1. System Transformation for Homeless Individuals Worcester, Massachusetts Leah Bradley, MSW Community Healthlink, Inc. Worcester, MA

2. Necessary Components Community Support/Buy-in Community Support/Buy-in Targeted Resources Targeted Resources Culture Change Culture Change

3. Community Support January 2007 – Home Again Initiative Starts Planning Process January 2007 – Home Again Initiative Starts Planning Process April 2007 – City Manager Establishes Task Force to End Homelessness in 3 Years April 2007 – City Manager Establishes Task Force to End Homelessness in 3 Years Summer/Fall 2007 - State Establishes Commission to End Homelessness in 5 Years Summer/Fall 2007 - State Establishes Commission to End Homelessness in 5 Years

4. Results All Three Adopt Housing First as Model of Choice to End Homelessness All Three Adopt Housing First as Model of Choice to End Homelessness State Provides Resources to Establish Regional Networks Statewide State Provides Resources to Establish Regional Networks Statewide City of Worcester Establishes Closing of Local Emergency Shelter as Primary Goal City of Worcester Establishes Closing of Local Emergency Shelter as Primary Goal Home Again Establishes Ending Chronic Homelessness as Goal Home Again Establishes Ending Chronic Homelessness as Goal

5. Closing Shelter Community Goal Community Goal Collaborative Effort of Shelter Provider and Community Healthlink - Healthcare for the Homeless/Home Again Provider Collaborative Effort of Shelter Provider and Community Healthlink - Healthcare for the Homeless/Home Again Provider Replace with 25-Bed Assessment Center Replace with 25-Bed Assessment Center Ensure Responsible and Sustainable Closure Ensure Responsible and Sustainable Closure Ensure Needs of Chronically Homeless Met Ensure Needs of Chronically Homeless Met

6. Closing Shelter (Con’t) Closed Referral to Shelter Closed Referral to Shelter Triage Center Established Triage Center Established –Ensures all individuals receive an assessment and services –Creates one coordinated list of all homeless individuals and plans for each person –Co-located with Health Care for the Homeless, detoxification program and emergency mental health assessment program

7. Targeted Resources Home Again Program Home Again Program –The Health Foundation of Central Massachusetts provides services dollars matched with CoC Resources to end homelessness Continuum of Care Continuum of Care –Vote in Fall of 2009 to target 75% of all vacated and new slots to chronically homeless individuals

8. Targeted Resources (Con’t) City Leads Area Regional Network City Leads Area Regional Network –Controls resources coming into area City HPRP Resources City HPRP Resources –Targeted to homeless individuals to close shelter State HPRP Resources State HPRP Resources –City prioritizes funds for homeless individuals

9. Home Again Program 21-Month Pilot Project 21-Month Pilot Project –Evaluate and Adapt Health Foundation Provides Funding for Services Health Foundation Provides Funding for Services CoC Provides Funding for Housing CoC Provides Funding for Housing No Exclusionary Criteria No Exclusionary Criteria Demonstrates Success of Housing First Demonstrates Success of Housing First

10. Home Again Model Scattered and Clustered Housing Scattered and Clustered Housing Individuals Re-housed When Needed Individuals Re-housed When Needed Services Provided In Home of Individual Services Provided In Home of Individual No Requirement for Treatment Compliance No Requirement for Treatment Compliance Uses Harm Reduction Model Uses Harm Reduction Model

11. CoC Resources Targeted for Chronically Homeless Targeted for Chronically Homeless Samaritan Initiative (2007 and 2008) Samaritan Initiative (2007 and 2008) Bonus Project 2009 Targets Chronically Homeless Individuals AND Families Bonus Project 2009 Targets Chronically Homeless Individuals AND Families Only Eligibility Criteria is Chronic Homelessness – Flexible Resource Only Eligibility Criteria is Chronic Homelessness – Flexible Resource Use Vacancies in Existing Programs for Chronically Homeless Individuals Use Vacancies in Existing Programs for Chronically Homeless Individuals

12. CoC Resources (Con’t) Shelter Plus Care Savings Used for Chronically Homeless Shelter Plus Care Savings Used for Chronically Homeless Supportive Housing Programs Operate as Leasing Programs – Services Funded through Other Funding Streams Supportive Housing Programs Operate as Leasing Programs – Services Funded through Other Funding Streams All Providers Assess Chronically Homeless Individuals for Vacancies All Providers Assess Chronically Homeless Individuals for Vacancies

13. HPRP Resources Targeted to Homeless Individuals with Short-term Housing Needs Targeted to Homeless Individuals with Short-term Housing Needs Individuals Referred through Triage Center Individuals Referred through Triage Center

14. Culture Change Use Success of Home Again Program Use Success of Home Again Program Belief that All Homeless Individuals Can be Successfully Housed in the Right Model with the Right Services Belief that All Homeless Individuals Can be Successfully Housed in the Right Model with the Right Services Belief that Individuals Do Not Have to Be Sober to Live Successfully in the Community Belief that Individuals Do Not Have to Be Sober to Live Successfully in the Community

15. Challenges Resource Seeking Individuals Resource Seeking Individuals Pre-Chronic Individuals Pre-Chronic Individuals Chronic Alcoholic/Drug Addicts Who Need 24-Hour Supervision for Safety Chronic Alcoholic/Drug Addicts Who Need 24-Hour Supervision for Safety Collaborative Partnership Challenges Collaborative Partnership Challenges Provider Count of Chronically Homeless Provider Count of Chronically Homeless Capital Funds for Triage Center Capital Funds for Triage Center

16. Results Hope Hope Reduced Chronic Homeless Individuals from 116 in 2007 to 19 as of Today (Have CoC Slots for 15 as of Today) Reduced Chronic Homeless Individuals from 116 in 2007 to 19 as of Today (Have CoC Slots for 15 as of Today) Diverted 65% of Those Seeking Shelter Diverted 65% of Those Seeking Shelter Census at Shelter Reduced to Approx. 55 Census at Shelter Reduced to Approx. 55

17. Next Steps End Chronic Homelessness by January 1 st End Chronic Homelessness by January 1 st Develop Model for 6-8 Individuals in Need of 24 Hour Staffing Develop Model for 6-8 Individuals in Need of 24 Hour Staffing Secure Medicaid Funding for Case Management Services Secure Medicaid Funding for Case Management Services Secure Capital Funds for Assessment Center Secure Capital Funds for Assessment Center