GUIDE TO INTENSIVE CASE MANAGEMENT IN CANADA

Transcription

1 GUIDE TO INTENSIVE CASE MANAGEMENT IN CANADA A RESOURCE FOR THOSE CREATING AND SUSTAINING AN INTENSIVE CASE MANAGEMENT PROGRAM UTILIZING THE HOUSING FIRST MODEL Karen Poffenroth

2 PARADIGM SHIFT MANAGING HOMELESSNESS TO ENDING HOMELESSNESS 10 YEAR PLANS PRIORITIZING HOUSING PROGRAMS OVER TRADITIONAL HOMELESSNESS MANAGEMENT PROGRAMS SHIFT AWAY FROM LAYING BLAME HARM REDUCTION COMMITMENT TO HOUSING FIRST PROGRAMMING INCREASED EMPHASIS ON USING INTENSIVE CASE MANAGEMENT TO TRANSITION PEOPLE OUT OF HOMELESSNESS

3 INTRODUCTION TO HOUSING FIRST HOUSING IS A HUMAN RIGHT INDIVIDUALS DO NOT NEED TO PROVE THAT THEY DESERVE HOUSING OR ARE HOUSING READY SUBSTANCE USE AND NON-COMPLIANCE WITH MENTAL HEALTH TREATMENT ARE NOT BARRIERS TO HOUSING GOAL IS TO PREVENT A RETURN TO HOMELESSNESS

4 INTENSIVE CASE MANAGEMENT INTENSIVE CASE MANAGEMENT PROVIDES SUBSIDIZED HOUSING INTENSIVE AND FLEXIBLE SUPPORT FOCUS ON INDIVIDUALIZED PSYCHO-SOCIAL RECOVERY FOCUS ON HOUSING RETENTION RATHER THAN EVICTION PREVENTION

5 COST OF HOMELESSNESS VS COST OF HOUSING FIRST $60,000 $50,000 $40,000 $45,743 $30,000 $20,000 $10,000 $0 $9,660 Before Housing $18,283 $2, Months After Being Housed Cost of Homeless Shelter Cost of Public Systems Use Cost of Housing Program with Supports CALGARY HOMELESS FOUNDATION 2013

6 SYSTEM USE REDUCTION IN HOUSING FIRST 100% 90% 80% 70% 60% 50% 40% Before Housing After Housing 30% 20% 10% 0% Police Interactions Incarcerations Hospital Stays EMS Use Emergency Room Visits CALGARY HOMELESS FOUNDATION 2013

7 CALGARY WAS LOSING PROGRAM EXPERTISE DUE TO STAFF TURNOVER HOMEBASE IS IDENTIFIED AS THE LOWEST BARRIER, HIGHEST ACUITY, HARM REDUCTION, SCATTERED-SITE HOUSING FIRST PROGRAM IN CALGARY (MAYBE IN CANADA) HAVING ENDURED THE GROWING PAINS OF A HOUSING FIRST PROGRAM WE WANTED TO SHARE OUR KNOWLEDGE AND OUR (SOMETIMES PAINFUL) LESSONS LEARNED

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9 MORE AND MORE PROGRAMS ARE BEING GRANTED FUNDING WITH THE EXPECTATION THAT THEY USE THESE DOLLARS TO PROVIDE HOUSING AND SUPPORT SERVICES FOR THE MOST VULNERABLE AND HIGH ACUITY CANADIANS EXPERIENCING HOMELESSNESS..AND THEN THEY START TO PANIC

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13 WE NOW KNOW THAT: THERE IS A VERY LARGE PORTION OF CANADA THAT IS NOT LOCATED IN CALGARY CANADA HAS MANY MANY PERSONS EXPERIENCING HOMELESSNESS OTHER PROGRAMS ACROSS CANADA ARE FACING THE SAME CHALLENGES THAT WE DID ONE, THREE AND SEVEN YEARS AGO WE GOT REQUESTS FROM ALL OVER CANADA FOR THIS RESOURCE, YET PEOPLE FOUND THAT THERE WAS A LOT OF CALGARY SPECIFIC CONTENT THAT WAS NOT APPLICABLE TO THEIR REGION

14 ROLE OF THE RESOURCE PROVIDES GUIDELINES AND SUPPORT FOR AGENCIES AND PROGRAMS INTERESTED IN ICM AND/OR HF PLANNING TO IMPLEMENT ICM AND/ORHF INCREASE ICM AND/OR HF ADHERENCE AND OUTCOMES IN EXISTING PROGRAMS PRACTICAL SOLUTIONS FOR CLINICAL INTERVENTIONS PROGRAM PLANNING ADMIN AND FINANCES FUNDING STRUCTURE

15 INTRODUCTION THEFUNCTION OF THIS RESOURCE:

16 UNDERSTANDING HOMELESSNESS AND THE ROLE OF HOUSING FIRST IN CANADA HOMELESSNESS IN CANADA: CANADIANS EXPERIENCING HOMELESSNESS: TAKING ACTION TO END HOMELESSNESS: HOUSING FIRST: HOUSING FIRST IN CANADA: HOUSING FIRST FOR ABORIGINAL CANADIANS: FINANCIAL BENEFITS OF HOUSING FIRST: SYSTEMS USE REDUCTION THROUGH HOUSING FIRST PROGRAMS:

