National Conference on Ending Homelessness

July 14, 2011

Washington, DC

Voluntary Service Models: Serving Families in Their Own Homes

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1998In Shelter Case ManagementCommunity Housing/Transitional Housing

A brief history of Services at The Road Home in Salt Lake City

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All programs had “Mandatory Services”Clients must be case plan compliantFamilies needed to be Housing ReadyHeavy Emphasis on treatment of substance

abuseHeavy Emphasis on being out of violent

relationships

At That Time

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Failure to complete treatmentFailure to place UAViolence in homeRepeated police callsFailure to secure incomeNot following case planNon payment of rent

Reasons for exits

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We knew what clients needed to succeedCannot be self-sufficient with substance

abuseSelf-sufficiency looks the same for everyone

Clean, employed, meeting with case managerNon-tolerance for discomfort around childrenIf family doesn’t want our help we will help

someone who does

Philosophy at that time

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Many clients do respond to Mandatory Services

Served those who “wanted” to be servedLittle to Zero tolerance of Substance AbuseDecisions are clear cut

Benefits of Mandatory Philosophy

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Doesn’t work for all familiesCase managed families out of housingSame intervention over and over againLimits case manager ability to build

relationshipAdversarial relationship between case

management and Difficult for case manager

Challenges of Mandatory Philosophy

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Chronic Families Exited from shelter and housingReturned to shelter with same issues often

worse offRealized this wasn’t working Shifted philosophy to stick with families no

matter whatPlaced 20 families over 4 years, only exited 1

(old habits die hard)CR&CRThis ran over into other community housing

case management

Evolution Part 1

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Rapid RehousingNational numbers talking about most families

enter into and out of homelessness quickly and don’t return

Experimented on the small scale, seemed to work

Collaborated with DWS on large scalePlaced over 600 families in 20 monthsVery minimal requirementsOnly 57 have returned to shelter

Evolution Part 2

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Permanent Supportive HousingFifty 2 bedroom apartment in a complex for

chronically homeless familiesPlaced here all the families that we had failed

with before100% voluntary cm’t for client. Mandatory for

the case managerGoal is to keep client housed no matter whatUnconditional support for clientHealing relationship MG and family

Evolution 3

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ShelterRapid RehousingCommunity/Transitional HousingPermanent Supportive HousingVariety helps-You can be respectful of client

with in service model, let them make choices

Family Services Had Expanded

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Still MandatoryBeing High or Drunk

in Shelter not tolerated

Being Violent in Shelter not tolerated

Clients with history are not housed as quickly as possible but rather must wait for a more intensive opportunity

Active addiction in shelter something to work on

Not kicked out for lack of increase in income

Being in a violent relationship is something to work on

No more housing readiness criteria

Current Shelter Services

Now Voluntary

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Still MandatoryNeed to agree to

employment planNeed to meet with

Employment WorkerNeed to meet with

Case Manager once a month

(required by funders)

Income not requiredNot denied for substance

abuseNot denied for family

violenceClients reassessed every

monthExceptions are the ruleExtensions as neededMore intensive housing

as needed

Rapid Rehousing

Now Voluntary

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Still Mandatory Every family creates case plan

with case manager Must meet with case manager Most community housing is

time limited Substance Abuse important

issue, may lead to exit Domestic Violence important

issue, may lead to exit Children cause a lot of stress

in staff, issues may lead to exit Belief that return to shelter

may be only effective solution

Case Manager has a lot of flexibility with approach

Emphasis on relationship When case plan not followed,

flexibility ensues Focus on issues as they affect housing Allow CPS course of action to occur Avoiding losing housing as long as

possible Back and forth with case manager and

supervisor Nobody exited without meeting with

supervisor, so that clients can make informed decisions

No services based exits for almost 2 years (over 60 family households)

Community/Transitional Housing

Now Voluntary

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MandatoryProperty

Management may exit for violence, illegal activity, failure to pay rent

Belief that this is client’s only housing opportunity for now

Understanding that to get to this point mandatory services have had no effect

Work closely with Property Management

Goal to form supportive relationship

Attempt to remove all judgment

Unconditional acceptance of client

Permanent Supportive Housing

Voluntary

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No longer deny families housing or assistance based on what we know about them

• Families stay housed that did not used to stay housed. RRH - Out of 600 families in almost 2 years, only 57

return to shelter. 19 intensive families in community, 1 evicted over 3

years. Community/Transitional Housing – ZERO services

exits for almost 2 years (60 family households) PSH, 63 families over two years, 11 moved out on

own, 2 evicted both for dealing.

Results in shift of philosphy

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Most families enter into and out of homeless quickly and do not return

Not all families need the same amount of service to manage

We can vary the intensity of case management services as appropriate

Making a family homeless makes the problem worse

It’s all about the relationship

Things we learned that influenced change

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“Not sure if we were helping people but we were definitely making them jump through hoops”

“It’s now, How do you guys think you can make it, rather than do this”Q – What if they weren’t ready for housing?A - “If they come back, we reassess and try again”Q - Wouldn’t they have been better off staying longer for more support?A - “Better off in housing than shelter because shelter is tough…kids regress…stress…no sleep”

“Everyone deserves chance”“Staff were fearful of rapid rehousing at first, but once they

saw that it worked they embraced it”“Pressure is off the case manager”

5 year Case manager turned 2 year Supervisor in Shelter

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“Meet 1 – 2 times a week first 2-3 month, then taper. We are flexible”

“Case Manager talks about adjustment with supervisor” “Don’t evict anymore for non-compliance….more options help to

ease the process” “We feel really good about where we are at” “Kids are tough, I am more uptight with kids involved, I feel

responsible for well being of kids” yet….No evictions in almost 2 years.

“We will work with them as long as they are progressing, our definition of progress has gotten really radical”

Q – How do you view the changesA – “So much better..client is doing what they want to…

infinitely better….really important for clients to make their own decisions, if it’s an informed decision then we will support it no matter what”

13 year Supervisor in Shelter then Housing

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“We’ve gone from policing to having relationship”“Switched from trying to catch people to trying to

understand”Q – What was the effect of mandatory case management?A – “Created animosity, people had to distance themselves”Q – And now?A - “We are supporting, it’s not our agenda, it’s their agenda. They want to stay housed, it’s more connected”

“Before we tried to change people, now we support change in people”

10 year case manager

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Contact Info

Jselfridge@theroadhome.org

(801) 706-1467

John Selfridge, LCSWThe Road Home

Salt Lake City, Utah

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Motivational Interviewing - Preparing People for Change, Miller & Rollnick

Trauma and Recovery – The aftermath of violence-from domestic abuse to political terror, Herman, J.Traumatic Stress – The effects of overwhelming experience on mind, body and society, Van der Kolk, McFarlane, Weisaeth

Helpful Texts

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Violet, Mother of 1 with longtime partner (2004) In and out of shelter/community housing 4 times due to meth addiction Housed family in intensive cm’t community placement (2006) Continued to use, refused treatment, called our bluff, we stopped fighting

her and started to simply be there for her Relationship opened up Continued to use, got protective order, kicked out abusive partner (2008) Landlord kicked her out Got herself clean in treatment (2009) Moved into PSH with son, clean for 4 months before relapse Lost son to family due to addiction, numerous staff cps calls (2010) Meets voluntarily with therapist and case manager several times a month Has strong relationships with staff, talks about getting clean on her terms Housed (2011)

This is voluntary case management not working

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