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TABLE OF CONTENTS

Letter from Mayor Michael R. Bloomberg 2

Acknowledgments 3

Introduction 4

Chapter 1: Overcome Street Homelessness 7

Chapter 2: Prevent Homelessness 11

Chapter 3: Coordinate Discharge Planning 15

Chapter 4: Coordinate City Services and Benefits 18

Chapter 5: Minimize Disruption to Families who Experience Homelessness 22

Chapter 6: Minimize Duration of Homelessness 25

Chapter 7: Shift Resources into Preferred Solutions 29

Chapter 8: Provide Resources for Vulnerable Populations to Access and Afford Housing 32

Chapter 9: Measure Progress, Evaluate Success, and Invest in Continuous Improvement 36

AppendixGuiding Principles APrevention Principles BPlanning Process CCoordinating Committee DTask Force Members E

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Dear Friends:

All across America, small towns and large cities are experiencing increased levels of homelessness. This is certainly the case in New York City, where we continue to see record levels of homeless men, women, andfamilies in shelters each night.

I am proud to report that over the past two and a half years, the City launched a series of initiatives aimed atstrengthening our response to those in need – and we have made significant progress. The Department ofHomeless Services introduced new homeless prevention initiatives, helped record numbers of people leaveshelters and find permanent homes,and asked those receiving shelter services to take steps to help themselvesand move toward self-sufficiency.

To address the long-term concerns, my administration released The New Housing Marketplace, a plan to buildand preserve more than 65,000 homes and apartments in neighborhoods around the City. Sustainedinvestment in affordable housing is fundamental to our long-term economic prosperity, as well as to overcominghomelessness. We must continue to find innovative ways to support affordable and supportive housingdevelopment, even in challenging economic times.

Uniting for Solutions Beyond Shelter is a 10-year action plan that brings together the business, nonprofit, andpublic sector communities to address the challenging issue of homelessness at its core, rather than manage itat the margins. It reflects my strong belief that every individual and family deserves safe, affordable housing –a goal we can achieve through proactive, coordinated action and investments in cost-effective initiatives thatsolve homelessness.

I look forward to working with you to achieve these important objectives that will further improve our greatCity for all New Yorkers.

Sincerely,

Michael R. BloombergMayor

TH E CI T Y O F NE W YO R KOF F I C E O F T H E MAY O RNE W YO R K, NY 10007

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ACKNOWLEDGMENTS

Uniting for Solutions Beyond Shelter is the result of the dedication and generosity of numerous New Yorkers. Manythanks are extended to:

• Lilliam Barrios-Paoli, Peter Madonia, and William C. Rudin for their leadership in co-chairing the planning and initiative development process;

• The commissioners and their staff members at participating agencies;

• Presenters and special guests at the planning conference;

• The homeless and formerly homeless individuals who offered input throughout the process;

• All the other experts who donated their time to working with the task forces;

• Nan Roman and the National Alliance to End Homelessness for their advocacy and support; and

• Philip Mangano, Executive Director of the United States Interagency Council on Homelessness,for his guidance and support.

The City of New York is grateful to the following organizations and individuals for their support and donations:

• The Association of the Bar of the City of New York• The Association for a Better New York• B.R. Guest, Inc.• Brooklyn Botanical Gardens• John P. Curran• John Feerick• The New York Community Trust• The New York Times Foundation, Inc.• The Rockefeller Foundation• The Sirus Fund• The Starr Foundation• United Way of New York City

Special thanks go to members of the coordinating committee for their leadership and insight, and to all the task force members for their willingness to share their knowledge and work tirelessly towards the completion of the plan. A detailed list of the coordinating committee and task force participants is included in the appendices.

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INTRODUCTIONThe City of New York has created the most comprehensiveand extensive shelter services system in the world.

In the last decade, approximately 4.6 billion dollars havebeen spent building and maintaining a network of emer-gency shelters and an astounding 416,720 individuals,including 163,438 children, have received shelter servicesduring this time. New Yorkers can take pride in the com-passion and generosity that has come to characterize thecity’s response to those in need.

But as vast resources and energy have been focused oncreating and maintaining this extensive shelter network,the discussion around how best to address homelessnesshas become a discussion about the provision of shelter,rather than long-term solutions.

As a result of these factors and a persistent and signifi-cant affordable housing crisis, the number of people inshelter continues to exist at extremely high levels.The average daily census in the shelter system for the firstnine months of fiscal year 2004 hovered around 38,200individuals, including 16,100 children. Several thousandadditional men and women remain on city streets.

Highlighting the need for a new response to homeless-ness are the following observations, made by publicofficials, homeless services providers, and business andnonprofit leaders.

• Street homelessness should not be accepted as a fact of city life.Today it is.

• Children should not grow up in homeless shelters.Today they do.

• Incentives should not encourage or needlessly prolong dependence on shelters.Today they do just that.

• Direct discharges of clients from other service systems into shelters represent failures of public agencies.Today,discharges to shelter occur frequently.

• Long-term shelter stays represent a failure of the systemand a negative outcome for those in shelter.Today this is commonplace.

• Tax dollars earmarked for homelessness should support solutions like prevention, rental assistance, and supportivehousing.Today they mainly support shelters.

• No single public agency – indeed, not even a single sector – can by itself overcome the complex issue of chronic homelessness.

Today, the city’s first line of response to nearly any type ofhousing instability – i.e., potential eviction, householdtension, medical emergency, or falling behind on rent – isshelter. Despite the fact that the shelter system wasdesigned specifically to protect people from the streets,shelter has become the de facto, institutionalizedresponse to wide-ranging needs – many of which couldbe better addressed with nuanced and more flexibleinterventions that help people stabilize housing, retaincommunity ties, or transition successfully from institu-tional or custodial settings to community housing.

Ensuring access to shelter to those in need remains a corevalue. A “shelter first” response to any and every need orhousing crisis, however, will continue to drive up costsand shelter usage, while diverting attention away fromprevention, supportive housing, and other community-based interventions that solve homelessness.

TAKING ACTIONIn November 2003, Mayor Bloomberg convened anunprecedented group of public, private, and nonprofitleaders to develop a 10-year, multi-sector strategy toaddress these concerns and strengthen the city’sresponse. A 41-member coordinating committee, as wellas hundreds of task force participants and experts convenedfrom November 2003 through April 2004 to produce anine-point strategy.That strategy aims to:

1. Overcome street homelessness2. Prevent homelessness3. Coordinate discharge planning4. Coordinate city services and benefits5. Minimize disruptions to families whose homelessness

cannot be prevented 6. Minimize duration of homelessness7. Shift resources into preferred solutions 8. Provide resources for vulnerable populations to access

and afford housing9. Measure progress, evaluate success, and invest in

continuous improvement

In ways large and small, these strategies will reshape thecity’s approach to assisting at-risk and homeless NewYorkers. Collectively they will:

• Create a roadmap that invests new money and redirects existing resources from shelters to expanded community-based prevention programs and other housing solutions.

UNITING FOR SOLUTIONS BEYOND SHELTER:THE ACTION PLAN FOR NEW YORK CITY

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• Raise the level of public awareness and communityinvolvement to challenge a collective acceptance ofhomelessness both on the streets and in shelter.

• Bring public agencies together in a coordinated campaignto maximize available government assistance to those in need and to reduce institution-to-institution dischargesthat result in homelessness.

• Reverse the trend in which families and individuals whobecome homeless remain homeless for excessively longperiods of time, with a particular emphasis on preventingchronic homelessness in shelters and on the streets.

• Ensure access to shelter for those in need, whileaffirming the responsibilities of those receiving servicesto move toward self-sufficiency.

Achieving reforms of this magnitude will require differentspending priorities, policies, and programs. Uniting forSolutions Beyond Shelter includes the principles, concepts,and policy directions that will guide the city over the nextdecade.

NEXT STEPSFollowing the release of this plan, a full implementationstrategy will be developed within 60 days.This will identifyresponsible authorities for each task, as well as a workplan with timeframes.The strategy will include targetsand milestones, which will gauge progress in achievingthe following key indicators:

• Decrease in the number of individuals living on the streets and in other public spaces

• Increase in the number of people leaving shelter to stable housing

• Increase in the supply of affordable,service-enriched and supportive housing

• Decrease in the number of applications for shelter• Decrease in the length of stay in shelter• Decrease in the total number of people in shelter

Uniting for Solutions Beyond Shelter represents the poten-tial to deliver improved outcomes to those at risk ofhomelessness, as well as those already homeless in NewYork City. By incorporating the best thinking and contri-butions of the public, private, and nonprofit communities,the potential for a true citywide campaign to effectivelyreduce homelessness and better meet the needs of thoseat risk becomes possible.

