Say What Volume 2
The blog I did outlining the outrageous things I had seen and heard in the first quarter was so popular, I present to you “Say What Volume 2” which shares my favourites from April, May and June.
1. “Our faith tells us to serve the homeless. That doesn’t mean we end homelessness. If there were no homeless then how could we live our faith? What you propose – housing people – is against my faith. I find the whole idea offensive and against God’s wishes.”
Thank you nice man in Florida who felt compelled to email me after I delivered training there. If there is good news, he and his church are praying for my soul, and praying that I learn to listen to Jesus in my heart and appreciate that God wants the poor to be with us always so that we appreciate the gifts and blessings that God gives to his believers. Whew.
2. “We realized with cats and dogs that spaying and neutering was the answer. It’s about time someone had the courage to say the same thing about the poor and homeless.”
This was said in a whisper to me by the Deputy Director of Human Services in a mid-sized city before I started a workshop in the Northeast. There was no indication from her voice that this was meant as a joke – not that it would have been a funny one. I think she wanted me to say something (being the “someone” that would have the “courage to say”). I must have disappointed her when I said no such thing.
3. “All harm reduction does is condone drug use.”
Nope. Though that is a common myth. I get why this person from Alberta was struggling a bit with it, as a former user herself. Trying to explain to people that harm reduction accepts that some people will not cease using substances, but that does not mean the use is being condoned is difficult for some people to wrap their head around. The person using the substance is making the decision to use. It is accepted that they have the right to make that choice. While we want to help them use in ways that are less harmful to themselves and the broader community, an understanding that some will continue to use regardless of knowing the risks it presents, does not mean that all substances are sanctioned for use in all circumstances.
4. “The reason we don’t have enough money for housing is Obamacare.”
Maybe you have been to, live in, or has seen a certain news channel that hates the Affordable Care Act and sees it as the root cause of all that is wrong in America? Now imagine someone trying to tell you that the reason that they cannot end homelessness is because they have no money for housing and the ONLY reason there is no money for housing is Obamacare. The problem of homelessness in America, according to this lovely soul, lies squarely on the lap of Obama – and he should be ashamed of how his policies have resulted in millions of Americans becoming homeless. (Seriously folks, you can’t even make this stuff up.)
5. “The reason the VA classifies your website as a cult is because you are a cult.”
The truth is, people that work at the VA cannot access the OrgCode website at work. I have been told on several occasions it is because the website has been classified as a cult. I have never seen it. I cannot confirm whether it is true or not. But I do make jokes about it when training VA staff. However, the last time I made the jokes there was a gentleman at the back at the end of the training who declared that we are a cult – making people believe lies about how to help the homeless.
6. “I don’t care what anyone says or any data people have, our transitional housing should be a national model and we should have more of it.”
This time from Maryland. Some people are very protective of their transitional housing. In this case, the person was trying to argue that neither HUD nor any other organization has been trying to shift the conversation away from Transitional Housing. He also believed it was possible to genuinely say you welcome people that use substances, when what it really means is forced abstinence and treatment as soon as they arrive.
7. “If you had done this work for even a day in your life you’d know that all you talk about are stupid fairy tales and lies.”
I find this incredibly amusing. Thank you California dreamer. It doesn’t happen too often that people think I have no practical experience. Most often I get the opposite reaction – people grateful that I have done the work and know what it is like on the ground day after day. I guess if people don’t like the idea of ending homelessness, though, one strategy is to suggest the person talking about how to do it has no experience working directly with program participants.
8. “Our pastor created this ministry to show us each where the pathway to sin leads.”
The pastor of a church group in Michigan created a feeding program that goes out onto the streets to hand out sandwiches, juice and clothes. They meet as a congregation before they go out, and then again when they get back. This is another example, though, of the state of homelessness being seen as a sinful. The pastor uses the get together after handing out food and clothes to walk through all of the sins that were seen, and how God wants no one to live in that much sin, therefore stay true to the Word of God or else you will become homeless.
9. “The only reason we have teenagers that are homeless is a lack of discipline in the home, and absent fathers.”
When pressed, this LEADER OF A YOUTH-SERVING ORGANIZATION, was adamant this was the ONLY reason. He then went on to explain to other service providers in his community how he knew this to be true by telling selective stories of the young men and women served through his program. When challenged by me about things like abuse, substance use, lack of acceptance of sexual preference or gender identity, extreme poverty or the like, he was completely dismissive suggesting all that does is try to dilute the conversation away from the actual issue.
10. “It takes a few years to build a relationship with the street homeless before you can even bring up the idea of housing.”
