over the course of a year, approximately what percentage of those who receive your
        services (all services combined) do you believe are homeless? Check one of the boxes
        below.

                                            Table 30
                              Provider Estimate of Homeless Served
0-25%                   26%- 50%               51%-75%                   76%- 100%
9                       -                      -                         4

Nine (9) of the 13 providers serve both the homeless and other community members (many of
whom were described as “near homeless”). Examples of these services would include soup
kitchens, places to obtain clothing or other personal items and the like. Four of the 13, however,
provide services primarily to persons who are homeless.

Questions 3 through 5 have to do with information which the respondents gathered during the
designated survey week ONLY.


In response to the following questions, respondents were to count those persons served who were
homeless (that these counts were of homeless individuals only was verified by follow-up
telephone contact with a member of the Salisbury University Center staff)


    3. During the week of January 24 through January 30, 2005, please indicate in the table
       below, the number of homeless individuals and families you served during this time
       period. Please count each individual served ONLY ONE TIME even if they came to
       receive services more than once during the course of this week.

                                               Table 31
                                Provider Survey – Number Served
                                Number served          Individuals in Families
                                                       Total Adults         Total Children
Single Individuals              105
Family Groups                   29                     49                   49



                                                                                                 37
This count does NOT represent an unduplicated count of the homeless who were provided services
during this week. Individual or families could have been counted twice as they received services
from different providers during the survey week; however, the tally does provide unduplicated
counts from each individual provider. In two instances, the number of adults and children in
family groups were reported without providing a count of the family units themselves (for
example, in one survey one adult and one child was reported but no family units). In those
instances, the number of family units was attributed based on other comments or indicators found
elsewhere in the survey. Comments: See Appendix 2, page 95.


     4. During the week of January 24 through January 30, 2005, please indicate in the table
        below how many homeless individuals (either single individuals or individuals who are
        part of a family group) received services BY TYPE. For example, if 50 individuals
        received a meal, indicate that by entering the number “50” in the second column. This
        question is to ascertain the number of people receiving each type of service, not the
        number of services provided. (For example, you would still enter 50 even if one or more
        persons had more than one meal during the week). Of course, some individuals may
        receive more than one type of service.

                                               Table 32
                                   Provider Survey – Services Provided
 Service Type                                    Number of Individuals to whom each service
                                                 was provided during the week
 Emergency Shelter                               29 + 2(motel vouchers)
 Transitional Housing                            63
 Permanent Housing
 Housing Placement                                13
 Food Pantry                                      45
 Meals                                            103
 Clothing                                         75
 Personal Items ( ex., sleeping bags, blankets,   29
 etc.)
 Case Management                                  52
 Child Care                                       5
 Job Training
 Mental Health Treatment                          12
 Substance Abuse Treatment
 Life Skills Training                             21
 Other(s)
 Food Stamps                                      4 (2 applications pending)
 Medical Assistance                               5 (1 application pending)
 Temporary Cash Assistance                        (7 applications pending)
 Day Program/ shower, phone, mail, etc.)          20

Again, this tally does NOT represent an unduplicated count of the homeless who were provided
services during this week. As mentioned above, individuals or families could have been counted
twice as they received services from different providers during the survey week; however, the
count gives unduplicated counts from each individual provider. What this table does provide,
however, is a broad description of the highest number of services provided to the homeless during



                                                                                               38
the survey week. Meals, clothing, and transitional housing were the most frequently provided
services. Comments: See Appendix 2, page 95.


     5. Of the clients who came to your site during the week of January 24 through January 30,
        2005, in the table below please list the types of homeless client needs (of which you were
        aware) that you were NOT able to meet at your service site. Indicate if you were
        successfully able to refer the homeless clients to other local organizations/ agencies for
        these services.

                                                Table 33
                             Provider Survey – Unmet Client Needs
 Unmet Need                                       Referral
                                                  YES                          NO
                                                  (Successfully linked
                                                  to service)
 Emergency Shelter*                               1                            2 (defined by one as
                                                                               1-5 night stay)
 Temporary Shelter*                                                            1
 Homeless Shelter *                                                            7
 Permanent Housing                                                             3
 Employment                                          1(Job Bank)               2
 Medical                                             1
 Transportation                                                                2 (1 to apply for job)
 Medical Transport out of area                                                 1
 Picture ID (to enter DSS building)                                            1
 * These three terms may have been used interchangeably by respondents re: respondent comments. Terminology
 used by respondents was used in tabulating counts in above table.



 From respondent comments, it appears that the terms temporary, emergency and homeless
 shelter may have been used interchangeably. In other words, these three terms, offered by
 respondents, may have been referring to the same or similar needs. If grouped together, the need
 for shelter to the homeless, no matter the description—emergency, temporary or homeless—
 appears to have been the greatest unmet need during the survey week.

 The remaining survey questions gave respondents the opportunity to offer their perspectives on
 the most pressing needs of the homeless in Cecil County as well as their perception of the most
 evident contributors to homelessness locally. Each time a need of the homeless or cause of
 homelessness was asked to be identified, so also was a corresponding solution or prevention
 strategy asked to be described. Respondent answers were weighted in order to give a ranking to
 the collective responses. This was done by giving 3 points to a #1 response, two points to a #2
 response, and one point to a #3 response. The number of mentions as a first, second, or third
 need/cause and the point totals for each need/cause type are reported below in tables.


     6. In your opinion, OVERALL what are the three most critical unmet needs among homeless
        individuals and families in Cecil County? Why (i.e., no resources, inadequate existing


                                                                                                          39
       resources, other explanations, etc)? For each critical unmet need you identify, what do
       you think would be the most effective way to address these unmet needs?

                                               Table 34
                            Collective Survey findings on Need (weighted)
Need                                   Mentions      Mentions      Mentions   Total points
                                       as #1         as #2         as #3
Affordable/ low cost housing           7             2             1          26
Shelter space                          3             1                        11
Emergency shelter                      2             1             1          9
Public transportation (especially for                2             3          7
employment)
Transitional housing                   1             1             1          6
Education (job re-education)           1                                      3
Employment with benefits                             1             1          3
Blighted housing areas                               1                        2
Government regulations are too                       1                        2
complex
Better cooperation between local                     1                        2
agencies
Medical follow up after                              1                        2
hospitalization
Mental health/ substance abuse                                     2          2
counseling
Day Care                                                           1          1
Limited social service and safety net                              1          1

Ten (10) of the 13 respondents mentioned affordable housing as one of the top three needs of the
homeless in Cecil County. Affordable housing also got the most mentions (7) as the top need.
Solutions offered by those who mentioned affordable housing as one of the top three needs
included:

   !   More affordable/subsidized housing opportunities
   !   Work on NIMBY; require developers to do set-asides for low and moderate income
       renters
   !   Build more low income housing
   !   Incentives to build/provide lower cost housing for single adults
   !   Development of a center where persons could receive a multitude of services by able
       trainers and an out-source group to follow up thereafter
   !   Build affordable (transitional?) rental housing; build more single room occupancies or
       rooming houses to share expenses. ALL must be affordable!!!
   !   Pray…tough to blame landlords who need to cover costs
   !   Develop transitional housing programs with intensive case management
   !   Intervention from government for federal housing and section 8

Again, shelter, space, and emergency shelter are terms that may have been used interchangeably
by respondents. Combined, the need for shelter space is clearly the second most often mentioned
current need:

   !   More government support


                                                                                                40
   !   More shelters (2)
   !   Add more beds/open more shelters
   !   Limit length of time one can stay at shelter
   !   Work to identify and support providers who can do the difficult job of offering shelter to
       those who are unable/unwilling to be clean and sober
   !   Family shelter

For the text of all comments and offered solutions to these problems, see Appendix 2, page 95 .

The following question asked respondents for their perceptions of the most evident contributors
of homelessness in Cecil County in the same manner as current needs of the homeless were
solicited in the previous question. Responses are weighted in the same manner and presented in
the table below.

   7. In your opinion, what are the three most significant contributors to homelessness in Cecil
      County today? Why?

                                              Table 35
               Collective Survey findings on Contributors to Homelessness (weighted)
Contributor                            Mentions     Mentions      Mentions     Total points
                                       as #1        as #2         as #3
Lack of affordable housing             3            4             3            20
Employment (living wage, low skill,    2            2             3            13
non-seasonal)
Substance abuse                        1            3                          9
Lack of education, job skill training  2            1             1            9
Transportation ( to maintain jobs)                  3             2            8
Mental illness                         1            1             1            6
Medical disabilities                   1             1                         5
Poor judgment leading to unstable      1                                       3
families
Housing while in Mental Health or      1                                       3
Substance Abuse treatment
Way of life                                         1             1            3
School drop out                                     1                          2
Need for more emergency shelters                                  1            1
Improved Veterans’ services                                       1            1

Again, lack of affordable housing received the most mentions and registered the highest point
total as a prime contributor to homelessness. Too few employment opportunities that can
provide a living wage for low-skilled, non-seasonal workers was the second most frequently
mentioned contributor. Substance abuse was recognized as the third most significant
contributing factor. Other issues specifically impacting employability such as adequate public
transportation and the need for job skill enhancement were also thought to be significant
contributors.

For the text of all comments, see Appendix 2, page 95.




                                                                                                 41
Finally, Question #8 asked respondents for suggestions on approaches that might be helpful in
preventing homelessness. Responses are weighted in the same manner as the previous two
questions and presented in the table below.

   8. What can be done to prevent individuals and families from falling into homelessness?
      Please list three suggestions.

                                             Table 36
    Collective Survey findings on Prevention Strategies for Homelessness (weighted)
Prevention Strategy                   Mentions      Mentions      Mentions     Total points
                                      as #1         as #2         as #3
Affordable housing                    4             1             1            15
Transportation (specifically to       1             1             1             6
support employment)
Increased eviction prevention funds   1             1                           5
Jobs with benefits                    1                           1             4
Job skills training and placement                   1             2             4
services
Coordination among providers re:      1                                         3
discharge planning
Family planning                       1                                         3
Increase temporary disability funds                 1                           2
Expedite SSI                                        1                           2
Increase medical care and                           1                           2
medication availability
More addictions rehab programs                      1                           2
Increased availability of mental                    1                           2
health TX (especially for those
without insurance)
Increase child care during off hours                1                           2
Increase penalties for violation of                               1             1
protective orders
Life skills education for children in                             1             1
welfare system

For the third time, affordable housing received the most mentions and highest point total. In
other words, increasing affordable housing was thought to be the best prevention strategy for
homelessness by survey respondents. Increasing the availability of public transportation
specifically as it relates to being able to maintain employment received the second highest
number of mentions as well as point total. Two respondents thought that increased eviction
funds would be an effective prevention strategy. Finally, by both increasing the availability of
employment opportunities as well as increasing job skill development and placement support,
five respondents thought that homelessness could better be prevented.

   9.    Please feel free to make any additional comment about any topic you think impacts the
        causes and “cures” for homelessness in Cecil County today?

For the text of all comments, see Appendix 2, page 95.




                                                                                                   42
B. Key Informant Survey
From mid-January through mid-March, 2005, fourteen (14) individual interviews were
conducted with key informants identified by the Meeting Ground organization. Ten (10)
individuals were interviewed as key informant community stakeholders with an interest in the
issue of homelessness in Cecil County. However, for reporting purposes, the responses of Mr.
Ricciuti and Ms. Diem of the Cecil County Department of Social Services are presented as a
single response since they were interviewed together as representatives of the agency and agreed
on all points. Thus, the nine (9) key informants were:

   Nelson Bolender, County Commissioner, Cecil County
   Terry Peddicord, Editor, Cecil Whig
   Nicholas Ricciuti, Director, and Margaret Diem, Human Service Coordinator, Cecil County
       Department of Social Services (interviewed together)
   David Mahaney, Director of Housing, Cecil County Housing Office
   Chuck Talley, President, Beacon of Light Ministries, Inc.
   Jim Sloan, Intake Worker, Cecil County Department of Social Services
   Carolyn King, Psychiatric Social Worker, LCSW-C, Union Hospital
   Carla Reeves, President, Cecil County Drug Awareness Program
   Reverent Tom Layman, President and CEO, Sunday Breakfast Mission

Each key informant interview was conducted by trained Center staff and lasted approximately
thirty (30) minutes. Each of the ten stakeholders was asked the same six (6) questions:

   1. From your perspective, how large a problem is homelessness in Cecil County?
   2. How would you rank the problem of homelessness compared with other problems facing
      the county?
   3. What factors do you think contribute to homelessness in Cecil County?
   4. In your opinion, OVERALL what are the three most critical unmet needs among
      homeless individuals and families in Cecil County? Why (i.e. no resources, inadequate
      existing resources, other explanations, etc.)?
   5. For each critical unmet need you identified, what do you think would be the most
      effective way to address them?
   6. Is there something you can think of that would prevent future homelessness in the
      county?

In addition, during the same time period, four (4) persons previously homeless – one (1) male
and three (3) females, all between 45 and 55 years of age - were individually interviewed as key
informants. The first 12 questions employed in these interviews were unique to these previously
homeless key informants. However, the final six (6) questions were the same used with other
stakeholders interviewed as key informants thus allowing comparison across groups. Because
the questions between the two groups differ, the results of each will be reported separately.
Summary comments will compare the two groups where appropriate. The initial 12 questions
asked only of the previously homeless were as follows:

    1. What has been your experience with homelessness?


                                                                                              43
       2.  How many times have you been homeless?
       3.  Where were you at that time (state, county or town)
       4.  For each time, how long were you homeless?
       5.  What were the primary reasons that you were homelessness each of those times?
         Were you employed? What type of work were you doing?
       6. Where did you live during those periods? (Shelter, street, friends, relatives, etc.)
       7. Did or didn’t you use a shelter?
       8. What other resources did you use in the community?
       9. How did you overcome your situation of homelessness? (Job, transitional housing, etc.)
       10. How secure do you feel your current living situation is now?
       11. Do you need any assistance now?
       12. What resources do you need to feel more secure in your current situation?


1. Community Stakeholder Key Informant Survey
Each community stakeholder Key Informant was asked six (6) questions with an opportunity for
open comment at the end of the interview. The data are presented below based on the answers to
those questions. The full text of stakeholder interview responses can be found in Appendix 4,
page 102.


1. From your perspective, how large a problem is homelessness in Cecil County?

Eight of the interviewees responded to this question. Their assessment of the extent of the
problem of homelessness in Cecil County ranged from “Not a problem—it really is a mental
health problem,” to “Major problem.” Three (3) of the interviewees felt that the problem was
either a non-existent, small, or modest problem while five (5) characterized homelessness as a
major or significant problem. One was unsure. Some major points from their comments are
listed below.

   !        There is real problem in the lack of affordable housing. There are three existing shelters
            (Wayfarers, Settlement House, Clairvaux Farm). They turned away 1000 people last year.
            They are full every night and there is a waiting list. As soon as someone leaves the spot is
            immediately filled.
   !        It’s a problem that people generally don’t see. I now recognize men on bicycles or in the
            park that I know are homeless because they have called for help. Prior to that I would not
            have thought about these men as being homeless.
   !        The facts and information are not there—we don’t have accurate numbers to compare the
            problem, yet I know we do have homeless in the county.
   !        Some (of the homeless) are from Delaware. There is a core group that are homeless for
            months at a time for various reasons. Some homeless get housing then lose housing and
            are homeless again.

2. How would you rank the problem of homelessness compared with other problems facing
   the county?




                                                                                                     44
The three (3) respondents who did not perceive homelessness as a large problem (see Question
#1 above), not surprisingly ranked the problem of homelessness very low in comparison to other
county problems. One felt as if there is not currently enough information on the extent of
homelessness to compare it to other county problems. Some major points from their comments
are listed below.

   !   Seeing a younger group of homeless people
   !   It is a subset of other problems like mental health or substance abuse
   !   Relatively low – in bottom third of concerns. It is less of an issue than it was 5-6 years
       ago.

The remaining survey questions gave respondents the opportunity to offer their perspectives on
the most evident contributors to homelessness locally as well as greatest unmet needs of the
homeless in Cecil County; possible solutions to these needs were also solicited. The numbers of
mentions made of each category as a contributor to homelessness or unmet need of the homeless
are reported below in tables.

3. What factors do you think contribute to homelessness in Cecil County?

The most frequently mentioned contributor to homelessness was substance abuse (including both
drug and alcohol abuse). The second most frequently mentioned contributor was mental illness.
The table below depicts the categories of response and the number of time that contributor was
mentioned by all interviewees combined.

                                                  Table 37
                          Factors Contributing to Homelessness
Contributing Factors                               Number of mentions
Substance Abuse                                    9
Mental Illness                                     7
Work ethic (don’t want to work at available        3
jobs)
Cecil County’s location on I-95/ by-way from       3
New Jersey
Minimal expectations re: jobs, relationships, life 3
in general
Lack of job opportunities                          2
Low self-esteem                                    1
Poor decision making (financial)                   1
Lack of transportation                             1
Lack of child care (for the one-time homeless)     1
High housing costs                                 1

While expressed in various manners, some of the contributing factors identified by the
interviewees might fall into a cluster of concerns around “life skills”—work ethic, life
expectations, self-esteem, and decision-making ability. Combined, these contributors were
mentioned a total of eight (8) times.

The following questions asked respondents for their perceptions of the most evident needs of the
homeless in Cecil County as well as suggested solutions to meet these unmet needs. The


                                                                                                    45
responses to these two questions are presented together so that the reader can see the suggested
solutions as they were matched to the identified unmet needs.

4. In your opinion, OVERALL what are the three most critical unmet needs among
   homeless individuals and families in Cecil County? Why (i.e. no resources, inadequate
   existing resources, other explanations, etc.)?

5. For each critical unmet need you identified, what do you think would be the most
   effective way to address them?

The table below depicts the categories of unmet needs identified, the number of times that unmet
need was mentioned by all interviewees combined and the corresponding suggested solutions.

                                               Table 38
                            Unmet Needs and Suggested Solutions
Unmet Need                              Number of       Suggested Solutions
                                        mentions
Affordable housing                      4               Increase affordable housing
                                                        Increase Section 8 housing
Too few shelter beds                    4               Shelters with limited rule; provide
                                                        shower and meals
                                                        Shelters where clients can receive
                                                        Mental health and Substance abuse
                                                        treatment
“Wet shelters” (places that still       2               Wet shelter
provide shelter to a homeless
individual who is using substances)
Mental health treatment that deals      2               More flexible housing f or difficult
with the difficult client (one                          group*
suggested residential treatment for                     Greater effort by churches to increase
difficult clients)                                      available counseling
Lack of emotional support for the       2               Provide unconditional listening and
homeless                                                help
                                                        Restore relationships through God*
Case management                         1               Court appointed social worker to
                                                        handle important needs of homeless
Transitional housing for men            1
Transitional housing for abused         1
women
Life skills education and training      1               Residential life skills program*
Homeless don’t know where to get        1
help (more than just DSS available in
community)
Day jobs                                1               Day labor programs
Inpatient substance abuse treatment 1                   More beds for substance abuse
facility                                                treatment
Racism impacts low income housing       1
choices
* See below for full text of comment

Both affordable housing and additional shelter space were the two most frequently mentioned
unmet needs in the county. Although categorized by type, residential programs—from inpatient


                                                                                                 46
substance abuse treatment to transitional housing—were collectively identified four (4) times as
an unmet need.

Comments on suggested solutions included:

!   Program with limited rules that would house the homeless in one room bungalows. One
    kitchen/ cafeteria. Residents would share meals and receive life skills training and education.
    Each person would have a personal representative to help apply for disability and benefits.
    Allow a 6 month stay.
!   More flexible program for difficult group. Workers that do not give up so fast and say
    person is too difficult to work with. Losing housing through mental health system.
!   Restore relationships through God. Talk about relationships using Christian principles.
    Drugs are taking the place of God in the relationship. Deal with anger, self abuse, spousal
    abuse and other issues. Model how to have right relationships with family, friends,
    employer, government, etc. Encourage relationship with God.

6. Is there something you can think of that would prevent future homelessness in the
    county?

Suggestions for preventive measures were varied. Below is a list of suggestions, each made by
only one respondent:

    !   Build relationships and share faith. Help others realize there is more to life than just
        existing.
    !   Education in good decision making skills
    !   Financial help for the working poor
    !   Caseworker for he chronically homeless
    !   Mental health and addictions treatment outreach
    !   Economic development
    !   Affordable housing
    !   More and better transitional housing for men
    !   Transitional housing for abused women
    !   Wet shelter

The following notable comments were also made:

    !   Prevention is tied into two issues:
        o The average age of a person seeking shelter is 30. A generation ago the average age
           was 55.
        o Young children are exposed to alcohol and drugs at younger ages. (The majority of
           homeless say they were under the age of 12 when they began using). Tackle this issue
           early.
    !   Can’t prevent homelessness but have to deal with the problem that is there




                                                                                                   47
2. Key Informant Interviews with Persons Previously Homeless
During the same time period, four (4) persons previously homeless – one (1) male and three (3)
females, all of whom were between 45 and 55 years of age - were individually interviewed as
key informants. The first twelve questions are unique to these previously homeless key
informants. However, the final six (6) questions are the same used with other stakeholders
interviewed as key informants thus allowing comparison across groups. Questions posed to the
previously homeless are in bold; a summary of interviewee responses follows each question. In
most instances, the interviewee responses, themselves, are clustered following each question.

