(Unranked) List of Priorities Identified in the 2000-2001 Needs Assessment Process

Note: The following unranked list of unmet needs includes both needs which could be met by SHP projects, as well as needs which would be better addressed in other ways (e.g., shelter-related needs which cannot be funded by McKinney-Vento; needs related to staff training; needs best addressed by policy changes; needs best addressed by other sources of funding with more flexible definitions of homelessness or more flexible guidelines regarding use of funds; etc.) The needs included on this list were raised during the course of discussions at Homeless Services Planning Committee meetings, or Consumer Forums conducted in the Winter/Spring of 2001. I have attempted to summarize those discussions and extract the needs identified as editorially neutral as possible. To the best of my ability, the needs listed represent the opinions of homeless consumers and providers, and not necessarily those of the City or its Department of Human Services.

Need

OK for SHP?

Shelter

 

Increased need for shelter for women; many of these women are afraid to stay in larger shelters in Boston, are instead staying in risky, sometimes abusive, relationships with men who can offer housing or "protection" on the street.

 

Need for increased capacity or, preferably, a separate, smaller, wet shelter for homeless women actively drinking or drugging.

 

Need for separate shelter space for young adults, who don't belong in the same shelter as chronically homeless, chronic substance abusers, etc. In the absence of shelter, homeless youth are staying on the street and in other dangerous and inappropriate locations (e.g., South Station), and lack the supportive base from which to take the steps (continuing their education, finding employment, getting straight) they need to stabilize their lives. While some of these young adults are able to tolerate the more limiting rules imposed by an organization such as Bridge Over Troubled Water, many forego access to services in favor of the freedom to dress as they please, to stay with their partners, to sleep when they need it, etc.

 

There is a need to provide shelters for couples; rather than force couples to find dangerous alternatives to shelter, rather than isolating couples who have unhealthy dynamics, it would be preferable to offer them shelter services, supporting healthy relationships, and offering constructive intervention to address unhealthy relationships.

 

Changing regulations will require battered women's shelters to provide shelter to women with complicating substance abuse and mental health/behavioral problems that they have historically screened out. Shelters will require greater adjunct services, and their graduates will need stabilizing transitional housing.

 

Families in shelter have a range of problems in addition to homelessness Ė mental health issues, cognitive problems, problems involving substance abuse, problems related to children acting out Ė that shelter staff arenít prepared to deal with. There are various reasons why shelter staff are unable to deal with these issues: (a) because of intense DTA (Mass Department of Transitional Assistance) pressure to focus on housing search and not on the needs that families have (depression, parenting problems, etc.), (b) because families often donít acknowledge the problems, and (c) because shelters arenít funded to hire staff with clinical expertise, and donít have access to in-house clinical back-up. Failure to furnish necessary services delays successful housing search, jeopardizes the ability of a housed family to sustain housing, contributes to the later dysfunction of the children, and compromises the shelter experience for other families. While DSS intervention or the threat thereof may be effective in promoting a connection with services, DSS is not effective in cases where apparent neglect is a result of dysfunction and not intention.

 

There continues to be a serious shortage of non-DTA shelter beds for families. Families whose earnings are inadequate to help them escape poverty and homelessness are nonetheless over-income for DTA shelter. Families in DTA shelters who are taking the steps that they should be taking to develop economic independence are punished by having to choose between curtailing their earnings or give up their shelter.

 

Concern was expressed about the break-up of intact families due to the inability of shelters to handle male parents or older boys

 

There is a need to adjust shelter policy and funding to allow shelters to remain open during daytime hours, so that persons who are too ill or frail to be put out on the street can remain during the day, and so that people who work non-traditional hours can have a place to sleep when they get home from work. There was a general concern that shelters are not geared to supporting people who work, ranging from disturbances at night to early evening meeting requirements, etc.

 

There is a need for wheelchair accessible shelter space for men and women (in addition to CASPAR's ESC, which is only for active substance abusers.)

 

There is a need for additional staffing at shelters, so that staff have time to work with and support guests, as well as to ensure guest safety and security

 

There is a need for more "contract" or "extended stay" shelter beds for people who are working, so that they have a stable place to stay. On the other hand, the expansion of contract beds reduces the supply of emergency beds, which leaves homeless persons who are not working without adequate access to shelter.

 

There is a need for spiritual guidance to support the recoveries and transitions of homeless people from their instability to housing and purposefulness.

 

 

 

 

Transitional Housing

 

There is a shortage of transitional housing beds, especially, transitional housing beds with the flexibility to take people who don't quite have the necessary recovery time, who may not have serious disabilities, or who otherwise don't fit the mold that a particular program is looking for. In the meantime, homeless persons unable to access transitional housing instead getting on waiting lists for Section 8 subsidies, which they often get before they are ready for independent housing. That is, it is sometimes easier to get a subsidy than to get a bed in transitional housing, especially for women.

(

There is a need for clarifying and simplifying guidelines for various transitional housing programs.

