Car Dealerships & Homeless Facilities

Car dealerships try to get you to do three things:

1. Buy/lease from them

2. Finance through them

3. Service your vehicle with them

The entire experience of the dealership keeps reinforcing these three things, implicitly and explicitly. In the process of buying/leasing the car they talk with you about finance options and how great the service team is. When engaging with the finance people, they reinforce your purchase/lease and talk about how great the service team is. Go to get your oil change, and they have stimulation that reinforces your purchase/lease and may even get you thinking about the next vehicle with them because of the sales team or the amazing financing opportunities. 

Visually, the car dealership knows their business and reinforces it unrelentingly. The psychology of reinforcing decisions through advertising is rather amazing. What you won't see in a car dealership, for example, is messaging about the importance of taking public transit or why biking to work is good for you and the environment. 

Maybe it is time homeless service facilities like shelters and drop-ins starting functioning more like car dealerships.

Let us assume that we all agree that we are in the business of ending homelessness. (As an aside, I know that sentiment is not universal.) Our business model - and advertising - needs to support our objective. If we are not doing that, with fierce singularity of purpose, we may be inadvertently be making our work that much harder. 

When I tour through homeless shelters, what do I see on the walls and bulletins boards and such? In a nutshell, confusion. I see advertisements for spaghetti dinner at the local church and when the podiatrist is coming to visit and day labor services and what the VA can do and where to worship and where to get clean underwear. I see advertisements for AA meetings and when the career fair is and how to use the telephone and when to do laundry and who to meet with to get a bus pass. I see rules posted and changes to operating hours of another organization and places to worship and when the barber is coming and a reminder not to loiter outside the front doors on the sidewalk. Some of these are on colored paper. Some of these have long-since expired. Some lack sufficient detail for me to know exactly what to do. Some are so seemingly intrusive I wonder who got access to the facility to post it and why they were granted permission to do so.

What I don't see in most shelters and drop-ins? Clear advertising and messaging - implicitly and explicitly - about the core business, which is getting people out of homelessness. We bombard people with noise and confusion. Generally we are well-intentioned but misguided. We overwhelm service users with stuff that does NOT help them get out of homelessness, but rather help them manage their experience of their homelessness.

When we work on homeless service facility improvement, one of the first things we do is try to harness the message so that the business intention is clear. All of those things (podiatrists to AA to spaghetti dinners - and everything in between) may be well-intentioned. Heck, for some they may even be helpful (though maybe more helpful after moving into housing). But they are the WRONG things to be supporting, messaging and focusing on in homeless shelters and drop-ins. 

My request of you this week is to take a look around - literally - and remove anything that is not absolutely focused on the core business of ending homelessness. If that seems to extreme, then consider housing messaging to be the dominant focus with all else relegated to its own area. 

What should that housing messaging be? Think back to the car dealership. How do people get housing (the ability to figure it out on their own or through a program like Rapid ReHousing or Permanent Supportive Housing)? How do people maintain their housing (what supports and community resources will help people when they are in housing)? And, how do we make sure that people do not return to homelessness? You can enhance the message by infusing data like the number of people that moved into housing, how long it took, and how many returned. 

Our ability to focus on housing should be unapologetic and blatant. For some, this will be a focus on how people can figure it out on their own. For others, it will be how coordinated entry works, the assessment process and such. Confusing the message only confuses the process and strays us away from the core business of what we are trying to achieve. 

Be more like the car dealership. Even if you loathe car salespeople (especially of the used variety). You may not like them, but they are really effective. People that you serve don't necessarily need to like you, but you too need to be effective.

Hurricanes Do Not Discriminate, but Others Do

The full extent of Irma's devastation at the time of writing is not known. I hope there are few if any fatalities. I want to focus on a couple of aspects of the hurricane as it relates to homelessness.

The first is that there were definitely two groups of people served in advance of the hurricane when it came to sheltering. Take a look at this story from Volusia County (Daytona) here. 

In a nutshell, those that were seeking shelter but had a permanent residence were offered one type of shelter. Those that were homeless were told that they needed to go to a homeless shelter.

Then there is what happened in Miami. As this story from the Toronto Star demonstrates, people that were homeless were assessed for the Baker Act to forcibly remove them from the street. 

I get that people who are poor, including those that are homeless, struggle to have transportation options to vacate a location where a hurricane is projected to hit. And, I would argue that there may be instances where it is justified to use an instrument like the Baker Act to take people out of harm's way if they are not making good decisions for their own safety.

