BAKERSFIELD, CALIFORNIA. The City of Bakersfield, California is teaming up with Kern County to develop a 10-year Plan to End Chronic Homelessness. Bakersfield is the 13th largest city in California located in sprawling Kern County, with its 200-crop agribusiness base, at the southern end of California's Central Valley. Last week, United States Interagency Council on Homelessness Executive Director Philip Mangano met with Bakersfield Mayor Harvey Hall and members of a Steering Committee to discuss the 10-year planning process to end chronic homelessness. Praising City and County officials for joining together in this effort, Director Mangano noted that "creating this plan will position you to maximize your resources and invest both old and new in solutions."

Pictured here on top from left to right are Miriam Krehbiel, President of United Way of Kern County; Executive Director Mangano; Bakersfield Mayor Harvey Hall; Louis Gill, Executive Director of the Bakersfield Homeless Center; and Council Regional Coordinator Eduardo Cabrera. On the bottom is Executive Director Mangano addressing Mayor Hall and members of the Steering Committee.

Director Mangano took special note of Mayor Hall's "Unity in the Community" theme for his city, the type of approach needed to bring together the broad range of community stakeholders- business, corrections, the medical community, housing and service providers, community and faith based organizations, academia and others - to develop a successful plan. In his kickoff remarks, Mayor Hall expressed his concern for the estimated 1000 homeless persons living in Bakersfield. "We must adopt a Kern County commitment to Housing First," he said. A Kern County/Bakersfield plan would be the 17th jurisdictional 10-year planning effort in California.

FRESNO, CALIFORNIA. While in California, Director Mangano also met with representatives of Fresno City and County officials at the invitation of Congressman Jim Costa's office to discuss a 10-Year Plan for that city and region. In a meeting with Fresno County Board of Supervisors Chairman Phil Larson, Georganne White of Mayor Alan Autry's office, and Congressman Costa's District Director Bob Sanders and Outreach Coordinator Fabiola Gonzalez, Director Mangano discussed the elements of a successful 10-year planning process, and noted 10-year plan efforts underway in other California cities and counties.

Angela Alioto, who chairs the San Francisco 10-Year Plan effort, attended the meeting and invited the City and County to participate in California Keys, a network of California cities and counties engaged in the 10-year planning process. Representatives of these jurisdictional planning efforts meet bimonthly to share information on innovations, and compile data on outcomes and accomplishments to share with the Governor, State Legislature, and other officials to support additional funding for community efforts to end chronic homelessness. As reported in the May 25 edition of e-news, Governor Schwarzenneger recently announced Phase II of an initiative that will provide an estimated $4.5 billion over time to build 10,000 supportive housing units.

U.S. Department of Labor: The U.S. Department of Labor's Veterans Employment and Training Service (DOL-VETS) published grant application instructions for its Veterans Stand Down grant awards in the June 6 Federal Register.

"Today, more than 160 organizations around the country partner with local businesses, government agencies, and community and faith based service providers to hold Stand Down events for homeless veterans and their families in the local community. Each year, the Assistant Secretary for Veterans Employment and Training awards Homeless Veterans Reintegration Program (HVRP) grants to programs that enhance employment and training opportunities and/or promote self-sufficiency for homeless veterans. Residual HVRP funds can be awarded as grants to organizations sponsoring Stand Down events for homeless veterans.

The critical services provided at a Stand Down are often the catalyst that enables homeless veterans to re-enter mainstream society. Some of the services available at these events include shelter, showers, haircuts, meals, clothing hygiene kits, medical examinations, immunizations, legal advice, State identification cards, veterans benefit information, training program information, employment services, and referral to other supportive services."

DOL-VETS anticipates spending approximately $325,000 to make grants of up to $8000 for multi-day Stand Downs and up to $5000 for single day Stand Downs. Applications from State Workforce Agencies, State and Local Workforce Investment Boards, Veterans Service organizations, local public agencies and non-profit organizations are to be submitted to your State Director for Veterans Employment and Training no later than 60 days prior to the planned Stand Down and by no later than June 30 for events that are to occur on or prior to November 30.

