Ending Homelessness Through Housing First

1. Ending Homelessness Through Housing First Elizabeth McClam Lake Shore Behavioral Health Services Karen CarmanLt. Col. Matt Urban Human Services Center of WNY

2. DEFINITION – CHRONIC HOMELESSNESS • The federal government’s definition of chronic homelessness includes homeless individuals with a disabling condition like: • Serious mental illness • Substance use disorder • Developmental disability • Chronic physical illness or disability • HIV • and • Must be homeless12 months or longer or 4 homeless episodes in the past 3 years • Must be an unaccompanied individual up to 2011 • Homeless families are now considered as chronic if they meet the same criteria above

3. Low Demand Permanent Housing These housing options utilize “low demand” approaches that addresses the risk-taking behavior without forcing clients to eliminate the behavior altogether. Relapse should not result in termination from program. Low Demand Permanent Housing focuses on permanent housing for persons with significant functional impairments that provides high degree of choice, integration, and community inclusion All national research confirms that these housing options continue to be the most successful for individuals who are chronically homeless !!!

4. Lake Shore opened its doorsDecember 2009 A form of supportive housing that serves : • hard-to-reach homeless persons with severe mental illness • living on the streets , alleys, park bench, under bridges, etc • unable or unwilling to participate in supportive services • Provides safe housing …1st, without restrictions or requirements

5. SafeHaven … a new way of thinking • Not a group home (highly structured) • Extremely independent • No curfew • No treatment requirements • No medication requirements

6. A safe, supportive and home-like environment

7. Program Differences Safe Haven Housing First • Transitional or permanent housing • Shared/common facility • No limit on length of stay • Disabling mental illness • Services in facility • Individuals only (Training and Development Associates, Inc ) • Permanent housing • Scattered site, rental housing • Long-term leases • Any disabling condition • Services in home • Individuals/families .

8. Lake-Shore’s Safe Haven residence • 16 beds (co-ed) • No curfew for residents/visitors leave at midnight • Rent calculated using local fair market rent (FMR) • Eligibility is street homeless, severe mental illness, poor linkage to treatment • Our rules… • No sex between tenants • No drugs or alcohol on the premises • No weapons • No criminal activity • No violence to other tenants or staff

9. STATISTICS Out of the 28 individuals served… • 7 recipients were hospitalized (that’s a good thing!) • 85% agreed to linked to treatment and/or care coordination services • 68% have length of stay6 months • 43% have length of staybeyond 12 months • 32% pursued education/employment goals • 14.3% obtained employment • 75% addressed medical needs • 75% accepted linkage to financial entitlements

10. What is Engagement • Engagement is the most effective tool in working with chronic homeless individuals ! • Baby steps…”pump your brakes” • Build trust by consistency (same place, same time) • Be genuine and authentic • Listen to his or her story without judgment • Find that small need you can meet without “strings attached” • Respect the individual’s perspective • He or she feels safer in the streets • He or she has experienced many “closed doors” • He or she wants to be treated with RESPECT

11. What is Engagement • While identifying a need, listen and quickly learn the priority • Exercise Activity Take 60 seconds and Prioritize the following items for your client...

12. What order should these be • Shopping cart filled with belongings • Pet • Food • Clothing • Shelter (Successful engagement is meeting an individual where they’re at)

13. HOUSINGFIRST

14. What is housing first? • Housing first is a philosophy and program model that does not put conditions on housing. • It serves the “hard to serve” Key elements of any housing first program: • Direct or near direct housing placement from streets or shelter • Supportive services offered, but participation is not required to stay in housing • Low demand methods of case management • Effort to hold housing when client leaves program (short periods)

15. Housing First x Least Structured Permanent Housing Transitional Housing Shelter Streets Ideal Housing Ready Trajectory Moderately Structured Highly Structured No Structure Chronic Homelessness TRANSITIONAL MODELS VS HOUSING FIRST

16. OUR FOCUS HARSH REALITY • Identifying and eliminating behaviors that jeopardize housing • Assist with establishing an income or to maintain/increase an existing income • Social Reintegration • Property damage • Drug/Alcohol Abuse • Abusive to staff & neighbors • Arrests • Poor budgeting • Job Skills Development Program • Special Activities/Events • Advisory Group

17. HOUSED Other Impairment Scales Include: Mood – Behavior – Socialization – ADL’s – Chemical Dependency - Lethality

18. First Year • 46 Residents Housed • 3 Departed Program • 5 Had to be moved to a new unit • 1 Moved to Permanent Housing • 7 Job Skills Development Program 94% Are Still Housed After One Year

19. ? Q & A Karen Carman Matt Urban Center Elizabeth McClam Lake Shore Behavioral Health

20. READING MATERIAL • The Applicability of Housing First Models to Homeless Persons with Serious Mental IllnessPrepared for U.S. Department of Housing & Urban Development – 2007 • Carol L. Pearson,, PhD., Walter R. McDonald & Associates, Inc. Gretchen Lock, Abt Associates Inc., Ann Elizabeth Montgomery, Walter R. McDonald & Associates,, Inc. Larry Buron, PhD, AbtAssociates • “Providing Housing First and Recovery Services for Homeless Adults with Severe Mental Illness”Psychiatric Services: http://ps.psychiatryonline.org – October 2005; Vol. 56, No. 10 The Soloist – DVD movie depicting Chronic Homelessness Training and Development Associates www.tdainc.org Projects For Assistance In Transition From Homeless (PATH) http://pathprogram.samhsa.gov National Alliance to End Homelessness (NAEH) http://www.naeh.org National Council for Community Behavioral Healthcare www.nccbh.org Homeless Alliance of Western New York (HAWNY) www.wnyhomeless.org Housing and Urban Development (HUD) www.hud.gov Ward Family Foundation www.wardfamilyfoundation.org