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?