17 INTENSIVE CASE MANAGEMENT FOR ENDING HOMELESSNESS CASE MANAGEMENT FOR ENDING HOMELESSNESS: INTENSIVE CASE MANAGEMENT: ENHANCEMENTS TO INTENSIVE CASE MANAGEMENT PROGRAMS: PLACE-BASED AND SCATTERED-SITE MODELS OF SERVICE:

18 REFERRAL AND SCREENING CENTRALIZED INTAKE AND TRIAGE: THEINTAKE PROCESS: BASELINE FUNCTIONING/ACUITY SCALE: THE SPDAT:

19 ASSESSMENTS ASSESSMENTS: SELECTING TOOLS AND ASSESSMENTS: MULTNOMAH COMMUNITY ABILITY SCALE: COMORBID CONDITIONS LIST: GLOBAL APPRAISAL OF INDIVIDUAL NEED - SUBSTANCE PROBLEM SCALE: EQ-5D: QUALITY OF LIFE INDEX: COLORADO SYMPTOM INDEX: OUTCOMES STAR

20 IMPLEMENTING INTENSIVE CASE MANAGEMENT THE ART OF INTENSIVE CASE MANAGEMENT: CASE MANAGEMENT STANDARDS OF PRACTICE FOR ENDING HOMELESSNESS: HOUSING FIRST PRINCIPLES:

21 IMPLEMENTING INTENSIVE CASE MANAGEMENT THE ART OF INTENSIVE CASE MANAGEMENT: CASE MANAGEMENT STANDARDS OF PRACTICE FOR ENDING HOMELESSNESS: HOUSING FIRST PRINCIPLES: INDIGENOUS HOUSING FIRST PRINCIPLES: DEVELOPING PROGRAM DOCUMENTS: SELECTING PROGRAM SPACE: COMMUNITY ENGAGEMENT: THE IMPORTANCE OF THE HOME VISIT:

22 IMPLEMENTING INTENSIVE CASE MANAGEMENT RISK ASSESSMENT/MANAGEMENT: EQUIPMENT: CLIENT INFORMATION MANAGEMENT: ACCREDITATION THROUGH THE CANADIAN ACCREDITATION COUNCIL: SUMMARY OF THE PROCESS OF ACCREDITATION: COMMUNITY PARTNERSHIPS: RECOMMENDED RATIOS: PROVIDING 24/7 SUPPORT:

23 HOUSING HOUSING AND RE-HOUSING: LANDLORD RELATIONS AND SECURING HOUSING: EVICTION PREVENTION VS. HOUSING RETENTION: RENTAL SUBSIDIES AND OTHER COSTS OF HOUSING: HOUSING SUPPORT: PROVISION OF BASIC FURNITURE AND NECESSITIES:

24 KEY PRINCIPLES OF EFFECTIVE INTENSIVE CASE MANAGEMENT ENGAGEMENT IN THE HOME: HARM REDUCTION: HARMREDUCTION VS. HARMACCEPTANCE: RECOVERY ORIENTATION: INDIVIDUALIZED RECOVERY PLAN: MONITORING AND EVALUATION OF THE INDIVIDUAL RECOVERY PLAN: PERSON CENTERED CARE:

25 KEY PRINCIPLES OF EFFECTIVE INTENSIVE CASE MANAGEMENT CULTURAL COMPETENCY: INDIGENOUS CULTURAL COMPETENCY: INDIVIDUALIZED ASSERTIVE ENGAGEMENT: STAGE-WISE SERVICE PROVISION: STAGES OF CHANGE: THE ROLE OF TRAUMA IN HOMELESSNESS: THESUPPORTED FAIL AS A THERAPEUTIC INTERVENTION: OUTSOURCING AND COMMUNITY LINKAGES:

26 STAFFING INTENSIVE CASE MANAGEMENT PROGRAMS STAFFING: HIRING PRACTICES: CORPORATE CULTURE: STAFF RETENTION: SUPERVISION/FIELD SUPERVISION: RECOMMENDED TRAINING: STAFF CARE AND SELF CARE:

27 ENDING THE INTENSIVE CASE MANAGEMENT RELATIONSHIP GRADUATION: PLANNED DISCHARGE: UNPLANNED DISCHARGE:

28 SUMMARY: SUMMARY

29 TOOLS FOR INTENSIVE CASE MANAGERS HOME VISIT TIP SHEET FOR INTENSIVE CASE MANAGERS: SAMPLE RECOVERY PLAN: SAMPLE POINT OF CONTACT SHEET FOR LANDLORDS: SAMPLE CONTACT SHEET FOR CLIENTS

30 TOOLS FOR IMPLEMENTING INTENSIVE CASE MANAGEMENT SAMPLE PROGRAM BUDGET: CORE COMPETENCIES: JOB DESCRIPTIONS: SAMPLE ORGANIZATIONAL CHARTS:

31 WE NEED YOU PLEASE COME SPEAK TO US IF YOU ARE INTERESTED IN CONTRIBUTING PROGRAM DATA, A CASE STUDY, OR A QUOTE TO THE UPDATED NATIONAL RESOURCE

32 THANK YOU