Staff Change as the Shelter Changes

I have the pleasure of working on some large scale shelter transformations these days. It is easy to say you are becoming a housing-focused shelter and something different to put into practice. The ideas, concepts and techniques are transferable across jurisdictions. That said, we are noticing a distinct patter in the reactions of existing shelter staff as they work through the transition over several months.

The transformation of a shelter to become housing-focused is hardest to achieve with existing staff. Invariably, there are some people that self-select out of the organization. Then there are others who are genuinely curious and want to see how things unfold. Then there are others who have checked out, but stick around if you know what I am saying.

Huh?

In some shelters you’d swear that being housing-focused was a different language where they have no frame of reference of how to engage effectively with shelter guests. Staff were good at quick conversations, handing out towels, breaking up fights, and ensuring the AA meeting goes off without a hitch, but have no clue how to talk about housing applications, prioritization, listings, or security deposits.

I know everything.

Get one person housed and some staff act as though they should get a Congressional Medal of Honor (or Order of Canada). There are quick wins in becoming housing-focused. The danger, though, is taking a handful of low-hanging acuity, getting them housed quickly (because they probably could have done it themselves), and thinking everything will go that smoothly for everyone else thereafter. One of the tell-tale dangers of this phase – you’ll assess anything that moves thinking there is a magic answer behind every score. Assessment scores is not the knowledge you actually need.

There’s more to this than I thought.

Start becoming housing-focused in one part of a shelter operation and in no time you are over your head in all of the things that need to change to be effective. The two most transformative are rewriting shelter expectations to be housing-focused, and altering your service-restriction/trespassing/barring policy to align with a strength-based, housing-focused approach to service delivery. Be prepared for a bunch of staff to quit (or at least want to) at this juncture. And one of the other tell-tale signs of this phase – you won’t want to assess anybody because you see the bottleneck you have created and wonder what the point is of putting people on waiting lists. As change starts, so too does the disillusionment and lack of trust in the vision.

I’m never going to understand this.

Then the day comes when the lightbulb goes off and you start to realize that things like your approach to diversion and intake is directly related to your success in getting people to exit the shelter in a timely fashion. And you appreciate that the building needs some renovations to be more aligned to trauma-informed practice and a housing orientation. You will find yourself questioning very form and every field in HMIS. On top of that, you realize much of what you have been doing with shelter guests for years has been all the wrong things – and there is a career crisis. Plus, you have been looking at all of the wrong data and doing funding applications all wrong. Some long-time shelter guest at this point will remark that they miss the good ol’ days, and waxing nostalgic you probably think they are on to something.

It’s starting to make sense.

When housing-focused approaches start to click, there is consistency in higher acuity people accessing housing through or apart from coordinated entry. Shelter guests are staying for a shorter period of time and most of the conversations with shelter guests are about housing rather than day to day transactions. The new staff that are coming on board are eager to get on with housing as many people as possible. You likely find yourself quizzical and sometimes downright giddy when looking at your monthly housing statistics and how far you’ve come, being flummoxed but determined to house those people that have alluded you up to this point.

Trust me. It’s complicated.

By the time you reach this stage, if you are still around, you find yourself cringing every time your boss tells a story of one of the people housed through your shelter. It sounds like a sample size of one, and while you are happy that your boss is so excited about housing people, they seem to forget how hard it was to get to this place and how many staff were lost in the process. On top of this, a whole bunch of staff that were kicking and screaming along the way are now acting like the biggest cheerleaders for being housing-focused – the homeless service industry equivalent of Holden Caulfield’s phonies.

Three Aspects of Coordinated Entry

Many communities have worked hard on coordinated entry. This has been transformative in many communities. Side doors are closing. Access to housing with supports is becoming better defined. Priorities are being established at the community level. These are all good things.

But coordinated entry is just one part of the process. An important part, but not the whole picture. My fear is that so much effort has been placed upon entry that communities are creating and generating wait lists to nowhere. That is a problem.

So, when we think about designing and implementing coordinated entry, we must also think of two other aspects of the process: coordinated passage, and, coordinated exit.