If I had a nickel for every time I have heard statements like this over my career, I would probably have over $100 by now. I contend that some people think building a relationship means becoming friends rather than creating professional trust. I contend that some people think providing socks, sleeping bags, food, etc is necessary in order to build a relationship, rather than seeing it as potential bribery for conversation or creating dependency. I also contend that too often street outreach workers are entry level positions rather than being the most trained, experienced staff with the greatest skill level. All interactions should be about ending homelessness when it comes to working with people living outdoors.
11. “That afternoon he visited with some of the families in residence and ended up physically restraining one of the residents because she was being loud. He put his hand over her mouth and pulled her away from the rest of the group.”
This was written to me in an email from someone I really admire who was flabbergasted by the events that had transpired that day when a “professional” did this while engaging with a family. More amazing is that others did or thought nothing of it, and his employer refused to even investigate. Physical engagement with program participants should be in exceptionally rare cases, and matters where health and safety is truly at risk. Being loud doesn’t cut it – especially when the being loud is not violent or threatening.
Stop and Think about the Homeless Children and Youth Act (even if you do not work with this population)
This is a special blog to discuss Homeless Children and Youth Act, S.256 in the United States given the urgency of beginning our discussions surrounding it. The regular blog returns on Monday.
Whether you work with unaccompanied youth, families, or single adults experiencing homelessness, I want you to stop and think about the proposed Homeless Children and Youth Act, S.256 and its implications. Frankly it is one of those pieces of legislation that sound awesome until you pull back the curtain. It is not mom and apple pie. There are implications to this that we need to dissect and consider from a funding, operational, and policy perspective. It is possible to think critically about the bill and still be supportive of ending homelessness amongst youth, as well as ending homelessness for children and their families. And yes, there are implications to communities and service providers that customarily do not work with youth or families. S.256 impacts all people experiencing homelessness, funders, service providers, and Continua of Care.
Here are the highlights of S.256:
The definition of homelessness expands so that all poor families living with others on a longer-term basis for economic reasons are included. What this means is that many, many more millions of additional families and youth become eligible for HUD homeless assistance.
Communities would be required to do counts of the number of families and youth doubled up for economic reasons.
Strategic use of HUD resources would revert back to a time where services were not guided by evidence because of who it demands be served and how.
Some of that you may agree with and some you may not. Consider that:
There are NO new resources attached to the bill and the nation is already short a couple hundred million to effectively serve existingunsheltered families and unaccompanied children and youth.
The bill is likely to be attached to other legislation meaning the route of usual discussion and debate in the political process is not there.
But that is not all that I am worried about.
I think the people at HUD have done an amazing job in recent years establishing a national agenda about population groups to serve and prioritize. In effect their policy and funding has moved us away from creaming and helped us get to the nuts and bolts of people that need services the most, not just those that want services the most. It has had the impact of getting service providers to elevate their game and learn how to best serve individuals and families with complex, co-occurring life circumstances, while remaining focused on housing. Data and evidence have become critical to communities learning how to best house and support people.
I fear that, if passed, communities will start to revert to a time where resources are aligned to families with lower and moderate issues prior to being used for those families and individuals (including unaccompanied youth) that have the highest needs and issues. I liken it to an emergency department of a hospital choosing to use its resources to help set the broken leg of the 8 year old that fell off her bike before helping the 57 year old that had a heart attack because children are the future, and the 57 year old is an overweight smoker who has had three previous heart attacks.
I have seen, in recent years, considerable improvement in how data is used to help understand homelessness in a given community and then reorient funding to address the deepest needs. S.256 moves us more towards an emotional response to the issue more than a data driven one, in my opinion. But data requirements that come with it, like understanding the number of households that are living in doubled-up situations on a longer-term basis for economic reasons, are labor intensive to even try to address and dang near impossible to do accurately. If you thought there may be some flaws with your Point in Time numbers, you ain’t seen nothing.
I also think the Act confuses poverty and homelessness. Are the two related? Yes. Are they the same thing? No. About 49 million Americans live in poverty, while at any given time about 600,000 experience homelessness (using HUD’s existing definition; unsheltered or staying in homeless programs). Those numbers are not even close to being the same. Almost all of the former number is housed, while all of the latter number is homeless. What will happen is homeless resources will be diverted to address households that are precariously housed, but housed nonetheless.
In the past few years a ton of work has gone into getting communities to work as systems. I fear S.256 gets us more back to silos and less into systems-thinking. Instead of looking at the entire homeless population comprehensively and organizing services by acuity, this legislation takes us back to what I have often referred to as “pet population” approach where decisions are not driven by data, but are inherently driven by feelings of a deserving and undeserving poor.
