Category Archives: Best Practices

Western Mass. Homelessness Providers: Complete this survey!

The  Western Massachusetts Network to End Homelessness, in conjunction with the Hampden County CoC and the Three County CoC, is working on an updated and localized plan to end homelessness which is coordinated with the federal Opening Doors plan and provides us with a data-driven framework for measuring progress. As a key piece of this work, we are enlisting the the National Alliance to End Homelessness to lead our region through a Systems Design Clinic.

This clinic includes a survey of all providers of homelessness services.  We need your input!  Please go here to complete this brief survey: https://www.surveymonkey.com/s/WMAProviderSurvey.  Please complete it by Friday, April 17.

We thank you for your input and look forward to working together to implement the Western Mass. Opening Doors Plan to End Homelessness in the months ahead.

 

Urban Institute Study on the 100,000 Homes Campaign

An Urban Institute study, just out, concludes that “the 100,000 Homes Campaign had a major impact on national efforts to end homelessness.” Researchers noted that communities that participated in the Campaign reported greater reductions in unsheltered, veterans, and chronic homelessness than non-participants.  Over the life of the campaign, the average community saw a 262% increase in the percent of the community’s homeless population housed each month.

This news is great for us locally because we are working toward incorporating best practices that evolved from the campaign, particularly in Hampden County, where we are participating in the follow-up Zero 2016 campaign.

As noted in a Community Solutions blog post, several of the Campaign’s core strategies were associated with greater reductions in homelessness, including:

  • Transparent, monthly tracking and reporting  Communities that publicly tracked the number of people moving into housing each month against predetermined monthly targets on the Campaign’s website saw significantly greater reductions in homelessness than communities that neglected this measurement-based approach.
  • Registry weeks  Communities that completed a registry week, in which community members document every person experiencing homelessness by-name, saw chronic homelessness decline by 26 percent, while those who did not complete registry weeks saw reductions of only one percent.

HUD guidance on prioritizing persons with highest level of need in permanent supportive housing

A message from Ann Oliva, HUD’s Deputy Assistant Secretary for Special Needs:

In a perfect world, there would be enough affordable housing and supportive services to ensure that no one has to experience homelessness. But what do you do when there are not enough resources to achieve that vision? At the local level, this is all too familiar. Every day you are having to make decisions about who to serve when there simply are not enough beds and resources to serve everyone. This is also a dilemma that HUD and its Federal partners have been grappling with in recent years, particularly as appropriated funds become more and more limited. Here at HUD we are working hard to secure additional resources, as reflected in the President’s FY 2016 Budget request, to make sure that communities have the necessary resources to end homelessness locally.

Although the Opening Doors goal of ending chronic homelessness has been pushed back to 2017 we cannot afford to wait for those resources. The most important thing that communities can do to maximize resources is to ensure that all homelessness assistance is prioritized for homeless households with the highest needs. HUD recently published a policy brief on coordinated entry that talked about this more broadly. Today, however, I want to focus on prioritization in permanent supportive housing.

We know that permanent supportive housing is the most intensive solution that HUD has to combat homelessness. Research has consistently found that permanent supportive housing is the most effective solution for people experiencing chronic homelessness. It is not a one-size-fits-all approach and should only be offered to those households that truly need that level of support. Most people experiencing homelessness may need some level of assistance but do not likely need permanent supportive housing. Yet, unless there is a systematic way to prioritize households with the highest needs, this is often not who receives this type of assistance.

For this reason, HUD published the Notice CPD-14-012: Prioritizing Persons Experiencing Chronic Homelessness in Permanent Supportive Housing and Recordkeeping Requirements for Documenting Chronic Homeless Status(Prioritization Notice) in July 2014. The Prioritization Notice established an order of priority for households served in permanent supportive housing and provided uniform recordkeeping requirements for all recipients of CoC Program-funded permanent supportive housing to document the chronically homeless status of program participants. HUD has received significant feedback since publishing the Prioritization Notice and has recently posted Frequently Asked Questions to address the most common questions and concerns.

As you know, the original goal of Opening Doors was to end chronic homelessness by 2015. Progress towards this goal has been slower than we hoped, due in large part to budgetary constraints which have made it necessary to push the goal back two years. While insufficient resources has been a significant challenge, we can also look at our existing stock of permanent supportive housing as reported on the 2014 Housing Inventory Count and see that despite making significant gains on the number of permanent supportive housing available, the overall percentage of those permanent supportive housing beds funded under the CoC Program that are dedicated to serving persons experiencing chronic homelessness is only 30 percent. Far too many CoCs and recipients continue to place people in permanent supportive housing on a first-come-first serve basis, rather than prioritizing those who have the most significant needs. Additionally, where CoCs and providers continue to not fully implement a Housing First approach, unnecessary barriers that screen out those households who need the assistance the most continue to persist.