Coordinated passage is the art and science of journeying with the individual or family to take care of all of the tasks that make housing possible. Paperwork. Documentation. Identification. Income supports and benefits. All of these require careful and skilled navigation and an eye to administrative accountability and necessity. Rarely are these linear, short in duration to attain, or easy. But if someone or some family is entering your system but is not navigated through the system, something is wrong. You will end up with a number of names of people you wish you were housing but cannot because their administrative tasks are incomplete.

Coordinated exit is the prize at the end of the coordinated passage. It is the acquisition of a place to live. Once people are “paper ready” there has to be results in moving from homelessness to housing. The measure of success of coordinated entry is not how many people are on a list or assessed, it is how many people actually move into housing. Without outflow, the entire system gets gummed up. Many communities we work with have come to realize that they don’t teach real estate in social work school. There can be a different set of skills necessary to get housing units available at scale, especially in expensive rental markets with low vacancy rates. Having the right staff with the right skills to find units to ensure coordinated exit is critical.

Reimagining Engagement and Roles for Volunteers and Donors During the Holiday Season

Since Giving Tuesday I imagine many of your organizations have been gladly accepting financial donations and the like. It is the time of year of giving, and for many non-profits, more money will come over in this stretch towards Christmas than any other time of the year. There will also be a seeming abundance of people wanting to volunteer or get involved in a toy drive or want to deliver Christmas hampers or serve Christmas dinner. Some of this may make sense to you; some of it will not. There is a madness to it all that repeats every single year that can seem overwhelming. And there are legitimate questions like, “Where is all this help the rest of the year?”

I think there is an opportunity to use the outpouring of engagement to strategically gather allies for those other times of the year when help is needed and to get more out of volunteers and donors than just their once a year giving. It requires time to plan, but the payoff is worth it. Here are five ideas you may consider doing:

1. Survey

We make assumptions about motivations and giving all the time. Create a survey – paper or a quick link to an electronic survey – that lets you gather insights into why they felt compelled to give or volunteer and what other opportunities they may consider in the future. You could have a great candidate for a board position or committee chair or organizer for future events in your midst.

2. Invite

Engagement is an opportunity for invitation. You may want some of the volunteers to commit to future meal planning and service, or you may have vacancies on committees that could be filled through volunteers. Or maybe you are planning a new capital campaign or service campaign where you want to invite people to either give or rally others to give. Plan specific invites that you can provide to people.

3. Create opportunity

Rather than just accepting that the holiday season will bring its rush of volunteers and donors, consider creating other types of engagement opportunities throughout the year for the same volunteers and donors to get involved. Christmas in July! End of school year party! Harvest festival! True, it may not be as catchy as people’s natural inclination to give during the more traditional holiday season, but with the right marketing and education, it can work.

4. Advocacy

Every volunteer is a potential advocate. Many just need information on how to advocate and to whom to advocate. Jane and John Doe volunteers, for example, would be happy to sign a petition or write a letter to an elected official about, say, affordable housing needs. They just require instruction on how to do it. Create allies in the work through their engagement in giving.

5. Educate

Many of the volunteers and givers you experience this holiday season will know very little or nothing at all about homelessness, especially the solutions to it. Their joy often comes because of the feeling of donating time or money. With the right education, they can become better versed in the issue, assist with advocacy, and feel the joy of reorienting their work towards solutions rather than just a charitable response. Education can take many forms, from sessions and presentations to brochures and informal engagement with the volunteers are involved. Don’t miss the opportunity.

Making Warm Handoffs Work

A warm handoff is a transition conducted between two members of the support team in the provision of homelessness and housing services. Usually the warm handoff (and the focus of this blog) occurs between the homelessness side of the system (outreach worker, shelter staff, navigator) and the housing side of the system (case manager, aftercare worker, follow-up worker, housing support specialist). That said, there are times when the warm handoff can occur between case managers (for example, a reshuffling of the caseload means the client is moved from one case manager to a new case manager). I want to explore ways in which the warm handoff can be improved upon for maximum success in the support process.

To start, a warm handoff should occur in front of/with the service recipient. We have to see the service recipient as a partner in the process of information sharing, the discussion of supports, reinforcing what is happening in their case plan, and providing an opportunity to provide clarification and ask questions in the process. The warm handoff is not something that happens behind the scenes. It is not something that happens to the service recipient – it is something that happens with the service recipient.

