Interview - Sieglinde Von Deffner and Steve Diaz
Sieglinde Von Deffner and Steve Diaz
Noé Montes
Can you introduce yourself? Can you say your name, the organization you work for, and your title in that organization?
Sieglinde Von Deffner
Sure. My name is Sieglinde Von Deffner and I work for Department of Health Services, Housing for Health as the Skid Row coordinator for the county of Los Angeles.
Steve Diaz
Hi, I'm Steve Diaz and I also work for Housing for Health.
Noé Montes
How long have you been in this position?
Sieglinde Von Deffner
In this position for five years.
Steve Diaz
In this position about a year.
Noé Montes
So tell me about the organization. You're both county employees. That's one thing that I'm trying to understand. It's a really big, complex structure, so I'm trying to get a handle on the different parts of it.
Sieglinde Von Deffner
We're part of the County Department of Health Services. When Mitch Katz came down from San Francisco to become the director of the Department of Health Services [2011], he had a really bold vision around work with housing and unhoused folks that were frequent fliers through county hospitals and clinics, which was work he had done in San Francisco. He put together a unit called Housing for Health that was meant to be a lot less bureaucratic and a lot more flexible to move work forward quickly. That work started around 2012. Initially, it was with folks that were identified as really complex, vulnerable folks that were cycling through the emergency rooms and hospitals. Housing was funded through some flexible housing subsidies and some federal vouchers paired with case management. And, of course, the outcome was that [positive] health outcomes increased. They were less frequently using the emergency room. It was a lot less expensive. People were able to participate in their healthcare.
The work was so successful that it started to expand but was still touching just those folks that touch the county hospital and healthcare systems. And then with the homeless initiative and the passing of Measure H, the work expanded tremendously to working with all vulnerable folks. It expanded to be everything from funding multidisciplinary street outreach teams to enhanced permanent housing for folks with more medical complexities. That's what we do. It's everything from street outreach and some benefits advocacy to temporary housing and permanent housing. And then we also have a clinic, here on Skid Row. We moved to Skid Row in 2014 because it was really important to be on the ground in one of the most impacted communities. And we, at the same time, opened a health clinic here on Skid Row called the Star Clinic that works with folks that are very complex and vulnerable.
Noé Montes
So it started as a smaller program in 2012 for permanent housing; it was efficient and successful. It expanded, then there was funding through Measure H that expanded it as well.
Sieglinde Von Deffner
Expanded the arc of services. It started as permanent housing and then they realized, "Well, we're gonna need temporary housing for folks that are more complex." That current system didn't meet those needs. And from there: “We're always gonna need outreach teams that have more disciplines available to them like substance use, mental health, medical that's coming out with them." And there's something that we have called CBEST, Countywide Benefits Entitlement Services Team, and they do really great work getting people on SSI [Supplemental Security Income] that aren't currently on SSI and qualify or can't be, if they have a certain immigration status. So, it's really a full portfolio of work now.
Noé Montes
And you are, tell me again your position?
Sieglinde Von Deffner
I'm the Skid Row Coordinator for the county and I'm housed at Housing for Health.
Noé Montes
And I understand that you've also been working in this space for... how long?
Sieglinde Von Deffner
I've been working in the space here for seven years and homeless services for twenty years.
Noé Montes
Steve, what about you? How did you come to this work to begin with?
Steve Diaz
I actually was recruited into a social advocate organization, more activist driven, at the age of nineteen.
Noé Montes
Was that LACAN [Los Angeles Community Action Network]?
Steve Diaz
LACAN, yes. I was living in a residential hotel. And there was increased attention that was being paid to it by the city, but not attention in the sense of addressing the systemic barriers that were occurring, such as living conditions or bad management practices, but more around the sort of behavior that people that were moving to downtown didn't like, or didn't feel comfortable around. Such as large groupings of people being outside, without putting any context around it. Well, people are outside because there's no park space, for example. So I started volunteering at LACAN at nineteen. And then I worked there for the last twenty, twenty-one years until I came over here to work at Housing for Health.
Noé Montes
How long ago was that?
Steve Diaz
A year ago.
Noé Montes
What you've described reminds me of the complexity of the work. That's one thing that I'm trying to understand, and this is what I've learned so far. I'll tell you and you guys can fill me in. So there is obviously the unhoused population, which is very big in LA County. And then there is the government, both city and county, who have different initiatives and departments to address and reduce homelessness. Then there are service providers who are contracted by the government, in a lot of cases, for specific things. And then there are grassroots community organizations, often volunteers. And within that, of course, there's overlap and nuance. There are the missions and other faith-based organizations who are often contracted by the government. So you are in government, you are a government department.
