Meeting the Needs of the Hardest to House Clients

Report
Department of Health and Social Services
Division of Substance Abuse and Mental
Health
DHSS DSAMH
10.7.14
Contents

 Overview of the Settlement Agreement between
State of Delaware and the U.S. Department of Justice.
 Explanation of Target Population
 State Annual Targets
 State Housing Targets
 Housing Programs For Target Population
 Established Partnerships to Meet Housing Targets.
 Target Population Client Challenges and Successes.
DHSS DSAMH
10.7.14
Delaware vs.
U.S. Department of Justice

 USDOJ investigated and issued a findings letter which
resulted in a settlement agreement.
 Delaware’s current mental health system failed to provide
services to individuals with serious and persistent mental
illness (SPMI) in the most integrated setting appropriate
to their needs, as required by the ADA.
 Persons, who could have been served in the community,
had been hospitalized for a prolonged period of time for
the lack of mental health community based services.
 Without comprehensive community mental health
services individuals with SPMI were at risk of
unnecessary institutionalization because that was the
primary place they could receive comprehensive services.
DHSS DSAMH
10.7.14
Delaware vs.
U.S. Department of Justice

 July 6, 2011 Delaware entered into a settlement
agreement with the U.S.DOJ.
 Overarching goal of the agreement is to ensure that
persons with SPMI receive appropriate treatment in
the community.
 The settlement agreement defined the Target
Population to be served.
DHSS DSAMH
10.7.14
Target Population

 Persons with Serious and Persistent Mental Illness
(SPMI) who are currently hospitalized or who are at
the highest risk of institutionalization.
 Persons who have been diagnosed with SPMI and
meet the eligibility criteria as defined through the
Eligibility and Enrollment Unit of DSAMH
 Persons with SPMI and who are funded through the
state systems (DSAMH or Medicaid)
DHSS DSAMH
10.7.14
State Targets
 Crisis Services






Crisis Hotline
Mobile Crisis Teams
Crisis Walk-In Centers
Crisis Stabilization Services
Crisis Apartments
 Intensive Support Services
 Assertive Community Treatment Teams (ACT)
 Intensive Case Management Teams (ICM)
 Care Management Teams (TCM)
DHSS DSAMH
10.7.14
State Targets

 Supportive Employment and Rehabilitation Services
 State shall develop options for people to work or
access education and rehabilitation services.
 Offer integrated employment opportunities.
 Supportive employment providers will adhere to an
evidence-based model.
 Rehabilitation Services – education, substance abuse
treatment, volunteer work, and recreational activities
all which enhance social, functional and academic
skills in integrated settings.
DHSS DSAMH
10.7.14
State Targets

 Family and Peer Supports
 Family Supports are designed to teach families skills
and strategies for better supporting their family.
members’ treatment and recovery in the community.
 Peer Supports are services delivered by trained
individuals who have personal experience with mental
illness and recovery.
DHSS DSAMH
10.7.14

 Housing Targets.
 FY14 Housing Target – 100 integrated units – total of
550.
 FY15 housing target of 100 more integrated units for a
total of 650.
 FY16 State to assess need and provide additional units.
DHSS DSAMH
10.7.14
Status of State Compliance

 State completed the third year of a five year
Settlement Agreement – June 30, 2014.
 State has met and exceed 90% of its Targets
DHSS DSAMH
10.7.14
State Targets

 Housing
 No more than 20% of the units in a building and/or
apartment complex can be occupied by known
persons with SPMI.
 No more than 2 people can live together – the 2 people
have to have been given the opportunity to live alone
and they choose their roommate.
 Fund Rental Subsidies or Vouchers.
 State will provide Bridge Funding – deposits and
funds for household items.
 Provide 650 integrated units throughout Delaware.
DHSS DSAMH
10.7.14
Meeting the Housing Needs
Target Population Clients

 Clients who have been institutionalized for a period
of time may have lost their community living skills
or may never have learned them.
 Clients have co-occurring disorders with substance
abuse being an issue.
 Clients have criminal backgrounds (caused by their
disability) which could challenge lease approval.
 Clients have credit issues which could affect lease
approval.
DHSS DSAMH
10.7.14
Meeting the Housing Needs
Target Population Clients

 Landlords reluctant to participate in a voucher
program.
 Landlords unfamiliar with the supportive services
that assist the client.
 Stigma of a mental health disability.
DHSS DSAMH
10.7.14
Creative Housing Solutions
Target Population Clients

 DSAMH developed multiple housing programs to
address the needs of the Hard to House Clients in
the Target Population.






