# Presentation: 017600

## New Tools for Engagement-”Housing First/Work Fast”

- Presented by:
- Gary Shaheen & Ann Denton
- Advocates for Human Potential, Inc
- _[gshaheen@ahpnet.com](mailto:gshaheen@ahpnet.com)_
- _[adenton@ahpnet.com](mailto:adenton@ahpnet.com)_

## Contact Us!

- Gary Shaheen, Managing Director, Advocates for Human Potential, Inc. New York Office. 2 E-Comm Square, Albany, NY (518) 475-9146, ext. 243 _[gshaheen@ahpnet.com](mailto:gshaheen@ahpnet.com)_
- Ann Denton, Managing Director, Advocates for Human Potential, Inc. Texas Office. 9727 FM 1826, Austin, TX  78737, 512-288-8733 _[adenton@ahpnet.com](mailto:adenton@ahpnet.com)_

## Some Resources

*“**Work as a Priority”* ftp://ftp.health.org/pub/ken/pdf/SMA03-3834/workpriority.PDF
- SAMHSA: www.samhsa.gov
*“**Creating Change: Pushing Workforce Systems to Help Participants* *Achieve Economic Stability and Mobility”-*Annie Casey Foundation-July 2002 http://www.aecf.org/
*“**Economic Engagement: An Avenue to Employment for Individuals with Disabilities”* - Institute for Community Inclusion-2004 www.communityinclusion.org
*“**Innovative Methods for Providing Vocational rehabilitation Services to Individuals with Psychiatric Disabilities”-* RSA/George Washington University - http://www.gwu.edu/~iri/psg.htm
- “Profiles of One Stop Career Centers Serving Homeless Persons” at www.csh.org/CHETA

## Work Fast Principles

- Most homeless people are working
- Must redefine what we mean by “job ready”
- Must redefine what we mean by “work”
- Recognize skills and strengths derived through survival
- Allow flexible measures of success on a “slow entry ramp”
- Celebrate success/redefine failure
- Customize the employment experience to meet people where they are at, rather than vice-versa

## “Work Fast-Practices”

- Conversations and exposure to the prospect of working begins at outreach
- Opportunities to talk about and test work continue upon housing placement
- Not every moment is a competitive job placement moment
- Use “standing offer of employment” as an engagement strategy and slow entry ramp into work

## Employment-Centered Outreach

- Make work part of the conversation about engaging in services
- Prompt and listen to people’s stories about jobs they had and jobs they may want
- Provide information
- Assess the value of an offer of work as a ‘hook’ to influence positive change
- Understand the ‘stages of change’

## Principles and Practices Helping to Develop Motivation for Work

**Typical Challenges**
- Sense of hopelessness about vocational goals based on experience to date
- Numerous setbacks in general or negative work or other vocational experiences
- Many think of jobs or tasks that have historically been available without a great deal of creativity
- Some may be struggling with depression or other clinical/medical issues that make it difficult to get motivated
- Current stresses in life that make feeling motivated difficult
- Negative consequences of work such as child support payments, credit debts, SSI/DI disincentives, etc

**Suggested Responses**
**Motivation as a State not a Trait**: it can change over time and be influenced
**Ambivalence is Good**: Tease out both sides, help tip balance towards change
**“****Resistance”** is not a Force to be Overcome-Roll with it
- Focus on Person as **Ally**, not **Adversary**
**Recovery, Change and Growth** are intrinsic to being Human
- Remember that People who have suffered many losses may **relinquish hope to survive**
- Paint a picture of immediate incentives that can trigger motivational thinking

## Principles/Practices :Linking Employment and Housing

**Challenges**
- People may not be interested in services once they are in the housing unit
- They are not sure what they want to do and avoid staff
- They are engaged in behavior they are trying to hide from staff
- Staff try to “over –engage” or overstep boundaries and push participants away
- Staff may not maintain proper boundaries with participants, especially if he/she can relate to a particular challenge or situation
- Lack of cultural sensitivity to the background, needs, challenges and goals of a specific participant

