Slide 1:

Missouri Division of Alcohol and Drug Abuse
Using Block Grant and Other Funding to Serve Homeless Persons
May 20, 2003
Jefferson City, MO

Michael Couty,
Director, Division of Alcohol and Drug Abuse
mzcoutm@mail.dmh.state.mo.us

Slide 2:

Missouri State Overview

• 5.6 Million Residents
• 115 Counties
• Mix of Rural, Suburban and Urban
  Communities and Issues

Slide 3:

Need for AOD Homeless Housing

• Based on 2001 Missouri Association of Social Welfare (MASW) data, the homeless population in Missouri is estimated at about 48,000 individuals and families:
  • 37,350 individuals and families are sheltered
  • 11,000 individuals and families are unsheltered
• About 21,000 of these individuals and families have unmet needs for both housing and addiction services.

Slide 4:

Need for AOD Homeless Housing

• The 2001 MO Association of Social Welfare (MASW) study also shows that 44% of the homeless in MO are alcohol or substance involved.
• During Fiscal Year 2002, ADA programs in MO had 38,914 substance abuse treatment admissions--- 3,065 of these were homeless persons (CTRAC DATA)

Slide 5:

2001 Homeless Client Admissions

Male	2,365	77%
Female	700	23%

Primary Substance of Abuse
Cocaine	30.8%
Alcohol	29.5%
Crack	29.3%
Marijuana	5.9%
Opiates	4.5%

Slide 6:

2001 Homeless Client Admissions

Principal Referral Source
Self/Family-Referral	64.0%
Criminal Justice	13.7%
Health Care Provider	12.4%
Community Program	9.9%

Slide 7:

Missouri Funding

• The Department of Mental Health (DMH) serves as a conduit for Federal and State funding.
• In Missouri, the Substance Abuse Prevention and Treatment (SAPT) Block Grant is the primary source of Federal funding for addiction treatment and prevention services.
• DMH uses these Federal dollars in combination with State aid and other funds to support a broad range of local programming efforts.

Slide 8:

HUD Funding (2002)

Fund Type	State Total (millions)	Amount for Homeless* Services (millions)
HUD S+C	$5.7	$5.7
Total	$5.7	$5.7
(Missouri has 18 HUD S+C Programs)

Slide 9:

Block Grant Funds

• Block Grant funds support a broad range of treatment and prevention services in MO.
• In terms of services to homeless, funds are used to match HUD rental assistance funding and to support needed case management – not fundable under Shelter Plus Care.

Slide 10:

Missouri’s Treatment Admissions(FY 2002)

Service	Total Served
Residential	6,779
Detoxification	5,172
Outpatient	26,963
Methadone	371
CSTAR Women and Children	5,187
CSTAR Adolescent	3,274
CSTAR General Adult	9,691 *

Slide 11:

Homeless Tx Services

• Outreach/evaluation/referral services through scheduled visits to shelters, primarily in the St Louis and Kansas City areas.
• Crisis services are provided in many Missouri communities that do not have large-scale homeless shelters.

Slide 12:

Homeless Tx Services

• A critical component of DMH’s continuum for homeless persons involves outpatient client treatment programming, in conjunction with supportive, permanent housing for clients, such as Shelter Plus Care or community residence services.

Slide 13:

Homeless Housing Services – Shelter Plus Care

• Shelter Plus Care (S+C) is the core of our homeless services approach and an excellent linkage between two systems -- services and housing.
• DMH currently works with nonprofit service providers, including the Community Action Agencies to operate 18 of the 21 Shelter Plus Care programs in MO which provide rental assistance to over 700 units and 1300 individuals and their families.
• HUD provides rental assistance; DMH provides administrative oversight; participating providers are responsible for treatment and supportive services.

Slide 14:

Homeless Housing Services – Shelter Plus Care

• S+C utilizes the HUD Continuum of Care (CoC) planning model. There are currently 9 Continuums of Care in MO. DMH Housing staff coordinates the State Continuum of Care which covers 98 of the 115 counties. CoC planning helps communities develop a common vision and goals, provides an excellent framework for:
  • determining housing needs among various target populations in a given community and for
  • identifying and accessing resources in a coordinated manner.

Slide 15:

Homeless Housing Services – Shelter Plus Care

• S+C grantees must match the rental assistance provided by HUD with an equal value of supportive services appropriate to the target population. (The services match is typically funded through a combination of State and Block Grant funds.)
• Many providers have also independently pursued and received HUD Supportive Housing awards, Section 8 rental subsidies and other Federal and State homeless assistance funds.

Slide 16:

MO Homeless Housing Initiatives

• Amethyst Place, located in Kansas City, provides independent, supportive housing to homeless women and their children.
• DMH is a partner in two proposals submitted by Missouri for the Collaborative Initiative to Help End Chronic Homelessness initiated by the Interagency council on Homelessness. (One in Kansas City and One in St. Louis.)

Slide 17:

Other Housing Resources in MO

• Various other sources for homeless people with chemical addictions, mental illnesses or co-occurring disorders --
  • HUD: Shelter Plus Care, Supportive Housing Program, Section 8 - Housing Choice Vouchers, Section 811 Supportive Housing for Persons With Disabilities, Section 8 Mainstream for persons with disabilities, Public Housing Program, Home Investment Partnership Program, Community Development Block Grant.
  • VA: VA's Supported Housing Program, H U D - VASH
  • PATH: Projects for Assistance in Transition from Homelessness

Slide 18:

Homelessness Initiatives

• The MO Governor's Committee to End Homelessness attended the 3rd annual Policy Academy in Atlanta in January 2003
• Homeless Missourians Information System—HUD funded program to establish data system to track all services delivered to persons experiencing homelessness in the State Continuum of Care process. This will eventually link with other HMIS systems in the urban areas of MO.
• Transition from Prison to Community Housing Committee— developing recommendations to improve discharge planning to increase number of people released from correctional institutions into permanent housing situations with connections to needed services to succeed.

Slide 19:

Current Housing Services Priorities

DMH providers need to develop and institute housing assistance services that focus on:

• assessment of clients’ housing needs and level of readiness for housing
• treatment and discharge planning that identifies appropriate housing options to be pursued
• case management to ensure integration of all treatment, support and housing services

Slide 20:

Current Housing Services Priorities

• linkages with local public and private housing agencies, other DMH providers of homeless/housing services along with all CoC groups.
• housing resource development, to increase affordable housing options, including ownership, subsidies and other fiscal resources.
• State and community advocacy for safe, suitable housing options with appropriate supports for all DMH consumers.