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from 51,303 in 1980 to 113,941 in April 1999. There are approximately 193.1 people per squaremile in St. Johns County. The unemployment rate for St. Johns County is 3.0%, one of thelowest in the state. St. Johns County has the 19th highest cost of living in Florida, which is3.08% lower than the state average. The median household income for the county is 33,960.Though tourism is the major industry in St. Johns County, the economy is also supplemented byaeronautics, aluminum extrusion, auto parts manufacturing, and health food preparation.INVENTORY OF SERVICES AVAILABLE TO THE HOMELESSTargeted populations. Many of the organizations and agencies (55%) from Region IVtarget their services to all persons irrespective of age, gender, needs, and/or problems. Morethan 22% of the respondents indicated they focus only on servicing children and youth. Onlyseven percent target their services only toward adults. The physically frail and/or medicallycomplex are specifically targeted by only one organization. No organization or agency focuseson providing services to only male adults.Outreach services. Table 1 presents the most frequently cited outreach services providedin Region IV. Mental health counseling service is the most common outreach service providedby the responding organizations in the region. In addition to these top five services, emergencyfood, elderly services, and street outreach are also provided. Despite the variety of outreachservices provided, 31.0% ofthe organization in Region IVdo not provide any outreachTable 1 Outreach Services Providedservices to the homeless. Notfor the Homeless in Region IVonly were the outreachservices examined in RegionMental Health Counseling Services31.0%IV, but they were also studied Case Management26.2%in each county. Most of theSubstance Abuse Treatment Referrals19.0%outreach services provided by Primary Health Care Referrals11.9%the respondents from ClayYouth Services9.5%County are mental healthcounseling services and case*Respondents were able to answer more than one outreachmanagement. Over half of the service, therefore, the percentages do not equal 100%.St. Johns County respondingorganizations claimed thatthey do not provide any outreach services at all. Only one respondent provides outreach servicesfor the elderly and only one respondent provides for veterans. Both organizations are in ClayCounty.Emergency shelter/housing. Affordable housing continues to be a seeminglyinsurmountable barrier for the homeless in Duval County. Forty-four percent of the homelesssurveyed in Duval County in November 1999 stated that shelter or affordable housing is the mostimportant service to them (n 234). Therefore, it was important to examine the types of sheltersand housing available, if any, in Region IV. Over three fourths of the organizations do not6

provide any type of emergency shelter or housing. Only six (15.4%) offer emergency shelters, atleast one organization in each county. St. Johns County and Clay County each had twoorganizations or agencies providing emergency shelter and were also the only counties thatprovided any numbers for available beds. One agency in Clay County provides 42 beds forwomen and their children. Anagency providing emergencyshelter in St. Johns County hasTable 2 Emergency assistance services providedsix beds total: for male andin Region IVfemale children and youth. Theorganization in Baker CountyUtilities23.8%that supplies emergency shelter is Rent21.4%classified as an American RedClothing19.0%Cross Emergency Shelter.Food Bank/Pantry19.0%Food Vouchers16.7%Not only is it essential toprovide emergency shelters, but *Respondents were able to answer more than one emergencypermanent and low-incomeassistance service, therefore, the percentages do not equalhousing are also crucial in aiding 100%.the needy and the homeless. Theonly respondent that providespermanent housing, allowing residents to stay at least two years, is located in Clay County. Thesame organization is the only respondent to offer permanent supportive housing with a limit oftwo or more years and provide support services. St. Johns and Clay County were the onlycounties with an organization that provides low-income housing. There are 32 low-income unitsfor the elderly (62 years and over) provided at the St. Johns County agency. The respondentfrom Clay County providing low-income housing has 106 beds available for families.Using the numbers provided, Clay County has a total of 156 emergency, low-income, andpermanent housing beds. As mentioned earlier, using the Barry Method, there are approximately433 homeless persons in Clay County. Using these figures, there is clearly a shortage inavailable beds for homeless persons. St. Johns County also has an insufficient number of bedswith a total of forty-four beds and an estimate of 353 homeless persons.Emergency assistance services. Much of the homeless population requires not only anaffordable place to call home, but they also need assistance with obtaining food, medical care,and other everyday necessities. Respondents were asked what emergency assistance servicesthey provide. As with the provision of outreach services, almost one third (31.0%) of theorganizations do not provide any type of emergency assistance service. Table 2 lists the fivemost frequently cited emergency assistance services available and the percent of respondents thatoffer them. Assistance with utilities is the most offered emergency assistance service in RegionIV. Although four of the organizations or agencies help with meals, no one offers a soupkitchen, a place for needy persons to gather and have a hot, balanced meal. Two of the threerespondents from Baker County offer at least one type of emergency assistance service.Although seven respondents from Clay County said they do not provide any type of emergency7

