Impactful Outreach

At the recent National Alliance to End Homelessness conference in Oakland, CA I was pleased to provide a presentation on impactful outreach. You can download my presentation here. (Related to this, you can see the recent piece we put out on responding to unsheltered homelessness here, and you can read my thoughts on street outreach in The Book on Ending Homelessness by ordering it here.)

What is impactful outreach?

Impactful Outreach is a professional intervention that is structured, documented and strategic, to meet people where they are at - literally and circumstantially. Impactful Outreach is respectfully persistent in helping people achieve housing and exit homelessness through a process of assessing, understanding and addressing both immediate and housing needs.

The overarching objective of impactful outreach is to reduce and end unsheltered homelessness.

To achieve the overarching objective, impactful outreach shall:

• Be discerning regarding who they want to engage with and why, relative to the community’s priorities

• Know people by name

• Establish rapport

• Meet immediate needs without creating dependency and without enabling

• Focus on connecting people to housing through or outside of CES, and engaging in all processes associated with this (e.g., getting people paper ready)

• Develop strategies to effectively engage with people who do not wish to engage or struggle to engage

• Leverage strengths of various service providers beyond street outreach, within a systems context

• Drive decision-making through the use of data

The impact part is two-fold. For one, it impacts overall unsheltered homelessness by resulting in reductions in unsheltered homelessness in the community. For another, it impacts the lives of each person it touches by moving toward a solution to each person’s/family’s homelessness.

Impactful outreach, in some organizations and communities, disrupts the street outreach paradigm. The measure of effective outreach is not the number of contacts made or provision of goods. Rather, the measure of effective outreach is how many people have their homelessness ended as a result of the outreach intervention.

It must be noted that moving from contact-driven outreach to solution-driven outreach can be a tough sell for some existing outreach teams and for some communities as a whole. There isn’t a magical switch that gets flipped with existing street outreach workers to suddenly become solution-focused in their work. Quite often there is extensive training to be done, and processing of the new approach can require coaching. To be honest, not every outreach worker that currently does contact-driven outreach is able to make the switch to impactful outreach.

At the community level, the paradigm and practice shifts can come with pushback and hiccups along the way. No longer are street outreach workers pseudo-first responders or simply moving from location to location to encounter as many people experiencing homelessness as possible. Impactful outreach is a very targeted approach to street outreach that sees outreach workers engage with a smaller group of unsheltered persons intensely rather than a larger group of unsheltered persons peripherally. The outreach worker, in impactful outreach, is charged with the task of problem solving and getting all of the paperwork and/or documentation in order that will accelerate the unsheltered person in being able to access housing. While quite often housing access comes through Coordinated Entry in impactful outreach, there are some instances where the outreach worker can assist the unsheltered person/family access housing outside of Coordinated Entry-dedicated resources, especially when they have sufficient income.

As more and more communities see rises in unsheltered homelessness, they should examine their current street outreach services. If the way outreach is being delivered is not impactful, we miss the opportunity to impact unsheltered homelessness overall and the lives of many unsheltered persons/families that would benefit from an impactful approach to receiving services.

Police and Effective Responses to Homelessness

I have written about criminalization of homelessness and the likes of Salt Lake City’s Operation Rio Grande before. The ACLU of Utah has done a fantastic job analyzing Operation Rio Grande crime statistics (worth a read) and provides a cautionary tale for other communities that may be at their wits end on addressing street involved behavior and think that upping police engagement from an enforcement perspective is the way to get effective results. I also dedicate a chunk of The Book on Ending Homelessness to why criminalization approaches to homelessness do not and will not work.

So, what is the role of police in order to have an effective response to homelessness?

When it is positive, police can be one of the greatest resources in the work of ending homelessness.

When it is negative, police can be one of the greatest hindrances in the work of ending homelessness.

Analysis conducted by the California Policy Lab at UCLA using over 60,000 VI-SPDAT records from across the country show the unsheltered homeless population has, on average, more than 20 contacts with police in a six-month period. That level of contact should be a call to action to get the work right and positive, resulting in less homelessness because those who are homeless move to housing.

