A Diversity of Approaches

Last week I went to the State of North Carolina's Homeless Conference. It is one of the best conferences available for the price of $75 for the two days. The next one will be in November of 2008.

This year, I walked away from the conference thinking about the diverse strategies that are being implemented to end homelessness throughout the country. One of the workshops was the San Diego Seriel Inebriate Program. The program is run through San Diego's police department and is designed for folks who are being arrested for public drunkeness (an arrestable condition in San Diego). When you look at the model you can see that it is about making sure there are choices for those who are chronically drunk, including the choice of treatment vs. the choice of incaraceration. And when treatment is chosen there is no waiting time, the individual participants are enrolled immediately.

One fact I've learned is that head injury is more common in homeless people. This has added a new dimension for researchers requiring them to examine the cognitive function of those who are homeless. Interestingly enough, the many behaviors that I often time attributed to noncompliance, could have really been linked to head injury or another brain related injury that resulted in lower cognitive functioning. Many signs including confusion, poor memory, inability to organize and plan, inability to learn new information, impulsivity and poor decision making, and "simple" tasks that produce high levels of anxiety, are often overlooked by providers. These subtle behaviors, however, may be the key to determining whether or not there is an underlying disabling condition that can result in additional income and services that are available to homeless clients.

Targeting emergency assistance and focusing on preventing family homelessness is another big topic of discussion. The CAMBA HomeBase Program is one being funded by and evaluated by the New York City Department of Homeless Services. There program is described in detail and was one of the presentations at last weeks conference.

Finally, after the conference was over there was an additional session about the work being done in New York City, specifically in Times Square. Common Ground is a nonprofit organization in New York. There Street to Home Initiative is a good example of Housing First. Starting in 2004 with 40 some homeless people in the neighborhood, they started trying to place these folks in housing. In 2005, the number increased to 54 and they were puzzled because they had been placing people into housing directly from the street. Staff discovered that there were certain "anchors" in the homeless community in the neighbhorhood. These were individuals who had been chronically homeless and the ones whom newly homeless individuals would seek advice and assistance from. Outreach staff began targeting these individuals and moving them to permanent housing. Interestingly enough, some of the challenges of moving these people off the street were the many ways in which businesses, churches, and other providers enabled their survival on the street. Strategies were used to remind people that housing is available for these folks and as of the conference last week, the number of homeless people has dropped to 7 in the targeted region.

The other story that goes with this is the power that data has on policy makers. My understanding is that the NYC Department of Housing has renegotiated many of its outreach contracts to focus on this type of intervention that targets the center of the network of a group of homeless individuals.

All in all a great conference. Many diverse approaches to be considered.