assistance service, help with utilities was the most often cited emergency assistance service fromClay County organizations. Clothing is the most frequently provided emergency assistanceservice in St. Johns County.Support Services. The provision of support services in these counties was also examined.Such services may include mental and primary health care, education assistance, assistance withobtaining food, children andyouth services, or legal aide.Table 3 Support service provided for the homeless in RegionTable 3 provides a look at the topIVsupport services provided inCase Management31.0%Region IV. Only fourFood Bank/Pantry28.6%respondents claim not to provideLife Skills Training/Parenting28.6%any type of support service. CaseRent/Mortgage Assistance28.6%management is offered mostUtility Payment23.8%frequently by the organizations inClothing21.4%Region IV. The only supportTransportation Assistance21.4%services not provided by anYouth Services21.4%organization is a soup kitchen orassistance in obtaining a state*Respondents were able to answer more than one support service,I.D. card. The most frequenttherefore, the percentages do not equal 100%.support service in Clay County iscase management. St. JohnsCounty offers life style training,youth services, and clothing morethan any other support service.Meals served. Although none of the organizations claimed to provide a soup kitchen,some do provide meals for their clients during their stay in the program. More than threequarters of those that responded to these questions claimed they did not serve any meals at all in1998 or 1999. Many of those that do serve meals indicated they served over one thousand mealsduring 1998. Only one organization served less than one thousand. They served five meals in1998. From January 1, 1999 to June 30, 1999 five respondents cited that they had served morethan one thousand meals. One served almost five hundred fifty meals and one only served threemeals.Initiation of services. Services can be initiated by the clients being served or targeted,caseworkers, court, or by other means. Many agencies utilize multiple referral methods. Almostthree quarters (73.2%) of the organizations in Region IV have caseworkers that refer theirorganization to clients. We find a different pattern for agencies with regard to court referrals,with only 26.8% of the respondents having respondents enter their program in this manner. Over80 percent of the respondents also initiate their services with self-referrals. More than half of theorganizations use other means to initiate services. Some of these other means are throughreferrals from other agencies, schools, churches, and physicians or hospitals.Barriers to services. Although services may be available, they are not always easily8

accessible. If the clients cannot utilize the services available, they might as well not exist.Respondents were asked to rank possible barriers to their services. One such barrier rated wastransportation. A majority of the organizations (58.3%) ranked transportation as a severe barrier,while only slightly over 5 percent believed it is not a barrier. At least fifty percent of therespondents from each individual county saw transportation as a severe barrier.The capacity limit of an organization can also hinder or prevent the provision of services.The limited capacity of the organization or agency was cited as a moderate barrier by 51.5% ofthe respondents and 15.2% of them ranked it as not a barrier. Most of the respondents from eachcounty believed limited capacity to be a mild or moderate obstacle, with the exception of NassauCounty. Nassau County only had two responses to this particular question; one believed it to bea moderate barrier and the other saw it as a severe barrier.The availability of child care can also be a problem for some that are searching forservices. Over fifty-five percent of the respondents cited child care as a moderate barrier to theirprograms, while just over 15 percent indicated it is not a barrier for their clients. At least half ofthe organizations from each Clay, Nassau, and St. Johns County cited chid care as a moderateobstacle. Two of the three Baker County respondents ranked child care as not a barrier.Many homeless persons do not have access to a telephone, which can be an obstaclewhen trying to obtain particular services. Over forty-three percent of the respondents sawtelephone access as a mild barrier for their clients. Only 10 percent cited it as a severe problemand more than twenty-three percent believed that it is not a problem. At least fifty percent of therespondents from Clay, Nassau, and St. Johns County viewed access to a telephone as a mildbarrier.Disabled persons also encounter barriers to service that many others do not. Althoughthere are laws that help protect disabled persons from being denied accessability into publicfacilities and businesses, some of our respondents cited that access for disabled persons is abarrier. Almost 47 percent stated it is a mild barrier, while slightly over six percent saw it as asevere barrier. Over thirty-seven percent claimed that access for the disabled is not a barrier totheir program. At least half of the respondents from Clay and St. Johns Counties saw access forthe disabled as a mild barrier. Almost every respondent from Baker and Nassau County did notsee accessability as a barrier.The hours of operation of an agency can provide another obstacle for prospective clients.None of the respondents cited the hours of operation as a severe barrier, but over a forth ofthem thought it to be a moderate barrier. Over a third believed it is not an obstacle to theirservices. Most of the respondents in Baker and St. Johns County viewed the hours of operationas a mild barrier. A majority of the organizations from Clay County did not see their hours ofoperation as a barrier. One respondent from Nassau County did not see a barrier, while the otherorganization saw it as a moderate obstacle.Some agencies require clients to have a state I.D. card in order to receive services. With9