ON ENDING CHRONIC HOMELESSNESSThe national conversation is shifting from “managing” to“ending” homelessness, especially chronic homelessness.New York City embraces the goal of ending chronichomelessness in 10 years. At the same time, the way inwhich New York City experiences homelessness is differ-ent from other jurisdictions. The scope of Uniting forSolutions Beyond Shelter, therefore, must also be different.Broader commitments to preventing and divertinghomelessness and rapidly re-housing those who dobecome homeless will do much to overcome the massurban homelessness now experienced in New York City.

For the purpose of measuring progress toward endingchronic homelessness, the following definition will be used:

• A chronically homeless individual is any currently homeless individual (including single adults and individuals in adult couples) who is disabled and has been homeless for at least 365 days of the last 2 years,not necessarily consecutive; or any currently homeless individual who has been homeless for 730 days of the last 4 years, not necessarily consecutive.

• A chronically homeless family is a currently homeless family that has been homeless for at least 365 days of the last 2 years, not necessarily consecutive.

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Source: DHS Administrative Data


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THE CHALLENGE

Several thousand homeless individuals remain on citystreets despite the fact that the city guarantees freeshelter and sponsors outreach teams that work aroundthe clock to encourage street homeless individuals tocome inside.

Many of these individuals, especially those who arechronically street homeless, believe that remaining out-side makes more sense than entering the shelter systemas it now exists. Some acknowledge that they cannotmaintain sobriety or comply with program require-ments. Others resist the structure and order that com-munal shelter life requires. And others believe thatshelters are unsafe, despite many gains in creatingsafer environments over the years.

The street homeless population is largely comprised ofindividuals with mental illness and/or substance abuseissues. They are survivors, having forged lives in publicspaces for many years. No doubt, the generosity ofpassers-by enables many to remain on the streets.

New York City’s outreach teams and drop-in center staffare successful in convincing some individuals to giveprograms or shelter a chance. But outreach and drop-incenter efforts are under-equipped for the task at hand.There is, at times, a lack of coordination with other pro-grams that provide aid.These nonprofit organizationsare limited by an inability to offer individuals flexibleservice options – especially in that fleeting momentwhen engagement is possible.

SOLUTIONS

A successful effort to overcome street homelessnessmust ensure the availability of and easy access to safeand viable alternatives to the street.This must be cou-pled with accountability mechanisms that hold providers,as well as public agencies, responsible for producingresults.

Ending street homelessness also requires an acknowl-edgment that street homelessness is harmful for thosewho live in public spaces, and has negative effects onthe communities and areas in which street homeless-ness proliferates. For humanitarian and quality of lifereasons alike, people on the street should be helped andstreet homelessness, as a condition of urban life, shouldnot be tolerated.

The initiatives in this chapter build on best practices,such as the coordination and expansion of outreach anddrop-in center services. They expand “housing first”options and low-threshold shelter – permanent andtransitional housing models that first focus on movingpeople from the streets and incorporating progressiveservices over time.They also establish goals and targetsfor reducing street homelessness complete with neigh-borhood-by-neighborhood strategies and strongaccountability standards for agencies and providers.

In the last decade, tremendous progress has been madein reducing the number of individuals living on thestreets, yet street homelessness remains a fixture of citylife. The knowledge and skills to end it exist. What’sneeded now is the commitment of resources and thepolitical will to make it happen. The initiatives hereprovide that critical foundation.

OVERCOME STREET HOMELESSNESS

8

Source: DHS Homeless Outreach Population Estimate 2004


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The Next Step Current Status Taking Action

Expand the Capacity ofDrop-in Centers

New York City currently has 10 drop-incenters that offer street homeless indi-viduals a range of social and medicalservices, assistance in accessing bene-fits, and permanent or transitionalhousing placement services.Thesecenters are effective at engagingthose who wouldn’t ordinarily comeinto shelter.

The capacity and coordination ofdrop-in centers will be expanded.Using data from the annual street survey in conjunction with input fromoutreach providers, the city will workto ensure increased availability ofservices, particularly in underservedareas.

Create an AccessibleCitywide ClinicalDatabase

A database system containing demo-graphics, lodging and housing history(including hospitalization and incar-ceration), clinical information, anddetails about prior homelessnessepisodes will be created.This systemwill be accessible to participatinghomeless outreach and drop-in serviceproviders and others to share informa-tion to better engage clients. Safeguardsto ensure client confidentiality will beestablished and maintained.

At this time, no system exists to collect,manage, and share information aboutstreet homeless individuals whoreceive services from drop-in centersand outreach programs. Because manystreet homeless individuals arenomadic, they receive services from avariety of providers in different loca-tions.The absence of a citywide data-base sometimes slows the process ofengagement and may actually hinderoutreach efforts.

TAKING ACTION

Establish a CitywideOutreach/Drop-in CenterCoordinating Council

Dozens of organizations today servestreet homeless individuals, yet thereis no system in place to facilitate formal communication or coordinationamong them. As a result, efforts areduplicated, some opportunities toreach homeless individuals are lost,and resources are not coordinated or maximized.

A citywide coordinating council willguide and coordinate policy and practice of providers engaged in outreach and drop-in services. It willensure that providers and city agenciesestablish and meet goals for reducingstreet homelessness. It will also ensurebetter coordination among groupswhose different funding streams haveled to varied approaches.

Reconfigure OutreachServices

Historically, outreach programshaven’t employed clinically trainedstaff or utilized a traditional casemanagement approach for thosewith co-occurring mental health orsubstance abuse issues. Outreachprograms have had few resourcesbeyond shelter to offer those wholive on the streets.

Borough-based, multidisciplinary out-reach teams will offer comprehensiveintegrated treatment for co-occurringmental health, substance abuse, andmedical issues (particularly HIV).Thenew approach will include a strongpeer component, enhanced ties tolocal communities, and increasedaccess to permanent and transitionalhousing options with minimal entryrequirements.

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Conduct Citywide StreetEstimate Annually

A complete estimate of the size of thestreet homeless population in New YorkCity does not exist. The HomelessOutreach Population Estimate (HOPE),apoint-in-time estimate of the streethomeless population, has been con-ducted in Brooklyn, Manhattan, andStaten Island.The lack of an annual city-wide estimate makes it difficult to knowif outreach programs are reducingstreet homelessness.

In 2005, HOPE, which is carried outwith the assistance of hundreds of volunteers, will be conducted in all fiveboroughs. It will be repeated on thesame night of the year, every yearmoving forward.The estimates will beused to measure the effectiveness ofoutreach programs and ensure thatprograms adapt to changing conditionson the streets.

Three smaller intake centers will beopened throughout the city to easeentry into the shelter system for singleadult men.The new centers will includea user-friendly design, a computerizedbed reservation system to ensure swiftplacements, and enhanced staffingmodels.

The 30th Street Men’s Shelter in midtownManhattan is currently the only placefor homeless men to enter the sheltersystem.The large number of people thatreceive services there, the perception ofthe site as unsafe, and its inaccessibility tomen living on the streets in other bor-oughs discourages some homeless menfrom seeking shelter.

Decentralize Men’s Intake

Expand “Housing First”Options for Those on theStreet

The existing range of services doesnot meet the needs of some streethomeless individuals. Chronicallystreet homeless individuals, in particu-lar, may not be able to meet therequirements (such as sobriety) ofexisting programs. In other words, the“threshold” is too high.

Permanent housing program modelsthat couple supportive services withindividual apartments,single rooms,orother housing options,will be expanded.This “housing first”strategy,which hasproven extremely effective in engagingchronically street homeless individualsto leave the streets,aims to stabilize indi-viduals in permanent housing and thenprovide services that lead to recovery,stability,and ultimately independence.

Expand TransitionalPrograms with LowThreshold/ProgressiveDemand

Transitional housing models thatrequire less of individuals in the begin-ning and more over time will beexpanded.These models include “SafeHavens,”which are similar to drop-incenters but have onsite beds,and shelterprograms that accept people directlyfrom the street and subsequently engagethem in drug and alcohol rehabilitation.

Some street homeless individuals rejectexisting services. Others are unable toaccess them or meet entry require-ments. Many existing programs haverequirements that are in fact unattain-able, especially to those with profoundmental health or substance abuseissues.

Create Community StreetPopulation Estimates,Targets, andAccountabilityMechanisms

Once taken citywide,HOPE data will beused to target neighborhoods withhigh levels of street homelessness.Neighborhood-based policies will then beenacted to reduce street homelessness inhigh concentration areas,encouragingand supporting communities to addressthe issue locally. Outreach providers inthese areas will establish goals and beheld accountable for reducing the localstreet homeless population.

There is no estimate of the neigh-borhoods with the highest concen-trations of street homelessindividuals. Therefore, no targetedplan to reduce homelessness inthese areas exists.

THE CHALLENGE

Thousands of people enter shelter each year withouthaving benefited from homeless prevention programs.Some attempt to receive aid, but the assistance fails or isotherwise insufficient. Many do not seek aid from exist-ing programs that might have stabilized or saved theirhousing.

