1. DHSS DSAMH 10.7.14 Department of Health and Social Services Division of Substance Abuse and Mental Health

2.   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 Contents

3.   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

4.   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 Delaware vs. U.S. Department of Justice

5.   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 Target Population

6.   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

7.   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

8.   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 State Targets

9.   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

10.   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 Status of State Compliance

11.   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 State Targets

12.   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

13.   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 Meeting the Housing Needs Target Population Clients

14.   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 Creative Housing Solutions Target Population Clients

15.   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 Crisis Beds

16.   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 Resource Beds

17.   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 Transitional Housing

18.   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 Supervised Apartment Program

19.   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

20.   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 State Rental Assistance Program

21.   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 Section 811

22.   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

23.   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 Successes

24.   Carlyle Hooff, Director of Behavioral Health Community Integration – Housing  302-225-2780  carlyle.hooff@state.de.us  Melissa Smith, Deputy Director DSAMH  302-225-9427  melissa.a.smith@state.de.us DHSS DSAMH 10.7.14 Contact Information