In FY 2005, HVRP funded homeless veteran Stand Down activities at 34 locations. Over 5,300 homeless veterans received on-the-spot services and referrals for support services. On average, over 150 homeless veterans were served at each of these Stand Down events, according to U.S. Department of Labor Assistant Secretary for Veterans Employment and Training Charles Ciccolella.

A recent Veterans Stand Down in Las Vegas, NV involved more than 20 non-profit agencies, local government, business, U.S. Department of Housing and Urban Development employees, and volunteers from AmeriCorps and Nellis Air Force Base who provided clothing, medical and dental services, showers, haircuts, and other supportive services to over 300 veterans. 39 veterans received housing assistance, more than six times the number provided housing through last year's event.

U.S. Department of Veterans Affairs: The U.S. Department of Veterans Affairs will continue its free informational sessions on a Pilot Loan Guarantee Program for Multifamily Transitional Housing with a presentation in Washington DC on June 14. Previous informational sessions have been held in San Diego, CA and Chicago, IL. Through this pilot effort, the VA will provide a 100% guarantee on up to 15 mortgage loans, funded by the Federal Finance Bank, an arm of the U.S. Treasury, to be used for the development, rehabilitation or acquisition of transitional multifamily supportive housing for homeless veterans. For more information, email multifamily.loan@va.gov or call 202-273-7462.

In testimony before the U.S. Senate Veterans Affairs Committee this spring, the VA's Homeless Veterans Programs Director Pete Dougherty spoke about this Multifamily Transitional Housing Loan Guarantee Program:

"Public Law 105-368 authorized the VA to establish a pilot program to guarantee up to 15 loans or $100 million, whichever first occurs, for multifamily transitional housing. The VA has issued two final commitments for guaranteed loans for transitional housing projects that would, when completed, provide 285 new beds for homeless veterans. Those projects are: Catholic Charities of Chicago, Chicago, Illinois, with 141 beds; and, Vietnam Veterans of San Diego, San Diego, California, with 144 beds. The Catholic Charities' project is under construction and is expected to open and be serving veterans by the end of the year. Vietnam Veterans of San Diego is expected to close on its guaranteed loan by early summer, which leaves funding available for up to thirteen (13) remaining program loans or until the remaining $92.1 million in program funds have been guaranteed."

U.S. Department of Health and Human Services: Three new training publications are available from the U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration (SAMHSA) on co-occurring mental and substance abuse disorders:

• Overarching Principles to Address the Needs of Persons with Co-Occurring Disorders
• Definitions and Terms Relating to Co-Occurring Disorders
• Screening, Assessment, and Treatment Planning for Persons with Co-Occurring Disorders

These publications are the first of ten short papers to be produced by SAMHSA including epidemiology, treatment, workforce and system issues, prevention/early intervention, and evaluation and monitoring as part of its commitment to disseminating state of the art information about the treatment of individuals with co-occurring mental and substance abuse disorders. Copies are available at no cost from SAMHSA's Clearinghouse (800-729-6686) or from SAMHSA's website at www.coce.samhsa.gov.

Also available from the U.S. Department of Health and Human Services is a fact sheet on helping homeless clients understand the Medicare Prescription Drug Coverage program and be able to choose a prescription drug plan appropriate for them.

PORTLAND, OREGON. The 2006 National Health Care for the Homeless (HCH) Conference was held in Portland June 8-10. Providing access for homeless persons to key mainstream and targeted systems and services was a central theme of this year's conference, Natural and Unnatural Disasters: What We Have Learned About Poverty, Homelessness, and Health, that also included a focus on Hurricane Katrina response and its aftermath. More than 60 workshops provided opportunities for experts from around the country to "support and inspire" the work of practitioners by presenting information on new and innovative approaches to health care access and delivery to improve services in the community.