Families who become homeless in New York City typi-cally enter shelter after leaving a shared living situation,usually with immediate family members. Single adultsgenerally become homeless after leaving an institutionor losing housing. Most of these families and individualsare grappling with underlying issues that precipitatedtheir housing crisis.

Today, the overwhelming majority of resources and pro-grams that help those with housing instability only takeeffect after someone has become homeless. Whileensuring shelter to those in need is critical, the thrust ofresources should be spent preventing rather than shel-tering homelessness.

SOLUTIONS

The initiatives outlined in this chapter shift priorities andservices to homelessness prevention, primarily bystrengthening programs, resources, and collaborationsat the community level. Innovative programs that focuson helping landlords and tenants avoid evictions athousing court will also be pursued. It is at these commu-nity locations that the underlying needs of those at riskcan be spotted and addressed.

Making this shift will require some trade-offs, as well asdisciplined decision making.This will include takingaffirmative steps to ensure that prevention programsoffer meaningful alternatives to shelter services, usingdata and cross-agency partnerships to target resourcesto those at risk, and creating strong accountability provi-sions to ensure providers, agencies, and those receivingprevention services all take necessary steps to make pre-ventive interventions work.

It is well documented that preventing an episode ofhomelessness costs less than sheltering an episode ofhomelessness – and the potential to generate cost sav-ings is important. But shifting the city’s reliance awayfrom an ever-expanding network of shelters to expandedand integrated community-based prevention servicespresents the potential for achieving something moreimportant: diminishing the trauma and dislocation thathomelessness causes in the lives of too many individualsand families.

PREVENT HOMELESSNESS

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12

Source: Vera Institute of Justice and DHS Administrative Data


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Introduce Innovations toHousing Court to Focus onHomelessness Prevention

In certain cases, evictions are orderedbecause the tenant is unable to obtainproof of income and benefit docu-mentation.There is little support cur-rently available at housing court toprevent these avoidable evictions.

Expand Aftercare Initiatives High rates of families and individualswho leave shelter re-experiencehomelessness after losing permanenthousing again. Aftercare servicesincrease the likelihood for some toachieve stability in their new homesand communities. Historically, theseservices have been provided to alimited number of high-risk families,and only to those who have wantedthem.

Aftercare services will be expanded sothat more families and individuals benefitfrom them.These programs will beevaluated to learn the best ways tohelp at-risk households avoid anotherexperience in shelter. Services will bemandatory for those who need, butreject, this assistance.

ImplementCommunity-BasedPrevention Services

In 2004, DHS launched the HouseholdStability Initiative, a neighborhood-based homeless prevention program,in six communities that experiencehigh rates of homelessness. An evalua-tion of this program will follow. DHSwill continue to expand the programto reach more communities, individuals,and families with rental assistance,anti-eviction services,and other preven-tion initiatives.

Shelter has often been the first andonly assistance offered to families, sin-gle adults, and couples faced withhousing instability. In addition, rentalassistance, anti-eviction services, andgeneral casework that may preventhomelessness have only been offeredon a limited basis.

Provide “Brief” LegalServices

City-funded nonprofit legal serviceswill provide a more flexible range ofservices. Full legal representation willbe available in some instances, whilebrief legal assistance (such as draftinga document or negotiating with alandlord) will be available in others.This will increase the number of peo-ple receiving assistance, while maxi-mizing public resources.

Currently, there is a “one size fits all”approach to providing anti-evictionlegal services. This results in some ten-ants getting more anti-eviction legalservices than needed, while others areunable to access these services.

The New York City Civil Court willcoordinate with public agencies toconduct case conferences and addressissues that may result in an eviction.Community court models that stresslandlord-tenant mediation will be exa-mined and best practices incorporated.

TAKING ACTION

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Implement Standards ofClient and ProviderResponsibility inPrevention Interventions

Individuals and providers do not atthis time benefit from clearly definedroles and responsibilities that ensurethat expectations are clear and bestoutcomes achieved, as preventionservices are received and administered.

Enhance Client Involvementand Self-Advocacy

Despite the fact that programs andservices are designed to meet theneeds of clients, they have had littlerole in shaping those programs.Thishas led to missed opportunities fordeveloping services that empowerclients and take the strengths ofclients into consideration.

Those responsible for creating pro-grams will include clients as partnersin program development and deci-sion-making.This builds on the beliefthat when clients are able to advocatefor themselves, clients and communi-ties benefit. Opportunities to includeclient participation will be activelypursued.

Include HRA AdultProtective Services(APS) as a FullPartner in TargetingPrevention Services

A joint HRA-DHS initiative will assist inpreventing homelessness among APSclients. Also, at-risk individuals whoare not eligible for APS services will bereferred, when appropriate, to preven-tion and aftercare programs.

APS helps special populations, such assenior citizens,adult dependent children,and developmentally delayed individuals.At this time it does not link thosedeemed ineligible for its services tohomeless prevention programs.

Make Alternative HousingSolutions Preferable toShelter

Programs will continue to provide safeand appropriate shelter and servicesto those in need. Incentives that makeshelter preferable to available housingoptions will be redirected into com-munity-based prevention settings.Other options, including supportivehousing, will also be expanded as apreventive intervention.

Most people who receive shelter serv-ices are homeless and have nowhereelse to go. In some instances, however,shelter may be seen as preferable to analternative housing situation.

Standards of mutual responsibility willbe introduced in homeless preventionprograms. A principle will be estab-lished that individuals and familiesreceiving prevention services mustparticipate and take responsibleaction to the extent they are capable.

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THE CHALLENGE

One common avenue into homelessness is a “discharge”into shelter from another custodial or institutional set-ting. Data show that significant portions of the singleadult population, in particular, become homeless inthis way.

Adults leaving jails and prisons, for example, often entershelter immediately after release or after a less-than-stable housing situation falls through.These individualsoften have few social or family supports to lean on andface major challenges finding employment, stayingclean and sober, and accessing housing or rental assis-tance.Taken together, these challenges are difficult toovercome.

Institutional discharges occur from other settings aswell. Adults discharged from mental health facilities andhospitals routinely enter shelter.Young people agingout of foster care sometimes have nowhere else to turn.Too often, parents reunifying with children who havebeen in foster care do so in shelter. Many times, clientsfind themselves applying for shelter after being advisedto do so or referred by a social worker from anotherservice system.

While ensuring shelter to those in need is critical, thereality is that shelter is no substitute for permanenthousing or the stability that comes with it. For many ofthese vulnerable populations, stable housing is key torecovery or successful integration back into community.Homeless shelters are neither equipped nor meant toserve this purpose.

SOLUTIONS

The initiatives in this chapter outline new commitmentsand increased partnerships to reduce the number ofindividuals and families leaving one system and enteringanother.They embrace the notion that homelessness isan outcome that all agencies and institutions shouldwork to prevent.

Promising new collaborations between the Departmentof Correction and the Department of Homeless Services,which focus on reducing homelessness and re-incarcera-tion, will be expanded. A pilot undertaken by the StateDivision of Parole that helps parolees currently in shelterquickly transition to permanent housing will also beexpanded. Ongoing work by the Administration forChildren’s Services will continue to be strengthened tobring the stability of permanent housing to high-riskpopulations.

For many years, shelter-providing agencies have beendiscussing the high number of individuals and familiesdischarged into homelessness. Uniting for SolutionsBeyond Shelter replaces that discussion with the activeparticipation of all key agencies and institutions neededto reduce this pervasive trend.

COORDINATE DISCHARGE PLANNING

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Source: Dept. of Correction and DHS Administrative Data

Source: Study by Park, Metraux, Brodbar and Culhane (2004) using ACS and DHS Administrative Data

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Coordinate DischargePlanning for IndividualsEntering Shelter fromPrison

Many individuals released from stateprisons enter shelter each year. A pilotprogram between the State Divisionof Parole and DHS, which was startedin 2002, helps parolees move fromshelter to independence.

Coordinate DischargePlanning for IndividualsEntering Shelter fromHospitals and Community-based Treatment Facilities

Some at-risk or homeless individualsin hospitals, mental health facilities,and substance abuse programs enteror return to homeless shelters aftercycles of care.Too often, shelters areused as a discharge resource, yet shel-ters and homelessness do not offerthe stability these individuals needduring recovery.

Providers and treatment facilities willdevelop a range of initiatives todecrease the number of people leavingtreatment facilities for shelter. Anaccountability and evaluation systemwill be created to monitor and improveresults.Referrals,when appropriate, tosupportive housing settings for at-riskindividuals will be encouraged.

