6 Things I Learned in Australia

From December 16-21, 2013 I spent time with Micah Projects in Brisbane, Australia. It was a fabulous opportunity to share the SPDAT with another community, as well as informally take in homelessness services first hand in another part of the world.

Here are six things I took away from that trip:

1. Mobile Government Benefit Workers Is Possible

I have encountered several communities in North America that have worked hard to get streamlined access to government benefit offices to get income supports. I have seen income support staff attend weekly case conferences and offer helpful commentary.

And now I have seen what I thought was only a dream actually happen.

Centrelink is an agency of the Department of Human Services. They actually have staff with laptops that go out to locations where homeless people are (in this instance a food program where there was also outreach) and have the ability to do applications, amend benefits, make notes and approve income supports. Imagine a person in your community in charge of public benefits sitting on a ledge in a park with laptop perched on her knees with a homeless person sitting beside her, and her having the ability to pull up his file, amend information, and approve a payment to him to be picked up the same afternoon. This all was happening before my eyes before 7am.

Skull blown.

2. Homelessness is Homelessness and the Cure is the Same

No matter where I go in Canada or the United States I am able to see more similarities in homelessness and effective program responses and policies than I see differences. Sure, it requires “translation” sometimes to a local context, but the instruments are boldly the same and the evidence that supports certain interventions over another is transferable.

Having now gone to a different hemisphere on the other side of the planet it is obvious to me that homelessness is homelessness (at least in developed countries) and the cure (that is housing, by the way) is the same.

3. Outdoor Feeding is More Structured

Vans that feed people in public spaces – whether that be faith groups or organized outreach teams or service clubs or whatever – has been a hot button issue in many communities I have been in throughout the United States and Canada. I really appreciate what has occurred in Brisbane, and think this may be transferable to other locations. The local government has sanctioned certain locations on certain days of the weeks as the places where food distribution can occur. This also means that other services (housing workers, income support workers, nurses, etc.) can co-locate at the same time and offer a more comprehensive array of services to homeless people coming to get food.

While I remain convinced that food sustainability is better than charitable feeding, and that having people eat indoors can be more humane than having large groups amass outdoors for these types of feedings, the designation of specific locations and specific times is a terrific idea.

4. Scarcity of Affordable and Supportive Housing Is an Underlying Issue in Other Parts of the Developed World Too

Like many large urban centers, Brisbane is experiencing shortages of housing that is affordable to a broad range of its population, and specifically a shortage of housing that is affordable to persons that are homeless and may benefit from additional supports.

I was very impressed with Brisbane Common Ground, and feel the community would like benefit from more of this housing model – as, I understood, would most other communities across Australia.

In discussions with many brilliant people in Australia I also had one of me feelings confirmed – that the thought of expecting government of any level to see the necessity to invest in a suitable number of social or supportive housing units is from a bygone era. We are in a position where some government investment has to be more balanced with additional voucher and rent supplement programs. If we don’t get into this pragmatic mindset, I fear a lot of additional energy will be invested in advocacy efforts that will fall on deaf ears of government leaders.

5. Juggernaut Organizations can Drive Change

If you have never heard of Micah Projects, Inc., I encourage you to check them out.

There are a few non-governmental organizations in my career that I have found can change the nature of the conversation about homelessness and housing, are determined to innovate and balance that desire for innovation with evidence, and be reflective on how to get better and better and better. It was a pleasure to meet another one in Micah Projects. They have a wide range of programs with an underlying commitment across all of the program areas to be awesome at their work – while at the same time participating in state and national discussions and work groups.

6. We Need Better Opportunities to Link of Practitioners Internationally

I have always thought when of the great joys of my job is that I get to cross-pollinate ideas…I meet someone in Place X that is doing something amazing and when I am in Place Y can connect the two of them because Place X has the cure for what Place Y is experiencing. I hope this opportunity never ceases for me.

All the same, I wish there was a cost-effective, accessible way that organizations across countries could learn from each other’s practices in very tangible ways. I am not talking about a research consortium…that exists and is de-linked from a lot of the day-to-day experience of frontline staff. What I would love to figure out is how we can create international communities of practice across organizations that are committed to ending homelessness.

Now the question is just to figure out how. Anybody know a billionaire who would be willing to bring together practitioners in a common place in the world to have a 3-5 day in-depth sharing experience?

Prioritizing Who Gets Served Next Matters – The Service Prioritization Decision Assistance Tool (SPDAT)

When I led the largest Housing First program in North America, one of the things that bothered me was that we had no defensible way to prioritize who we served next. We dabbled with different instruments and had some stellar research thanks to folks like Toby Druce – but couldn’t quite put our finger on exactly how to prioritize who got served next and why. At least not in a defensible, reliable, consistent and valid way.