As one police officer who works on homeless outreach remarked to me, “The police are just as guilty as homeless service providers of confusing inputs and activity with outcomes and performance. The police love to quantify activity, usually as a measure of performance. As you can probably guess, it doesn't work very well. If I'm a police officer making loads of contacts (but not actually solving anything), then I'm a superstar. However, if I spend all day working with one client, resolving their challenges, then it is easy to view me as less-than-effective. The police are not good at measuring something they don't traditionally understand, such as homelessness. A case in point: I spent 4-1/2 years on one client. This is contrary to the usual police response model of rolling into a scene, with lights and sirens blaring, resolving a hostage crisis and delivering a baby, all before lunch. Officers in many busy agencies, such as mine, may handle 20-30 calls for service in a shift. The mindset is that calls for service are holding, and we need to clear this call to get to the next one. You cannot get into problem-solving mode if you are always in crisis-response mode. Also slowing down to the molasses-like pace of homeless bureaucracy is a giant leap for cops used to quantity.”

We need to acknowledge and respect that the police are open 24/7/365, and will respond to crisis, no matter what. The ever-expanding list of demands upon their time has increased from the traditional model of apprehending suspects and maintaining the peace, to fulfilling the role of taking on the societal issues that others will not, which can include homeless outreach worker. 

In some communities, police working in homeless outreach have become the only option for helping those that no else will. Their role is often a reflection of a community's (lack of) response to homelessness. In other words, the police fill the service gaps and voids left by others. In these types of communities, it seems to police that every agency wants to pick the low-hanging fruit but no one wants the difficult cases, leaving the police to assist the high-need, high-system utilizers (mostly the chronically homeless) that are not assisted by the more mainstream and popular service providers.

There are common features found amongst those police officers that are doing fantastic work in the pursuit of ending homelessness. Here is what I have found in exchanges and interviews with police that fall into this category:

They don’t see homelessness as a nuisance.

They see homelessness as a condition of housing. The problem to be solved, in the view of those that do it well, is not about getting businesses or members of the general public to be placated by moving people along or temporarily relocating people to jail. It is about trying to find a permanent solution to the person’s homelessness so that whatever “problem” was complained about by others is solved in the best way possible for the person who is homeless.

Effective police homeless outreach realizes that permanently solving an issue also results in reduced calls for service generated by high system utilizers; that getting people to move along solves nothing other than displacing people (and the “problem”) elsewhere.

They believe in Housing First.

Data and analytics changed the way policing occurs. Data and analytics changed the way homeless services occur. When there is an opportunity to provide education on what Housing First is and its practice, those police that believe in evidence-informed practice not only get behind Housing First, they become champions of it. A shock to some communities that have negative experiences with police and homelessness, is to learn that in some communities there are Housing First champions who are police officers.

Noted one of the cops that I engaged for this blog who is a Housing First advocate, “Housing solves homelessness; a concept that seems obvious. However, to the police, this seems counter-intuitive, almost an exercise in rewarding bad behavior. Many cops are conservative; we never had any training in harm reduction or trauma informed care. So, giving a chronically homeless client housing and wrap-around services is a foreign concept.” 

They get training on homelessness.

Many a police officer has shared with me that they didn’t get into policing to have to deal with homelessness. But because they do respond to homelessness issues (a lot in some communities) they start to assume that their experience makes them an expert. The best responses to homelessness by police, especially Homeless Outreach Teams established by a police department, are ones that realize they need training in homelessness if they are going to have a positive impact on homelessness.

They are effective, collaborative communicators.

When police are having a positive impact on homelessness, the officers involved tend to be collaborators with other homeless service providers and the CoC, and effective communicators with people who are experiencing homelessness. They attend meetings not because they have to, but because they see the benefits of being a partner and contributor. Police do not offer housing or homelessness specific services. As such, if they want a solution for someone who is homeless, they need to work with outside agencies. Police who do this work well collaborate with those service providers rather than making unreasonable demands of them.

