Acting Administrator
James A. Williams
General Services Administration

Innovative Initiatives by Theme

1. Partnership

Collaboration: SIP Saves Lives and Public Funds

Leveraging Private Investment: Atlanta's 10-Year Plan to End Chronic Homelessness

Industry Partnership: HomeAid America Provides Model of Success

Increasing Transportation Access: New FTA Interagency Council

Cost Effective Health Care Interventions: Augusta's Project Access Targets Consumer Choice

Student Innovation in Ending Homelessness: A 10-Year Plan Service-Learning Partnership

Partnering for Performance: The Food Stamp Program in Massachusetts

Hawai`i Governor Unveils Results-Oriented State Plan to End Chronic Homelessness

Greater Los Angeles to Conduct First Homeless Census

Hawai`i's New Housing Proposals Target Increased Housing Options

California Builder Uses Housing Sales to Help Meet Homeless Housing Need

San Francisco Demonstrates Civic Partnership to End Chronic Homelessness

Creating Interjurisdictional Partnership to End Chronic Homelessness

Comprehensive Reentry Policy Recommendations Unveiled

Improving Discharge Planning Outcomes: Kentucky Passes Homelessness Prevention Legislation

Essential Resources for Discharge Planning

Closing the Gap for Homeless Persons With Mental Illness in Seattle

Ending Homelessness: A "Key"

Ending Homelessness With Housing And Health Care: Gennesaret Free Clinic Respite Program

Using Innovation for a Better Future: Britain's Shift to New Strategies for Permanent Housing for Homeless Families

Committing to a Housing Strategy: Hartford's Immaculate Conception Housing Corporation

Reaching Permanent Housing: Homeless Families in Massachusetts No Longer Use Welfare Hotels

Saving Lives and Public Costs: San Francisco's Direct Access to Housing

Building Bridges to Health, Wealth, and Housing: Nashville's Urban Housing Solutions Leads the Way

Using HOME Funds to House Persons Experiencing Chronic Homelessness

Utilizing VA Property to End Chronic Homelessness

Massachusetts Housing Strategy Awards Federal Housing Tax Credits to Homeless Housing Initiatives and Targets Below 30% AMI Population

City of Presidents Advances Housing Solutions

California Program Moves People From the Streets to Jobs and Housing

Addressing Urgent Needs: Health Resource on Issues of Homelessness

Creating a Path to Housing For Persons Experiencing Chronic Homelessness: Portland's Central City Concern Health Services

Federal Tax Credits to Fund Statewide Residential Substance Abuse Treatment in Kentucky

HRSA Supports New Resource on Disability

San Francisco's Behavioral Health Court

SSA HOPE Grantees Use Web Based Data and Evaluation Tool

Since its inception 15 years ago in Orange County in Southern California, HomeAid America has modeled innovative partnership as its path to results. Established by the Building Industry Association of Southern California, an affiliate of the National Association of Homebuilders, HomeAid is, in the words of President Michael Lennon, “driven by a singular passion– to give opportunities for new beginnings to temporarily homeless men, women and children across the country.” Supported primarily through corporate donations, foundation grants, and individual contributions, HomeAid emergency and transitional facilities are owned and operated by non-profit partners and include specialized supportive counseling and job training services to achieve self-sufficiency.

HomeAid’s model provides for local communities to exercise choice in becoming partners. Building associations select a community provider and a specific project and then recruit a Builder Captain, a role HomeAid views as the centerpiece of its mission. The local HomeAid Chapter recruits the Builder Captain from among building industry professionals to play the lead role in the planned construction or renovation project. The Builder Captain then turns to trade partners (sub contractors, suppliers, and consultants) in the local building community to contribute labor, materials, and services to the construction or renovation project. HomeAid sets a goal to obtain 50% or more of the estimated market value of the project through the donation of resources.

Twenty-two HomeAid chapters currently operate in 11 states (California, Colorado, Texas, Georgia, Illinois, Massachusetts, Missouri, Nevada, Oregon, Virginia, and Washington). HomeAid Portland is the most recent addition, established under the Home Builders Association of Metropolitan Portland (HBAMP). The new chapter will support projects in Clackamas, Columbia, Multnomah, Washington, and Yamhill Counties.

(top)

INCREASING TRANSPORTATION ACCESS: NEW FTA INTERAGENCY COUNCIL

A new federal interagency initiative recognizes the role of transportation as a vital link to increased mobility, employment opportunities, and access to community services for persons with disabilities or limited income, elders, and others seeking self-sufficiency. Transportation is often hard to access despite over 60 federal programs across eight departments providing supportive transit resources. In response, President Bush signed an Executive Order in February 2004 to create the Interagency Transportation Coordination Council within the U.S. Department of Transportation (DOT) with the goal of minimizing duplication and increasing access and performance. DOT launched “United We Ride: Coordinating Human Services Transportation” as a first step to meet the goals of the Executive Order.

Included in the new Council are the Departments of Transportation, Health and Human Services, Education, Labor, Veterans Affairs, Agriculture, Housing and Urban Development, Interior, and Justice, and the Social Security Administration.
Through the Federal Transportation Administration (FTA), headed by Jennifer Dorn, DOT is now forwarding initiatives to identify state and local practices that increase access and coordination and reduce duplication and barriers, whether for seeking or holding employment, keeping medical appointments, or accessing other services. FTA is also working to build awareness of technical assistance resources that states and local communities can use to enhance transit options. FTA has on-line tools for community self-assessment, including assessments of partnership opportunities and consumer needs, as well as a guide to technical assistance providers.

“United We Ride is an important initiative to increase access and use resources effectively,” stated Interagency Council Executive Director Philip Mangano.
“Transportation is a mainstream resource that homeless people need to achieve stability and self-sufficiency both in urban and rural areas. Mainstream systems need to make every effort to ensure that homeless people are not disadvantaged by the differing eligibility rules, restrictions on program use, or confusing participation requirements of multiple programs. Bringing transportation stakeholders to the table can help ensure that every State Interagency Council on Homelessness and 10-Year Planning process can assist in developing and advancing community transportation initiatives to meet the needs of persons experiencing homelessness.”

Read about United We Ride

(top)

COST EFFECTIVE HEALTH CARE INTERVENTIONS: AUGUSTA’S PROJECT ACCESS TARGETS CONSUMER CHOICE

Providing comprehensive medical care and saving public expenditures on expensive acute care, while engaging the consumer in a partnership for improved health – all are components of the award-winning, Augusta/Richmond County, Georgia, Project Access, a volunteer, physician driven health care program delivering medical care to uninsured people at no cost to the patient. Project Access’s target population is local residents between the ages of 18-64 with family income below 150% of the federal poverty guidelines. Project Access does not replace any health care program but provides an additional resource leveraged from the community itself by relying on a volunteer system of physicians and specialists.

Augusta/Richmond County’s program is derived from the Project Access model first established in Asheville/Buncombe County, NC, in 1995 by physicians in the Buncombe County Medical Society (of whom 85% volunteered in the program) and now replicated in more than 20 communities across the country from Maine to Texas to Washington State. Partners in Project Access communities include: hospitals, city and/or county elected officials, health clinics and community-based care facilities, United Way, faith-based communities, philanthropy, pharmacies/pharmaceutical manufacturers, Chambers of Commerce, insurance claim form processors, health education centers, social service and health providers.

In 1998 Buncombe County Medical Society's Project Access won the Ford Foundation/Harvard Innovations in Government Award, recognized for a combination of “positive incentives, subtle sanctions, keen political savvy and meticulous management, “ with evidence of medical management aimed at improving care and controlling costs for chronic conditions. Outcome studies documented that almost three-fourths of those in need used the program. Both patients and caregivers were satisfied with the program. Data showed decreased inpatient hospitalization and emergency visits.

Participating physicians and hospitals are not reimbursed for their time or services, but agree to provide laboratory, X-ray, diagnostic outpatient tests, and inpatient services at no charge. In Richmond County, participants include Doctors Hospital, Medical College of Georgia, St. Joseph Hospital, University Hospital, and Walton Rehabilitation Hospital. Project Access provides prescription drugs to enrollees for a $4.00 co-pay. Although still a new initiative, physician volunteers of the Richmond County Medical Society have already donated more than $250,000 in medical services under the program.

To demonstrate the model’s cost effectiveness, the value of services provided is tracked using federal Centers for Medicare and Medicaid Services claim forms submitted by physicians and hospitals. This information is reported to community partners to quantify the services that their support has leveraged. In Asheville/Buncombe County, the commitment of physicians to treat uninsured residents leveraged inpatient and outpatient services, lab work and x-rays from local hospitals; consultations and low-cost medications from pharmacies; and funding for overhead and medications from local government.

(top)

STUDENT INNOVATION IN ENDING HOMELESSNESS: A 10-YEAR PLAN SERVICE-LEARNING PARTNERSHIP

Three Raleigh, North Carolina, colleges combined their resources to create an innovative service learning collaborative in support of the Raleigh 10-year planning process. NC State, Meredith College (an all-women’s institution), and St. Augustine’s College (an Historically Black College) showcased the results of their partnership at the Inter-College Conference at St. Augustine’s College In April 2004. Council Executive Director Mangano addressed conference participants, stating, “We need to ensure that we are investing resources currently allocated in the results we are looking for - ending homelessness. We need to change the verb of homelessness from managing the problem to ending the disgrace.”

