1. Housing is Health Care, now what? Presented by Ericker Phillips-Onaga, Sr. Deputy Executive Director, Programs, Gale Alwill, Deputy Director, Programs Project Hospitality

2. Here is how Project Hospitality is helping to get our clients there Housing is Health Care Gratefully, this mantra, established through years of CHAIN research, is accepted in 2012

3. Realization of goals: stability Increase in esteem, confidence, respect of self Connection to others, trust in professional relationships, link to family, social supports Security of body, including health, resources (entitlements) Housing, Food, Clothing Continuum of housing care that allows each step in the hierarchy of needs to be realized. Consistent access to care leads to improved health outcomes.

4. Hallmarks of continuum Recognition that our clients often come to us still utilizing the same maladaptive behavioral coping strategies that put them at risk for HIV/AIDS. Use of these coping strategies as the starting point

5. Essential Programming HOPWA HPA partnered with Aids Institute Enhanced Supportive Housing (ESH), function as continuum entry point. These programs assess the initial Who, What, Where, When, and How. Concrete tools needed to access housing services are provided through HPA. ESH enables clients through an ILS and psychosocial focus to build proficiency around addressing housing needs.

6. Essential programming Emergency housing placement (congregate and scatter site); Transitional congregate housing placement; Several models of supported housing, varying in intensity for dually and triply diagnosed populations; HPA to facilitate independent housing placements.

7. Critical Program characteristics: Flexible continuum of housing: movement may not be linear and/or progressive. Acceptance of a client’s right to choose Focus on housing fit Challenge clients to think broadly about what housing may be best. Educate them about their options. Interdisciplinary approach

8. Long Term Planning What does this mean and what can we do? Resolving housing issues is a long term process. Programs need to be structured to make long term commitments. Intensive low threshold engagement practices earlier on to keep clients linked and optimistic. CHAIN study outcome: about one-quarter of formerly homeless persons who secure housing return to homelessness or unstable housing within six months of placement. CHAIN study outcome: clients who just started getting housing help can expect double the rate of housing instability.

9. Service makes the difference— How do we keep a client connected to us? Recognize that every interaction plants a seed for the next. We need a client to “wrap services around”. When clients choose to limit access to themselves we respect the distance and use other interdisciplinary tools to engage them.

10. Tool Box Low threshold peer engagement through use of stipend funds Low threshold staff engagement: creative groups and individual programming Flexibility regarding what constitutes a “session”

11. What’s helpful moving forward: Support for use of EBIs and EBPs that work. Needed to provide teeth to the dictum: “provide service to clients”. Priority given to development of housing continuums, multiple points of access—not linear. Recognition that change is the clients option, and if chosen will be a gradual process. Realistic discussions about the barriers of housing our clients with maladaptive coping strategies. Models that assume clients enter system ready and willing to address behaviors that placed them at risk should be put to bed.