But I struggle in the selective application of an instrument like this. Maybe I am naive. I watched CNN. I heard telephone interviews with people in the Keys who were not in great structures planning on getting drunk and riding out the storm. I saw people going out for a jog in the rain in the background of a segment on CNN, even with a curfew, and even with debris falling all around. I saw interviews with people planning on riding out the storm on their boat, and post-hurricane interviews with people from mobile home parks. Maybe as a person that lives with a mental illness I find it stigmatizing that we think of just those who are homeless as unwell and in need of assessment prior to a hurricane, rather than looking also at those that are making poor decisions about where they will be during a hurricane. 

Finally, there will be billions spent in disaster relief, including some forms of assistance for that that did not have any or the right type of insurance. Now I will be naive and suggest this - imagine if we saw homelessness as the disaster that it is, and invested in the same way with the same urgency.

We Need to Tackle Grant Per Diem Funded Programs – NOW

If there is one pressing issue to be tackled from a policy and funding perspective in the pursuit of ending homelessness, it is grant per diem funding in any homeless services. While much of the spotlight has been on Veterans Affairs and its massive inventory of GPD funded beds, they are not alone. Other jurisdictions have wrestled with the concept of GPD funding in shelters for quite some time – and with little success. I say now is the time for tough change to get GPD aligned to the pursuit of ending homelessness.

If you don’t know what a GPD program is, in a nutshell it goes like this: as a service operator, you get a set fee for a head on a bed each night. Used in a sheltering context (which varies by jurisdiction, but can include things like transitional shelter, something resembling transitional housing, or emergency shelter…or in some antiquated models in the northeast something resembling a nursing home), the service provider most often provides some support services to the participants in this program.

In my experience and travels, these services are all over the map in terms of intensity, professionalism of delivery, and purpose. For example, in some instances I have seen highly qualified addiction counsellors provide a form of residential support and counselling to those striving for sobriety. But I have also seen too many poorly constructed life skills and budgeting classes, as well as terrible employment readiness programs. Some GPD programs offer around the clock access and supports. Others have periods of time where residents are expected to be out during the day. Some GPD programs require sobriety or meeting with a case manager within a certain number of days of entry or an employment plan. Others are much more low barrier. I guess my point is, people say “GPD” and make assumptions that they are all the same thing, when there is overwhelming diversity and a lack of quality assurance from city to city (or even within the same city). Country to country it is even more diverse.

What should bother us more than the diversity of programming though – and what I don’t get – is how any community or leader on the one hand can say they are all for housing first and then in the next breath support a GPD program. GPD, as it is most often delivered, is the epitome of housing readiness, which is the antithesis of housing first. The programs do not facilitate rapid access to permanent housing with supports wrapped around in the community.

GPD incentivizes homelessness. No service operator, from a financial perspective, wants to have people vacate their program until whatever imposed stay limit is exhausted. Why? They would have to find another head for the bed to ensure financial sustainability. Maybe this is not a concern in communities where there is considerable demand that outstrips supply, but the demand should not be what drives the program or its funding model in this instance. Should people stay homeless longer because it is in the financial best interest of the operator?

Those in the know will say GPD programs cannot and will not change until there is a legislative change, which steers the ship for providers. So what are we waiting for? If we know the answer, why is there little movement in most jurisdictions to rectify the matter? Is there a GPD lobby group so strong that it should overwhelm evidence and dare I say common sense? This is a classic example of a leadership void for a solution waiting to happen; an instance where popularity of a program and the fear of backlash trumps what is necessary.

Let me layout a funding transition plan that would get the ball rolling.

Offer each GPD provider guaranteed income of $25 per bed in their facility. Multiple that by 365 days. That should be enough to keep the place with a bare-bone staff and pay essential operating bills. In a 25 bed facility, that would equal $228,125.

Ensure GPD providers take people with the highest acuity first. So, the deeper the need on the part of the person that is homeless, the more likely they are to get access to the bed.

Then, offer an incentive of $500 for each person housed out of the GPD funded program. If the person does not return to homeless for three months, provide an additional $100. Do the same at 6 and 9 months. At the 12 months mark, if the person has not returned to homelessness, $1,500 bonus. If 100 people were housed through the program each year, this would actually result in the GPD funded program operator having a slightly greater annual budget (from GPD resources) than operating in the traditional manner – and it would move us all closer to ending homelessness. That would more than take care of all other staffing and building costs.