The service-learning tie-in was originally conceived by Dr. Liz O’Sullivan, Director of the Public Administration program at NC State and member of the 10-Year Plan Policy Committee for the Raleigh/Wake County planning initiative. In January, Raleigh initiated its process and an inaugural 10-Year Plan forum was hosted by Meredith College in February. The three participating institutions then linked nine courses to the effort, across fields such as Political Science, Public Administration, Social Work, Psychology, and Criminal Justice. At St. Augustine’s, Dr. Monica Porter presented to her Senior Seminar in Psychology class the situation of the impending closure of Dorothea Dix Hospital, a local mental health facility. She challenged the students to think about whether patients might fall into homelessness without proper planning. Students then directed their thesis research to some aspect of homelessness.

Students pursued research and experiential learning that could directly contribute to Raleigh’s strategy. Meredith students hosted a teleconference on Civil Engagement, and NC State students conducted focus groups with shelter residents. St. Augustine’s students researched discharge planning, nutrition, mental health services, health care, and education as they relate to homelessness. NC State initiated a new course, Community Dialogue to End Homelessness. Community speakers addressed class sessions, with speakers including representatives from the NC Department of Human Services, the City of Raleigh, Wake County, community-based service providers, advocates, and people experiencing homelessness. The speakers were video taped and broadcast to the community at large on a local cable station.

Read about the Student 10-Year Plan Initiative

(top)

PARTNERING FOR PERFORMANCE: THE FOOD STAMP PROGRAM IN MASSACHUSETTS

With the introduction of a shortened food stamp application about two years ago, the Massachusetts Department of Transitional Assistance (DTA) launched extensive efforts to increase food stamp participation in Massachusetts. Although optimistic at that time that those efforts would have an impact, even DTA has been amazed at how quickly that impact has been felt.

Participation in the Food Stamp Program has increased from 114,859 cases in federal fiscal year 2002 to 135,195 cases in fiscal year 2003, and again to over 154,000 cases for fiscal year 2004. This means that almost 100,000 more Massachusetts residents are now receiving food stamp benefits than two years ago. But food stamps are not just a nutritional benefit. Every $1 in food stamp benefits coming into Massachusetts generates $1.84 in additional economic activity in the state. This increase in participation in the program has contributed approximately $160 million boost to the Massachusetts economy.

And DTA is not stopping there. The department's goal is to make food stamps accessible to all who are eligible. Working together with many partners in the community as well as with sister Health and Human Services agencies, DTA is continuing in many ways to reach out to those who need this critical resource to buy nutritious food. DTA has made the application process much easier for people by encouraging mail-in applications and phone interviews. This is of particular help to those who are working and may find it difficult to get to a DTA office to apply. DTA has been able to reach out and provide benefits to many non-citizens whose eligibility for food stamps has been restored by the 2002 Farm Bill. This year for the first time DTA worked collaboratively with the state Department of Education to automatically certify eligible children for the school meal programs. Approximately 88,000 children will benefit from this effort.

DTA has also worked closely with Project Bread, a statewide hunger relief agency in Massachusetts, and the state's Executive Office of Health and Human Services to develop new ways for potential clients to apply for food stamps through the Internet. Project Bread's web application (located at gettingfoodstamps.org) and EOHHS' Virtual Gateway (located at Mass.gov), although still in their initial stages of operation, have already proven to be effective ways to increase participation by making it possible to apply for food stamps online. DTA has staffed a toll-free department hotline at 1-800-249-2007 for food stamp questions and mail-out applications, and has also funded a second hotline at 1-800-645-8333 at Project Bread for added help in providing these services.

In September, the United States Department of Agriculture awarded DTA a $1.25 million bonus for the timely approval and delivery of food stamp benefits in over 98% of applications received. The dimensions of this award are far-reaching. With a public announcement from the Massachusetts State House recognizing DTA's efforts, the news of the award resonated across the air waves and the announcement appeared in many local newspapers. This helped to educate the public about the availability of food stamps and DTA's mission to increase food stamp participation. Most importantly, the award dollars received will allow DTA to continue its efforts to provide employment and training opportunities to many client families. These services will enable clients to make meaningful changes in their lives and help them establish a more sharpened focus on their future.

DTA's goal is simple yet ambitious: to have food stamp benefits available to all who are eligible so that individuals and families across the Commonwealth will have the nutritious food they need for good health.

(top)

HAWAI`I GOVERNOR UNVEILS RESULTS-ORIENTED STATE PLAN TO END CHRONIC HOMELESSNESS

Stating that "having people who are homeless, on the street or in shelter, goes against how we see ourselves," Hawaii Governor Linda Lingle unveiled "The Hawaii Plan to End Chronic Homelessness," which embraces in its guiding principles the ideas that homelessness is unacceptable and solvable, and that all sectors of society will benefit when people are housed. Hawaii was one of eight states chosen in 2002 to participate in the Federal Policy Academy focused on chronic homelessness. The 23-member Interagency Council on Homelessness -- made up of state, local and private authorities on homelessness -- collaborated on the resulting plan.

Governor Lingle, pictured here during a State House news conference to announce the plan, is pictured with (left to right) Hawaii County Executive Director Andy Levin, Kaua`i Mayor Bryan Baptiste; Honolulu County Department of Community Services Director Debbie Morikawa; United States Interagency Council on Homelessness Executive Director Philip Mangano; Housing and Community Development Corporation of Hawai`i Executive Director Stephanie Aveiro; and Hawaii Lt. Governor James R. "Duke" Aiona, Jr.

"We now have an unprecedented level of partnership in Washington, recognizing that no one level of government can get the job done alone. We all need to be partnered together. So we've been working with states and localities to move forward to create a partnership across our country to get the job done. Governor Lingle's leadership in forwarding a plan that stresses both prevention and intervention strategies for the state's homeless population, holds great promise," stated Director Mangano. The Plan proposes to fund remedies that are flexible and outcome oriented, affirming federal themes in its call for all community leaders and policy makers to be in partnership to achieve the Plan's goals. The Plan commits to monitor results and fund what works.

Read the Hawaii Plan

(top)

GREATER LOS ANGELES TO CONDUCT FIRST HOMELESS CENSUS

On January 25, the Los Angeles Homeless Services Authority will conduct its first street count of unsheltered people in Los Angeles County over the course of three nights, using 1,200 volunteers organized in teams that include homeless and formerly homeless people. The new initiative will be one of many such counts from coast to coast as local communities line up resources and volunteers to conduct street counts of unsheltered people during the next several weeks. Spurred on by the need to develop new data about persons experiencing chronic homelessness in their communities, cities and towns are organizing census activities for late January and beyond. In the 2004 Department of Housing and Urban Development (HUD) McKinney-Vento Homeless Assistance competition, applicants were asked to describe local plans for conducting data collection for completing the 'unsheltered' population, including at least a biannual count starting with in 2005 based upon a one day, point-in-time study, preferably in the last week of January 2005. To help communities perform this census, HUD published "A Guide to Counting Unsheltered Homeless People. "

In addition to counting people on the streets, the Los Angeles initiative will also reach homeless people who are in shelters, jails, mental health facilities, hospitals, drug treatment facilities, and motels. According to HUD, many communities have long understood the need to count, describe, and understand the homeless people who do not use shelters and are typically found on the streets, in abandoned buildings, or in other places not meant for human habitation. Unsheltered homeless people are an important subpopulation of homeless persons and their characteristics and needs must be accommodated within any strategy to reduce homelessness and help eliminate chronic homelessness. Collecting good baseline data about this subpopulation is essential to understanding the causes of homelessness and to designing effective responses, and can be used as a basis for comparison in future years.

The HUD guide describes several methods for identifying, counting, and learning something about homeless people who are unlikely to be found in shelters or in other residential programs within a local homeless assistance network. Information about these approaches was gathered from communities throughout the country, and examples of their methods are provided throughout the Guide. Examples of work sheets, timelines, surveys, forms and more from Boston, New York City, Denver, Philadelphia, Seattle, Atlanta, Long Beach, Broward County, Florida, Washington, and Kentucky are included.

Read the HUD Guide

(top)

HAWAI`I'S NEW HOUSING PROPOSALS TARGET INCREASED HOUSING OPTIONS

"Recognizing the growing need for affordable housing on all major islands in the state, we reached out to the business community and housing advocacy groups to help us find real solutions, and they stepped forward in a very big way," said Hawaii Governor Linda Lingle as she recently unveiled her state's new report to the Hawaii State Legislature. Prepared by the Affordable Housing Task Force and outlining specific recommendations for short- and long-term solutions to Hawaii's affordable housing shortage, the report calls for changes in the government permit process, using government land for housing developments, tax breaks for landlords with affordable units and increasing the conveyance tax for housing that meets affordability standards. The release of the report precedes Governor Lingle's soon to be announced legislative proposals on housing, expected this month and accompanied the release of the state's Plan to End Chronic Homelessness. The state legislature has given the Governor $100 million in bond authority to develop housing, the largest sum ever provided.