As reported in the May 31st edition of the e-news, meeting the physical health needs of homeless persons, especially those who have been living on the streets and in and out of shelters for long periods of time, is an important element in planning to end chronic homelessness. Health Care for the Homeless programs provide much needed access to health care regardless of the ability to pay for this population and should be included as stakeholders in jurisdictional 10-year plan efforts. HCH services are delivered in a variety of ways including free standing facilities, hospital-based clinics, clinics in homeless services sites and community health centers, mobile units, and street outreach.

While not a clinical service, assistance in benefit application - such as for SSI or SSDI determinations -- is an important part of the contribution HCH projects make to the effort to end chronic homelessness. To find out whether there is an HCH program in your community, visit the website of the U.S. Department of Health and Human Services' Bureau of Primary Health Care.

The Council took part in the conference planning and Council Regional Coordinator Eduardo Cabrera presented a workshop on Project Homeless Connect. The Council encourages communities to adopt Project Homeless Connect as an important tool for both providing direct health care services to homeless persons and for generating new energy and commitment in the community for ending homelessness. As reported in previous editions of e-news, Project Homeless Connect originated in San Francisco and is an initiative that the Council believes can be replicated in every community with good result. Twenty-six cities participated in the first Council-promoted National Project Homeless Connect Day last December, providing assistance to nearly 6,000 homeless persons with the help of nearly 4,000 volunteers. Additional PHC events have been held in communities around the country since then. Altogether nearly 12,000 homeless persons have received assistance with the help of over 7,000 volunteers.

San Francisco, which holds a Project Homeless Connect event bi-monthly, held its eleventh and most recent one on Friday, June 9. Once again the value of this volunteer driven, one-stop center type approach as an effective way to connect homeless people to the services they need was proven. A record 2,300 homeless persons received assistance that included 2,000 pairs of shoes, with the help of more than 2,100 volunteers including 500 employees of Deloitte Touche who chose to participate as their second annual Volunteer Impact Day project. In May, Mayor Newsom announced that San Francisco was four years ahead of schedule in its goal to find permanent supportive housing for 3,000 homeless people, having already found housing for 1,340 formerly homeless persons.

Upcoming PHC events include St Paul, MN on June 19, Portland, OR on July 11, and Norman OK on July 24.

With this issue, the e-news continues coverage of resolutions considered by the Housing and Community Development Standing Committee at the recent U.S. Conference of Mayors Annual Meeting in Las Vegas.

Two resolutions approved by the Committee and adopted by the Conference, Endorsing Innovative Policies to Successfully End Chronic Homelessness Across the Nation, and Improving Homelessness Programs and the Continuum of Care were discussed in last week's e-news.

A third resolution, Improving Housing Opportunities: Maximizing Federal Housing Funding was also considered and approved by the Committee and adopted by the Conference. In this resolution, the mayors affirmed their commitment to "improving housing opportunities for residents at all income levels and to ending homelessness" and noted that "many cities have adopted a Plan to End Homelessness and need consistent, sufficient, and diverse federal funding streams to maximize resources to accomplish this ambitious goal."

A fourth resolution, Expanding HUD's Definition of Homelessness, was not approved. The resolution called on the U.S. Department of Housing and Urban Development to "include within its definition of homelessness people who are sharing the housing of others due to loss of housing, economic hardship or similar reason, and those who are staying in motels because of the lack of alternative accommodation." The Mayors noted an absence of data to quantify the impact of the resolution on finite funding resources and growing evidence that current policy is allowing them to develop and implement strategic plans that are achieving for the first time, visible and measurable results in reducing the number of homeless persons living on the streets and long term in shelters. Recognizing that the resolution was well-intended, but realistic about needing to know the implications of such a policy change on funding resources, and wanting to avoid creating expectations that can't be met that damage public trust, the Housing and Community Development Standing Committee Mayors declined to recommend the resolution for approval.

In the second of our series of e-news profiles on the recipients of the Council's A Home for Every American Award, we highlight the contribution of Dr. Sam Tsemberis (pictured here) to the National Partnership to End Chronic Homelessness.

