Overview and Definition of Integrated Services

1
Improving Access to Mainstream Services for
Chronically Homeless Persons, Including
Individuals with Serious Mental Health and/or
Substance Abuse Problems CREATING A
COMPREHENSIVE AND INTEGRATED SERVICE SYSTEM FOR
PERSONS WHO ARE CHRONICALLY HOMELESS
Jointly Sponsored by U.S. Department of Health
and Human Services U.S. Department of Housing and
Urban Development and U.S. Department of
Veterans Affairs
2
Why A Comprehensive Service System?

• People who are chronically homeless have multiple
  needs that can not be addressed by one service
  system
• Needs include access to mental health services,
  substance abuse treatment, health care, housing,
  income supports and entitlements, basic life
  skills training, education, job training

3
Why An Integrated Service System?

• People who are chronically homeless experience
  many obstacles to accessing housing and services.
  
• System-level Obstacles
• Fragmented systems, services, and funding
• Restrictive and excessive administrative
  procedures
• Poorly trained staff
• Ineffective programs
• Insufficient resources (housing and services)
• Long waiting lists
• Stigma

4
Why An Integrated Service System?

• Client-level Obstacles
• Mistrust of system
• Denial
• Criminalization of homelessness
• Multiple needs
• Complex application processes
• Services not client-centered
• Transportation to geographically dispersed
  services

5
Goal of a Comprehensive and Integrated Service
System

• People who are chronically homeless can enter any
  service door, be assessed, and obtain access to
  the full complement of services and supports and
  housing that they want and need

6
Principles for Creating A Comprehensive and
Integrated Service System for Homelessness

• Support concept of No Wrong Door to services
• Provide services determined by evidence to be
  effective
• Change ineffective policies or regulations
• Leverage existing resources
• Use mainstream resources
• Pursue new resources

7
Elements of a Comprehensive and Integrated System
to Address Homelessness

• Prevention
• Outreach and Case Management
• Mental Health Substance Abuse Treatment
• Health Care
• Integrated Treatments for Co-occurring Disorders
• Emergency Shelters
• Permanent Supportive Housing
• Employment and Education
• Culturally relevant services
• Consumer-centered services

8
Steps to Achieving a Comprehensive and Integrated
Service System

• Involve Key Stakeholders
• Establish a formal plan
• Build linkages and partnerships from top-down and
  bottom-up
• Enhance funding and other resources
• Streamline the administration of funding
• Perform ongoing monitoring and quality assurance

9
Involve Key Stakeholders

• Executive Branch Leaders
• State and local departments of Housing, Mental
  Health, Substance Abuse, Health, Medicaid,
  Welfare/Social Services, Education, Homeless,
  Transportation, Labor, Criminal Justice
• Senior-level staff with authority to make policy
  and budget commitments
• Legislators
• Providers
• Homeless or formerly homeless persons
• Advocacy groups

10
Establish a Formal Plan Sample

• Mission Statement To create an integrated
  system of care for persons who are chronically
  homeless by making optimal use of existing
  mainstream resources, creating new resources and
  improving coordination and collaboration across
  service and housing systems.

11
Establish a Formal Plan Sample

• Goal 1 Create a permanent interagency committee
  that will oversee the implementation of the
  strategic plan
• Goal 2 Realign Federal, state and local funds
  for developing services and housing
• Goal 3 Implement evidence-based effective
  services
• Goal 4 Decrease programmatic, procedural and
  policy barriers
• Goal 5 Develop affordable housing

12
Build Linkages and PartnershipsStrategies

• Interagency Coordinating Body
• Systems Integration Coordinator
• Interagency Agreements or MOUs
• Cross-training
• Co-location of services
• Pooled/Joint Funding

• Interagency MIS/Client Tracking System
• Uniform Applications/Intake Assessments
• Interagency Service Delivery Team
• Flexible Funding
• Program Consolidation
• Negotiation

13
Enhance Funding and Other Resources

• Discretionary resources (e.g., general fund)
• Mainstream Federal programs (e.g., TANF, Mental
  Health Block Grant, Substance Abuse Block Grant,
  HOME)
• Dedicated revenue stream
• Matching contributions
• Incentives

14
Streamline Administration of Funding

• Interagency agreements
• Legislative mandates
• Pooled funding
• Separate funding but single application process
• Coordinated funding priorities

15
Perform Monitoring and Quality Assurance

• Establish consistent data collection, performance
  standards, reporting requirements
• Create single point of accountability
• Tie quality assurance to funding

16
Key Requirements for Building a Comprehensive and
Integrated Service System

• Develop infrastructure and leadership
• Have dedicated full-time staff person(s)
• Provide flexible funding
• Conduct ongoing planning
• Regularly update strategies and action steps