# Presentation: 047484

## Creating and ImplementingState-level Polices

- Blake Chard
- Deputy Secretary
- Washington State Department of Social and Health Services (DSHS)

- Washington State
- Department of Social
- & Health Services

## Overview

- Homeless Housing and Assistance Act
- Interagency Council on Homelessness
- Collaboration in Action
- Examples of Collaboration

## Homeless Housing and Assistance Act (HB 2163)

- Mandated State 10 Year Plan
- Annually conduct a Washington homeless census or count
- Homeless housing account
- Funding by local document fee
- Interagency Council on Homelessness
- Section creating required Cabinet level
- Governor vetoed that section

## Interagency Council on Homelessness (ICH)

- Governor directed ICH be created and Departments to participate with senior staff
- Community, Trade, and Economic Development
- Corrections
- Social and Health Services
- Health
- Veterans Affairs
- Employment Security
- Governor’s Office of Financial Management

## Collaboration in Action

- Formal agreements and/or Memorandums of Agreement vs. Contract
- Valuable tool to establish initial and ongoing relationships and expectations
- Complex systems
- Public, private, or faith-based
- Local, State, or national
- Little or no contractual or leverage over partners
- Opportunity to meet others from different “industries”
- Medical
- Housing
- Transportation
- Education
- Employment
- Criminal justice

**Notes:**
Policies and procedures, as well as contract language, Inter-Intra-agency Agreements and Memorandums of Understanding (MOUs) addressing discharge are written and operationalized in multiple state and local systems.  The challenge continues to be the direct linking of discharges to housing units immediately when the units are needed. 
At the local and state levels, policies and procedures throughout Washington have increasingly included formal agreements and/or Memorandums of Agreement (MOU) to implement issues where partnerships, rather than contracts, are the mechanisms for complex systems change. 
Working together to develop agreements on collaborative efforts is often the first time people from different “industries” such as medical, housing, transportation, education, employment, and criminal justice, have had the chance to learn about the barriers and opportunities for others.
Since agencies at all levels, whether public, private or faith-based, often don’t have contractual or leverage over partners they wish to work with, agreements and/or MOUs may be a valuable tool to establish initial and ongoing relationships and expectations.

## Examples of CollaborationsPublic-private partnerships

- Corporation for Supportive Housing
- Integrated housing and services for persons with disabilities, particularly targeting mental illness and substance abuse
- Sound Families
- Goal to create network of 1,500 units of housing with services for families in transition out of homelessness in Pierce, King and Snohomish counties
- http://www.soundfamilies.org/
- Washington Families Fund (WFF)
- Expand service-enriched affordable housing for homeless families throughout Washington State
- Established by the Washington Legislature in 2004
- Fund leveraged initial $2 million appropriation to attract private investments and is expected to reach $5 million by year's end

**Notes:**
Corporation of Supportive Housing
A very active Taking Health Care Home cross-systems workgroup, funded by the Cooperation for Supportive Housing and Robert Wood Johnson and including the U.S. Interagency Council on Homelessness regional representative, Region X HUD staff, and state and local partners, has been working for several years to connect medical care, mental health and other services with housing for the homeless. Robert Wood Johnson includes funding for an evaluation of these grant activities. 

MOU between partners at local, state, federal levels with the Corporation for Supportive Housing to initiate integrated housing and services for persons with disabilities, particularly targeting mental illness and substance abuse. 

Sound Families 
A $40 million from the Bill & Melinda Gates Foundation launched the Sound Families Initiative, a program to develop new housing with support services for homeless families, or families in danger of becoming homeless in King, Pierce and Snohomish counties. 
This program will help homeless families in a number of ways beyond putting a roof over their heads. Research has shown housing alone is probably insufficient to pull families out of homelessness. Services include on-site case management, job search and referral services, and tenant education. 

Sound Families Initiative has created a true private-public partnership. The program unites the vision and resources of the foundation with the expertise of the seven public jurisdiction partners from the Puget Sound area. The public partners have further offered their capacity for ongoing asset management of the projects.

