Unsheltered No More InitiativeHomeless Registry Community Debrief

February 1, 2013

Registry Sponsors

Thank you

Our Provider Partners

Thank you

ACSSAtlanta MissionAtlanta OutreachCaring WorksCentral OutreachCommunity FriendshipCrossroadsDennis bowmanFirst Step StaffingGatewayGrady Hope AtlantaProject Community Connections, Inc.Project Interconnections, Inc.Quest 35St. Joseph’sUnited Way of Greater AtlantaVA

Thank You

Our Volunteers

“I was very intrigued and moved by this experience. I got an opportunity to interact with a very misrepresented part of America’s population…I 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

- Experienced homelessness for > 1 yearOR

- Experienced 4 episodes of homelessness in last 3 years

AND- Has a disability (or debilitating disorder)

HUD Definition of Homeless

HUD Definition of Chronic

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 is a Registry?

What the VI Measures

At least 1 Risk Factor- 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

Time on the Street

Street homeless 6 months or more

7

AND

- Developed by Dr. Jim O’Connell- 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.

Resource Planning

Who the most vulnerable are

Scope of predominant issues

Scale of subpopulations

What the VI Tells Us

Atlanta Registry Night

190 volunteers in two shifts:Shelter and Street Outreach

90 concentration areas

Registry Summary

5 shelters

20 APD Officers

637 VI surveys conducted

What They Told Us

49%51%

Homeless >1 yr OR 4X in 3 yrs Other

Population Profile

- Avg age : 47-Oldest: 83 yrs-Youngest: 18 yrs-5 were 18 years old-81% are Male- longest time living on the street: 50 years

Findings: Risk Indicators

Indicator Atlanta National

3X hospital last yr 85/13% 12%

> 62 yrs old 55/9% 10%

Liver Disease 35/5% 10%

3X ER last 3 mos 127/20% 10%

HIV+/AIDS 33/4% 3%

Tri-Morbid 172/23% 30%

Weather Injury 75/12% 10%

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

69.5% reported at least one of the risk factors

Debilitating Disorders - Comparables

Mental Health 336 44% 48%

Substance Abuse 489 64% 59%

Tri-Morbid 172 23% 24%

Co-occurring (MH+SA) 240 32% 35%

NUMBER PERCENTAGE NATIONAL AVERAGE

POPULATION

23%

15%

5%8%

32%

18%

Chronic Veterans HIV+/AIDS Families Episodic Other

Registry by Subpopulation

Housing Strategies

- 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

Chronic

Episodic

31%

69%

Episodic Other

Episodically Homeless Profile

53% homeless less than 6 months

Of these...

• 10% with “house-able” income of >$700/mo

• 60% without serious criminal background

• 21% with work experience

• 21% with income in last 6 months

Cost to the System

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

Research shows a 60% reduction in healthcare costs after the first

year of housing.

$5,228,976 potential savings to Grady.

Healthcare Registry Results

Annual cost of over $8 Million

= $210,760

958 Homeless arrests in 2012 (misdemeanors)

17,944 nights in jail

= $1,769,560 cost to corrections

68% of those surveyed have been to jail or prison

Criminal Justice Costs

$11,000

$5,774

$500

$17,274

Personal

Services

Housing

Cost of PSH for Chronic Homeless/year

Cost to house 200 chronically

homeless: $3,098,200

$1,540

$439

$198

$2,200

Administrative

Avg Utilities

Avg Move-in Costs

Cost to Re-House Episodically Homeless

Cost to house 200 episodically

homeless: $440,000

Next Steps

-Registry- ID most vulnerable

-Validate vulnerable status

-Begin intake process

Outreach

-Designated Assessment Centers

-Standard Assessment Tool

-Referrals from Registry Only

Assessment

-Healthcare as Stabilizer

-Shared Standards-Evidenced Based practices

-Centralized Housing Inventory

Housing/Services

Thank You!