Agenda

1. 2014 South Hampton Roads Regional Conference on Ending HomelessnessCase Management Professional Development SessionSuzanne WagnerMarch 11, 2014

2. Agenda

3. National Trends and Best Practices • HEARTH – Homeless Emergency Assistance and Rapid Transition to Housing • Federal Strategic Plan (FSP), Opening Doors

4. HEARTH Objectives

5. HEARTH Performance Measures

6. Evidence-Based and Best Practices • Housing First • Rapid Exit from Homelessness • Housing Stabilization and Eviction Prevention • Critical Time Intervention • Supported Employment • Stages of Change

7. Housing Shelter Rapid Exit 2. Exit Strategy • Main Goal – Rapid Access to Housing • Focus on Relocation and Stabilization services Source: NAEH Center for Capacity Building

8. Housing First • Housing First is a programmatic and systems approach that centers on providing homeless people with housing quickly and then providing services as needed. • Housing is not contingent on compliance with services – participants expected to comply with a standard lease agreement and are provided with services and supports to help maintain housing • Services are provided post-housing to promote housing stability and well-being • No evidence that “prep” pre-housing improves housing outcomes

9. Housing First Principles • Choice/Affordability of Housing • Housing is Integrated into the Community • Separation of Housing and Treatment • Service Philosophy and Service Array • Low Barrier and Low Demand Approach • Access to Treatment Resources and Supports • Recovery Principles • Team Structure, Supervision and Resources

10. Prevailing Model Emerging Model Employment Assistance Employment Assistance Day Care Day Care Shelter Housing Stabilization Shelter/TH MH/SA Services Housing Placement MH/SA Services Family Supt Services Family Supt Services Turning the Continuum of Care Inside – Out? Source: Culhane, Homeless Assistance: A Paradigm Shift?

11. Housing Stabilization Services Strategy to assist each person to maintain housing and establish a base in the community • Priorities: • Tenancy and Meeting Lease Obligations • Income • Services and Supports • Achieving self-defined goals

12. Housing Focused Case Management – Core Elements

13. Expectations of Tenancy

14. Housing Focused CM Core Elements

15. Goals of Housing-Focused Case Management

16. Measures of Success

17. Core Elements: Housing Stabilization Services

18. Engagement Strategies

19. Engagement

20. What do people want?

21. Stages of Change

22. Stages of Change

23. Jimmy

24. June and her children

25. CTI

26. Critical Time Intervention • Critical Time Intervention (CTI) is an Evidence Based Practice (EBP) proven to assist with transitions to community housing for vulnerable populations • CTI is a specialized intervention provided at a “critical time” - when a person/family first moves into housing • CTI connects people with formal and informal community supports • CTI is a time-limited intervention lasting approximately 9 months, divided into 3 specific phases that focus on a limited number of service areas that support housing stability

27. Critical Time Intervention - 2 • Focused on Housing Retention and Life Goals • Time-limited • Three 3-month phases of decreasing intensity that begin when the person is housed • Transition to the community • Try out • Termination or transition to lower level of service

28. Critical Time Intervention - 3 Focused Assessment and Services • 1-3 areas from 6 service areas • Based on threat to long-term housing stability • Rent payment • Following rules re visitors, noise etc • Keeping unit healthy and safe • Only allowing those on lease to live there • Other lease requirements • AND • Access to care and supports • Lots of focus on linkages and making them work • Think about natural supports

29. Critical Time Intervention - 4 Areas of Focus for Assessment and Planning • Housing and homelessness history, housing stability barriers • Income and financial literacy • Life skills • Family, friends and other supports • Psychiatric and substance abuse issues • Health and medical issues See www.criticaltime.org

30. Key Ingredients of CTI • Provide services in the home and the community • Persistent Engagement • Process not an event • Based on tenants expressed needs and aspirations • Offers services and defines worker role • Ongoing assessments of housing barriers to prevent housing loss • Connect with other mainstream and community-based services – benefits and services • Connect with natural supports including spiritual

31. Key Ingredients of CTI • Focus on eviction prevention and use the structure of the lease to guide your interventions • Work with landlords and building managers • Need Assertive approach • Hold person to lease obligations • Coordinate interventions • May accept services if threatens housing

32. CTI Focus • Focus on Self Sufficiency • Goal setting • Connection to high quality sustainable services and supports and • Empowerment Focus on Long-Term Stability • Use lease to structure the work • Role and Expectations • Not symptom or crisis based services • Goal includes sustainability as opposed to acute interventions Strong Expectation that Person becomes Integral Part of Community • Considers purpose and activity as part of life in housing • Role and life transition from “homeless” to “housed”

33. Changing Expectations: Role • Full rights and responsibilities of tenancy • Using structure of the lease to set expectations • Moving from crisis to planning • May be from immediate to 15 minutes from now • Critical Thinking • Using strategies and resources that work best for each person • Structure and purpose • Developing a structure and purpose to days that are different from when homeless • Developing new or changed roles • From homeless person to tenant, parent, worker, advocate

34. CTI Assessment & Planning Focus Areas • Housing • Financial • Health and Mental Health • Substance Use and Misuse • Family and Other Relationships • Life Skills

35. Focused Housing/Service Planning

36. Components of the CTI Plan -- Goals • Goals set as a team of clients and worker • Focus on the issues that affect housing retention – base on what caused the current crisis and previous episodes of housing instability • Immediate and longer term goals clear • Focus by phase • Use the plan for the intervention • Steps to reach goal clearly defined and measurable • Longer term needs require connections to other resources

37. Components of the CTI Plan

38. Components of the CTI Plan

39. Evaluating the Plan

40. Building Skills • Educating on rights and responsibilities • Modelingfor people to negotiate for services and enlisting the service’s/support’s help • Trying it out and debrief • Establishing regular check-ins to see if it is working • Review cost and benefits – critical thinking • Recognizing strong partners and good skills • Renegotiate the relationship as necessary • Focus on longer term planning ( non crisis based)

41. Transition to the Community • Assistance in making linkages • Meeting with the person and the resource if necessary • Refine communication structures with landlord, services and other supports • Make a plan for connections to continue • Housing planning revision • Re-engage, Assess for new needs and revise plan based on current housing and lease compliance. Identify resources needed. Focus on community support, role and activity • Skill building for community resources • Provide education about rights, responsibilities, and expectations; model negotiation skills • Begin termination process and transition needed services • Develop a plan to address issues in housing and community Connections

42. Closing or Step Down

43. Coordination with Partners

44. Working with Housing Providers

45. Communication Structures with Housing Providers • Clear guidelines about when to talk (monthly call or visit to landlord/ property manager) • Policies and Procedures for home visits, resolving problems and role, emergencies, on-call • Address tenancy issues in team meetings and supervision • Cross Training, In-Services and Trainings • If resident services available: work together

46. Coordination with Housing Providers

47. Assistance to meet the expectations of tenancy

48. Assistance to meet the expectations of tenancy

49. Case Discussions

50. Mainstream and Community Resources