The Housing Task Force was chaired by Marvin Awaya of Pacific Housing Assistance Corporation, Craig Hirai of the Hawaiian Association of Realtors, Nani Medeiros of the Governor's Office, Don Tarleton of Hawaii Community Reinvestment Corporation, and Dean Uchida of the Land Use Research Foundation. Following an August forum convened by the Governor, five smaller working groups met from October through December to address the issue areas that were identified as top priorities in addressing the affordable housing shortage. The five working groups focused on: streamlining the state and county land use entitlement processes; developing creative financing for infrastructure development; improving the coordination of federal, state and county financing programs to facilitate affordable housing development; identifying financing strategies to develop affordable housing, including funding for the Rental Housing Trust Fund; and creating an institutional structure to focus on stimulating the development of affordable, workforce housing.

"The task force members had the heart to do this, and they developed sound, well thought-out recommendations that will make their way into legislation," stated the Governor. "Collaboration is critically important to get everyone together, talking together, moving forward as one. This is an issue that clearly will allow us to work together as a team." State Senator Ron Menor will co-chair a Senate task force that will now hold public meetings on affordable housing around the state.

The housing report builds on the Governor's commitment of last year, when speaking to an audience of almost 1000 people at the Hawaii Chamber of Commerce Annual Meeting on July 15, she announced a state planning process to end homelessness in the 50th state. Calling for a partnership among government, private sector, and non-profit organizations, Governor Lingle said that she would seek ways to create 17,000 additional rental units in the state over the next six years to address a housing shortage and assist the state's estimated 6,000 homeless people, stating, "We have come dangerously close to accepting the homeless situation as a problem we just can't solve." Governor Lingle also met with the Mayors of Honolulu, Hawaii, Kauai, and Maui counties to discuss housing issues.

Read the Governor's Report

(top)

CALIFORNIA BUILDER USES HOUSING SALES TO HELP MEET HOMELESS HOUSING NEED

In some parts of San Diego County, there's a new requirement when buying a house: a mandatory charitable contribution by the buyer to assist in meeting the housing needs of homeless people. Lennar Corp., one of the nation's largest builders, now requires homebuyers to make a payment that will be given to local housing organizations chosen by a foundation set up by the builder. Lennar Corp. requires the fee (amounting to 1/20th of 1 percent of the sales price of its new houses) under a program started three years ago in Orange County.

Lennar Corp. brought the program to San Diego County initially two years ago and now requires the payment. For a $500,000 house, the amount collected from a buyer would be $250, which is added to the purchase price. Making the required contribution even more unusual is that legal documents recorded with the county require future buyers to fund the trust over the lifetime of the Lennar homes.

According to Nicolas Retsinas, director of the Joint Center for Housing Studies at Harvard University, this is a unique program. Lennar executives said the foundation's primary focus is on the "transitional homeless," such as workers who have lost their jobs or battered women living in shelters. Administrative costs for the foundation are absorbed by Lennar, which will track future sales through a title company. Lennar also makes contributions to its charitable housing foundation. Exempted from the program are Lennar houses designed to meet lower-income housing requirements. The program is under way at about 120 Lennar developments in Southern California and this year the foundation should collect $1.5 million, an increase over $700,000 collected last year. Lennar division president Mike Levesque said the first local organizations to receive money from the foundation will be announced this summer. He expects the company to award more than $200,000.

(top)

SAN FRANCISCO DEMONSTRATES CIVIC PARTNERSHIP TO END CHRONIC HOMELESSNESS

"Project Homeless Connect is breaking the myth that people do not seek assistance and services and would simply prefer to be on the street," stated Mayor Newsom in an appeal to the citizens of San Francisco to join in a new expression of civic will to end chronic homelessness. "The data prove that when people are approached in a respectful and kind manner, and with available resources, they are eager to accept help towards self-sufficiency. National outreach professionals agree that it takes multiple contacts to build trust towards accepting assistance. The goal of this effort is to do just that."

Project Homeless Connect is a new and successful bimonthly event that encourages both the experienced volunteer and the concerned citizen to work directly with people experiencing homelessness in San Francisco and to help link them to needed services. Volunteers, trained and paired with more experienced workers, encourage homeless people to come to a "linkage station" where they can receive medical treatment, substance abuse and mental health counseling, legal services, sign up for food stamps, GA and SSI benefits, learn more about housing options and get food and other giveaways. Street Outreach workers go out in groups of 2 or 3 to engage clients and help bring them inside to connect with the City's web of social services.

The new initiative is directly linked to the City's 10-Year Plan, in which every action step has an outreach component that includes a Central Intake Point that must be easy to navigate and access all available resources in the City. Implementation leader Angela Alioto stated, "Project Connect is the central intake point. It connects City services and non-profit services to homeless citizens brought in by volunteers. It is a perfect model for connecting homeless people to permanent supportive housing services and at the same time involving the citizens of the City as outreach volunteers. Citizen involvement is essential to our ability to end homelessness. And that is exactly what Project Connect does."

The successes and lessons of Project Homeless Connect 4 are offering planners opportunities to increase both the number of volunteers and the number of clients served. It is the lessons learned and best practices documented that lend the initiative its replicability, as indicated by Director Mangano: "Project Homeless Connect offers a model for communties across the nation to express their political, public, and civic will in ending chronic homelessness."

April 2005's Project Homeless Connect event, where volunteers connected with 1,037 homeless clients, showed that the new initiative - previously staffed by government workers--has taken hold in the City. In October 2004 the City recruited 278 volunteers to engage in a survey of the downtown homeless population, which consists of a 60-square block area in the Tenderloin District where 85% of the City's social services currently exist. To date, over 2,000 homeless people have been helped since the first event.

Mayor Newsom's Deputy Chief of Staff Alex Tourk, who spearheads the outreach events, commented, "December's Mass Mobilization event helped evolved the model further. Anticipating the demand, the City put 50 transitional housing units on line, each available for 60 to 90 days. In one afternoon, 54 people (46 singles and four couples) were placed into temporary housing. Just as importantly, all 54 were connected to an intensive case manager, who will assess each of their needs and ensure appointments for substance abuse counseling, medical care, and permanent housing are kept."

Project Homeless Connect uses Graham Auditorium as a one-day, mega service site to help homeless adults, especially those staying on the streets, connect to resources and services. Client Support Services, a specific group of volunteers, assists clients to get from one service area to another, acting as guides, giving directions or escorting clients to the areas where they can get food, services, appointments, whatever they need. Integral to connecting clients with services is providing a suitable atmosphere while they wait for assistance. The activities center provides a means for the clients to occupy themselves while transitioning between services and a forum in which they can connect with volunteers through different activities.

(top)

CREATING INTERJURISDICTIONAL PARTNERSHIP TO END CHRONIC HOMELESSNESS

Collaboration and systems alignment is a crucial strategy for a successful 10-year plan for Portland and Multnomah County. In Portland, each jurisdiction represents different services and resources. Multnomah County is responsible for human services and the City of Portland is responsible for housing. Multnomah County is the lead agency over homeless youth, homeless families and the domestic violence system. The City of Portland is responsible for the system that serves homeless adults and the system that develops non-profit affordable housing. Multnomah County operates the jails, and the City of Portland manages the police. The list goes on. There are many intersections among these different governmental agencies, and all of them touch homelessness directly or indirectly.

While there was general agreement on the benefit of collaboration across these agencies and systems, there was also recognition of how difficult it is to manage relationships with other entities, with many leaders finding it easier to accomplish a task single- handedly. According to Portland Homeless Programs Manager Heather Lyons, the partnerships would not have formed if it were not for City Commissioner Erik Sten's willingness to reach out to Multnomah County elected leaders and support a fully collaborative effort. In return, the County elected officials offered support and co-leadership to the planning effort.

The process led to development and recognition of shared interests and shared values. Multnomah County has an interest in ensuring services for the most vulnerable people in the community were effective and determined that housing was an essential component to successful outcomes. The City of Portland has an interest in ensuring adequate human services for homeless adults and families, as well as providing housing that is affordable to people who experience homelessness. These interests, along with concerns from police, corrections, hospitals and business converged under the political leadership from both the City and the County to create a 10-year plan to end homelessness.

That support has translated to real systems change and shared financial support of permanent supportive housing projects and other projects under the 10- year plan. Within the first six months of implementation, the City and County have contributed $3 million of local funding toward activities in the 10-year plan. Additionally, the City and County leadership are jointly working with local foundations to discuss opportunities for strategic investments related to homelessness and the 10-year plan.

(top)

HOMELESSNESS PREVENTION

Comprehensive Reentry Policy Recommendations Unveiled

Noting that virtually every person incarcerated will eventually be released, posing significant impact for public safety and public spending, the public-private Re-entry Policy Council (RPC), supported by three federal agencies and several philanthropies, has issued an extensive report on how policy can influence this critical prevention strategy. Preventing homelessness upon release has long been recognized as a key strategy for communities. Federal support comes from the U.S. Department of Justice, Office of Justice Programs and National Institute of Corrections; U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation and Substance Abuse and Mental Health Services Administration; and U.S. Department of Labor, Employment and Training Administration.

The 600-page report reflects the views of 100 experts from areas of workforce, health, housing, public safety, family, community, and victims around the country. Created by the Council of State Governments, the Re-entry Council seeks to assist state government officials through the development of bipartisan policies and principles for elected officials and other policymakers and to facilitate coordination and information-sharing among organizations implementing re-entry initiatives, researching re-entry trends, communicating about re-entry related issues, or funding re-entry projects.