    1. What has been your experience with homelessness?
         - Homeless for 2 years
         - Difficult lifestyle, no one to turn to for help, if you can bear the shame
         - Homeless at age 32 for 2 years, staying at Meeting Ground
         - Homeless, gave few a better look or

    2. How many times have you been homeless?
        - 1
        - 2
        - off and on from ages 19-35
        - 3

    3. Where were you at that time (state, county or town)
        - Elkton, MD
        - MD- Cecil County; New Castle, DE
        - VA, DE, and MD
        - DE and MD

    4. For each time, how long were you homeless?
         - 2 years
         - 1st time - 3 months, 2nd time - about a year
         - N/A - too many times, can’t remember
         - All 3 times - about 6 or 7 weeks

    5. What were the primary reasons that you were homelessness each of those times?
      Were you employed? What type of work were you doing?

       Two of the respondents indicated that drug or alcohol abuse was a primary reason for
       their homelessness; however, two indicated that they were single mothers, out of work
       with no child care and those conditions led to homelessness.
           - Drugs, alcohol, jail, no money
           - 1st time – drugs and money, lost job at warehouse production; 2nd time – poor
               health and no money
           - Out of work, single mother, could not get work
           - Single mother, benefits, child care




                                                                                               48
6. Where did you live during those periods? (Shelter, street, friends, relatives, etc.)

  All four of the respondents lived in a shelter for at least some time. One first lived with
  friends; one lived in a car for a period of time; two lived at “the farm;” one was “kicked
  out” of a shelter and lived on the street.

7. Did or didn’t you use a shelter?

  All four used a shelter at some point. One commented that he/she “hated all of the rules.”

8. What other resources did you use in the community?


                                             Table 39
                   Resources Used by the Homeless in Addition to Shelter
   Resource                    On a scale of 1-5, rate the helpfulness of each    Average
                               resource. 1=Not helpful and 5=Very helpful         Rating
   Community Kitchen           5, 4, X, 5                                         4.7
   Help Center                 4, 4, X, 4                                         4.0
   Churches                    5, 4, 1, 5                                         3.8
   Hospital Emergency          2, 2, 4, 5                                         3.3
   rooms
   Mental Health Clinic        2, 0, X, 4                                         2.0
   Substance Abuse             2, 2, X, X                                         2.0
   Shelters
   Social Services             2, 2, 1, 2                                         1.8
   Friends                     X, 0, 3, 2                                         1.7
   Family                      0, 0, 3, 3                                         1.5
   Halfway House               X,X,X,X                                            X
   Shelters for battered       X,X,X,X                                            X
   women
  X = Didn’t use this resource



  Overall, the respondents rated the Community Kitchen highest in terms of helpfulness.
  The next two most helpful organizations were the Help Center and churches. Friends and
  family were rated lowest in terms of helpfulness.

9. How did you overcome your situation of homelessness? (job, transitional housing,
   etc.)

  Respondents pointed to jobs, affordable housing, shelter help, and child care as factors
  helping them out of homelessness.

       !   Got a job while at the farm and was able to get section 8 voucher
       !   Social services, HUD, and shelter help
       !   Find a job, got child care as , then received HUD
       !   Someone helped me through the shelter



                                                                                             49
    10. How secure do you feel your current living situation is now?

       All four respondents indicated that they still did not feel secure in their current situation.
       Two comments of note were:

           !   Not a good job – could lose it and then be back on the street
           !   Never really secure living situation

    11. Do you need any assistance now?

       Two respondents did not think that they needed assistance now. The other two did – one
       needed health care while the other was in need of subsidized housing.

    12. What resources do you need to feel more secure in your current situation?

       While one of the four responded “don’t know,” the other three indicated that “more
       money” through increased benefits or better job was their primary need. One indicated
       that a lower house payment would make him/her feel more secure.

    13. From your perspective, how large a problem is homelessness in Cecil County?

       All four respondents rated the problem of homelessness as “very big.” Some significant
       comments included:

           !   Lots of homeless people now living on the streets
           !   Know a lot of people on the street now

    14. How would you rank the problem of homelessness compared with other problems
        facing the county?

       Three of the four indicated that they felt the problem was “big” in comparison to other
       county issues. One response was unclear. Some significant comments included:

           !   Big but drugs are the real problem
           !   Big problem, as big as drug use

The remaining survey questions gave respondents the opportunity to offer their perspectives on
the most evident contributors to homelessness locally as well as on the greatest unmet needs of
the homeless in Cecil County; possible solutions to these needs were also solicited. The numbers
of mentions made of each category as factors contributing to homelessness or as unmet needs of
the homeless are reported in the tables below.

The following question specifically asked respondents for their perceptions of the most evident
contributing factors to homelessness in Cecil County. Each respondent described up to three
such factors.



                                                                                                    50
     15. What factors do you think contribute to homelessness in Cecil County?

                                             Table 40
                   Collective Survey findings on Contributors to Homelessness
Contributor                                    Number of Mentions
High rent                                      2
Not enough money                               2
Jobs                                           2
Drugs                                          2
Government                                     1
Inadequate Housing                             1
No one to help                                 1

High rent, jobs, drugs and simply “not enough money” each received two mentions as
contributors to homelessness.

The following questions specifically asked respondents for their perceptions of the most evident
needs of the homeless in Cecil County as well as for suggested solutions to meet these unmet
needs. The responses to these two questions are presented together so that the reader can see the
suggested solutions as they were matched to the identified unmet needs.

     16. In your opinion, OVERALL what are the three most critical unmet needs among
         homeless individuals and families in Cecil County? Why (i.e., no resources,
         inadequate existing resources, other explanations, etc)?

     17. For each critical unmet need you identified, what do you think would be the most
         effective way to address them?

The table below depicts the categories of unmet needs identified, the number of times that unmet
need was mentioned by all interviewees combined, and the corresponding suggested solutions.
                                                Table 41
                         Collective Survey findings on Needs of the Homeless
Need                                     Number of       Suggested Solutions
                                         Mentions
Low income housing                       2               Better shelters (2)
                                                         More housing in Elkton
Better Social Services (government)      2               More money
help                                                     Social services, helping more people
Medical Help                             1               Free clinics
Drug rehab                               1               More houses
Jobs                                     1               Better entry level jobs in county
Financial assistance                     1               More government funding
Services                                 1               More community support
Better policing of drug dealers          1

“Low income housing” and “better social services” received two mentions each as unmet needs
of the homeless. However, it is interesting to note that if “financial assistance” and “services”


                                                                                                51
are added to increased social services/government support those related factors would have
received the highest total mentions.

     18. Is there something that you can think of that would prevent future homelessness in
         the county?

Because few prevention strategies were offered, the full text of respondent remarks is found
below:

       !   No, not really; too big of a problem
       !   More money to help those who do not have money to help them survive
       !   Russia had a good plan - government helps everyone (poor, rich, etc.) – they provide
           services to everyone
       !   Better presidents

3. Analysis of Key Informant Interviews
From the information provided in the first 12 questions of the interviews with persons previously
homeless, it appears as if they were either homeless for a significant period of time (two years)
or were homeless “off and on” over a span of years. Drug and alcohol abuse appears to have
played a significant role in causing homelessness for two of the respondents; however, for the
other two, being a single mother with no job and no child care was cited as primary causative
factors. All four stayed in shelters at some time. Of the community resources they used during
periods of homelessness, they found the Community Kitchen, the Help Center and churches most
helpful. Getting a job and finding affordable housing was most often mentioned as the way in
which homelessness was overcome. On the other hand, none of the four felt secure in their
current living situations.

In considering the data from the two groups of key informants on the following six questions
asked of all interviewees, one should keep in mind the difference in the limited size of the two
groups – nine stakeholders and four previously homeless persons. These responses, then, are
best considered in conjunction with the data from all other sources employed in this study.

While three of the stakeholders felt that the problem of homelessness in Cecil County was either
non-existent, small, or modest, five believed that homelessness was a major or significant
problem. All four of the previously homeless respondents characterized it as “very big.” As
might be expected, how the problem of homelessness was ranked by both sets of respondents in
comparison with other county issues of concern fell much along the same lines as responses to
the first question.

Among key informants, personal factors such as drug or alcohol abuse, mental illness, poor work
ethic or low personal expectations, were seen as primary contributors to homelessness. The
previously homeless respondents focused more on the economic contributors to homelessness
such as high rent, “not enough money,” and lack of jobs.

Low income or affordable housing was the most frequently mentioned unmet need in both
groups of respondents. Stakeholders also ranked additional shelter beds high as an unmet need.


                                                                                                   52
Stakeholders indicated that “wet shelters,” mental health treatment that deals with difficult
clients (including residential treatment), and emotional support for the homeless were also
evident needs. The previously homeless persons indicated that better social services
(government) help was also a need from their perspective. Across groups, the most often
mentioned solutions to these needs were increased availability of affordable housing and shelter
space. Suggestions for prevention strategies were quite varied both among both within and across
groups. The reader is referred to the text of the Key Informant Interview section.

C. Survey of the Currently Homeless

1. Study Setting
The homeless surveys were carried out between January 8th and March 5, 2005. Initially four
interviewers were identified to conduct the in-person interviews; however the preponderance of
the interviews were conducted by only two, a white female and African American male. The
interviewers were chosen, in part, because of their experience with the homeless population in
Cecil County. Interviewers were paid a fee of $30.00 for each completed interview. To ensure
the reliability of the data, a half-day training was provided to all interviewers. Throughout the
survey period regular telephone and email dialogue was maintained between the interviewers and
Center staff.

Rather than selecting a sample an attempt was made to interview as many homeless adult
persons in the county as possible. This was done by establishing a presence at all of the local
shelters, soup kitchens, and localities frequented by homeless individuals such as parks and
“Acme Acres”. Over the eight week period seventy-five interviews were completed.

The interviewers reported that only ten individuals declined to be interviewed. In addition the
interviewers reported a high level of confidence in their ability to have conducted a complete
census of the homeless adults residing in Cecil County during this period of time. Although the
study was conducted county-wide, the vast majority of the homeless interviewed resided in the
greater Elkton area.

2. Definition of Homelessness
This study used the same operational definition of homelessness that was used in “Homelessness
in rural areas: Causes, patterns, and trends” printed in Journal of Social Work, January 1994.
(First, R. J., Rife, J. C. (1994). Homeless in rural areas: Causes, patterns, and trends. Social
Work, Vol. 39, 97-109) As in that study, each potential respondent was first screened and in
order to be included in the study the potential respondent must have:
     • slept in limited or no shelter for any length of time
     • slept in shelters or missions operated by religious organizations or public agencies that
         serve homeless people and charge either no fee or a minimal fee
     • slept in inexpensive hotels or motels where the actual length of stay or intent to stay was
         45 days or fewer
     • slept in other unique situations where the actual length of stay or intent to stay was 45
         days or fewer, including staying with family or friends for short periods of time




                                                                                                  53
3. Study Instrument
The interview consisted of three sections.
   The Homeless Person Survey Instrument was adapted from Roth et.al. (1985). (Roth, D.,
   Bean, G., Lust, N., & Saveanu, T. (1985) “Homeless in Ohio: A study of people in need.”
   Columbus: Ohio Department of Mental Health) The Demographic and Life Experience
   Information consisted of 101 questions related to various aspects of the individual’s life such
   as current and past living arrangements, patterns of and reasons for homelessness, health
   concerns, substance use, and general well-being.

   1. The Personality Assessment Screener (PAS) (Morey, L. C. (1997) Personality
      Assessment Screener professional manual. Odessa, FL: Psychological Assessment
      Resources) is designed to provide a rapid screening for a broad range of different clinical
      issues. The PAS contains 22 items organized hierarchically into both a total score and 10
      “elements” representing distinct mental health domains such as negative affect, acting
      out, psychotic features, social withdrawal, suicidal thinking, alcohol problems and anger
      control.

   2. The Interview postmortem section contained items that were completed after the
      interview, including the setting where the interview occurred, respondent characteristics
      and an assessment of the accuracy of the respondents’ answers.

4. Data Collection and Analysis
This study attempted to locate and interview all of the homeless people in Cecil County over a
two month data gathering period in the winter of 2005. To facilitate the identification of
homeless individuals the interviewers visited soup kitchens, homeless shelters, and met with
service providers in the community. Using a snowball technique the interviewers attempted to
identify both homeless individuals and places where they congregated. Once an individual was
identified he/she was asked to participate in a 50 minute interview in exchange for which they
were told they would receive a $5.00 gift certificate to a McDonald’s Restaurant.

Once a potential respondent was identified a detailed screening related to the respondent’s
eligibility was conducted. Interviews were conducted immediately in a variety of settings
including shelters, churches, parking lots, truck stops, wooded areas, and a community kitchen.

Each potential respondent was assured that he/she had the right to not participate in the survey
and that, should they agree, all responses would be kept confidential. Even if the individual
agreed to participate he/she was given the option to refuse to answer sensitive questions. No
personal identifying information was recorded. Each respondent was assigned a unique
identification number based upon month and date of birth and the first three digits of their social
security number. This eliminated the possibility of the same individual being interviewed more
than once.

5. Findings
        a. Demographic Characteristics of Respondents (see Appendix 7 on page 134.)
Of the seventy-five (75) respondents, 78.7% (59) were male, and 21.3% (16) were female (see
Table 1). Almost two-thirds (65.3%) of the sample were white, and 25.3% were African



                                                                                                 54
Americans. Another 6.7% were Hispanic, and 2.6% were “Other.” By comparison, according to
2000 Census in the county population as a whole, the percentage of African Americans was
3.9% and Hispanics was 1.5%. Thus, minorities were overrepresented in the sample.
                                            Table 42
                               Gender and Ethnicity of Respondents
          Demographic                Frequency                 Percentage
          Gender
            Male                       59                         78.7
            Female                     16                         21.3

          Ethnicity
            White                      49                         65.3
            African American           19                         25.3
            Hispanic                   5                          6.7
            Other                      2                          2.7
          No answer                    0                          0

The age range of respondents was 21 to 67 years. The mean age was 46 years and almost half
(44%) were age 50 and older.
                                             Table 43
                                        Age of Respondents
              Age Range                Frequency          Percentage
              18-29 years              5                  6.7
              30-39 years              13                 17.3
              40-49 years              24                 32.0
              50-59 years              29                 38.7
              60 years and older       4                  5.3
              No answer                0                  0

Although a total of 15 states were reported as residences of birth, over half of the respondents
(50.7%) said they were born in either Maryland or Delaware (22.7%). The only other birth state
of any significance was Pennsylvania where 16% of the individuals said they were born. Most
respondents (90.7%) were born in the United States.

It was perhaps a little surprising to find that this group of respondents was not transient in nature.
Over half of the homeless respondents (65.3%) report that they have “always lived” in Cecil
County. Of those relatively new to the county, 24.6% have lived there for six months or more.

For the approximately 35% who were not born in Cecil County the following is a rank ordering
of reported a number of reasons for leaving their previous home. Top among those were:

   !   No jobs
   !   Trouble with police
   !   Family problems
   !   Had no place to stay

The primary reasons they indicated that they came to Cecil County were:

   !   To live with a relative or friend
   !   To take a job


                                                                                                   55
   !   Heard there were public sleeping shelters

Approximately a quarter (25.3%) of the respondents had never been married. Over two-thirds
(64.1%) were separated, divorced, or widowed; and 10.7% were married or in a common-law
relationship. Of those who reported being married or having a partner, 80% indicated that the
partner was almost homeless.
                                                Table 44
                                     Marital Status of Respondents
              Status                         Frequency          Percentage
              Married or living together     8                  10.7
              Separated                      17                 22.7
              Divorced                       26                 37.7
              Widowed                        5                  6.7
              Never been married             19                 25.3
              No answer                      0                  0

Over half (56.8%) of the respondents reported having children. Of those who have children,
85% have three or less. Interestingly, only about 4.0% indicated that their children are in the
care of a state agency. The greatest percentages of non-adult children were reported to live
either with their other parent or with a relative/friend.
                                           Table 45
                              Number of Children of Respondents
                 Number of children     Frequency       Percentage
                 One                    9               22.5
                 Two                    13              32.5
                 Three                  11              27.5
                 Four                   5               12.5
                 More than Four         2               5.0


                                               Table 46
                                   Child’s Reported Current Status
                 Status                        Frequency       Percentage
                 Lives with me                 3               6.0
                 Lives with other parent       12              24.0
                 Lives with relative or friend 6               12.0
                 In custody of state           2               4.0
                 Adult                         17              34.0
                 Don’t know                    2               4.0
                 Other                         8               16.0



Slightly over 40% (42.7%) of respondents had graduated from high school, and another 26.7%
had an advanced degree, some college, or advanced training. Less than a quarter (22.7%) had
completed grades nine through eleven, and only 8.0% had an education of eighth grade or less.




                                                                                                  56
                                           Table 47
                                  Education of Respondents
               Education Level                     Frequency       Percentage
               Completed grades 1-8                6               8.0
               Completed grades 9-11               17              22.7
               High school graduate                32              42.7
               Some college or advanced training   14              18.7
               College graduate or above           6               8.0
               No answer                           0               0


Slightly more than one-fourth (27.8%) had served in the armed forces, and, of those, 80%
reported being combat veterans. Given the reported age of these respondents, one would
conclude that these individuals are Vietnam era veterans (although this question was not asked
directly). The vast majority (85%) of those who served in the military reported having received
honorable discharges. Only two (1%) reported dishonorable discharges. All of the veterans
were males.

A number of differences based on gender of respondents was found (see Appendix 8). Females
were more likely to be minorities (43.9% as compared to 32.3%). In addition they tended to be
younger than men; 43.8% of the women were under the age of 40 as compared to 18.7% of the
men. Men were also more highly educated (74.6% had at least a high school education as
compared to 50% of the women). In contrast to the men, females were more likely to be
currently married (25% vs. 6.8%).

There was one interesting demographic difference based on race/ethnicity. Minority respondents
were more likely to have a high school education or better (83.3%) than were white respondents
(63.3%).

        b. Patterns of Homelessness (see Appendix 9 on page 138)
At the time of interview the overwhelming majority the homeless respondents (85.3%) were
found in the greater Elkton area.

                                          Table 48
                                 Community Where Interviewed
                 Community           Frequency          Percentage
                 Elkton              64                 85.3
                 Chesapeake City     4                  5.3
                 Cecilton            3                  4.0
                 Northeast           3                  4.0
                 Other               1                  1.3



Females and whites appear to be slightly more transient than males and nonwhites.
Approximately 60% of female and 25% of nonwhite respondents indicated that they have lived
in three states. This is as compared to 5.5% of males and 0% of white respondents.

Shelter settings were the most frequently reported (43.2%) current living setting with about an
equal number indicating that they lived either on the streets or in their car.




                                                                                                  57
                                                 Table 49
                                          Current Living Situation
              Living Situation                Frequency           Percentage
              Shelter setting                 32                  43.2
              On the streets                  16                  21.6
              In my car                       14                  18.9
              Hotel or motel                  6                   8.1
              With a relative/friend          5                   6.8
              Other                           1                   1.4

The question “when was the last time you had a home for at least 45 continuous days” was asked
to determine the first time respondents had been homeless. The table below shows that only
about a fourth (26.7%) report a long term pattern of homelessness, with less than half (43.4%)
reporting being homeless for the first time less than two years earlier.

                                                   Table 50
                                            First Time Homeless
                  Two or less years                  43.3%
                  2- 5 years                         30.0%
                  5 – 10 years                       15.0%
                  More than 10 years                 11.7%


The trend appears to be that once respondents become homeless the tendency is to stay that way.
In fact, 80.5% of those interviewed indicated that since their first such experience, they remained
homeless. Reporting the duration of homelessness, respondents’ comments included:

   !   I’ve been homeless three time since 1997
   !   I have been in jail several times since the year 2000
   !   I have lived in my car and washed and shaved at the men’s shelter for a long time
   !   I have been homeless on and off a few months at a time mainly from house to house
   !   I have been moving from one place to another – no real home

Over two-thirds (68.1%) reported having been in their current situation for one year or more.
Some respondents had been homeless for extended periods, including ten people (23.3%) who
had been homeless for more than two years. The mean length of time of homelessness for all
respondents was 531 days, just over seventeen months while the median was 270 days
(approximately 8.5 months).