**Suggested Responses**
- Offer incentives in order to develop their interest
- Keep the conversation focused on what the participant is thinking or feeling, and what he/she wants to do about it
- Be aware of how your body language or other non-verbal communication
- Remember that the staff role is to guide and support, not direct, over-invest, “mother “ a participant, or become emotionally involved
- Suggest meeting in an open space such as outdoors or in a private space such as a counseling room
- Try to never force an interaction unless absolutely necessary, or unless someone’s safety is at risk
- “Vocationalize” the housing environment by having a variety of available activities that offer opportunities for engagement around work

## Vocationalizing

- Creating a culture that expects work - verbally, mentally, environmentally and literally.
- Arranging things, activities and resources to include and/or support employment.
- Assign accountability for employment outcomes to all staff.
- Develop and maintain organizational policies and practices that support client employment
- Begin tracking employment outcomes.

## Principles and Practices Implementing a Standing Offer of Work (In-House Jobs)

**Typical Challenges**
- Changing attitudes and expectations of all parties
- Acquiring jobs with built-in flexibility and opportunities for growth and transition
- Finding effective partners and employers-internal/external
- Resolving alcohol/substance abuse and mental health issues affecting work
- Staff and new worker training
- Providing supervision and support
- Fulfilling employment services contract/performance requirements
- Funding the effort
- “Fit” with SE Evidence based practices

**Suggested Responses**
- Assume employability
- All staff supports peoples’ desire to work
- Look internally as well as externally for $$
- Provide direct, tangible workplace-based support to break down barriers
- Avoid lengthy prerequisites –rapid access to a low-impact job
- Allow multiple work options-one job does not fit all
- Understand peoples’ needs, abilities and values
- Communicate your work expectations
- Celebrate all degrees of success
- Weave in conversations and support for the next step

## Linking Housing and Employment – Promising Practices

- Learn about employment services practices being used throughout the country, especially in housing environment
- Integrating use of Evidence Based Practices into provision of employment services
- Understand how to use partnerships to improve program delivery, including relationships with employment training providers and Workforce System
- Learn about critical staff competencies needed to providing employment services

## 6 Principles of Evidence-Based Supported Employment 

- Competitive employment is the goal.
- Eligibility is based on consumer choice.
- Employment services are integrated with mental health treatment.
- Job search process starts soon after a consumer expresses interest in working.
- Follow-along supports are continuous for  employed consumers.
- Consumer preferences are important.

**Notes:**
No one is excluded who wants to participate.
Evidence does not support exclusion on basis of diagnosis, previous work history, symptom levels.
Although overall employment rates are lower for some subgroups, SE is as helpful, if not more so, for improving the employment rates of people in these disadvantaged groups.
There are no requirements for completing extensive pre-employment assessment and training or intermediate work experiences (like prevocational work units, transitional employment, or sheltered workshops)
As long as consumer wants the assistance.
Choices and decisions about work and support are individualized based on the person’ preferences, strengths, and experiences.

## Consistent with Supported Employment EBP:

- Assertive engagement and outreach
- Zero exclusion
- Integration w/TX
- Ongoing, work-based assessment
- Rapid job search
- Individualized job search
- Diversity of jobs
- Permanence of jobs
- Jobs as transitions
- Follow-along supports
- Community-based services

## Are Practices for Employment for People who are Homeless Consistent with SAMHSA SE EBP?

***YES-***Each does not require prerequisites
***YES-***Each are consumer-driven
***YES-***Each supports rapid access to work
***YES-***Each requires integrated services planning with an employment-focus
***YES-***Each endorse the goal of a competitive job at a living wage
**Differences: **
**The option of “standing offer of work” using in-house jobs as a tool for engagement and trust-building**
**A “Menu” approach to employment that includes, but is not limited to SE EBP options**

