Closing in on Zero: Lessons from Worcester, MA Community Healthlink, Inc. Leah Bradley Gary Comeau Patty Angevine
Where we began <ul><li>2004 – CSPECH Pilot </li></ul><ul><ul><li>MHSA monitoring costs </li></ul></ul><ul><li>2007 –  Home...
Home Again Model <ul><li>No Exclusionary Criteria – only entrance criteria is chronic homelessness </li></ul><ul><li>1:10 ...
Housing Model  <ul><li>Creative Engagement strategies  </li></ul><ul><li>Housing type options (SRO, efficiency, 1 bedroom,...
Paradigm Shift  <ul><li>Central Intake </li></ul><ul><li>Single List of chronically homeless individuals in city </li></ul...
Closing of Shelter/Opening of Assessment Center <ul><li>Planned reduction in number of available overnight beds </li></ul>...
Identified gaps in our system <ul><li>24 hour staffed facility for clients actively using AOD who are unsafe in independen...
Resources <ul><li>HUD CoC – leasing dollars </li></ul><ul><ul><li>Able to move clients </li></ul></ul><ul><ul><li>Can hous...
Results <ul><li>Over 90% retention rate in housing </li></ul><ul><li>Most do not re-enter homeless system </li></ul><ul><l...
Results (Con’t)
Next Steps <ul><li>Advocating with state for Medicaid dollars for case management </li></ul><ul><li>Focus on new target po...
Lessons Learned <ul><li>New Triage and Assessment model is effective, but resource intensive </li></ul><ul><li>Engage inte...
Lessons Learned (Con’t) <ul><li>Everyone can function in the right community housing </li></ul><ul><li>New populations eme...
Lessons Learned (Con’t) <ul><li>A client-centered treatment approach creates an opportunity for healing. </li></ul>
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1.8 Leah Bradley

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1.8 Leah Bradley

  1. 1. Closing in on Zero: Lessons from Worcester, MA Community Healthlink, Inc. Leah Bradley Gary Comeau Patty Angevine
  2. 2. Where we began <ul><li>2004 – CSPECH Pilot </li></ul><ul><ul><li>MHSA monitoring costs </li></ul></ul><ul><li>2007 – Home Again Planning Process </li></ul><ul><li>City of Worcester Task Force </li></ul><ul><li>State Commission to End Homelessness </li></ul><ul><li>All concluded that a paradigm shift to Housing First/Rapid-rehousing was most effective way to end homelessness </li></ul>
  3. 3. Home Again Model <ul><li>No Exclusionary Criteria – only entrance criteria is chronic homelessness </li></ul><ul><li>1:10 staff to client ratio to start, increase as clients stabilize </li></ul><ul><li>Client choice in housing </li></ul><ul><li>Housing adapts to client’s changing needs </li></ul><ul><li>Timely access to treatment programs </li></ul>
  4. 4. Housing Model <ul><li>Creative Engagement strategies </li></ul><ul><li>Housing type options (SRO, efficiency, 1 bedroom, shared apartment) </li></ul><ul><li>Relocating clients when necessary </li></ul><ul><li>Re-housing clients when a placement isn’t working </li></ul><ul><li>Rep payee option for money management </li></ul>
  5. 5. Paradigm Shift <ul><li>Central Intake </li></ul><ul><li>Single List of chronically homeless individuals in city </li></ul><ul><li>Regular meetings with multiple providers </li></ul><ul><li>Services co-located with treatment programs </li></ul><ul><li>Regular “required” check-ins </li></ul>
  6. 6. Closing of Shelter/Opening of Assessment Center <ul><li>Planned reduction in number of available overnight beds </li></ul><ul><li>Created urgency to house chronically homeless </li></ul><ul><li>Provided opportunities to work with long-term shelter users </li></ul><ul><li>Provided opportunity for engagement during day hours </li></ul><ul><li>Respectful setting with clear expectations </li></ul>
  7. 7. Identified gaps in our system <ul><li>24 hour staffed facility for clients actively using AOD who are unsafe in independent housing </li></ul><ul><ul><li>Transformed our Safe Haven model </li></ul></ul><ul><li>Young Adult programs </li></ul><ul><li>24/7 case management at the Assessment Center </li></ul><ul><li>Small efficiency units </li></ul>
  8. 8. Resources <ul><li>HUD CoC – leasing dollars </li></ul><ul><ul><li>Able to move clients </li></ul></ul><ul><ul><li>Can house more clients with “savings” </li></ul></ul><ul><li>The Health Foundation of Central Massachusetts (THFCM) - services dollars </li></ul><ul><ul><li>Furniture/household supplies; moving costs; landlord assistance; transportation </li></ul></ul><ul><li>Federal Stimulus Dollars – 24/7 case management for Assessment Center </li></ul>
  9. 9. Results <ul><li>Over 90% retention rate in housing </li></ul><ul><li>Most do not re-enter homeless system </li></ul><ul><li>Reduced chronic homeless population to 1 </li></ul>
  10. 10. Results (Con’t)
  11. 11. Next Steps <ul><li>Advocating with state for Medicaid dollars for case management </li></ul><ul><li>Focus on new target populations </li></ul><ul><ul><li>“ Pre-chronic” </li></ul></ul><ul><ul><li>Young Adults </li></ul></ul><ul><ul><li>Women </li></ul></ul><ul><ul><li>Previously unstably housed </li></ul></ul>
  12. 12. Lessons Learned <ul><li>New Triage and Assessment model is effective, but resource intensive </li></ul><ul><li>Engage intensively from the start </li></ul><ul><li>Preserve tenancy whenever possible </li></ul><ul><li>Short stays to reduce institutionalization of homelessness </li></ul>
  13. 13. Lessons Learned (Con’t) <ul><li>Everyone can function in the right community housing </li></ul><ul><li>New populations emerge as chronically homeless are housed </li></ul><ul><li>Staff shift their roles to housing case managers vs. shelter case managers </li></ul><ul><li>Repurpose resources to meet new needs and for cost effectiveness </li></ul>
  14. 14. Lessons Learned (Con’t) <ul><li>A client-centered treatment approach creates an opportunity for healing. </li></ul>

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