Respondents were asked where they had slept during the last 30 days, and, not surprisingly,
shelters had the most activity. This may be related to the fact that the survey was conducted
during the winter. The table below shows the responses to this question.
                                                  Table 51
                                       Places Slept in Last Thirty Days
                 Shelter                                 56.3%
                 Friend                                  23.6%
                 Car                                     22.7%
                 Rented Room                             21.6%
                 Park                                    18.1%
                 Public Place                            6.8%



                                                                                                58
That shelters bear the burden of housing these respondents was confirmed when respondents
were asked where they stayed the previous night. The table below shows that shelters housed the
greatest percentage.
                                              Table 52
                                       Place Slept Last Night
                 Shelter                              39.2%
                 Car                                  18.9%
                 Street, woods, outside               10.8%
                 With a friend                        9.5%
                 Rented a room                        9.5%
                 Other                                10.8%

A related question asked where the respondent had been eating in the past month. Given the
above answers, it is not surprising that the most frequent answer was community kitchen/shelter.


                                             Table 53
                               Sources of Meals in Last Thirty Days
               Community Kitchen/Shelter             80.0%
               Buy at store, cook my own food        9.3%
               Restaurant                            4.0%
               Food pantry, cook my own food         1.3%
               Other                                 5.3%

It does not appear that respondents come from families with patterns of homelessness. Less than
10% (9.3%) reported having a homeless relative, but when respondents did report such a relative,
that person was most often a sibling.

Respondents were asked to identify the most important reason for their current homelessness. Up
to three responses were recorded. The first answer was reported here as the most important.
Respondents’ answers were weighted in order to give a ranking to the collective responses. This
was done by giving 3 points to a #1 response; two points to a #2 response, and one point to a #3
response. The number of mentions as a first, second, or third need/cause—and the point totals
for each need/cause—are reported below in tables.


                                           Table 54
                             Reasons for Homelessness (weighted)
      Reason                      Mentions      Mentions    Mentions         Total
                                  as #1         as #2       as #3            points
      Unemployment                15            10          21               86
      Alcohol/drug abuse          13            10          19               78
      Family Conflict             15            12          5                74
      Problems paying rent        12            13          5                67
      Eviction                    7             10          11               52
      Family Dissolution          7             4           7                36
      Other                       6             4           8                34
      Jailed                      2             2           0                10



                                                                                              59
It appears that respondents are rather split between interpersonal issues(family problems,
substance use) and economic issues(unemployment, problems paying the rent) as their perceived
primary reasons for being homeless.

When the primary issue for homelessness is crossed by gender, it appears that women are more
often displaced because of family conflict and unemployment than are men. Men are more often
homeless because of substance abuse issues.
                                             Table 55
                            First Reason for Homelessness by Gender
                   Identified Reason            Male          Female
                   Family conflict              18.6%         25.0%
                   Unemployment                 18.6%         25.0%
                   Alcohol/Drug Use             22.0%         0%
                   Problems paying rent         16.9%         12.5%

                                             Table 56
                             First Reason for Homelessness by Race
                  Identified Reason              White        Nonwhite
                  Family conflict                22.5%        21.0%
                  Unemployment                   16.3%        15.8%
                  Alcohol/Drug Use               12.20%       31.6%
                  Problems paying rent           16.3%        10.5%

When the same question is looked at by race, it appears that economic factors more often
contribute to the homelessness of white individuals while substance abuse is a more significant
factor with nonwhite respondents.

        c. Needs of Respondents (See Appendix 11, page 142.)
Most (72%) of the respondents reported their general health status to be either good or fair. Only
28.0% stated their health was poor. However, when asked if they had major health problems for
which they should see a doctor, almost half (44.6%) indicated that they did. More than one-third
(36.1%) had seen a doctor in the last three months. The picture was very different regarding
dental care. Only 5.4% reported having seen a dentist in the past four to six months.

                                              Table 57
                                   Last Saw a Medical Professional
                 Time Period                        Doctor           Dentist
                 In the last 3 months               36.1%            0%
                 4 -6 months ago                    13.9%            5.4%
                 Some time in the past year         15.3%            13.5%
                 1 -2 years ago                     13.9%            31.1%
                 More than 2 years ago              12.5%            10.5%

The ten most frequently mentioned health problems were:

   !   Headaches (33.3%)
   !   Mental health issues (32%)
   !   Gastroenteritis (24%)
   !   High blood pressure (22.7%)


                                                                                                60
   !   Diabetes (16%)
   !   Liver problems (16%)
   !   Asthma (14.7%)
   !   Heart problems (14.7%)
   !   Kidney problems (13.3%)
   !   Bronchitis (10.7%)

Respondents reported relatively little use of hospitals. Although almost 30% (27.8%) of the
respondents were veterans, only 8% reported being admitted to a VA hospital, and 60% of those
report only one admission. In addition, 2% reported general hospitalization, and 16% indicated
being hospitalized for psychiatric reasons. Of the latter respondents, 75% report two (2) or more
psychiatric admissions. This indicates that respondents overwhelmingly use the hospital for
mental health reasons rather than any other need.

Interestingly, of those reporting mental health related hospitalizations and related follow-up with
out-patient referral upon discharge, most (57.9%) report making that initial follow-up contact.
What is perhaps less surprising is that only 12.5% completed more than two follow-up contacts,
and only 13.6% have had any contact with a counselor or a case manager at a mental health
clinic in the past month. Clearly, respondents are not good at maintaining follow-up for mental
health needs.

One health related issue which is of major concern is the matter of contraceptive use. Whereas
60% of respondents reported being sexually active with one to three partners, only a little over
half (56.8%) reported always using contraceptives (primarily condoms). Another 35.1%
indicated that they never use any contraceptives. This suggests that this population is at high risk
of becoming HIV positive.

When asked specific questions about substance use, 33.3% of respondents said the use of drugs
(other than alcohol) has caused problems for them in the past thirty days. In addition, 44.0%
indicated that they currently have an addiction, and 30.7% say they have found themselves using
larger amounts of drugs to get effects or that they could no longer get high on the amount they
used. In addition, 18.7% report spending at least one night in a hospital or treatment center for
drug use. When asked if they had problems with drugs before becoming homeless, only about
one-third (32.9%) said yes. Only 6.8% of respondents feel their drug problem is in response to
their homelessness.

Interestingly, drinking behavior seems to be reported as less of a problem than drugs. The table
below looks at this reported behavior.

                                             Table 58
                                    Drinking in the Past Month
                       Some                       44.4%
                       A lot                      9.7%
                       Not at all                 38.9%
                       No Answer                  7.0%

An only a slightly different picture emerges when respondents commented on receiving help for
drinking in that 13.3% reported receiving such help, and 9.3% reported having stayed overnight
at a treatment facility because of alcohol use. One, perhaps contradictory picture, is that 25.7%
reported that someone, at some time in the past, had told them they had a drinking problem.


                                                                                                 61
When the issue of substance use was looked at by race and gender, the following picture
emerged. African Americans more often reported that drugs had caused them trouble in the past
(52.6% vs. 30.6%), but there was no significant difference between African American and white
respondents on the issue of “drinking a lot” (10.5% vs.10.6%). Men were twice as likely as
women (37.3% vs.18.8%) to report that drugs had caused a problem for them at some time in
their lives. The same picture emerged when respondents were asked about drinking “a lot” with
12.1% of the men answering “yes” compared to 0% of the women.


         d. Resources of Respondents (See Appendix 11, page 142.)
Over half of respondents (69.3%) report having worked for pay previously in their lives, and a
little less than one-third (30.7%) had worked for pay in the thirty days preceding their interview.
Of the respondents who had worked in the past month, 45.5% had worked in full-time positions;
31.8% had worked between 100 – 150 hours, and 22.7% had worked between 20 – 80 hours.
Only a little over one-third (35%) considered themselves fulltime permanent employees. Of
those who were not fulltime employed, 57.5% had not had a fulltime job in six months or more.

Men were slightly more likely to have had jobs at some time in their lives than were women
(76.4% vs. 66.7%); perhaps more interesting was that white respondents were almost three times
as likely (93.2% vs. 36.8%) to have had a job at some point than were African Americans.

A number of reasons were cited by respondents for losing their last fulltime employment. These
included:

   !   Got fired (22%)
   !   Drinking/drug use (20%)
   !   Quit (14%)
   !   Poor mental health (12%)
   !   Company closed/moved (9%)

Respondents were also asked about current barriers to employment. The following were reasons
given:

   !   Disabled, can’t work
   !   Do not feel ready for work
   !   Do not know where to look for work
   !   Plan to look for work
   !   Looked for work but can’t find any
   !   Do not want to work
   !   Don’t have transportation
   !   Health is bad
   !   Don’t have immigration papers
   !   Just plain lazy

Over half of respondents (53.3%) reported having received income within the last thirty days.
For those having income in the past month, the most frequently mentioned source was earnings
(29.7%) followed by family, friends, disability, and charity.




                                                                                                 62
Almost half of the respondents (48%) said that they had relatives they could go to for help, but,
of these, less than half (43%) reported regular contact with relatives. The reasons given for poor
contact with family included such comments as:

   !     They would not help.
   !     I have no desire to maintain a relationship.
   !     They don’t want to see me.
   !     I’m ashamed of my current situation.
   !     They don’t live close by.

Friends seemed to be a greater source of support than family in that 71.4% of respondents
indicated having friends they could count on for help. Respondents also seemed to have more
contact with this support network with 56.8% reporting “regular” contact with friends.

Respondents were asked what local resources they had used in the previous month. The
following table shows the responses to that question.
                                              Table 59
                                            Resource Use
                        Community Kitchen                  90.7%
                        Social Services                    84.0%
                        Shelters                           81.3%
                        Churches                           58.7%
                        Hospital ER                        42.7%
                        Mental Health Clinic               28.0%
                        Substance Abuse Shelters           5.3%
                        Halfway Houses                     4.0%
                        Domestic Violence Shelters         2.7%



In addition respondents were asked which services they felt were helpful and would use again.
The following services are listed in order of helpfulness/would use in future.

       1. Community kitchen
       2. Shelters
       3. Welfare support
       4. Health care
       5. Subsidized housing
       6. Single room occupancy
       7. Job training
       8. Transportation
       9. Job placement
       10. Mobile homes
       11. Churches
       12. Drug treatment
       13. Reading/basic education
       14. Alcohol treatment
       15. Central listing
       16. Mental health counseling


                                                                                                63
     17. Family planning
     18. Child care
     19. Halfway houses

A little more than one-fourth (29.3%) of respondents reported having been in jail for felonies,
and approximately the same amount (32.0%) have been jailed for a misdemeanors. Of those
who have been in jail, less than half (48.6%) indicated that they had a place to stay upon release.

       e. General Well-being of Respondents
Two questions asked about this issue. The first was: “How would you rate your nerves, spirits,
outlook, or mental health at present?”

                                              Table 60
                                 Self-Rating of General Well-Being
                       Excellent                  6.7%
                       Good                       37.3%
                       Fair                       40.0%
                       Poor                       13.3%
                       Very bad                   2.7%

An overwhelming majority (84%) rated their well-being as fair to excellent. This indicates that
respondents see themselves as relatively emotionally healthy. In fact, 44% rated well-being as
good to excellent.

This is consistent with the reported feelings of life satisfaction where one-third (33.3%) report
feeling that their lives have been “somewhat” to “very satisfying” as compared to 22.7% who
report feeling the opposite.
                                                  Table 61
                                             Life Satisfaction
                       Very satisfying                5.3%
                       Somewhat satisfying            28.0%
                       Mixed                          44.0%
                       Not Very satisfying            16.0%
                       Not at all satisfying          6.7%

An interesting picture emerges when these two issues are crossed by gender and race. Women
are less likely to report satisfaction with their lives (31.3% vs. 33.9%) or good to excellent
mental health (25.0% vs. 49.2%). When these issues are looked at by race, white respondents
are less likely to report being satisfied with their lives (26.5% vs. 42.0%) and are also less likely
to report having good mental health (32.7% vs. 73.7%).

        f. Post Mortem
Interviewers were asked to answer a series of opinion questions regarding each interview and
respondent. The following suggests that interviewers felt reasonably confident in the accuracy of
the answers they received.

                                             Table 62
                                         Question Accuracy
                       Completely accurate        40.8%
                       Fairly accurate            53.5%
                       Not very accurate          5.6%


                                                                                                    64
A subsequent related question asked whether or not the interviewer believed any respondent had
lied at any time during the interview. To this question, 15.7% answered “yes.” The three most
often listed issues about which interviewers believed respondents had lied were related to:

   !    Mental health issues (7 comments)
   !    Substance use (6 comments)
   !    Illegal status (3 comments)


D. Mental Health Screening with PAS
Following the in-depth interview, respondents were asked to fill out the Personality Assessment
Screener (PAS) developed by Leslie Morey of Psychological Assessment Recourses, Inc. (1997).
(See Appendix 6 for PAS instrument.) The PAS was administered to each respondent as a way
to provide a quick screening for a broad range of clinical issues.

The PAS contains 22 items that permit an overall (PAS Total) score and ten (10) distinctive
domains or subscales of clinical problems. The PAS was developed from the Personality
Assessment Inventory (PAI ; Morey, 1991) and can be used as stand-alone screening tool. It was
selected because of its sensitivity, wide range of coverage, and reading level (fourth grade). It
was not meant to provide a comprehensive assessment of the domains of psychopathology or
normal personality as is the PAI; however, it does provide a clinical impression of emotional
problems, behavior, or both that respondents might be experiencing. Given the different higher
incident rates of mental illness and addiction reported for the homeless population, this was an
important area to document.

The ten subscales include:

    !   Negative Affect (NA) – is indicative of personal distress and reflects the experience of
        unhappiness and apprehension. This element is highly correlated with depression and
        anxiety. High scorers are likely to feel tense, worried, and demoralized.

    !   Acting Out (AO) – is suggestive of the potential for a number of behavior problems
        including impulsivity, sensation-seeking, and a disregard for convention. High scorers
        are likely to have a pattern of reckless behavior and a history of difficulty with authority.

    !   Health Problems (HP) – element of the PAS involves indicators of somatic complaints
        and health concerns such as vague symptoms of malaise to severe dysfunction in specific
        organ systems. High scorers will have significant concerns about somatic functioning
        and will probably report impairment arising from somatic symptoms.

    !   Psychotic Features (PF) – element involves indicators of persecutory thinking and other
        psychotic phenomena. The item content focuses on features of paranoid psychosis.

    !   Social Withdrawal (SW) – element reflects social detachment and discomfort in close
        relationships. High scorers will have little apparent interest or investment in social


                                                                                                   65
        interactions. SW can stem from apathy (as in depression), from marked shyness or
        anxiety (as in social phobias), from trauma-induced alienation (as in PTSD), from autistic
        withdrawal (as in schizophrenia), from distrust (as in paranoia), or from instability of
        relations (as in borderline personality).

    !   Hostile Control (HC) – element represents an interpersonal style characterized by needs
        for control and inflated self-image. The HC element is unique among the 10 PAS
        elements in that problems are associated with both high (i.e., 3-6) and low (i.e., 0)
        scores; thus, the likelihood of problems increases with both very high and very low HC
        raw scores.

    !   Suicidal Thinking (ST) – element includes items tapping thoughts of death or suicide.
        Elevated scores suggest that the respondent has had a least some thoughts of suicide. ST
        elevations tend to be highest in disorders at elevated risk for suicide, such as major
        depression or borderline personality.

    !   Alienation (AN) – element is indicative of an unsuccessful history of attachment
        relationships and a distrust of or disinterest in such relationships. High scorers feel that
        they have been unsupported and treated unfairly by those closest to them, and they
        maintain their distance in relationships and approach them skeptically. AN elevations
        tend to occur in diagnostic groups where defects in the ability to form attachment
        relationships are prominent.

    !   Alcohol Problem (AP) – The item content of the AP element involves behaviors and
        consequences related to alcohol use, abuse, and dependence. Questions inquire directly
        about the use of alcohol; therefore, prominent denial of alcohol problems can suppress
        scores on the scale.

    !   Anger Control (AC) – The items on the AC element tap difficulties in the management of
        anger. High scorers are likely to be chronically angry and will potentially express anger
        and hostility through verbal means, physical means, or both.



The PAS P Total score provides an estimate of the likelihood that an individual is experiencing
some type of clinically significant problem. The Total score is a composite score that combines
the individual element scores, thus the total score is a more powerful assessment indicator since
it is composed of more individual responses (22 items), but a less specific descriptor than the
individual element scores themselves. The following tables provide interpretation of both the
PAS Total scores and the PAS Element scores.




                                                                                                   66
                                              Table 63
                                Interpretation of PAS Total Scores


                              Reported risk
PAS Total score                for problems                  Interpretation


≥ 45 (> 99.81P)                Extreme         Reported potential for emotional and/or behavioral
                                               problems is substantially greater than is typical for
                                               clinical patients; follow-up self-report assessments are
                                               nearly certain to identify significant problems. Rule out
                                               the possibility of malingering.


24 to 44 (75.00P to 99.81P)    Marked          Reported potential for emotional and/or behavioral
                                               problems is substantially greater than is typical for
                                               community adults; follow-up self-report assessments
                                               are very likely to identify significant problems.


19 to 23 (48.00P to 74.99P)    Moderate        There are suggestions of potential emotional and/or
                                               behavioral problems of clinical significance. More
                                               extensive follow-up assessment is recommended.


13 to 15 (15.00P to 29.99P)    Normal          Reported potential for emotional and/or behavioral
                                               problems is less than is typical for community adults.
                                               More extensive follow-up assessment is
                                               recommended in contexts where false-negative
                                               decisions are costly and the individual has scored
                                               above the median of the local population.


≤ 12 (< 15.00P)                Low             Reported potential for emotional and/or behavioral
                                               problems is substantially less than is typical for
                                               community adults; follow-up self-report assessments
                                               are unlikely to identify significant problems. Rule out
                                               the possibility of positive impression management.




                                                                                                     67
                                            Table 64
                             Interpretation of PAS Element Scores



PAS element P score          Reported risk                  Interpretation
                             for problems



> 74.9P                      Marked           Reported potential for problems within the domain
                                              tapped by the element is substantially greater than is
                                              typical for community adults; follow-up assessments
                                              are very likely to identify significant problems.


50.0P to 74.9P               Moderate         There are suggestions of potential problems in the
                                              element domain that are of clinical significance. More
                                              extensive follow-up assessment is recommended.


40.0P to 49.9P               Mild             If the Total Score is elevated, potential for problems
                                              within the element domain may be elevated relative to
                                              community adults. More extensive follow-up
                                              assessment is recommended in contexts where false-
                                              negative decisions are costly.


<49.9P                       Normal           Reported potential for problems within the element
                                              domain is typical of well adjusted community adults.
                                              Also consider the possibility of positive impression
                                              management in contexts where such distortion is
                                              common.




All seventy-five (75) respondents completed the Personality Assessment Screener. The most
important finding is the PAS-P Total score since it is a composite score composed of the
individual element scores. Both the total and the individual element scores are displayed in
Tables 65 and 66.
                                        Table 65
                               Respondents’ PAS-P Total Scores
                                          Total Score
                           Range         Frequency      Percentage
                           Low                      3            4.0
                           Normal                   1            1.3
                           Mild                     4            5.3
                           Moderate                 8           10.7
                           Marked                  54           72.0
                           Extreme                  5            6.7
                           Totals                  75           100



                                                                                                     68
      In Table 65, one can see that 54 or 72.0% of respondents scored in the Marked range while 5 or
      6.7% scored in the Extreme range. In other works, nearly 80% of respondents recorded scores
      that indicate a high to very high potential for emotional and/or behavioral problems.


                                                                                                            Table 66
                                                                                                    Respondents PAS Scores
                                                                                                      Individual Elements
                                                                                                (Frequency/ Percentages)

Score                                                                                                     Element Scores / Percentages
Ranges                 NA                            AO                        HP                        PF      SW         HC       ST                                                                       AN                        AP                         AC
                        Percentage




                                                      Percentage




                                                                                Percentage




                                                                                                          Percentage




                                                                                                                                   Percentage




                                                                                                                                                            Percentage




                                                                                                                                                                                     Percentage




                                                                                                                                                                                                               Percentage




                                                                                                                                                                                                                                         Percentage




                                                                                                                                                                                                                                                                    Percentage
           Frequency




                                         Frequency




                                                                   Frequency




                                                                                             Frequency




                                                                                                                       Frequency




                                                                                                                                                Frequency




                                                                                                                                                                         Frequency




                                                                                                                                                                                                  Frequency




                                                                                                                                                                                                                            Frequency




                                                                                                                                                                                                                                                       Frequency
Normal     24           32.0             12           16.0          8           10.7         16           21.3         12          16.0          0             0         27          36.0          8           10.7          7            9.3           5            6.7
Mild        0              0              0              0         14           18.7          0              0          0             0         32          42.7          0             0         18           24.0         13           17.3          16           21.3
Moderate   26           34.7             30           40.0         21           28.0         21           28.0         26          34.7         43          57.3          1           1.3         18           24.0         32           42.7          47           62.7
Marked     25           33.3             33           44.0         32           42.7         38           50.7         37          49.3          0             0         47          62.7         31           41.3         23           30.7           7            9.3
Totals     75            100             75            100         75            100         75            100         75           100         75           100         75           100         75            100         75            100          75            100




      To better understand the factors that made up the total score, one needs to examine the individual
      element scores in Table 66. A cursory look at the combined Moderate and Marked scores and
      percentages show that 70% or more of respondents had elevated scores on six elements. It also
      shows the element with the lowest score; low scores are equally as problematic as high scores.
      From high to low, the rank order of the element scores is: SW - Social Withdrawal; AO - Acting
      Out; PF - Psychotic Features; AP - Alcohol Problems; AC - Anger Control; HP - Health
      Problems; NA - Negative Affect; AN - Alienation; ST - Suicidal Thinking; HC - Hostile Control.

