Transcript Organizational Structure

Ryan White Funded Transitional Housing
Integration of Care (IOC) Committee meeting of the Ryan White Planning Council: January 4, 2012
New York, NY
Lynn Walker, D.Min., M.S.Ed., M.A., Director for Housing Operations, Housing Works, Inc.
Kenneth Robinson, M.Ed., M.A., CASAC, Vice President for Housing Operations, Housing Works, Inc.
Housing Works:
A BriefWorks,
Overview Inc.
Housing
• Founded in 1990 – spun off of ACT-UP – now the US’s largest minority
controlled provider of housing & supportive services for homeless people
living with HIV/AIDS.
• Three Adult Day Healthcare Centers, including four complete medical
clinics.
• Community-based (COBRA) case management programs in all five
boroughs of NYC; the largest in NY State.
• Advocacy offices in NYC, Albany, Washington & Mississippi
• Job Training Program – successful completers receive a FT job at HW at a
sustainable wage and with full benefits
• Social Enterprise: 12 Thrift Stores; Used Book Cafe; The Works Catering;
Gotham Property Management
• 183 units of housing
Housing at Housing Works
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Women’s Housing Program
Transgender Housing Program
Staten Island Housing Program
Stand-Up Harlem House
Bronx Claremont
Jefferson Ave (in dvlpmt)
Keith D. Cylar House
East New York House
www.housingworks.org
Women’s Transitional
HousingHousing
Works,Program:
Inc.
• Initiated in 2000; City of NY (MHRA/PHS) contract.
• As you know, Ryan White funds.
• Women living with HIV/AIDS and newly released from a correctional
setting.
• Program started with 20 scatter-site apartments in Brooklyn with staff
offices at our ENY location.
• Residents have access to the complete HW continuum of care.
• Moved into new 20-unit congregate facility in March of 2009.
• Staffed by PD, AA, 2 CMs, and residential staff.
• Average length of stay is just greater than one year.
• Approximately 70% of residents transition to permanent housing.
• Follow-up initiatives indicate that about 50% remain in PH for at least 18
months.
Transgender
Transitional
HousingInc.
Program:
Housing
Works,
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Initiated in 2003; City of NY (MHRA/PHS) contract.
Program started with 20 scatter-site apartments in Brooklyn with staff offices at
our ENY location (2640 Pitkin Ave.).
Expanded to 30 apartments in 2010.
Residents have access to the complete HW continuum of care.
Unique – one of the very few housing programs in the U.S. exclusively for gender
variant folks with HIV.
Almost all clients have been MTF folks of transgender experience.
Nearly all have been either African American or Latina.
High incidence of substance use, mental illness and sex work with this population.
Average length of stay is approximately 15 months; about 50% move to PH; tend to
stay in PH at a high rate.
PD, AA, 2 CMs, and a Residence Mgr.
Housing Works, Inc.
• “Housing First” or “low demand” housing
models place persons with substance use
and/or mental health issues directly into
housing w/out requiring sobriety.
• Growing evidence shows that these programs
achieve housing and service use outcomes
comparable to traditional abstinence-only
supportive housing.
Housing Works, Inc.
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Strictly enforce house rules
24 hour security (congregate)
Case management
Life skills training
Home visits
Referral to ADHC and Primary Care
Behavioral contracts/case conferences
Threat of eviction
Housing Works, Inc.
• Low-demand housing models that enrolled “more
challenging” consumers did not see worse housing
outcomes, demonstrating that “housing readiness” is
not a good predictor of outcomes.
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Burt, 2004
Bendixen, 2008
Caton, et al., 2007
Martinez & Burt, 2006
Rosenheck, et al., 2003
Sadowski, 2008
Shubert, 2006
Tsemberis, et al., 2004
Housing Works, Inc.
• Homelessness and unstable housing are linked to greater HIV risk,
inadequate care, poor health outcomes & early death
• Studies also show strong & consistent correlations between improved
housing status and…
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Reduction in HIV/AIDS risk behaviors
Access to medical care
Improved health outcomes
Savings in taxpayer dollars
• Dramatic new evidence shows housing is an effective and cost saving HIV
prevention & health care intervention for homeless/unstably housed
persons with HIV
• Go to www.nationalaidshousing.org for references and fact sheets on
housing & HIV
Summary of
Key Findings
on Housing
Housing
Works,
Inc.& HIV:
• Homelessness and unstable housing are linked to greater HIV risk,
inadequate care, poor health outcomes & early death
• Studies also show strong & consistent correlations between improved
housing status and…
– Reduction in HIV/AIDS risk behaviors
– Access to medical care
– Improved health outcomes
– Savings in taxpayer dollars
• Recent research shows that that housing is both effective and cost saving
as a health care intervention for homeless/unstably housed persons with
HIV & other chronic conditions
Housing is Healthcare
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Stable
Housing
Improves
Housing Works, Inc.
Health Outcomes:
• Homeless/unstably housed PLWHA whose housing status improves over
time are:
– More likely to report HIV primary care visits, continuous care & care that
meets clinical practice standards
– More likely to return to care after drop out
– More likely to be receiving HAART
• Increased housing stability is positively associated with:
– Effective HAART (viral suppression)
– Better HIV related health status ( as indicated by viral load, CD4 count, lack of
co-infection with HCV or TB)
• Placement is supportive housing has been found to reduce mortality
among homeless PLWHA by as much as 80% over time
Housing
Works,
Inc.
Practice-Based Evidence at Housing Works:
• Community based participatory research (CBPR) partnership with the
University of Pennsylvania School of Social Policy & Practice
– Collaborative agenda setting
– Advocacy-based research agenda
• Agency-wide standardized assessment process/tools
– Incorporating validated measures
– Staff training & mentorship
• Examining the effectiveness of a housing-first program in promoting
HAART adherence for a sample of previously homeless PLWHA
– Initial findings: residents 3x more likely to have undetectable viral load at follow up
– Exploring the pathways through which housing influences medication adherence
. the WTHP:
Consumer from
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Introduction
Experience with homelessness and incarceration
Navigating the system
Experience with Housing Works
Benefits to her of the program
Housing
Works, Inc.
Get Involved!
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Contact Lynn Walker at [email protected] and Ken Robinson at
[email protected]
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Visit Housing Works’ website at www.housingworks.org
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Join the International AIDS Housing Roundtable: http://groups.yahoo.com/group/iahr/
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Endorse the International Declaration on Poverty, Housing Instability and HIV: http://nationalaidshousing.org/2008/07/endorseconference/
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Use the NAHC Policy Tool Kit to inform local policy & funding decisions:
http://www.nationalaidshousing.org/policytoolkit.htm
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Share your successes – let NAHC know how you use research findings to inform practice and
policy: [email protected]