Supportive Services for Veteran Families (SSVF)

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Supportive Services for Veteran Families (SSVF). A Housing First Approach to Preventing and Ending Homelessness Among Veterans Tom Albanese, Abt Associates Marge Wherley, Abt Associates Patti Holland, TAC. Key Components of SSVF. Outreach Services Case Management Services - PowerPoint PPT Presentation

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Targeting, Screening and Assessment

Supportive Services for Veteran Families (SSVF)A Housing First Approach to Preventing and Ending Homelessness Among Veterans

Tom Albanese, Abt AssociatesMarge Wherley, Abt AssociatesPatti Holland, TAC

1Key Components of SSVFOutreach Services Case Management Services Assistance in Obtaining VA Benefits Assistance in Obtaining and Coordinating Other Public BenefitsOther Supportive ServicesTemporary Financial Assistance2Homeless(street, shelter)HEARTH Act & SSVF Programs: Relevance to CoC Performance3VA PolicySupport a Housing First model in addressing and ending homelessness.

Housing First approaches emphasize rapid stabilization in permanent housing as central focus of intervention.4Housing First Principles:A source of inspirationand challengeHomelessness is a housing problemHousing is a right not a rewardConsumer choice Everyone is housing ready programs must be consumer readyEnd housing crisis and stabilize in permanent housing firstTHEN address other needed and desired services directly or through linkage55Housing First: Critical ElementsGoal: permanent housing as quickly as possibleHousingConsumer choicePermanent (i.e., not time limited, consumer holds lease)Not contingent on service participation and complianceServices Consumer choiceProvided primarily following housing placementFlexible and responsive to needs and preferencesMay be time limited or long term (or some combination)Success = staying housed and not becoming or returning to literal homelessness 6Housing First (and SSVF) ChallengeProvide the right resources to the right people at the right point in time for the right amount of time.

77Challenging Assumptions:Housing ReadinessAssumption: People need to be ready before moving into permanent housing.Adequate and sustained income source Comprehensive psycho-social assessment completed with all key issues identified and plan to address each Disability, mental health and substance use issues are acknowledged, addressed and under controlDemonstrated competence in all skills necessary for permanent housingStems from good intention of not wanting people to fail but research does not support8Challenging Assumptions:Housing ReadinessChallenging the Assumption:Overwhelming evidence shows positive outcomes for households with range of barriers with HF approach, such as:Obtaining and maintaining housingReduced or stabilized substance use that did not negatively impact housingIncreased service participationIncrease in perceived choiceEven somany providers still reluctant to consider housing first as viable approach for their client9Challenging Assumptions:Housing ReadinessHousing Ready often means clean, sober and treatment compliantOne main reason individuals remain chronically homeless is reluctance of traditional programs to provide housing to consumers who refuse treatment and/or are actively using (Bridges and Barriers to Housing for Chronically Homeless Street Dwellers, T. Mechede 2004)There is little evidence that treating substance abuse and mental health problems prevents homelessness (Preventing and Alleviating Homelessness Prevention Approaches, MaryBeth Shinn)

1010Challenging Assumptions:Housing ReadinessService providers and homeless individuals and families often disagree on needs.Service providers often express concern with service needs, individuals and families stress need for housing (Bridges and Barriers to Housing for Chronically Homeless Street Dwellers, T. Mechede 2004)

11Challenging Assumptions:Housing ReadinessIn Vivo Learning:Developing and applying new skills is often situation-specificUsing a skill in one setting does not guarantee person will use it, or know how to use it, in a different settingDelivering SSVF services to participants in their living environment and community is essential for successful housing retention

12Challenging Assumptions:Housing StabilityAssumption: Housing stability can only be achieved by households who have the means to readily pay for their housing costs now and in future.

