Top 51 Pilot in Hennepin County Minnesota: Lessons Learned

Chris Michels

Lisa Thornquist

Hennepin County, Minnesota• 1.2 million residents – 1/3 Minneapolis

• 2,300 in shelter on any given night. 1,400 are in families, 900 are single adults.

• Over year, 7000 single adults in shelter.

• About 500 single adults stay off and on for over a year

• 3,000 PSH Units for single adults – 600 turn over each year

Distribution of Nights in Shelter

Top 51 clients identified

• Top users of shelter 1/1/2008-4/15/2011

• They had 47,294 nights in shelter during this time

• They accounted for 8 percent of shelter capacity (we typically have 900 single adults in shelter on any given night)

Service Use of Top 51

Top 51 Pilot

• 4 case managers contracted to agencies (with supervision)

• 2 county staff PATH homeless outreach

• Steering committee of 10-12

• $710,000 for 2.5 years in contracted services

• Started July 1, 2012

Top 51 Program Participants

• 55 clients selected – 49 men and 6 women

• 12 had been in shelter since at least 1997 – first year of record

• Average first year in shelter 2002

Pre-Engagement

• Case Manager can identify client

• Case Manager watches/observes a client whenever possible and identifies daily routine

• Case Manager does research on client, obtains information from various sources and plans/strategizes how to approach client

Early Engagement

• Client knows Case Managers name and is aware of Case Managers role and program involvement. CM offers incentives to a client, begins to establish trust and build a relationship.

• Client Assessment completed

Advocacy• Case Manager approaches client to

discuss client needs, offers resources and support.

• Client approaches Case Manager and expresses needs.

• Case Manager identifies barriers through verbal interaction with client and begins plan for addressing needs and pilot goals.

Partnership

• A mutually trusting relationship has been established.

• CM and client meetings have been set up and client is showing up for meeting. CM and client form common goals and plan and are actively working on client's plan.

Outcomes - Housing

• Of the original 55 clients, 34 are housed – 62%.

• Clients obtained housing in various housing settings (single room occupancy, scattered site Group Residential Housing, private market housing, nursing home, transitional housing)

Outcomes – Reduction in shelter

• In first year – 55 clients reduced shelter use by 23% one year pre versus post - mostly by those housed.

• Saved 2,980 bed nights – equal to the bottom 2,463 shelter users

• Equivalent to opening up 8 shelter beds a night.

Outcomes – Health care utilization for first 20 housed

Outcomes – criminal justice

• 41 arrests in year prior to pilot. 34 arrests in first year of pilot – 17% reduction.

• Of the 13 people with arrests, only 3 occurred while they were housed

• Almost half the arrests were related to alcohol consumption.

• Other arrests: disorderly, trespassing, panhandling. No violent crimes

Vignettes

• Jorge – 10 years in shelter, undocumented, non-English speaker

• Gus – severe mental illness

• John – severe mental illness

Who is left to house???

• Barriers of the remaining 21 yet to house– Immigration status– SPMI (especially female clients)– Individuals that have a higher thresholds of

income and do not see housing as a priority– Criminal record– Chemical Dependency

Lessons Learned

• To effectively move people into housing, it takes time.

• It takes 8 months to get them into housing.

• It takes another year to engage them around issues that kept them in shelter.

Lessons Learned

• Not every client see a need to leave shelter. Dedicated case managers are needed to work with those who are not willing to leave.

• Multiple Housing Options

• Payment for case management services has to start before housing placement

Lessons Learned

• Program development is an iterative process – HF should be monitored to see who it is serving and who is it NOT serving

For More Information

• Websitewww.hennepin.us/HeadingHomeHennepin

• Email– Lisa.Thornquist@hennepin.us– Christine.Michels@cctwincities.org