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Strategies for Serving the Chronically Homeless

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Citrus Health Network

Federally Qualified Health CenterPharmacyMedical Home

Case ManagementPsychiatric Model

Out-Patient ServicesCrisis UnitSTAR

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Origin & Expansion of Housing Model

Citrus began the first HUD funded “low demand” residence in Miami Dade County in 1992 targeting chronically mentally ill homelessSafe Haven & Drop-In CenterShelter Plus CareSpecialized OutreachJail DiversionHousing FirstCase Rate

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Low Demand Housing

In 1992, Citrus opened a transitional housing program which served psychiatrically disabled homeless persons with co-occurring chemical dependencies.

Designed to engage single, adults who refuse mainstream homeless programs, we had few rules

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Safe Haven

Single bedroom design intended to engage homeless persons suffering from severe mental illnesses.

Designed to engage single, adults who refuse mainstream homeless programs, we had few rules

85% successful out-placements

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Safe Haven

Outreach

Drop-In Center

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S+C

•Approximately 300 Independent living units

intended for formerly homeless, disabled

adults and families

•Miami-Dade Housing Agency: Rent subsidy

only

•Match requirement

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Coordinated Outreach

Philadelphia Model

Chronic Homeless focus

Census 180 from 400, annually 400-600 (40% success rate)

SOAR

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Relationship Based Care Philosophy

Relationship Based Care uses the empathy, respect and connectedness that are inherent in healthy relationships to engage individuals in therapeutic activities and empower them to take responsibility for their lives

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Relationship Based CareEngagement Phase

May require multiple contacts & outreach in their environment

Motivational Interviewing a MET technique (Role play with the staff)

Encouraging Voluntary acceptance of servicesPersonal freedom & choice

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Jail Diversion

Miami-Dade County initiative geared at diverting mentally ill individuals away from incarceration and into community-based treatment programs.

Scattered Site, Transitional Housing

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Jail Diversion

Outcomes published in Psychiatric Services,

June 2009 ed.

151 individuals served by Citrus over three

years, compared to control group

Citrus clients had statistically significant

reduction in criminal recidivism

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Housing First

Pathways to Housing visit

Designed to engage chronic homeless adults who refuse existing, mainstream housing resources

ACT staffing model

97% retention rate

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Case Rate

Menu of housing choices

Clients can move between models

Payment structure is designed to reward performance

Food and Beverage Tax