At the same time, ensure there is a financial disincentive for anyone that has a prolonged stay in a GPD program (perhaps with some exceptions for people that are palliative). So, for example, if someone has not had a positive housing destination within 6 months, the GPD provider only gets $15 for that person each night. If that reaches a year it is $10 for that person. If the person is still in GPD at 18 months, the provider only gets $5 in funding for that person.

That would work for the “traditional” GPD programs.

Then, if there is an appetite for service enriched programs like the professionally staffed addiction counselling and substance use recovery programming that I referenced earlier, call it something other than a GPD program. Give it block funding. Because really, a substance use recovery program is great (and needed for many people) but do NOT confuse a substance use recovery program with a homeless program. Homeless programs end homelessness through housing. Substance use recovery programs end the use of substances. They are NOT the same thing.

At the same time we need analysis on what the right size of GPD needs to be in each community. Some of this work has started, I know. If there has been such a HUGE investment in things like SSVF programs for veterans, and rapid rehousing in other jurisdictions where GPD is not limited to veterans, we should be seeing a reduction in GPD demand. As such, we should start decreasing the overall volume of GPD beds. With proper (and simple) analysis, this should be something that could be implemented over the next 12-18 months.

Now onto something I am going to say that will certainly be unpopular in some circles: until you have wrestled your GPD programs to the ground, do not make a claim that you have ended homelessness for veterans or any other population group for that matter. When, for example, any group doesn’t want to include GPD beds as people being homeless it is a misrepresentation of the true state of homelessness. When, for example, a community gets “cute” with how they name or classify their GPD beds in order to claim some sort of victory in getting an entire population housed, they are kidding no one and creating an overwhelmingly dangerous interpretation of what is actually happening on the ground. Out of sight does not mean out of mind. In fact, I will go so far as to say take any claim of ending homelessness with a grain of salt until there is a transparent answer on what is happening with its GPD beds. New Orleans did a good job of being transparent in this manner; but even then I would argue they should be called something other than a GPD bed.

As more and more communities start claiming “functional zero” in ending homelessness for veterans across the United States while having full GPD programs, it is a powder keg waiting to explode in the media and a public relations disaster waiting to happen. It doesn’t matter what any “takedown list” was, so long as people that are homeless continue to be served by GPD programs that are actually any variation of a shelter or transitional housing program, then let us have the courage to say: “They are still homeless and we are not done ending homelessness yet.”

Let me tackle the other argument that I hear a lot regarding any sheltering program that is funded through GPD. It goes something like this: “But, (insert name of population group like veterans, survivors of domestic or intimate partner violence, youth, people in recovery, people with concurrent disorders, recently hospitalized, etc.) NEED this GPD program in order to be successful in permanent housing.” What I think people are confusing is a mechanism for funding from a specific type of program. There are loads of great programs for different population groups. We know some work. We are still learning more about others. We know that other types of programs quite plainly fail. It is an injustice to suggest that a program that incentivizes a longer length of stay because of its funding source is a BETTER program.  I can think of no population group that has a better housed experience through a prolonged homeless experience.

So now is the time to take action. Now is the time to challenge what is occurring and demand that we do better. If we are serious about ending homelessness in any community (and I really hope we are), we have to get serious about changing the nature of GPD programs to get more people housed. In the meantime, we need to be counting people in GPD funded programs as homeless. Calling it anything else is not an honest representation of what is really happening.

Tough Love Ain't Love

"Sometimes you gotta show clients tough love so that they'll get their act together."

That is a direct quote in a community I was just in, and the third time in just over a week I had heard a similar sentiment. 

Tough love ain't love. It's being a coercive, power-hungry jerk and convincing yourself that it is love. Tough love is so far from love that it is like saying your socks are a portable napkin stuck in your shoe.

It is appropriate to set and socialize expectations with people. But denying people access to service unless they conform to a certain way of responding is akin to telling people to change who they are so that you can give them what they need. I don't subscribe to any belief of service delivery that uses housing as a reward instead of a right.

I get it - it can be frustrating to try and help people change that are resistant to the idea or actions of changing. This is why we have tools like Motivational Interviewing and Assertive Engagement. This is why we try to find strengths and assets to create a truly person-centred approach to service delivery. This is why effort (on the part of the service provider) is the siamese twin of success.