"With the presentation of the A Home for Every American Award to Dr. Sam Tsemberis, we are recognizing the role that he has played in changing the verb and the vocabulary and even the equation of homelessness. Through the success of Housing First, in the Pathways to Housing program and now around the country, moving us from managing to ending. From enabling to engaging. From shelter and street to a home. From funding to investing. From servicing to housing. From inputs to outcome. Beyond programs to consumer."

                                             Executive Director Mangano

Dr. Tsemberis is Founder and Executive Director of Pathways to Housing in New York City. Dr. Tsemberis used his personal experience as an outreach worker to take two of the principal tools for ending street homelessness - engagement and housing - and retool them to get better results. His pioneering efforts to (1) make street engagement of long term homeless persons with mental illness and/or substance abuse disorders more effective by utilizing and refining the Assertive Community Treatment (ACT) team approach developed in the mental health field and (2) make permanent housing the first act of assistance offered (Housing First), rather than the hoped-for end product of a long step by step series of services, have demonstrated results in housing sustainability and cost effectiveness that have awakened policy makers and practitioners to a new outcome-oriented solution for this typology of homelessness.

Pathways to Housing uses Assertive Community Treatment (ACT) teams to engage homeless persons with mental health and/or substance abuse disorders and offer them immediate access to permanent housing. There is no requirement that they accept treatment services as a precondition to housing or as a condition of remaining in the housing. However, in more than 70% of the cases, Pathways to Housing clients request services once they are housed. In the Pathways experience,"people became more motivated when we lowered the barriers to getting them into housing."

"It's not that you house people and then your job is over, " says Dr. Tsemberis. "You house people and then you ask 'What do you want next?' So what they want next could be mental health or substance abuse treatment services. It could be a job. It could be family. It's individualized."

The ACT teams are interdisciplinary including a psychiatrist, social worker, vocational rehab specialist, substance abuse counselor, nurse practitioner, and housing specialist. The latter two are refinements the Pathways to Housing program made to the standard ACT model. Once engaged by the ACT team, the client is placed in permanent housing within two weeks with temporary housing provided in the interim. The ACT team remains available 24/7 to the client. Whatever services the clients may want after housing, are available to them in the sequence they choose. Pathways to Housing has only two program requirements. Clients are required to pay 30% of their income- often SSI or SSDI-- toward rent, generally handled through representative payee, and must agree to meet with a staff member at least twice a month in their apartment.

The results of a SAMHSA-funded study involving 162 homeless men and women who had an Axis1 diagnosis of severe mental illness and were assigned randomly to either Pathway's Housing First initiative or to continuum of care approaches (control group), showed that over the first 12 months, the Housing First group were stably housed 80% of the time while the control group was stably housed only 23% of the time. While all the participants were homeless at the beginning of the study, 58% had been literally living on the streets. By the end of the first 12 months, only 3% of those who had literally been living on the streets and who were randomly assigned to the Pathways' Housing First model remained homeless on the streets. 25% of the control group continued to live on the streets at the end of twelve months. More information about these results can be found in an article published in the American Journal of Public Health.

The Pathways to Housing program, which now serves approximately 500 men and women, has a nearly 85% housing sustainment rate. Sources of housing utilized in the Pathways to Housing program include Shelter plus Care units, Section 8, and tenant based rental assistance through the HOME program. Cost analysis of the Pathways to Housing program shows an annual per person cost of approximately $22,500 compared to $175,000 for a bed in a psychiatric hospital.