All parties should prepare for the warm handoff. It is not something that happens ad hoc, and it is something that does not go well when all parties are not prepared. The sending party (outreach worker, shelter staff, etc.) should have all documentation in order in HMIS and the file completely up to date with the likes of consents to release information, assessment results, etc. The receiving party (case manager, housing support specialist, etc.) should review all documentation in HMIS and where possible the file prior to meeting with the service recipient and sending party. They should write out the questions that they feel necessary to ask to get clarification in the transfer process. The service recipient should be briefed by the sending party on why the warm handoff is occurring, when it will occur, how it will occur, and what happens during the warm handoff. The service recipient should be encouraged to think about the questions they want to ask of the receiving party and any parts of their case plan they feel is necessary to comment on in the warm handoff process.

The warm handoff generally works best when it goes as follows:

• The sending party, in consultation with the service participant and the receiving party, schedules the warm handoff.

• The sending party, with appropriate consents in place, shares all information regarding the service participant with the receiving party.

• The receiving party reviews information prior to the meeting and prepares any questions of clarification they want to ask in the meeting.

• The sending party prepares the service participant for the warm handoff meeting. This includes things like reminding them when the meeting will occur, why it is occurring, and what happens during the meeting(s).

• The service participant has the opportunity prior to the meeting to think about questions they wish to ask of the sending or receiving party and any clarification or additional information they wish to share.

• When the meeting date and time comes along, the sending party calls the meeting to order. They introduce the receiving party, and then outline the amount of time allocated to the meeting and again outlines the purpose of the meeting.

• The sending party reviews a summary of the work that has occurred with the program participant, assessment results, and their understanding of the service participant’s strengths, goals and opportunities for improvement.

• The service participant is afforded the opportunity to respond to, add or amend what the sending party has shared. The sending party is primarily responsible for responding to the service participant at this juncture.

• The receiving party then asks any questions of clarification followed by outlining how the support process will continue with them.

• Again, the service participant is provided the opportunity to ask questions of clarification or respond to what the receiving party has outlined.

• The meeting concludes with the receiving party primarily responsible for further contact, guidance and support of the service participant.

The warm handoff may take more than one interaction. Depending upon the complexity of the case plan and presenting issues of the service recipient, it can be beneficial to conduct the warm handoff over a series of shorter meetings rather than trying to do the entire process all at once. In these instances, the first meeting may be a simple, short meet and greet. The second meeting may be an opportunity for the sending party to outline and review all that they know and are working on. A third meeting may be an opportunity for the service recipient to ask questions of the sending and receiving party. The fourth meeting may be when the receiving party asks their questions of clarification. Or any variation thereof.

Once the warm handoff is complete, it is necessary for there to be a clean break where supports and planning are concerned. Sometimes the outreach worker or shelter staff thinks they are being helpful by following up with the program participant from time to time once the they have moved into housing. While well intentioned, this can be confusing to the service participant and muddy the waters of the case planning and support processes.

The warm handoff should be documented. It is our recommendation that the receiving party assume responsibility for the documentation given they are now the lead with the service participant. It is important that the content of the warm handoff is documented, not just that the warm handoff occurred. This can be an important reference point if there are later glitches in the support process.

Warm handoffs are likely to be increasingly important and essential to our work as coordinated entry continues to become more robust in its evolution. I hope these suggestions help improve the process in your community, keeping the interests of the service participant at the center of what and how we deliver the warm handoff.

8 Tips to Add More Harm Reduction Practices to Your Shelter

Harm reduction exists on a continuum. So, too, does the implementation of harm reduction practices in shelter. You can range from managed alcohol programs within shelter like the Shepherds of Good Hope in Ottawa (sometimes called Radical Harm Reduction) or smaller steps by providing access to shelter after having used alcohol or other drugs without precondition or things like breathalyzers.  I am a big fan of shelters like Alpha House in Calgary which is one of the preeminent wet shelters I have ever visited and has integrated harm reduction into all that they do, as well as specialized harm reduction programs within larger shelters, like the Riverfront program at the Calgary Drop-in Centre. Not every shelter is ready to immerse themselves into a managed alcohol program like the Shepherds of Good Hope or fully integrate harm reduction into all that they do like Alpha House, but there are some tips and practices that can be followed to add more harm reduction practice to your shelter. Here are eight:

1. Self Bag Search

If you do bag searches, have the program participant open their bag for staff and provide visual inspection of contents rather than staff opening the bag or touching contents. This is a more dignified approach to bag inspections, while also decreasing inadvertent pricks from sharps if present.