Snohomish Housing Authority, Everett Housing, King County Housing Authority, Seattle Housing Authority, Renton Housing Authority, Pierce County Housing Authority and Tacoma Housing Authority have all entered into an agreement to use rental subsidy funds (Section 8) to provide a source of operating funds to Sound Families funded projects. These housing authorities have also agreed to provide an individual rental subsidy voucher to each family that graduates from the service program of each Sound Families’ sponsored project. 

Evaluation is an integral part of the Sound Families Initiative. The latest evaluation update prepared by the University of Washington School of Social Work illustrates positive results for homeless families.

Washington Families Fund (WFF). 
The WFF is a public-private partnership to expand service-enriched affordable housing for homeless families throughout Washington state. Established by the Washington Legislature in 2004, the fund fills a critical need by providing stable, long-term funding for housing-based services. To date, the fund has successfully leveraged the Legislature's initial $2 million appropriation to attract private investments and is expected to reach $5 million by year's end.  

## Examples of Collaborations

- State Agencies MOU
- Housing
- Corrections
- Health
- Social Services
- Maximize opportunities to coordinate and integrate housing and social services
- Low-income people
- People with disabilities
- Individuals/families experiencing chronic homelessness

## Examples of Collaborations

- SSI/SSDI Outreach, Access, and Recovery (SOAR)
- Homeless Outreach, Stabilization, and Transition (HOST)
- Expedited Medical Determinations
- Housing High-risk Offenders

## SSI/SSDI Outreach, Access and Recovery (SOAR)

- Technical assistance grant awarded
-  DHHS, HUD, DOL, and VA
- Train case managers to expedite access to Social Security disability and other benefits to:
- Homeless individuals
- Including individuals discharging from state and local institutional settings
- Includes an evaluation component with the Social Security Administration to measure success

## Homeless Outreach, Stabilization and Transition (HOST)

- Downtown Emergency Services Center of Seattle County
- Goal of providing services and housing for the chronically homeless with serious mental illness or co-occurring serious mental illness and substance abuse/chemical dependency*
- Policies and procedures between DSHS Belltown Office in Seattle and the Seattle County HOST were developed
- *http://www.metrokc.gov/dchs/mhd/host.htm

## Expedited Medical Determinations

- Part of HB 1290 – passed 2005
- Washington RCW 74.09.555
- Key Reentry Requirements
- DSHS required to expedite eligibility determinations and timely access to medical assistance by persons with mental disorders being released from confinement
- Collaboration to develop procedures and processes for coordination with:
- Washington Association of Sheriffs and Police Chiefs
- Department of Corrections
- Regional Support Networks
- Social Security Administration
- Requires Regional Support Networks
- Develop interlocal agreements
- Accept referrals prior to release

**Notes:**

Recognizing the critical need to link these people as quickly as possible to mental health services and treatment, 1290 requires the Department of Social and Health Services to work closely and in concert with the Washington Association of Sheriffs and Police Chiefs, Department of Corrections, Regional Support Networks, and the Social Security Administration to develop policies and procedures that result in speedy medical assistance determinations by our local DSHS Community Services Offices.  

## Expedited Services are for persons with a mental disorder who:
Received Medicaid, SSI, or General Assistance benefits immediately before being confined, or
Received these benefits at any time during the 5 years prior to confinement; expected to be disabled for at least 12 months after release
“Best Practice” Approach
Prerelease planning, including effective screening and assessments
Formal agreements in place
Dedicated eligibility staff for applications, may be outstationed
Time for all parties to build relationships and learn each other’s service populations and service delivery processes

- Received Medicaid, SSI, or General Assistance benefits immediately before being confined, or
- Received these benefits at any time during the 5 years prior to confinement; expected to be disabled for at least 12 months after release
- “Best Practice” Approach
- Prerelease planning, including effective screening and assessments
- Formal agreements in place
- Dedicated eligibility staff for applications, may be outstationed
- Time for all parties to build relationships and learn each other’s service populations and service delivery processes