Coordinate DischargePlanning for IndividualsEntering Shelter from Jail

New efforts are underway to preventdischarges from jails into homelessshelters and re-entries from sheltersinto jails. These initiatives focus onhelping former inmates gain employ-ment and substance abuse assistance,as well as access to other benefits orassistance that helps them find hous-ing stability.

Many individuals released from jailenter shelter each year. Studies showthat these individuals are more likelythan others to end up in jail again. Formany, a pattern of cycling back andforth between jail and shelter devel-ops – at great cost to individuals andsociety alike.

Coordinate City Servicesand Benefits in a ChildWelfare Collaboration

Initiatives will help families reunite inhousing rather than shelter so theycan avoid the negative consequencesof homelessness at a moment of familyvulnerability. Efforts to connect teensaging out of foster care with supportedindependent living programs will alsobe pursued.

Some parents with children in fostercare are ready to bring their familiesback together, but need housing inorder to create a stable home environ-ment. Sometimes these families reunitein a homeless shelter, which does notprovide the stability of permanenthousing. Also, when young adults ageout of foster care they experience anincreased risk of homelessness.

The current pilot program will be eval-uated and, if successful, expanded.State and local agencies will increasethe use of data to understand the sizeof the problem, increase access toresources that lead to housing stabil-ity, and form new partnerships thathelp ex-prisoners with mental illnessavoid homelessness.

TAKING ACTION

THE CHALLENGE

Homelessness is triggered by the loss of housing, butthe loss of housing is usually precipitated by the presenceof other risk factors.These include poverty; a history ofchildhood housing instability or incarceration; a lack ofadequate education, employment readiness or opportu-nity; and the presence of mental health or substanceabuse issues.

By the time individuals and families reach out for shelter,many have had long histories of interaction with othersocial service agencies and providers. Yet these agen-cies do not routinely or easily share information witheach other to create integrated service plans,maximizeresources available to clients, and decrease housinginstability that may lead to homelessness.

In addition, eligibility rules and the service approaches ofvarying agencies sometimes come into conflict, leavingclients confused or unaware of services that can helpthem. These disruptions can add to the challenges at-risk or homeless New Yorkers already face.

SOLUTIONS

At-risk and homeless New Yorkers are typically eligibleto receive a wide range of benefits from federal, state,and local agencies.The initiatives in this chapter aim toensure that benefits are maximized and services stream-lined in order to increase stability in their lives.

New case conferencing models will bring together caseworkers from multiple agencies to problem solveand mitigate barriers their shared clients may face. Newtechnologies will enable caseworkers to share informa-tion about those they serve – again to troubleshootmore effectively on their client’s behalf. An emphasis onensuring access to benefits at the community level isalso included.

The ultimate goal for those serving homeless and at-riskNew Yorkers is to help them move toward self-sufficiency.By ensuring the streamlined delivery of services to individuals and families during their most vulnerablemoment, public agencies work to advance this important goal.

COORDINATE CITY SERVICES AND BENEFITS

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19

Source: HRA and DHS Administrative Data

Source: HRA and DHS Administrative Data

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Implement Cross-AgencyCase Conferencing

Clients often receive services frommultiple public agencies.Yet eachagency is designed to address a spe-cific issue.This can lead to conflictingdirections and a fragmentedapproach. Few opportunities exist forclients to interact with multiple agen-cies at the same time in order to cre-ate coordinated service plans.

Deliver and CoordinateServices and Benefits at theCommunity Level

Individuals seeking and receiving services are not always able to do so intheir neighborhood. Community-basedproviders experience frustration as theyattempt to access benefits from multi-ple agencies for their clients.

With services delivered at a communitylevel through neighborhood groups,holistic service plans that build onclients’ strengths and minimize theirfrustrations will be developed.The citywill pilot this effort in one communityin order to develop strategies that canbe taken citywide.

Coordinate City’s HumanServices and Benefits with a“One-City” Integrated CaseManagement System

A “one-city” case management systemwill improve information sharing, thedelivery of resources, and the ability ofclients to receive timely and responsiveaid. It will include every appropriatesafeguard to ensure confidentiality.

Some people receive services frommany public agencies, yet there are notechnologies in place to systematicallyshare information from one agency tothe next.This leads to unnecessarywaiting periods for clients, as well assome duplication of work for cityagencies and clients.

Implement New Tools toImprove Access to Benefits

The city will expand use of computer-ized technologies to help calculate thebenefits at-risk and homeless NewYorkers are eligible to receive.This willenable caseworkers to help themaccess and learn about appropriateresources,in order to avoid homelessnessor move from shelter to permanenthousing and self-sufficiency.

Many people who are eligible for butdo not receive benefits have difficultykeeping housing and accessing services.Technologies do exist that minimizeaccess challenges, but they are not inwidespread use.

Mechanisms will be created to enableand ensure that agency case workerscollaborate with colleagues at otheragencies.This will help to avoid con-tradictory decisions and reduce dupli-cated efforts. Clients will participate increating service plans and addressingproblems, stressing a client-centeredand strengths-based approach toservices.

TAKING ACTION

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Pursue “Express Eligibility” Individuals who are eligible for onepublic benefit are often eligible toreceive others. Yet agencies haveseparate application processes and donot share information.This creates lostopportunities for clients and duplicativestaff efforts.

Expand Benefits AccessSupports

A unit at DHS called the CaseManagement Field Team has beenvery successful in helping homelessfamilies who are eligible for publicassistance access those benefits. Otherhomeless populations, however, donot receive similar assistance.

The city will expand the unit’sresponsibilities and the populationsserved, with a particular focus on prevention assistance.

Coordinate Services andBenefits to ChronicallyHomeless Individuals

New strategies to link street homelessindividuals with available assistancewill be pursued. Cross-agency partner-ships and accountability mechanismsto track outcomes will be developed.

Many chronically homeless people,particularly street homeless individu-als, are eligible for a range of federal,state, and local benefits that couldhelp them access services and leavethe streets. Accessing benefits is diffi-cult, often because of the mentalhealth or substance abuse issues theyexperience.

Advance Take CareNew York CommunityInitiatives

As close points of contact to at-riskNew Yorkers, new community-basedprevention providers will provide educational materials and make referrals that support the goals ofTake Care New York. This will supportthe Department of Health and MentalHygiene’s health-related preventionefforts and reduce reliance on acutecare interventions like emergency rooms.

People living in poverty experiencehigh rates of HIV, depression, substanceabuse, mental health problems, andother medical issues. The city recentlyreleased Take Care New York, a healthpolicy that prioritizes actions that helpindividuals, health care providers, andNew York City as a whole improve itshealth.

New standards will be developed sothat individuals who are known to beeligible for one benefit will have accessto a shortened review for other benefitsor an assumption of eligibility in limitedinstances.This may include a shareddatabase between participating agencies.

THE CHALLENGE

The reasons that families approach the city for assis-tance are as diverse as they are complicated.Yet the his-toric response to almost any type of housing instabilityhas been shelter.This “one size fits all” reliance on shelterhas come at a particularly high cost to children, who arepulled away from their communities, their friends, andtheir schools.

Nowhere is this more obvious than at the EmergencyAssistance Unit (EAU), the family intake center located inthe South Bronx. Crowded conditions and late nightbusing to one-night shelters, for example, take a toll onthousands of families applying for shelter each year.

Throughout the years, the push and pull of well-mean-ing court orders and administrative policies has createdan intake process that does not meet the needs of at-risk and homeless families. As a result, staff’s ability toeffectively assess and address the needs of families isundermined. At best, families are merely processed intohomelessness.

SOLUTIONS

As a result of a landmark settlement in homeless familylitigation, a three-member court appointed panel hasconducted thorough evaluations of homelessnessprevention and the family intake and eligibility processes.The City of New York is committed to achieving reformsin these areas.

The initiatives in this chapter incorporate actions aroundfamily intake and eligibility into the city’s long-termstrategy. Key areas of focus include increasing preven-tion at the intake office, streamlining the applicationprocess, and assuring that families whose homelessnesscannot be prevented are placed quickly into shelters intheir home communities, when appropriate.

A system that provides timely, humane, and effectiveassistance to at-risk and homeless families mustembrace holistic and thoughtful policies and practices.The initiatives listed here create that new foundation.

MINIMIZE DISRUPTION TO FAMILIES WHOEXPERIENCE HOMELESSNESS

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24


Streamline Application andEligibility Process at FamilyShelter Intake

When a family applies for shelter theprocess can take two to four days. Inaddition, the intake office’s ability toserve homeless families is challengedbecause many families who are nothomeless attempt to have their needsaddressed in shelter when other assis-tance could work.

Expedite ShelterPlacements from FamilyShelter Intake

When a family first applies for shelter,they are often placed for one or twonights in a temporary placement.Thisoften results from the fact that manyshelters do not accept certain types offamilies, such as those with adult menor adolescents. In addition, manyshelters do not take placements lateat night, so families are left to stay in temporary placements until the next day.