The report covers topics ranging from incorporating reentry into organizational missions to a step-by-step review of the reentry process and analysis of housing, workforce, substance abuse treatment, mental health care, primary health care, and child and family issues. Each section of the report contains analysis, policy insight, and recommendations.

Read the Report

(top)

IMPROVING DISCHARGE PLANNING OUTCOMES: KENTUCKY PASSES HOMELESSNESS PREVENTION LEGISLATION

On April 13, 2004, Kentucky Governor Ernie Fletcher signed into law HB 376, the Homeless Prevention Pilot Project, a bi-partisan bill sponsored by Representatives Scott Brinkman and Joni Jenkins and passed unanimously by the State Legislature. The new legislative initiative states: “discharge to an emergency shelter is not appropriate” and bars discharges from foster care, mental health hospitals and corrections into homelessness. Public systems will be required to provide appropriate discharge planning supports that include housing placement and links to other resources to achieve successful re-entry into the community. “Stopping institutional discharge into homelessness is part of our Metro Louisville Blueprint to End Homelessness, which we created in 2001,” stated Marlene Gordon, Executive Director of The Coalition for the Homeless in Louisville, which supported passage of the legislation.

A Coalition survey of emergency shelters in Louisville and Lexington found that, of the over 1,000 people surveyed, 77.5% had experience in at least one of the public systems. 26% of those who had been in prison and 38% of those who had been in a mental health institution had been released directly into homelessness. The survey also found that, while 75-85% of youth aging out of foster care or being discharged from state juvenile justice programs are reunited with their families, 50% of those become homeless within 6 months of discharge. The new legislation requires that an individualized, comprehensive discharge plan must be coordinated with community-based services and address education, employment, health care, and other needs in addition to housing.

A diverse group of advocates supported passage of the legislation, including homeless, mental health, youth, and prisoner advocacy groups as well as the State Fraternal Order of Police, which testified on behalf of the bill. As a result of the legislative process, the Kentucky Cabinet for Health Services, Justice Cabinet, and Cabinet for Families and Children moved to create re-integration plans.

Read Kentucky HB 376

(top)

CLOSING THE GAP FOR HOMELESS PERSONS WITH MENTAL ILLNESS IN SEATTLE

"That makes five homes and counting" says Catherine Walker, Chair of Plymouth Healing Communities, a small and growing faith based organization in Seattle that houses homeless persons with mental illness and provides a secure bridge from treatment to housing, thus reducing the risk of homelessness often faced by persons being discharged. The organization's flagship house, Plymouth House, takes in mentally ill persons who have just left the hospital and who were formerly homeless, living in the streets and shelter in Seattle. These individuals live side by side with volunteer companions for anywhere from three weeks to three months while they wait for permanent housing placement. Plymouth's other four houses provide permanent, supported housing for twenty persons recovering from mental illness and the effects of long-term homelessness, many of who were first at Plymouth House. These homes are operated in partnership with two mental health agencies, Harborview Mental Heath Services and Community Psychiatric Clinic.

Plymouth Healing Communities took an innovative approach to partnership with public agencies when it recognized that it could move rapidly to develop community based housing. They raised needed funds including through close connection with Plymouth Congregational Church of Seattle. Their formula for success in their permanent housing units includes operating support through the HUD McKinney Shelter plus Care program for the permanent housing units, as well as support services through Harborview Mental Health that are funded principally through the federal Medicaid program. Individual church members put up about 50% of the capital development fund. An additional $60,000 of the construction/rehab costs was "in-kind" by volunteer labor from the church. Plymouth Congregational Church adds about 60% of the $75,000 annual operating cost it takes to run Plymouth House each year. The other 50% of the initial capital development was acquired through private foundation grants. Part of the flexibility that group has comes from their capacity to loan money from the church at virtually no interest. The houses can be acquired when they are found, and then the capital campaign pays back the loan to the church.

Plymouth Healing Communities is inspired and led by the work of Chaplain Craig Rennebaum of the Seattle Mental Health Chaplaincy. "This is a ministry of companionship with homeless persons. We walk with them and listen and share ourselves with them as they share with us." Chaplain Craig Rennebaum has walked the streets of Seattle for the last twenty years ministering to homeless, mentally ill persons. An ordained United Church of Christ pastor, he left parish work in Seattle after he felt called to minister directly to the increasingly numbers of homeless people showing up at the doors of his church. Troubled by the lack of housing available for the homeless persons with mental illness Chaplain Rennebaum conceived of a place of healing for persons emerging from the fog of untreated mental illness and homelessness.

Plymouth Healing Communities has been adding a house at the rate of one a year. Its development strategy includes an understanding of its place within the Seattle/King County 10-Year Plan to End Homelessness that is soon to be completed.

(top)

ENDING HOMELESSNESS: A “KEY”

At the Housing First program of St. Louis’ St. Patrick Center, the formula seems too simple. End chronic homelessness by providing a home to those in need. However, St. Patrick Center in St. Louis, MO is discovering just that. In January 2004, this faith-based agency launched a 3-year Housing First program supported by an Assertive Community Treatment (ACT) team. Thus far, the program is achieving some incredible results. “These are the people who’ve never responded to services and basically have just existed on the streets or in our shelter system,” said Mary Lim-Lampe, the ACT Team Leader who previously spent 8 years as a mobile outreach worker for St. Patrick Center.

“I never dreamed this population would respond to housing in such a profound way. We’re amazed how behaviors and habits are changing so quickly, from hygiene to attitudes. It’s human nature I guess to respond better when you have a stable, safe, secure environment each and every night. We don’t often consider the value of a good night’s rest. But we do now!” St. Patrick Center has successfully engaged 32 men in 4 months, all suffering from severe mental illness and substance abuse. Of those they have placed 15 into permanent housing and 22 are medically compliant. “That’s been the most surprising discovery. Almost two of every three ACT clients are taking their medications and responding to their psychiatric and mental health therapy. They want to get better. We’re to the point with many of them where we’re already talking about goals and objectives for their life,” said Lim-Lampe.

The ACT Program at St. Patrick Center is funded by the Missouri Foundation for Health (MFH) at a cost of $1.5 million over 3 years. “MFH is taking a stand with us that we need to stop making housing a reward of a person’s recovery, and begin making it the first step toward recovery,” said Dan Buck, CEO of St. Patrick Center. “I can’t wait to promote our one year retention rates and to share some of the personal stories of how lives of dignity and self-worth were built from lives that society has been warehousing for decades,” added Buck who points out that of the 15 mentally ill men housed in the past 4 months, they have ended 80 years of homeless despair (average of 5.25 years of homelessness per client housed.)

In partnership with BJC Behavior Health, The St. Patrick Center ACT team is made up of a full-time psychiatrist, psychiatric nurse, substance abuse counselor, mental health counselor, entitlement specialist, employment counselor and community activity specialist. Many of the current clients are finding it hard to believe that their housing is almost unconditional (tenant – landlord agreement). “We just tell them, ‘Here’s a key. You have a home. Come with me,” Lim-Lampe says. “They’ve known me long enough to know that I’m telling the truth. A lot of our success with this complex population begins with trust and years of relationship building. It’s nice to have real hope and long-term help to offer them now. At last we have a solution!” Next spring, St. Patrick Center plans to break ground on a 32 unit permanent, supportive housing project with support services coming from a second ACT Team.

Read about St. Patrick Center

(top)

ENDING HOMELESSNESS WITH HOUSING AND HEALTH CARE: GENNESARET FREE CLINIC RESPITE PROGRAM

Indianapolis’ Gennesaret Free Clinic is a well-established health care program with over 350 volunteer health care professionals providing over 12,000 medical and dental care visits at 13 sites in the area for homeless and poor people. Gennesaret has combined its health care commitment with a focus on housing since it embarked upon a new health service in 2000 to provide eight homeless men with respite transitional care through its Health Recovery Program, the first and only respite in Indiana and one committed to housing its residents post-recovery. Individuals are admitted to the program post-discharge from local hospitals when facing recovery from illness, injury, or surgery and when their homelessness would leave them to recover on the streets or in shelters.

The Program is firmly committed “to correct the instability and anguish that homelessness brings by working to provide a housing opportunity for each man upon discharge.” This commitment to housing shows in the outcomes for the 126 men who have been served in the respite to date. The Health Recovery program has placed 86% of residents in permanent or transitional housing on discharge from the respite. The Program staff work with clients for at least one year after discharge to ensure housing stability and self-sufficiency. According to Program Manager Mark Douglas, “this program shows that you cannot assure health care without housing. Reliable, stable housing is the rest of the prescription, especially for homeless people with chronic illnesses.”

The respite uses a residential model with private rooms for all residents. Caregivers
live on-site to provide 24/7 support, including comprehensive health care, case management, medication management, and transportation to other services. Major diagnoses are orthopedic injury, HIV related illness, foot and leg problems, coronary diseases, and cancer. An average of 37 individuals are admitted annually to the respite, with an average length of stay of 70 days. The Health Recovery Program reports that use of the program eliminated emergency room visits and an average of two hospital stays per person. Of those individuals served in the first three years of the program, 20% were veterans. 36% were assisted with employment and 21% secured full-time or part-time employment. 38% were assisted with disability claims. The commitment to a housing outcome marks the result that sets this respite program apart.