Sieglinde Von Deffner
Yes, and we're a funder. If you think about most of the work we do, we contract out to service providers. We do some of the work in house, but a lot of the work we do is contracted to service providers, mostly nonprofits.
Noé Montes
You are part of county government. Your funding is through county government?
Sieglinde Von Deffner
Yes.
Noé Montes
And you've already talked a little bit about all of the things that this department does. What does it look like on a daily basis for you guys?
Sieglinde Von Deffner
The work we're doing in Skid Row came out of really recognizing that the community has the answers and that for a long time we've been making decisions for the community, but not including them in a way that is meaningful or actually reflects what they want and need in terms of the services and housing components. We were directed by the board [County Board of Supervisors] to have a community-based Skid Row Action Plan and then work with a couple of nonprofit providers to really put that plan together from the community up. Starting in summer of 2022 to the winter of 2022, there was a series of meetings to flesh out the Skid Row Action Plan and then a report back to the board with that draft of a plan. From there, the next step was to bring the community back together to flesh out “What does implementation look like for these buckets?” The buckets were interim housing, permanent housing, safe services, harm reduction, health hub. A health hub that's more of a 24/7 model. And then a grouping of community recommendations like economic development, jobs, arts, business incubators, entrepreneurship, safety.
So from that plan that was written, we've been able to get a variety of different types of funding and start actualizing the plan. The goal is to lift everything up at once or close to it. We've been able to get a grant from the state, for example, using that plan as a template, Philanthropy dollars, local county dollars, buy-in from the city. And now we're moving those pieces of the work forward to really shift the way we're doing a lot of the work in Skid Row specifically, to truly meet the needs of the community.
Steve Diaz
I think the only thing I would add is, you talked about the day to day, right? When you think about the day to day, you think about housing for health, right? Housing for health was created as an innovative model of removing barriers to accessing other supportive services and to accessing permanent supportive housing that existed. The Skid Row Action Plan is a continuance of that example of coming from a space of innovation and really looking at it as “We've got to create a community-based planning effort that ensures that we're looking at it from the community's needs, not necessarily from the funding needs.” Because oftentimes, it's vice versa. It's “Here's the money, we got to go do something.” For us, it was more about “Here's the need, let's go find the money.” Continuing to evolve the historical work of the organization is really crucial and the story that's being told with the Skid Row Action Plan. Because that really is what's gonna guide us into the next steps of trying to create these tools and these processes to create a better system of service delivery, but also enhance the system of service delivery that exists. That's a co-design model, not necessarily a top-down model, which has been a historic critique of homeless services.
Noé Montes
That the directives come down with the funding?
Sieglinde Von Deffner
Well, and without really exploring what it is that people want, need. An example being, many people really need their own space for a variety of reasons when they come into temporary housing, what we call interim housing, but we've historically built dorm-like settings that can be very overwhelming for people with complex vulnerabilities, histories of incarceration, or just if we think about what we want or need, privacy is really important to dignity and growth and rest. That was so apparent during COVID when we had funding for Project Room Key. So many people came inside that hadn't before. So really listening to that. Listening to people wanting to be treated with respect and dignity as an adult. “Why do I need a curfew for this temporary space I'm living in? As long as I'm respectful and quiet when I come in, what does it matter if it's at 2 AM or 10 PM or 10 AM?” So really those shifts in the way we think about it. And then, one other piece that I would say is "How do you really have a direct line of voice from the community to the funder without all the noise in between?" So, one of the big pieces that came out of many parts of the Skid Row Action Plan is having resident councils for interim housing, permanent housing, and a few of the other buckets that really, literally, can speak for their community directly to funders about large-level issues that need addressing and change.
Noé Montes
It sounds like your work has a significant organizing aspect to it.
Sieglinde Von Deffner
For sure. For example, Steve's leading a lot of the work in terms of the resident councils. And that can't come through the government because then it's defeating the purpose of having this organized voice that can work with the funders. So it was finding a Skid Row-based, trusted grassroots-organizing organization that could do the work as an intermediary. So that it is truly neutrally facilitated. If you want to hear more about it, Steve's doing really great work on that.
Noé Montes
Tell me a little bit about the Skid Row Action Plan. What's the history of this recent plan? And has it been adopted?
Sieglinde Von Deffner
It has been adopted. The report backs have gone to the board [County Board of Supervisors]. It has been adopted. We've been blessed to move forward to work on finding funding and work with the other relevant county departments.
Noé Montes
Is this recent? The adoption of the plan by the board?
