1. ActionAIDS

2. A Philadelphia-based Organization in partnership with people living with or affected by HIV/AIDS, working to sustain and enhance quality of life. Provides a wide range of direct services Takes an active and professional approach to leadership in service, education and advocacy.

3. ActionAIDS Clinical Programs Housing Prevention Education & Testing Case Management

4. ActionAIDS Housing Services

5. The Community Homelessness and lack of affordable housing are critical issues for many people living in and around this city, state, country and beyond.

6. ActionAIDS The staff, board members, volunteers and consumers of ActionAIDS all recognize that most people living with HIV/AIDS report that housing is a critical aspect of their physical, mental and overall well-being.

7. Department Mission The Housing Department is dedicated to reducing and preventing homelessness, as well as promoting economic and self-sufficiency amongst people living with HIV/AIDS.

8. Department Mission Housing specialists work with consumers to develop a goal plan and to identify interim steps to meet the consumers ultimate goal of attaining safe, secure and affordable housing.

9. ActionAIDS Housing Department In 1991, ActionAIDS hired the agencys first Housing Specialist and since then the department has grown to six Housing Specialists who serve over 600 individuals and families each year.

10. The Departments Goal The Housing Department is dedicated to reducing and preventing homelessness, as well as promoting economic and self-sufficiency.

11. Housing Services Housing Services are provided for consumers who are living with HIV/AIDS and their household family members.

12. Role of Housing Specialist Assist in applying for and managing applications for affordable, low income, subsidized and/or transitional programs Assist with tenant/landlord issues Help clients apply for low-income utility programs Budget counseling

13. Casa Nueva Vida In 2004, ActionAIDS opened Casa Nueva Vida. Casa Nueva Vida consists of 12 apartments which, offer Supportive Housing to homeless families living with HIV.

14. Positive Living In 2006, ActionAIDS introduced the Positive Living housing program. The Positive Living program provides subsidized housing to 22 individuals and families.

15. Positive Living and CNV Applicants must be homeless and living with HIV/AIDS. In addition to providing housing, both Casa Nueva Vida and Positive Living offer case management, vocational services, life skills training and in-home supports.

16. HOPWA The HOPWA program is independent housing, which provides rental assistance for eligible clients. The waiting list for this program is maintained by The AIDS Activities Coordinating Office. Applicants must have an AIDS diagnosis.

17. Harbor Project ActionAIDS partnership with Pathways to Housing Housing First program. ActionAIDS provides the Case Management Services for this program.

18. Medical Case Management Medical Case Management is ActionAIDS core service and serves over 3,000 individuals and families each year out of over 35 locations. Our medical case managers are trained in various disciplines including social work, psychology, sociology and nursing and represent a diverse group of professionals.

19. Case Management Specialists in the Deaf & Hard of Hearing, Drug and Alcohol Addiction, Families, LGBT, Immigration, Mental Health, Nursing, Perinatal Care, Prison Systems, Women and Youth Services.

20. Medical Case Management Establishing and maintaining trust through one-on- one relationships, case managers and clients work together to coordinate care, navigate through complex governmental systems, and access medical, social, legal, and emergency services.

21. Case Management Prisons today account for the largest concentration of people living HIV and AIDS. ActionAIDS provides case management, prevention, and outreach within the county prisons and keeps prisoners connected with medical and social services upon their release.

22. Harm Reduction Model The agency supports a harm reduction model – embodying the notion of meeting the consumer where they are to help the consumer create a goal plan that is incremental and manageable.

23. What is Housing First? The Housing First model involves offering rental assistance for individuals who are chronically homeless and living with a serious mental health diagnosis. The model serves individuals who are actively engaging in substance abuse, as long as they fit the above criteria.

24. Why is Housing First Necessary? All federally funded housing programs require the residents and family members to be drug free- this creates barriers to housing for many vulnerable populations.

25. Why is Housing First necessary? Housing First allows the grantee to be the primary lease holder, as well as, the customer responsible for utility services. There are some housing options for people who have an AIDS diagnosis, as well as some that require applicants to be asymptomatic.

26. Program Eligibility Eligible clients must meet the Federal definition of chronically homeless, live with HIV/AIDS and have an Axis I Mental Health diagnosis Can include individuals actively engaging in substance (as long as first 2 criterion are met).

27. Definition of Homeless Homeless individual lacks a fixed, regular, and adequate nighttime residence- has a primary nighttime residence that is in a publicly or privately operated shelter designed to provide temporary living accommodations and transitional housing; or is in an institution that provides a temporary residence; or stays in public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings.

28. Chronic Homeless Chronic Homeless individuals are individuals who are homeless continually for one full year or individuals who have had 4 episodes of homelessness in the past 3 years-documented by records from a homeless shelter.

29. Program Goals To provide independent housing to: people living with HIV/AIDS and who are chronically homeless and who have co-occurring mental health & substance abuse issues.

30. Housing First Program Objectives Clients will be more likely to participate in outpatient behavioral health services Clients will be more adherent to medical treatment(s) and medication regimens. Increase family and social interactions

31. Pathways to Housing service Model Harbor Project is a reproduction of the Pathways to Housing Program that originated in New York City, which includes: Evidence-based practice of Assertive Community Treatment (ACT) Best practice of immediate access to supportive housing Harm Reduction Model of Recovery

32. Homelessness Statistics Philadelphias Office of Emergency Shelter and Services serves approximately 14,986 homeless people through its emergency shelter system, each year.

33. Harm Reduction Model of Recovery Is defined by any decrease in substance use is a positive step Some individuals will only be able to attain sobriety through long term support engagement.

34. Daily Costs of services utilized by homeless individuals Inpatient hospital stay = $1285 Psychiatric hospital = $700 Emergency Room Visit =$200 Detox = $200 Prison = $75 Emergency Shelter =36 Permanent Supportive Housing =$28

35. Treatment Team Multi-Disciplinary team which includes: ActionAIDS Medical Case Manager Pathways Service Coordinators Psychiatrist Nurses Mental Health, D&A and Vocational Specialist

36. Housing Clients are provided a one bedroom apartment, that are scattered throughout the city. This "scattered site" model fosters a sense of home and self- determination, and it helps speed the reintegration of Pathways clients into the community.

37. Housing First @ ActionAIDS Program Capacity: 20 Accepted the first clients April 2012

38. Housing First Challenges Locating people who are Chronically Street Homeless Locating appropriate housing for clients Tenants issues with neighbors and/or landlord

39. Moving in! Clients receive a move in kit, which includes the necessities for daily care and new home.

40. Outcomes Harbor Project outcomes have yet to be measure. Upon one year of services ActionAIDS will provide measurable outcomes. Other Housing First Programs throughout the country report 78% reduction in inpatient admission with their clients, after being housed.

41. References McCarroll, Christina, Pathways to housing the homeless, The Christian Science Monitor, May 1, 2002. Tsemberis & Eisenberg, Pathways to Housing: Supported Housing for Street-Dwelling Homeless Individuals with Psychiatric Disabilities, Psychiatric Services, Vol 51, No.4, April 2000

42. Questions