Crisis Beds
Resource Beds
Transitional Housing Beds (TH)
Supervised Apartment Program Beds (SAP)
State Rental Assistance Program Vouchers (SRAP)
Section 811 Demonstration Program
DHSS DSAMH
10.7.14
Crisis Beds

 Two houses 4 beds each.
 One in NCC and one in Kent/Sussex
 3-5 day stay.
 Crisis intervention to divert clients from going into
the hospital.
 Average number of clients served a month per house
– 9.
 Average length of stay 10 days.
 24/7 supervision.
DHSS DSAMH
10.7.14
Resource Beds

 Offered to clients who are discharged from DPC and
are new to the ACT Team.
 Total 10 beds.
 Opportunity to assess the client to determine which
housing program would be best for them..
 Length of stay depends on the needs of the client.
 Units managed by Columbus Property Management
through master lease program.
 Supervision
DHSS DSAMH
10.7.14
Transitional Housing

 Beds available through the state – 20 beds.
 Managed by NAMI and Columbus Property.
Management Master lease program.
 Designated for clients who are discharged from DPC
and have SRAP voucher.
 Length of stay – 3 to 6 month stay.
 Little or no supervision.
DHSS DSAMH
10.7.14
Supervised Apartment Program

 Before Settlement Agreement SAP was managed by
the service providers.
 After the Settlement Agreement DSAMH redesigned
the program by separating housing management
from supportive services.
 Housing management – Columbus Property
Management.
 On site supervision – Recovery Innovations.
 Master lease program 8 properties throughout the
state – 145 beds.
DHSS DSAMH
10.7.14
State Rental Assistance Program

 Developed by DSHA in partnership with
Department of Health and Social Services (DHSS)
and the Department of Services for Children, Youth
and their Families (DSCYF).
 The clients of the Division of Substance Abuse and
Mental Health (DSAMH) are the primary recipients
of the SRAP vouchers: as a result of the Settlement
Agreement and the Housing Targets
DHSS DSAMH
10.7.14
State Rental Assistance Program

 Voucher program similar to the Section 8 voucher
program.
 Clients have a case manager who assists them in all
aspects of the application process to finding housing
and on going while in housing.
 Case managers and clients work in tandem on
housing issues.
 Partnerships between landlords and the Service
providers, Housing Counselors and DSAMH
DHSS DSAMH
10.7.14
Section 811

 Partnership between DSHA and DHSS.
 Project Based rental Assistance for DHSS enrolled
clients form all Divisions.
 Units in Tax Credit Properties throughout the state
 DSHA and DHSS Housing Team working on referral
procedure and will be launched by the end of the
year 2014 (we hope).
DHSS DSAMH
10.7.14
Successes

 Successes
 Conducted outreach meetings with landlord
associations.
 Landlords all over the state willing to rent to clients
with SRAP voucher.
 Over 350 clients have been housed within a three year
period in SRAP.
 Over 200 clients have been housed in SAP, TH and
Resource Beds.
DHSS DSAMH
10.7.14
Successes

 Landlords willing to participate in the master lease
program.
 90% of the clients living in SRAP housing are
successfully living in the community receiving
community based services.
 33% of the clients living in Supervised Apartments are
ready to move into a more independent setting.
DHSS DSAMH
10.7.14
Contact Information

 Carlyle Hooff, Director of Behavioral Health
Community Integration – Housing
 302-225-2780
 [email protected]
 Melissa Smith, Deputy Director DSAMH
 302-225-9427
 [email protected]
DHSS DSAMH
10.7.14

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