Unsheltered No More Initiative

Homeless Registry Community Debrief

February 1, 2013

Registry Sponsors

Thank you

Our Provider Partners

ACSS Atlanta Mission Atlanta Outreach Caring Works Central Outreach Community Friendship Crossroads Dennis bowman First Step Staffing Gateway Grady Hope Atlanta Project Community Connections, Inc. Project Interconnections, Inc. Quest 35 St. Josephs United Way of Greater Atlanta VA

Thank you

Our Volunteers
Thank You

I was very intrigued and moved by this experience. I got an opportunity to interact with a very misrepresented part of Americas populationI can honestly say this experience touched my life and will stay with me for a long time. - Amanda Gosselin, Emory University Student

Who is Homeless?
- Living in uninhabitable space; shelter, TH or exiting an institution with no place to go - People losing their primary night time residence - Families with children or youth unstably housed - People fleeing domestic violence with no place to go

HUD Definition of Homeless

HUD Definition of Chronic

- Experienced homelessness for > 1 year OR - Experienced 4 episodes of homelessness in last 3 years AND - Has a disability (or debilitating disorder)

What is a Registry?
A tool used to identify and prioritize the homeless population for housing based on the fragility of their health.
-A by name list of every homeless neighbor who is willing to be registered -Info is collected via a survey called the Vulnerability Index (VI) -The VI measures mortality risk and ranks individuals by their risk factor and length of time on the street

What the VI Measures

At least 1 Risk Factor Time on the Street
Street homeless 6 months or more
-3+ hospitalizations in prior year -3+ ER visits in prior 3 months -End State Renal Disease -History of Cold Weather Injuries -Liver Disease or Cirrhosis -HIV+/AIDS -Over 62 years old -Tri-morbidity: co-occurring psychiatric, substance abuse and chronic medical condition

AND

-Developed by Dr. Jim OConnell -In Boston, 40% of those living with a risk factor died prematurely

Voice Over: This picture was taken in 2000 all of these gentlemen have been homeless for > 6 mos and have at least one risk factor. Only one of them are alive today.

What the VI Tells Us

Who the most vulnerable are Scope of predominant issues Scale of subpopulations

Atlanta Registry Night

Registry Summary

190 volunteers in two shifts: Shelter and Street Outreach 20 APD Officers 5 shelters 90 concentration areas 637 VI surveys conducted

What They Told Us

Population Profile

- Avg age : 47

51%

49%

-Oldest: 83 yrs -Youngest: 18 yrs -5 were 18 years old -81% are Male -longest time living on the street: 50 years

Homeless >1 yr OR 4X in 3 yrs

Other

Findings: Risk Indicators

69.5% reported at least one of the risk factors

Indicator 3X hospital last yr 3X ER last 3 mos > 62 yrs old HIV+/AIDS Liver Disease Weather Injury Tri-Morbid

Atlanta 85/13% 127/20% 55/9% 33/4% 35/5% 75/12% 172/23%

National 12% 10% 10% 3% 10% 10% 30%

*numbers based on total registry of 762 to include pilot data

Debilitating Disorders - Comparables

Mental Health Substance Abuse Co-occurring (MH+SA) Tri-Morbid

Registry by Subpopulation
Chronic Veterans HIV+/AIDS Families Episodic Other

Housing Strategies

17%

23%
Chronic

32%
Episodic

15% 8%

5%

- Chronic pilot with DBHDD and 17 providers - Veterans Initiative has housed 323 since May 2012 - Episodic launching 100 housed with 100 jobs in 100 days in partnership with First Presbyterian and ACSS

Episodically Homeless Profile

53% homeless less than 6 months
Of these...

31% 69%

10% with house-able

income of >$700/mo criminal background

60% without serious

21% with work experience 21% with income in last 6
months

Episodic

Other

Cost to the System

Healthcare Registry Results

1,147 ER Visits in the past 3 months = $1,055,240 in ER Costs ($4,220,960 annulaized) 642 hospitalizations in the past year = $4,494,000 in hospitalization
Annual cost of over $8 Million

Research shows a 60% reduction in healthcare costs after the first year of housing.

$5,228,976

potential savings to Grady.

Criminal Justice Costs

958 Homeless arrests in 2012 (misdemeanors) = $210,760 17,944 nights in jail = $1,769,560 cost to corrections

68% of those surveyed have been to jail or prison

Cost of PSH for Chronic Homeless/year

$17,274
Personal Services

Housing
Cost to house 200 chronically homeless: $3,098,200

Cost to Re-House Episodically Homeless

$2,200
Administrative Avg Utilities

Avg Move-in Costs

Cost to house 200 episodically homeless: $440,000

Next Steps
Outreach
- Registry - ID most vulnerable - Validate vulnerable status - Begin intake process

Assessment

Housing/Services

- Healthcare as - Designated Stabilizer Assessment - Shared Standards Centers - Evidenced Based - Standard Assessment Tool practices - Referrals from - Centralized Housing Inventory Registry Only

Thank You!