Sure, there are some awesome instruments out there like the Vulnerability Index used by Common Ground and now the 100k Homes Campaign (and we are big fans of both); the Camberwell Assessment of Needs; the Outcome Star; the Denver Acuity Scale. But none of these were a perfect fit for the type of Housing First program that I was leading or other Housing First programs that I was familiar with.

One of the first things I started working on when I made the move to OrgCode was to develop the right tool for determining who should get served by what type of housing intervention and why. Being the nerd that I am, I took an inventory of all existing tools that I could get my hands on – hoping that I had just missed something in my previous work. No point re-inventing the wheel. Truth is, not much with credible overlap other than the ones previously mentioned – and even then, too many limitations or shortcomings.

I found a small number of communities and individual practitioners willing to work with us in developing a proper assessment tool for Housing First. Dedicated professionals were found who would implement our drafts, provide detailed feedback, tell us about the associated client interactions and the like. The process was amazing. Repeatedly in the draft stage we heard over and over again how the SPDAT was making them look at their practice differently – from intake through to case planning through to discharge.

In the end, the final version of the SPDAT examines 15 main components for each client. Those 15 components provide a baseline at intake and are tracked throughout the case planning process. The 15 components are:

  1. Self Care & Daily Living Skills
  2. Meaningful Daily Activity
  3. Social Relationships and Networks
  4. Mental Health & Wellness
  5. Physical Health & Wellness
  6. Substance Use
  7. Medication
  8. Personal Administration & Money Management
  9. Personal Responsibility & Motivation
  10. Risk of Personal Harm/Harm to Others
  11. Interaction with Emergency Services
  12. Involvement in High Risk and/or Exploitive Situations
  13. Legal
  14. History of Housing & Homelessness
  15. Managing Tenancy

By using the SPDAT throughout the case planning process, it helps case managers in focusing their attention on those areas where clients are in pre-contemplation or contemplation, and to some degree preparation. It also ensures an ongoing client-centred and strength-based approach to service delivery. Finally, for those clients that are visual learners or have limited literacy and numeracy, the SPDAT provided the opportunity to visually demonstrate their movement – and momentum – in various dimensions of their case plan.

Version 1 of the SPDAT was implemented with thousands of clients across North America. After a year, we asked all practitioners to provide input on how to make the tool better through a detailed survey. After analysis of their comments we tested Version 2 extensively and finally launched the Version 2 in March 2011. Whereas Version 1 was focused exclusively on Housing First, Version 2 now takes into account Rapid Re-housing and more general Housing Help services as well.

There have been several interesting findings relayed to us from people and entire communities using the SPDAT:

  • Practitioners have been able to make significant transitions from jumping from one crisis to another to planned, logical service delivery through the SPDAT;
  • Many frontline workers resist the SPDAT for the first few weeks before they finally realize that it improves their job and interactions with clients;
  • Improved housing choices are put on the table for clients – from independent living through to permanent supportive housing;
  • Some of the people that previously staff may have thought were really high acuity turn out not to be – and the reverse is also true;
  • Local service managers and researchers really love how the SPDAT data allows them to meaningfully engage in advocacy, brokering and research and explore other areas for program improvements which are based upon evidence, not hunches or anecdotes;
  • Team Leaders indicate that they are better able to match the client to the staff person with the right skills to meet their needs; and,
  • Client outcomes (not just outputs) have significantly improved.

So far in addition to the thousands of clients and dozens of communities & organizations using the SPDAT we have had one Province seek permission to use it and integrate it with their data system, and two States that are in initial discussions with us to make it a standard in service delivery (tres cool!). The tool has also been shared at National Alliance to End Homelessness Conferences in the US and distributed to Service Managers throughout Canada.

The tool has been tested and used with a wide range of populations: youth; substance users; persons with serious and persistent mental illness; Aboriginal people; older adults & seniors; newcomers; families; childless couples; ex-offenders; and people leaving institutionalization. We are confident that given the huge implementation and reliability that the SPDAT represents considerable potential in helping to end homelessness.

The SPDAT is free. No gimmick. No bull. Free. It is our way of giving back. Any organization that chooses to use the SPDAT will get free updates in perpetuity. The only thing we ask is that practitioners are trained on how to successfully use the SPDAT the way it was intended. And even then, training is provided at a very reasonable cost to make the tool as accessible as possible, including webinars and in person workshops.

If you would like to talk more about the SPDAT, get a FREE copy of it or chat about how it can be implemented in your organization or community, please let me know idejong@orgcode.com or 416-698-9700 ext. 2