Would more resources help communities better meet the needs of unaccompanied youth and children in families experiencing homelessness? Yes. But let us be pragmatic and realistic and start with households that are unsheltered and languishing within shelter.
Are there many households living in poverty? Yes. But let us rethink income supports and government benefits, access to employment, and food security. It would be terribly unfortunate to use homeless resources to combat these structural issues. S.256 is misguided in wanting to address these fundamental problems through homeless resources, and without additional funding. I also feel it will let elected officials off the hook by not engaging them in the structural issues and not having to provide additional funding (which is one of the greatest measures of priority for a person in office – where they put your tax dollars).
Should we improve services to youth and families experiencing homelessness? Yes. I will submit that some communities have put the needs of chronically homeless single adults above the needs of all others and that is a problem. I argue that we need to look at the depth of needs of all people experiencing homelessness regardless of whether they are a single adult, family or unaccompanied youth and allocate resources accordingly rather than considering sub-populations in isolation.
I urge you to pause and think of the broader implications if this becomes law. We need a more thoughtful, involved process rather than tagging this onto an unrelated appropriations bill. Now is the time to contact your elected officials with urgency and purpose to let them know you support ending homelessness and this Act, while it sounds good, actually does more harm than good.
Time Sucks that Get in the Way of Ending Homelessness
I think homelessness should be ended with a sense of urgency, married with strategy and intelligent, effective programs. However, there are a bunch of things that get in the way on a day to day basis that suck up time and interfere with achieving results.
1. Useless Meetings – homelessness has never been ended in a meeting or committee. This is not to say meetings can have no value (they can) but make sure you know why are are meeting, for what purpose, and the intended result of the meeting. Also, don’t send multiple staff to a meeting from one organization when one will do.
2. Complaining – last I checked complaining about co-workers, other organizations, paperwork, or how hard it is to find housing did not actually solve any of those problems.
3. Gossiping – you may find it titillating to keep abreast of who is screwing who, who is about to be fired, or what client did what to whom, but I fail to see how that actually helps end homelessness.
4. Procrastinating – I think you will find action today beats planned action at some undefined later point of time.
5. Waiting for Something to Happen – whenever you have the ability to influence the timeframe within which things happen, you should, rather than waiting for others to make decisions for you.
6. Indecision – to not make a decision is actually a decision. And while you may be waiting for the perfect piece of data (or even wishing the thing you need to make a decision about just disappears) lives are lost during your time of indecision.
7. Always Answering Your Phone – YOU decide when it is best to answer YOUR phone and engage with the person calling YOU. Someone wanting to get in touch with you should not trump other important work you are trying to get done. Voicemail was invented for a reason.
8. Distractions by Email Pop-ups – remember when we did not have technology strapped to us all day long? Even if you can’t, allow me to remind you that it is possible for YOU to decide when to engage with email, not for an email notification to rule your behaviour. Turn off the pop-ups. Schedule your email check-ins.
9. Playing Email Pong – remember the classic arcade game Pong? I feel people use email that way. I hit it over to you. You hit it over to me. I hit it over to you. And so on. Call me crazy, but maybe a face to face conversation is in order, if possible, if all emails are a steady chain of back and forth.
10. Not Documenting Solutions – having the same discussions about the same issues over and over and over again is a huge time suck. Write down what was agreed to. Stay to it.
11. Being Caught up In the Incompetence of Others – you can control your own performance. You cannot control the performance of other people or organizations. Focus on being awesome yourself. Don’t waste your time lamenting how terrible another service provider is because you do not control what they do.
12. Manually Documenting Case Notes – newsflash: there are various apps you can put right on your phone that allow you to dictate your case notes. Then you just copy and paste them right into your HMIS or other data system. Go from hours of documentation to mere minutes.
13. Dog and Pony Shows – doing a series of small presentations on what you do and how you do it can eat up tons of time in any given week. Put your PR and educational stuff on a website, or pull together less frequent, but larger gatherings to explain what you do and how you do it.
14. Mistaking the Urgent for the Important – some people are busy all day, but actually accomplish nothing. The reason? They are caught up in crisis after crisis, or pressing issue after pressing issue. Being run off your feet but not getting anything actually done is a huge waste of time.
Quit the Dreaming and Start the Effective Goal Setting
Dreams can be inspiring.
But they are imaginary. A dream exists only in your mind. Dreams actually don’t come true: goals do.
