# Presentation: 670822

## DISCHARGE PLANNING

**DISCHARGE PLANNING**

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

- Leadership in Promoting, Implementing, and Sustaining Cultural Change in Systems of Care
- Joseph Finn

## Discharge Planning

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

**Massachusetts Housing and Shelter Alliance (MHSA)**

- The process—beginning on admission—to prepare a person in an institution for return into the community and the linkage of the individual to essential community services and supports

- Linking the consumer to appropriate next-step resources

- Preventing vulnerable populations from becoming homeless or criminalized

- Assisting the consumer with re-entry to the community

- Goals

## Elements of Discharge Planning

-   Must be tailored for different needs of different consumers
-   Needs to be comprehensive
-   Must create a system that is continuous and coordinated
-   Must prevent consumers from falling into homelessness
-   Should begin on admittance

**Massachusetts Housing and Shelter Alliance (MHSA)**

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## Resources, Resources, Resources

- Next-step resources are central to discharge planning. Without these resources, discharge planning is illusory.

**Massachusetts Housing and Shelter Alliance (MHSA)**

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## LEADERSHIP

*For more information please contact MHSA at 617/367-6447.*

**Massachusetts Housing and Shelter Alliance (MHSA)**

- INSTITUTIONALIZING CHANGE

- POLICY
- CHANGE

- RESOURCE
- DEVELOPMENT

- RESEARCH
- ADVOCACY
- EDUCATION

- Discharge Planning to Prevent Homelessness: Steps to Change

## A Reminder to Us All...

*Even Custer had a plan.*

- What real impact has discharge planning had?

## Discharge Planning: What We’ve Gained

**Massachusetts Housing and Shelter Alliance (MHSA)**

-  Administrative change: zero tolerance
-  Attitudinal change: sense of ownership
-  Redirection of resources: housing as a responsibility
-  The beginnings of outcome data
-  Creation of culture of change: prevention as a strategy

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## Discharge Planning and its Impact Addressing Homelessness within Systems of Care

**Massachusetts Housing and Shelter Alliance (MHSA)**

- “When I started working with the homeless mentally ill in the mid-1980s, I was excited about having the opportunity to learn about the pathology that made these people homeless. But after all these years, I’ve discovered that what I was really learning about was the pathology of the system.”
- – Peggy Lester, DMH Director of Residential Services

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## Discharge Planning: A Cultural Comparison

**Massachusetts Housing and Shelter Alliance (MHSA)**

-  Individual-based responses
-  Reactive
-  Clinical-based
-  Single-model
-  Mental Health Centers
-  Emergency response

-  System-based solutions
-  Proactive
-  Need-based
-  Diverse housing
-  Community-based services
-  Prevention

-  After Discharge Planning

-  Before Discharge Planning

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## The Homeless Mentally Ill in Greater Boston

**Massachusetts Housing and Shelter Alliance (MHSA)**

- Source: Massachusetts Department of Mental Health

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## Overview of the Metro Boston Residential System

**Massachusetts Housing and Shelter Alliance (MHSA)**

-  In 1988, the Metro Boston area had 469 beds in the community, primarily in 8-12 person group homes.
-  Over the past 16 years, with more than 30 community partners, the area has leveraged over $67 million from a wide variety of non-DMH housing funding sources to create an additional 1,652 beds in the community, bringing the total today to 2,121, not including the 165 transitional shelter beds.
-  1,038 are set aside for mentally ill people who are homeless through the State Legislature’s Special Initiative to House the Homeless Mentally Ill. Metro Boston receives approximately $16 million annually of the $22 million the Legislature appropriated.
-  Programmatically, the system has evolved into a diverse array of settings and services to meet the complex needs of consumers.

- April 2004

- Source: Massachusetts Department of Mental Health

## Massachusetts Department of Mental Health

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

- Source: Massachusetts Department of Mental Health

**Massachusetts Housing and Shelter Alliance (MHSA)**

- Metro Boston Residential System FY 2003

- 17% Street or generic shelter
- 19% DMH transitional shelter
- 13% DMH hospital
- 9% “Displaced” from their own housing
- 35% Moved within the system
- 7% Other

- 38% Non-DMH housing
- 35% Moved within the system
- 7% Family
- 6% Hospital
- 3% Street or generic shelter
- 2% Jail
- 9% Other

-  440 Discharges

-  440 Admissions

## Moving Forward: How Such Success is Impacting                      the Struggle to End Homelessness

**Massachusetts Housing and Shelter Alliance (MHSA)**

-  Creation of an active interagency council
-  Submission of a plan on ending chronic homelessness
-  First integrated interagency recommendation for budget resources
-  Ongoing advocacy for housing
-  Strategic planning for prevention

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## Prediction

- When homelessness comes to an end and social historians analyze what brought it to an end, they will say that the turning point came when leadership began to apply the principles of discharge planning across all systems of care and developed appropriate housing strategies for all citizens.

## FIVE PARK STREET 

- FIVE PARK STREET
- BOSTON, MA 02108
- PHONE: 617/367- 6447
- FAX:  617/367-5709
- EMAIL:   abolition@mhsa.net

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

## DISCHARGE PLANNING

**DISCHARGE PLANNING**

*MHSA is a statewide homeless advocacy alliance of 87 agencies serving homeless people throughout Massachusetts.*
*For more information please contact MHSA at 617/367-6447.*

- MASSACHUSETTS HOUSING AND SHELTER ALLIANCE
- FIVE PARK STREET
- BOSTON, MA 02108
- PHONE: 617/367- 6447
- FAX:  617/367-5709
- EMAIL:   abolition@mhsa.net

- Leadership in Promoting, Implementing, and Sustaining Cultural Change in Systems of Care