Alameda County Home Stretch

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Presentation transcript:

Alameda County Home Stretch Health Care Services Agency Email: Homestretch@acgov.org Phone: 510.891.8938 Fax: 855.658.5466 Mail: PO Box 29172, Oakland, CA 94612 Website: http://everyonehome.org/our-work/home-stretch/

Topics Overview Eligibility and Prioritization Definitions Process Overview Submitting a Referral Referral Processing Document Readiness & Housing Navigation Housing Match Verifications Exercise: Sample Housing History Home Stretch Alameda County

Overview A collaboration between: Key partners: Alameda County Health Care for the Homeless Behavioral Health Care Services, Housing Services Office EveryOne Home Key partners: Alameda County Housing and Community Development Local housing authorities County and community healthcare and housing providers

Overview The goal of Home Stretch is to prioritize and streamline access to supportive services and permanent supportive housing for homeless people with disabilities. Specifically, the program aims to: Prioritize persons with highest needs for housing opportunities Provide housing navigation support from enrollment to move-in and beyond Reduce emergency department visits and inpatient stays Reduce law enforcement interactions and time spent incarcerated Measure housing outcomes Potentially expand availability of long term affordable and mixed income housing Home Stretch Alameda County

Overview Operationally, the program: Combines data from outreach, healthcare, law enforcement, and emergency medical services to identify high need users Creates a countywide system of prioritization for permanent supportive housing and supportive services Matches individuals with appropriate housing and services Housing Navigation Vouchers Existing Programs Home Stretch Alameda County

Eligibility and Prioritization Persons* are eligible for referral to Home Stretch if, at the time of referral, they are both: HUD Literally homeless HUD Disabled 18 years or older or an emancipated youth Priority will be given to those that are HUD chronically homeless AND high need * Families are eligible for Home Stretch if the head of household is eligible. Home Stretch Alameda County

Eligibility and Prioritization Home Stretch has four prioritization categories: Priority Group Required Documentation Chronically Homeless (HUD) Disabled (HUD) High Need (CoC) Literally Homeless 1 X 2 3 4 Home Stretch Alameda County

Definitions – “Literally Homeless” An individual or head of household is literally homeless who is: Living on the streets, in a place not meant for human habitation, or in an emergency shelter or safe haven; OR In an institutional care facility for no more that 90 days, where the individual was literally homeless at the time of entry into the care facility; OR In transitional housing designated for homeless individuals and it is documented that they were homeless at the time of entry * Institutional care facilities include jails, licensed inpatient substance abuse facilities, licensed inpatient mental health treatment facilities, hospitals, etc. An individual who has been residing in an institutional care facility, including a jail, substance abuse or mental health treatment facility, hospital, or other similar facility, for fewer than 90 days and met all of the criteria above before entering that facility; or (c) A family with an adult head of household (or if there is no adult in the family, a minor head of household) who meets all of the criteria above of this definition, including a family whose composition has fluctuated while the head of household has been homeless. Home Stretch Alameda County

Definitions – “Chronically Homeless” HUD’s “chronically homeless” definition has three elements: Place Duration Disability To be considered chronically homeless, an individual must meet all three elements An individual who has been residing in an institutional care facility, including a jail, substance abuse or mental health treatment facility, hospital, or other similar facility, for fewer than 90 days and met all of the criteria above before entering that facility; or (c) A family with an adult head of household (or if there is no adult in the family, a minor head of household) who meets all of the criteria above of this definition, including a family whose composition has fluctuated while the head of household has been homeless. Home Stretch Alameda County

Chronic Homelessness - Place The client must be homeless and living in a place not meant for human habitation, in an emergency shelter, or in a safe haven. Image from: http://sanfrancisco.cbslocal.com/2016/01/31/sf-supervisor-fears-booming-tent-cities-could-become-new-homeless-policy/ Image from: http://www.transequality.org/blog/win-hud-tells-homeless-shelters-to-respect-self-identified-gender Home Stretch Alameda County

Chronic Homelessness - Duration The client must have been homeless and residing in a place not meant for human habitation, a safe haven, or in an emergency shelter continuously for at least one year or on at least four separate occasions totalling a minimum 12 months in the last 3 years. Each period separating the occasions must be at least 7 days; Home Stretch Alameda County