 

The ambiguous status of halfway houses and residential treatment/recovery programs was discussed. Although HUD does not consider the residents of these programs to be homeless, they, in fact, have no where to go to when they are ready to move on.

 

The impending opening of two programs offering transitional housing for families will address an ongoing need of families coming from both DTA shelters and shelters for battered women.

 

There is a need for longer term transitional housing. Some programs with six-month time frames donít provide enough time for residents to work through their issues, maintain sobriety despite spending money, and find housing.

(

(future grant amendment?)

 

 

 

Permanent Housing with Supportive Services

 

Affordable housing is increasingly hard to find; approximately 2/3 of subsides issued for housing search are returned to the CHA due to inability to find an apartment.

 

Because it is increasingly easy to get a Disabled Section 8 Certificate, and because Shelter Plus Care certificates are much harder to come by, many persons who might be better off with supportive services-enriched housing rather than independent housing are instead going it alone. If there were more S+C certificates Ė or some similarly accessible housing certificates that are offered with the requirement of participation in a service plan, some of these individuals, especially persons with backgrounds that concern landlords or with more limited recovery time, might opt for those certificates, given their higher rent ceilings. Of course, some homeless persons with disabilities will choose not to self-identify as having a disability for fear of the consequences of being stigmatized, marginalized, and deprived of their autonomy.

(

There is a need for congregate housing options for younger persons with disabilities, although in many cases, such persons might not accept that kind of placement.

(

There are inadequate stabilization resources for people who need supportive services when they enter permanent housing; however, many such individuals and heads of families are unwilling to accept intrusive stabilization services. There is a need for permanent housing with flexible stabilization services that adjust to the participants' needs.

(

 

 

 

Education / Training / Employment Services

 

There is inadequate training available to help people get better-than-minimum wage jobs; if you donít earn better than minimum wage, then you canít retain housing. ESOL, GED, and basic computer literacy are fine, but they don't help you advance in the workplace. There is also a need for training in conjunction with literacy programming and other basics, so that persons with education deficits don't experience failure when they do access training opportunities. Unfortunately, access to training often depends on the existence of a disability, rather than on simple motivation.

 

There was concern about the impact of a CORI on an ex-offender's ability to get a good-paying job. Frustration was expressed that ex-offenders cannot be employed in shelters, etc. due to State requirements.

 

Some homeless people need or would benefit from supportive services to help them keep employment or manage income after they have gotten a job; often, though, the desire for independence is stronger than the willingness to get help.

 

Very high correlation between participation in special education and homelessness. Over 40% of young adults who are homeless were in special education programs while in school. Young adults need an opportunity to catch up with their schooling and get training and a chance to succeed. The longer they don't have access to gainful employment, the more likely they are to be involved in criminal activity which will just make it harder later on to get housing and employment.

 

There is a need for work-quality men's clothing

 

 

 

 

Substance Abuse / Mental Illness / Trauma

 

There is a need for relapse tolerant housing, at the same time that there is the feeling that relapse tolerance may undermine the recovery of some persons. On the one hand, relapse tolerance would enable a person who is in early relapse to ask for help without jeopardizing their bed, and would mitigate the stigma of "failure" to sustain recovery. On the other hand, experience shows that relapse may have a domino effect, and often, people who relapse once soon relapse again.

(

(and policy)

There is a shortage of residential programming for persons using methadone, for persons taking psychiatric meds, for persons abusing psychiatric meds, for persons in substance abuse recovery who are also taking psychiatric meds, for persons who are abusing both prescription drugs and other substances.

 

There is a general shortage of detox beds, and especially, detox beds for persons taking certain psychiatric meds, especially clonipan, an over-prescribed drug. By mid-morning most detox programs are full.

 

There is a need to address compulsive gambling

 

There is a need to provide services for mothers who have relapsed, so that they don't have to choose between treatment and staying with their children.

 

There is a need for staff at programs that serve homeless people to be substance abuse-informed, mental illness-informed, and trauma-informed, so that they can recognize, support, be sensitive to, and be prepared to address these often-present, sometimes hidden adjuncts of homelessness, without labeling or stigmatizing a client who may not be ready or willing to accept a label.

 

There is a need for youth-specific or youth-friendly detox and treatment services, because older addicts and younger users shouldn't mix, and because the message isn't always the same

 

There is a need to make counseling services more accessible to persons who have mental health problems, but who donít have diagnoses, or who wonít access the services required in order to obtain a diagnosis, or who donít acknowledge a prior diagnosis. In order to serve these people, it is important to reach out and develop a trusting relationship, which takes time and, sometimes, clinical skills. Some of these individuals can be very challenging to serve: some have been barred from shelters due to their occasionally aggressive behaviors; some wonít use shelters due to safety or other concerns. One possible approach would be to deploy specialized staff in shelters to serve persons who are not sufficiently ill to qualify for DMH services, or who are unwilling or unable to acknowledge their illness. [Ed Note: Tri-City Mental Health Shelter Specialists are funded to regularly make the rounds in shelters. Unfortunately, there have been staffing vacancies for a protracted period. A new Tri-City collaboration with CASPAR will put such a specialist in the Street Outreach van and also at places like Bread & Jams.] In many cases, these individuals understandably want to get out of shelters as fast as they can, and in the current environment, some of these individuals can get Section 8 subsidies even though they are not ready for housing and independence.

