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:
- No housing readiness requirements
- Self-determination and choice
- Recovery orientation
- Individualized service planning
- 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