Category:
Homelessness
Prevention/Discharge Planning
The Discharge Planning Protocols in Massachusetts
Background:
Bailing
a Leaky Boat
For
twenty years homeless programs across the country have experienced
a common occurrence best characterized as bailing a "leaky
boat." While they have actively and entrepreneurially moved
homeless people out the back door of homeless programs into housing,
stability, and jobs, the emptied beds have refilled immediately.
For two decades this cyclical pattern has continued. Out the back
door; in the front door.
The
lack of policy attention to prevention of homelessness, especially
as related to homeless individuals being discharged from systems
- of care, health, substance abuse treatment, mental health, managed
care, incarceration, youth detention, foster care, welfare, and
military service - resulted in those discharged having no plan and
no permanent destination.
Tourniquet
on the Hemorrhaging
Such
discharges lead to the streets and homeless programs. Without a
tourniquet on the hemorrhaging, those discharged fill every empty
bed vacated by someone leaving a homeless program and drive homeless
systems into overflow.
Achievements
of entrepreneurial homeless program staff in moving people beyond
shelter were often obscured by the hemorrhaging through the front
door. Without careful and corroborated data collection to quantify
both the successes moving out the back door to housing and stability,
and the failures of other systems resulting in a front door crowded
with new homeless people, policy could not respond to the reality
of the cycling and resources could not be appropriately invested
and targeted.
Inappropriate
Discharge and Zero Tolerance
In
Massachusetts we* did gather the data at the front door of homeless
programs. In doing so we knew which systems were discharging inappropriately
into homelessness, releasing their "clients" with no place
to go. We then began working with the state, both the Administration
and individual departments and agencies,
to inform them of the research and data and to educate them regarding
discharge planning strategies and protocols. Any discharge to homelessness
was deemed "inappropriate."
Eventually,
all state agencies developed a common definition of discharge planning
and began efforts to reduce and eliminate discharges to homelessness.
Ultimately,
agency after agency adopted our objective as their on-going mission
- zero tolerance for discharge to homelessness.
Visit
this Innovative Initiative
The
links below will provide you with the full story of this Innovative
Initiative. Prevention of homelessness, especially for those at
risk of chronic homelessness, is the central theme of this replicable
strategy.
We
are indebted to the Massachusetts Housing and Shelter Alliance for
the vision and implementation of this Innovative Initiative and
to the National Healthcare for the Homeless Policy Council for support
in disseminating those efforts.
- Introduction
and Overview
Overview of the work of the Massachusetts Housing and Shelter
Alliance (MHSA) to document the connection between growing homelessness
and discharge from public systems of care, to create resources
to address the problem, and to develop a comprehensive strategy
of homeless prevention that assures successful discharge to the
community.
- Introduction
and Overview
- Assessment
Materials
- Introduction
to Assessment Material
- Homeless
Shelter Census and Overflow Data Initiative
- Impact
of Homelessness and Supported Housing on Health Services and
Shelter Utilization
- Health
Care: Data from the Lives of Homeless People: Morbidity Review
of 13 Homeless People who Died in Boston July 1998 - January
1999
- Collaboration
with Local Stakeholders
- Introduction
to Collaborating with Local Stakeholders
- Tools
for Convening Conversations with Local Stakeholders
- Exemplary
Policies and Practices
- Introduction
to Exemplary Policies and Practices
- Exemplary
Practices in Discharge Planning: Report and Recommendations
of the Working Conference
- CMHS
Cultural Competance Standards for Discharge Planning in Managed
Care Mental Health Services
- HUD
McKinney Act Special Project Certification Form for Discharge
Planning
- Massachusetts
Executive Office for Administration and Finance Policy Report:
Moving Beyond Serving the Homeless to Preventing Homelessness
- Massachusetts
Department of Mental Health Discharge Protocol
- Improving
Outcomes
- Introduction
to Improving Outcomes
- Optional
Purchasing Specifications: Medicade Managed Care for Individuals
who are Homeless
- Improving
Behavioral Health Services and Discharge Planning for Homeless
Individuals
- Discharge
Planning Specifications for Requests for Responses
- Triple
8: the Road Home
- Medical
Respite Services for Homeless People: Practical Models
- For
People with Serious Mental Illness: Finding the Key to Successful
Transition from Jail to the Community - An Explanation of
Federal Medicade and Disability Program Rules
*Prior to being appointed Executive Director of
the Interagency Council on Homelessness, Philip Mangano was the
executive director of the Massachusetts Housing and Shelter Alliance.
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