SKID ROW HOUSING TRUST Whoweare Whatwedo OurPermanentSupportiveHousingprogram OurmultiͲagencycollaborations 1 Purpose • Practically speak...

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SKID ROW HOUSING TRUST Whoweare Whatwedo OurPermanentSupportiveHousingprogram OurmultiͲagencycollaborations


Purpose • Practically speaking how operating a housing first model and aiming for project sustainability can impact fidelity to the essential components of the approach.

• Why does it matter?


Drawing a Straight Line • One person as our guide • Walk through each step of his process • Identify areas that worked well • Primary and mental health care, outreach, substance abuse treatment and targeted case management. • Identify situations when fidelity was threatened or impacted either due to programming or funding limits. 3

Learning Objectives • Planning for new project

• Evaluating your current program

• Potential areas of advocacy


Move people into housing directly from streets and shelters without preconditions of treatment acceptance or compliance Approach: The outreach team continued to visit him regularly over a period of weeks, initially Samuel flared up when his housing situation was mentioned stating: I want housing but not another program. A lot of engagement was done with Samuel at a pace he seemed comfortable with; often his housing was not mentioned at all. Samuel eventually asked if he could see where the housing was located and after several visits to the building and meeting the property manager he asked for help getting into an apartment. Fidelity Impact: Programmatic and Funding


The provider is obligated to bring robust support services to the housing. These services are predicated on assertive engagement, not coercion.

Approach •PMC considers abandoning the apartment •Team worked together to visit Samuel on the street on most days, visit his apartment and leave notes or be observable in the lobby of the building. •Case manager attempted to get Samuel to agree to IHHS for his apartment, advocated with property management for rent payments psychiatrist and nurse practitioner made home visits and offered services •Substance Abuse counselors had coffee with Samuel, walked with him to get money orders when his rent was due and helped him make long distance phone calls to reconnect to family. Fidelity Impact: FQHC, Targeted Case Management via mental health provider, Drug Medical.


Fidelity Impact • Primary Care Access-Ineligible for MediCal billing, FQHC has a contract for uninsured-lower rate, limited dollars, does not pay for engagement. • Psychiatry-MediCal would not allow Samuel to see the psychiatrist and health care provider on the same day or same place and because he is not on MediCal the uninsured rate would have to be accessed which does not adequately cover the costs of psychiatry. • Mental Health services require Samuel to receive MediCal in order to bill for the services. He would attend an assessment which can take two hours , agree to treatment planning goals, attend appointments regularly or his chart may close. 7

Housing Operations Team OnsiteServicesStaff • ProgramManagers • ResidentServiceCoordinators • Benefitsadvocates,recovery specialists,therapists,nurses Propertymanagementensuresthe healthofbuildings;servicesensures thehealthofresidents OnsitePropertyMgmtTeam • ResidentManagers • DeskClerks • MaintenanceStaff • JanitorialStaff Senator






Resident Life SimoneHotel’sfrontdesk– abedroomattheCobbApts.


Resident Life RainbowApartments,viewfromthe4th floor


Resident Life St.GeorgeHotel


Resident Life RainbowApartmentsgardengroup


Staff at work


Our Permanent Supportive Housing • SkidRowHousingTrustapproachesPermanent SupportiveHousingusingtheEvidenceBased PracticeofHousingFirst.ThetenetsofHousingFirst include: – DirectorneardirectplacementintoPermanentSupportiveHousing withnopreͲconditions – Servicesthatarevoluntaryandclientdriven – Lowstafftoresidentratios – Servicesareongoingandavailableonalongtermbasis – ServicesareprovidedonͲsiteinanintegratedsystem


Collaborative Projects ‰ SkidRowCollaborativeͲ St.GeorgeApartments ‰ IntegratedServicesinHousingͲAbbey/RainbowApartments ‰ CharlesCobbApartmentsͲformerlyProject50 ‰ RecoveryinHousingͲmultiplebuildings ‰ SkidRowPrioritizationProject–multiplebuildings


Our Partners Collaborations ‰ BehavioralHealthServices,Inc.(RecoverySpecialists,Project Coordinator/Therapist) ‰ JWCHInstitute(Primarymedical,psychiatricservicesandbenefits advocacy) ‰ LAMPCommunity(MentalHealthandCaseManagement) ‰ CommonGround,NewImage(Outreach) ‰ PublicCounsel 19

Target Populations ‰Individualswhoarechronicallyhomeless ‰Individualswithmentalillness,substance addictionsorcoͲoccurringdisorders ‰Individualswithhighmortalityrisks ‰VulnerabilityIndex


Common Features ‰ Outreachtovulnerablepopulations ‰ AccesstoPermanentSupportiveHousing ‰ PrimaryMedicalCare,PsychiatryandMentalHealthCare ‰ SubstanceAbuseTreatment ‰ BenefitsAdvocacy ‰ CaseManagement


Benefits of Multi-Agency Collaboration ‰ Carethataddressesmultipledomains ‰ Underservedpopulationsaccessservices ‰ Reductioninduplicationofcare ‰ MultiͲdisciplinaryapproachtocomplexresidentneeds ‰ Improvedhousingretention,incomeandwellͲbeing


Important Considerations for Success ‰ UnderstandingHousingFirst ‰ Implementationprocessatbeginningofprogram ‰ Commonunderstandingofprogramgoalsandobjectives ‰ Outreachandengagementstrategiesforenrollment ‰ Serviceprovisionandcoordination ‰ UnderstandingsubsidiesandroleofPropertyManagement 23

Permanent Supportive Housing • Thankyou!Questions?