      Some of the most striking findings are:

                                     !         The two elements with the highest percentage of problematic responses were
                                               Social Withdrawal – associated with little apparent interest in social interaction
                                               and can stem from apathy, anxiety, trauma-induced alienation, among other
                                               possibilities and, Acting Out – characterized by impulsivity, sensation-seeking,
                                               and a disregard for convention. High scorers are likely to have a pattern of
                                               reckless behavior and a history of difficulty with authority.
                                     !         The next ranked element was Psychotic Features – involving indicators of
                                               persecutory thinking and other psychotic phenomena. The item content focuses
                                               on features of paranoid psychosis.
                                     !         The element with the lowest scores was Hostile Control – representing an
                                               interpersonal style characterized by needs for control and inflated self-image.
                                               However, in this case low scores can be as problematic as high scores as the HC


                                                                                                                                                                                                                                                      69
               element is unique among the 10 PAS elements in that problems are associated
               with both high (i.e., 3-6) and low (i.e., 0) scores; thus, the likelihood of problems
               increases with both very high and very low HC raw scores. Thus the 42.7% of the
               respondents with the lowest scores need to be viewed as reflecting the possibility
               of very submissive, self- defeating interpersonal styles that could be exploited by
               others.

When one reviews these findings it is important to remember that the PAS is a screening tool,
not a comprehensive assessment instrument. It is used for initial identification of problems
rather than as a diagnostic tool. Its function is to identify those who might need further in-depth
assessment.

In addition, there are three other issues that need to be kept in mind when interpreting the PAS
data. First, the PAS is a self-administered instrument; therefore, its findings should be viewed
with a degree of caution in light of the possibility that respondents might under- or over-report
certain data for reasons of their own. This is always a concern when the data are sensitive—a
status which is certainly the case in this instrument. Second, the data are cross-sectional,
meaning they were collected at a specific point in time and might not represent the respondents’
feelings or behaviors at another time. It is possible that if the same questions were asked of the
same respondents today, the answers might be different. Finally, and perhaps most important in
this instance, is the inability to determine cause and effect with this particular instrument and its
single administration. It is not possible, for example, to know if the reported feelings of social
isolation are in response to one’s homelessness or are the cause of that homeless state. This lack
of ability to determine cause from effect should be considered when reviewing each of the PAS
subscales.




                                                                                                  70
               Section IV

Summary, Discussion, and Recommendations




                                           71
This section will first summarize the salient points from each of the five data sources (existing
data, provider survey, key informant interviews, homeless interviews, and PAS scores),
emphasizing the specific import of information provided by each source. The review will be
followed by a discussion of interpretations of the findings, and finally, by recommendations
which reflect current best practices to address the identified problems.

A. Summary of Salient Points

 1. Demographic and Existing Data
    The following points reflect important findings related to population growth and housing
    costs:

        a. While the total county population increased 20.5% between 1990 and 2000, the
           county urban population increased 198% while the rural population decreased by
           21.8%. This compares with an increase of 17.2% in Maryland’s urban population
           and decrease of 17.4% in statewide rural population. Importance – Cecil County is
           becoming more “urban” or less “rural” at a faster rate than the state as a whole.
        b. Exceeding the percentage of growth found across Maryland as a whole (10.8%),
           Cecil County’s population grew by 20.5% between 1990 and 2000. This percentage
           of growth ranked Cecil County fifth among Maryland’s 24 jurisdictions. Recent data
           based on 2003 population estimates show that Cecil County continued to grow
           between 2000 and 2003 at a rate slightly higher than the state. Importance – Cecil
           County is growing at faster overall rate than the State.
        c. Cecil County evidenced a mean income in 1999 below the state average. According
           to 2003 estimates, Cecil fell even further behind the state mean income in the
           ensuing four years. According to the 2003 estimate, Maryland households have
           experienced an $11,000 mean household income increase since 1999, a gain of
           16.3%, while Cecil County households have seen a $4,600 increase, a gain of 7.9%.
           Likewise, Cecil County falls below the state per capita personal income figure.
           Importance – Cecil County’s family incomes are lower than the state average and
           the gap is widening.
        d. Cecil County’s unemployment rate at 5.8% exceeded the state’s unemployment rate
           of 4.0% for 2003. In looking back over the past five years, Cecil County has
           consistently had a higher unemployment rate than the state average. Data for 2004,
           however, showed an encouraging drop in county unemployment figure. Importance
           – The county’s unemployment rate, though historically higher than the state’s has
           improved during the past year.
        e. A total of 7.2% of county residents live below poverty. This compares with a
           statewide individual poverty percentage of 8.5%. When ranked across the state,
           these individual poverty percentages place Cecil County 14th (Rank: 1=highest
           poverty) among the 24 jurisdictions. Importance – County poverty rates are lower
           than the state average placing the County in the upper 50th percentile of all
           counties in the state, thus though poverty exists, it is not disproportionately high as
           viewed from a state perspective.
        f. Maryland Department of Planning’s analysis indicates that monthly rent was shown
           to have increased an average of $9 per month between 1990 and 2000, ranking Cecil


                                                                                                    72
               14th of Maryland’s jurisdictions in rate of increase. Across the state, however, the
               constant dollar value for monthly rent decreased by $11. Importance – Though
               rents have increased, the rate of increase in the county is not disproportionately
               high compared to other counties in the state.
          g.   On the other hand, simply comparing 1990 and 2000 rental figures in Cecil County,
               there were net decreases seen in the number of units available at rents under $500 (-
               953 units) and net increases in the number of units available at rents over $500
               (+2,634 units) with the greatest increase in units available at rents between $750 and
               $999. Importance – The number of lower rent units in the county has decreased
               in the past few years.
          h.   During the first quarter of Fiscal Year 2005, which ended in September 2004, Cecil’s
               median price for houses jumped to $211,000. Between 1990 and 2000 the median
               sale price of owner occupied property in the county increased from $129,000 to
               $187,500, a 45.3% increase. Concurrently, statewide the median sale price of owner
               occupied property has increased from $150,000 to $221,103, a 47.4% increase during
               the same time period. Importance – Though the price of houses has increased in
               Cecil County, the rate of increase is approximately the same as the state average.
          i.   In Cecil County, there are 1,566 “extremely low-income renters” (families with
               income that falls below 30 percent of the area median income [AMI]), but only 845
               rental units are “affordable and available.” This leads to a county shortage of 720
               low income units. Importance – The shortage of low income housing puts a large
               group of low income renters “at-risk” of not being able to locate affordable
               housing.
          j.   In Cecil County, it takes an annual income of $30,840 or an hourly wage of $14.83 to
               afford a two-bedroom apartment. Importance – Affordable housing is beyond the
               income of many low income families.

    The following points reflect on the existence of homeless services:

         a. According to the Maryland Department of Human Resources Office of Transitional
            Services “2005 Directory of Emergency Shelters and Transitional Housing Programs”
            (updated 12/23/04), there are currently seven (7) providers serving the homeless with
            DHR funds in Cecil County. These seven providers have an 87 shelter bed capacity1;
            29 emergency shelter beds; eight transitional shelter beds and 50 “undesignated.” Of
            these, 22 are designated for battered women and children only. Importance – These
            data are consistent with what was found in the current provider survey conducted
            for this study.
         b. Between FY01 and FY03, “turnaway” occasions (of homeless from shelter beds due
            to lack of resource) increase from 390 to 1035. Importance – There appears to be a
            shortage of beds for men especially during the winter. Cecil County reports serving
            more women and children than are served in other jurisdictions. This may be due
            to the number of beds designated for women and children.


1
 The 2003 OTS Annual Report (most recent available) indicates that there are 93 shelter beds in Cecil County. It is
unclear which number is an accurate reflection of current shelter bed capacity.



                                                                                                                73
2. Key Informant Interviews
   Stakeholders’ Comments:

      a. The stakeholders’ assessment of the extent of the problem of homelessness in Cecil
        County ranged from, “Not a problem—really a mental health problem,” to “Major
        problem.” Three (3) of the interviewees felt that the community did not see it as a
        significant problem or it was either a, small, or modest problem while five (5)
        characterized homelessness as a major or significant problem. Importance – There
        was a pronounced lack of consensus among the key informants as to the extent of
        the problem of homelessness.
      b.The most frequently mentioned contributor to homelessness was substance abuse
        (including both drug and alcohol abuse). The second most frequently mentioned
        contributor was mental illness, though other contributing factors named by the
        interviewees fell into a cluster of concerns around “life skills,” work ethic, life
        expectations, self-esteem, and decision-making ability. Combined, these contributors
        were mentioned a total of eight times – compared to nine for substance abuse and
        seven for mental illness. Importance – There was a consensus that mental illness
        and substance abuse and other “personal characteristics” rather than economic
        factors were the most significant contributing factors to homelessness.
      c. Both affordable housing and additional shelter space were the two most frequently
        mentioned unmet needs in the county. Importance – Though they were not named
        as the cause of homelessness, the respondents saw housing and shelter space as an
        important need to be addressed to help the homeless.

   Previously Homeless Key Informants (Four interviewed, one male, three female):

      a. Drug and alcohol abuse played a significant role in causing the homelessness of two
         of the respondents; however, for the other two, being a single mother with no job and
         lack of child care were cited as primary causative factors. Importance – Though the
         sample was small, both economic and personal issues were mentioned as
         contributing factors to their condition. For the women, economic reasons were
         more pronounced.
      b. Respondents pointed to jobs, affordable housing, shelter help and child care as
         factors helping them out of homelessness. Importance – Affordable housing and
         shelter care were noted by both key informant groups as a high priority need.

  Comparison of the two groups:

     a. While three of the stakeholders felt that the problem of homelessness in Cecil County
        was non-existent, small, or modest, five believed that homelessness was a major or
        significant problem. All four of the previously homeless respondents characterized it
        as “very big.” Importance – It is not surprising that the group who experienced
        homelessness rated it as a more serious problem than the group who had not been
        homeless.
     b. Among stakeholder key informants, personal factors such as drug or alcohol abuse,
        mental illness, poor work ethic, or low personal expectations were seen as primary



                                                                                           74
         contributors to homelessness. The previously homeless respondents focused more on
         the economic contributors to homelessness such as high rent, “not enough money,”
         lack of jobs. Low income or affordable housing was the most frequently mentioned
         unmet need in both groups of respondents. Stakeholders also ranked additional
         shelter beds high as an unmet need. Importance – Though there was disagreement
         about causation, both groups saw the need for affordable housing and shelter.

3. Provider Survey
     a. The terms temporary, emergency, and homeless shelter were used interchangeably
         by respondents in the survey. If grouped together, for the homeless—no matter the
         description—emergency, temporary, or homeless shelter—was the greatest unmet
         need during the survey week. Importance – It is not surprisingly that shelter was
         seen as the greatest need since the survey took place in January during the coldest
         weather of the winter.
      b. Ten of the 13 respondents mentioned affordable housing as one of the top three
         needs of the homeless in Cecil County. Affordable housing also got the most
         mentions (7) as the top need. Too few employment opportunities that can provide a
         living wage for low-skilled, non-seasonal workers was the second most frequently
         mentioned contributor to homelessness. Substance abuse was given as the third most
         significant contributing factor. Importance – Affordable housing, employment, and
         substance abuse help were all factors that were repeated in the study across
         settings.

4. Homeless Survey
   A primary goal of the study was to determine the number of homeless individuals in Cecil
   County at the time of the study. Though there is no way verify the accuracy of the number
   given the difficulty of doing a census of the homeless, we think that because of the
   diligence of the surveyors, nearly all of the homeless were identified and that the 75
   individuals interviewed and ten who declined to be interviewed, represent at least 75% or
   more of homeless population in Cecil County during January and February 2005. In other
   words, our estimate of the number of adults who were homeless during the study time
   period is between 85 and 106. The following summary is based on this estimate.

      a. Almost two-thirds (65.3%) of the sample were white, and 25.3% were African
         Americans. Another 6.7% were Hispanic and 2.6% were “Other”. For comparison,
         according to 2000 Census, the percentage of African Americans was 3.9%, and the
         percentage of Hispanics was 1.5% in the county-wide population. Importance –
         Given the rigor that went into finding homeless individuals to be interviewed for
         the study, it is very likely that the population of homeless in the county is composed
         of a greater percentage of non-white individuals than their percentage in the
         general population.
      b. The mean age of the respondents was 46 years and almost half (44%) were age 50
         and older. Importance – The median age for the survey respondents was higher
         than that of OTS 2003Annual Report. That could be due to several reasons;
         perhaps the two most likely are that the interview respondents group contains
         individuals who may not have requested services and would thus not be counted;


                                                                                            75
     the other reason is that the OTS data was collected two years ago and used a
     different methodology.
c.   Only about 13% (12.7%) of the respondents reported being married or living in a
     common-law situation. Importance - The vast majority of the homeless were
     single.
d.   Only about a fourth (26.7%) have a long term pattern of homelessness, with less than
     half (43.4%) reporting being homeless for the first time less than two years earlier.
     Importance - Less than half of the respondents reported being homeless for the
     first time; therefore, a majority have a repeated history of homelessness.
e.   It appears that the trend among respondents is that once the respondents became
     homeless the tendency was for them to stay that way. Of those interviewed, 80.5%
     indicated that since their first incident of homelessness they had remained that way
     for 100% of the time. Importance – Homelessness for this group appears to be
     chronic.
f.   As compared to only 2% of respondents who reported being hospitalized for general
     medical reasons, 16% reported being hospitalized for psychiatric reasons and, of
     those, 75% report two or more psychiatric admissions. This indicates that
     respondents overwhelmingly use the hospital for mental health reasons rather for
     physical problems. Importance – Given other indicators of mental health
     problems, this finding is a very important indicator of the need for the availability
     of mental health services for this population.
g.   A third (33.3%) said that the use of drugs (not including alcohol) has caused a
     problem for them in the past thirty days. Importance – Given the tendency for
     people to under-report drug use, this is very high percentage to report a problem
     with drugs.
h.   Less than 10% (9.7%) said that they have used “a lot” of alcohol in the past thirty
     days. Importance – Given the response to the earlier question on drugs, it appears
     that drugs are a bigger problem than alcohol for this population.
i.   Men were more likely than women to report that drugs had caused them problems at
     some time in their lives and that they were currently drinking “a lot.” Importance –
     Gender was related to substance abuse.
j.   Over half of the respondents (69.3%) report having worked for pay previously in
     their lives, but a little less than one-third (30.7%) had worked for pay in the thirty
     days preceding their interview. Importance – There was a loose attachment of the
     respondents and the workplace.
k.   Friends seemed to be a greater source of support to respondents than were family for
     help. Importance – This is one of several indicators that the respondents had weak
     family connections.
l.   One-third (33.3%) reported feeling that their lives have been “somewhat” to “very”
     satisfying while another 44.0% reported mixed feelings. Importance – On a whole,
     the respondents were not that unhappy with their lives, thus it is possible that they
     may be less motivated to change.




                                                                                        76
5. Personality Assessment Screener
       a. Nearly 80% of respondents recorded scores that indicate a high potential for
          emotional and/or behavior problems. Importance – This statistic indicates a very
          large percentage of the respondents suffer some emotional or mental-health-
          related disorder.
       b. The respondents had elevated scores on all ten of the elements that compose the PSA
          with especially scores on Social Withdraw, Acting Out, and Psychotic Features.
          Importance – The PSA results strongly suggest the need for supportive mental
          health services.



    B. Discussion
   The data from all the data sources point to two themes: first, there is a need in Cecil County
   for more affordable housing, as the economic and housing data demonstrate that there is an
   insufficient stock of lower rent housing to serve county residents. Secondly, the problems
   with the current homeless population may have less to do with the economy and with
   housing availability than with the populations’ individual personal characteristics.

    The purpose of this study was to examine the problems of homelessness in Cecil County.
   As part of this effort we discovered a large group that we have named the “near-homeless.”
   These are people who “double-up” with friends or relatives or who find other living
   arrangements to avoid homelessness. They make up the vast majority of those who go to the
   Resource Center and who use the resources/support from other public and private agencies
   and churches. The near-homeless are many times visible in the waiting room of DSS or at
   community kitchens. They are among the 1,566 “extremely low-income renters” with
   incomes 30% below the median incomes. These are the people who were on the minds of
   many of the key informants and service providers when they advocated for additional lower
   income housing. If one conservatively estimated that the 1,566 extremely low income
   renters represent a three-member household, there are approximately 4,700 individuals in the
   county who may have serious problems finding and maintaining housing. For this population
   of near-homeless and the temporarily homeless, efforts to expand the availability of low cost
   housing are essential.

   For most of the 75 homeless individuals who were interviewed for this study, lack of work
   was not the primary cause an individual respondent’s state of temporary homelessness. Many
   (nearly 70%) are currently estranged from employment; most (80%) appear to have severe
   emotional/mental health issues; some have a history of substance abuse, and most have a
   significant history of homelessness. Most were what the literature refers to as chronic
   homeless. Though some of the “near homeless” have short periods of “situational”
   homelessness because of family violence and/or family breakups, the vast majority of cases
   studied were homeless for reasons other than economic hardship.

   The following recommendations are made to address the problem of chronic homelessness.
   They are based on the latest best practices research findings.




                                                                                                77
 C. Recommendations
In 2004, the United States Department of Housing and Urban Development Office of Policy
and Research issued a comprehensive report on ending chronic homelessness. This report,
entitled Strategies for Reducing Chronic Street Homelessness, examined the efforts of seven
cities to reduce homelessness and identified common elements of success or best practices.
Though Cecil County does not contain a large city, it is classified on the U. S. Urban-Rural
Continuum as a “1” or a county in a metro area of one million population or more, making it
a non-rural area. In addition, most of those identified as homeless were staying in the Elkton
area; therefore, a strategy that views the problem as primarily an Elkton community issue
seems justifiable.

The 2004 report identified 11 key elements for successful programs. This set of elements
defines the philosophy and practices that are common among successful programs. Together
they do not define a specific program in the narrow sense of the word; however, they do
provide the outline of what a successful program should look like. They are specific enough
to allow replication, yet broad enough to be adjusted to individual situations. The emerging
consensual model for homeless programs is away from the shelter and provision model to a
community-wide focus on eliminating chronic homelessness through mainstream public
agency programs which maintain permanent supportive housing.

HUD found five of the identified elements essential to all seven successful programs that
they studied. In addition, a catalytic element was important in four of the communities to the
success of the models. Finally, there were five contributing elements which strengthened the
probability for a program to be successful. These elements are:

   Essential Elements:

           •   A paradigm shift
           •   A clear goal of ending chronic homelessness
           •   Community-wide level of organization
           •   Strong leadership and an effective organizational structure
           •   Significant resources from mainstream agencies

    Catalyst Element

           •   Trigger event

    Contributing Elements

           •   Significant resources from the private sector
           •   Commitment and support from elected officials
           •   Outcome evaluation mechanisms for program support and improvement
           •   Openness to new service approaches
           •   Strategies to minimize negative neighborhood reactions to projects




                                                                                            78
Essential Elements

1. Paradigm Shift

The report maintains that of all necessary elements the most important is a paradigm shift (a
different way of thinking about chronic homelessness) away from traditional homeless programs
to a new community-based approach. The old paradigm was that the street homeless should be
cared for by charitable, often religious, agencies rather than by mainstream public agencies. The
old paradigm relied extensively on emergency shelters, transitional housing, and sobriety-based
programs. The old paradigm had no plan to end chronic homelessness.

The new paradigm focuses on ending chronic homelessness through an integrated community-
wide approach featuring broad participation by mainstream public agencies. In addition, the new
focus is on ending, not treating homelessness. As part of this shift, communities had to
recognize that the old model was not working and that something new had to be tried. New
permanent supportive housing programs are essential to the model as are other new resources.
Existing programs may continue, but they need to be integrated into the new model.

At the center of the new paradigm is a call for low-demand permanent supportive housing with
mental health, substance abuse, and social services available. Low-demand means that residents
do not have to use the services consistently—a situation which can cause resistance from
traditional providers until these providers understand and adopt the new model.

Locally one can see the beginnings of new paradigm thinking at the Mental Hygiene
Administration in the adoption of the co-occurring treatment model of addressing mental health
and addictions together.

2. A Clear Goal of Ending Chronic Homelessness

A common feature of successful programs is that they have an explicit goal of ending chronic
homelessness. The focus is away from emergency or even transitional programs to permanent
supportive housing. Though such programs go by different names, they follow a “housing first”
model with low demands. This goal appears to be compatible with Meeting Ground’s basic
philosophy. The next step will be to get the community to endorse the goal.