## Additional elements for integrating EBP and housing

- Employment services integrated with housing lead to potentially greater stability for the client
- “Housing First/Work First” model assumes a high level of potential for the individual
- Housing environment creates a positive place for individual to pursue vocational goals

## Ongoing Support as Needed for Re-Placement, Job Acquisition, Advancement

**Ongoing Support as Needed for Re-Placement, Job Acquisition, Advancement**

## Expected Outcomes of “Work Fast”

- Improved self-esteem and confidence
- Establish trust in self and others
- Develop insight into core gifts, skills, abilities
- Desire to increase hours of work, obtain a better job through mainstream sources
- Develop an initial job goal
- Develop an initial support services plan
- Improve knowledge of job options, skills and credentials needed
- Practice job skills and aptitudes
- Make $$

## Work crews
Sheltered workshops
Referral out
Extensive pre-assessment and testing
Work preparation/skills development
Transitional employment positions

- Work crews
- Sheltered workshops
- Referral out
- Extensive pre-assessment and testing
- Work preparation/skills development
- Transitional employment positions

- One-time placement
- On-site job coaching
- Rehabilitative day treatment
- Generic psychosocial rehabilitation
- Clinical services alone

## Work Fast is Also Not...........

- A reward for attending treatment groups
- A privilege after maintaining three months of sobriety
- An option one receives after a pre-determined length of housing stability
- Sheltered workshops
- Rapid placement in a competitive market job when the consumer and employer are not ready

## Some Program-Level Challenges

- Changing attitudes and expectations
- Acquiring jobs with built-in flexibility
- Finding partners-internal/external
- Resolving alcohol/substance abuse and mental health issues affecting work
- Staff training
- Providing supervision and support
- Fulfilling contract/performance requirements
- Business plan/budgetary issues
- Establishing credentials
- Linking to other employment programs and/or mainstream jobs

## Living Examples of Housing Linked with Employment

- Lamp Village, Los Angeles
- Supported Housing Employment Collaborative, San Francisco
- Community Engagement Program, Portland, OR
- New Horizons, Ft. Meyers, Florida
- SEARCH, Houston
- Thresholds, Inc., Chicago

## Keys to Success

- Trust-building is fundamental
- Give people what they say they want
- Offer hope and real opportunity
- Recognize/utilize personal strengths
- Recognize and address complex needs
- Affirm personal dignity and self-worth
- Reinforce personal responsibility, choice and empowerment
- Adapt employment services to meet needs
- Provide comprehensive, long-term supports
- Develop partnerships and collaborations

## Resources on the Web

- _[www.dol.gov/odep](http://www.dol.gov/odep)_
- _[www.mentalhealthpractices.org](http://www.mentalhealthpractices.org/)_
- _[www.redf.org](http://www.redf.org/)_
- _[http://www.psych.uic.edu/eidp/eidptoolkit.htm](http://www.psych.uic.edu/eidp/eidptoolkit.htm)_
- _[www.ahpnet.com](http://www.ahpnet.com/)_
- www.csh.org
- www.hud.gov/offices/fheo/section3/section3brochure.cfm

## Accessing Mainstream Resources for Employment

- Medicaid (www.cms.hhs.gov)
*1619(b)*
*Buy-In*
*Rehab Option*
- HUD (www.hud.gov)
*Section 8*
*CDBG*
*ESG*
*ROSS/Hope VI*
*Tenant-Based Rental Assistance*

- USDOL (www.dol.gov)
*WIA*
- SSA (www.ssa.gov)
*Ticket to Work*
*SSA Work Incentives*
- Dept. of Agriculture (www.usda.gov)
*FSET*
- RSA/VR (**http://www.ed.gov/offices/OSERS)**
*State VR*
- HHS (http://www.acf.hhs.gov/programs/ocs/dcdp/joli/welcome.htm)
*JOLI*