A key goal of a reformed process ismaking a conditional placement onthe same day a family applies for shelter.This will require many morefamily shelters to accept all family typesand to do so at any hour of the day.

Reinforce Prevention andDiversion at FamilyShelter Intake

The current system of family shelterintake must be reworked to focusmore attention on prevention andother forms of emergency assistance.A redundancy of efforts to help familiesfind a way to avoid homelessness willbe built into the intake process.

When families leave housing andapproach the homeless system, somemay still be able to benefit from alter-native emergency assistance or pre-vention services. Today, very fewfamilies receive and/or ask for thisassistance. In addition, the range andeffectiveness of prevention resourcesdoes not meet the current need.

Place Families In SheltersNear Their HomeCommunities

The city will continue to place home-less families in shelters in their homecommunities whenever possible andappropriate. In particular, efforts willbe made to increase the number offamilies who are placed in a shelter inthe school district of the youngestchild.

Historically, there has been little priorityplaced on sheltering homeless familiesin their own communities.This hasmade it more difficult for some familiesto maintain community and family ties,while making it hard for children toremain in their own schools. Recent initiatives have begun to reverse thesetrends.

The city will implement major reformsto shorten the application process,improve the physical space of an intakecenter, and direct those families who donot need shelter to more appropriatesupports and resources.

TAKING ACTION

MINIMIZE DURATION OF HOMELESSNESS

THE CHALLENGE

Over the past 20 years, vast improvements have beenmade in shelter conditions and services. During thissame time, the average length of shelter stays hasgrown.The average family today stays in shelter for justover 11 months. Nineteen percent of families stay formore than a year and a half. Sixteen percent of the singleadults in shelter use more then 50% of all of theresources.

These longer-term stays are caused by a number of fac-tors, including the lack of affordable housing. Historically,there’s been a lack of urgency in helping families andsingle adults prepare for and secure permanent housing(although significant progress has been made by familyproviders). Some clients have also been reluctant toleave, preferring the safe and stable living arrangementsprovided at no cost. Pathways out of shelter do not existfor many who are challenged in living independentlywithout supports.

All of these factors have created a need for the city tocontinue to build more and more shelter. After all, whenthe number of people entering shelter exceeds thenumber of people leaving, shelter expansion becomesnecessary.

SOLUTIONS

Shelter must again become a short-term and emergencyintervention for the overwhelming majority of shelterresidents.The initiatives in this chapter advance a strategyto reduce the average length of stay, while helping toprevent long-term shelter stays.

First, a series of performance and accountability meas-ures will be strengthened.These include heightenedstandards for providers and fair expectations for clientsto move with greater urgency to independence.

In addition, targeted housing and rental assistance andsupportive housing resources will be made available tochronically homeless shelter residents in order to improvethe speed and likelihood of their transition to perma-nent housing.These resources will also be developed foradult couples without children, for whom permanencystrategies have not yet been developed.The city will alsoenhance its ability to intervene early with single adultswhose homelessness could be averted through referralsto anti-eviction and other services provided by commu-nity-based groups.

Long-term shelter stays represent a failure on the part ofpublic agencies, providers, and clients alike.While NewYork City will always have unique housing and afford-ability challenges, this does not mean that shelter stayscannot be shortened. Rather, a profound shift in cultureand expectation in combination with the resourcesincluded in this chapter can help individuals and familiesmore quickly overcome their homelessness.

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Ensure that Clients AssumeResponsibility for ReducingReliance on Shelter

Client responsibility standards – rulesand expectations for clients in carry-ing out a plan for self-sufficiency –were implemented in shelters in 2003.Rates of clients leaving shelter for per-manent housing, particularly amongfamilies, have increased since thesestandards were introduced.

Introduce New Tools toTrack and Assist Help Long-Term Shelter Residents

Criminal histories, public assistancebarriers, a lack of client participation,and other factors sometimes result inclients staying in shelter for excessiveperiods. In some instances, shelter staffhave not had the resources or helpneeded to transition these clients toindependence.The costs of extendedshelter stays are high for clients andtaxpayers.

New client monitoring tools will tracklong-term residents in shelters,enabling staff and public agencies totroubleshoot around particular cases.Shelters with unusually high rates oflong-term residents will be examinedand assisted.Technical assistance willbe provided throughout the system toreduce long-term stays.

Strengthen PerformanceManagement Systems forShelter Providers

Performance incentive programs willbe enhanced.This will further shift theculture of shelters from one thatfocuses on providing services to onethat focuses, first and foremost, onreturning clients to permanent housing.

Performance incentive programs,which encourage providers to helpclients move to permanent housing,are already in place in shelters.However, the average length of staycontinues to be too high.

Prioritize HousingResources for ChronicallyHomeless Individuals andFamilies

Recent efforts to prioritize chronicallyhomeless individuals for supportivehousing apartments have been suc-cessful and these efforts will beexpanded. In addition, efforts will bemade to expand rental assistance forthe population, as well as develop newmodels of supportive housing thatmeet their unique needs.

Chronically homeless people are, attimes, unable to access permanenthousing.This is due to an inability toqualify for subsidies, a lack of viablehousing options for this population, orunwillingness on the part of housingproviders and landlords to accept them.

The commitment to client involve-ment will be strengthened.The princi-ple that no individual or family will berequired to do any more than they arecapable of doing will be maintained.An evaluation of the standards will beconducted so that quality improve-ments can be made.

TAKING ACTION

28


Assist Single Adults at theFront End of the ShelterSystem to AvoidHomelessness or AvoidUnnecessarily Long Stays

When single adults approach the cityto access shelter, little effort is made tohelp those individuals who can avoidhomelessness do so. After enteringshelter, and even as an assessmentbegins, little effort is made to helpthose whose housing instability couldstill be addressed get necessary assis-tance.

Develop PermanencyInterventions for AdultFamilies

Increasing numbers of adult familieswithout children are seeking shelter.Their needs are unique from other populations and their reasons forneeding shelter range from domesticviolence to eviction to substancedependency and other issues.This subpopulation falls outside the traditional framework of family composition; therefore, targeted casemanagement and permanency strategies are underdeveloped.

Building on recent efforts to create aseparate intake office for these fami-lies, targeted services and community-based resources will be developed tohelp them transition from shelter topermanent housing options. Clientresponsibility standards will also bestrengthened.

Develop a MobileServices Model to BridgeTransition of ChronicallyHomeless Individualsand Families from Shelterto Housing

A new service intervention will be cre-ated to help chronically homeless peo-ple before, during, and after their moveto permanent housing – in order toensure the placement is successful.Once the client has moved and stabi-lized in permanent housing, case workwill focus on connecting these individ-uals to existing community-basedservices for ongoing care if necessary.

The transition of chronically homelesspeople from the shelter or the streetsto housing is extremely challenging.The transition itself may intensify thealready profound service needs theseindividuals and families have.Today,there are no “bridge” services that canhelp ensure a successful transition.

Support services will be added to theintake offices for single adults.Theseservices will help individuals reunitewith families, obtain anti-eviction serv-ices and financial assistance that canprevent homelessness, and enter alter-native residential settings for mentalhealth or substance abuse whenappropriate.

29

THE CHALLENGE

The majority of public resources earmarked for home-lessness today are spent supporting shelters and shelterservices. In fact, for every dollar spent on prevention by thecity, three and a half are spent on shelter services by DHS.

In some ways, New York’s extraordinary commitment toguaranteeing shelter has had the unintended conse-quence of driving most resources into shelter. Meanwhile,those who provide services to homeless New Yorkersbelieve that further investments in prevention programs,rental assistance, and supportive housing are the bestway to actually solve homelessness.

In addition, funding streams from the state and federalgovernment reimburse the city for a portion of home-less shelter services. It is not known if these streams willalso reimburse prevention or aftercare services. As aresult, ensuring new and predictable funding streamsfor prevention services has been an ongoing challenge.

SOLUTIONS

The initiatives in this chapter explore approaches tosecuring money for prevention and other solutions tohomelessness. In a world of limited resources, and giventhe extraordinary commitment of resources now lockedinto shelters, this work will require flexibility, a commit-ment to change the status quo, and political will.

Initiatives include a first-ever cross-sector analysis offunding opportunities, obtaining waivers from state andfederal partners to support prevention programs withshelter dollars, and increased up-front investments onthe part of the city.

The results of implementing this “prevention first”agendamay not immediately be noticed, even though the costsof supporting the shelter system will continue. Only intime, as prevention programs are established and theculture begins to shift, will the shelter census decreaseand shelter savings materialize. Reinvesting these sav-ings into best performing prevention programs, as wellas converting shelters to supportive or affordable housing,are the logical – and much desired – consequences.