Read about the Health Recovery Program

(top)

USING INNOVATION FOR A BETTER FUTURE: BRITAIN'S SHIFT TO NEW STRATEGIES FOR PERMANENT HOUSING FOR HOMELESS FAMILIES

Using clear performance targets backed up by top-level commitment and ongoing specific outcome measurements to track progress, the British Government continues to achieve success in tackling homelessness. Britain’s dramatic success in achieving a 2/3 reduction in “rough sleeping” (known in the U.S. as chronic homelessness) has been well publicized. As described here, the success of the Rough Sleepers Initiative has produced other concrete results: opening the door for new initiatives in other areas of homelessness, as well as for new investment, based on the documented outcomes in the Rough Sleepers Initiative. Policymakers and legislators, convinced by the evidence in the Rough Sleepers Initiative, next targeted the needs of homeless families with children.

Britain’s success in curtailing the use of Bread & Breakfast hotels (B&B) for families (the equivalent of “welfare hotels” used in the U.S.) has turned the corner on the existing practice of placing families long-term in these settings. In 2002, encouraged by the demonstrated results of the Rough Sleepers Initiative, the British Government set a target to end the use of hotels within two years, and the B&B unit, part of the Homelessness Directorate within the Office of Deputy Prime Minister, allocated 35 million pounds in the 2002/2003-budget cycle to use toward achieving the target. The Government committed to restrict B&B placement to less than 6 weeks and for emergency use only.

On May 4, 2004, the British Government declared that the ambitious target established just two years earlier had been met, with Minister for Homelessness Jeff Rooker stating: “If trends in temporary B&B accommodation use had continued, there would now be between 8500 and 9700 families in B&B long term. Local authorities across the whole of England are now making reliance on B&B a thing of the past by preventing homelessness, finding better forms of accommodation, and pursuing innovative ways to offer families with children a better future”.

The latest results, achieved through a greater focus on homelessness prevention and access to permanent accommodations, add to the measurable results of Britain’s approach and have taken Britain from a March 2002 level of 4000 families with children living in B&B accommodations for over 6 months to a March 2004 figure of just 28 families still living in B&Bs for over six months.

Government research has shown both social and fiscal costs in the B&B system. In 2001, a report issued by the British Government, entitled “More Than a Roof” described how long term placements in temporary B&B accommodations often led to “social isolation” for families and that health and behavioral problems were greater among these homeless children. Chartered Institute of Public Finance and Accountancy figures on local authority expenditures across England and Wales also showed that while the use of B&Bs made up just 15% of total temporary accommodations, they accounted for 55% of the costs incurred by local authorities.

Working with local authorities, which have statutory responsibility for meeting housing needs, the B&B unit used the new resources to develop a program of practical and innovative measures to achieve the 2004 target. These measures included (1) allocating 25 million pounds to 44 local authorities to develop alternative temporary accommodations to replace the poor quality B&B hotels, (2) establishing teams of specialist advisors to work with the local authorities to develop more effective prevention programs and increase access to private rental housing and (3) developing agreed upon Action Plans with the top 50 authorities which had the highest number of families with children living in B&Bs.

Local authorities were encouraged to increase the supply of alternative temporary accommodations through private rentals or direct leasing and to use mobility and under-occupation incentives to maximize permanent housing opportunities. Among the prevention efforts promoted were mediation services for families in relationship difficulties, rent deposit guarantees to help families obtain housing in the private rented sector, “landlord advice services” to reduce evictions and “debt and welfare counseling” to help families sustain tenancies. The B&B unit also instituted a series of good practice summits for local authorities. The B&B reduction target has now been incorporated into statute giving families the power to take local authorities to court if they are placed in a B&B for more than the six-week limit.

The recognition of the unsuitability of B&B’s as temporary accommodations for homeless families with children and the effort to eliminate their use for this purpose is but one part of the continuing broad approach taken by the British Government to tackle the key issues surrounding homelessness. In addition to the Rough Sleepers and B&B reduction targets, The Homelessness Act of 2002 has placed a new duty on local authorities to undertake a detailed homelessness review leading to specific local authority plans which identify the key local drivers of homelessness and incorporate effective local solutions.

United States Interagency Council on Homelessness Executive Director Philip Mangano last week participated in a transatlantic dialogue on housing and homelessness sponsored by the Rothermere American Institute at Oxford University. While in England Director Mangano met with Britain's Terrie Alafat, head of the Homelessness Directorate and Canada’s Jeff Bullard, Director of Research for the Canadian National Secretariat on Homelessness to exchange best practices.

(top)

COMMITTING TO A HOUSING STRATEGY: HARTFORD'S IMMACULATE CONCEPTION HOUSING CORPORATION

“The conclusion drawn from these findings was the need for a change in the strategic direction of the organization,” states the Business Plan rather dryly. But that final line in the new strategy of the Immaculate Conception Shelter & Housing Corporation (ICSHC) reflects the decision of a longstanding Hartford, CT, faith-based provider of emergency services to homeless individuals to turn from a focus on emergency shelter operations to permanent supportive housing for chronically homeless individuals. The new strategy was unveiled as part of the ICSHC's 2004 “Symphony of Light” event in Hartford. Mayor Eddie Perez of Hartford, who is moving forward with a 10-Year Plan for his city was joined at the event by United States Interagency Council on Homelessness Executive Director Philip Mangano who was invited to keynote. During the event, Mayor Perez recounted his own move from Puerto Rico to Hartford and his commitment to homeownership and ending homelessness in his city.

ICSHC, providing services to homeless men in the city of Hartford since 1980 and to over 1,000 people needing shelter last year, has also provided case management, educational, and job training services, in addition to shelter, on property owned by the Archdiocese of Hartford. The emergency shelter was housed in the church’s basement and administrative services, case management and the educational services were housed in the rectory. Like many providers, ICSHC initiated a permanent supportive housing program, Casa de Francisco, in 1998 to move 35 shelter residents into permanent settings. This Department of Housing and Urban Development funded program has been successful and has a retention rate that is comparable to other housing programs in the city of Hartford.

Relocation and cost issues, as well as a hard look at the needs of those it serves, caused the organization to, in its words, “participate in a national call to end homelessness.” States the Business Plan, “Immaculate has embarked on this bold journey, because addressing the national crisis of homelessness is no longer about managing homelessness, it is about ending homelessness.”

(top)

REACHING PERMANENT HOUSING: HOMELESS FAMILIES IN MASSACHUSETTS NO LONGER USE WELFARE HOTELS

Friday, August 13, 2004, was far from an unlucky day in the Commonwealth of Massachusetts. That day marked the last day a homeless family was placed in a state funded motel used as shelter and demonstrated the results of several state initiatives and investments that brought in new partners and new expectations to its family shelter system. While just one year before the state was spending in excess of $20 million for hotel placements for 599 families, the pilot projects and incentives instituted to change outcomes for homeless families demonstrate partnerships and investments applicable beyond Massachusetts.

Under the leadership of Lieutenant Governor and Interagency Council on Homelessness and Housing Chair Kerry Healey the state earlier this year sought to change its approach and set a goal of ending hotel use within 24 months. The August 13 landmark date, which far exceeded the timetable set by the state for itself, was reached by implementing several pilot programs aimed at achieving different results for families. “Today we are celebrating a significant achievement on the part of many state homeless staff whose work has ensured that homeless families have better options than they did a year ago. Because of their efforts, more than 1,000 children will be in a more stable environment when they begin school this fall, said Lt. Governor Healey. “This dramatic progress demonstrates that we are truly changing what it means to be homeless in Massachusetts. We're moving away from just managing shelters to addressing the issues of family homelessness head-on.”

“Once again Massachusetts is demonstrating that homelessness yields to planful partnerships and innovative initiatives,” said United States Interagency Council Executive Director Philip Mangano. “Lt. Governor Healey’s Interagency Council and Commissioner Wagner’s strategies have done away with the disgrace of welfare hotels.”

The first step by the Commonwealth’s Department of Transitional Assistance, responsible for the family homelessness programs, was to reverse the equation for families upon entry into motels. Much as good discharge planning begins on the day of entry to a system of care, DTA created a new approach based on the idea that, from the first day a family enters shelter, focus is on the day the family will exit. To do this, DTA implemented a new Self-Sufficiency Plan (SSP), a document spelling out all parties' responsibilities in addressing the family’s barriers to obtaining and maintaining housing and completed for each family in emergency shelter. DTA and shelter staff were trained on the SSP, and the training itself helped form a partnership among DTA staff, shelter providers, and homeless families in planning for their exit from shelter.

With the SSP as a base, DTA then purchased additional shelter capacity using its lack of additional funding to shape collaboration with shelter providers to bring on additional family shelter capacity, with the understanding that a new shelter unit could not cost more than the current price of a hotel placement. Some units ended up costing less, and these collaborative efforts led to an increase of 148 rooms in FY 04. With additional shelter capacity in place, DTA commenced initiatives to change the “front door” of its system. Previously, when there was not space available for a family, a hotel placement would be used until a shelter unit opened.