3. Strong Community-Wide Level of Organization

A community-wide level of organization exists when agencies work together to end chronic
homelessness. Organizations need to cooperate on three levels: communication, coordination,
and collaboration. The levels are listed in hierarchical order from the easiest achieve to the most
challenging.

Communication is the first level of cooperation and requires only a minimal loss of autonomy
for involved organizations. Communication simply requires the organizations to share accurate
information about programs, services, and clients. This leads to a formal referral process and
shared meetings and committees. This level of cooperation already exists in Cecil County with
the providers committee.

The next level of cooperation is coordination. At this level, agencies work together to develop
common resources. They do not, however, work to develop common programs or shared
governance.




                                                                                                 79
The highest level of cooperation is collaboration. At this level, organizations work together to
develop common goals and programs. Collaboration always involves some loss of autonomy
and is therefore frequently resisted.

4. Strong Leadership and an Effective Organizational Structure

Strong leadership is critical in the development of successful community-wide approaches. It is
the people and not the system that make a successful effort. People make things happen. The
research into successful programs always points to the importance of effective leadership.
However, leadership without an effective organizational structure is insufficient for success. The
specific structure is less important than its ability to link people and resources.

5. Significant Resources from Mainstream Public Agencies

Ending chronic homelessness requires resources well beyond those of programs like Meeting
Ground. Major commitments of resources are needed from housing, health, mental health,
substance abuse, and social services. Public agencies have four roles to play:

       •   Facilitating homeless people’s access to services
       •   Developing specialty approaches
       •   Establishing funding priorities
       •   Contributing leadership of various types

Getting the “buy in” from mainstream agencies can be challenging, but it has been shown to be
very important to the eventual success of programs.

Catalyst Element
 Ability to Capitalize on Trigger Events

 Timing seems to be an important variable to the success of many programs. “Trigger” events
 stimulate a re-examination of a community’s approach to chronic homelessness. In Cecil
 County this report could trigger such a re-examination.
Contributing Elements
 The last five elements are identified as Contributing Elements—associated with success but not
 essential to the model

 1. Significant Involvement of the Private Sector

 In addition to governmental agencies, private business and foundations provide sources of
 support for programs to reduce homeless. Private business becomes involved as part of
 redevelopment projects. Organizations such as the United Way, or in Cecil County, the Brown
 Trust, have the potential to make a significant contribution to the community-wide effort of
 reducing homelessness.




                                                                                                   80
 2. Commitment and Support from Elected Officials

 Commitment and support from elected officials can be a significant contributing factor in the
 success of community-wide efforts to reduce chronic homelessness. Their support lends
 creditability and influence to the process.

 3. Outcome Evaluation Mechanisms for Program Support and Improvement

 Program process and outcome evaluations are essential to program improvement and
 accountability. Successful programs used data to demonstrate the effectiveness of their efforts
 or to make needed changes in a timely fashion. The primary variables that these evaluations
 examined were:

       !   Homeless street headcount
       !   Number and percentage of chronically homeless who have moved into permanent
           housing
       !   Reductions in cost of providing emergency health, mental health, and other services
           to the homeless
       !   Reductions in days homeless, hospitalized, or incarcerated
       !   Less recidivism in homeless

 4. Openness to New Service Approach

 Ending homelessness requires new service approaches and new ways of thinking about
 homelessness. It requires new ways of helping people (such as harm reduction), new ways of
 providing old services (such as housing first), and new agency relationships (such as joint
 provision of mental health and addictions services). The tendency of many service systems is
 to continue to do things the same old way; however, openness to change is very important to
 success.

 5. Strategies to Minimize Negative Neighborhood Reaction to Locating Projects

 Frequently people resist the location of housing for the homeless in their own neighborhoods.
 Careful selection of locations and well-planned community programs can go a long way in
 mitigating these problems.


Conclusion
The secondary data on Cecil County describe an area that is rapidly growing. Cecil County’s
growth rate is fifth in the state, and that is projected to continue growing through at least 2010.
In addition, the population is relatively young with a median age of 35. Cecil County’s
population also has a lower educational attainment than the statewide population with only
16.4% of county residents having attained a bachelor’s degree or above compared to 31.4%
statewide.

The economic and housing picture relative to the area is mixed. While Cecil County’s poverty
rate is lower than the state average (7.2% vs.8.5%), the unemployment rate exceeds that of the



                                                                                                      81
state (5.8% vs. 4.0%); the number of lower rent units in the county has been decreasing over the
last decade, and there is a shortage of low income and affordable housing.

Given this picture it is, therefore, not surprising that Cecil County has three distinct groups
affected by or threatened with homelessness. There is clearly a large group of individuals who
are “near-homeless” meaning that although they are currently able to find living arrangements as
a means of avoiding being homeless, they are not able to be independent in those living
arrangements. Although the study did identify this group, the group was not included in the
survey because its members were not actually homeless according to the operational definition of
“homeless” used in the study; therefore, little is known about the characteristics of the people
who make up this group beyond what was said earlier (see page76). However, it should be noted
that the “near homeless” clearly do impact the service delivery system in Cecil County and need
to be studied in order to gain a clearer picture of the County’s low income housing needs.

Among the actively homeless we find two distinctive sub-groups. There are those for whom
being homeless is relatively new and others who have been homeless for a longer period of
time—for whom homelessness is a more chronic state.

This “two group” dynamic is especially evident in the data on education and employment.
Slightly fewer than a third of respondents (30.7%) have less than a high school education while
over 40% (42.7%) did graduate from high school, and 27% of respondents have some college or
advanced degrees. A similar picture emerges from the employment data where approximately a
third of respondents report having worked in the past thirty days, yet almost two-thirds had not
had a fulltime job in six months or more.

Data addressing the reasons for homelessness among these individuals show a similar
dichotomous picture. Of the top six reasons for homelessness, three were economic in nature
(unemployment, problems paying rent, eviction) while the other three were more interpersonal in
nature (substance abuse, family conflict, family dissolution).

That there are clearly two distinct profiles of individuals who are homeless in Cecil County is an
important fact for service providers in the area. This fact suggests the need for a wide array of
services to meet a broad continuum of needs. For example, for those persons who are not
chronically homeless, it is realistic to assume they might merely need the services of a non-
structured supportive environment designed to allow them to regain personal autonomy with the
goal of becoming economically and interpersonally successful. On the other hand, there are
those individuals who appear to be more chronically homeless and, therefore, may well need
more structured case management supplemented with mental health and substance abuse
services.

What should be noted about both those who are “chronic” and those who are “newly” or
“situationally homeless” is that the data show they originate from Cecil County or the
surrounding areas. It is, therefore, not the case that they are transient. These are primarily
individuals who report “always living” in the county. This is important to note because it
contradicts the belief that Cecil County’s homeless are individuals who have come to the
county because they are homeless. On the contrary, they are residents of the county who have



                                                                                                82
become homeless. While it is beyond the scope of this report to suggest a causal link between
the county’s employment, housing, and economic issues and the county’s homeless, it is
reasonable to speculate there is enough of a link to suggest that an affordable housing study
might be considered as a “next step” in understanding this dynamic.

In terms of government and non-profit resources for the homeless, respondents indicated using a
wide range of both resources. Although this use of services was quite broad, there was a clear
preference for services provided by the Community Kitchen which was used by over 90% of the
respondents. In addition, this facility was noted as number one in terms of usefulness and
helpfulness. Although it is beyond the scope of this work to understand specifically what it is
about this service that makes it uniquely valued by the respondents, it clearly is seen as critically
important. A suggestion for future work is to study this resource to determine what specific
factors, methods, and philosophies have contributed to its obvious success in the eyes of those
needing homeless services. It is possible that the “paradigm shift” discussed on pages 77 and 78
of this study may be already beginning in Cecil County at the Community Kitchen.

A first step in addressing the issues of homeless persons in Cecil County will inevitably entail
the community’s discussion of the data in this report and the community’s commitment to reach
consensus about the nature of the problem and what they want to do about it. As mentioned
earlier, this report could be the catalytic event which starts that conversation.




                                                                                                   83
Section V

Appendices




             84
 Appendix 1

Resource Guide




                 85
                            Area Resource Guide

Federal, State, and County Agencies

Cecil County Health Department
  501 Bow Street, Elkton, MD
      WIC Nutrition Program
        Economic and Nutritional Needs
                  (For appointments)               (410)996-5255
               Maternal Health                     (410)996-5155
               Pregnancy                           (410)996-5135
               Pediatric Consultation              (410)996-5100
      Community Health Services                    (410)996-5100
               Clinic                              (410)996-5100
               Child Health                        (410)996-5145
      Upper Bay (Mental Health Dept.)
        401 Bow Street, Elkton                     (410)996-5104
      Core Service Agency                          (410)996-5112

Cecil County Government
            General Information                    (410)996-5200
            General Information, Rising Sun Area   (410)658-4041
     Circuit Court
                 General Information               (410)996-5200
     Public Defender                               (410)996-0640
          Legal assistance, Child Support
     Board of Education
               Elkton                              (410)996-5400
               Rising Sun Area                     (410)658-5577
               Head Start                          (410)287-3936

Emergency Numbers
     Maryland State Police                         (410)398-3815
             JFK Highway Barrack                   (410)378-3186
             Northeast Barrack                     (410)398-8101
     Sheriff
             Cecil County                          (410)398-3344
                                                   (410)996-5500
              TTY/TDD only                         (410)398-1350
     Local Police
              Elkton                               (410)398-4200
     Fire & Ambulance                              (410)398-3815
     Poison Center                                 (800)492-2414



                                                                   86
Housing and Energy Assistance
      Elkton Housing Authority                               (410)398-5018
      MEAP (Maryland Energy Assistance)                      (800)352-1446
                                                             (410)996-0270
Maryland Dept. of Human Resources
  St. Paul St., Baltimore, MD
                      General Information                    (800)332-6347

Social Security Administration                               (410)398-7396
  Big Elk Mall (next to Popeye’s)
            Replacement card - Proof of birth required
      Supplemental Security Income (SSI)                     (800)772-1213
            Proof of birth and medical exam required

State Department of Social Services
  170 E. Main St., Elkton, MD
     AFDC                                                     (410)996-0100
            Aid to Families and Dependent Children
     Family Services                                          (410)398-4060
            Medical Card
     Family Support                                           (410)392-9272
            Food Stamps
     Temporary Disability
            Apply at social services 8 AM (Medical exam required)

Veterans’ Administration
  Charles Lutz                                               (800)949-1003 (ext. 5808)
     VA at Perry Point                                       (410)642-2411 (ext. 5005)
     Veterans’ Center
           Tom Pinder                                        (410)569-0050
      Medical Emergency                                      (800)865-2441

Vocational Rehabilitation                                    (410)398-7866
      DORS (Dept. of Rehab Services)                         (410)996-0620

Non-Profit Agencies and Services
Emergency Assistance
      American Red Cross                                     (410)398-2470
         Landing Lane & High St., Elkton
                   Fire emergency assistance
      Cecil County Help Center and Salvation Army
        135 E. High Street, Elkton, MD
             Steve Rice or Sam Haley                         (410)996-0260
             Fax                                             (410)996-0696


                                                                                         87
                    Emergency formulas or medications
                    Clothing, Food, Financial Assistance
                    Note: Must be referred by DSS
      Traveler's Aid
         204 N. Liberty St. Baltimore, MD                   (410)658-3569
                            (Nights & weekends)             (410)658-5874

Crisis Intervention Hotlines
      Domestic Violence/Rape Crisis                         (410)996-0333
      The Family Tree                                       (800)243-7337
            Family Stress, Child Abuse Prevention,
            Parent Stress, Sexual Assault, Spouse Abuse
      SARC (Harford Co.)                                    (410)836-8430
      Youth Crisis Hotline                                  (800)422-0009
      Suicide Hotline                                       (800)652-2929

Adult Education and Job Training
      Elkton Center for Adult Education
         105 Railroad Ave., Elkton
             ESOL (ESL)                                     (410)392-3366
             G.E.D. Day and evening classes                 (410)658-4836
             Family Support Center                          (410)996-0510
               G.E.D. and job training day care available   (410)392-9272
             Job Start Program                              (410)392-3366 (day)
             Job Start Transportation                       (410)392-3366 x 639
                    (Evenings/weekends)                     (410)287-6060 x 639
      Wage Connection (Harford County)
         975 Beards Hill Rd., Aberdeen
                    Job transitional services, education

Health, Health Transport, and Age-Related Services
      HIV/AIDS Resources
             Aids Action Hotline                            (410)837-2437
             Gift of Mary Mother Theresa Convent
                     Office                                 (410)494-7424
                     Residence                              (410)497-9941
                     Betty Bland                            (410)752-1593
      Medical Transportation                                (800)827-8287
             (Call 24 hours ahead)                          (410)996-5171
              MDRC                                          (410)287-5023
      On Our Own                                            (410)620-7300
             Mental health self-help
      Senior Center                                         (410)398-7228
              Transport for Seniors                         (410)996-5298
              General Information                           (410)996-5295



                                                                                  88
Maryland Homeless Shelters & Services
Emergency Shelters
     Anna's House (Harford County)                             (410)803-2130
     Clairvaux Farm
         21Veazey Cove Rd., Earleville, MD
                 Udo Sommerhoff                                (410)275-8990
                     Emergency housing for men, women,
                     and families
     Domestic Violence Shelter (Elkton)                        (410)996-0333
     Echo House                                                (410)836-1688
     George Porter House
         138 Mackall St., Elkton, MD
                 Marsha Mazza                                  (410)398-4381
                     Transitional housing only for men & women
                     Written application required
     Haven House (Elkton)                                      (410)398-5868
                     Drug & alcohol
     House of Ruth                                             (410)889-0333
         2201 Argonne Dr., Baltimore, MD                       (410)889-0554
                             Legal Clinic                      (410)889-0804
     Meeting Ground
         Cecil County, MD
     My Sister's Place                                         (410)727-3523
         123 W. Mulberry St., Baltimore, MD
     Oxford House                                              (410)398-4076
         High St., Elkton, MD
     Pregnancy Center                                          (410)398-7888
         247 S. Bridge St., Elkton, MD
                     Mon, Wed, Sat 9 AM- 12 noon
                     Weekends 6 PM - 8 PM
                       Has some used baby equipment
     Project Place                                             (410)539-5177
         139 E. North Ave., Baltimore, MD
                     Women's shelter
     Settlement House
         168 E. Main S., Elkton, MD
                   Alice Tarr                                  (410)392-8066
                                                               (410)392-6848
                  Fax/Resident phone                           (410)392-6324
                     Emergency & transitional housing for men
     St. Mary Anne's Episcopal Outreach                        (410)287-5522
         North East, MD
                      Office                                   (410)287-2230
     Wayfarers House
         107 Delaware Ave., Elkton


                                                                               89
                Marsha Mazza                                    (410)398-4381
                    Emergency housing for women
                    & women with small children
     Witsett Center                                             (410)778-7055
                                                                (410)778-6404

Food Pantries/Community Dinners
     Elkton Community Kitchen
        Elkton Presbyterian Church
        209 E. Main St., Elkton, MD
                    Fridays 12-1 PM - free lunch buffet & takeout
     Perryville United Methodist Church
               Florence Little                                 (410)642-3411
                    Saturday soup kitchen 11 AM-Noon
                    Emergency assistance
     Baptist Bible Church
        144 Appleton Rd., Elkton                               (410)396-2688
                    8 AM - 4 PM, Mon - Fri
                    Food Pantry (Call in advance)
     Harford/Cecil Foodbank
        Rt. 40, Aberdeen, MD                                   (410)272-1883
                                                               (877)913-3338
     First Baptist Church of Elkton                            (410)398-2915
        607 Delaware Ave., Elkton
                    Food pantry for Elkton residents only
                    9 AM - 2 PM, Mon - Fri

Other Faith-Based Services

     Chesapeake City Ecumenical Association, Inc.
             Bud McKee                                            (410)885-3244
                    Frenchtown Rd. to Bohemia River only
     Faith in Action
             Mary Davis                                           (410)275-8511
                    Sassafras River to Bohemia River only
     First Assembly of God                                        (410)398-4234
         290 Whitehall Rd., Elkton
                    Food, limited financial assistance
     Glorious Presence Church                                     (410)392-3456
         1522 Singerly Rd., Elkton
                    Food, some clothing, limited financial assistance
                    9 AM - 2 PM, Mon - Fri
     St. Vincent dePaul Society
             Rectory                                              (410)642-6534
             Fax                                                  (410)642-2234



                                                                                  90
                   Serving western Cecil County
    Immaculate Conception/St. Jude Outreach
            Dorothy Fritz                                    (410)398-2110
            Fax                                              (410)398-1175
                   Open Mon, Wed, Fri, 9:30 AM- 12 Noon
    Janes United Methodist Church
        Rising Sun, MD
            Rev. Jim Jones                                   (410)658-6800
            Fax                                              (410)658-9905
    Leeds United Methodist Church
        Blueball Rd, Elkton, MD
             Don Hurst or Mrs. Pat                           (410)398-1897
    Maranatha Baptist Church                                 (410)398-3764
        3141 Old Elk Neck Rd, Elkton
                   Limited benevolence funds
    Seventh Day Adventist Churches
        Providence, Rising Sun, and Blythesdale, MD
            Anna Gall or Rev. Stevenson                      (410)642-3411
    Ray of Hope Mission Center
        Rising Sun/Port Deposit, MD
             Frank Rinaldi                                   (410)658-7799
                   Hunter's Sale Barn
    St. Mary Anne's Episcopal Church Outreach
            Office                                           (410)287-2230
            Fax                                              (410)287-5602
                   Open Mon, Wed, Fri      9:30 AM – 12 Noon
    Wesley United Methodist Church
            Church secretary                                 (410)392-3031
            Fax    (410)398-9091
                   Elkton/North East area
                   No walk-ins; appointments only
                   Mon and Tues 12 Noon - 5 PM and
                   Thurs 9:30 AM - 2:30 PM

Substance Abuse Support Groups
    Al-Anon
      Support groups for family & friends of alcoholics
      Cecil County                                        (410)398-2004
                 Elkton Presbyterian Church, Sundays 7:30 PM
                    307 E. Main Street, Elkton, MD
                 AFG at Good Shepherd School, Tuesdays 8 PM
                    Aiken Avenue, Perryville, MD
                 AFG at North East Methodist Church, Fridays 8 PM
                    308 South Main Street, North East, MD



                                                                             91
Alcoholics Anonymous
     Cecil County                                   (410)272-4150
                                                    (800)570-4150
           New Life Group, Sundays 7:30 PM
              Elkton Presbyterian Church
              209 E. Main St., Elkton
           A Port in a Storm, Sundays 7:30 PM
              Nesbit Hall
              (across from Tome United Methodist Church)
              Main Street, Port Deposit, MD
           Serenity Group Special, Mondays 12 Noon
              Alcohol and Drug Building
              Beyers Health Center
              401 Bow Street, Elkton, MD
           Monday Night Group , Mondays 8 PM
              First Presbyterian Church
              Biddle St., Chesapeake City
           Spirit of Life Group, Mondays 8 PM
              Immaculate Conception School
              Bow Street Extended, Elkton
                   Basement entrance
           Rising Sun Group, Mondays 8 PM
             West Nottingham Presbyterian
              Rising Sun, MD
                   Basement of school building
           Almost Serene Group, Tuesdays 8 PM
              Zion Methodist Church
              Main Street, Cecilton. MD
           Three Legacies Group, Tuesdays 8 PM
              Conwingo Baptist Church
              Conwingo, MD
                   Basement
           North Street Group, Tuesdays 8 PM
              Beyers Health Center
              401 Bow Street, Elkton, MD
           Freedom Group, Tuesdays 8 PM
              Good Shepherd School
              Aiken Ave, Perryville, MD
           Trinity Group, Wednesdays 8 PM
              Trinity Episcopal Church Group
              Main & Bridge Sts., Elkton, MD
           Big Book Group, Wednesdays 8 PM
              North East Methodist Church
              S. Main Street, North East, MD
                   2nd floor      Women's meeting
           12-Step Meeting, Wednesdays 8 PM


                                                                    92
               West Nottingham Presbyterian
               Rising Sun, MD
                    Basement of school
            Serenity Group Special, Thursdays 12 Noon
               Beyers Health Center
               401 Bow St., Elkton, MD
            Chesapeake City Group, Thursdays 8 PM
               United Methodist Church, Elkton,MD
            12 & 12 Group, Thursdays 8 PM
               St. Mary Anne's Fellowship Hall
            Port Deposit Meeting, Thursdays 8 PM
               Nesbit Hall
               Main Street, Port Deposit, MD
               317 S. Main St., North East, MD
            Just for Today, Thursdays 7:30 PM
               10 Walnut St., Rising Sun
                    Next to St. James United Methodist
            Bow Street Beginners, Fridays 8 PM
               Beyers Health Center
               401 Bow St., Elkton, MD
            Friday Night Group, Friday 8 PM
               North East Methodist Church
               South Main St., North East, MD
            Saturday Night Live Group, Saturday 7:30 PM
               Union Hospital cafeteria, Elkton, MD
                    2nd floor
            As Bill Sees It, Saturdays 8 PM
               Perryville United Methodist Hall
               Susquehanna Ave. & Broad St.
               Perryville, MD
            Saturday Group, 10 PM
               Zion Methodist Church
               Bow Street Extended, Elkton, MD


