Our pilot rapid response program for our most vulnerable neighbors The H.E.A.R.T. Project Our pilot rapid response program for our most vulnerable neighbors Hi, I’m Obie Johnson with the Empowerment Project from the Winston - Salem/Forsyth County, NC Continuum of Care. I’m here to talk about the H.E.A.R.T Project to house unsheltered homeless persons. About our CoC: a single county CoC, county population 370K, city population 240K; 2018 PIT 440 (38 unsheltered); AHAR 2017 2,000; HIC 228 ES, 59 Th, PSH 271; SPMs: LOTH avg 73 median 36, Returns ES 24%, TH 25%, PH 8%; other data….TH exits to PH 70%, average cost per PH exit: TH $12,366, RRH $6570.

Timeline 1996 - 2015 —Persistent need/gap 2016 — United Way took lead in project management 2015/2016 — Community Planning Meetings 2017 — HUD awarded joint TH/RRH grant 2015 — Rapid Response Housing Team created 2017 — Services funding awarded by mental health agency 2016 — CoC Retreat on the project 2018 — Implementing the project 2016 — Visits to best practice programs July 1, 2018 For a long time we as a continuum of care where aware of the small population of homeless people who were not being best served through our system. In 2015 the idea for an immediate and extremely low barrier housing option for the people in most critical need was born in a community planning meeting. The Rapid Response Planning Team was first headed by Laura Lama, Lisa Hinson, and myself. We began began-storming and invited other community agencies to join us. I presented the vision to CFAC; MH\SA; and the Mental Health Collaborative. These strong advisory and advocacy groups were instrumental United Way began to lead the project and began to raise funds. … HUD funding is for a joint TH and RRH venture, which allows for the best parts of short term and medium term housing to come together for the benefits of the clients.

Population in Need Unsheltered homeless persons, usually on the streets Persons without all of their documentation Avoid the shelters due to: High cost to the community (est. $42,000/year) Difficulty being in close spaces with others Can be challenging to motivate them to action Difficulty building relationships; lack of trust Extremely difficult to locate or contact Mental health symptoms can be disruptive in the shelter setting Heavily dependent on hospital emergency rooms, jails, services 40 - 60 persons estimated need

Can meet the person during the crisis Transitional Housing No Hoops No Wrong Doors NNonn Overview Rapid Response Team Screening Tool Rapid Response Team Can meet the person during the crisis Jail Emergency Room Street Shelter Homeless Person Chronically homeless MH/SA/IDD Diagnosis Frequent utilization of crisis services to meet basic needs Motivational Enhancement CTI Harm Reduction Permanent Housing Wrap around services: Medical Assistance Assistance with applying for benefits including Medicaid and SSDI Transportation Change lease to Guest Rapid Re-Housing

H.E.A.R.T. Project Goals Make Housing First a reality for the underserved target population Same day move - in Low barriers to housing - paperwork, criminal history, credit, income Shift from TH to RRH in same unit avoids disruption in healing Foster stability by embedding services on-site Make Housing First a reality for the first time for this underserved target population If a case manager finds them in an ER, or under a bridge, they can be moved in THAT DAY. No more appointments to keep! Low barriers to housing - no paperwork, criminal history rules, credit checks, income requirements Move from TH to RRH in same unit to help stability Site visits by nurse practitioner to improve health, live in peer support specialists, visits from mental health professional, all contribute to housing stability Note I learned at 2018 NAEH conference: if we get Medicaid waiver, we could also bill for mobile psych services

Project Elements Master - Leased Transitional Housing 3 TH units; 7 RRH units Transition in Place to RRH Peer Support & Direct Services Mainstream and Health Services on-site (will not be ready at July 1, 2020. Services will be referred out) Simplified Screening Factors Name, DOB, Contacts Living Situation Health Information (Disability, Diagnoses, Treatment) Legal History Assessment Score Andrea Kurtz with United Way of Forsyth County is the project lead and is raising money for the project. It has a $530K total budget. So far we have $78K from HUD CoC and $130K for services from our regional MH org. (Norm acknowledged that a challenge is to know how much to put in the CoC master leasing budget vs. the CoC rental assistance budget.)

Ideal Budget Services Housing Total $530,000 Additional Costs Wrap Around Services: Staffing: 5 positions On Site Housing Units & Rent Household Start - up Funds Additional Costs Cleaning Transport SOAR Specialist - Disability application support Total $530,000 Staff Street Outreach person(s) Intensive Case Manager Nurse Practitioner or PA (part time) Psychiatrist (part time) Peer Support Specialists (24 hours 7 days) Housing Master Lease/Property Manager Household Startup Funds

Funding HUD has awarded $78,528 The Cardinal funding, $130,000 one year of funding to master lease 3 TH units provide financial assistance for 7 RRH slots.  The idea is transition in place from TH to RRH The Cardinal funding, $130,000 key for services in the project United Way is continuing to raise funds for all the services needed and is in communications with potential landlord(s)

Issues to Resolve or Finalize Hiring Peer Support Coordination with Hospitals and Mainstream Agencies Balance of Funding Long Term Rental Assistance Andrea Kurtz with United Way of Forsyth County is the project lead and continues to work on these issues. We do have a potential site in discussion. We plan to launch the project by the end of calendar year 2018.

Contact Information Russ May, Project Lead Cities with Dwellings Winston - Salem/Forsyth County North Carolina Continuum of Care (336) 306-3562