- Expedited Medical Determinations

- Expedited Medical Determinations

- Cross-Agency Planning Process
- Steering Committee – 15 members representing
- Department of Social and Health Services
- Washington Association of Sheriffs and Police Chiefs
- Department of Corrections
- Regional Support Networks
- Institutes for mental diseases
- Social Security Administration
- Interagency agreements to formalize cooperative efforts
- Information for jails, prisons and IMDS
- Medical, cash, and food assistance programs
- What is needed to determine eligibility

**Notes:**
Section 12 of House Bill 1290 requires the Department to do speedy medical eligibility determinations for people in confinement who meet one of the following criteria:

-  A person who received Medicaid, federal Supplemental Security Income (SSI) disability benefits, of state General Assistance benefits immediately before being confined, or

-  A person who received any of these benefits at any time during the five years before being confined, and the person is expected to be disabled for at least 12 months after release.

## MOU to prevent homelessness by rapidly processing applications for eligibility and benefits for individuals transitioning out of corrections to the community
DSHS local community services office 
Local county jails

- DSHS local community services office
- Local county jails

- Expedited Medical Determinations

- Expedited Medical Determinations

- 14 sites across the State
- Local jails
- Prisons
- Institutions
- Regional Support Networks and mental health providers
- Includes correctional facilities with large inmate populations in Spokane, Yakima, Snohomish, Pierce, Thurston, Clark, and King Counties

**Notes:**
Section 12 of House Bill 1290 requires the Department to do speedy medical eligibility determinations for people in confinement who meet one of the following criteria:

-  A person who received Medicaid, federal Supplemental Security Income (SSI) disability benefits, of state General Assistance benefits immediately before being confined, or

-  A person who received any of these benefits at any time during the five years before being confined, and the person is expected to be disabled for at least 12 months after release.

## What is Department of Corrections (DOC) doing? 
Training 
Staff in major facilities have been trained on the Implementation of HB 1290
A standardized application process has been developed 
Allows for application packets to be submitted within 45 days of release
DSHS and DOC application process consistent
Partnerships
Working relationships developed between agencies and community
Barriers
Work release – if working, denied services
DOC does not document offender’s inability to function in their daily living hindering DSHS ability to make an eligibility determination

**Training **
- Staff in major facilities have been trained on the Implementation of HB 1290
- A standardized application process has been developed
- Allows for application packets to be submitted within 45 days of release
- DSHS and DOC application process consistent
**Partnerships**
- Working relationships developed between agencies and community
**Barriers**
- Work release – if working, denied services
- DOC does not document offender’s inability to function in their daily living hindering DSHS ability to make an eligibility determination

- Expedited Medical Determinations

## Housing High Risk Offenders

- All offenders are assessed** **at intake to determine risk level.
- If an offender is assessed as high risk and has a requirement for supervision, a housing plan must be approved prior to release.
- A Reentry Specialist is assigned to each high-risk offender at least 9 months prior to release.
- A Risk Management Intensive Transition (RMIT) Team is convened to develop an appropriate release plan.
- RMIT includes the offender, staff, providers, landlords, potential employers, etc.—anyone necessary to plan for the success of the individual high-risk offender.

## Future Direction

**Historically**:
- Release planning for high-risk offenders begins 9 months prior to release
**New Direction**:
- Ultimate outcome and most essential statewide responsibility is still to ***increase public safety***
- To do that – major goal in the Department’s 2007–2013 Strategic Plan is to ***increase successful reentry of offenders to communities***
- Release planning begins at intake or even as early as sentencing
- Engage community and family in all phases of release planning
- ALL STAFF are responsible for successful reentry

## National Governors Association

- Center for Best Practices Offender Reentry Policy Academy
- Five States (PA, MN, ME, IN, and WA)
- Cabinet-level members
- Corrections
- Social and Health Services
- Employment Security
- Community and Trade
- County Elected Official