If we truly work from a place of compassion, then we embrace that it is a relationship between equals; not a relationship between healer and wounded. Tough love has a horrible power differential where the service provider deals in absolutes. I say it is like the person that wants to race home even though it is rush hour. Our work is more about moving slowly forward...but still moving. It is not about creating expectations that cannot or will not be met and then see it as a failure of the person on the journey for not getting to the destination quick enough.

A tough love approach is antithetical to understanding and practicing a recovery orientation in our work. Adding more pain is not going to stimulate more growth. Tough love increases feelings of shame, especially if the person does not measure up to the expectations that are laid out to them. Tough love does not appreciate that recovery is non-linear, and instead often circular and incremental. Tough love tries to force a one-size-fits-all approach rather than working through individual nuances.

While tough love continues to be very present in the substance use recovery industry - and that many practitioners in homeless services try to borrow the "logic" and apply it so homeless services - we must also remember that the substance use recovery industry is largely unregulated and many treatment programs institute programs and approaches that are not supported by solid, or any, evidence. Harsh rules and brutal confrontation rarely produce the desired outcome of the person enforcing the rules or engaging in the confrontation. And what is the message we are giving people with this? If you break the rules or do not respond the way that I want you to when I confront you then you are a failure. 

Those who want to practice tough love give us insight into their view of homelessness as well. Essentially, if you want to practice a tough love approach you are suggesting that homelessness is a choice, that the person is lazy, or that their homelessness is immoral. In other words, your approach is to try and break them of this bad habit. So no wonder tough love rarely works, especially over the long term, because homelessness is not a choice, a sign of laziness, or immoral. 

Let us instead radically practice kind love, not tough love. Let us begin by embracing where people are truly at, and that whatever place people are at when we engage with them is the right place for them at that moment. Let us avoid punishment or shaming if people do not change on a timeline we establish for them. Let us challenge ourselves to be more creative in our problem solving. Let us truly see and accept the dignity and worthiness of each person rather than seeing them as less than worthy of what we have to offer - and demanding that they change in order to get it.

NAEH17

The annual conference of the National Alliance to End Homelessness is happening this week. For more than a decade I have been here presenting. I have seen the conference grow through several hotels that could accommodate the increased demand for the conference and what it has to offer. I have seen superstars within the sector stay with it as long as I have, and seen others come and go.

For years, this conference has been the re-energizer that I need to keep going in this work. There is something infectious about the passion of others, and really uplifting when you see and hear the results that are being reached.

At the opening plenary this year, I was really struck by the fact that homelessness has gone down in all population groups across the country, while at the same time rents have gone up 21% and wages amongst the poorest have gone down. In other words, there is no reason why homelessness should be decreasing, yet it is.

How is this possible? What does it mean?

To me, it means that the overall perspective of homelessness as something that can be ended has taken hold.

To me, it means that knowledge and skills within service providers has improved.

To me, it means that there is a steadfast resolve to tackle problems and fix them rather than coming up with excuses of what cannot be done.

To me, it means that we have seen a shift in leadership that promotes ending homelessness rather than perpetuating therapeutic incarceration. 

I am so grateful to be here again, share what I know, and learn from others. I hope and some point in my lifetime this conference is no longer necessary. But until that time, there is no place I would rather be when the conference is happening.

Retrospective

This week marks another birthday for me. It isn't one of those milestone birthdays, and yet I have found myself more retrospective than usual for some reason. This blog is an attempt to share some of the lessons I have learned up to this point in my life.

1. People are not the problem. The problem is the problem.

Everywhere I go it is likely that a sentiment of some sort will be shared about people that do not want to change or are resisting services or are sabotaging what is being made available to them. In other locales it is that the business community or a neighbourhood group is flabbergasted that homelessness is seen as disrupting their way of life or livelihood. People are not the problem. The problem is the problem. Problems are solvable. People will just keep being people. If you focus on solving problems rather than trying to treat people as the problem, you find more success.

2. You don't need permission to be awesome.

Inspiring awe in others is a by-product of living your passion while being effective. Over and over again I meet people who know exactly what needs to be done, and often know how to do it. So why don't they? Because they live in fear of the view of others. Because they exert more effort trying to be liked than on being effective. Awesomeness is a force multiplier. Be brave enough to be awesome when it is the right thing to do and support for your impact will follow.