They change the way the police conduct their business with people who are homeless.

Can the police help someone move from homelessness to housing? The answer is a resounding yes. It takes time like any other support provider, but it is possible, and it is happening in some jurisdictions. One of the common features in many of those places is that the police wear a completely different uniform so they are easily identified as doing something different from enforcement.

They separate engagement and support from enforcement.

Having police involved in the provision of support services does not grant a person who has committed infractions or offenses – homeless or otherwise – immune from enforcement. But having different police involved has been demonstrated to be helpful. You don’t want the person that was offering assistance today to be the person who is putting you in cuffs tomorrow, if it can at all be avoided.

As one cop put it, “I haven't written a ticket or made an arrest in almost 8 years (this makes me an ineffective officer if you utilize traditional performance metrics).”

They don’t try to lead a response they are not trained to lead.

When policing is effective at serving people who are homeless, the police want to work within the strategy that the community has already developed rather than creating their own or parallel process. The police don’t see themselves as above the system of care in these instances, but rather a partner in the system of care.

They respond to encampments differently.

Police that are working hard to have a positive impact on homelessness respond to encampments as part of a coordinated response to resolve without requiring enforcement if at all possible. This is remarkably different from those jurisdictions where enforcement happens without coordination with a service response.

One of the great examples of a police officer in the United States doing positive work to assist those who are homeless is Daniel McDonald in Tampa. His insights and knowledge of the issues of homelessness and panhandling are in such demand that in his time off he runs a consulting business (www.homelesspolice.com) dedicated to helping other police and elected officials better respond to matters of homelessness and panhandling other than a law and order approach. If the ideas in this blog captured your attention and may be of use to your local police response to homelessness, he is worth the time and energy to engage.

It is my hope that we can create more partnerships that are effective between police and service providers. We share a common interest in helping people who are homeless in not being homeless.

Giving Tuesday

For some non-profits, especially medium and large ones, Giving Tuesday is a day to make hay. Nothing wrong with putting money into the organization to help it achieve the mission it aspires to reaching. As one of the biggest philanthropic opportunities of the year, many a non-profit relies upon the generosity of donors on Giving Tuesday to give them the push and resources they need to do remarkable things. Many of those remarkable things only come about because the funding received is unrestricted in the sense that it is not tied to any government funding that may prescribe a certain type of program for a certain population is a certain way (though there is a place for that too).

Giving Tuesday also becomes a sensational example of poverty porn at its finest. By that, what I mean is, organization after organization will go to great lengths to demonstrate they serve the neediest of the neediest. At the same time, said organization will put out a success story or two to demonstrate how incredibly transformative a person or family life can be if only touched by said organization. 

Let's call bullshit when it is necessary.

Sample sizes of one (or two) shouldn't cut it when it comes to Giving Tuesday. Want to be an organization worthy of investment? Want to be a donor that makes a difference?  Stop focusing on outputs and start focusing on outcomes. This shouldn't be a contest of who serves more. If we want to focus on volume of service, needless to say there are oodles of organizations I could mention that see and "serve" lots of people but suck at making a difference in the lives of many if any of them. 

Focus on outcomes. Be an organization that demonstrates your work makes a difference. Be an informed donor. Look at the totality of the volume of households served and see what difference they made in not only accessing housing, but sustaining housing...or not only prepared for a job interview, but got a job and kept it...or not only signed up for assistance to become a better parent, but actually can demonstrate they are parenting better...or not only got access to emergency food assistance, but are now food secure...and so on.

We need great donors and we need great organizations. Thoughtful and results-oriented gets my vote every year. 

The Book on Ending Homelessness

Three years in the writing and over twenty years in the making, The Book on Ending Homelessness is now available here.

I have collected almost everything I have learned about ending homelessness over more than two decades of being immersed in the work from different angles – practitioner, funder, policy developer, researcher, consultant – and put it in one place. It was my intention to ensure there is something for everyone in the book, including frontline practitioners in the homelessness services sector, elected officials, and the general public.