On Cape Cod, DTA piloted a regionally-based approach to managing family homelessness from Provincetown up to Brockton. Networks were created across local DTA offices that leveraged community- based resources and open shelters that might not have been in the immediate community. This regional approach led to further dramatic declines in the number of hotel cases on the Cape.

On the North Shore, DTA experimented with an intake/assessment model. Rather than being placed in hotels, families were put into a 30- to 45-day assessment shelter that helped identify their needs and barriers to housing. Again there was a dramatic decline in the number of families in hotels and the number entering the shelter system as roughly half of all families found alternatives to homeless shelters.

With the fiscal savings that resulted, the pressure was off of the state's family shelter account, and DTA explored investments to provide further assistance to families in shelter. Not only have these initiatives paid off, they've helped to better assist homeless families. Among them: DTA crafted Shelter to Housing (S2H), a one- time, $6000 placement bonus for housing providers who placed employed homeless families into apartments with a 12-month lease. Over 200 families have been placed in private apartments, further freeing up capacity and resources for other families.

With its increased shelter capacity, DTA expanded hired 13 Intensive Case Managers (ICMs), who were put through several weeks of training on working with homeless families. They began visiting all remaining families in hotels on a daily basis, and their regular presence yielded a greater ability to place families in more appropriate settings as well as to ensure that the Self-Sufficiency Plan as on track.

Along with the new ICMs came the Motel to Shelter (M2S) initiative focused on moving remaining hotel families into vacant shelter units. M2S efforts were augmented over the summer months in order to eliminate the disruption such moves would cause homeless children during the school year.

With the Commonwealth’s Department of Housing and Community Development (DHCD), DTA invested funds in a pilot program with local housing authorities (LHAs), which places homeless families for 6 months and then transitions them into regular LHA units. This initiative placed 10 families in FY04 and is on schedule to place an additional 100 families this fiscal year. A DTA survey showing nearly half of the longer- term families in hotels had some self-reported disability, with the most prevalent being a behavioral or mental health issue, lead to a partnership with the Massachusetts Behavioral Health Partnership (MBHP). A targeted effort was implemented with local DTA offices on the North Shore to better serve families with behavioral/mental health barriers to obtain and maintain housing.. MBHP is a for-profit corporation that holds the state’s managed behavioural health care contract and has worked on numerous homelessness related initiatives in Massachusetts.

“We have now developed not only new ways to address the immediate housing needs of homeless families, but also the long-term supports to help them become self-sufficient,” said DTA Commissioner John Wagner. “Spending $6,000 to lease up a homeless family was much more prudent than spending the $18,000 that it typically costs to merely provide temporary shelter for that same family. In concert with the focus provided by the federal Interagency Council on Homelessness and the leadership provided by the Lt. Governor, the Department is pleased to be able to offer better options for those families.”

(top)

SAVING LIVES AND PUBLIC COSTS: SAN FRANCISCO'S DIRECT ACCESS TO HOUSING

With documented outcomes that demonstrate that two-thirds of chronically homeless people placed just in its units are still successfully housed two years later with reduced use of expensive acute public systems, the City and County of San Francisco's Department of Public Health (DPH) Direct Access to Housing (DAH) program is a model of outcome- oriented public sector investment in housing resources for the most costly homeless people in communities. The high utilizers of public systems who are housed in DAH units are persons who have experienced chronic homelessness, generally have complex medical and behavioral health disorders, a history of institutional care, and have never or not successfully been housed. Retention rates are even higher when moves to other housing are included.

Established in 1998 and with over 400 persons housed, DAH has shown that its residents, most of whom have one or more disabilities, have a 58% reduction in emergency room use, a 57% reduction in hospital inpatient bed use, and a reduction in the length of psychiatric hospitalization. San Francisco first decided to invest in housing resources to reduce over-utilization of high-end health care resources and increase the effectiveness of DPH services by providing a safe and healthy environment for clients, by providing housing tailored to the needs of clients, and providing community based exits from DPH and other systems. DAH has established access points to its units for street outreach teams, emergency shelters, case managers for high utilizers, and primary care clinics, as well as other public systems.

DAH uses primarily City General Fund resources to provide permanent supportive housing by Master-Leasing entire SRO buildings and providing a low threshold housing environment. Other resources are state funds and reimbursement as a Federally Qualified Health Center (FQHC). Master leasing allows DPH to bring units on line quickly, rely on private investment for renovation costs, and negotiate improvements to common areas. Costs per unit are $400 monthly each for support services, leasing costs, and property management, or $1,200 per unit per month. Residents pay fifty percent of their income towards rent, with the average rent about $300. About 80% of residents receive public income supports, such as SSI.

On-site support services are coupled with an approach of “screening-in” persons in need and providing voluntary services through active engagement by the social services staff on site. Services include case management, medical and behavioral health care, and third party rent payments. All residents have tenant rights in their housing.

Read more about Direct Access to Housing

(top)

BUILDING BRIDGES TO HEALTH, WEALTH, AND HOUSING: NASHVILLE'S URBAN HOUSING SOLUTIONS LEADS THE WAY

Combining sobriety, economic self-sufficiency, and permanent housing, Urban Housing Solutions (UHS) of Nashville owns and operates 13 permanent housing developments for homeless individuals and families including four sober properties. The Nashville based non-profit has specialized in housing and support services for homeless people, individuals in recovery, and people with mental illness since 1991, designing communities to provide independent living in a drug-free environment. To be eligible for UHS, residents must be homeless, have an income below 50 percent of the area median income, pass a drug test, and be willing to comply with property rules.

UHS offers 600 affordable rental apartments throughout Nashville, and units are Section 8 approved and accessible by public transportation. The formula for UHS’ success involves attention to behavior, consequences, and opportunity. Residents are held accountable for their behaviors that violate property rules, but at the same time, are offered opportunities for self-improvement and economic success. Education and employment services offered to help individuals move ahead include literacy, computer basics, web site design, videography, and money management. Micro-enterprises are encouraged and supported. “Bridges to Wealth” is USH’ economic opportunity program, helping residents save for school, a car, a home, or a PC. By attending money management classes, participants earn a match to their savings.

UHS’ “Journey of Hope” program offers 84 permanent housing opportunities to homeless individuals who are on the road to recovery. Residents in these apartments commit to securing employment, attending aftercare and participating in resident community meetings.

Initial assessment and orientation for potential participants occur at local treatment centers prior to the completion of the individual’s rehabilitation program. Upon acceptance into the program participants are required to complete a rental application and sign a recovery contract and resident rules for sobriety. An Individual Life Recovery Plan is developed for each resident, and every participant visits a counselor regularly to track progress with in the program. Since its inception in 1991, the program has assisted 80% of participants to achieve sobriety for at least 12 months.

(top)

USING HOME FUNDS TO HOUSE PERSONS EXPERIENCING CHRONIC HOMELESSNESS

City of Presidents Mayor William J. Phelan of Quincy, Massachusetts, has put his city's resources where his rhetoric is. In an innovative partnership with Interfaith Housing, Inc., local foundations, business, and corporate leaders, Quincy has committed over $1,000,000 in HOME funds in the last 2 years to create permanent housing for chronically homeless persons, while working to develop a 10-Year Plan. Once the plan is completed, the Mayor has committed future HOME funds to implement recommendations in the plan. United States Interagency Council on Homelessness Executive Director Philip Mangano recently met with Mayor Phelan to learn more about the results of the HOME Funds Investments. At that meeting, Mayor Phelan expressed his commitment to move forward with a 10-Year Plan that would be expansive in its involvement of all segments of the community.

"The time is right for a pilot program that seeks to end homelessness using innovative strategies. Quincy is the right place to implement this new solution because of the City's long-standing commitment to ending homelessness and the community's strong support for the work done by Neighborhood Housing Services and Father Bill's Place," said Mayor Phelan.

Neighborhood Housing Services is a Quincy-based affordable housing developer, and Father Bill's Place is a provider of housing and services to homeless persons. Two years ago they created a jointly owned subsidiary called Interfaith Housing, with a goal of bringing a housing development company and service provider for homeless people together to focus on creating permanent supportive housing specifically for people experiencing chronic homelessness. Together they raise resources needed for the projects, and jointly oversee tenant selection, support services, and property management.

In the past two years, with $1,007,000 in HOME funds, the Partnership has leveraged $1,136,000 in other funds. The Partnership has created 53 permanent units, with 37 units earmarked for persons experiencing chronic homelessness. Of the 37 units, 18 units are for women who struggle with severe mental health, substance abuse, and domestic violence issues. The 19 units for men are assisting chronically homeless veterans and other men with substance abuse and mental health issues.

Over the past six years this partnership has created 156 tenant-based scattered-site and project based housing units for homeless adults and families. Supportive services are provided to all tenants, with state and local agencies as well as foundations paying for these services. One of the Partnership's projects, The Claremont, is a new lodging house for 12 chronically homeless women in Quincy. It has been recently recognized along with the City of Quincy at the National Community Development Association as a winner of the HOME Program Awards for Excellence.

Read about HUD HOME projects

(top)

UTILIZING VA PROPERTY TO END CHRONIC HOMELESSNESS

The United States Department of Veterans Affairs, led by Secretary and United States Interagency Council on Homelessness Chair Anthony Principi, continues to mark the progress of several initiatives in the VA Great Lakes Health Care System, VISN 12. All of the joint VA-Catholic Charities initiatives reported here were described at the most recent meeting of the Region V Federal Regional Interagency Council on Homelesness, chaired by Dr. Joan E. Cummings Network Director of VISN 12.