 

See also discussion about needs of families in shelters.

 

At the same time, some people in the DMH programs at the YMCA and YWCA donít want to leave those programs to create openings for persons moving out of shelter. Whatís also needed is more programs that combine housing with supportive services to serve people who arenít ready for independent housing, but who canít tolerate the shelter environment.

 

Concern was expressed about the perversity of the need for a person with a mental illness and a substance abuse to get high or drunk in order to get a detox bed; a need to relapse for over three days before departure from recovery is "officially" recognized as relapse.

 

 

 

 

Youth and Young Adults

 

See shelter section on need for young adult shelter; See section above on substance abuse

 

There is a need to expand the number of hours and days of operation of Youth on Fire, the only low threshold drop-in program for street youth. Drop-In services meet the need for a safe place to spend time off the street, with access to clinical and social services. There are related ongoing needs for services that could be based at a drop-in to assist youth with continuing their education, helping them access housing and employment, and helping them address mental health, sexual identity, and relationship issues.

(

There is a need for providing youth with a stable source of income to help with food, clothing, and housing. Street youth are not in a position to become economically independent, and in the absence of adequate means of legal self-support and putting a roof over their heads, are likely to turn to illegal means of support, prostitution, and self-destructive substance abuse. In fact, prior criminal activity and CORI records, bad credit due to fraudulent check-writing, etc. have made it that much harder to get jobs and housing, and they need that much more help in overcoming those barriers and becoming independent.

 

Bottom line is that young homeless need compassionate adults who will accept them and provide guidance. Acceptance is especially for young adults struggling with their sexual identity, especially non-mainstream sexual identities (gay, lesbian, bisexual, transgender)

 

Youth need opportunities to contribute to their community

 

 

 

 

Housing Search and Stabilization (see also Permanent Housing Section for discussion of stabilization)

 

There is a shortage of housing search services, particularly as the HRT winds down its operations, but even with the HRT in full operation, the HomeStart housing advocate was unable to see all of the people who are looking for housing.

(

There is a need to inform homeless people early on in their homelessness about the mechanics of housing search, so that they can begin to take the necessary steps: getting on subsidy, housing authority, and apartment wait lists; work on building their credit; understand their obligation to develop some savings; etc. This entails a combination of "deep outreach" to shelter guests and meal program patrons and greater access to case management.

 

There is a need for housing search that fits the hours of working persons who are homeless

 

There is an ongoing need for and shortage of stabilization services to help support the transitions from homelessness to housing. Stabilization services need to flexible enough to address the widely varying need for and interest in such services by people making that transition.

(

There is a need to create greater clarity among providers and homeless persons about mechanisms for accessing cash assistance with the up-front costs of moving: first and last month's rent, security deposit, realtor's fee.

 

There is a need for transportation assistance for homeless persons engaged in housing search. Families engaged in housing search can, if they are also working, participate in the Trans-Access program and get a free T Pass. However, families who are not working cannot get a T pass and still have to travel to remote communities in order to apply for housing. Likewise single individuals are left to their own devices to obtain transportation to apartments. In addition to a T pass or tokens, it would sometimes be helpful if there were some kind of van transportation

 

 

 

 

Child Care and Children's Services

 

There is a lack of child care to assist parents who are working or enrolled in training during after-school or evening hours; this lack of child care applies to both school-age and pre-school age children:

 

Families in crisis need counseling that addresses the needs of the whole family, including the children, and not just the parents.

 

 

 

 

General

 

There is a general need to raise the level of awareness of services and resources within the Continuum, and to promote greater cooperation and collaboration among providers. Although there are various sources of information about resources, staff turnover and the necessary focus of staff on the program-specific basics of the agencies in which they work undermine their ability to help homeless people take full advantage of the programs and services available to them

 

Many programs are categorically-focused (substance abuse, metal illness, disability, trauma, etc.) and people who don't see themselves as fitting into those categories feel excluded from services, even if they might benefit from some of those services. And, there are some people who are homeless for economic or other reasons, and who lack clinical diagnoses, but still need the basic assistance that supportive services programs offer.

 

There is a need for greater access to tokens and T passes to facilitate housing search and job search and commuting to employment. The cost of transportation is prohibitive.

 

It was suggested that in the same way that a nurse visits all the family shelters on a regular basis, it would make sense for a health care provider to regularly visit all the individual shelters on a regular basis to provide health promotion activities ranging from smoking cessation to identification of untreated problems and referrals for services

 

 

 

 

HMIS

 

At the same time that there is some recognition of the utility of client tracking, at least within programs, there continues to be concern about the compromise of confidentiality attendant to the exchange of information across programs. There is also concern about the lack of some clients' competence to consent to the sharing of information when they are under the influence or alcohol or drugs, or in the middle of an episode of mental instability.

 

 

 

 

 

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