1. National Alliance to End Homelessness ~ Targeting for Success: Serving Families with the Highest Needs Karen Batia, Ph.D. [email_address] July 2011

10. ACT Fidelity ACT FACT Program Meeting Team meets frequently to plan and review services for each participant (daily) Team meets frequently to plan and review services for each participant (three to four times per week) Practicing Team Leader Supervisor of front line clinicians provides direct services Continuity of Staffing Program maintains same staffing over time Staff Capacity Program operates at full capacity Psychiatrist on Staff 1 FTE per 100 - 120 participants 0.20 FTE Psychiatrist; access to Child Psychiatrist Nurse on Staff 1 FTE per 50 - 72 participants Brokered medical services based on insurance provider coverage (IL All Kids)

11. ACT Fidelity ACT FACT Substance Abuse Specialist on Staff 1 FTE per 50 – 72 participants 1 FTE per 50 – 72 participants Vocational Specialist on Staff 1 FTE per 50 - 72 participants Brokered employment, vocational and financial literacy services through partners; vocational expertise of team used to develop soft skills with participants Program Size Program is sufficient absolute size to provide consistently the necessary staffing diversity and coverage (5 - 6 direct service FTE)

12. ACT Fidelity ACT FACT Explicit Admission Criteria Clearly identified mission to serve a particular population and has and uses measurable and operationally defined criteria to screen out inappropriate referrals Single adults with serious mental illness and extensive psychiatric hospitalization history Homeless families, defined as women between the ages of 18 and 25 with at least one child below the age of five who are currently living in shelters or exiting the child welfare system into homelessness Priority criteria— mothers who have a mental health or substance use disorder (or both), who may be experiencing domestic violence, and a history of chronic, often multigenerational homelessness, whose children may display or be at risk of developmental delays and attachment disorders

13. ACT Fidelity ACT FACT Intake Rate Program takes participants in at a low rate to maintain a stable service environment Full Responsibility for Treatment Services In addition to case management, program directly provides psychiatric services, counseling/psychotherapy, housing support, substance abuse treatment, employment/rehabilitative services In addition to case management, program directly provides counseling/psychotherapy, housing support, substance use counseling, and child development assessment and intervention. FACT will connect families to brokered services including: employment/rehabilitative services, financial literacy, medical and oral health care, supportive permanent housing, Beacon’s LIOP/TOTS and Thresholds Mother’s Project. Responsibility for Crisis Services Program has 24-hour responsibility for covering psychiatric services

14. ACT Fidelity ACT FACT Responsibility for Hospital Admissions and Discharge Planning Program is involved in admissions and discharge planning Program works to coordinate entry and discharge from any needed service Time Unlimited Services (Graduation Rate) Program rarely closes cases and remains point of contact for all participants as needed Program works with families to secure stability and connection to needed community resources (18 to 24 months typically) Community-Based Services Program works to monitor status, develop community living skills in the community rather than the office (60 – 80% contact in the community) No Dropout Policy Program retains a high percentage of its participants through continued assertive engagement and re-engagement efforts Program engages a high percentage of families identified as meeting entry criteria through continued assertive engagement and re-engagement efforts

15. ACT Fidelity ACT FACT Intensity of Service High total amount of service time as needed (average of 2 hours of contact per week) Frequency of Contact High number of service contacts as needed Work with Informal Support System Program provides support and skills for participant support network Individualized Substance Abuse Treatment One or more members of the program provide direct treatment and substance abuse treatment for participants with substance use disorders Dual Disorder Treatment Groups Program uses group modalities as a treatment strategy for people with substance use disorders Program brokers group treatment services as needed

16. ACT Fidelity ACT FACT Dual Disorders Model Program uses a stage-wise treatment model that is non-confrontational and has gradual expectations Program uses a wrap-around, stage-wise, strengths-based, trauma-informed and harm reduction oriented approach Role of Consumers Consumers are involved as members of the team providing direct services Consumers may be hired as members of the team; consumers provide program development input as participants of the Planning Coalition and through site visits and program evaluations

21. Systems integration process Heartland Alliance for Human Needs & Human Rights Coalition formation Identify systems and leaders Work plan development Identify focus Outcomes