SHIFT RESOURCES INTO PREFERRED SOLUTIONS

30

Source: DHS Budget

Source: DHS Budget

31


Obtain State and FederalWaivers to CurrentReimbursementLimitations

At the state and federal levels, fundsare not available to offset costs forprevention, aftercare, and other similarprograms.This creates concern, espe-cially at the local level, that investmentsin prevention will end up costingmore money than is saved.

Increase Up-FrontInvestments for PreventionModels

Almost all money for homelessness istied to shelter – and these costs con-tinue to rise.This makes it difficult tofind additional money to begin newprevention programs, even thoughthey have potential to reduce the shel-ter census and create shelter savingsin the future.

There will be an initial period of simul-taneously funding new preventionprograms and shelter until preventionefforts reduce the size and cost of theshelter system.This “seed money” willsupport programs such as theHousehold Stability Initiative, a newcommunity-based prevention pro-gram. In addition,existing programs willbe surveyed to identify potential pre-vention components.

Analyze ResourceReinvestment by Sector

A review of funding streams will beundertaken to evaluate the cost effec-tiveness of programs in terms of theirability to reduce the shelter census.This will explore opportunities to usefederal and state money now dedi-cated to shelter to support prevention,as well as strategies to reinvest costsavings into other effective solutions,such as supportive or service-enrichedhousing.

The majority of city, state, and federaldollars targeting homelessness arespent on shelter and shelter services.No analysis exists that reveals oppor-tunities for shifting these resources toprevention. Further, no analysis existsto know which prevention programshave the greatest potential to reducethe shelter census and save money.

Reinvest Targeted Savings Prevention programs will be evaluatedand the resulting shelter savings willbe reinvested in the most successfulprograms. In addition, savings fromreduced costs of shelter can be dedi-cated to expand housing resources forthe chronically homeless.

Because the shift from shelter to preferred solutions like prevention has yet to occur, no savings havebeen generated.

Close Shelters to ReinforceSavings

As prevention programs begin to reducethe shelter census, performance incen-tive programs and other criteria willbe used to determine which shelterswill be closed first. Opportunities forconverting shelters into supportive orpermanent housing will be maximized.Shelter-closing schedules will be exam-ined routinely to make sure that thereis always enough capacity to accom-modate fluctuations in the population.

For the last several years, the city hasaggressively increased the number ofshelters to house record levels of home-less people.The costs of opening andmaintaining these shelters areextremely high.

Federal and state funds will be securedand redirected through demonstrationprojects and other innovative fundingmechanisms. Key goals include redi-recting existing funds now dedicatedto shelter, as well as savings-reinvest-ment strategies that support preven-tion, supportive housing, and othersolutions. Advancing new legislationthat funds prevention and aftercareservices is also needed.

TAKING ACTION

THE CHALLENGE

The City of New York is experiencing a profound shortageof available housing at every rental level.This is particu-larly the case with affordable housing. In fact, recentsurveys conducted by the NYC Department of HousingPreservation and Development report that the vacancyrate for very affordable apartments is under 3%, meaningthere is a “housing emergency” for the lowest incomeNew Yorkers.

Many at-risk and low income New Yorkers turn to rentalassistance programs to maintain and secure housing.But demand continues to outpace supply; various agen-cies and their clients are in competition for these scarceresources; and the eligibility requirements and applicationprocesses can be confusing and contradictory. Inaddition, some people have a need for services beyondrental or financial support. The need for housing withsupport services also outpaces supply.

In addition, entering the shelter system has become thequickest and most certain way for families to receiverental subsidies. A family applying for assistance fromexisting housing will likely wait years to receive assistance,if they receive it at all. A family entering shelter may waitjust months.

SOLUTIONS

The initiatives in this chapter embrace and build uponMayor Bloomberg’s housing plan, The New HousingMarketplace, which is the most significant housingdevelopment and preservation strategy introduced inthe city in over a decade.That plan pledges $3 billionover five years to create and preserve 65,000 new unitsof housing.

Included, here, are new commitments to increase sup-portive and service-enriched housing.These are proven,cost-effective interventions that provide permanenthomes, as well as services, to formerly homeless people– people who might not be successful in permanenthousing without support services. Expanding New YorkCity’s leadership in the area of supportive housing isessential to overcoming chronic homelessness.Thisincludes increasing access to new and established at-risk populations, as well as using these interventions inhomelessness prevention efforts.

These initiatives also streamline and expand rental assis-tance options for individuals and families at risk ofhomelessness.They level the rental assistance playingfield, in order to reduce competition for subsidies andcounter the perverse message that becoming homelessis the best way to receive assistance.

PROVIDE RESOURCES FOR VULNERABLE POPULATIONSTO ACCESS AND AFFORD HOUSING

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33

Source: HPD

Source: Corporation for Supportive Housing, DHS Budget, Culhane Study

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Develop a RentalAssistance Primer

Today, multiple rental assistance pro-grams exist,each of which have differentrequirements, rules, and applicationprocedures. As a result, there is confu-sion and competition between serviceproviders and those who receive the aid.

Streamline the RentalAssistance Application

Applying for rental assistance todayis a time consuming process thatrequires extensive paperwork andprocessing for applicants and publicagencies.

The city will introduce a new web-based application process.The use oftechnology such as signature pads,online client files, and digital scannerswill reduce paperwork, minimize infor-mation and documentation loss, andincrease efficiency for clients and staff.

Coordinate RentalAssistance AcrossAll Agencies

A citywide strategy will be imple-mented that grants uniform access torental assistance based on a citywidedetermination of priority need.Thisstrategy will reduce competitionbetween agencies, minimize inconsis-tent practices between agencies, andensure resources are allocated basedon need.

Currently, rental assistance is grantedto members of prioritized populations(such as homeless families and victimsof domestic violence), and consists ofprograms developed in isolation fromeach other.This leads to incoherenceand confusion by service providersand clients over what benefits areavailable. It also leads to competitionbetween agencies for limited housingresources.

Redesign RentalAssistance toDisincentivize Shelter

Rental assistance will be shifted fromshelter to the community so that entryinto shelter is not necessary to obtainassistance. At the same time, rentalassistance resources must continueto be available in shelter to re-housechronically homeless individuals andfamilies.

At present, the most effective way for afamily to receive rental assistance is toenter the shelter system.The currentsystem places those in shelter at ahigher priority for housing assistancethan those at risk of homelessness.Inadvertently, this system provides anincentive for people to leave unstablehousing rather than find solutions tostabilize and keep it when appropriate.

Once the citywide rental assistanceprogram is revamped, a plain lan-guage guide to rental assistance willbe created and broadly distributed toagencies, providers, and residents.Theguide will include essential informa-tion about eligibility requirements,regulations, and levels of aid available.

TAKING ACTION

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Increase the Supply ofService-Enriched Housingfor Adults and Families

Service-enriched housing includes sin-gle apartments rented on a permanentbasis to formerly homeless individualsand families.Transitional or longer-term services that aim to link thesepeople with community-based serv-ices are “tied” to the apartment.

Advance The New HousingMarketplace

The Mayor’s 5-year plan to develop andpreserve 65,000 units of affordablehousing for individuals and families isambitious and will require collectivecreativity and support to accomplish.

City agencies and private interests col-lectively will leverage funding, providefinancial incentives, and simplify theregulatory and development processesto increase the supply of affordablehousing.This plan will encourage thedevelopment of lower-cost housing,for singles in particular, by reducingbarriers to the development of moremodern models of SRO-type housing.

Increase the Supply ofSupportive Housing forAdults and Families

The commitments made in The NewHousing Marketplace will be reinforcedand expanded. City and state agencieswill collaborate to identify appropriatefunding to support additional devel-opment and to identify additional at-risk subpopulations to serve.“MovingOn,” a successful program that providesaccess to rental assistance for those“graduating” from supportive housingwill be expanded to open existingunits to new clients.

New York City is the leader in develop-ing innovations in supportive housing.Mayor Bloomberg’s The New HousingMarketplace builds on this commitment.Nonetheless, demand for supportivehousing continues to outpace supply.

Improve CommunityRelationships to SupportNew Community HousingInitiatives

A coordinated effort to educate thepublic about the benefits and successof supportive housing and other inter-ventions will be undertaken. Improvedefforts to engage with communitieswill increase confidence around theseinterventions.

While there is support for affordablehousing generally, communities some-times feel less certain about supportivehousing and rental assistance programs.Not enough public dialogue hasoccurred around the success of theseinterventions and the ways in whichthey benefit communities.

The availability of service-enrichedhousing, as part of the city’s continuumof services, will be expanded. Differentmodels for different subpopulations,including chronically street homeless,will be explored.These will include“housing first”models.

THE CHALLENGE

The city’s response to homelessness has been wellresourced and well meaning, but has not always bene-fited from ongoing accountability and quality improve-ment efforts based on emerging research and existingdata. Similarly, existing prevention efforts have not beenevaluated routinely, leaving policy makers with littledata analysis to target resources to the right people atthe right time. Significant challenges exist in developingnew prevention programs that effectively intervenewith at-risk populations.