I wrote the book for several reasons. After delivering a keynote address I would frequently get asked if I had a book. When providing policy advice to elected officials or senior public servants, I would often get asked if I had a book. Certain blog posts also resonate with people, and it had been suggested I take ideas from various blog posts and put them into a book. Finally, I wrote the book to take the pulse of my own knowledge on the subject of ending homelessness, and to evaluate what holes in information and practice I possess and take stock of that which I knew to be true and effective.

I have organized the book into six parts: 

1. Homelessness – What It Is and What It Isn't

2. Service Orientation

3. Emergency Services: Shelters, Outreach and Day Services

4. Supporting People that Have Been Homeless in Housing

5. Getting the Money and Policy Parts Right to Make Success Possible

6. Where We Go from Here

The Book on Ending Homelessness offers a range of solutions which I hope will stimulate discussion and encourage action-oriented dialogue on how to effectively respond to the crisis of homelessness. I want this book to help generate even more creative solutions to the ones that I propose. I don't claim to have all the answers or the only answers. Rather, I have endeavored to offer workable strategies, insights and approaches derived from my experience working with hundreds of communities throughout the United States, Canada, and Australia. I have drawn heavily from service providers and communities that have made reductions in homelessness and practiced and funded services in particular ways that have contributed to that result.

Homelessness is one of the most complex social issues of our time. The Book on Ending Homelessness leans into the complexity rather than shying away from it. The book does so in ways that are pragmatic rather than theoretical, firmly entrenched in the day to day realities of responding to homelessness and trying to ensure it is rare, brief and non-recurring.

I will have accomplished my objective with The Book on Ending Homelessness if it results in advancing the work of everyone involved in homelessness. The book, I hope, helps move the needle forward in ending homelessness. I appreciate, as I state at the beginning of the book, that ending homelessness is a bold, whacky, and somewhat preposterous idea to some, while being an entirely possible scenario for others. Perhaps the book can help convert some who think it is impossible to at least giving the idea a solid "maybe" moving forward, and at the same time, provide encouragement to those that already believe to keep going.

I am deeply indebted to the people that have taught me so much in this journey of working to end homelessness. Those partnerships and relationships over the years have made this book possible. Nonetheless, there is still more to learn. There is lots more to do. The work continues. I'd like to think the Book on Ending Homelessness will make the work a tad easier for those that practice in this field and those impacted by homelessness daily. Lastly, it is my hope that the book will help decrease and end homelessness one person, one family at a time.

Using an Intensive Case Management Approach with Rapid ReHousing Resources

The question comes up time and again – is it possible to serve people with higher acuity using Rapid Re-Housing?

The answer, simply, is yes. However, you need to use an Intensive Case Management approach. What does this mean practically speaking?

You are aiming for housing stability within 18-24 months.

Unlike other approaches to Rapid Re-Housing where the sooner you exit the program participant the better, it is a long-game when applying an Intensive Case Management approach. Start the planning with a year and a half in mind which may expand to two years. This will help you with the sequence of things you work on, the intensity with which you apply supports, and how you measure change. Remember, the goal is to achieve housing stability within this time frame. You are not trying to heal or fix the person.

You are applying the five core principles of Housing First.

If you need a quick reminder, they are:

1. No housing readiness requirements

2. Self-determination and choice

3. Recovery orientation

4. Individualized service planning

5. Community and social integration

What does this mean? This means people do not need to be "housing ready" to be a candidate for the ICM approach. Their participation is completely voluntary and they get to determine the type, duration, frequency and intensity of supports. There is a focus on helping people recovery from mental illness, use of substances and their experience of homelessness. All service planning is practical and structured to the unique strengths and needs of the individual. The intention is to have the person integrated with an array of other community resources and meaningful daily activities.

Your caseload is smaller.