Nar-Anon
     A support group for friends and family of addicts
     St. Marks Church, Perryville, MD            Mondays 8 PM
              Debbie                                   (410)378-0620
                   First names only

Narcotics Anonymous
   Free State Region Hotline                         (800)317-3222
     (Meeting Codes: O=open, C=addicts, D=discussion,
      W=wheelchair accessible, St=step, T=tradition,
     Beg=beginners, NS=no smoking, TS=text study,


                                                                       93
            RR=round robin, Sp=speakers)
            Against All Odds
               Union Hospital (conference room B)   Sundays 7:30 PM
               High Street, Elkton                  O, D, Sp
            Just for Today
               First Baptist Church of Elkton       Mondays 8 PM
               607 Delaware Avenue, Elkton
            Cleaning Up
               St. Marks Church                     Mondays 8 PM
               St. Marks Church Road, Perryville    O, D, NS, St
            Spiritual Break
               Health Department                    Tuesdays 12 Noon
               401 Bow Street, Elkton               O, TS
                                                    Wednesdays 12 Noon
                                                    O, B, T, D
                                                    Wednesdays 8 PM
                                                    NS, O, D, Sp
            Nature of Recovery
              Trinity Episcopal Church              Tuesdays 7:30 PM
              Main & Bridge Sts., Elkton            C, D, TS
            Way We Can
              Rock Church, MD                       Thursdays 8 PM
                                                    O, D
            Day By Day
              Union Hospital (conference room B)    Fridays 7:30 PM
              High Street, Elkton, MD               O, Alt.
            We See the Light
              West Nottingham Church                Fridays 10 PM
                  1195 Firetower Rd., Colora, MD           O, D

Delaware Services & Homeless Shelters
Crisis Intervention Hotlines
            Runaway Hotline for Children                  (302)654-0808
                   24-Hour Hotline
            Child Abuse and Neglect Report Line           (800)292-9582
                   24-Hour Hotline
            Domestic Violence Hotline, Child, Inc.
                   New Castle County, DE                  (302)762-6110
                   Kent /Sussex Counties , DE             (800)874-2070
                   Families in Transition                 (302)422-8058
            Delawareans United to Prevent Child Abuse
                   New Castle County, DE                  (302)996-5444
                   Kent County, DE                        (302)674-1112
                   Sussex County, DE                      (302)856-1737



                                                                          94
Emergency Shelters
          Amazing Grace Outreach Ministry                  (302)777-7791
             4531 Summit Bridge Rd.
             Middletown, DE 19709
          Andrew's Place                                   (302)652-8278
             Eighth & Orange Street
             Wilmington, DE 19801
                 Winter shelter for men, October- April
          Casa San Francisco                               (302)684-8694127
             Broad Street                                  (302)684-8708
             PO Box 38
             Milton, DE 19968
          Crisis House
             Sussex Community Crisis Housing Services Inc. (302)856-2246110
             North Railroad Ave
             Georgetown, DE 19947
          Door of Hope                                     (302)834-46962884
             Summit Bridge Road
             Bear, DE 19701
                 For pregnant women w/ 1-2 pre-school children
          Emmaus House                                     (302)737-224134
             Continental Ave.
             PO Box 9740
             Newark, DE 19714
                 For families
          Friendship House                                 (302)652-8573
             Eighth & Orange Street
             Wilmington, DE 19801
                 Women's Day Center
          Friendship House                                 (302)652-8278
            Third & Walnut Street
            Wilmington, DE 19801
                 Men's Day Center
          Haven Place Night Shelter                        (302)652-8033
             Eighth & Orange Street
             Wilmington, DE 19801
                 For working men
          House of Joseph I                                (302)652-0904
            1328 West 3rd Street
            Wilmington, DE 19805-3662
                 For working men
          Love, Inc.                                       (302)221-5683
                 Referrals in Delaware
          Martha's House
                       Day phone                           (302)764-7545
                       Emergencies                         (302)429-0580


                                                                               95
           Mary Mother of Hope House I                       (302)652-8532
              1103 West 8th Street
              Wilmington, DE 19806-4605
                  For women
           Mary Mother of Hope House II                      (302)652-1935121
              North Jackson Street
              Wilmington, DE 19801-3670
                  For women & children
           Mary Mother of Hope House III                     (302)652-0970515
              North Broom Street
              Wilmington, DE 19805-3114
                  For women & children
           Sojourner's Place                                 (302)764-4713
                  No Children, must be 21 years old
           Sunday Breakfast Mission                          (302)652-8314110
              North Poplar Street
              PO Box 342
              Wilmington, DE 19899
                  For men
           Salvation Army
              400 North Orange Street
              Wilmington, DE 19899
                  Main office                                (302)656-1696
                  Shelter                                    (302)472-0760
           Whatcoat Social Service Agency                    (302)734-0319381
              State College Road
              Dover, DE 19947
                  No single men

Child and Family Services
           Child Mental Health
             Northern New Castle County (North of Canal)     (302)633-5128
             Southern New Castle County (Myrna to Canal)     (800)969-4357
             Kent and Sussex Counties (South of Myrna)       (302)424-4357
           Child Watch                                       (800)752-9393

           Childrens’ Advocacy Center of Delaware            (302)651-4566
           Children and Families First                       (302)655-6486
                  Counseling for Spanish speaking families
           Families First                                    (302)658-5177
           Warmline
            Child, Inc.                                      (302)762-8938
                  Parent Support/Information
            Kent County/Sussex - Child, Inc.                 (800)874-2070
            New Castle County - Child, Inc.                  (302)762-8938



                                                                                96
Drug and Alcohol Treatment
             Delaware Detox                                     (302)995-8610
             Recovery Center                                    (302)836-1200
                                                                (302)836-3080
HIV/AIDS Resources
             AIDS resource person
                Delores Macklan                                (302)656-6473
             Daughtry House                                    (302)654-5214
                   For HIV positive men and women
             SCAC (Sussex County Aids Committee)               (302) 644-1090
                P O 712
                Rehoboth Beach, DE 19971
                    Services for people with HIV/AIDS, referrals, transportation, support

Other Resources and Services
      Alternatives                                              (302)836-8924
      Catholic Charities                                        (302)762-9244
      Contact Delaware
         Kent/Sussex                                            (800)262-9800
         New Castle County                                      (302)761-9100
         Statewide Hearing Impaired Helpline                    (302)761-9700
      Delaware Helpline                                         (800)464-4357
      How to Help
         Volunteer Hotline                                      (800)244-5373
          Foster Parent Information                             (800)464-4357
      Net Counseling                                            (302)633-4343
      Traveler's Aid                                            (302)656-1667
         Wilmington, DE
      United Way                                                (800)492-0618
                                                                (410)685-0525
                                                                (302)657-8104
      YWCA                                                      (302)658-7161

Pennsylvania Emergency Shelter
Water Street Rescue Mission                                     (717)393-7709
Lancaster, PA
       Families




                                                                                            97
         Appendix 2

Cecil Provider Survey Comments




                                 98
#3 – Comments:

   !   Three of these (4) individuals were living in cars and one in the local park
   !   The DV Shelter is part of a larger program that serves others that are not in shelter;
       however, these numbers only reflect those in shelter
   !   During January we served 5 adults and 6 children in motels. None during survey period.
       Office was closed Monday due to weather so only open 2 out of 3 scheduled mornings
   !   Of those seen (3 individuals and 10 in 2 family groups), applications were made but
       benefits are still pending for two in food stamps; one in MA; and seven in TCA.
   !   The blanket/ personal care packages are available thru Mom’s kitchen, a nonce a month
       “open meal” hosted by Trinity UMC Youth Ministries. 4-8 people attend some meal
       each month from Clairvaux Farms. On average 4-6 each month attend from Elkton who
       are known to be homeless and use our shuttle service
   !   Of the 45 served during this week, 15 were transitional housing and 30 is an unduplicated
       count of those receiving meals and served in the day program.

#4 – Comments:
   ! The Elkton Community Kitchen serves one meal each week. Numbers attending the
       kitchen at the beginning of the month are always smaller than a the end of the month
       when monthly checks have been spent
   ! The 12 sheltered people all received counseling about Domestic Violence and I logged
       this as mental health treatment
   ! We serve 2-4 families a month who are housing with other families, facing eviction or in
       substandard housing (I.E. travel trailers, garages, etc.)

#5 – Comments:

   !   Transportation is very limited
   !   Many residents cannot enter Social Service Bldg because they have no ID (cost $20 at
       MVA) so cannot apply for services
   !   This is the coldest season of the year. Shelters are full. Three of the homeless have cars
       in which they sleep. Thanks to the United Methodist Church of Elkton, I was able to
       provide warm sleeping bags to these people.

#6 – Unmet Needs/ Solutions

First (3 pts)
   ! Affordable housing availability/ More affordable/subsidized housing opportunities
   ! Affordable housing/ Work on NIMBY; require developers to do set asides for low and
        moderate income renters
   ! Lack of affordable housing/ No solution offered
   ! Available shelter space/ More government support
   ! Inadequate existing resources (shelters)/ More shelters
   ! Insufficient emergency/ transitional housing for demand/ Add more beds/open more
        shelters
   ! Adequate emergency shelter space/ Limit length of time one can stay at shelter



                                                                                                99
   !   Full shelters/ more shelters
   !   Lack of affordable rental units or housing/ Build more low income housing
   !   Low income/ affordable housing – especially for single adults under 55/ Incentives to
       build/ provide lower cost housing for single adults
   !   Housing – lack of affordable units and Education – lack of available resources to help
       re-train not only employment wise but day to day living/ Development of a center where
       persons could receive a multitude of services by able trainers and an out-source group to
       follow up thereafter
   !   Housing – too expensive; landlords take advantage of tenants; not available close to
       work/ Build affordable (transitional?) rental housing; build more single room occupancies
       or rooming houses to share expenses. ALL must be affordable!!!

Second (2 pts.)
   ! Full-time employment with insurance/ More job opportunities with benefits
   ! Safe havens (cold weather drop in locations)/ Work to identify and support a providers
      who can do the difficult job of offering shelter to those who are unable/ unwilling to be
      clean and sober
   ! Lack of public transportation/ No solution offered
   ! Cooperation of local agencies/ Better communication between agencies
   ! Short term housing while they wait on list/ Family shelter
   ! Low cost housing/ Pray…tough to blame landlords who need to cover costs
   ! Affordable housing/ Develop transitional housing programs with intensive case
      management services
   ! Our government regulations are too complex. Takes too long to process homeless
      families. Too much pressure is put on non-profits to place families. Government falls
      back on regulations; we are left holding the bag/ Ease up on government regulations.
      Have government officials who make homeless regulations spend a week in their cars.
   ! Lack of transitional housing program for domestic violence victims. We only have 8
      week emergency shelter program. Often there is no place to go but back to abusers./
      Develop transitional housing program for DV victims. Needs to be 12 – 24 months long.
   ! Public/ Community transportation. Without a car it is very difficult to reach new
      employment centers in county and outside (Perryville)/ Provide transportation along Rt.
      40 from Elkton to Perryville; provide transportation from outlying areas to Elkton
   ! Blighted housing areas – there are many blighted areas in Elkton/ Research cost to
      continue development of affordable housing while working with those needing this or
      being responsible residents
   ! Medical follow-up. Drugs too expensive; no where to go when released from hospital/
      More transitional housing with some medical overnight; drug prescription plan

Third (1 pt.)
   ! Transportation/ Public transportation/ buses
   ! A wider variety of transitional housing options/ Create scattered site rental units whose
       residents receive a variety of case mgmt and aftercare services from any one of the
       mental health/substance abuse/VA/DV or other resources
   ! Counseling/ Local agencies need to work together to guide the homeless back into
       society



                                                                                            100
   !   Low income housing/ Intervention from government for federal housing and section 8
   !   Transportation/ Improve bus access
   !   Mental health/ substance abuse treatment (lack of insurance for same)/ Make health care
       available to everyone
   !   Transportation to employment/ Get better public transport
   !   Jobs with benefits, especially health and disability insurance/ Encourage job growth/
       expansion of business here with tax incentives to help provide benefits.
   !   Day care – safe and affordable/ A community-based project with sliding scale for fees.
       His could provide both employment and safe day care.
   !   Limited social services and church safety net/ ??
   !   Lack of emergency shelter/ ??


#7 – Contributors to Homelessness

First (3pts.)
   ! Affordable housing – it is impossible to work a minimum wage job and pay market value
        for housing. Subsidized housing lists are 1-4 years wait.
   ! Lack of housing component to mental health and substance abuse services
   ! Substance abuse
   ! Lack of affordable housing
   ! Education – more job training
   ! Poor judgment leading to unstable family units
   ! Lack of job skills
   ! Lack of employment
   ! Mental illness
   ! Medical disabilities – many lose their jobs (income) due to medical emergencies and
        deteriorating health
   ! Lack of employment with living wage – not enough industry.
   ! Lack of affordable housing

Second (2 pts.)
   ! Medical disabilities – limited benefits and 1 – 4 years for SSI approval
   ! Unmet transportation needs
   ! School drop outs
   ! Addiction – drugs and alcohol
   ! Shortage of non-skilled jobs and non-seasonal jobs
   ! Limited job skills/ job opportunities for those with limited job skills
   ! Drug/alcohol abuse
   ! Typical way of life
   ! Substance abuse
   ! Affordable housing – rental costs have gone up in recent year and individual with limited
      or low incomes can no longer afford local rents
   ! Transportation – no public transportation which would enlarge the potential areas to seek
      and maintain employment
   ! Low wage jobs and lack of transportation and housing to get folks to higher paid jobs



                                                                                           101
Third (1 pt.)
   ! Full time job opportunities available with insurance (too few)
   ! Inadequate preparation for employment that actually exists for people leaving the school
       system
   ! Poor job market – Jobs offering minimum wage cannot support an individual or a family
   ! Transportation (public)
   ! More low income housing (lack of)
   ! Limited low income housing
   ! Mental health issues
   ! Product of their environment
   ! Lack of resources including transportation and lack of affordable housing.
   ! Not enough job opportunities – especially for those with limited skills
   ! Lack of emergency shelter for true homeless
   ! Inability of Veterans Hospital and VA Administration to address needs of VETS, i.e.:
       residential housing of those receiving treatment


#8 – What can be done to prevent homelessness?

First (3 pts.)
   ! Affordable housing/ subsidized housing
   ! Jobs with benefits – most folks WANT to work
   ! Eviction prevention funds
   ! Better coordination among service providers regarding discharge planning
   ! In so many cases, homelessness is a direct outcome of uncontrolled circumstances
   ! More low income housing
   ! Mandate birth control until financial and economic responsibility is established
   ! I wish I knew!
   ! Don’t have a clue
   ! Establishing public transportation
   ! More affordable housing – especially for single adults under age 55, maybe more
        efficiency apartments, rooming houses, etc.
   ! Affordable housing!! Where no more than 30% of income is spent on housing.

Second (2 pts.)
   ! Temporary disability funds are very small (about $135/month). Medical care is
      limited and medications, if at all. Expedite SSI approval.
   ! Increase the available low income housing choices
   ! In the case of addiction, we need more rehab programs available to those without
      medical insurance.
   ! Job training
   ! Public transportation
   ! Improving mental health services and availability to people without insurance
   ! Eviction prevention funds – More emergency help with rent for those in at-risk
      situations



                                                                                          102
   !   Affordable child care that is available off hours when low wage earning mothers are
       working 2nd and 3rd shifts

Third (1 pt.)
   ! Sometimes a little assistance can prevent homelessness in the first place
   ! Increase penalties for violations of protective orders (including jail) in family violence
   ! Education for children in the welfare system so that they can learn to survive
       independently.
   ! Transportation to work
   ! Better usage/ coordination of jobs and job services
   ! Develop more low cost housing opportunities
   ! More jobs with insurance benefits for those with limited skills. Job training to
       match skills needed for area jobs

#9 – Additional Comments:
   ! These survey results need to be shared fully and completely with all of the
      organizations that responded. Open and free exchange of information in the only way to
      foster collaborations that lead to success.
   ! The Elkton area seems to “attract” homeless. I do not know why. They come from
      Delaware and Pennsylvania

   The following bullet, by request, should be attributed to an individual NOT the organization
   for whom she completed the survey
       The lack of public transportation is extremely limiting and coupled with the lack of
       reliable un-skilled labor job forces these marginally educated folks live consistently on
       the edge.
       There seems to be no mechanism for a casework or management system to really
       “adopt” these people and help them step-by-step improve their lives
   ! Stabilizing individuals/ families in a housing arrangement is critical. Meeting basic
       needs (re: food, clothing and shelter), is paramount to effecting change. Case
       management services, time limited, intensive services, can serve to move the family
       along toward independence
   ! Our government and community need to take a hard look at this problem. It doesn’t
       matter what brought on this homelessness situation, the fact is that men, women and
       children are sleeping in cars, tents and in abandoned buildings. We can’t say NO to
       anyone; I don’t want to be responsible for someone dying from the cold because they
       made a mistake in their finances or a poor judgment call about their life style.
   ! I would really like to see Cecil County provide public transportation outside of Elkton
       that would connect to public transportation currently available in Harford County,
       Maryland and Delaware. For those is the southern parts of the county that find
       themselves without a car, transportation to Elkton is very difficult. For those in Elkton
       who would like to apply for jobs in Perryville or Harford County – no public
       transportation is currently available. This also limits those without a car who might find
       lower-cost housing in other areas of the county to stay in Elkton to be close to shopping
       and government services but which force them to pay higher rents.




                                                                                             103
!   Cecil County has become a “bedroom community” for Newark, DE; Phil, PA; and
    Baltimore, MD. (yet) It remains “rural.” Lack of transportation and industry
    make it difficult to secure jobs with living wages. With so much seasonal employment,
    i.e. construction and tourism many families are a pay check away or a medical emergency
    away from disaster. The powers that be need to bring more jobs to the county and public
    transportation.
!   Public opinion needs to change! Need public debate and discussions.
    Homeless are not bad people. Affordable housing does not mean “bad people in my
    neighborhood.” And the homeless don’t come from other places to live in Elkton—they
    are home grown directly related to VA.
!   More gov’t friends at the State, Fed, local Level
!   Casinos for VETS organizations, etc




                                                                                       104
           Appendix 3

Key Informant Interview Questions

 Community Stakeholders’ Comments




                                    105
1. From your perspective, how large a problem is homelessness in Cecil County?

       a) There is real problem in the lack of affordable housing. There are 3 existing
          shelters (Wayfarers, Settlement House, Clairvaux Farm). They turned away 1000
          people last year. They are full every night and there is a waiting list. As soon as
          someone leaves the spot is immediately filled.
       b) It’s a problem that people generally don’t’ see. “I now recognize men on bicycles
          or in the park that I know are homeless because they have called for help”. Prior
          to that I would not have thought about these men as being homeless.
       c) “I am not sure how big a problem it really is in the county” Stakeholder feels that
          the homeless tend to be taken care independently though churches, shelters, DSS
          etc. Stakeholder also cited lack of accurate information to really make a
          substantial comment about how big the problem is. “The facts and information
          are not there – we don’t have accurate numbers to compare the problem, yet I
          know we do have homeless in the county.”
       d) Significant Problem. Some are from Delaware. There is a core group that are
          homeless for months at a time for various reasons. Some homeless get housing
          then lose housing and are homeless again.
       e) Not a problem – it really is a mental health problem
       f) Not large. It is a very low priority for the community decision makers
       g) A modest problem at best
       h) Major problem

2. How would you rank the problem of homelessness compared with other problems facing
   the county?

       a) “I feel that the problem is not ranked very high compared to other problems
          facing the county” (without proper information or people bringing the
          information to him, stakeholder “cannot compare it to some of our other county
          problems”)
       b) Seeing a younger group of homeless people
       c) Not a high ranking problem
       d) Not major – it is a subset of other problems like mental health or substance abuse
       e) Relatively low – in bottom third of concerns. It is less of an issue than it was 5-6
          years ago.

3. What factors do you think contribute to homelessness in Cecil County?

       a)   Alcohol and Drug Use
       b)   Mental Health Issues
       c)   Do not want to work and hold down a job
       d)   Low self view, See themselves as worthless
       e)   Drug dependency and alcohol issues
       f)   Decision making: poor choices financially
       g)   Minimal expectations about jobs, relationships, life chances, etc.