In addition, large amounts of useful data sit in variouspublic agency and provider databases. Often, informationabout a specific person or household’s public assistancehistory is in one database, their involvement with childwelfare in another, and their history of homelessnesssomewhere else. Few efforts are made to bring these datasources together to create more holistic profiles of thoseat risk or experiencing homelessness.

A tremendous amount of interest exists in the academicand research communities to explore this informationand assist in policy formation and quality improvements,but these efforts are not always coordinated or compli-mentary to new directions in public policy making.

SOLUTIONS

The initiatives in this chapter recognize the centralimportance of evaluation and data analysis in creatingeffective programs and practices.They also acknowledgethe often untapped but critical assistance academics andresearchers can offer in improving the city’s response tothose with housing instability.

These initiatives establish a research advisory board andbuild on the Bloomberg Administration’s successfulefforts to coordinate the sharing of data between publicagencies.They establish meaningful opportunities forinterested researchers to help evaluate existing programsand inform the development of new strategies.

Perhaps most importantly, these initiatives establish thebenchmarks and outcomes associated with key initia-tives throughout Uniting for Solutions Beyond Shelter. Bybuilding into initiatives specific targets and evaluationcomponents, partners involved in their implementationwill hold themselves accountable for producing theresults envisioned in this plan.

MEASURE PROGRESS, EVALUATE SUCCESS,AND INVESTIN CONTINUOUS IMPROVEMENT

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Conduct One-City DataMatches

DHS has recently conducted anunprecedented number of datamatches with databases from otherpublic agencies.This information iscasting light on why many peoplebecome homeless, as well as the greatdegree to which different agenciesserve the same clients.

Track Key IndicatorsImpacting HomelessNew Yorkers

Research indicates that drug, alcohol,mental health, and health problemsare prevalent among segments of thehomeless population – particularlythose on the streets.While a wealth ofdocumentation about these issuesexists, there is no centralized databaseand tracking system.

A new homeless health tracking initia-tive, drawing on data from DHS andthe NYC Department of Health andMental Hygiene, will be used to trackand present information about thehealth status of homeless New Yorkers.With a commitment to continuousquality improvement, the system willhelp identify service gaps, aid programplanning, and assist in targeting medicaland other resources more effectively.

Create and Maintain aResearch Advisory Board

A board will assist public agencies andproviders as they launch new researchinitiatives. By setting priorities andreviewing methods, the board willencourage productive research thatadvances the initiatives in Uniting forSolutions Beyond Shelter. It will alsocommunicate key information to theresearch, provider, and governmentcommunities.

During the past few years, the city hasgreatly expanded efforts to useresearch and data to inform, evaluate,and improve programs for homelesspeople. A tremendous amount ofadditional interest on the part of aca-demics and researchers exists. But it isnot part of a coordinated effort toimprove results.

Use Data and Researchto Inform and EvaluateHomeless PreventionEfforts

HOMESTAT will give public agenciesand providers new data on reasons forhomelessness, best practices, andinsight into broader policies that canreduce homelessness. In addition,work conducted by various city agen-cies is identifying the most commonroutes to homelessness and will guideand serve as a baseline for comparingthe results of new prevention programs.

A significant amount of data andresearch exists on why individuals andfamilies become homeless.This samedata show the difficulties of effectivelytargeting homeless prevention efforts.Major projects have been undertaken toinform the city’s homeless preventionapproach.

These efforts will be formalized andthe data will be used to improve inter-agency partnerships to prevent home-lessness. For example, data matchesbetween the New York City HousingAuthority and DHS show when Section 8households fail to renew their subsidies.This information will be used to targetresources to at-risk households beforethey become homeless.

TAKING ACTION

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Reinforce the Objectives ofUniting for Solutions BeyondShelter Through StaffTraining and Development

DHS has provided shelter staff withtraining on client responsibility andhosted quality improvement seminarson a range of initiatives. Some cultureshifts have occurred, but more areneeded.

Implement a Broad PublicEducation Campaign

Despite widespread concern for thewell being of homeless people, thereare few opportunities for meaningfulengagement for communities andindividual volunteers.This contributesto the sense that homelessness can-not be solved.

Marketing and public relations profes-sionals will be tapped to create a long-term public education campaign.Thiswill build public support for solutions,create community ownership aroundaddressing homelessness, and buildconfidence around ongoing and sub-stantial public resource investments.

Track Community LevelPerformance

With the release of Uniting for SolutionsBeyond Shelter, public agencies willidentify and track progress in achiev-ing milestones, targets, and results.A key tracking manager will bringtogether participants to discussprogress and maintain accountability.

Without concrete targets and mile-stones, a heightened level of account-ability for the many initiatives includedin this plan will not exist, with thechance they will not get accomplished.

In coordination with the release ofUniting for Solutions Beyond Shelter,staff training will be conducted utiliz-ing resources that focus staff on theplan’s priority areas.These will increasestaff fluency in subjects like homelessprevention and the principles of clientself-advocacy and responsibility.

APPENDIX

Guiding Principles A

Prevention Principles B

Planning Process C

Coordinating Committee D

Task Forces E

A

All individuals and families should have safe,affordable housing.• Ensuring all New Yorkers safe, affordable housing

requires effective collaboration among stakeholders.• Necessary support and preventive services should be

available to assist individuals and families to avoid homelessness.

• An individual or family that can be supported within their current appropriate housing situation should not come into the homeless system.

Homeless individuals or families should receive safe,temporary shelter; planning for permanent housingshould begin immediately.• If preventive interventions cannot support an at-risk

individual or family in their current housing situation,temporary shelter should be provided.

• Temporary shelter is a short-term intervention, not asubstitute for permanent housing.

• Homeless individuals and families should receive a thorough assessment for placement into shelters withservices that meet their particular needs and will expedite permanent housing placement.

• Individuals and families have the responsibility to provide accurate and complete information about theircircumstances and needs.

• Services should be culturally sensitive and available inthe client’s community to maintain community ties,if appropriate.

• Children in homeless families should be assured accessto a sound education by minimizing school disruptionthat may occur as a result of becoming homeless.

• Services must be structured to ensure permanent housingis preferable to shelter and maintained once achieved.

Individuals should not have to make their home onthe street or in other public spaces; safe and humaneoptions should be available.• Effective outreach must be provided to encourage

individuals living on the street to accept services and shelter.

• Practices that encourage individuals to live on the streetare counterproductive and should not be supported.

• Safe environments must be provided that appropriatelysupport individuals who fear service engagement.

All individuals and families deserve and are expectedto actively participate in the development and imple-mentation of their independent living plans.• Every individual and family deserves respect.• Individuals and families must receive clear information

and consistent services as they transition through the shelter system.

• Individual and family strengths should be integratedinto service plans.

• Individuals and families must be responsible for achievingindependence, and must be informed on how they areaccountable for completing service plans, and how thoseexpectations relate to securing permanent housing.

• Individuals and families should treat every personinvolved in their care, other temporary shelter residents,and their shelter space, with respect.

• Individuals and families should have permanent housingthat is reflective of their assessed needs, including services, if necessary, to support permanency.

All agencies must work as partners to ensure successful,long-term outcomes for individuals and families whoare, or who may become, homeless.• Public agencies must coordinate their services to ensure

their practices do not result in any individual or familybecoming homeless.

• Achieving successful, permanent housing for individualsand families depends upon inter-agency accountability,collaboration, and cooperation.

• Discharge planning and resource coordination shouldoccur to facilitate a safe and appropriate transition forindividuals and families being served by multiple service systems.

Services must be provided with the goal of achievingthe highest standards of practice through continuousquality improvement.• Every employee has a significant role in achieving

positive outcomes for clients, regardless of rank or title.• Open and honest communication in an atmosphere

without fear is critical to success.• Every effort must be made to engage clients to actively

participate in service delivery and planning, and torespond to feedback received from them.

• Providers should have the appropriate training andresources to enable them to achieve successful outcomes.

• Information must be used to drive improvements in out-comes and quality and must be made publicly available.

• Evaluation systems must be developed to accuratelymeasure and recognize success.

• Every provider is accountable for meeting standardsand achieving successful outcomes for clients.

GUIDING PRINCIPLES

B

All individuals and families should have safe,affordable housing.• Ensuring safe, affordable housing for all New Yorkers

requires effective collaboration among stakeholders –including providers, public agencies, community organizations, and clients.

• Services and support should assist individuals and families to avoid becoming homeless by maintainingcurrent, appropriate accommodations.

• Every effort must be made to prevent individuals andfamilies who have appropriate housing from enteringthe shelter system.

