Housing-Based Case Management

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Jun 102013
 

Case management. I suspect service providers, funders, CoCs, policy wonks, elected officials and a whole whack of others have used the phrase or even deliver a case management service but have never defined what it means in their context. The problem with not defining what case management means for your organization and community is that it is open to gross misinterpretation if you don’t. It will be defined for you by others, probably implicitly, and likely incorrectly (or at least differently than how you internally defined it). I will spare you the full academic breakdown of the phrase. (You’re welcome.) BUT…I do want to cover the basics briefly from that perspective. There is no single defined history of case management in the literature. We can’t point to just one point in time and say “aha – that’s when case management started”. Because there isn’t a single defined history or point of origin, there is an absence of absolute consensus on what case management is (and isn’t). There also isn’t one dudette (or dude) considered (or at least universally accepted) to be the pre-eminent pioneer of case manager when it comes to housing and life stability. Want to complicate things further? Once you start adding qualifiers like “intensive” as in “intensive case management” things get even messier. Does it mean more time with people? Does it mean a smaller caseload? Both? How small of a caseload? How much time? More intensive compared to what – ”case management”? Interventions like Assertive Community [...]

Distinguishing Between Enabling and Supportive Relationships

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Jan 032012
 

My thanks for the blog request on this specific topic. I’d be hard pressed to think of a housing support worker/case manager that deliberately tries to make the life of any client worse. People go into this type of work because they tend to want to help others. But I think we need to take time to reflect on when helping becomes hurting – even when it is unintentional…when our actions aren’t actually helpful at all. Understanding the differences between enabling our clients and supporting our clients is an important part of self-reflection as a practitioner and is an essential distinction to be made in the type of help we are providing to people. I look at support as the art and act of encouraging a person to achieve goals. It is the function of working with the clients we have the privilege of assisting, not working for them. We want the individual to deliberate before making decisions, have information to make informed choices, and to experience and understand the consequences of their actions. In a supportive relationship, we want our clients to accept full responsibility for their life – to increase their self-awareness and self-management to the point where they can reframe and rebuild their life. Through supportive relationships we are respectfully presenting opportunities – at times challenging opportunities – for positive life changes while increasing opportunities for growth, learning and awareness. I look at enabling as the act of encouraging or failing to prevent a person from engaging [...]

Professional Works Gets Professional Results

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Nov 222011
 

PART EIGHT: Professional Works Gets Professional Results Successful housing programs have a professional orientation. Well-trained staff deliver the housing program. Successful housing programs tend not to be those operated in a charity context where “well intentioned” is sufficient to get the job done. There is too much at stake, and generally too much complexity for a layperson without training to help a client achieve long-term sustainability. I am not anti-charity. There is a time and place for it. And in fact it is often charitable organizations that hire the professional staff to deliver the housing program. The mistake, however, is when untrained staff are directly involved in client interactions. Truth is, it can do more harm than good. With the properly trained staff, housing programs get better outcomes. Here are some of the essential ingredients for ensuring your housing program is provided by professionals who get professional results. Start with the Right Job Description I love to take a poll when I do training about whether the job people are in with their organization is exactly how it sounded on paper when they applied. My non-scientific polling results would suggest that between 90-100% of people in any given audience say the job is different than how it looked in the job description. I encourage organizations to pull together professionally polished and accurate job descriptions for their housing staff team. (You can learn more about the staff compliment for a successful housing team here.) Be clear on the qualifications that you [...]

Objective-Based Home Visits

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Nov 212011
 

PART SEVEN: Objective-Based Home Visits Successful housing programs require case managers/housing support workers to visit their clients in their homes. You can’t have a successful housing program by having clients only come to your office. You can’t do it over the phone or by text message or email. Home visits are absolutely critical. A common mistake that case managers make is to show up at a client’s home and say, “How are you today?” This type of open-ended question takes the conversation and purpose of the visit off the rails from the start. Yes, I want case managers to care about the welfare of their clients. Yes, I believe in conventional niceties in society. But I have very specific reasons for wanting Objective-Based Home Visits to be structured differently. During the weekly case review meeting (as discussed in an earlier blog in this series) I want each case manager to identify the three objectives that they have for their next home visit. Each of these three objectives must be related to goals and anticipated outcomes identified in the individualized service plan. Some of these objectives may also be related to facilitating change with the client that is being supported. The objectives selected week to week will be directly related to the amount of time that the case manager and client have set aside for the meeting, as well as where the client is at in their service plan journey. A conversation when a case manager shows up to conduct a [...]

National Alliance to End Homelessness Conference 2011 – aka #naeh11

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Jul 192011
 

My last tweet from the conference claimed that #naeh11 rocked harder than KISS on a stadium tour. I stand behind that even as the days pass since the conference ended and reflection sets in and turns in part to wisdom. I think what made it rock for me this year was different than past conferences. From my vantage point there was a bit of an edge amongst conference delegates. The edge wasn’t defiance. It wasn’t even anger per se. It struck me that there was frustration. The source of the frustration? I heard over and over again the impact of the economy on local communities and state governments and decreased fundraising efforts. I heard over and over again about increasing demand for services. But I actually don’t think it was solely either or limited to both of those things. I think there are communities that entered into 10 Year planning fully committed to seeing homelessness ended. But now they see the 10 Year Plan sit on a shelf or the local leadership shift or the resources made unavailable. I think there are people and organizations that understand truly what effective approaches and evidence-based practices are and work hard to implement them, only to find other organizations still questioning Housing First, Rapid Re-housing, Critical Time Intervention, Harm Reduction, Trauma Informed Service Delivery and the like. They feel it is a constant, up-hill battle. I think that the misuse of phrases and terms is stoking the frustration. There was Sam Tsemberis – [...]