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Michael Scott, 55, sat at the edge of a small makeshift tent set up between discarded concrete chunks along the railroad tracks near Jennings Avenue in Santa Rosa.

The morning sun had just begun to bring a little warmth to the day after a long, rainy, near-freezing night for Scott and an estimated 3,295 others who are homeless in Sonoma County. Just after dawn Wednesday, a team of outreach workers, police officers and deputies visited camps along the railroad tracks and nearby creeks to offer housing and services to some of the most vulnerable homeless people.

“Take these guys up on their offers for housing; you have to leave as early as Friday,” Santa Rosa Police Officer Jesse Cude said to Scott, whom he’s known for about 20 years. “You can’t stay here when the SMART train comes.”

Scott nodded.

“I can’t stand it,” Scott said. “I’m dirty all the time. I can’t wash my clothes. My stuff gets stolen all the time. Last night it rained for hours.”

Homeless for decades, Scott represents the kind of people the outreach workers were hoping to find during the effort with Santa Rosa police and Sonoma County sheriff’s deputies.

Typically, shelter beds and other services have been offered on a first-come basis, and the result was the most capable people were getting housing. Sonoma County last fall launched a new program overhauling how the shelters and nonprofits that receive funding from the county allocate beds and services.

Factors including mental illness, substance abuse, criminal history, bad credit, chronic homelessness and others that used to prevent people from finding even emergency housing are now tickets to shelter.

“They are the most likely to die on the streets,” said Jennielynn Holmes, director of shelter and housing with Catholic Charities Diocese of Santa Rosa, the organization spearheading the change.

Catholic Charities is running the county’s Homeless Outreach Services Team, joined by staff with homeless services nonprofit Buckelew Programs, Social Advocates for Youth and other agencies as well as the Santa Rosa Police Department and Sonoma County Sheriff’s Office.

The federally mandated initiative aims to make it easier for the sickest, neediest people to connect with the county’s network of services. The most current homeless census data, from 2013, found 4,280 homeless people on the streets, with 77 percent living outdoors and the remainder living in emergency shelters or temporary housing.

Since January, outreach workers and Santa Rosa police have gone once a week to homeless camps. Using a new “vulnerability index,” they have assessed the amount of time people have been homeless, the severity of their health conditions and mental health complications, criminal history and other factors to rank people on a vulnerability scale of 1 to 16.

They have so far contacted 168 people, made 116 assessments and put nine people into housing. The average person ranks at a level 10, Holmes said. The nine individuals housed so far are in market-rate apartments rented by Catholic Charities with funds from the county.

In the six months before those nine people were housed, they reported 257 interactions with law enforcement, 14 ambulance rides, 24 hospitalizations and 39 emergency room visits, according to Holmes.

“That’s just in six months. And that is what they self-report,” Holmes said.

The greatest challenge is finding apartments.

Holmes said Catholic Charities and their partner agencies are actively seeking housing for 50 people who ranked high and need services.

“We have the funding to house them, but we don’t have the landlords willing to partner with us,” Holmes said. “That’s our biggest struggle right now: Our housing market.”

After visiting several camps along the train tracks, the group visited a homeless camp established about a month ago along Mark West Creek in a rural area behind a tortilla factory.

Wednesday was the first time the weekly outreach effort included encampments in unincorporated areas of Sonoma County. Two deputies, a sergeant and lieutenant with the Sonoma County Sheriff’s Office joined the outreach workers and they will continue going out every other week.

Sgt. Rey Basurto, who runs the Sheriff’s Office community-oriented policing project that was relaunched last year, said one of his team’s early projects is to focus on homelessness in the county, especially the Russian River area, and address the health, crime and environmental degradation issues that often accompany homelessness.

Deputy Jose Acevedo asked the group to visit a series of camps he found behind the tortilla factory because he was concerned about a particular woman he had met there the day before.

The group hiked about 100 yards down a path and found a series of tidy camps on the embankment above Mark West Creek. Rope slung between trees was used to hang tarps and tents. A series of steps down to the creek had been carved into the embankment. A handful of outreach workers and a police officer passed a small sculpture and planted flowers placed at the entrance to a group of tents. They were greeted by a man and woman who stepped outside.

Another group of outreach workers continued down the path and were stopped by two men, including one who put up his hands and said, “I can’t even tell you how much I don’t want to talk to you right now.”

They persisted in talking with them, and the resistant man’s friend eventually stepped aside to talk about possibly getting into housing.

“I don’t mesh well with most people out here,” said the man, a 22-year-old Marine Corps veteran who only wished to be identified by his first name Matt. “Most are untrustworthy scumbags; society has outcasted them for a reason. But I guess I’m out here, too.”

Matt said he grew up in Middletown, served two tours in Afghanistan and has worked as an ironworker. He said that when he got out of the North County Detention Center on Christmas Eve after serving time for a DUI, he walked straight from the jail to a nearby homeless camp. About a month ago, deputies cleared that camp and he moved to the Mark West Creek location.

“Work started slowing down, one thing led to another. Finally I gave up,” Matt said, describing the circumstances that led him to homelessness nearly one year ago. “I’ve lost everything over and over again, I didn’t have the motivation to start over again.”

Holmes told him that there are lifetime housing benefits for veterans. She said she would try to get him into shelter within the week.

You can reach Staff Writer Julie Johnson at 521-5220 or julie.johnson@pressdemocrat.com. On Twitter @jjpressdem.

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