**[Slide 1]{.underline}**

Discharge Planning: Getting Mainstream Systems to the Table 

HUD-HHS-VA-DOL Policy Academy

Miami, FL

December 2003

United States Interagency Council on Homelessness

451 7th Street, SW, Suite 2200 \* Washington, D.C. 20410

Phone (202) 708-4663 \* www.ich.gov \* Fax (202) 708-1216

**[Slide 2]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Bar Graph depicting the

NUMBER OF MONTHS THE MASSACHUSETTS

EMERGENCY SHELTER SYSTEM WAS OVER CAPACITY

IN EACH OF THE LAST 11 YEARS

· 1993: 0 Months

· 1994: 1 Month

· 1995: 4 Months

· 1996: 5 Months

· 1997: 8 Months

· 1998: 9 Months

· 1999: 12 Months

· 2000: 12 Months

· 2001: 12 Months

· 2002: 12 Months

· 2003: 11 Months

**[Slide 3]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Emergency Shelters for Homeless Individuals\
Have Overflowed 70 Consecutive Months

and 70 of the Last 72 Months

Bar Graph depicting information gathered from the MHSA Shelter Census,
reflecting monthly occupancy as a percentage of capacity.

· Oct-98: 101%

· Nov-98: 102%

· Dec-98: 104%

· Jan-99: 110%

· Feb-99: 110%

· Mar-99: 112%

· Apr-99: 108%

· May-99: 104%

· Jun-99: 103%

· Jul-99: 102%

· Aug-99: 102%

· Sep-99: 102%

· Oct-99: 105%

· Nov-99: 110%

· Dec-99: 113%

· Jan-00: 116%

· Feb-00: 116%

· Mar-00: 116%

· Apr-00: 115%

· May-00: 111%

· Jun-00: 109%

· Jul-00: 106%

· Aug-00: 107%

· Sep-00: 108%

· Oct-00: 112%

· Nov-00: 112%

· Dec-00: 114%

· Jan-01: 119%

· Feb-01: 120%

· Mar-01: 119%

· Apr-01: 116%

· May-01: 113%

· Jun-01: 110%

· Jul-01: 110%

· Aug-01: 109%

· Sep-01: 112%

· Oct-01: 114%

· Nov-01: 115%

· Dec-01: 116%

· Jan-02: 122%

· Feb-02: 123%

· Mar-02: 124%

· Apr-02: 120%

· May-02: 118%

· Jun-02: 115%

· Jul-02: 111%

· Aug-02: 109%

· Sep-02: 110%

· Oct-02: 113%

· Nov-02: 118%

· Dec-02: 123%

· Jan-03: 128%

· Feb-03: 127%

· Mar-03: 126%

**[Slide 4]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Average Shelter Census for the Past Ten Years 1993-2002

Bar Graph depicting information gathered from the MHSA Shelter Census,
reflecting yearly occupancy as percentage of capacity

· 1993: 95%

· 1994: 97%

· 1995: 97%

· 1996: 100%

· 1997: 102%

· 1998: 103%

· 1999: 106%

· 2000: 112%

· 2001: 114%

· 2002: 117%

**[Slide 5]{.underline}**

DISCHARGE PLANNING FOR HOMELESSNESS PREVENTION:

STEPS TO CHANGE

RESEARCH, ADVOCACY, EDUCATION

**[Slide 6]{.underline}**

MASSACHUSETTS HOUSING AND SHELTER ALLIANCE

Research on Emerging Homeless Subpopulations

Comparison of Emerging Populations in

Massachusetts Emergency Shelters

**[Slide 7]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Research on Emerging Homeless Populations

Ex-Prisoners and Massachusetts Shelters

Bar Graph depicting the number of Individuals Entering Emergency
Shelters Directly Upon Discharge from a

Federal, State, or County Correctional Facility per Year (1997-2001)

Federal Correctional Facilities:

· 2001 Census: 7 (2001 was the first year in which MHSA collected
Federal Prison statistics)

State Correctional Facilities:

· 1997 Census: 276

· 1998 Census: 298

· 1999 Census: 185

· 2000 Census: 231

· 2001 Census: 365

County Correctional Facilities:

· 1997 Census: 643

· 1998 Census: 813

· 1999 Census: 728

· 2000 Census: 715

· 2001 Census: 589

State and County Total:

· 1997 Census: 919

· 1998 Census: 1,111

· 1999 Census: 913

· 2000 Census: 946

· 2001 Census: 954

Slide 8

Massachusetts Housing and Shelter Alliance (MHSA)

Research on Emerging Homeless Populations

Corrections and Massachusetts Shelters

Bar Graph depicting the number of Individuals Entering Emergency
Shelters With Prison or Jail Records per Year (1997-2000)

New guests with prison or jail records:

· 1997 Census: 3,683

· 1998 Census: 4,681

· 1999 Census: 4,104

· 2000 Census: 5,302

**[Slide 9]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Research on Emerging Homeless Populations

Young Adults and Massachusetts Shelters

Bar Graph depicting the number of Individuals Age 18 to 24 Entering New
to Emergency Shelters per Year (1997-2000)

New guests 18-24:

· 1997 Census: 839

· 1998 Census: 1,278

· 1999 Census: 2,383

· 2000 Census: 3,144

**[Slide 10]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Research on Emerging Homeless Populations

Hospital Discharges and MA Shelters

Bar Graph depicting the number of Individuals Entering Emergency
Shelters Upon Discharge\
from Psychiatric Care in Hospitals per Year (1997-2001)

New Shelter Guests Arriving Upon Hospital Discharge:

· 1997 Census: 761

· 1998 Census: 806

· 1999 Census: 656

· 2000 Census: 705

· 2001 Census: 798

**[Slide 11]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Research on Emerging Homeless Populations

Discharges by Hospital Category

Pie Chart depicting the percentages of different categories of
Hospitals\' Discharges from 2001-2002

· Private: 72% of all hospitals\' discharges

· Public: 19%

· Other: 6%

· State: 2%

· Veterans: 1%

**[Slide 12]{.underline}**

Private Hospital Discharges by Facility

Pie Chart depicting the percentages of Total Private Hopital Discharges
by each facility from June 2001-May 2002

· Arbour: 18%

· Bayridge: 14%

· Cape Cod: 8%

· Bournewood: 7%

· McLean: 7%

· Brockton: 6%

· Baldpate: 5%

· Malden: 5%

· Cambridge: 4%

· Carney: 4%

· Lowell General Hospital: 4%

· Mass. General: 4%

· Newton-Wellesley: 4%

· Fuller: 3%

· Berkshire Medical Center: 2%

· Beth Israel: 2%

· Beverly: 2%

· Holy Family: 2%

**[Slide 13]{.underline}**

DISCHARGE PLANNING FOR HOMELESSNESS PREVENTION:

STEPS TO CHANGE

RESEARCH, ADVOCACY, EDUCATION

leads to

POLICY CHANGE

**[Slide 14]{.underline}**

A&F POLICY REPORT:\
MOVING BEYOND SERVING THE HOMELESS\
TO PREVENTING HOMELESSNESS

Organization Chart:

EXECUTIVE OFFICE FOR ADMINISTRATION AND FINANCE (A&F)

· DEPT. OF CORRECTION

· DEPT. OF HOUSING AND COMMUNITY DEVELOPMENT (DHCD)

· DEPT. OF VETERANS' SERVICES (DVS)

· COUNTY SHERIFFS

· OPERATIONAL SERVICES DIVISION

· EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES (EOHHS)

· DEPT. OF TRANSITIONAL ASSISTANCE (DTA)

· DEPT. OF PUBLIC HEALTH (DPH)

· DEPT. OF YOUTH SERVICES (DYS)

· DEPT. OF SOCIAL SERVICES (DSS)

· DIVISION OF MEDICAL ASSISTANCE (DMA)

· MA BEHAVIORAL HEALTH PARTNERSHIP (MBHP)

· HMOs

· DEPT. OF MENTAL HEALTH (DMH)

**[Slide 15]{.underline}**

The A&F State Interagency Process:

