What is Crisis Response? An Overview and Guidance on Building Better Systems
HUD initiated the Continuum of Care (CoC) process in the mid-1990s to stimulate community-wide planning and coordination of programs for individuals and families experiencing homelessness. In many communities, the CoC concept was implemented as a linear model where people experiencing homelessness are expected to progress through levels of care including emergency shelter, transitional housing, and finally permanent housing.
Over the last decade, both research and practical experience have taught us a great deal. Building on this knowledge, many communities have begun to adopt an approach that focuses on immediate placement into permanent housing. For individuals and families that have recently become homeless, the goal is “rapid re-housing,” and, for individuals with long histories of homelessness, we talk about “housing first.” The tools and strategies look slightly different for different populations, but the philosophy is the same: return people to housing quickly and thenprovide the specific level of assistance and services needed by that individual or family to remain in housing. A central tenet of this approach is that people have more success dealing with other challenges in their lives - including substance abuse, physical and mental health conditions, unemployment, and family preservation and reunification - when they are in their own home.
While many providers across the country have adopted rapid re-housing and housing first models, it is our ability to take the concept to scale nationally that will ultimately determine our success at ending homelessness. It is not enough for a few providers in each community to have adopted this approach. We need entire communities to embrace this philosophy and restructure their systems around it. If the old model was emergency shelter, transitional housing, and permanent housing, the new model is based on the three “A’s”: 1) Access; 2) Assessment; and 3) Assignment of Intervention.
Access to a Community-Wide Response System
When a housing crisis occurs, how do people access help? Do they know where to go? Can assistance be provided in time to avoid housing loss and/or to avert (or minimize) trauma associated with housing loss? In some communities, the decision has been made to transition to a central point of access, while in other communities, they have elected to use a regional (yet coordinated) approach. In addition to systems of centralized or coordinated intake, comprehensive system access also includes street outreach to provide system access for those unable or unwilling to access assistance through more traditional channels. Lastly, system access includes connections to institutions (such as prisons and hospitals) and other mainstream systems (schools, TANF agencies) in an effort to prevent homelessness before it occurs
Service providers have the very difficult job of helping clients deal with very real and often traumatic personal crises. Since it is natural to want to assist people with every resource available, it can be challenging on the front lines to maintain a big picture perspective. When focused on helping the person or family in front of you, it is difficult to remember the fact that “extra” assistance for one household, assistance above and beyond what that household truly needs to achieve or maintain stable housing, can mean housing loss or a delay to stability for someone else in the community. Exactly how much help each household actually requires can be difficult to determine. Every low-income household could benefit from an ongoing housing subsidy, but not every household requires an ongoing subsidy to maintain housing. Unfortunately, there are not sufficient housing subsidies for every low-income household. For these reasons, formal assessment and referral protocols are necessary to efficiently and effectively evaluate and triage people in need of housing services. These protocols are most effective if they use a balanced approach that considers the household’s assets, not just their barriers/deficiencies.
Some communities have elected to have one agency perform this function, while others allow for multiple points of entry but rely on the use of a common tool and referral procedures. While the process may be a bit different for people experiencing chronic homelessness and highly vulnerable unsheltered individuals than it is for families and unaccompanied youth experiencing homelessness, effective communities still use a common tool to assess needs and prioritize individuals for placement into housing often in the form of a vulnerability index or other prioritization tool.
Assignment of Intervention
Last but not least is assignment to the intervention. As discussed above, the new model is focused predominantly on permanent housing solutions, but those solutions may take different forms. Some households may need only a short-term subsidy (using the rapid re-housing model), while others may require an ongoing subsidy to remain stably housed (through coordination with the local Public Housing Agency or other affordable housing provider). Still others will need an ongoing subsidy with intensive, wraparound services in the form of permanent supportive housing. Services are associated with each type of intervention, but the level and duration will necessarily vary for each household.
Emergency shelter and transitional housing programs still play important roles in the 3 A’s model, but admittedly different roles than they currently play in most communities. Unless access to affordable housing is widely available, we would not expect to be able to prevent all crises that lead to homelessness, so there may always be a need for shelter in metropolitan communites. People need a safe and secure place to stay during their crisis so they can focus on the pressing need at hand: locating permanent housing. Helping arrange short-term placement with family or friends and other methods of shelter diversion should always be explored first, but sometimes diversion is not possible. As communities establish efficient housing search and placement strategies and become increasingly sophisticated at administering rapid re-housing and housing first assistance, they will significantly reduce the amount of time people spend in shelters. This means that people will move through shelters much more quickly, which means fewer overall shelter beds will be needed in the community.
There might also be a subset of individuals who need single-site transitional housing. This might include youth or individuals in recovery who have intensive service needs that are best met in a congregate setting. However, the majority of people experiencing homelessness do not need transitional housing for the reason mentioned above – services to enhance well-being are typically more effective when people are in their own home. In most communities, the amount of single-site transitional housing stock is likely too large for the number of people that truly need it in order to achieve housing stability, so there will be work to do to repurpose these programs to more efficient models. For more information on this topic, view USICH’s webinar on Reallocation and Repurposing.
So that’s objective 10 of Opening Doors in a nutshell – transforming your system from one that manages homelessness to one that quickly and effectively resolves it. This systems change work is truly the foundation for all other work happening at the community level. Implementing Objective 10 will require difficult work and hard choices, but, without implementation, we will never be able to help everyone in need of housing assistance and end homelessness in America.