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54 Alameda Countywide Homeless and Special Needs Housing Plan · Substance use. The ACSSS found that 30 percent (1,736 adults at a point in time) of community-defined homeless adults had alcohol dependence or drug abuse, as did 50 percent (799 adults at a point in time) of the HUD-defined chronically homeless. Institutionalization: Foster Care, Hospitals, and Jails or Prison Nationally and locally, there is growing documentation and understanding that many people become homeless upon leaving an institution such as foster care, hospitals, and jail or prison, and that ending homelessness requires ensuring that people do not exit institutions to homeIessness. For example, in the ACSSS survey, 12 percent of all respondents (864 people at a point in time) said that they became homeless most recently when they were "released from jail, prison, or a hospital.,,42 Further detail follows: · Foster care. 1 in 5 homeless adults (20 percent) in Alameda County reported having been in an institution before age 18, including 14 percent who had been in foster care.43 The proportion of community-defined homeless adults younger than age 30 in Alameda County who reported being in an institution before age 18 was even higher, at 37 percent.44 The California Department of Social Services estimates that 65 percent of the 219 youth who exit foster care every year need housing assistance.45 · Formerly Incarcerated. More than two-thirds of the community-defined homeless population in Alameda County had been in either jailor prison at some point in the past. This includes 4 percent who had last been released a month to a year prior to the survey, and 16 percent who had been released within the 30 days prior to the survey.46 · Hospitals. 11 percent of community-defined homeless adults and] 6 percent of HUD-defined chronically homeless reported having been hospitalized two or more times in the previous year.47 Nine percent of the community-defined homeless and 21 percent of the HUD-defined chronically homeless reported having been in a psychiatric hospital within the past year.48 42 Ibid, p. 5-3. 43 Ibid, p. 4-9. 44 Ibid, p. 8. 45 California Department of Social Services, Report of the Survey of the Housing Needs of Emancipated Foster/Probation Youth, p. I. A vailable online: www.childsworld.ca.gov/res/PDF/RptontheHousingNeeds.pdf (Accessed: March 8, 2005). 46 Ibid, p. 4-11. 47 Richard Speiglman and Jean Norris, Alameda Countywide Shelter and Services Survey: County Report, prepared for the Alameda Countywide Homeless Continuum of Care Council, May 2004, p. 10-10. 48 Ibid, p. 10-12.