no permanent address, this can be difficult for homeless individuals to obtain. No organizationclaimed the lack of a state I.D. card as a severe barrier. In fact, more than 53 percent believed itnot to be a barrier at all. Slightly over thirty-five saw it as a mild barrier. Most of therespondents from St. Johns County view state I.D. cards as a mild barrier, while most of the ClayCounty respondents do not see it as an obstacle. Only one respondent from Nassau Countyanswered this question and did not see it as a barrier. Only two respondents from Baker Countyresponded to this particular question; one did not see state I.D. cards as a barrier and one saw itas a moderate obstacle.In addition to the barriers listed on the survey, two respondents believed that there areother barriers to their programs. Interestingly, both listed funding as the other barrier and theyboth indicated that it is a severe barrier to the services they provide.Unmet needs of homeless adults. Although there may be many organizations andagencies providing a multitude of services for needy and homeless adults in Region IV, theremay still be many other needs that go unmet in these communities. Respondents were asked tolist their perception of the five most important unmet needs for homeless adults. Notsurprisingly, shelter or housing was listed by just over 80 percent of the respondents.Transportation was also a frequently listed unmet need (45.2%). Among shelter andtransportation, food or soup kitchen, medical care or insurance, and counseling or mental healthservices were also listed as unmet needs for homeless adults. Dental care, school, rentalassistance, phone/address, referrals, and emergency assistance were also listed. Shelter andtransportation are the most cited unmet needs for homeless adults by Clay, Nassau, and St. JohnsCounties individually. Baker County respondents cited shelter and counseling the most. It isimportant to note that these unmet needs are the respondents perception of unmet needs. Whenasked how aware their organization or agency is of the services provided in their county, almostsixty percent claimed that their agency s awareness is very or somewhat limited. Only 16percent believed their organization has a good awareness of the services provided for thehomeless in their county.SERVICE COORDINATION AND REFERRALSService coordination. One critical aspect of delivering services to clients is thecoordination of the services. People needing the services may not know where they are offeredand therefore, organizations and agencies can act as contacts for their clients. Slightly overeighty percent of the respondents coordinate services with other agencies. When an agency doesnot provide a particular service, they can refer their clients to other agencies to receive therequired service. More than 57 percent refer clients to agencies locally as well as out of theircounty, and thirty percent of the respondents refer clients only to local agencies. Of those thatrefer to agencies outside of their area, 27.9% refer an average of ten percent of their clients toDuval County organizations or agencies. Almost 10 percent of the organizations refer one infour clients to Duval County agencies. One respondent refers about fifty percent of their clientsfor necessary services to Duval County. This was an organization in Clay County and it refersthe highest percentage of clients to Duval County.10

Organizations refer their clients to other agencies for a number of services. Substanceabuse treatment was the most frequently cited service that agencies make the most referrals foroutside of their county. Services for shelter/housing and medical problems are also referredquite frequently. Other services that are referred the most to out-of-county agencies include:dental, mental health and legal aid. Individually the counties cited different services that arereferred to agencies out of their county. Shelter was listed most frequently by Clay Countyrespondents as the service most referred to agencies outside of their county. Two thirds of theSt. Johns County respondents cited substance abuse treatment as the most referred service toagencies outside of their county. The most locally referred service for a majority of therespondents is food. Public assistance service is also a major referral for many of theorganizations. Shelter, mental health, rent and utility assistance, and domestic violence wereamong those services listed as most frequently referred to another local agency. A comparisonof the individual counties shows that they locally refer different services. One quarter of theClay County respondents refer shelter and food the most to other local agencies. One out of fiveof the respondents from St. Johns County refers clients in need of food, mental health, and rentand utility assistance the most to other local agencies. Organizations from Baker County citedthat public assistance and truancy services are referred to other local organizations the most.Rent and utility services are referred the most to local agencies by a Nassau County organization.Table 4 provides the most frequently cited local and out-of-county referred services fromRegion IV.Table 4 Services referredAnother CountySubstance Abuse TreatmentMedicalShelter/Housing9.3%7.0%7.0%Another Local AgencyFood/Meals11.6%Public Assistance9.3%Mental Health7.0%Rent/Utility Assistance7.0%Shelter/Housing7.0%Organizations that coordinate services. When asked what organizations they coordinateservices with, Salvation Army and Florida Department of Children and Families were namedmost frequently. United Way, religious organizations, schools, and hospitals were also cited asorganizations they coordinate services with. Respondents were also asked from which agenciestheir agency receives referrals. Salvation Army was once again one of the top cited, along withschools and the Sheriffs Office/Courts. Other agencies from which respondents receive referralsare United Way, County Health Department, and religious organizations.THE POPULATION SERVEDRace, age, and sex. Understanding the population being served is very important indeciding what services need to be provided. Because of this, the respondents were asked to give11

a breakdown of the race, age, and sex of their clients. Although 75% of the respondents claimedto systematically collect and store data about their clients, less than ten respondents answeredthese questions. With such a small response we cannot interpret the data. We believe that lackof adequate data to report on activities represents a major challenge facing these services.Reasons adults seek services. To gain more knowledge of the population being served bythe organizations or agencies in Region IV, the respondents were asked why adults request theirservices. A majority of respondents (57.1%)claimed that adults seek their services as aresult of a loss of income. Table 5 exhibits the Table 5 Reasons adults need services inRegion IVmost frequently listed reasons. Mild ormoderate mental illness, poor or unsafe living57.1%conditions, and spiritual needs were cited once Loss of IncomeSubstanceAbuse/Addiction28.6%each as reasons for adults using their services.25.7%By far, Clay County respondents cited the

mile in St. Johns County. The unemployment rate for St. Johns County is 3.0%, one of the lowest in the state. St. Johns County has the 19th highest cost of living in Florida, which is Though tourism is the major industry in St. Johns County, the economy is also supplemented by