Working Group on Discharge Planning

Working Group on Housing Search and Retention

**[Slide 16]{.underline}**

DISCHARGE PLANNING FOR HOMELESSNESS PREVENTION:

STEPS TO CHANGE

RESEARCH, ADVOCACY, EDUCATION

leads to

POLICY CHANGE

which leads to

RESOURCE DEVELOPMENT

**[Slide 17]{.underline}**

MASSACHUSETTS HOUSING AND SHELTER ALLIANCE

POSITIVE INITIATIVES TO PREVENT\
AND END HOMELESSNESS

**[Slide 18]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Special Initiative to House the Homeless Mentally Ill

FY '92 -- FY '01:

DMH developed or gained access\
to 1,154 new housing units

Annual State appropriation increase of \$1-2 million\
leverages 1:4 match in Federal funds

Ongoing costs annualized into Departmental budget

**[Slide 19]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Special Initiative to House the Homeless Mentally Ill

· Placed 2,359 homeless clients with mental illness into new or existing
units with services, including 443 in FY '01

**[Slide 20]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Special Initiative to House the Homeless Mentally Ill

FY '92 -- FY '01:

8,106 homeless individuals have received community-based services,
including health care, counseling, and referral\
and case management services.

**[Slide 21]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Criminal Justice Recovery Home Admissions

Criminal Justice Initiative (CJI)

Bar Graph depicting the number of Criminal Justice Recovery Home
Admissions per Fiscal Year

· FY 98: 293

· FY 99: 339

· FY 00: 533

· FY 01: 494

· FY 02: 593

SOURCE: Compiled by MHSA Staff from Massachusetts Department of Public
Health, Bureau of Substance Abuse Services,\
and Correctional Recovery Bed Initiative Reports.

**[Slide 22]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

Referrals to Residential Recovery Homes

by Correctional Source

Criminal Justice Initiative (CJI)

Bar Graph depicting the number of Referrals to Residential Recovery
Homes by Correctional Source per Fiscal Year

· FY 00: DOC: 104; HOC: 349; Total: 533

· FY 01: DOC: 180; HOC: 314; Total: 494

· FY 02: DOC: 220; HOC: 373; Total: 593

SOURCE: Compiled by MHSA Staff from Massachusetts Department of Public
Health, Bureau of Substance Abuse Services,\
and Correctional Recovery Bed Initiative Reports.

**[Slide 23]{.underline}**

Massachusetts Housing and Shelter Alliance (MHSA)

MORE POSITIVE INITIATIVES

· HUD Affordability Study

· MA Affordable Housing Trust Fund Setasides

· MA Housing Bond Bill Setasides

· MA LIHTC Allocation Requirement

· MA Department of Correction -- DOJ Offender Reentry Funding:
Pre-release Housing Search

**[Slide 24]{.underline}**

DISCHARGE PLANNING FOR HOMELESSNESS PREVENTION:

STEPS TO CHANGE

RESEARCH, ADVOCACY, EDUCATION

leads to

POLICY CHANGE

which leads to

RESOURCE DEVELOPMENT

Finally leading to

INSTITUTIONALIZING CHANGE

**[Slide 25]{.underline}**

INSTITUTIONALIZING CHANGE

1\. Prioritizing Homeless Populations through Targeting and Setasides

2\. Applying Evidence-based Approaches

3\. Monitoring Outcomes through Procurement Language

**[Slide 26]{.underline}**

ESSENTIAL RESOURCES

FOR DISCHARGE PLANNING

Published collaboratively by the Massachusetts Housing and Shelter
Alliance (MHSA)\
and the National Health Care for the Homeless Council (NHCHC)

I. Introduction and Overview

\
II.  Assessment Materials  

III\.  Collaborating with Local Stakeholders

\
V.  Exemplary Policies and Practices  

V.  Improving Outcomes\
\
Available on-line at www.nhchc.org

and www.ich.gov/innovations

**[Slide 27]{.underline}**

The federal United States Interagency Council on Homelessness

develops and implements comprehensive national strategies to end
homelessness

through interagency, intergovernmental, and intercommunity
collaborations.

Information on innovations in discharge planning for homeless
prevention\
can be found on the ICH web site:

www.ich.gov