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
2. Homelessness Prevention/Discharge Planning
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
3. Permanent Housing Strategies
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
4. Health Care
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
5. Data and Research
SSA HOPE Grantees Use Web Based Data and Evaluation
Tool
PARTNERSHIP
COLLABORATION: SIP SAVES LIVES AND PUBLIC
FUNDS
Using innovative partnerships and interventions to halt the revolving
door of substance abuse and homelessness, San Diego’s Serial
Inebriate Program (SIP) not only saves lives, but also taxpayer
money. Starting in 1998, the University of California/San Diego
Medical Center tracked 15 serial inebriates (chronic alcohol abusers)
as they entered local emergency rooms and interacted with law enforcement
hundreds of times over the course of a year. The taxpayer bill for
these services amounted to over $3 million annually. Researchers
estimated there to be 180-250 such individuals living on the streets
of San Diego.
SIP was designed as an alternative sentencing pilot program in
2000, using the principles behind the drug court model. A collaborative
team of law enforcement, prosecutors, public defenders, the court,
and non-profit alcohol abuse treatment providers offered individuals
in custody for public drunkenness treatment instead of jail time.
SIP incorporates community-based treatment and rehabilitation, psychological
counseling, job readiness, housing, and other resources needed to
help participants succeed in not returning to the streets or to
substance use.
SIP’s outcomes point to the success of the approach. In its
first two years, 63% of clients accepted treatment. Calls to law
enforcement and requests for medical treatment for serial inebriates
in San Diego are down. Current statistics show that roughly half
of all individuals who enter the program complete it and move on
to healthier lives. The pilot program was deemed to be a success
and was incorporated into the City’s Special Needs Homeless
Program by the San Diego City Council. The SIP models how a collaboration
of public and private services can partner to stop the cycle of
chronic alcohol abuse and homelessness for individuals and the burden
on public resources for the community.
Read about San Diego’s
10-Year Planning Process
(top)
LEVERAGING PRIVATE INVESTMENTS: ATLANTA’S
10-YEAR PLAN TO END CHRONIC HOMELESSNESS
Atlanta is building partnerships to increase investments to end
chronic homelessness. “Most people now believe we can tackle
this,” said Atlanta Mayor Shirley Franklin, referring to implementation
of Atlanta’s Blueprint to End Homelessness. The Atlanta Blueprint
has drawn almost $10 million in new private and philanthropic investment
to its strategies, with the most recent addition being a $3 million
anonymous gift. Of the new resources being attracted by the Blueprint,
many will support the Gateway, one of the plan’s key strategies:
a 24/7 center projected to reduce overflow shelter demand and assist
homeless persons with disabilities to obtain appropriate service
referrals. The Gateway, expected to open in December 2004, will
offer 300 beds, as well as services, including showers, toilets,
storage, telephones, and specialized services for veterans.
Mayor Franklin’s Commission, directed in November 2002 to
develop a practical action plan, reported back in March 2003 with
a plan co-signed by Commission on Homelessness Chair Horace H. Sibley
and United Way of Metropolitan Atlanta President Mark O’Connell,
who stated in a letter to Mayor Franklin, “We have attempted
to follow your suggestion that those who find themselves without
a home should be treated with ‘both compassion and a sense
of accountability.’ ” Other Commission members included
civic leader and Co-chair Myrtle Davis, Morehouse School of Medicine
President Emeritus and Co-chair Dr. Louis Sullivan, Atlanta Community
Food Bank Executive Director Bill Bolling, attorney Jack Hardin,
Fannie Mae Atlanta Partnership Office Director Archie Hill, Community
Development Bank of America Director Laura Keenan, Emory University
President Emeritus Jim Laney, CB Richard Ellis Senior Vice President
Randy Merrill, Kennesaw State University/Coles College of Business
Dean Tim Mescon, Rev. James Millner, Georgia State University President
Carl Patton, Grady Health Systems President Ed Renford, Atlanta
Municipal Court Judge William Riley, Ebenezer Baptist Church Senior
Pastor Dr. Joseph Roberts, and Georgia Banking-Wachovia CEO Gary
Thompson.
The Atlanta Blueprint has been built on partnership, recognizing
that “state and federal governments must play a key role in
any successful action plan, and the Commission has concluded that
the most effective plan must approach homelessness from a regional
basis. Accordingly, although not specifically requested by the Mayor,
the Commission strongly recommends the creation of a Regional Authority
on Homelessness to develop and execute a long range planning process
for coordinating and funding care to homeless individuals and families
in the metropolitan Atlanta area.”
Read Atlanta’s
10-Year Plan
(top)
INDUSTRY PARTNERSHIP: HOMEAID AMERICA
PROVIDES MODEL OF SUCCESS
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)
PERMANENT
HOUSING STRATEGIES
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)
DATA AND RESEARCH
SSA HOPE GRANTEES USE WEBBASED DATA
AND EVALUATIONS TOOL
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)
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