The overarching intent of the Prioritization Notice is to move CoCs and recipients of CoC Program funding for permanent supportive housing in a direction where chronically homeless persons and other high need households are prioritized for assistance above other eligible households. I also want to be clear—we are not saying prioritize chronically homeless individuals over all other household types. To the extent that a recipient of CoC Program-funded permanent supportive housing is targeting unaccompanied youth, for example, HUD would only expect for the recipient to first serve any unaccompanied youth that met the definition of chronically homeless and if there are not any youth within the CoC that meet that criteria, to then prioritize those unaccompanied youth with the highest needs in accordance with the Prioritization Notice. HUD strongly encourages CoCs to incorporate the process described in the Prioritization Notice into their written standards, making it a requirement of all recipients of all CoC Program-funded permanent supportive housing to use this priority order to fill vacancies.

We will not end chronic homelessness as a nation unless we systematically prioritize persons experiencing chronic homelessness and do so in a manner that ensures persons with the longest histories of homelessness and most severe services needs get housing first. Therefore, the Prioritization Notice establishes two orders of priority—one for beds that are either dedicated or prioritized for persons experiencing chronic homelessness and another for those that are not—both of which aim to prioritize persons with the longest lengths of time homeless and the most severe service needs. Recipients should examine their program design to ensure that it adheres to Housing First principles and that barriers to program entry have been removed to the greatest extent possible.

We recognize that serving people experiencing chronic homelessness and other highly vulnerable populations may require enhanced services that will increase costs, staff training and support needs, and present other challenges for providers. Recipients are encouraged to explore partnering with community resources to meet the needs of their new tenants. New or expanded partnerships with agencies with the expertise and resources to serve this population and a shared goal of stabilizing housing may be essential to ending chronic homelessness in your community.

Recently the Department of Health and Human Services (HHS) published two new documents that provide guidance on how services that are provided in permanent supportive housing can be covered and financed through Medicaid. These documents include Primer on Using Medicaid for People Experiencing Chronic Homelessness and Tenants of Permanent Supportive Housing andMedicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field. Shortly after the documents were released, the U.S. Interagency Council on Homelessness posted a blog by Richard Cho: Medicaid Can Pay for Services for People in Permanent Supportive Housing. The blog helps to summarize what you can find in these HHS resources and how Medicaid can be used to finance permanent supportive housing for the chronically homeless. I would encourage you to read his message along with the HHS documents because, as Richard states, “We need more Continuums of Care and homeless services providers to learn to speak the language of Medicaid.” HUD expects CoC-Program funded recipients and CoCs to closely examine opportunities to help clients access Medicaid and other mainstream supportive services as quickly as possible. CoC-Program funding should not be used to pay for Medicaid-eligible services for Medicaid-eligible clients.

We believe that ending chronic homelessness is possible but it cannot be done without you. Thank you for all that you do in your community’s efforts to end homelessness.

As always, thank you for your commitment and hard work.

Ann Marie Oliva
Deputy Assistant Secretary for Special Needs

Here’s what a coordinated system looks like

Like the Hampden County CoC, Arlington, VA is a Zero 2016 Community.  But Arlington is ahead of us, because they participated in the 100,000 Homes campaign. The Washington Post describes the system they have put in place–and what we are working toward.  The full story is copied below:

Arlington’s no-silos approach has housed hundreds of chronically homeless adults

January 31 at 5:01 PM

Late at night, David Clark wakes up and goes to the kitchen to choose from the boxes of cereal atop his refrigerator. He pours cold milk into the bowl and counts his blessings.

Toilet paper, which he keeps in abundant supply. Body wash that lathers up nicely. A machine to shampoo the rugs in his immaculate one-bedroom apartment.

“When I come in, I can sit right there on that couch and turn on the television,” said Clark, 57, pointing to the worn beige sofa. “Don’t have nobody telling me when to get up or go to sleep.”

Clark has lived in his apartment in Arlington County for the past two years, after 26 alcohol-soaked years on the streets, when he frequently slept under Key Bridge. He is one of close to 300 chronically homeless men and women whom Arlington has placed in housing since 2011, using a rigorously organized, all-hands-on-deck approach that experts say could also work in cities with much larger homeless populations. The county found housing for about 100 homeless families during the same four-year period.

“Arlington is not alone, but they’re on the leading edge,” said Jake Maguire, a spokesman for Community Solutions, an anti-homelessness group. “It shouldn’t be unusual. It’s startlingly simple.”

 

Arlington has a master spreadsheet that lists homeless individuals by name, drawing from an annual survey of people living on the streets and carefully cultivated contacts at food distribution sites, shelters and other places where the vulnerable gather. The spreadsheet includes whether the people want housing, what health problems they have, their income sources and anything that might help or hinder their search for a home.

Once a month, there is a meeting of a task force that includes advocates and specialists in physical and mental health, as well as county social service workers. One person takes responsibility for each name on the spreadsheet. They go line by line, brainstorming about which public and private treatment programs and funding can be tapped to help each homeless person.

The process ignores agency divisions. The official in charge of federal Section 8 housing vouchers, for example, isn’t allowed to disregard someone on the spreadsheet who doesn’t qualify. Neither can the employee who tracks veterans’ housing disregard a nonveteran. Those who specialize in families can’t ignore the mental health needs of single adults.