All efforts should be made to assist individuals andfamilies as soon as possible to avoid crises that causehomelessness.• Interventions should be delivered at the community

level before points of crisis, to avoid the disruption andinstability created by homelessness or the risk ofbecoming homeless.

• Coordination should occur to serve individuals and families holistically, addressing the circumstances thatcan cause homelessness.

• Agencies and providers should provide cohesive servicesfor individuals and families being served by multiple systems.

Homeless preventive services should provide flexibleassistance to meet individual and family needs.• Preventive services should be culturally sensitive and

easy to access at the community level, if appropriate.• Services should be flexible and responsive to client

needs, ensuring the earliest possible interventionsthrough a range of services.

Agencies that provide services to clients in institutionalsettings should ensure successful discharges to stable,permanent housing.• Discharge planning and resource coordination should

occur to facilitate a safe and appropriate transition thatensures individuals and families do not become homeless.

• Discharge planning should include provision of or referralto appropriate support services, when necessary.

All individuals and families receiving services deserverespect and must be respectful.• Individuals and families should have knowledge about

available preventive services.• Individuals and families should be aware of their rights

and responsibilities as tenants and clients, as well as therights and responsibilities of landlords.

• Individuals and families receiving preventive assistanceshould receive clear information, responsive services,and information about their rights as clients and theresponsibilities of agencies.

Preventive services should be guided by data andresearch.• Data should inform prevention interventions that

address the causes of homelessness.• Research should routinely inform policy development.• Service delivery should be based on both quantitative

and qualitative data, including client and staff feedback.• Agencies and providers must be accountable for meeting

standards and achieving successful outcomes for clients.

PREVENTION PRINCIPLES

C

PLANNING PROCESSIn the fall of 2003, Mayor Bloomberg reached out to three individuals to lead the development of the 10-year strategyto address homelessness.They were his Chief of Staff Peter Madonia, Association for a Better New York ChairmanWilliam C. Rudin, and the United Way of New York City’s Senior Vice President Lilliam Barrios-Paoli.

The co-chairs formed a coordinating committee made up of leaders from every sector.The coordinating committee,comprised of 41 individuals, then invited providers, advocates, academics, government officials, and private sectorleaders to participate as members of four task forces focused on the following themes: 1) prevention and diversion,2) outreach, shelter services, and permanency, 3) community-based services and resource reinvestment, and4) research and quality improvement.

In November 2003, the Mayor kicked-off the planning process at a Gracie Mansion breakfast meeting. Soon after, thetask forces established their processes and routine meeting schedules. All the task forces consulted with external expertson various issues, inviting them to present and participate in meetings. In total, the four task forces, representing morethan 125 organizations, held close to 50 meetings through the end of February 2004.

The work of the coordinating committee and the task forces culminated in a two-day working conference, whichengaged a broader cross-section of stakeholders. More than 250 participants attended plenary sessions featuringnationally recognized experts and breakout workgroups focused on advancing the discussion around key themesof the 10-year plan.

Following the conference, task force recommendations were reviewed by the coordinating committee for final inclusionin Uniting for Solutions Beyond Shelter: The Action Plan for New York City.

Immediately following the release of the plan, public agencies designated as task leaders for various initiatives willdevelop work plans, listing responsible managers and timeframes for task implementation. Routine reporting updateswill be scheduled and released to the public.

D

CO-CHAIRSLilliam Barrios-Paoli, United Way of New York City Peter Madonia, Office of the Mayor William C. Rudin, Association for a Better New York

COORDINATING COMMITTEE• Michelle Adams, Association for a Better New York• P.V. Anantharam, Office of Management and Budget• Douglas Apple, New York City Housing Authority• William C. Bell, Administration for Children’s Services• Lauren Bholai-Pareti, Council on Homeless Policies

and Services• Eric Brettschneider, Agenda for Children Tomorrow• Alfred Cerullo III, Grand Central Partnership• Peter Cobb, Fried, Frank, Harris, Shriver & Jacobson, LLP• Mayor David N. Dinkins, Columbia University’s School

of International and Public Affairs• Shaun Donovan, Department of Housing Preservation

and Development • Verna Eggleston, Human Resources Administration• John D. Feerick, Fordham University School of Law• Father John Felice, St. Francis Friends of the Poor• Justice Fern Fisher, New York City Civil Court• Maureen Friar,The Supportive Housing Network

of New York• Ester R. Fuchs, Office of the Mayor • Linda Gibbs, Department of Homeless Services • John J. Gilbert III, Rudin Management Company• Lawrence Graham, Brookfield Financial Properties• Rosanne Haggerty, Common Ground• Steve Hanson, B.R. Guest, Inc.• Tino Hernandez, New York City Housing Authority• Peter Hoontis, West Side YMCA• Martin F. Horn, Department of Correction• David R. Jones, Community Service Society• Robert O. Lehrman, Resheff, Inc. and Community

Capital Bank • Carleton K. Lewis, United States Interagency Council

on Homelessness• Barbara Lowry,The Northern Manhattan Improvement

Corporation• Donald Marron, Lightyear Capital• Reverend Win Peacock, John Heuss House• Jennifer Raab, Hunter College• Steven Spinola, Real Estate Board of New York• Joseph Strasburg, New York City Rent Stabilization

Association• Constance Tempel, New York State Office of the

Corporation for Supportive Housing• Reverend Terry Troia, Project Hospitality• Nancy Wackstein, United Neighborhood Houses• Alan Wiener, American Property Financing• Paul T.Williams, Jr., Bryan Cave LLP and One Hundred

Black Men, Inc.

E

TASK FORCES Prevention and Diversion• Scott Auwarter, Citizens Advice Bureau • Clarke Bruno, Department of Homeless Services• Jane Corbett, Human Resources Administration• Justice Fern Fisher, New York City Civil Court• Henrietta Fishman, Veterans Administration• Mike Gagliardi, Department of Homeless Services• Carleton K. Lewis, United States Interagency Council on

Homelessness• Carolyn McLaughlin, Citizens Advice Bureau• Jane Orenstein, United Way of New York City• John Sheehan, Phoenix House • Jackie Sherman, City Council• Marcia Stevenson, Department of Homeless Services• Jessica Ziegler,Task Force Liaison

Outreach, Shelter Services, and Permanency• Douglas Apple, New York City Housing Authority• Dennis Culhane, University of Pennsylvania• Brad Gardiner, BR Guest, Inc.• Lisa Green, Department of Health and Mental Hygiene• Tony Hannigan,The Center for Urban Community

Services• Mark Hurwitz, Department of Homeless Services• Reverend Win Peacock, John Heuss House• Sherry Schuh, New York City Housing Authority • Lloyd Sederer, Department of Health and Mental Hygiene• Fred Shack, HELP USA• Bob Skallerup, Department of Homeless Services• Reverend Terry Troia, Project Hospitality • Joe Weisbord, Housing First!• Amber Gay,Task Force Liaison

Community-Based Services and ResourceReinvestment • P.V. Anantharam, Office of Management and Budget• Robert Bishop, Pryor, Cashman, Sherman & Flynn LLP• Peter Hoontis, West Side YMCA • Sandra Jimenez, Department of Homeless Services• Verona Middleton-Jeter, Henry Street Settlement• Roger Newman, Department of Homeless Services• Steve Pock, Department of Homeless Services• Barbara Rosenberg, Department of Homeless Services • Anne Teicher, Neighborhood Coalition for Shelter• Nancy Wackstein, United Neighborhood Houses• Anne Williams-Isom, Administration for Children’s

Services• Pascale N. Graham,Task Force Liaison

Research and Quality Improvement• Jeff Barnes, New York State Office of Temporary &

Disability Assistance• Lauren Bholai-Pareti, Council on Homeless Policies and

Services• Carol Caton, Columbia University• T. Edwards, Department of Homeless Services• Kim Hopper, Nathan Kline Institute• Gabby Kreisler, Office of the Mayor• George McDonald,The Doe Fund• Roy Mogilanski, Office of Management and Budget • Muzzy Rosenblatt, Bowery Residents’ Committee• Maryanne Schretzman, Department of Homeless Services• Beth Shinn, New York University• Jessica McCabe,Task Force Liaison

Legislative Agenda • Michelle Adams, Association for a Better New York • Lauren Bholai-Pareti, Council on Homeless Policies and

Services• Clarke Bruno, Department of Homeless Services • Alfred Cerullo III, Grand Central Partnership• Peter Cobb, Fried, Frank, Harris, Shriver & Jacobson, LLP• Rosemarie Coppola-Baldwin, Department of Homeless

Services• Maureen Friar,The Supportive Housing Network of

New York• John J. Gilbert III, Rudin Management Company• Ellen Levine, Office of Management and Budget• Steven Spinola, Real Estate Board of New York• Joseph Strasburg, New York City Rent Stabilization

Association• Constance Tempel, Corporation for Supportive Housing• Alan Wiener, American Property Financing

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