Help for the neediest?

Social service volunteers identified a 65-year-old homeless veteran as one of the people most likely to die on skid row in downtown Los Angeles.

The man, who suffers from kidney and liver disease and has lived for decades on the streets, belonged at the top of a new list of 50 skid row residents deemed in urgent need of permanent housing, county officials said. But identifying the 50, which volunteers accomplished recently through early morning interviews of several hundred homeless people downtown, was only the beginning.

Today, the county Board of Supervisors is scheduled to vote on additional steps for the three-year, $5.6-million pilot program called Project 50, which is designed to provide immediate housing and services for the participants.

If the board approves the next phase, beginning next week a county social service team of seven -- including a social worker, mental health employees, advocates for the homeless, a representative of the Veterans Administration and a benefits specialist -- will return to skid row. They’ll search for the 50 people identified earlier and encourage them to move to county-funded apartments downtown and get regular medical and mental-health care.

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Not an overnight process

The process of moving someone from the streets into an apartment could take as little as a day or up to six months, said Beth Sandor, Los Angeles field director for Common Ground, a New York City nonprofit group that is helping coordinate the L.A. effort. Common Ground launched a similar, largely successful effort to house homeless people living in Times Square.

Sandor said one goal is to streamline the complicated paperwork that goes into providing housing. Temporary rooms will be available during a transitional period, she said.

Skid Row Housing Trust, which helps refurbish housing for needy people, is providing 50 downtown living units for the program, plus two case managers, a medical exam room, offices and a support-group meeting space.

The top three people on the 50-most-vulnerable list have already indicated to outreach workers that they’d like a home, Sandor said.

Advocates estimate that more than 73,000 homeless people live in Los Angeles County.

The proposal before the supervisors today calls for the creation of an executive steering committee of county officials to oversee the program, a public health nurse to direct it, plus teams of county social service workers to help house people and provide them with medical and other care.

Program supporters say the effort could save taxpayers millions of dollars currently spent on homeless people who turn up at shelters, jails or emergency rooms.

“It’s not going to be easy, but we have a stake in doing this, and we have a stake in doing it right,” said Supervisor Zev Yaroslavsky. “The cost savings are potentially quite significant.”

Spokesmen for Supervisors Mike Antonovich and Don Knabe said the officials planned to question the cost of the program. Some advocates for the homeless praised the program in principle but wondered whether housing could be achieved at a lower cost.

Antonovich spokesman Tony Bell said the supervisor also wants more information on how the first 50 people were selected.

Late last year, as Project 50 launched, more than two dozen volunteers from county agencies and social service groups canvassed a roughly 40-block area with the help of Common Ground, plotting the concentration of tents and sleeping bags and identifying hubs of drug activity.

The surveyors counted 471 people regularly sleeping on skid row and persuaded 350 of them to be interviewed, offering free phone or fast-food gift cards.

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Identifying the neediest

Advocates analyzed the information from respondents, using measures developed by the Boston Healthcare for the Homeless Program.

The 50 categorized as most at risk had been homeless for at least six months with at least one chronic ailment, such as HIV or liver disease, or recent emergency room visits or hospitalizations. The members of that group visited emergency rooms 120 times in the previous three months and had lived on the streets an average of 9 1/2 years, according to the survey.

The data identified roughly 70% of the highest risk as black, 18% as Latino and 12% as white. The highest-risk homeless tend to sleep clustered around the missions or near the Central Division police station; 90% are substance abusers, and 76% are mentally ill.

Several advocates for the homeless praised the county for embracing the “housing first” approach, which places people in permanent homes -- rather than shelters -- while simultaneously offering healthcare and other help.

The ultimate goal of the effort, besides housing the first 50 people, is to replicate the program countywide.

“There’s a lot of things that need to happen in the county and the city to resolve homelessness,” said Joel John Roberts, chief executive officer of PATH Partners, a Los Angeles agency that provides services and housing to the homeless. “I think this is one small piece of the puzzle.”

Torie Osborn, senior advisor to Mayor Antonio Villaraigosa, said: “We hope that this is a model that can be scaled up so it becomes Project 500, 5,000.”

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susannah.rosenblatt@ latimes.com