"There's a philosophy and a belief system that supports the hopefulness of a message which says, 'I believe in you and you can do it.' That leap of faith is based on a true belief in others. It's based on the belief that people with psychiatric disabilities or other conditions are able to do just as much as the rest of us. Believing that, and conveying that hope, helps people to realize that dream. For the people who have been beaten down and abused, really by the mental health system and other systems, you have to help them rekindle the belief in themselves. I was trained as a psychologist. When people on the street would say to me, 'I'm hungry and I need a place to live,' I would say, 'What does that mean?' I was trained to interpret. I wasn't trained to listen. I tried to go the step by step by step way for years . . . but it was just too frustrating in its results. After thousands of efforts, I said, ' Well maybe people really mean what they are saying. Maybe they really want housing first. I am going to try this.' I tried it in complete trepidation and fear, not knowing how it would turn out. What convinced me that it's absolutely doable are the outcomes. People went in and they stayed in. They thrived. They flourished. That's how I was convinced."

                              Dr. Sam Tsemberis

From Seattle, Washington (metro population: 3 million+), to Portland, Maine (metro population: 230,000), the development of Housing First supportive housing is yielding results in the effort to end chronic homelessness.

With this issue, the e-news take a look at Logan Place in Portland, Maine, which has been awarded the 12th Annual Charles L. Edson Tax Credit Excellence Award for Special Needs Housing by the Affordable Housing Tax Coalition. Like Seattle's 1811 Eastlake project profiled in last week's e-news, the Logan Place project is achieving positive outcomes for its residents and for the community. Logan Place is a new construction 30-unit efficiency Housing First development for persons experiencing chronic homelessness. Logan Place was built and is managed by Avesta Housing, Maine's largest non-profit housing developer, with the Preble Street social services agency providing 24-hour support services. At its official opening last July, United States Interagency Council Executive Director Philip Mangano joined Maine Governor John Baldacci and other state and local officials, and community members in marking the opening of this first-of-a-kind facility in the State of Maine.

Logan Place's 30 residents are "home for good" after sleeping an average of 6 years on floor mats at the Oxford Street Shelter in Portland. The Oxford Street Shelter is northern New England's largest shelter and has grown from 50 beds when it opened 20 years ago to now using 154 floor mats. Until the construction of Logan Place, the Oxford Street Shelter reached capacity by 10 p.m. seven out of ten nights and would have to institute its "overflow" policy that consisted of walking everyone 3 blocks down the road to the Preble Street soup kitchen. Since the opening of Logan Place, the shelter has not had to implement its overflow policy once.

In the first year of operation, Logan Place has had a 66% housing retention rate, with 7% having moved to other permanent housing and 7% who passed away. Other outcomes include:

• 92.5% of all residents in this first year of operation developed an Individual Service Plan
• 66% with untreated mental illness accepted a psychiatric evaluation and/or treatment within 6 months of occupancy
• 29% have participated in work, vocational planning or an education program
• 77% of the residents with a substance abuse addiction demonstrated decreased use of substances during the year
• 73% were enrolled in Mainecare (medicaid) within 3 months of tenancy
• 72% were enrolled in food stamps within 3 months
• 100% of the current residents have received Section 8 housing subsidy through the Portland Housing Authority

The annual Charles L. Edson Tax Credit Excellence Awards recognize the most outstanding Low Income Housing Tax Credit (LIHTC) projects in four categories- metropolitan/urban housing, rural housing, special needs housing, and senior housing. The awards include a $5000 grant for the housing facility. This year's awards were presented at a Capitol Hill ceremony on June 7 with Avesta's President Dana Totman accepting the award from U.S. Senator Susan Collins on behalf of Logan Place, its residents and Preble Street. The Low Income Housing Tax Credit (LIHTC) was created by the Tax Reform Act of 1986 and has been successfully used to create more than 1.3 million housing units. The 1811 Eastlake project profiled in last week's edition of the e-news was also financed in part through the use of the LIHTC.

Pictured here is Maine Senator Susan Collins presenting the Charles L. Edson Tax Credit Excellence Award for Special Needs Housing to Dana Totman, President, Avesta Housing Development Corporation on behalf of Logan Place (top). Logan Place (center). Pictured bottom are from left to right Dana Totman; Maine Governor John Baldacci; Executive Director Mangano; Maine State Housing Authority Executive Director Dale McCormick; and Preble Street Executive Director Mark Swann at the project's official opening in July 2005.