Chronic Homelessness - Disability Client can be diagnosed with one or more of the following conditions: Substance use disorder Serious mental illness Developmental disability Post-traumatic stress disorder Cognitive impairments resulting from brain injury Chronic physical illness or disability An individual who has been residing in an institutional care facility, including a jail, substance abuse or mental health treatment facility, hospital, or other similar facility, for fewer than 90 days and met all of the criteria above before entering that facility; or (c) A family with an adult head of household (or if there is no adult in the family, a minor head of household) who meets all of the criteria above of this definition, including a family whose composition has fluctuated while the head of household has been homeless. Home Stretch Alameda County

Definitions – “High Need” There are several ways that a person may be determined to be “high need”: They are high utilizers of inpatient health and/or mental health services; They have high interactions with law enforcement and/or the criminal justice system; They have a high-risk health condition; or They have a qualifying score on the VI-SPDAT assessment tool Home Stretch Alameda County

High Need – Law Enforcement & Health Care Utilization An individual is considered high need if they have experienced at least one of the following in the 12 months prior to referral: High law enforcement contacts * 3 or more incarcerations 5 or more law enforcement contacts High health care utilization ** 3 or more admissions to Cherry Hill Detox or Sobering Station 3 or more medical and/or psychiatric hospitalizations * 5 or more Emergency Medical Services transports * Use Law Enforcement 3rd Party Verification ** Use Health Care Utilization – 3rd Party Verification or Clinician’s Gateway Face Sheet Home Stretch Alameda County

High Need – High Health Risk A person may also be classified as high need if they meet one of the high-risk categories defined below. 60 years of age or older AND one or more “chronic health conditions” i.e heart disease, emphysema/COPD, diabetes, asthma, cancer, or Hepatitis C Kidney disease (end stage renal disease/dialysis) History of frost bite, hypothermia, or immersion foot Liver disease (cirrhosis or end stage liver disease) Home Stretch Alameda County

High Need – High Health Risk cont. HIV+/AIDS Arrhythmia Seizure disorder Schizophrenia or schizoaffective disorder Trimorbidity (all of the following): Mental health, learning, developmental, or cognitive disability Substance use disorder Chronic health condition (heart disease, emphysema/ COPD, diabetes, asthma, cancer, or hepatitis C) These conditions must be verified by a licensed health care professional * * Use the Health Care Diagnostic Verification form Home Stretch Alameda County

High Need – VI-SPDAT A person also demonstrates high need if they have a score of 8 or higher on the VI-SPDAT.* Single Adults: VI-SPDAT 2.0 Families: VI-FSDAPT 2.0 Transition age Youth: TAY – VI-SPDAT 1.0 *A score higher than 8 does not increase the priority level. Home Stretch Alameda County

Home Stretch Process Overview Connection to PSH & Services Housing Match Document Readiness and Housing Navigation Referral Processing Outreach and Referral Submission Home Stretch Alameda County

Submitting a Referral Determine eligibility Complete Home Stretch Referral Packet: Fax Cover Sheet Signed Home Stretch Consent to Release of Information (ROI) InHOUSE Standard Intake High Need Verification and Supporting Documents (if applicable) Contact Information Submit by fax or mail: Fax: 855.658.5466 Mail: PO Box 29172, Oakland, CA 94612 Home Stretch Alameda County

Referral Processing – Home Stretch Staff Review referral and provide feedback Determine eligibility and prioritization by HMIS Standard Intake and supporting documents Enter eligible individuals and households into HMIS If client has no housing navigator, link with housing navigator based on priority and capacity Home Stretch Alameda County

Document Readiness Clients who are in the Home Stretch registry must have all housing match documents submitted and verified before they will be eligible for housing match. Home Stretch Alameda County

Document Readiness The following housing match documents are required for a single applicant or head of household: Required Forms: Housing Profile Form Government- issued photo ID Social Security Card Vets verification (if applicable) Disability verification (specific type, if applicable to client) – serious mental illness, HIV/AIDS, developmental disability, substance use disorder (dated within 60 days) Housing History Homelessness Verification (dated within 60 days) Recommended Forms: Income Verification Tenant Resume/Sample Housing Application Tenant/Credit History Report Other Documents from Household Members or Special Needs (see Home Stretch Documentation Checklist for further info) Home Stretch Alameda County