“Breaking down all our silos and focusing on individuals by name was a huge thing,” said Kathleen Sibert, executive director of the Arlington Street People’s Assistance Network (A-SPAN). “You have to find programs they fit into.”

Clark’s path to his apartment began when one of the A-SPAN workers who offer food, blankets or shower vouchers to homeless people on the street identified him as especially vulnerable. She persuaded him to enter a residential detox program, where he worked on sobering up and was prescribed medication for diabetes, neuropathy and other health problems.

Ayana Bellamy became Clark’s case manager. She helped him get a state identification card, using the address of the residential program. (In Virginia, a permanent address is required for a government-issued ID, which often is needed to apply for apartments. Obtaining an ID can be the hardest part of the process, Bellamy said, because, by definition, homeless people don’t have a fixed address.)

Clark had trained as a cook at D.C. Central Kitchen and worked in kitchens at the Ritz-Carlton and Hilton hotels. But his drinking and his health problems kept him from finding a job and housing on his own. “I used to drink to wake up, and drink to go to sleep,” Clark said.

He already received Social Security disability insurance income. Bellamy helped him fill out paperwork to qualify for food stamps and a federal housing subsidy. But Clark was turned down when he applied for a one-bedroom apartment — because of decades-old credit problems and a long-ago criminal record. With Bellamy, he successfully appealed to the landlord. He moved in on Feb. 1, 2013.

“We set out to house the hardest people, and we’ve done that,” said Robert Sharpe, assistant director of Arlington County’s Department of Human Services. “Because we’re meeting monthly, people follow up.”

Arlington employs a “housing first” philosophy — clients don’t have to overcome addictions or mental illnesses before the county will help them find a place to live. Housing, their biggest problem, is fixed first. Then, other issues are addressed.

Social service officials say the rent subsidies and other assistance needed to house one chronically homeless person generally cost the county about $22,000 a year, compared with $45,000 for that person to bounce between shelters, jail and hospital emergency rooms — what usually happens when a person is living on the streets. Caseworkers pay close attention to the newly housed and step in when needed.

For example, Clark was tempted to go out drinking after he moved into his apartment. But Bellamy was there waiting for him — with paperwork and a U-Haul full of donated furniture. While they were moving him in, another truck arrived with a new bed — something the organization buys for all its clients.

Clark’s desire for a drink, he says, slipped away.

Arlington, like other jurisdictions in the region, does an annual census of its homeless population. This year’s count happened Wednesday night, though the numbers won’t be released until sometime in April.

In recent years, the county’s homeless tally has declined, dropping from 531 in 2010 to 451 two years later. It fell last year to 291, a surprisingly low number that may be attributable in part to the county’s all-out effort to house people like Clark, but almost certainly reflects some homeless people seeking shelter at friends’ homes on last year’s census date, because the weather was bitterly cold.

Of the 278 individuals and approximately 100 families housed by the county since 2011, about 95 percent remain in their homes or apartments, officials say. (The others have been evicted; jailed; found shelter with family or friends; or left the area.)

The District, which has thousands of homeless residents, won praise for adopting a “housing first” approach under former mayor Adrian Fenty (D). But the effort slowed under Fenty’s successor, Vincent Gray (D), when federal funding dried up. Newly inaugurated D.C. Mayor Muriel Bowser (D) has hired Laura Green Zeilinger, who directed the city’s former effort, to direct the Department of Human Services and help revive the approach.

Karen Booker, 49, found her apartment with Arlington’s help in 2012. She had survived a harrowing childhood in the District, including sexual abuse by a stepbrother, and spent years raising her siblings and half-siblings while struggling with mental illness. She held jobs sporadically: receptionist at Walter Reed Army Medical Center; personal-care aide at a nursing home; janitorial worker. A drug habit drew her into a descending spiral of petty crime, prostitution and jail. “I had to do some horrible stuff to stay alive,” she said.

Booker’s children, now grown, were raised by their father. She was living at a women’s shelter when her name made the spreadsheet. “She was ready for housing,” Bellamy said.

Previous evictions made it difficult to find a landlord who would take her. And she had an outstanding debt that she believed she could not pay. Bellamy found out the debt was $96, low enough for Booker to cover with funds from her Social Security Disability Insurance. Federal money for permanent supportive housing was available to subsidize rent at a new place.

Booker’s apartment is an oasis from her previous life. Bright sunshine streams through the mini-blinds in the living room that she’s turned into a bedroom, after deciding the actual bedroom was too small and dark. A stuffed tiger sits on a queen-sized bed. There are red artificial roses on a side table.

Like Clark, she has slipped at times, But, she says, she has been clean since the fall. She earned a certificate as a home health aide, and is looking for a job in that field. She is proud that she worked as a cashier at Nationals Park on New Year’s Day during the National Hockey League’s Winter Classic. She is in touch with her children every day.

And Booker is getting used to having some financial stability. When she got her electric bill recently, she was puzzled by a line at the bottom: $200, with a two-letter code next to it. So she called Bellamy. Together they figured out that the low-income energy assistance Bellamy had sought on her behalf had kicked in.

That CR code? Clark had never before seen a credit on one of her bills.

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