The Council has two new members - Rob Portman, recently sworn in as the Director of the Office of Management and Budget replacing Josh Bolten, who is now President Bush' Chief of Staff, and Dick Kempthorne, who resigned as Governor of Idaho to become Secretary of the Interior.

In 2005, then Governor Kempthorne signed an Executive Order 2005-11 establishing a state interagency council on homelessness, the Idaho Homelessness Policy Council. The Council is chaired by the head of the Idaho Housing and Finance Association and includes the Secretaries of the Departments of Commerce and Labor, Corrections, Health and Welfare, Division of Veterans Affairs, and the Superintendent of Public Instruction. Pursuant to the Executive Order, a statewide homeless Idahoans action plan has been developed by the Council in cooperation with a Coordinating Committee also appointed by the Governor. The Coordinating Committee included not only top state officials but also representatives from the United Way, Salvation Army, YWCA, City of Boise, various service providers including faith based organizations, Boise/Ada County Housing Authority and the U.S. Department of Housing and Urban Development.

The Plan which will be " continuously reviewed and refined "identified strategies and action steps to implement three major goals:

• Enhance the capacity to elevate and sustain homelessness as a policy issue through clear leadership, improved planning, coordination, and outcome measurements
• Expand the availability of affordable supportive housing and services to adequately meet the unique needs of persons who are experiencing chronic homelessness
• Bolster the state's ability to prevent and eliminate conditions that lead to chronic homelessness by enabling persons to achieve and maintain their highest level of self-sufficiency

"During the discussion process, the committee members generously contributed energy, experience, creative problem solving ideas, and inter-organizational collaboration. Many hours were spent analyzing resources, gaps in service, and successes and failures of current methods. The result is a consensus plan reflecting our joint belief that implementing key pragmatic adjustments to current policies and processes, and improving data collection and performance based accountability, will establish a successful path to preventing and eliminating chronic homelessness in Idaho."
                         Excerpt from Transmittal Letter of Plan to the Governor

In addition to the work of the state interagency council on homelessness, three Idaho jurisdictions are currently engaged in developing 10-year plans to end chronic homelessness-Coeur d'Alene, Pocatello and the Capital City of Boise.

Rob Portman, most recently the United States Trade Representative, had previously been a Member of Congress representing the 2nd District of Ohio which includes Cincinnati. While serving in Congress, he was recognized by the National League of Cities, the National Council of State Legislatures, and the National Association of Counties for his efforts to reduce unfunded mandates. Director Portman will work with Council members in the development of homeless policies and budgets across the federal government to achieve the Administration's goals of ending chronic homelessness and preventing and reducing the incidence of all homelessness.

Pictured here are Interior Secretary Dirk Kempthorne (top) and OMB Director Robert Portman (bottom) being sworn in.

A June 7 New York Times article, New Campaign Shows Progress for Homeless, took note of positive outcomes in reducing street homelessness being reported by cities that are implementing 10-Year Plans to End Chronic Homelessness utilizing "housing first" approaches:

. . . I've sensed a new energy in city halls and state houses around the issue of ending homelessness, " said Robert V. Hess, who just took over as homeless services commissioner in New York City after years of similar work in Philadelphia. " This is unprecedented in my lifetime . . .

. . . Arthur Sena spent years living in a hole that he had dug near the railroad tracks. He would probably still be there, defying offers of help from social workers and using cardboard to ward off the chill, if Denver had not adopted a radical strategy of putting homeless people into apartments of their own, no strings attached. The "housing first" policy that this city adopted last year is part of an accelerating national movement that has reduced the numbers of chronically homeless-the single, troubled men and women who spend years in the streets and shelters- in more than 20 cities . . .

. . . Many of the early starters are reporting turnarounds. In Philadelphia, street dwellers have declined 60 percent over 5 years. In San Francisco, the number of chronic homeless is down 28 percent in two years, in Dallas 26 percent and in Raleigh- Durham, N.C., 15 percent . . .