Sieglinde Von Deffner
That was December 2022, early 2023, that they adopted the plan, which is the outline. And then we moved the work forward to putting some flesh on that and the implementation meetings in 2023. And now it's really about finding these ongoing funding streams and really putting some of these big things into fruition. And a big piece of it is the resident council work that Steve is doing.
Noé Montes
It sounds like the plan was made in collaboration with the community and the implementation is being done with the community as well.
Steve Diaz
It totally has been done from a co-design perspective of "We can all come together, identify the issues, figure out the commonality, understand that, because there are limitations in government versus non-government, we can figure out that workaround." (laughing)
Noé Montes
Why are you laughing? Because of that tricky gray area that you have to figure out how to work around?
Steve Diaz
Absolutely, that was one of the reasons why, for us, it was so imperative in the whole process to have a third party to be able to come in that had credibility in the community, but wasn't beholden to X, Y, or Z. So that they could challenge us if needed, but also work with us when needed as well. So that it's not this historical contention or "You're bad because you're X”, “Well, no, you're bad, because you're doing this" that usually plays out.
Noé Montes
And this third party is?
Steve Diaz
It's a community organization called the United Coalition East Prevention Project [UCEPP]. It's been downtown for about twenty some years now as well. They're gonna be the facilitators.
Noé Montes
It sounds like you do many things, but it could be described as providing services, health services.
Sieglinde Von Deffner
I think technically our work is more administrative as pushing that work forward. But there are chunks of the work we're doing that are providing services. For example, in this small Skid Row Action Plan shop, we have a training and support team that's going into the interim housing sites in Skid Row to really help provide a lot of support to the staff and change and shift the ways in which they work with folks to get to a much lower barrier, trauma-informed, person-centered model. And that's been really successful. It's a slow process, but just a really intensive training around de-escalation, trauma-informed care. What do you do with a mental health crisis? How do you shift the way you work? And really interestingly, the biggest piece is the security. A lot of the nonprofits have security providers, which can be very triggering. But those security guards have been the biggest fans of getting this training to be able to work with people differently, and that's been a really cool outcome because I don't think it was what we expected. As well as just seeing some really great shifts.
The goal is to make it lower barrier for more people to want to come inside. For them to be able to stay inside long enough to get into permanent housing. Reducing what we're calling negative exit. Going back to the street by choice or being kicked out. So that's in a way service provision that we're doing within the community. And then we also have something called Air Traffic Control. It's working with community providers, community volunteers, and outreach teams to very quickly get folks that want to come into interim housing because they have access to knowing where the beds are and working with the person or the team to find the best fit for them. So that's streamlining the process so that it can be a really quick turnaround. And then we've also got something we call a Safe Landing at the Cecil, which is a 24/7 facility run by a nonprofit, but we're very deeply involved, where folks can walk in, get a recliner, and stay until they're connected to temporary housing. It really helps with folks that are fleeing violence.
So I think it's this balance between the administrative work, but some of it is very client-facing. And then we've also got some really cool, super flexible, permanent housing subsidies; we can serve undocumented folks, people that don't qualify for federal vouchers that have been evicted. So, although we're administrative in a lot of ways, we have a pretty big footprint in the community. And we walk everywhere down here when we go to do trainings. So we're referring a lot of people into those subsidies. So it's pretty cool, it's this mix. The providers do the work but some of the links and the arms of linkage come in directly working with community members.
Noé Montes
How would you describe the organization and plan implementation work that you've been doing?
Sieglinde Von Deffner
Training and support training. A lot of training and support for each element of the plan so that it's successful. Even though we're administrative, very hands on with the permanent housing providers and interim housing providers. Just really having that footprint to help support the nonprofit to move the work forward in a way that is community-centered.
Steve Diaz
I think there's so much to be said on that question, because at the end of the day, theoretically and practically, it is quasi-organizing but it's also more around … a lot of the ideas of Housing for Health are building a model or structure that ensures that the most vulnerable folks are at the forefront. It's really taking upon that concept and providing that tool or that rollout. As we're focusing on these different buckets of areas, we're helping to better ensure that folks that are neediest are being targeted. Of course, because of the history of the organization, it comes from a health perspective or health lens. But at the end of the day, the idea is that the housing and the access to the service are crucial in order to stabilize the person and then as you're stabilizing the person, you're helping to build the vehicle and redirecting how services are provided directly to the person.
