Stephanie Hepburn is a writer in New Orleans. She is the editor in chief of #CrisisTalk. You can reach her at .
In November, Los Angeles County increased its transitional housing access with Safe Landing, a no-wrong-door 176-bed facility. Luana Murphy, CEO of Exodus Recovery, the provider the county contracted to operate the new facility, says it fills a vital gap in housing. Like many other communities in LA County, transitional housing historically hasn’t been immediately accessible. “It can take a while to get in,” she says. Safe Landing gives people a place to go now.
The chances of mitigating a person’s mental, substance use, or physical crisis plummet when they don’t have immediate access to housing. That’s why the new facility focuses on helping address people’s basic needs first and then connecting them to care. “My husband [Dr. David Murphy], who founded Exodus with me over 30 years ago,” always said to me, “If a person doesn’t have a place to sleep tonight or is hungry, you aren’t going to get them to talk about the medication they might need.”
According to the Los Angeles Homeless Services Authority, the homeless population count over three nights in February estimated that roughly 69,144 people were experiencing homelessness, a 4.1% increase from 2021, much lower than in previous years. For example, the county saw a 25.9% spike between 2018 and 2020. In a press release, the authority stated expansion in shelter beds and permanent housing placements contributed to the lower rise. Kristina Dixon, acting co-executive director at the agency, also pointed to economic programming that “helped keep people in their homes throughout the pandemic.”
Murphy notes that housing is critical to addressing social determinants of health, the conditions in which people are born, grow, live, work, and age. “Housing and health are connected,” she says. “People must have housing and something to eat, and then we’ll talk about the next steps to address mental illness or the gaping wound on their leg.” Safe Landing not only provides interim housing and on-site care but also works to connect people to permanent housing and community-based resources.
The facility comprises five buildings on three acres in the West Athens neighborhood. The modern, prefabricated metal buildings surround a landscaped courtyard and include an intake and clinic building, a community building, two housing buildings, and an administration building. KFA Architecture designed the campus to have a neighborhood feel.
Safe Landing follows the SAMHSA-recommended no-wrong-door approach, accepting all adults who come. However, Murphy emphasizes Safe Landing is far more than transitional housing. It also includes sobering and recuperation beds. “It’s a place for anyone who needs somewhere to sleep tonight in Los Angeles,” she says. “No questions asked—they can be drunk, have a mental illness, or have recently been discharged from a medical stay at a hospital and need a place to recover. They can all come in.”
The Department of Health Services in Los Angeles County contracts with Exodus Recovery to operate Safe Landing. When the department approached Murphy three years ago to open a no-barrier facility, she had a couple of requests: a medical clinic on-site and a full production kitchen and dining area. “In many LA transitional housing facilities, boxed meals are brought in and put on warming stations. I want people to have three hot meals a day.”
The 176-bed facility admits adults 24/7 year round. People can come on their own, by a clinic, emergency room, hospital, or crisis stabilization unit referral, or through drop-off from mobile crisis, street, or traditional first responders. Everyone the facility admits first goes to the admissions triage building, where a trauma-informed multidisciplinary triage team works with the person to determine how best the facility can meet their needs. “Our team includes doctors, nurse practitioners, nurses, sober coaches, and mental health professionals,” says Murphy.
The admissions triage building also houses the medical clinic and 36 observation beds or what Murphy calls “specialty beds”—for sobering, mental health, and recuperation. This area is staffed with nurse practitioners and nurses and has a higher staff-to-client ratio. If the person just needs a bed for the night, a residential aid will take them to a building for women, men, or couples. However, families with children are not yet permitted.
People can bring their pets. “We’ve found that allowing pets helps overcome a barrier to people getting off the street.” Each individual sleeping pod has a bed with a reading light, a locked closet for belongings, and an area large enough to house a pet. “We expect clients to have their animals with them at all times,” says Murphy. If the person has to leave the premises, there are kennels on the property.
On the campus is a community building where people eat their meals and participate in activities. Murphy shares that at most shelters, people must leave in the morning and return at night. “No one has to leave here—there are activities, three hot meals a day, and no predetermined length of stay.” Social service discharge planners work to connect people at the facility with whatever services they need, whether that’s reuniting them with family or finding permanent supportive housing. “That can take a while, and we will help people navigate the process.”
The administrative building is for personnel and where people meet with their recreational or occupational therapist. “It’s a connection hub for services,” she says.
Murphy has ensured the new facility connects with LA County’s behavioral health crisis services, including the area’s four Exodus crisis stabilization units. If someone needs a higher level of care, the facility can transfer the person to a nearby crisis stabilization unit and connect them to outpatient services. “Sometimes the person just needs access to a psychiatrist,” she says. The new facility has 24/7 telepsychiatry access.
LA County funds Safe Landing using braided funding, including from the federal American Rescue Plan and Measure H, the county’s tax-based program for homeless services and short-term housing. However, the medical clinic on the premises—a Federally Qualified Health Center—independently bills commercial health plans and Medicaid.
LA County has recently redesigned its crisis system to improve access to treatment and services, coordination, and divert people with mental health and quality of life challenges from criminal legal system involvement. That includes improving the connection between Didi Hirsch Mental Health Services, the 988 Lifeline accredited call center in the area, and the Department of Mental Health, which dispatches mobile crisis. The county also developed a 911 call matrix and procedures to divert most behavioral health calls from a law enforcement response to 988.
While Safe Landing is not yet directly connected with the 988 crisis system, Exodus has a working relationship with Didi Hirsch Mental Health Services, local mobile crisis services, and law enforcement. “Crisis teams know they can bring clients to our crisis stabilization units anytime, day or night, and we will help address the person’s needs,” she says. Safe Landing has the same no-wrong-door drop-off ethos.
Holly J. Mitchell, the LA County Supervisor who serves as the chair of the LA County Board of Supervisors, has said the facility is a model for a whole-person, trauma-informed approach “that honors the humanity and complexity of our unhoused residents.” Murphy agrees and aims to make the Safe Landing replicable in hopes that LA County and other communities in California and elsewhere integrate it into their 988 crisis system. That’s why she and her team are measuring outcomes. “We need to know how many people are not back on the streets and connected to permanent housing after being at Safe Landing,” she says. “That will help us determine, does this really work?” “We all think it will, but we need the data.”
“For years, LA County has been discussing the need to integrate medical care, mental health care, and housing. But that’s all we did—talk. So now we have a program—now it’s just one program and 176 beds—but it does what we’ve long wanted to do.”