                                                                                           106
       h) “Lack of job interest” (respondent stated he knew jobs were available and many
           unemployed including homeless show no interest – ex. McDonald’s has jobs
           available but many people do not want to flip burgers - would rather be
           unemployed then to feel by a job)
       i) “Many people are homeless by choice” (no desire to work or better themselves -
           ok with being homeless.)
       j) Chronic substance abuse and mental illness and the depression that comes with
           the substance abuse.
       k) Don’t fit residential programs for mental health. Don’t want to follow rules.
           Can’t hold a job.
       l) Seeing a younger group of homeless using cocaine and alcohol. Don’t want to
           quit using. Not employable.
       m) Substance Abuse
       n) Mental Illness: The system wants the cooperative individuals, not ones that buck
           the system
       o) Lack of transportation
       p) lack of employment opportunities
       q) For the one time homeless, child care is an issue
       r) Severed relationships
       s) Substance abuse
       t) Mental illness
       u) Lack of low income jobs
       v) High housing/ rent costs
       w) Alcohol
       x) I-95 – people traveling on the highway just exit and stay for one of many reasons
       y) Mental health issues
       z) Substance abuse issues
       aa) Local programs attract NJ homeless
       bb) Substance abuse
       cc) Mental health issues
       dd) Other non-addresses problems (family problems)
       ee) There is a certain percentage (15%) that are new to the county

4. In your opinion, OVERALL what are the three most critical unmet needs among
   homeless individuals and families in Cecil County? Why (i.e., no resources, inadequate
   existing resources, other explanations, etc)?
5. For each critical unmet need you identified, what do you think would be the most
   effective way to address them?

       a) Case management from DSS
       b) Due to lifestyle (alcohol and drug use) can’t get into existing shelters
       c) Life skills training and education
          Solutions offered:
          ! Court appointed person (social worker) to handle important needs of
              individual (Ex: social security, housing)
          ! Wet shelter for this group of people



                                                                                        107
   !   Program with limited rules that would house homeless in one room
       bungalows. One kitchen/ cafeteria. Residents would share meals and receive
       life skills training and education. Each person would have a personal
       representative to help apply for disability and benefits. Allow a 6 month stay.

d) Housing, not enough shelters
e) Feelings that no one cares about them
   Solutions offered:
   ! Affordable housing, shelters
   ! Listen and help without putting conditions on the person
f) “Not knowing where to get help” Respondent knows we have resources but
   feels people don’t know where to start when things start getting bad in their lives -
   then when they do need help, they are in direr need.
   “Many do not want help – they feel ashamed and do not want others to know of
   their situation. So they do not get help, they don’t realize the various ways they
   can get help – not all help is from DSS or Social Services.” Overall, the county
   organizations are doing a great job helping people in Cecil County.
       ! No solutions offered
g) Place to stay, shelter
h) A days work
       Solutions offered:
       ! Shelters that would house this group. Limited rules, provide shower and
            meals.
       ! Day labor program.
i) Lack of shelter space
j) Lack of affordable housing
k) Lack of Mental Health services that deal with the uncooperative folks
       Solutions offered:
       ! More shelters where clients are made to get mental health and addiction
            treatment when warranted
       ! More section 8 housing
       ! More flexible program for difficult group. Workers that do not give up so
            fast and say person is too difficult to work with.. Losing housing through
            Mental Health system
l) Inpatient substance abuse treatment
m) Mental health services: residential programs are cut and people end up on the
   street.
n) Homeless people lack supportive relationships
       Solutions offered:
       ! Provide more beds for substance abuse treatment
       ! Greater efforts by churches providing accessibility to counseling.
       ! Restore relationships through God. Talk about relationships using
            Christian Principals. Drugs are taking the place of God in the relationship.
            Deal with anger, self abuse, spousal abuse and other issues. Model how to
            have right relationships with family, friends, employer, gov’t, etc. Deal
            with fines. Encourage relationship with God.



                                                                                    108
       o) A place to stay
          ! No easy solutions – alcohol treatment
       p) Affordable housing
       q) Racism restricts where people will live in low income housing
          ! NO solutions
       r) Affordable housing
       s) More and better transitional housing for men
       t) Transitional housing for abused women
       u) Wet shelter
          Solutions offered:
          ! Continue the Community Provider Group to coordinate efforts

1. Is there something that you can think of that would prevent future homelessness in the
   county?

       a) Ultimately they need Jesus Christ. Build relationships and share faith and try to
          help the person realize that there is more to life than just existing.
       b) Educate the near homeless on making good decisions on how to spend their
          money (have computers and cable TV but may not be able to buy food or pay
          rent).
       c) Help for the working poor. They make too much to qualify for aid yet can’t afford
          to live on what they make.
       d) Caseworker focused services to chronically homeless. More housing opportunities
          for people on SSI.
       e) Prevention is tied into two issues:
               ! The average age of a person seeking shelter is 30. A generation ago the
                  average age was 55.
               ! Young children are exposed to alcohol and drugs at younger ages
                  (majority of homeless will say they were under the age of 12 when they
                  began using). Tackle this issue early.
       f) Not prevent but MH and Addictions outreach would help
       g) Economic development
       h) Affordable housing
       i) More and better transitional housing for men
       j) Transitional housing for abused women
       k) Wet shelter
       l) No, can’t prevent problem. Have to deal with the problem that is there.




                                                                                            109
                  Appendix 4

        Homeless Survey Questionnaire

Key Informant Homeless Person Survey Questionnaire




                                                     110
Good (morning, afternoon, evening) My name is __________________.

OFFER TO SHAKE HANDS.

IF APPOINTMENT WAS ARRANGED BY A REFERRAL, START BY CONFIRMING IT.

Name of person who arranged referral _______________________________________.

Name of agency that person represents _______________________________________.

IF NOT AN ARRANGED APPOINTMENT ASK, Could we talk a bit?

I am working with a group of people from Meeting Ground who are interested in understanding
the problems of people in your situation. Have you been interviewed recently by anyone from
Meeting Ground on homelessness?

       1. YES - THANK THEM AND TERMINATE THE INTERVIEW
       2. NO - GO ON

1A. Where are you currently living? __________________(COMMUNITY) IF NOT IN CECIL
COUNTY OR UNDER 18 YRS OLD, TERMINATE

       01. MY OWN PLACE, APARTMENT --- NOT HOMELESS---TERMINATE
                                                   _______
       02. ON THE STREETS, IN A PARK, OUT OF DOORS         ) HOMELESS
       03. SHELTER TYPE SETTING                            ) GO TO 1D
       04. IN MY CAR                                       )
       05. ABANDONED BUILDING                     ________)
                                                   _________
       06. WITH A RELATIVE                                   ) GO TO
       07. WITH A FRIEND                                     )  Q1B
       08. HOTEL, MOTEL, SINGLE ROOM OCCUPANCY HOTEL ) and Q1C
       09. OTHER _____________________________     _________)
       98. DON’T KNOW OR       99. NO ANSWER         GO TO 1D

1B. How long have you been staying there?
       _______DAYS                 IF 45 DAYS OR MORE – NOT HOMELESS

1C. How long do you think you will stay there?               IF 45 DAYS OR MORE
      _______DAYS, _______WEEKS, _______MONTHS                   NOT HOMELESS

1D. MAKE DETERMINATION IF PERSON MEETS OUR DEFINITION.
IF NO – GO TO SUPPLEMENTAL QUESTIONAIRE
IF YES ---- GO ON




                                                                                         111
We are doing a study of people from Cecil County who do not have a regular place to
live and we’d like your help. It will take a short time – less than an hour --- for an
interview. I will ask you about how you are getting along, the kinds of services you
need and use, and about your health and well being. This interview is voluntary and once
we begin you may still decide not to answer some of the questions or you may decide to
stop before we are done. Your name is not on the questionnaire and we promise that
everything you tell us is confidential. Are you willing to help us by being interviewed?

IF YES, SAY – Before we begin I have to set up a code for you. Please give me your birth date
____ ____ ____ ____ ____ ____Gender ____ Random # ____ Go to Q2.

IF NO – THANK THEM AND COMPLETE THE SUPPLEMENTAL QUESTIONAIRE

Q2. When was the last time you had a home for at least 45 continuous days? By home I mean
having your own room, apartment or house; living in a home with a family, friends, or
caretakers, staying in a hospital, treatment facility or board and care home.

       WRITE IN        MONTH _____             YEAR _____

Q3. When was the first time you were homeless? MONTH _____ YEAR _____


Q4. About how much of the time between the first time you were homeless and now have you
been without a regular home? TOTAL DAYS ___ ___ ___ ___
CLARIFY IF AMBIGUOUS              PROBE – WRITE WHAT THEY SAY.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________

ESTIMATE A PERCENTAGE               _____%

Q5. During the past 30 days, how many nights did you sleep or rest:
                                                                                 Number of
                                                                                   Nights
01   In a shelter or mission?
02   In a rented room?
03   On the streets, in a park or campground, or in an empty abandoned
     building?
04   In a public place like a bus, bus station, all night movie, airport, bar?
05   In a relative’s or friend’s home or apartment?
06   In a car, truck, or van?
07   Not homeless?
08   Somewhere else?




                                                                                             112
Q6. Where did you stay last night?
     1. WITH A RELATIVE
     2. WITH A FRIEND
     3. ON THE STREETS, IN THE WOODS, A PARK, OUT OF DOORS
     4. SHELTER TYPE SETTING
     5. IN MY CAR
     6. HOTELS, MOTELS, RENTED ROOM
     7. OTHER _______________
     98. DON’T KNOW
     99. NO ANSWER

Q7. Do you have any relatives who do not have a permanent home?
      1. YES
      2. NO
      98. DON’T KNOW
      99. NO ANSWER                         0. INAP
      IF YES, What is their relationship to you? ____________

IN ALL THE SUBSEQUENT QUESTIONS, ASK ABOUT THE PAST MONTH IF THE
PERSON HAS BEEN HOMELESS 30 DAYS OR MORE. OTHERWISE, ASK ABOUT THE
TIME PERIOD DURING WHICH THE PERSON HAS BEEN HOMELESS (FOR EXAMPLE,
FOR THE PAST FOUR DAYS . . . .)

Q8. What are the major reasons you no longer have a permanent or regular home?
Please give me the three most important reasons: MARK 1. NEXT TO THE MOST
IMPORTANT REASON; 2. THE SECOND MOST IMPORTANT REASON; 3. THE THIRD
MOST IMPORTANT REASON.

      _____1 DIASTER
      _____2 EVICTION
      _____3 PROBLEMS PAYING RENT
      _____4 DEINSTITUTIONALIZATION
      _____5 FAMILY CONFLICT
      _____6 FAMILY DISSOLUTION (DIVORCE, DEATH, ETC.)
      _____7 UNEMPLOYMENT
      _____8 ALCOHOL/DRUG ABUSE
      _____9 GOVERNMENT BENEFITS STOPPED
      _____10 JUST LIKE TO MOVE AROUND
      _____11 RACIAL OR ETHNIC DISCRIMINATION
      _____12 PHYSICAL APPEARANCE
      _____13 INABILITY TO READ OR DO MATH
      _____14. OTHER: ______________________________________
           98. DON’T KNOW (DK)
           99. NO ANSWER (NA)




                                                                             113
Q9. Have you always lived in this county?
      1. YES – GO TO Q15_____
      2. NO                        )
      98. DON’T KNOW               ) ASK Q10
      99. NO ANSWER _______)

Q10. How long have you been in this county?        _______
      1. LESS THAN ONE WEEK                                )
      2. ONE WEEK TO ONE MONTH                             ) GO TO Q11
      3. MORE THAN ONE MONTH TO SIX MONTH                  )
      4. MORE THAN SIX MONTHS TO ONE YEAR _______)
                                  __________
      5. OVER ONE YEAR                       )
      98. DK                                ) GO TO Q12
      99. NA       0. INAP        __________)

Q11. In how many states have you lived during the past year? ______ (write number)

Q12. Where did you live just before you came to this county?
     _____________ City __________________ County _________________State

       98. DK
       99. NA        0. INAP

Q13. Why did you leave that place? (Circle One Only)
     1. NO JOBS
     2. TROUBLE WITH POLICE
     3. FAMILY PROBLEMS
     4. JUST LIKE TO MOVE AROUND
     5. HAD NO PLACE TO STAY
     6. NO SERVICES
     7. OTHER: ______________________________________
     98. DK
     99. NA        0. INAP

Q14. Why did you come to this county? (CIRCLE ONE ONLY)
      1. HEARD THERE WERE PUBLIC SLEEPING SHELTERS
      2. HEARD THERE WERE BETTER WELFARE BENEFITS
      3. HEARD THE POLICE LEAVE YOU ALONE
      4. HEARD THERE WERE JOBS
      5. TO TAKE A JOB
      6. TO LIVE WITH RELATIVE OR FRIEND
      7. OTHER: ______________________________________
      98. DK
      99. NA       0. INAP




                                                                                     114
Q15. (In the past month) what have you generally done about meals? (CIRCLE ONE)

       01. RESTAURANT
       02. COMMUNITY KITCHEN / SHELTER
       03. FOOD PANTRY; COOK MY OWN
       04. DUMPSTERS; TRASH
       05. VENDING MACHINES
       06. BUY AT STORE; COOK MY OWN
       07. HANDOUTS
       08. STEALING
       09. DO WITHOUT
       10. OTHER: _________________________________________
       98. DK
       99. NA

SOCIAL SERVICES / HOSPITALS

Q16. On another subject, have you ever been in a hospital for emotional or mental health
problems?

       1. YES IF YES, ASK: Q17
       2. NO         )
       98. DK        ) GO TO Q26
       99. NA ______ )

Q17. What type of hospital have you been in for these difficulties? Have you been in a:

                            YES      NO      Don’t      No        INAP       #
                                             Know      Answer              TIMES

a. Veteran’s Hospital
b. General or private
hospital
c. State Psychiatric
Hospital

IF YES, Use chart to record how many times you were in each type of hospital.

Q18. What is the name and location of the hospital where you were most recently?

       NAME: _______________________________________________
       STATE: _______________________________________________

       98. DK
       99. NA           0. INAP




                                                                                           115
Q19. Is this hospital
      1. a veteran’s hospital?
      2. a general or private hospital?
      3. a state hospital?
      98. DK
      99. NA

Q20. When did you last get out of (NAME OF HOSPITAL IN Q18)?
      ____________/__________(MONTH/YEAR)

       98. DK
       99. NA         0. INAP

Q21. When you were released from (NAME OF HOSPITAL IN Q18), where did they arrange
for you to live?
                                            ____________
       1. FAMILY                                        )
       2. OWN APARTMENT OR HOUSE                         )
       3. GROUP HOME                                     ) GO TO Q22
       3. HOTEL/MOTEL                                    )
       4. OTHER                             ____________)
                                            ____________
       5. NO ARRANGEMENTS WERE MADE                      )
       98. DK                                           ) GO TO Q23
       99. NA      0. INAP                  ____________)

Q22. Did you go to the place arranged for you to live?
      1. YES
      2. NO
      98. DK
      99. NA                 0. INAP

Q23. When you were released from (NAME OF HOSPITAL IN Q18), did that HOSPITAL talk
to you about going to a mental health center?
        1. YES        GO TO Q24
                               ______
        2. NO                          )
        98. DK                         )      GO TO Q25
        99. NA        0. INAP______)

Q24. Did you contact this mental health center, did they contact you, or what?
      1. I CONTACTED THEM
      2. THEY CONTACTED ME
      3. NO CONTACT
      98. DK
      99. NA                0. INAP



                                                                                 116
Q25. If you ever felt as though you were having those problems again, how would you feel
about returning to a hospital? Would you:
       1. LIKE TO GO BACK
       2. NOT MIND GOING BACK
       6. NOT WANT TO GO BACK
       7. NOT THOUGHT ABOUT IT
       8. WOULD GO BACK FOR SHELTER
       98. DK
       99. NA                  0. INAP

Q26. (In the Past Month), have you had any contact with a counselor or a case manager in a
mental health clinic?

       1. YES         IF YES, (PLACE)_______________ How many times _______
       2. NO

Q27. Have you ever been in jail for a misdemeanor?
      1. YES
      2. NO
      98. DK
      99. NA

Q28. Have you ever been in prison, workhouse or jail for a felony conviction?
      1. YES
      2. NO
      98. DK
      99. NA

IF YES TO Q27 OR Q28 ASK Q29. Did you have a place to stay when you were last released?
      1. YES
      2. NO
      98. DK
      99. NA           0. INAP

Q30. People go to a variety of services for help when they need it. Have you used any of the
following services (in the past month)?
                                                    YES NO          DK    NA     INAP

       Shelters                                    1       2      8      9       0

       Mental Health Clinic                        1       2      8      9       0

       Community kitchen                           1       2      8      9       0

       Hospital emergency rooms                    1       2      8      9       0



                                                                                               117
       Social services                              1       2       8      9       0

       Shelters for battered women                  1       2       8      9       0

       Substance Abuse Shelters                     1       2       8      9       0
       (Haven House, Oxford House)

       Halfway House                                1       2       8      9       0

       Churches                                     1       2       8      9       0



Q31. I am going to list some services and resources. I want you to indicate if you feel these are
useful services by telling me if you have used them or would use them.
                                                    YES NO         DK     NA      INAP

       Subsidized housing                           1       2       8      9       0

       Community kitchen                            1       2       8      9       0

       Job placement assistance                     1       2       8      9       0

       Mental health counseling                     1       2       8      9       0

       Physical health care                         1       2       8      9       0

       Welfare support                              1       2       8      9       0

       Family planning clinic                       1       2       8      9       0

       Reading/basic education                      1       2       8      9       0

       Job training                                 1       2       8      9       0

       Alcohol treatment program                    1       2       8      9       0

       Drug treatment program                       1       2       8      9       0

       Shelters (any type)                          1       2       8      9       0
       Single Room Occupancy (SRO)                  1       2       8      9       0

       Mobile Homes                                 1       2       8      9       0

       Central listing of available rentals         1       2       8      9       0



                                                                                              118
       Transportation                             1      2       8      9      0

       Affordable child care                      1      2       8      9      0

       other (specify) ___________________        1      2       8      9      0


EMPLOYMENT HISTORY

Q32. On another subject, have you worked for pay in the past month?
      1. YES                GO TO Q33
                    __________
      2. NO                     )
      98. DK                    ) GO TO Q36
      99. NA      ___________)

Q33. Have you been working full-time, part-time, on a day-to day basis, or some other way?
      1. PERMANENT FULL TIME
      2. PERMANENT PART-TIME
      3. DAY LABOR
      4. TEMPORARY JOB
      5. OTHER ___________________________
     98. DK
     99. NA        0. INAP

Q34. What kind of work did you do during the past month?

________________________________________________________________________

Q35. About how many hours have you worked for pay in the last month?

           ___________# of hours

IF MORE THAN 100 HOURS, GO TO Q39; IF LESS GO TO Q37

Q36. Have you ever had a job?
      1. YES GO TO Q37

       2. NO    GO TO Q39
      98. DK                                ) GO TO Q39
      99. NA            0. INAP_____________)


Q37. When did you last work full time?




                                                                                             119
          ____________/_________ (MONTH/YEAR)
      98. DK
      99. NA             0. INAP

Q38. Why did your last full time job end? (CIRCLE ONLY ONE)
     1. IT WAS TEMPORARY ONLY
     2. COMPANY CLOSED/MOVED
     3. FIRED
     4. QUIT
     5. POOR PHYSICAL HEALTH
     6. DRINKING/DRUGS
     7. POOR MENTAL HEALTH
         OTHER: ______________________________________
     98. DK
     99. NA         0. INAP

Q39. What keeps you from working in a regular job now? (CIRCLE ONLY ONE)
     1. DISABLED; CAN’T WORK
     2. DO NOT FEEL READY TO WORK
     3. DO NOT KNOW WHERE TO LOOK FOR WORK
     4. I PLAN TO LOOK FOR WORK
     5. I’VE LOOKED BUT CAN’T FIND WORK
     6. I DO NOT WANT TO WORK
     7. DO NOT NEED TO WORK
     8. DO NOT WANT TO RISK LOSING BENEFITS
     9. HAVE TO TAKE CARE OF CHILDREN
     10. DO NOT HAVE TRANSPORTATION
     11. OTHER _____________________________________________________
     98. DK
     99. NA        0. INAP

Q40. What kind of work can you do? (WRITE UP TO 3 JOBS)
    1. ______________________________________________________________
    2. ______________________________________________________________
    3. ______________________________________________________________

Q41. Have you had any income (during the past month)?