Sieglinde Von Deffner
Thinking about those folks that haven't been able to successfully navigate any of the systems. If they have been able to come inside, they've been kicked out or they leave because of their vulnerabilities. How do we ensure that person is wrapped around the most? Folks with the biggest challenges, right? And it might be behavioral challenges and what does that look like? And how do we shift the way we work with folks with those needs to not be reactive but proactive and relationship build and really meet their needs so that that issue is addressed?
Noé Montes
One of the ways that I've seen the work described, and I've started to adopt in my thinking about it, is that it can be seen as work that is being done to address the needs of the homeless population and then there's policy, systems change work that is being done to reduce homelessness. Do you know what I mean? And there's overlap there. Are you involved in some of that work directly?
Sieglinde Von Deffner
Yeah, I would say that we are involved in some of the policy work and working closely with our leadership to push some of the really important policy pieces forward as well. I think we have some built-in flexibility with, for example, the flexible housing subsidy pool vouchers that were really created to address the needs of folks that can't get a federal voucher. I think some of it is baked into Housing for Health's history. But absolutely, I think a lot of the work we do [is policy-related]. There's a convening of government entities to move this work forward. And I definitely think we're in there advocating for what the community knows they need, so how do we influence that?
Noé Montes
So you're trying to bring the perspective, that voice, into that conversation, the policy conversation?
Steve Diaz
Absolutely. I also think oftentimes we get very linear when we think about all these strategies and tactics, right? It's like, policy means X person sits at a table with X expertise, talks to somebody with decision making power, and that decision maker goes and introduces X, and then that becomes Y, right? But what oftentimes is forgotten about in those conversations is, in order to get to that point, there have to be initiatives, there have to be programs, there have to be ideas that are created and used as success stories, success models that can be moved forward. Sieglende talks about Mitch Katz coming from San Francisco. And that was him bringing his political concept to LA and what Housing for Health has done is then roll that out in a political setting. It's not necessarily directly creating the policy, but helping to influence by the example of good policy outcomes. So for me, it's really important when we talk about the concept not to try to be so linear. Because if we get caught up, we'll end up becoming "It's good policy, bad policy," but in reality, we always forget the middle ground. What's the middle space of policy that exists? Because at the end of the day, you gotta have people that are having their needs addressed. You can't have everything you want at the same time, though. But you got to start from somewhere.
Noé Montes
That middle ground, would you describe it as the actual people who are being affected by the policy, receiving services, etc., and the ideas that are being generated through that work?
Sieglinde Von Deffner
Yeah, and it steps, right? I'll give you an example. Having a training and support team really going in, in person, to provide support to these interim housing sites. Policy change, and even the service delivery change, is an arc and you don't do it overnight. You're starting with the smaller things around how you're handling someone with an escalation or particular behavior issue, and training around a different way to do it. And then you're moving to the next [step]. You're starting with the not-so controversial topics. How to work with people and then moving towards these other pieces and building alliances and relationships in order to create that policy and delivery change.
Noé Montes
So you see the actual work as very important and central to describing that policy and shaping it.
Sieglinde Von Deffner
Yeah, I think there's arms of it. We've been able to get staffing so that we can be embedded in a lot of the work so that we're really ensuring and supporting the provider and moving the work in this direction. But providing the tools to do it and so really aligning with the staff.
Steve Diaz
I'm trying to find our mission statement and our vision statement. I'm trying to find it because I can't remember the actual bullets, but it really articulates it well.
Noé Montes
You've been doing this work for a couple of decades and in that time, I'm sure people have tried different ideas and different iterations of ideas.
Sieglinde Von Deffner
Absolutely. And there have been amazing innovations and shifts from twenty years ago to now.
Noé Montes
And, of course, the population changes.
Sieglinde Von Deffner
I think that's the big thing. As a society, our structural racism, oppression, criminal justice policy, mental health policies, funding, have significantly impacted the growth of homelessness. But not just the growth of homelessness, but the amount of trauma people have experienced and the level of need, and how long they're outside and able to access services that meet their needs. Folks have gotten a lot sicker on those streets and a lot less trusting, and it takes a lot more to build a relationship and the right way to serve them and be innovative enough to meet their needs. So I think that's the other piece. You leave someone outside with a variety of really complex issues, traumas, experiences, it's going to be a really different way you have to work with folks and it's not going to be the normal "Well, these are the rules and that’s it, this is how we do it." It's gonna have to really morph to meet people's needs in a different way.
Noé Montes
So their trauma is compounded and it hardens over time.