If you have an issue you are trying to address in your community or your own life, you may dream of a different reality. For example, you may dream that you have more help, or that there was more money available, or that someone (always an unnamed “someone”) will fix legislation or change policy or free up more resources. It becomes problematic when that dream becomes the cornerstone of a plan or call to action because it won’t come to fruition. It will be just another document that sits on a shelf (even though people may have busted their butts to research and consult and have community meetings to create it in the first place)
Let’s say $1 Million is required to put the necessary program in place in your community to address a well defined problem. A plan may identify that the $1 Million is required and why. But that is just a dream unless you can identify HOW the $1 Million will be secured (it won’t drop from the sky, and government doesn’t just drop that kind of coin out of nowhere). You need a goal of outlining how the money will be secured, by whom, and how it will be allocated.
Let’s say 500 units of housing are required to address the current volume of chronic homelessness in your community. A plan may well identify that the 500 units are needed and even articulate subsections of the chronic homeless population that would benefit (families, veteran’s, persons leaving incarceration, etc.). But this is just a dream unless you can identify HOW the 500 units will be secured (no developer is just going to hand over keys to 500 units, and government has not been investing in housing development at this scale for quite some time in most jurisdictions). You need a goal of outlining how the housing will be developed or secured, by whom, and how it will be provided to the 500 households identified as needing it.
People get confused and think plans are a wish-list or an advocacy document. They are not. A plan outlines a sequence of actions that will get the desired result(s) for the desired purpose(s). When a plan doesn’t work and people start point fingers at others because of lack of investment or such, I say shame on the plan creators. Clearly the plan lacked effective goals. It lacked a clear pathway from point A to point B (or whatever point it needed to get to).
Some people get confused thinking that if they have a plan that identifies an issue then others will feel the heed to take action. This is false on a couple of fronts. First of all, the purpose of plan is not to simply shine a light on an issue. It has to have a realistic set of steps that can be taken to actually solve the problem. Secondly, if the only way the issue gets fixed is “someone” else doing “something” then it isn’t a plan. There are no goals identified to put the change into place. The so-called plan is just a dream of what people wish. There is nothing realistic.
Look at the change you want to see in your life or in your broader community or your workplace. If you want to succeed in making the change you need to know the difference between goals and dreams, and you need to make sure you are focusing on goals. Ask yourself these questions:
1. Do I have a deadline?
Goals are time limited. Dreams can last a lifetime without ever being achieved. If a goal cannot be reached within a specified time it is time to either change the actions so that doing so becomes possible. Or it becomes necessary to recalibrate the goal.
2. Am I investing time, money, and effort to achieve the desired results?
If so, you have a goal. Dreams are free. It costs nothing to fantasize about a desired future. Goals require investment.
3. Is what I am doing grounded in reality?
Goals can be big. They can be audacious. They can be challenging. But they most definitely need to be grounded in the reality of circumstances. If something relies upon non-existent money, human resources or materials to be successful, chances are you have a dream, not a goal.
4. Do I have a clear focus of what needs to be achieved and how to do it?
If so, that is a goal. If not, you likely have a dream. Dreams are fluid. Dreams can perpetually change. Goals may get refined, but if it is the right goal, it doesn’t change.
5. Am I doing or am I thinking?
Goals require ACTION. Dreams can happen without ever actually doing anything (or only writing something on paper and then doing nothing more).
6. Do I control or influence the resources necessary to make this happen?
Whenever somebody or a plan says “the government must do x” or “the business community must do y” or “everyone else in this industry must do z” it is in the realm of dreams not goals. If you do not control or have influence over the resources, then getting the end result is going to be darn near impossible and probably lands you in dream land. (Unless, of course, your goal is to achieve results through advocacy or policy change, but even then you have to have clear metrics of measuring this achievement, not a blind dream of others changing.)
7. Am I producing tangible results?
Goals produce results. Dreams wish results happened or blame others for results not happening. If results are happening, then chances are you have a realistic, producing goal.
Health & Homelessness: This Should Make You Focus on Solutions
We need to focus on housing people experiencing homelessness – families, single adults, and youth. With only a few exceptions (obesity, cancer, stroke), people experiencing homelessness are more likely to experience every other category of chronic health condition. When you consider that some conditions like TB, HIV, diabetes, mental illness, etc. are extremely difficult to control, treat or cure without adequate housing, the impetus to focus on housing should be even greater.
Charity – feeding people on the street, handing out clothes, casual handouts – will not provide an environment where these health conditions can be satisfactorily addressed. Sheltering will not provide an environment to address these health conditions satisfactorily. Housing is required. And then intensive supports and health care. Sometimes there are, what are called “innovations”, really intensive health supports in shelter settings, but these do not create the necessary environment for ongoing wellness.