Challenging the Assumption:Majority of very low income households pay more than 50% of their income for housing and do not become literally homelessMajority who become literally homeless regain housing with limited help and do not become literally homeless again

13Challenging Assumptions:Housing StabilityDetermining future ability to pay housing costs and establishing housing stabilization plans:SSVF assisted households typically pay more than 30% of income towards rent, remain low/very low income, and may need to double up in future Lack of identified current/future means to pay housing costs = program challenge; not reason to screen out applicantsMust work with each SSVF household to develop plan right for them no magic formula

14Voluntary ServicesSSVF services meet a specific goal or need goal the Veteran wants to address, not necessarily what staff feel s/he needs Referrals made are mutually agreed upon and stem from Veterans choicesInformation, education and informed choiceSSVF staff provide information on services and resources that are available, educate on possible benefits and downside of services, assist the Veteran in making an informed choiceFoster real world expectations and consequences1515Voluntary ServicesThis does not mean.SSVF staff cannot offer suggestions, ask Veteran to do something or initiate uninvited contactStaff do not intervene, even when very real and serious health or safety risks existParticipants will never take action to change their circumstances if not encouragedParticipants will always take the money and runStaff have to tolerate abusive treatment from participants and can never discharge from the program for disruptive or dangerous behavior

16Housing First in Practice:From Crisis Response to Housing StabilityCrisis focus = HousingNo housing (literally homeless) OR Imminent risk of literal homelessness (imminent loss of housing and no other housing options, resources, support)

Two Step Process:

Step 1: Crisis intervention and resolution

Step 2: Housing stabilization17Housing First in Practice:Step 1: Crisis ResponseGoal: Identify and address immediate housing needCrisis AssessmentTriage and immediate housing plan

18Housing First in Practice: Step 1: Crisis ResponseCrisis Assessment:Focus: Persons experiencing a housing crisis Immediate needs may or may not be metWhat are we trying to figure out?Immediate & short-term housing needs and SSVF intervention to assure needs are metBasic characteristics necessary to know whos being assisted and immediate needsAny safe, immediate options besides emergency shelter?Plan for tonight and near term

1919Housing First in Practice:Step 1: Crisis ResponseAssessment tool, processTool should be staff and participant friendlyStandardized, but also serves as conversation guideFocuses on housing issues, is not a comprehensive assessment of needs

Staff training and supervisionSpecific content, training during orientation periodObservation as training componentOn-going review and supervision20Housing First in Practice: Step 1: Crisis ResponseLets use an analogy someone shows up at an E.R. in crisis due to diabetesNo time for in-depth assessment of patients overall needs or compliance with diabetes careRN does a few quick diagnostic lab tests to confirm diabetes with blood sugar out of controlER team immediately begins to stabilize the patients conditionOnce crisis is resolved and patient is temporarily stabilized, further assessment may be doneBased on this additional assessment, hospital team sends patient home with discharge orders, including referrals if needed There may be some follow up calls or a visiting RN to check on if patient is feeling ok, no current symptoms, understands discharge planBut, in the end the ER has no actual control over the patients future diabetes care or whether there will be future hospital visits21Housing First in Practice: Step 2: Housing StabilizationGoal: Identify and implement plan to maintain current housing or obtain new housing

Housing stability assessmentHousing stability plan (reasonable)Progressive engagement with flexible SSVF servicesService linkage

2222Housing First in Practice:Step 2: Housing StabilizationHousing Stability Assessment: Focus: Persons experiencing a housing crisis whose immediate housing needs are metWhat are we trying to figure out?Prevention: whether can be stabilized in current housing or needs relocation assistanceAdditional characteristics and relevant background (housing, health, AOD, education, etc.)Barriers impacting ability to obtain/maintain housingTenant screening barriers (if need to obtain housing)Retention barriersLeast amount of intervention needed to resolve and, if possible, prevent return to crisis

2323Housing First in Practice:Step 2: Housing StabilizationHousing Stability Plan:Progressive plan to increase stability and prevent future housing crisisFlexible, progressive SSVF services and temporary financial assistanceLinkages and referrals to address other identified immediate and long-term needs24Housing First:TipsEngage, collaborate with larger community services and Continuum of Care systemTrain staff on other CoC/community resources and programs to ensure best fit for participantBe clear about what SSVF can do & what it cannot do with staff and participants Maximize SSVF: design flexible program services that can vary in type/level/duration based on need Periodically revisit program design Incorporate eligibility recertification (required every 3 months) and other milestones in case plan2525Housing First:TipsUse best practices: harm reduction, motivational interviewing, skills teaching, resource developmentIf unsure and/or if there are not other resources to refer applicants with greater needs: better to err on

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