Housing Match When PSH opportunity becomes available, Home Stretch matches a client through the following steps: If no client is identified, repeat the process with Priority Group 2, then 3, then 4 If more than one client remains, select the client who has spent the most time on the Home Stretch registry Filter for those clients whose preferences, as indicated on their Housing Profile, are consistent with the available unit Filter for those who meet the eligibility requirements of the specific unit that is open Filter for those who are document ready Identify all clients in Priority Group 1 Home Stretch Alameda County

Connection to PSH Home Stretch notifies matched client's Housing Navigator of PSH opening Housing Navigator notifies client, confirms client's interest in the PSH opporitunity, and assists client in completing any additional documentation needed Housing Navigator infomrs Home Stretch of client's interest in the PSH opportunity and submits any additional documents needed Home Stretch sends the completed referral packet to PSH property / provider and to client's Housing Navigator For site-based PSH - Property Managers contacts Housing Navigator to schedule housing interview For voucher based - PSH service provider contacts Housing Navigator (if different) to schedule next steps Home Stretch Alameda County

PSH Services Moving-In and Transitioning– Important to help complete in partnership with Housing Navigator if available for client/tenant as part of service transition process. Support with completing core housing tasks: rental agreements, utilities, methods for paying rent, obtaining furniture, etc. Help develop skills relevant to living in a residential community: conflict resolution, communication skills, raising concerns with neighbors and landlords, etc. Develop a housing crisis response plan outlining plans if challenges arise that may jeopardize housing stability Provide ongoing support services to help maintain housing stability

Homelessness and Disability Verifications Home Stretch Alameda County

Documenting HUD Homelessness Types of Verifications Recognized by HUD Order of priority for obtaining verification: Third-party documentation (can use HMIS records) Self Certification (only if unable to obtain other forms of documentation) If third-party evidence could not be obtained, efforts made to obtain third-party documentation 3 months of a one year period can be self certification, the other 9 months must be third party, intake observation, or HMIS records

Documenting HUD Homelessness Verification must include: Date of verification Name of client Start and end date, as well as specific conditions of each homeless episode Client and/or third party signature Third party verifications must be written on agency letterhead Home Stretch Alameda County

Documenting Chronic Homelessness Use the Home Stretch Housing History Form to list each episode of homelessness starting with the current living situation and going back 3 years (in reverse chronological order). Determine what form of verification can be obtained for each episode of homelessness listed on the form. Obtain all verifications needed to verify each individual episode used to document chronic homelessness.

Documenting Chronic Homelessness Obtain documentation of a disability from a professional licensed by the state to diagnose and treat the disability and his or her certification that the disability is expected to be of long-continuing or of indefinite duration and substantially impedes the individual’s ability to live independently OR written verification from the Social Security Administration OR the receipt of a disability check. NOTE: For Home Stretch, documentation from a licensed professional is preferable as this documentation can help qualify individuals for disability specific services and housing opportunities that the other forms of documentation may not provide.

Roger Rabbit has been homeless multiple times in the past three years. From 7/1/13-7/6/14 he was homeless near Grove and 580 in Hayward. He worked with the HOPE Project from 10/1/13 - 7/6/14. Then he went to stay with family for two months. From 9/1/14 - 12/5/14 he stayed at EOCP emergency shelter After the shelter, he returned to the streets near Grove and 580 from 12/5/14 - 1/6/16 and regularly interacted with outreach workers from the HOPE Project. Right after New Year’s, he went and stayed at his sister’s house for 9 days. While at his sister’s house, he was able to get into the BOSS South County Homeless Project shelter and stayed there from 1/15/16-3/1/16. After exiting the shelter, he went back to his sister’s house from one month before returning to the streets in Hayward near Foothill and A St. While living on the streets he began working with the HOPE Project again.

Exercise: Sample Housing History Home Stretch Alameda County

Questions? Contact us Homestretch@acgov.org phone: 510.891.8938 fax: 855.658.5466 PO Box 29172, Oakland, CA 94612 http://everyonehome.org/our-work/home-stretch/ Home Stretch Alameda County