Certain illnesses while homeless are almost a death sentence. Chronic issues with liver, kidneys, heart, lungs or stomach pretty much make it game over. HIV status is also more terrible to experience as a homeless person than a housed person, and is more likely to result in AIDS.
Unlike the general population with a major health issue, people experiencing homelessness are more likely to have more than one health issue (a 1989 JAMA article showed 8-9 co-occurring health issues within homeless persons was average), and are more likely to deal with co-occurring issues such as a mental health disorder with a physical health issue, or a physical health issue while also having a substance use disorder. As if that was not bad enough, homelessness increases risks for trauma as a result of assault or rape (especially within women experiencing homelessness). It also makes people more reluctant to access care, or believe that they are going to get suitable care when sick.
At the same time, the provision of services in most communities does not focus on health, nutritious feeding. The lack of nutritious food security is a huge issue. This doesn’t meant food is scarce. On the contrary, food can be plentiful. BUT (and this is important) it is rarely prepared to the same standards and inspection controls as you would find in a restaurant, and it is rarely prepared with the perspective of safe food handler guidelines or public health seal of approval.
Then there are other matters like suicide, which should be considered a health issue. Did you know that rates of suicide are higher within the homeless population than the general population? Did you know that between a quarter and half of most homeless populations have made attempts at suicide or experience suicide ideation? The longer you are homeless (beyond six months) the greater the risks for suicide.
Dermatological conditions such as scabies, lice and allergic reactions are way more common in the homeless population than the general population. Imaging the irritations experienced as a result of these. Then imagine what it must feel like to cope with stress, other health issues, and a housing search at the same time.
Then there are women-specific health issues that MUST be considered. Rates of mental illness amongst homeless women are higher than homeless men – by a landslide. STIs within homeless women – most often as a result of prostitution or survival sex – are very high. Most women experiencing homelessness do not receive “routine” scanning and preparatory health access, from breast screening to appropriate gynaecological screening.
I could go on. The matter at hand though, begs the question – so what?
Good housing policy is actually good health policy. Policy that focuses on ending homelessness essentially is health promotion policy. Health promotion saves lives. It also saves money. We need to end homelessness if we want to promote health. And the healthier people that have experienced homelessness are, the healthier all of our society will be. Not a bad thing at all.
Unit Inspections: Are They Necessary Before Moving People into Housing?
I suspect you, like me, want to see program participants move into apartments that are clean, functional, and helps promote the dignity of being housed. Avoiding slumlords is a must. Avoiding units and buildings that are literally falling apart or are unsafe is a must. Is a unit inspection by a third party or a specific staff person with expertise inspecting units necessary to ensure that a unit is in decent shape and suitable to move into and live within necessary?
There is a lot of variation in how this is handled in communities across the United States and Canada. There is not tried and true method for doing it best. I think, however, the 5 biggest factors for consideration are:
Consistency in unit standards – the degree to which a unit may or may not be habitable should not be contingent upon opinions of whomever is doing the assessment;
Scope of assessment – ensuring that what is reviewed is focused on habitable and what would be within a tenant’s sphere of influence to correct or modify if there are deficiencies…not a complete building condition study or engineering audit;
If the process unduly interferes with the ability to get people housed rapidly – while many communities struggle to find housing that is within an affordable price range which already impacts the speed with which people can be housed, having to wait weeks or months for an inspection to occur after a unit has been identified is a no-win situation;
Caliber and reputation of the landlords – the ways in which smaller unit landlords/owners manage their product is often different from how larger property managers/landlords manager their entire portfolio;
Consumer choice – we offer housing choices and not housing placements, and the end user of our services should get a direct say in whether the quality of a particular unit meets her/his/their needs rather than being told by a program that they would be permitted or not permitted to live in a particular dwelling.
If a community/organization does not go the route of having a dedicated staff person to expediently handy unit inspections, that does not mean a unit should not be inspected. Housing support workers/case managers can be trained on how to do a layperson unit inspection prior to move in, which focuses on the same major parts of a dwelling that a third party or dedicated inspector would examine. Using a simple checklist it is possible to remark on the state of repair of such things as water, electricity, general wear and tear, doors, windows, sleeping area, closets, bathroom, kitchen, etc. prior to move in. We also recommend pictures be taken and stored prior to move in so that if there are any complaints or considerations there is documented visual proof of what the unit was like prior to moving into the housing.
If a community/organization continues to want third party or special staff to do the unit inspections, I would recommend that community/organization to be clear with itself on how they believe doing so adds value to the process, and whether there is any household unduly or negatively impacted by the process.