U.S. Department of Health and Human Services, U.S. Department of Housing and Urban Development, U.S. Department of Veterans Affairs, Improving Access to Mainstream Services for "Chronically" Homeless Persons, Including Individuals with Serious Mental Health and/or Substance Abuse Problems, Hyatt Harborside, Boston, Massachusetts, April 9-11, 2002


Slide 1:

Improving Access to Mainstream Services for “Chronically” Homeless Persons, Including Individuals with Serious Mental Health and/or Substance Abuse Problems

CREATING A COMPREHENSIVE AND INTEGRATED SERVICE SYSTEM FOR PERSONS WHO ARE CHRONICALLY HOMELESS

Jointly Sponsored by
U.S. Department of Health and Human Services
U.S. Department of Housing and Urban Development
and
U.S. Department of Veterans Affairs

Slide 2:

Why A Comprehensive Service System?

  • People who are chronically homeless have multiple needs that can not be addressed by one service system
  • Needs include access to mental health services, substance abuse treatment, health care, housing, income supports and entitlements, basic life skills training, education, job training

Slide 3:

Why An Integrated Service System?

  • People who are chronically homeless experience many obstacles to accessing housing and services.
  • System-level Obstacles:
    • Fragmented systems, services, and funding
    • Restrictive and excessive administrative procedures
    • Poorly trained staff
    • Ineffective programs
    • Insufficient resources (housing and services)
    • Long waiting lists
    • Stigma

Slide 4:

Why An Integrated Service System?

  • Client-level Obstacles:
    • Mistrust of system
    • Denial
    • Criminalization of homelessness
    • Multiple needs
    • Complex application processes
    • Services not client-centered
    • Transportation to geographically dispersed services

Slide 5:

Goal of a Comprehensive and Integrated Service System

  • People who are chronically homeless can enter any service “door”, be assessed, and obtain access to the full complement of services and supports and housing that they want and need

Slide 6:

Principles for Creating A Comprehensive and Integrated Service System for Homelessness

  • Support concept of “No Wrong Door” to services
  • Provide services determined by evidence to be effective
  • Change ineffective policies or regulations
  • Leverage existing resources
  • Use mainstream resources
  • Pursue new resources

Slide 7:

Elements of a Comprehensive and Integrated System to Address Homelessness

  • Prevention
  • Outreach and Case Management
  • Mental Health & Substance Abuse Treatment
  • Health Care
  • Integrated Treatments for Co-occurring Disorders
  • Emergency Shelters
  • Permanent Supportive Housing
  • Employment and Education
  • Culturally relevant services
  • Consumer-centered services

Slide 8:

Steps to Achieving a Comprehensive and Integrated Service System

  • Involve Key Stakeholders
  • Establish a formal plan
  • Build linkages and partnerships from top-down and bottom-up
  • Enhance funding and other resources
  • Streamline the administration of funding
  • Perform ongoing monitoring and quality assurance

Slide 9:

Involve Key Stakeholders

  • Executive Branch Leaders
  • State and local departments of Housing, Mental Health, Substance Abuse, Health, Medicaid, Welfare/Social Services, Education, Homeless, Transportation, Labor, Criminal Justice
  • Senior-level staff with authority to make policy and budget commitments
  • Legislators
  • Providers
  • Homeless or formerly homeless persons
  • Advocacy groups

Slide 10:

Establish a Formal Plan — Sample

Mission Statement: To create an integrated system of care for persons who are chronically homeless by making optimal use of existing mainstream resources, creating new resources and improving coordination and collaboration across service and housing systems.

Slide 11:

Establish a Formal Plan — Sample

  • Goal 1: Create a permanent interagency committee that will oversee the implementation of the strategic plan
  • Goal 2: Realign Federal, state and local funds for developing services and housing
  • Goal 3: Implement evidence-based effective services
  • Goal 4: Decrease programmatic, procedural and policy barriers
  • Goal 5: Develop affordable housing

Slide 12:

Build Linkages and Partnerships — Strategies

  • Interagency Coordinating Body
  • Systems Integration Coordinator
  • Interagency Agreements or MOUs
  • Cross-training
  • Co-location of services
  • Pooled/Joint Funding
  • Interagency MIS/Client Tracking System
  • Uniform Applications/Intake Assessments
  • Interagency Service Delivery Team
  • Flexible Funding
  • Program Consolidation
  • Negotiation

Slide 13:

Enhance Funding and Other Resources

  • Discretionary resources (e.g., general fund)
  • Mainstream Federal programs (e.g., TANF, Mental Health Block Grant, Substance Abuse Block Grant, HOME)
  • Dedicated revenue stream
  • Matching contributions
  • Incentives

Slide 14:

Streamline Administration of Funding

  • Interagency agreements
  • Legislative mandates
  • Pooled funding
  • Separate funding but single application process
  • Coordinated funding priorities

Slide 15:

Perform Monitoring and Quality Assurance

  • Establish consistent data collection, performance standards, reporting requirements
  • Create single point of accountability
  • Tie quality assurance to funding

Slide 16:

Key Requirements for Building a Comprehensive and Integrated Service System

  • Develop infrastructure and leadership
  • Have dedicated full-time staff person(s)
  • Provide flexible funding
  • Conduct ongoing planning
  • Regularly update strategies and action steps