Chronically homeless veterans will have a safe and sober environment and a path towards reentry to the mainstream of society as independent self-sustaining citizens, once the St. Leo the Great property at 78thand Halstead on Chicago's south side is in operation. St. Leo's Residences, one of five nationwide pilot programs under VA's Multifamily Homeless Veterans Loan Guarantee Program, is sponsored by Catholic Charities of the Diesis of Chicago through its Housing Development Corporation. It is a collaborative effort, which includes in addition to Catholic Charities, VA and the U.S. Department of Labor, to provide 141 units of transitional housing and support services, including job training and placement assistance to formerly homeless veterans. VISN 12 will open a Community Based Outpatient Clinic (CBOC) in conjunction with the housing development thus enabling VA to serve more directly an area of Chicago with a high concentration of Veterans. Project construction will begin this spring.

Spring 2005 is also the expected opening for an Enhanced Use Lease of the site on the VA Hines Hospital, which Catholic Charities is renovating into 40 private rooms. Additional projects at Hines by Catholic Charities is the planned assisted living project, with residential preference for veterans (40-60 units planned) and the Bishop Goddard home for low income seniors with 70 one bedroom residences and a 50% preference for veterans.

Read about VA initiatives

(top)

MASSACHUSETTS HOUSING STRATEGY AWARDS FEDERAL HOUSING TAX CREDITS TO HOMELESS HOUSING INITIATIVES AND TARGETS BELOW 30% AMI POPULATION

Massachusetts Governor Mitt Romney, who has tied his state's housing development strategy to a new set of "Sustainable Development Principles", has awarded over $45 million in federal housing tax credits and other federal and state housing resources, including $2 million for new homeless housing units sponsored by local shelters. Massachusetts's tax credit allocation plan requires all potential project sponsors to reserve 10% of their total units for persons or families earning less than 30% of Area Median Income. Funds awarded include resources from the Massachusetts Department of Housing and Community Development (DHCD) Housing Stabilization Fund (HSF), Facilities Consolidation Fund (FCF), HOME program, Housing Innovations Fund (HIF), and Massachusetts Affordable Housing Trust Fund.

Homeless housing projects funded included $500,000 for five new single rooms at River House Shelter on the North Shore, to house persons experiencing chronic homelessness. The Salem Mission will build 22 single rooms and an apartment building in the former St. Mary Italian Parish rectory, acquired by the shelter from the Boston Archdiocese last year along with its church and youth center.

Tax credits investments support a mix of housing projects, including small to medium-size projects that create new affordable units; preservation projects that maintain rents at affordable levels for low- income households; and HOPE VI redevelopment projects. One of the state's application threshold elements requires project sponsors to set aside 10% of their development for persons who are "extremely low income" by the definition of the U.S. Department of Housing and Urban Development. By this standard, a household has an income of 30% or less of Area Median Income. For a single individual, this figure in Massachusetts ranges from $12,950 to $17,650 annually. HUD has previously documented an acute shortage of rental housing for this income group.

Through the state's new Office for Commonwealth Development (OCD), an umbrella agency responsible for coordinating the mission and activities of the state's housing, transportation, environmental and energy agencies, agencies are being encouraged to cooperate and coordinate to invest public funds in sustainable development and give priority to investments that deliver living wage jobs, transit access, housing, open space, and community serving enterprises. OCD created ten Sustainable Development principles to guide investment decisions by DHCD and other agencies, and these are incorporated into the tax credit scoring process as well as other housing finance applications.

In summary the principles are: focus on redevelopment, concentrate development, promote equitable sharing of development benefits and burdens, restore and enhance the environment, conserve natural resources, expand housing opportunities, provide transportation choice, increase job opportunities, foster sustainable businesses, and plan regionally.

Read the Massachusetts Tax Credit Allocation Plan

(top)

CITY OF PRESIDENTS ADVANCES HOUSING SOLUTIONS

Quincy Mayor William Phelan, who has put his city's housing resources where his rhetoric is, was presented the HOME Program Award for Excellence on behalf of the city from the National Community Development Association. "Claremont SRO Project, Quincy Interfaith's initiative to provide permanent supportive housing for 12 chronically homeless women. Partnered with the City on the project were Father Bill's Place and Neighborhood Housing Services. Support services are provided by Father Bill's Place, Tri-City Mental Health, and the Massachusetts Department of Mental Health PACT team.

According to Quincy Interfaith's Executive Director John Yazwinski, "Claremont Street is Father Bill's initial effort to implement fully the Housing First model. For the past ten years Father Bill's has moved steadily toward provision of permanent affordable housing with supportive services--rather than emergency shelter-- as the solution to homelessness. In addition to its 140 emergency shelter beds Father Bill's now has 152 units of transitional and permanent housing for formerly homeless people. Claremont Street is the next logical step in this direction."

Quincy, which has unveiled its completed 10- Year Plan developed by a wide range of partners, put just such a partnership together to open Claremont Street. Major funders for the housing program include Community Care Recovery Initiatives, Neighborhood Reinvestment, Department of Housing and Community Development, Federal Home Loan Bank, The Boston Foundation, Rockland Trust, South Shore Savings Bank, Keyspan Energy Delivery, Citizens Bank, and Ciffolillo Foundation.

One aspect of the planning for Claremont House was facilitated discussion for senior staff on lessons learned from other housing initiatives. In discussing the design for the Claremont Street project, the senior staff drew on their experience with Paula's House, two three-bedroom duplex units, providing housing for six chronically homeless women with serious mental health conditions since 2003. The senior staff identified several additional areas that required attention in order to implement the Housing First model successfully at Claremont Street. They were: further definition of the management structure and treatment team model; acceptance and support for the housing first model by agency staff; neighborhood relations on Claremont Street; tenant selection criteria and process; physical layout and design of facilities at the site; operational issues; design of the evaluation process; and interagency cooperation with Neighborhood Housing Services and Interfaith Housing Partners.

Father McCarthy's House, now under construction and named for QISC's founder, is another QISC SRO project designated for chronically homeless men and veterans. Services for the 19 SRO units come from Father Bill's Place, City of Quincy Veterans Services, Healthcare for the Homeless, and Tri-City Mental Health.

(top)

CALIFORNIA PROGRAM MOVES PEOPLE FROM THE STREETS TO JOBS AND HOUSING

The North Beach Citizens program in San Francisco has successfully turned its operations to engagement strategies that lead to jobs and housing for persons experiencing chronic homelessness. The program does not receive government funds.

North Beach Citizens Executive Director Kristie Fairchild, the program's only full-time employee, credits the new national mindset and new city strategies with helping her shift her program from daytime drop-in services to a higher level of engagement and housing success in ending chronic homelessness. "North Beach Citizens' change in focus from being a chaotic triage service center to a program focused on housing the chronically homeless population has undeniably diminished the homeless population in North Beach. The new focus and energy within the City of San Francisco concerning permanent supportive housing for the chronically homeless will help the most desperate and vulnerable receive the services they require for success. With the policy change within the San Francisco government, NBC has been able to access housing for 32 individuals in the last year," stated Director Fairchild.

NBC clients placed in SRO's utilize North Beach Citizens as their support, and they are encouraged to maintain contact with their mental health provider and also receive help with obtaining Medical, SSI, or VA benefits. North Beach's clients number about 45 at any time with about 6-12 drop-ins per month. The program, now motivated to a housing focus, was founded with the view that homelessness is an issue that requires a neighborhood-by-neighborhood effort that shows concern for homeless people, merchants, and neighbors. The program continues to receive support from its original funder, filmmaker Francis Coppola, as well as recently developing new sources of support in the private sector and business community.

(top)

HEALTH CARE

ADDRESSING URGENT NEEDS: EXPERT HEALTH CARE RESOURCE ON ISSUES OF HOMELESSNESS

All those who offer care directly to people experiencing homelessness will benefit from a clinical and education resource by the National Health Care for the Homeless Council. The Health Care of Homeless Persons: A Manual of Communicable Diseases & Common Problems in Shelters & on the Streets is a practical, highly informative guidebook that is a resource for clinics, shelters, service sites, and housing facilities affected by the markedly poor health of homeless persons. “Terrible health problems precipitate, result from, and prolong homelessness. This new manual provides an unprecedented opportunity for everyone who works against homelessness to better understand the specific physical health problems of homeless people, and to respond more appropriately and effectively,” stated John Lozier, Executive Director of the National Health Care for the Homeless Council.

Edited by Dr. James O’Connell of the Boston Health Care for the Homeless Program, the heavily illustrated 384-page manual describes 36 serious health problems that frequently afflict homeless persons and discusses appropriate responses and treatment. The manual addresses communicable disease control and food handling in shelter settings, and describes current approaches to the management of chronic diseases. Also included are convenient patient education materials in English and Spanish that can be easily reproduced for clients, staff, and volunteers.