2. Availability of Naloxone With All Staff Trained

To better respond to incidents of opioid overdoses, ensure that all staff within the shelter are trained and have easy access to naloxone. It can be the difference between life and death.

3. Amnesty Totes

When a person cannot safely store their alcohol or other drugs, and/or cannot safely store their needles, pipe or other equipment used, it presents safety risks like increased incidents of binge drinking and greater exposure to needles. By providing a confidential tote at entry for people to store whatever they want to store – which they cannot access while in the shelter – people have a safe place to store their alcohol or other drugs and related equipment.

4. Floor Mats

Mattresses on a bed frame or bunk beds can be hazardous to someone is greatly under the influence. By having some mats on the floor for people that are quite inebriated it is safer for preventing falls, and also easier to help people sleep in the rescue position.

5. Sharps Containers

The more accessible sharps containers are the more likely they are to be used. Outside and at various places inside the building are beneficial.

6. Safe Works

With access to free supplies, people who use can use more safely. Consideration can be made to making everything available from new needles and syringes to cotton pellets, pipes and brass screens to alcohol towelettes, bandages to acidifiers, condoms and lube to dental dams – and more. This is likely subject to the laws of your local jurisdiction and the comfort level of your organization. If you cannot offer these internally, consider developing a pamphlet outlining where and how in the community people can access the supplies they need that would reduce harm.

7. Focus on Housing

Housing is harm reduction. The evidence is clear that many harms are reduced and wellness improved when people have access to safe, appropriate and affordable housing.

8. Involve People Who Use Substances in Reviewing Your Shelter Policies and Procedures

“Nothing about us without us” is a good framing for better supporting people who use substances who stay in shelter. By asking people who use alcohol or other drugs to review your policies and procedures you may learn of ways to adjust your policies or procedures to be more responsive to substance users.

Gaining Input from Service Users: A New Opportunity

One of the challenges confronted by service providers is, “How do I get meaningful feedback from service users?”

Let’s assume first that you are a service provider that actually cares about what your service users think. You may have tried exit surveys or exit interviews. You may have tried sending follow up surveys to people once they moved into housing. If you are a shelter or drop-in center you may have tried consumer meetings and focus groups.

If you get feedback from consumers, chances are you know best from the two extremes: those who love your services/programs/staff and those that despise or have a beef with your services/programs/staff. What you don’t have a good mechanism for is getting feedback from Jane or John Doe person experiencing homelessness and a regular basis.

Enter Pulse for Good which is revolutionizing how service providers and government/funders get feedback on a regular basis from individuals and families that use homeless services. By installing customized kiosks, it is possible to gather the feedback necessary for service providers to tweak their programs and make changes big and small to have an impact on services. The use of the platform to date shows that not only will service users take the time to provide feedback, but that the feedback is meaningful and the analysis and improvements that can be made are powerful.

Pulse for Good was started by a half dozen dudes who work in the private sector and were accustomed to designing software solutions for the justice system, the federal government and the military. They wanted to do something good and worthwhile with their skills for the homelessness services industry. So, they created Pulse for Good.

Pulse for Good has installed kiosks and been completing the analysis of consumer feedback in six homeless service organizations since they began collecting feedback in April. Service providers and funders have been impressed. On average, organizations receive 5 – 10 responses daily from service users. This has resulted in improvements ranging from adding shower curtains to the starting of a job program to help staff and train homeless individuals in a soup kitchen.

By way of full disclosure, I sit on the Advisory Board for Pulse for Good. One of the reasons why I think Pulse for Good is a good product is because of the advisors they have assembled to help ensure the product is hitting the mark and reaching its aims. This includes current and former homeless individuals, as well as national homeless experts like Mark Johnston and Lloyd Pendleton, people involved in service delivery and academia.

If you are serious about feedback from your service users or the organizations you fund, and you want a successful platform for doing so, then I strongly recommend you check out Pulse for Good. It is not a free service. But you have to ask yourselves, what is the cost of not getting good feedback on the programs and services you are offering?