Depending on the experience of the worker and the intensity of needs, caseloads tend to be closer to 1:15 or less in an ICM approach, though they can go slightly higher. Caseloads are staggered based upon length of time participants are in the program and their progression towards stability. As people progress out of needing supports, new participants are brought into the program.

Meetings are more frequent and intensive.

In the ICM approach, you can plan on visiting each service participant at least once per week for the most part. Those in the earlier stages of the program may be seen more frequently than that. Those in the latter stages of the program can have their visits spaced out once every two to four weeks.

Each meeting has clear objectives attached to it. There are no "check-ins" or ad hoc engagements to chit chat. The intention is to have clear actions established with each visit that progresses towards enhanced stability.

The service orientation is important.

Delivering the ICM approach requires steadfast alignment to the appropriate service orientation. The biggies are: being person-centred; using a trauma-informed approach; being strengths-based; delivering services in people's natural settings; progressively engaging; reducing harm; promoting recovery and wellness; and, serving compassionately. A deficit in any of these makes the supports less successful.

There are assessments at regular intervals to track progress and amend service plans.

Using the ICM approach requires an assessment process like the SPDAT (the full assessment tool, not the triage VI-SPDAT) at regular intervals. The reason being is to ensure that progress is documented and displayed to the program participant and used in future case planning. Furthermore, the assessment should highlight areas of possible housing instability that need to be addressed, as well as identifying strengths that should be celebrated.

You follow the five essential and sequential steps to housing stability.

The secret sauce is applying the five essential and sequential steps to helping people achieve stability. This means an initial focus on Housing Supports with attention paid to basic needs, supports, safety and relationship impacts. This is followed by Individualized Service Planning with attention paid to life stability, connecting to other systems, increasing social awareness, focusing on employment and education goals, and helping people connect with meaningful daily activities. From there the progression is to Self Awareness focusing on self assessment, triggers and building confidence, and Self Management focusing on control, accountability and maximizing optimism. Finally, the person is in a position where they have Rebuilt/Reframed their life because of a focus on relationship management, social and physical infrastructure, having a purpose and identity not linked to their homelessness, and having achieved the greatest amount of independence possible.

Need help understanding how to do it more than this blog? Reach out to us and you can schedule training with the OrgCode team – info@OrgCode.com

The Cost of Poop

Poop. It happens. For many people, daily. I am talking the real kind – not the metaphoric kind. We all got to go sometime.

Being homeless can mean fewer options of where to take care of this daily need. It is not uncommon in my travels to have people banned from using businesses' and restaurants' restrooms. They may also be banned from the library or city hall. Or it may be after hours and the person has no other options.

Then poop happens. Outside. Sometimes in the most inappropriate places.

In one smaller community I do work, they calculated the cost of poop removal to be $300 during daytime hours and double that after hours. It is a biohazard. It needs to be dealt with in a particular fashion to be safe. And all of this could have been avoided if the person had a place to take a dump.

Let’s say there is only one poop clean-up per day. Let us assume they all happened during the day. $300 per poop multiplied by 365 is $109,500 for the year. Depending on your jurisdiction, that is one or two case managers. Or rent subsidy of $500 for almost 20 people for a year. Poop removal is expensive. And it is money that could go elsewhere if we just figure out lower-cost solutions to the public poop issue.

If we cannot come up with a free solution to the poop issue, there are always portable potties. A quick online search shows me they rent for $175-$400 per month depending on how often they need to be cleaned. Yes, portable potties can present their own challenges (for example, drug overdose inside, drug dealing, location for sex work, etc.) but location and management of the portable toilet can mitigate a lot of that. Let’s say in our smaller community we agreed that five portable potties at $400 per month were to be made available. That is still only $24,000 per year, compared to the over $100,000 per year for public poop removal.

In a perfect world, everyone would be housed rapidly and there would be no need to talk about public poop and its costs and alternatives. But that is more of a dream than a reality. People got to go. If they are banned from everywhere that they can poop for free, then communities need to tackle the issue of where people can go in the meantime. Having to poop in a public space should never be the only option people have to take care of their business.