3. Sweat holds more value than tears.

If you work on a complex social issue it will be the hardest work you may ever do. Every day you choose to run into the fire while others are running out. And you do so for little pay or glory in almost all instances. Yet there are those whose motivation is to open a can of worms to go fishing for sympathy rather than silently working their butts off to compassionately live empathy. News flash - it is a privilege to serve others, not the other way around. Work hard in an effective manner and you will have more impact than trying to get people to feel sorry for you or the people you serve.

4. A big heart and a big brain are not the same thing.

Homelessness continues to be the only industry I know of where we think concern about the issue equates to knowledge of how to solve the issue. Caring does not equal qualified. Of those people and organizations I have met that have the biggest, long-term impact, they have figured out that marrying your heart with your head is the only way to go. We need smart compassion.

5. Therapeutic incarceration must be ended.

People do not need to be healed or fixed to be successful in housing. If you keep adding programs into a homeless service to try and heal or fix people, you are working against the objective of ending homelessness. Sure some people will need a lot of supports to be successful in housing. But put those supports where they belong - into your housing program - rather than prolonging the experience of homelessness.

6. The mistakes of our youth is what makes up the beauty of our age.

The more mistakes we make, and the faster we make them, the more we learn and the faster we perfect our craft. A musician considered to be a virtuoso did not become so over night. They practice. A lot. They make mistakes. A lot. Then they can continue to challenge themselves to get better and better and better. If you learn from your mistakes, you are doing it right. If you are risk adverse, you will become stagnant.

7. Being an innovator is unpopular.

If you are a disruptor - even a positive disruptor - by coming up with new ways of thinking and doing the work or being creating new tools and strategies, you will be hated - at least by some. The sooner you embrace that your job is not to be liked, but to serve, the easier it gets. Hatred is a problem of the hater, not a problem of the innovator.

8. Complex issues are solved by doing, not by planning.

Homelessness has never been ended in a committee. It has never been ended through a 10 year plan. It gets ended by doing. This is not to say that planning and meetings are not important. They most certainly can be. But committees and planning without dedication to doing is meaningless.

9. Figure out what you CAN do rather than lamenting what you CANNOT do.

Naming and discussing the barriers that exist becomes old fast if all you do is name and discuss and never get into the business of either: 1) what you can do regardless of the limitations and circumstances within which you work; 2) actually providing solutions to the barriers. 

10. Live an authentic and vulnerable life.

The worst, flawed real me will always be better than the best, fake me. As a recovering asshole, I can find myself relapsing back to lashing out rather than seeking understanding; I can find myself protecting my pain rather than opening myself up to sharing. Maintaining an open ear has always been harder than attacking with a sharp tongue. But the more I learn to let my guard down and invite others in, the more I find myself engaged in real relationship, real dialogue, and real change.

11. Don't waste time trying to convince others you are right when they cling to cognitive dissonance.

I have yet to see a public education campaign have a long-lasting impact on homelessness. I have seen small victories in challenges to NIMBYism but never seen it disappear. I have not seen a public deputation to elected officials result in a permanent shift in ideology. But what I have seen, time and again, is that action speaks louder than words. Show people what works rather than trying to convince people what works.

12. Time does not heal all wounds, and not everything happens for a reason.

I get while people cling to these notions, but they are trite and hollow and fake. The more I have learned to live, practice and teach others what it means to be trauma-informed, the more I struggle with how we live in a perpetual state of wanting everything to be okay rather than accepting that everything is not okay. This doesn't mean we cannot focus on healing and recovery and finding balance and supporting people to be well. We can and we should do those things. But some pains never go away and some of the shit that happens in life defies all logic. Once I realized that in my own life, I started to forgive myself for having feelings based upon past events that were completely outside my control.

13. If you don't define you, others will define you.

If I do not form the narrative of why I do what I do, what I do, and how I do it, then I am at the mercy of how others interpret and view my motivation and practice. Be who you are with your own inspiration. Otherwise you will spend a lot of time and be unsuccessful defending yourself to others.

14. Ask for and grant forgiveness.

It took me many decades to both realize and practice that requests for and providing forgiveness is a sign of strength, not a sign of weakness. The only cost of not doing so is my pride, and that is a small price to pay for the satisfaction of forgiveness. This is not to say all things are forgivable. Nor is it naive to say that all offences and wrongs are equal. My life, however, has been so much more peaceful once I realized the important function that forgiveness plays in moving forward rather than being stuck in the past. And this includes forgiving myself for many thoughts and actions in my past.