     1. YES GO TO Q42
     2. NO           )
     98. DK          ) GO TO Q43
     99. NA__________)

Q42. Would you be willing to tell me your primary source of income? (CIRCLE ONLY ONE)
     1. EARNINGS
     2. WELFARE



                                                                                   120
     3. FAMILY; FRIENDS
     4. CHARITY
     5. SOCIAL SECURITY (retirement)
     6. PENSION (VA or other)
     8. SUPPLEMENTAL SECURITY INCOME (SSI/SSDI)
     7. NO; REFUSED
     9. OTHER _______________________________________________
    98. DK
    99. NA        0. INAP


MEDICAL

Q43. Now I’d like to ask you some questions about your health. How would you describe your
health? Would you say it is:
    1. good
    2. fair
    3. poor
    98. DK
    99. NA

Q44. Do you currently have any major health problems for which you should see a doctor?
   1. YES ____      GO TO Q45
   2. NO        )
   98. DK       ) GO TO Q46
   99. NA _____)

Q45. What sorts of problems do you have: (RECORD ONLY TWO)

       RESPONSE ONE: ______________________________________________
       RESPONSE TWO: ______________________________________________
   98. DON’T KNOW
   99. NO ANSWER

Q46. Have you received any medical care for yourself in the last month?
   1. YES            GO TO Q47
   2. NO            GO TO Q48

Q47. What king of medical person did you see?
      PROFESSIONAL ________________________ PLACE___________________

Q48. When was the last time you saw a doctor/other medical person for your health?
   1. IN THE LAST 3 MONTHS
   2. 4-6 MONTHS AGO
   3. 1-12 MONTHS AGO
   4. 1-2 YEARS AGO



                                                                                          121
   5. MORE THAN 2 YEARS AGO
   98. DK
   99. NA

Q49. When was the last time you saw a dentist?
   1. IN THE LAST 3 MONTHS
   2. 4-6 MONTHS AGO
   3. 1-12 MONTHS AGO
   4. 1-2 YEARS AGO
   5. MORE THAN 2 YEARS AGO
   98. DK
   99. NA

Q50. Have you ever been hospitalized over night for a physical illness?
   1. YES            GO TO Q51
          _______
   2. NO          )
   98. DK         ) GO TO Q52
   99. NA_______)

Q51. Please give me the year you were hospitalized and the reason?
       Year                         Reason
   ____________              ___________________________________________
   ____________              ___________________________________________
   ____________              ___________________________________________

Q52. Have you ever been diagnosed with the following:

                                                    YES    NO      DK     NA   INAP

       Asthma                                       1      2       8      9    0

       Allergies                                    1      2       8      9    0

       Anemia                                       1      2       8      9    0

       Addiction to alcohol/drugs                   1      2       8      9    0

       Bronchitis                                   1      2       8      9    0

       Cancer                                       1      2       8      9    0

       Diabetes                                     1      2       8      9    0

       Frost bite                                   1      2       8      9    0




                                                                                      122
       Gastroenteritis (stomach problems)         1      2      8      9      0

       Headaches                                  1      2      8      9      0

       Heart Problems                             1      2      8      9      0

       Hepatitis                                  1      2      8      9      0

       High Blood Pressure                        1      2      8      9      0

       Kidney Problems                            1      2      8      9      0

       Liver Problems                             1      2      8      9      0

       Mental Health Problem                      1      2      8      9      0

       Neurological Disorders                     1      2      8      9      0

       Nerve problems                             1      2      8      9      0

       Pancreatitis                               1      2      8      9      0

       Tuberculosis                               1      2      8      9      0

       Venereal Disease                           1      2      8      9      0

       Other___________________                   1      2      8      9      0

       Females Only Endometriosis                 1      2      8      9      0

       Premenstrual syndrome (PMS)                1      2      8      9      0

       Yeast Infections                           1      2      8      9      0


Q53. During the past month have you taken any prescription drugs or medications?
      1. YES         GO TO Q54
             _______
      2. NO           )
      98. DK          )     GO TO Q55
      99. NA ______)
Q54. Were they prescribed, or given to you by a medical doctor?
      1. YES
      2. NO
      3. SOME WERE; SOME WEREN’T
      98. DK



                                                                                   123
       99. NA                0.INAP

Q55. (During the past month), has your use of any drug – not including alcohol or tobacco-
caused you trouble?
       1. YES
       2. NO
       98. DK
       99. NA               0. INAP

Q56. SHOW BUT DO NOT HAND CARD WITH DRUG LIST
        Here is a list of drugs. Have you ever used one of these drugs on your own more than 5
times in your life? By “on your own” I mean to get high or without a prescription or more than
was prescribed? Would you like me to read the list or would you rather read it yourself?
(READ LIST OR HAND TO RESPONDENT)

       1. YES
       2. NO          GO TO Q58

IF YES, Which drugs did you use more than 5 times?
MARK ALL DRUGS THEY SAY THEY USED MORE THAN 5 TIMES
      1. Sedatives (valium, Quaaludes, seconal, xanax, barbiturates, miltown, etc)
      2. Cannabis (marijuana, hashish, etc)
      3. Stimulants (speed, amphetamines, dexadrine, etc)
      4. Opiates (heroin, morphine, opium methadone, darvon, codeine, etc)
      5. Cocaine (crack, crank, freebase, etc)
      6. Hallucinogens (PCP, LSD, mescaline, peyote, STP, angel dust, etc)
      7. Other (steroids, glue, ecstasy, diet pills, sleeping pills)

Q57. Did you ever find you needed larger amounts of these drugs to get an effect or that you
could no longer get high on the amount you used to use?
       1. YES
       2. NO
       98. DK
       99. NA                 0. INAP

Q58. (During the past month), would you say you’ve been drinking……
      1. Some
      2. A lot, or
      3. Not at all.
      98. DK
      99. NA                0. INAP
Q59. Have you ever gone to anyone for help about drinking?
      1. YES
      2. NO
      98. DK
      99. NA                0. INAP



                                                                                               124
Q60. Did anyone ever think you had a problem drinking too much?
      1. YES
      2. NO
      98. DK
      99. NA                0. INAP

Q61. Have you ever drunk as much as a fifth of liquor in one day? That would be about 20
drinks, or 3 bottles of wine or 3 six packs of beer in one day.
        1. YES
        2. NO
        3. YES (says ONLY ONCE)
        98. DK
        99. NA                  0. INAP

Q62. Has there ever been a period of two weeks when every day you were drinking 7 or more
beers, 7 or more drinks or 7 or more glasses of wine?
        1. YES
        2. NO
        98. DK
        99. NA                0. INAP

Q63. Have you ever stayed overnight in a hospital or treatment program for problems with
alcohol?
       1. YES
       2. NO
       98. DK
       99. NA              0. INAP

Q64. Have you ever stayed overnight in a hospital or treatment program for problems with other
drugs?
       1. YES
       2. NO
       98. DK
       99. NA              0. INAP

Q65. Did you have a problem with drinking or drugs before you became homeless
      1. PROBLEM BEFORE AND NOW
      2. PROBLEM RESPONSE TO SITUATION (NOT BEFORE)
      3. NO PROBLEM BEFORE OR NOW
      98. DK         99. NA               0. INAP
Q66. Are you currently pregnant?
      1. YES         GO TO Q67
             ___________
       2. NO               )
      98. DK               )      GO TO Q72



                                                                                           125
       99. NA____0. INAP)

Q67. How did you find out that you were pregnant?
      1. CLINIC
      2. PRIVATE DOCTOR
      3. PREGNANCY TEST
      4. JUST KNOW MYSELF (NOT CONFIRMED BY DIAGNOSIS)
      98. DK
      99. NA                0. INAP

Q68. How far along are you? _____________ MONTH OF PREGNANCY

Q69. Are you receiving prenatal care?
      1. YES         GO TO Q70
      2. NO          GO TO Q72
      0. INAP

Q70. Where? ___________________________           0. INAP

Q71. How far along were you when you went for your first visit?
      __________WEEK OF PREG
      0. INAP

Q72. How many times have you been pregnant?
      0. ZERO     GO TO Q74

       __________WRITE NUMBER OF PREGNANCIES

Q73. How many children have been born to you?
      __________ WRITE NUMBER OF LIVE BIRTHS

Q74. I have some personal questions which I hope you will be willing to answer. They are
important for health reasons.
What percentage of the time do you or your current partner use contraception (or birth control?
       ________________
       1. Don’t use any                   )
       98. DK                             )        GO TO Q76
       99. NA                             )
       0. INAP         _________________)

      _______________ WRITE IN PERCENTAGE
Q75. What do you normally use? (CIRCLE ONLY ONE)
      1. condoms
      2. diaphragm
      3. foam/sponges
      4. pills



                                                                                             126
       5. withdrawal
       6. rhythm
       7. other ______________________________________
       98. DK
       99. NA       0. INAP

Q76. How many different partners have you had in the last 6 months?
      1. one
      2. between 2 and 4
      3. more than 4
      98. DK
      99. NA
      0. INAP

Q77. Do you have any relatives you can count on for help?
      1. YES
      2. NO, CAN’T COUNT ON
                            __________________
      3. NO, NO RELATIVES                         )
      98. DK                                      )       GO TO Q80
      99. NA                __________________)

Q78. How long has it been since you’ve had any contact with relatives?

       ______________________ (DAYS/MONTH/YEARS)
       97. TODAY
       98. DK
       99. NA

IF MORE THAN ONE MONTH, ASK Q79 IF LESS GO TO Q81

Q79. Is there some reason why you don’t have a contact with your relatives more often?
      (CIRCLE ONLY ONE)
      1. THEY WOULD NOT HELP
      2. I HAVE NO DESIRE TO MAINTAIN A RELATIONSHIP
      3. THEY DON’T WANT TO SEE ME
      4. THEY DON’T LIVE NEARBY
      5. IT’S BEEN TOO LONG SINCE I’VE SEEN THEM
      6. I’M ASHAMED OF CURRENT SITUATION
      7. OTHER: ___________________________________
      98. DK         99. NA                0. INAP
Q80. Do you have any friends you can count on for help?
      1. YES
      2. NO, CAN’T COUNT ON
                            ___________
       3. NO, NO FRIENDS                 )



                                                                                         127
       98. DK                         )           GO TO Q84
       99. NA        0. INAP__________)

Q81. Do you feel you have enough close friends?
      1. YES
      2. NO
      98. DK
      99. NA               0. INAP

Q82. How long has it been since you had any contact with friends?

      ______________________ (DAYS/MONTHS/YEARS)

      97. TODAY
      98. DK
      99. NA         0. INAP

Q83. Is there some reason you don’t have contact with friends more often?
               (CIRCLE ONLY ONE)
      1. THEY WOULD NOT HELP
      2. I HAVE NO DESIRE TO MAINTAIN A RELATIONSHIP
      3. THEY DON’T WANT TO SEE ME
      4. THEY DON’T LIVE NEARBY
      5. IT’S BEEN TOO LONG SINCE I’VE SEEN THEM
      6. I’M ASHAMED OF CURRENT SITUATION
      7. OTHER: ___________________________________
     98. DK
     99. NA                 0. INAP



DEMOGRAPHICS


Q84. What is your date of birth? MO_________DAY_________YR__________

Q85. How old does that make you?
     _____________ (YEARS)
      98. DK
      99. NA

Q86. Where were you born?
      _______________________(CITY) __________________________(STATE)
     98. DK
     99. NA




                                                                            128
Q87. Are you currently…_______
     1. married                   )
     2. living with a partner_____)        GO TO Q88
                            ________
     3. widowed                   )
     4. separated                 )        GO TO Q89
     5. divorced                  )
     6. never been married______)

Q88. Is your spouse/partner currently homeless with you?
      1. YES
      2. NO
     98. DK
     99. NA          0. IN

Q89. Do you have any children?
     1. YES        GO TO Q90
     2. NO         GO TO Q93

Q90. How many? _____________         0. INAP

Q91. Where are they living now?
      1. with you
      2. with other parent
      3. with relative or friend
      4. with agency
      5. OTHER (SPECIFY) ____________________________________________
     98. DK
      0. INAP

Q92. LIST INFORMATION FOR EACH CHILD IN CHART BELOW
                                                                  Who Do They
Gender      Age      In           Last Grade        Last Health   Live With
                     School?      Completed         Contact       1. With you
                     (Yes/No)                                     2. With other
                                                                  parent
                                                                  3. With relative
                                                                  or friend
                                                                  4. With agency
                                                                  5. Other_____
                                                                  98.Don’t know




                                                                                     129
Q93. How far did you get in school?
      1. NO FORMAL SCHOOLING
      2. 1-8TH GRADE
      3. 9-11TH GRADE
      4. HIGH SCHOOL GRADUATE
      5. SOME COLLEGE OR ADVANCED TRAINING
      6. COLLEGE GRADUATE OR ABOVE
     98. DK
     99. NA

Q94. Up to the time you were 18, did you ever live for more than 30 days….
       (CIRCLE ALL THAT APPLY)
      1. with a step parent
     2. with a relative, not your parent
      3. with a foster family
      4. in a treatment center
      5. in a group home or residential care
      6. in a corrections facility
      7. other __________________________
     98. DK
     99. NA           0. INAP

Q95. Have you ever been in the armed forces?
      1. YES___________
      2. NO               )        GO TO Q97
      98. DK              )
      99. NA__________ )

IF YES, What was your discharge status?
      1. HONORABLE
      2. DISHONORABLE
      3. GENERAL
      4. DK
      98. DK
      99. NA        0. INAP

Q96. Are you a Combat Vet?
      1. YES
      2. NO
      98. DK
      99. NA       0. INAP

Q97. With which of the following racial/ethnic groups do you identify yourself?
      1. White



                                                                                  130
       2. Black
       3. Hispanic
       4. Native American/ American Indian
       5. Asian/ Pacific Islander
       6. Other ________________
       98. DK
       99. NA

GENERAL WELL BEING

Q98. How would you rate your nerves, spirits, outlook, or mental health at present…
      1. excellent
      2. good
      3. fair
      4. poor, or
      5. very bad?
      98. DK
      99. NA

Q99. In general, how satisfying would you say your life has been…
      1. Very satisfying
      2. Somewhat satisfying
      3. Mixed
      4. Not very satisfying, or
      5. Not at all satisfying?
      98. DK
      99. NA

Q100. In your experience how much money would you need to make to afford adequate
      housing in Cecil County?




                                                                                      131
        Appendix 5

Interviewer Assessment Form




                              132
                                     POST MORTEM

COMPLETE THE INDIVIDUAL RESPONDENT CODE ON THE UPPER RIGHT CORNER
OF THE FIRST PAGE. THE FIRST 6 DIGITS ARE THE RESPONDENTS BIRTH DATE
FROM Q84; THE SEVENTH DIGIT IS THE RESPONDENT SEX- M OR F; THE LAST
DIGIT IS TAKEN FROM THE LIST OF RANDOM NUMBERS PROVIDED TO EACH
INTERVIEWER (8,4,7,6,5,3,0,9,1,2).

P1. Respondent refuses to shake hands.
    1. TRUE
    2. FALSE

P2. Was the interview completed?

    1. YES
    2. NO            IF NO,
                              P3. Why was this interview terminated?
                              1. RESPONDENT BECAME IRRITATED
                              2. SOMEONE ELSE INTERRUPTED
                              3. RESPONDENT WAS TOO DRUNK
                              4. OTHER____________________________________

P4. COMMUNITY/ MUNICIPALITIES
    1. Cecilton
    2. Charlestown
    3. Chesapeake City
    4. Elkton
    5. Northeast
    6. Perryville
    7. Port Deposit
    8. Rising Sun

P5. Interview location_____________________________________________________.

P6. Respondent’s sex:
    1. MALE
    2. FEMALE

P7. Interviewer name and phone #: __________________________________________

P8. Date: ____________________________

P9. Time of day: ______________________

P10. How accurate do you feel the respondents answers were?
     1. COMPLETELY ACCURATE



                                                                               133
     2. FAIRLY ACCURATE
     3. NOT VERY ACCURATE

P11. Did you feel the respondent was lying to you at any point during the questionnaire?

     1. YES
     2. NO
P12. Is there anything else noteworthy about this interview?

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________


                              EDITING AND CODING NOTES

Reviewed by: (County Coordinator)

___________________________________

_____complete         ______incomplete      ______meets definition

Edited by:
___________________________________

Editors comments:

______________________________________________________________________________

______________________________________________________________________________

____________________________________________________________


Coded by:

__________________________________________

Coder’s comments:




                                                                                           134
              Appendix 6

Personality Assessment Screen Instrument




                                           135
136
               Appendix 7

Demographic Characteristics of Respondents




                                             137
                     Demographic Characteristics of Respondents
Characteristic           Frequency               Percentage
Gender
Male                      59                     78.7
Female                    16                     21.3

Ethnicity
White                     49                     65.3
African American          19                     25.3
Hispanic                  5                      6.7
Other                     2                      2.7

Age
18-29 years               5                      6.7
30-39 years               13                     17.3
40-49 years               24                     32.0
50-59 years               29                     38.7
60 years and older        4                      5.3

Education
Completed grades 1-8      6                      8.0
Completed grades 9-11     17                     22.7
High school graduate      32                     42.7
Some college or           14                     18.7
advanced training
College graduate or       6                      8.0
above

Marital status
Married or living         8                      10.7
together
Separated                 17                     22.7
Divorced                  26                     37.7
Widowed                   5                      6.7
Never been married        19                     25.3

Veteran status
Yes                       20                     26.6
No                        52                     69.3
No Answer                 3                      4.0
Combat Veteran            12                     16.9




                                                                  138
           Appendix 8


Gender Differences in Respondents




                                    139
                            Gender Differences of Respondents
                  Males                                    Females
                  N=59                                     N=16
                  Frequency   Percent                      Frequency   Percent
Characteristic                             Characteristic
Ethnicity                                  Ethnicity
White             40          67.8         White           9           56.3
African           17          28.8         African         2           12.5
American                                   American
Hispanic          2           3.4          Hispanic        3           18.8
Other             0           0            Other           2           12.6

Age                                        Age
18-29 years       3           5.1          18-29 years       2         12.5
30-39 years       8           13.6         30-39 years       5         31.3
40-49 years       20          34.0         40-49 years       4         25.0
50-59 years       25          42.5         50-59 years       4         25.0
60 years and      3           5.1          60 years and      1         6.2
older                                      older

Education                                  Education
Completed         3           5.1          Completed         3         18.8
grades 1-8                                 grades 1-8
Completed         12          20.3         Completed         5         31.3
grades 9-11                                grades 9-11
High school       28          47.5         High school       4         25.0
graduate                                   graduate
Some college      12          20.3         Some college      2         12.5
or advanced                                or advanced
training                                   training
College           4           6.8          College           2         12.5
graduate or                                graduate or
above                                      above

Marital status                             Marital status
Married or        4           6.8          Married or        4         25.0
living together                            living together
Separated         13          22           Separated         4         25.0

Divorced          23          39           Divorced                    18.8
                                                             3
Widowed           4           6.8          Widowed           1         6.2
Never been        15          25.4         Never been        4         25.0
married                                    married




                                                                                 140
      Appendix 9

Patterns of Homelessness




                           141
                             Patterns of Homelessness

Where respondent
stayed night prior to
interview
                        Frequency                 Percentage
Doubling up             8                         10.8
   With family          1                         1.4
   With friends         7                         9.4
Mission or shelter      29                        39.2
Limited or no shelter   30                        40.5
   Car                  14                        18.9
   Street               8                         10.8
   Other                8                         10.8
Inexpensive hotels      7                         9.5
and motels
No answer               1                         1.4

Resident of county      60                        81.1
one year or more

Length of time
homeless
Mean                    715.9 days
Median                  270 days
Range                   10 days to 10 years




                                                               142
      Appendix 10

Reasons for Homelessness




                           143
                First Reason for Homelessness
Eviction                         9.3%
Problems paying rent             16.0%
Family conflict                  20.0%
Family Dissolution               9.3%
Unemployment                     20.0%
Alcohol/drug abuse               17.3%
Just like to more around         1.3%
Jail                             3.0%
Other                            3.7%



               Second Reason for Homelessness
Eviction                        13.3%
Problems paying rent            17.3%
Family conflict                 1.3%
Family Dissolution              16.0%
Unemployment                    5.3%
Alcohol/drug abuse              28.0%
Just like to more around        13.3%
Other                           5.3%


             Third Reason for Homelessness
Eviction                          14.7%
Problems paying rent              9.3%
Family conflict                   6.7%
Family Dissolution                9.3%
Unemployment                      13.3%
Alcohol/drug abuse                25.3%
Government benefits stopped       2.7%
Racial or ethnic discrimination   1.3%
Other                             17.3%




                                                144
           Appendix 11

Resources and Needs of Respondents




                                     145
                       Resources and Need of Respondents
                             Frequency       Percentage
Employment history
Have been employed            52             74.3
Worked in past month          23             30.7
Worked full-time              14             18.7
Had income during the past    40             53.3
month

Primary source of income for those who had income during the past month
Earnings                      22              29.7
Welfare                       3               4.1
SSI or SSDI                   0               0
Family or friends             2               2.7
Other                         9               12.2
Social security or pension    3               4.1
Respondents with relatives    36              48.0
they could count on
Respondents with friends      50              71.4
they could count on
Mental health needs
Prior hospitalization         27              36.0
Serious behavior problems
Serious psychiatric
problems

Physical health needs
No medical care for more      19             26.4
than a year
Have health problems          32             43.8
Pregnant                      1              2.5
Not receiving prenatal care   missing

Other indicators of need
Sought help for alcohol       10             13.3
problem
Served time for               24             32.0
Misdemeanor
Served time for felony        22             29.3
Experienced out-of-home       2              2.7
placement as a child




                                                                          146

				
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