Regional Conference to End Homelessness Norfolk, VA March 2012 Prepared by: Housing Innovations.

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  • Regional Conference to End HomelessnessNorfolk, VAMarch 2012Prepared by: Housing Innovations

  • What is CTI? OverviewWhy CTI? The EvidenceHow to CTI?Fidelity - the PrinciplesImplementation Tipswww.criticaltime.org

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  • Focused on Housing Retention and Life GoalsTime-limited (6-9 months)Three 3-month phases of decreasing intensity that begin when the person is housed Transition to the community Try outTermination or transition to lower level of service

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  • Focused Services 1-3 areas from 6 service areas Based on threat to long-term housing stability Rent paymentFollowing rules re visitors, noise etcKeeping unit healthy and safe Only allowing those on lease to live thereOther lease requirementsAND Access to care and supports Lots of focus on linkages and making them workThink about natural supports

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  • Areas of Focus for Assessment and PlanningHousing stability barriersIncome and financial literacyLife skills training Family and friendsPsychiatric and substance abuse servicesHealth and medical servicesPre-CTI Housing Selection and Planning

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  • Focus on Self SufficiencyGoal settingConnection to high quality sustainable treatment and supports and EmpowermentFocus on Long-Term Stability Use lease to structure the workNot symptom or crisis based servicesGoal includes sustainability as opposed to acute interventionsStrong Expectation that Person becomes Integral Part of CommunityConsiders purpose and activity as part of life in housingRole and life transition from homeless to housed

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  • CTI has been recognized an Evidence-Based Practice by the federal Substance Abuse and Mental Heath Services Administration (SAMHSA) and the Presidents New Freedom Commission on Mental HealthBased on the original research of Columbia Universitys Center for Homelessness Prevention Studies work with the homeless single adults with serious mental illnessHas been applied and researched in a variety of setting and with different populationswww.criticaltime.org

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  • ComponentsPhases worker steps back every 3 monthsFocused service plans only 1-3 goalsEngage, Outreach and Link Early Pre CTIContact with Links accompany to appts, ensure link sticks, meet with links, maintain communicationsTime Limited 7-9 months but may vary with population

  • Structure and ContextCaseload size between 16 18 clients per worker, varies by stageTeam Meetings weeklyCase Review weekly by supervisory staffOrganizational Support hiring and safety protocols and resources to assist clients*

  • Quality and CompetenciesStaff Role with Client provides direct service as needed, works on ADL skills, probes about threats to housing, fosters autonomy while remaining available, use Motivational InterviewingStaff Role in Community Meets with clients and linkages, educates linkages about CTI, maintains communicationInitial Assessment focus on strengths and barriers in terms of community living skills and support networkPhased Service Planning based on client history, revised with community linkages*

  • Quality and Competencies (cont)Progress notes content related to previous notes, specifies next stepsCase Closing final transfer of care meeting, identifies issues related to long-term housing stabilityClinical Supervision presentations of new, ending and particularly difficult casesFieldwork coordination ensures safety in the field, supervisor to model for new staff, monitors movement through phases by dates

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  • Can apply in a range of settingsMoving in to safe havens, transitional housingMoving into to permanent supportive housingMoving into affordable housing

    Work with landlords and property managersNeed Assertive approachHold person to lease obligationsCoordinate interventionsMay accept services if threatens housing

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  • Use Resources www.criticaltime.orgChallengesStaff letting goGetting others agencies to do their jobsProviding quality close supervision and clinical consultationCaseload levelsBilling/funder requirements

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  • Provide services in the home and the communityOngoing assessments of housing barriers to prevent housing lossConnect with other mainstream and community-based services benefits and servicesConnect with natural supports including spiritual*

  • Focus on eviction prevention and use the structure of the lease to guide your interventionsUse Evidence-Based Practices (EBPs)Motivational InterviewingPerson-centered PlanningSupported EmploymentIDDT Integrated Duel Disorder Treatment

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  • Basic Demographics (age, how long homeless, how long in housing)Health, MH, SA issues and connection to treatmentEngagement in Case Management: how the tenant is connecting to the worker, shared tasksCTI Phase and Focus Areas in the Housing Plan What does the person do during a normal day?Tenant strengths and successesTenants goalsProgress on adjusting to new housingAny current challenges and reason case was selected for conferenceAny tenancy/lease violations?Efforts made to address these challenges and/or expand on the strengthsHow does tenant see these challenges, what is their response, is this consistent with their priorities?Resources being used and/or needed (include communication with the resource)Involvement of friends/social supportsIs the person ready to move to the next phase? Feedback, questions and discussion with the group*

  • Maintaining housingIncrease IncomeNetwork of supportsLess emergency interventions: ER visits, hospitalization, incarceration, removal of childrenStructure and Purpose in each persons life*

  • Contact info:Suzanne Wagnerswagner@housinginnovations.us(917) 612-5469

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    One) building long term supports and strengthening the persons long-term ties to the community this is really the bulk of the work as youll see in a minute

    And also by providing critical emotional and practical supports during the critical transition time, **

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