Incentivized Sobriety Pilot Program for the Homeless

Health care access

San Fernando Valley Antelope Valley

Expand existing project, program, or initiative (expanding and continuing ongoing, successful work)

Hope the Mission is addressing the most prevalent issues of homelessness by providing an array of direct and immediate mental health and substance abuse services that include individualized therapy, group therapy, crisis intervention and counseling, suicide assessment and prevention, safety planning, life skills, substance use counseling, therapeutic activities and when necessary, linkages to psychiatric and medical services. These issues impact over 40% of those struggling with homelessness and we cannot expect long-term recovery unless we address the issues of mental health and substance abuse. In addition to the safety net services we provide of food, shelter, hygeine, healthcare, and safety, our goal is to empower everyone who comes to us so that when they leave, they will never be homeless again.

The Contingency Management Program is an “incentivized sobriety” pilot program that aims to promote harm reduction and sobriety among volunteer participants residing in one of two tiny home villages in the Southwest San Fernando Valley area. In collaboration with the City of Los Angeles Council District 3’s Office, Hope the Mission’s communities in Reseda and Tarzana are earmarked for this pilot program. Using a strengths-based approach of acknowledging successes through positive reinforcement, participants who yield a sample with only negative test results (i.e., negative, not preliminarily positive or invalid) on a multi-drug screen test at random testing dates will receive e-gift cards from select vendors. In accordance with SAMHSA best practices, the vendors listed do not sell alcohol and tobacco; as an additional measure, the vendors selected also do not sell firearms. To promote structural support and oversight with harm reduction and/or sobriety, an interdepartmental and interdisciplinary collaboration of leaders have established two goals and eight SMART-based objectives to determine outcome measures. To support implementation and clinical needs with harm reduction and/or sobriety, an interdisciplinary team will offer substance use-related assessments, interventions, and treatment. Meanwhile, linkages, referrals, and resources will also be offered to supplement substance use delivery and scaffold the hierarchy of needs for the participants.

According to data from HUD’s 2024 Continuum of Care Homeless Assistance Programs Homeless Populations and Subpopulations, nearly 27% of the surveyed participants endorsed chronic substance abuse. It is noteworthy to mention that the data specifically captures chronic substance abuse, where it can be extrapolated that less frequent use would likely yield higher results. It is also recognized that the presence of other variables could impact both homelessness and substance abuse, which can include, but are not limited to: employment challenges, incarceration, medical conditions, mental disorders, and trauma. The focus of this pilot program will be on the concurrent address of substance abuse treatment and housing needs, as SAMHSA’s Advisory on “Behavioral Health Services for People Who Are Homeless” highlights this as being the most effective model. If successful, the pilot program could demonstrate reduced emergency medical usage and law enforcement interactions among other benefits.