The Health Care of Homeless Persons will prove useful in:

• providing health care day-to-day, as a practical reference book teaching homeless people about their conditions and how to care for themselves
• training students and orienting new service providers of all disciplines
• educating shelter providers, outreach workers, service providers, and volunteers who work with homeless and formerly homeless persons regarding effective responses to the health conditions they encounter every day
• informing community partners about the grave health problems associated with homelessness

Read more about the Manual

(top)

CREATING A PATH TO HOUSING FOR PERSONS EXPERIENCING CHRONIC HOMELESSNESS: PORTLAND’S CENTRAL CITY CONCERN HEALTH SERVICES

Portland, Oregon’s, Central City Concern (CCC) Health Services was founded in 1979 to intervene in homelessness in Portland and surrounding Multnomah County. Its programs now include a broad range of health care, housing, and workforce initiatives. In 2003, CCC received one of 11 HUD-HHS-VA Collaborative Initiative awards for its partnership of CCC, Portland Housing Authority, Multnomah County Health Department, County Aging and Disability Services, and VA.

CCC Health Services include the Old Town Clinic, Hooper Detox with sobering center and subacute medical detox beds, and Portland Alternative Health Center (PAHC), a multidisciplinary, integrated care system that includes Alcohol and Drug-Free Community (ADFC) housing. Medically supervised respite care is also provided. Through the multiple services offered, CCC does more than medically manage detox or other health concerns. It provides primary care, prevention, and education as well as a Community Engagement Team that meets individuals while in detox and connects them with Assertive Case Management or professional mentoring, depending on the person’s needs.

These services lead to linkages with Central City Concern’s housing and workforce development programs or provide access and engagement with other needed services. Ed Blackburn, Director of Health and Recovery Services, states, “It is our fundamental belief that if people do not have safe, appropriate housing to live in, they cannot succeed in the long run.” CCC emphasizes the use of sober supportive housing as a key element in recovery treatment. CCC provides over 1,200 units of housing targeted to persons at or below 30% of Area Median Income, with over 600 units of ADFC housing.

Read more about the Initiative

(top)

FEDERAL TAX CREDITS TO FUND STATEWIDE RESIDENTIAL SUBSTANCE ABUSE TREATMENT IN KENTUCKY

Stating that "every corner of the Commonwealth" is affected by substance abuse, Kentucky Governor Ernie Fletcher has announced that his state will target $5 million in future federal housing tax credits to the development of a statewide network of residential substance abuse treatment programs that will serve the Commonwealth's homeless population. The state will build up to 12 peer model recovery centers around Kentucky to help as many as 1,000 people who are homeless or at risk of becoming homeless because of substance abuse. To finance the centers, the Kentucky Housing Corporation has set aside $2.5 million a year in federal tax credits in 2005 and 2006, part of the state's allocation of about $20 million a year in housing tax credits.

Joining the Governor for the announcement were Kentucky Housing Corporation Board Chairman Don Ball, a Lexington builder and philanthropist, and Corporation CEO Ben Cook. Cook said more details on the plan will be forthcoming this month. The plan follows on a statewide research project regarding treatment availability. Led by Lt. Gov. Steve Pence, a former federal prosecutor who is also state Justice secretary, Kentucky last year conducted a statewide review of illegal drug problems. The study found that Kentucky has about 1,750 public and private treatment beds, public averaging one bed per 152 people in need.

The federal tax credits are available to developers who sell them to investors and use the money to build or rehabilitate housing for low-income people. Operating funds for the new treatment centers will come from about $3 million in United States Department of Housing and Community Development block grant funds, and about $2 million from the state's corrections system. The new centers will mirror services currently provided at low-cost recovery programs at Louisville's Healing Place and Lexington's Hope Center, which use recovering addicts as mentors and counselors. While the state does not have a specific timetable for development of the centers and has not identified any sites, state officials hope to have two centers in each of Kentucky's six congressional districts.

Read about tax credits

(top)

HRSA SUPPORTS NEW RESOURCE ON DISABILITY

Obtaining health insurance and monthly income through the Social Security Administration's SSI and SSDI programs can help people move out of homelessness. In an effort to improve access to Federal disability benefits for eligible persons, including persons experiencing chronic homelessness who by definition have disabilities, the Department of Health and Human Services, Health Resources Services Administration (HRSA) has funded publication of Documenting Disability: Simple Strategies for Medical Providers, published by the National Health Care for the Homeless Council. United States Interagency Council on Homelessness Executive Director Philip Mangano, commenting on the new resource, stated, "This is another key and timely contribution from the Department of Health and Human Services that will support the effort to end chronic homelessness and provide a partnership tool for the more than forty HOPE awardees of the Social Security Administration, who are forwarding SSA's vital investment in the field."

"Clinicians and case workers have long needed resources in order to adequately utilize SSI and SSDI for their clients. This publication explains the process and identifies how clinicians can - in many cases surprisingly easily - contribute to quick determinations of disability. We hope that Documenting Disability will stimulate service providers to focus on disability determination as a critically important intervention for their clients, and to protect and improve the entitlements that comprise America's safety net for disabled persons, " stated National Health Care for the Homeless Executive Director John Lozier.

Authored by Drs. Jim O'Connell, Paul Quick, and Barry Zevin, and edited by Patricia Post, MPA, the new publication explains how medical providers can most efficiently and effectively document their patients' impairments in support of SSI or SSDI disability benefit applications. It provides practical, experience-based advice that is grounded in use of the Social Security Administration's Listing of Impairments. Documenting Disability and other useful resources are available for download, free of charge, at www.nhchc.org. Printed copies may be ordered at the same site.

The publication is available from NHCHC.

(top)

SAN FRANCISCO'S BEHAVIORAL HEALTH COURT

Facing increasing numbers of persons with mental illness in the criminal justice system, San Francisco acted in 2002 to shift its role from being the default solution to active partnership among city departments in addressing homelessness and behavioral health issues. The result was the establishment of Behavioral Health Court (BHC).

Under the direction of Public Defender Jeff Adachi, the court has three main objectives. It works to connect criminal defendants who suffer from serious mental illness to treatment services in the community, finds creative and appropriate dispositions to the criminal charges that take the mental illness and the seriousness of the offense into consideration, decreases recidivism in this defined population of offenders. To carry out its work, the court uses a team approach. Led by retired Judge Herbert Donaldson, the team consists of mental health providers in the community, Jail Psychiatric Services, volunteer psychiatrists, the Adult Probation Department, the Office of the District Attorney, and the Office of the Public Defender.

To qualify for Behavioral Health Court, individuals must have an Axis I Mental Disorder. The most common diagnoses in BHC are schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and post-traumatic stress disorder. Clients with developmental disabilities and mental retardation are also accepted into the program. In addition to the primary mental health diagnosis, participants must be willing to engage in treatment in the community mental health system. The Court presently treats individuals charged both with felonies and misdemeanors, as well as clients who are on probation.

Some general guidelines address which criminal charges are appropriate for BHC. For example, crimes of violence involving great bodily injury, sex crimes, domestic violence and arson are presumptively excluded from consideration for BHC. In certain limited circumstances, these types of cases are presented to the court. The judge, conferring with the prosecution and defense, examines the facts carefully and may decide to accept an individual whose criminal behavior falls outside of the guidelines. For those clients, the court considers the risks to the community and the likelihood of that particular person reoffending upon release. The court also looks carefully at the nexus between the mental illness and the behavior that led to the arrest. In almost all cases, clients who participate in the court were not on any psychiatric medication or actively participating in treatment at the time of the incident.

The Court is currently implementing the first phase of a three-phase study by the University of California, San Francisco, to look at outcomes. However, the partners are convinced that the program is necessary and successful and has great potential. For the first time in San Francisco, the mental health system and the criminal justice system are working together and concentrating experience and knowledge to assist clients with extraordinary needs. Public defenders, district attorneys, and judges in the court have the opportunity to share information with psychologists, psychiatrists and social workers to find solutions for individuals that have a greater chance of long-term success, while clients are encouraged to contribute and to help direct the course of their own treatment.

The Court team meets in the morning to discuss each case and to work out any disagreements. By the afternoon when clients appear in court, the team has a uniform, clear message. Clients see the same defense lawyer, the same prosecutor and the same judge week after week. This continuity eliminates confusion and alienation that individuals often feel in court. Individuals are encouraged to communicate freely with the judge about their treatment and to be honest with the court about both successes and failures in treatment. The atmosphere in court is positive, the judge talks directly to each individual and clients receive positive reinforcement from the team.

(top)

A web-based evaluation tool is being used by the Social Security Administration's $8 million Homeless Outreach Projects & Evaluation (HOPE) (see e-news article). HOPE grantees are required to make their data available for the evaluation of outcomes, impacts, and benefits of the program, being managed by Westat. HOPE seeks to demonstrate efficient, replicable, and sustainable approaches for identifying eligible homeless individuals for SSA benefits and proving direct assistance in the application process.

HOPE evaluation will seek to identify whether use of the program orientation materials and technical assistance improve the quality of applications and if the intervention reduces SSA administrative costs. Evaluation data will be collected from HOPE proposals, HOPE staff, SSA records, SSA staff, and quarterly reports. The web site has been developed for HOPE staff to input client and program data. All data collected will be used to evaluate changes in individuals living situation over 12 months, any reduction in time needed to develop medical evidence for disability, and effectiveness of training on making presumptive disability decisions, addressing application issues, and identifying rep payee issues. Web site data collection will begin in May 2005 and continue for two years.

(top)