Sieglinde Von Deffner
Over and over. We've got a lot of people coming out of twenty-, thirty-, forty-year prison sentences from when they were twelve, thirteen, fourteen, and fifteen. [People] did thirty years on some bullshit drug charge and were in solitary because they were gang members, were defending themselves, or needing to survive in prison. And then expecting them to be able to just perfectly fit into these little boxes and tolerate all the stuff that comes with that. They come out with ten years in solitary, twelve years in solitary, in the SHU [Special Housing Unit], and they're supposed to just be able to fit into every little box. Wait in line, sit quietly in a waiting room, fill out paperwork, have an ID. And why would I trust the system that also put me here?
Noé Montes
From what you've both described, you see the work as very incremental, evolving through interactions with the folks that you are serving. This generates ideas that are then implemented. My question was going to be, is there a big idea or approach that you feel needs more attention, more funding or more support? But it sounds like you guys have this approach of moving forward everything at the same time, as opposed to some big idea.
Steve Diaz
Yeah. The one thing I would say is the importance of dedicated ongoing funding streams is crucial. Most everything that has been put out has been "X number of years with a sunset" or "X number of dollars for X type." But there's that need of ongoing, because when you look at how spending was occurring on houseless issues twenty, thirty years ago versus now, the spending is very different. So you want to ensure that there's an ongoing commitment. I think that's the biggest idea. Because of everything that Sieglende just said. That, along with understanding that you're not gonna have answers overnight, can actually create huge amounts of impact. It can allow the average worker to build a relationship. It can allow the advocate to go and challenge NIMBYism. It can allow for the elected to have those deeper conversations with their friends. It can allow for different news story framing and having different conversations.
Sieglinde Von Deffner
Even different departments within the government that didn't traditionally do this work. How do we pull them in? How do we pull in the economic opportunity folks to help seed folks that are doing the work naturally done here to become nonprofits? To get funding? To get training and support to do that? To seed micro-businesses and entrepreneur work and shift work from a street-based economy into a more brick and mortar, sustainable [one]. We've got amazing cooks; how do you create a catering [business]? Those are really critical components that haven't necessarily traditionally been on the plate of different parts of the government. Even the arts and culture component. There's a rich history of arts in Skid Row but it's always been philanthropy-funded. How do we weave these things into bigger structures? And that they say, "Yes, that's ours. This work is ours" and find funding for it.
Steve Diaz
I would even say in a broader non-governmental way. Across all the four different sectors you mentioned at the beginning. Each one of those sectors has the same silos. And part of it is because there is not an ongoing dedicated funding source to allow for those organizations or those groupings to survive without the silo. How do you turn the silo into more of a holistic grouping of folks and individuals with basic needs, versus smaller groups of people that are targeted with a smaller [amount] of money for a smaller, shorter period of time, with some specific needs?
Sieglinde Von Deffner
Scale and sustainability.
Noé Montes
Lastly, is there anything else that you would like to share that is not talked about in these conversations? Something that you personally feel is important but doesn't get a lot of attention?
Sieglinde Von Deffner
I think a lot of attention is put on folks that have struggles with substances. Or maybe it's not a struggle; it's a survival technique that allows someone to feel well enough to survive from day to day. How we shift looking at folks who use drugs, participate in underground economies. Acknowledge that those services we've had are not successful with unhoused folks with lots of trauma. And really shift the way we engage in and service people on a much broader scale. There's great harm reduction work happening but it's very tightly funded; it's not broad. How do we have consumption? How do we have easier access to medications for addiction treatment that really work for folks? I think that's one piece. I think the other piece is the economic opportunities piece. I don't think that gets a ton of attention.
Steve Diaz
I think there's like so many different pieces, right? I think for me, at the end of the day, what I would say is that people oftentimes focus on solutions that they are trying to create, versus the solutions that have been here and that have a proven track record. Supportive housing, proven track record, harm reduction, proven track record, the interim to long term, proven track record. So really focusing on that. Uplifting it as a continuum.
Sieglinde Von Deffner
And then our natural providers in the community who haven't been funded, who have not been given opportunities, who haven't been given the support to build up a nonprofit based on their experience and work in the community as being unhoused. And then lastly, I like to think of our community as a whole community and [to] not other anybody in the community. We have a lot of unhoused folks that are longtime gang involvement, longtime incarcerated, hustling on the streets to survive out here, who are really critical and important members of the community, who care about this community, who are in tents in this community, who are in cars in this community, and they're often seen as the boogeyman or the community poisoner. "Why are you doing that?" instead of "What are the opportunities for change there? And how do we lift everyone up?" I gotta tell you, if I'm looking for somebody, nine times out of ten I just gotta call a couple of people that hustle in the street out here. They want to help, they want to shift, but their records and their life experiences have prevented them from entering the traditional economy. So how do we shift that?
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Transcript has been edited for clarity.