Streamlining Services and Expanding Opportunities for Homeless Families

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Massachusetts Department of Transitional Assistance

Problem Statement

The Commonwealth has historically been very generous in the amount of services and support afforded to homeless families. In fiscal year 2004, Massachusetts spent over $70 million in the Emergency Assistance (EA) family sheltering program, administered by the Department of Transitional Assistance (DTA)—an increase of 82 percent over spending in this area from just five years earlier. Despite this level of funding, the demand for emergency shelter services has often exceeded the capacity of the Commonwealth’s family shelter network. As a result, DTA has been forced to utilize hotels and motels as “overflow” when the emergency shelter system was full.

There were significant increases in the number of homeless families in the mid-1980s and again in the early 1990s. The Commonwealth resorted to using hotels/motels in 1999. With no available emergency shelter beds, when homeless families applied for assistance, they were placed directly into hotels/motels. Families remained in these settings for an average of three months, until a shelter placement became available. Over time, the number of families in hotels/motels rose steadily, to a peak of 599 families in August 2003.

No one could defend this practice; hotels/motels are clearly not an appropriate placement for homeless families. Unlike the contracted family shelter system, these settings provide no structure or support to families who are often experiencing a crisis. As a result, families in hotels/motels became isolated, without any services and minimal case management. Children suffered as their links with school and community were further disrupted. Cities and towns faced unpredictable fluctuations in the number of school-age children in their communities, based on the availability of local hotel/motel vacancies. Yet because better alternatives for homeless families could not be identified, in fiscal year 2003 the Commonwealth spent more than $20 million on such placements.

Although the financial resources directed to the EA program were steadily increased, DTA repeatedly needed to seek supplemental appropriations or risk terminating families’ shelter benefits. Early in fiscal year 2004, it appeared that this was again a likely scenario. At that time, the prospects for changing the emergency shelter system were not good. Massachusetts, like other states, was forced to freeze the number of federal Section 8 housing vouchers,¹ historically a significant resource for moving families out of shelters.

Clearly something had to change. In her role as chair of the Interagency Council on Homelessness, Lieutenant Governor Kerry Healey challenged the department to eliminate the need to place homeless families in hotels/motels over the course of the next 24 months.

The Solution: Shelter to Housing

In evaluating its strategies and practices for providing emergency assistance to families, DTA has implemented a multifaceted approach to addressing family homelessness called Shelter to Housing (or S2H). This new strategy provides a better service to homeless families, resulting in a more seamless transition to permanent housing and a more effective use of public resources. The various components of S2H are as follows.

• The first thing the agency did was to develop, implement, and train staff on the agency’s Self-Sufficiency Plan (SSP), a document completed for each family in an emergency shelter. The training instilled a partnership among department staff, shelter providers, and the families themselves in planning for their exit from shelter. SSPs spelled out the responsibilities of all parties in addressing the family’s barriers to obtaining and maintaining housing. When appropriate, work became an important component of the SSP. From the first day a family enters a shelter, the focus is now on the day it will exit.
  
• DTA also acquired additional shelter capacity. Given the lack of funding increases, the department worked in collaboration with its shelter providers to purchase additional capacity—with the understanding that a new unit could not cost more than the current price of a hotel/motel placement. Some units ended up costing less. These collaborative efforts led to an increase of 148 emergency shelter units in fiscal 2004 and 133 additional units this current fiscal year.
  
• Because of these additional units, DTA was able to undertake a number of initiatives that changed the “front door” of our system. Historically, given the lack of capacity, a homeless family entered the emergency shelter system by being placed in a hotel/motel for a couple of months until a shelter unit became available. The department turned this around. No longer would families be placed in hotels/motels upon entering the system. Instead, the following initiatives were developed:
  • On Cape Cod, DTA implemented a pilot that provided a regional approach to managing family homelessness from Provincetown to the Brockton area. Networks were created across local DTA offices that leveraged community-based resources that might not have been in the immediate community. This regional approach led to further dramatic declines in the number of hotel/motel cases on the Cape.
  • On the North Shore, the department experimented with an intake/assessment model. Rather than being placed in hotels/motels, families were put into a 30- to 45- day assessment shelter that helped us identify their needs and barriers to housing. Again the department saw a dramatic decline in the number of families in hotels/ motels and the number entering our sheltering system as roughly half of all families found alternatives to homeless shelters. DTA is expanding this successful model to the Boston area this year.

On January 2, 2004, there were 412 families in 50 hotels/motels across the Commonwealth. By August 13, 2004, there were no families housed in these settings. Not only has this change saved significant public resources, but more importantly, homeless families are now served in much more effective and appropriate settings.

• As DTA had been spending more than $20 million per year in hotel/motel placements for homeless families, eliminating those expenditures took the financial pressure off the EA account. This, in turn, allowed the department to explore investments in the sheltering system to provide further assistance to those families who found themselves in shelters. Among these initiatives are the following:
  • The agency crafted a one-time, $6,000 placement bonus called a Shelter to Housing (S2H) payment for housing providers who placed employed homeless families into apartments with a 12-month lease. Over 200 families have been placed in private apartments, further freeing up capacity and resources for other EA families. For the amount that would have been spent to keep these families in shelter for only two months, the department secured housing in private apartments for 12 months. Currently in month 10, all of the formerly homeless families remain housed.
  • Along with the increase in shelter capacity, DTA expanded its case management efforts by hiring 13 Intensive Case Managers (ICMs). These additional staff members were put through several weeks of training to deal specifically with homeless families and began visiting all remaining families in hotels/motels on a daily basis. This regular presence greatly enhanced our ability to place families in more appropriate settings as well as to ensure the family was complying with their Self-Sufficiency Plan.
  • The hiring of the ICMs was done in conjunction with a Motel to Shelter (M2S) initiative that focused on moving remaining hotel/motel families into vacant sheltering units. Although this initiative began earlier in the year, M2S efforts were augmented over the summer of 2004 in order to eliminate the disruption such moves would cause homeless children during the school year.
  • In conjunction with the Massachusetts Department of Housing and Community Development, DTA also invested funds in a local housing authorities (LHAs) pilot program, which places homeless families for six months and then transitions them into regular LHA units with leases. This initiative placed 10 families in fiscal 2004 and the department is on schedule to place an additional 100 families this fiscal year.
  • Under DTA’s Housing Assistance Program (HAP), a collaboration with 12 community-based organizations and regional nonprofit housing agencies, residents of shelters and hotels/motels received assistance with comprehensive housing search and placement services. Based upon evaluation of the program, HAP has been reconfigured to provide the aforementioned organizations and agencies with performance-based incentives and new tools, including prevention services, to more efficiently and effectively meet the needs of families.
  • With the findings of a DTA survey showing nearly half of the longer-term families in hotels/motels had some self-reported disability, the most prevalent being a behavioral or mental health issue, DTA joined with the Massachusetts Behavioral Health Partnership (MBHP)² to create a partnership for local DTA offices on the North Shore. This pilot allows the department to better serve families with behavioral/ mental health barriers to obtaining and maintaining housing.

All of these efforts have dramatically changed the department’s management of the family sheltering system—moving away from just managing shelters to addressing the issues of family homelessness head-on. Through the steps to augment capacity and more effectively case manage homeless families, DTA has changed what it means to be homeless in Massachusetts. Through these and other ongoing efforts, the department has ended the practice of having to place homeless families in hotels/motels and has enhanced the capacity of the sheltering system to better address the needs and leverage the strengths of homeless families. In the process, DTA saved millions of dollars, which can be redirected to more productive purposes.

Building on the department’s successes in the Shelter to Housing initiatives and the ongoing commitment to providing improved, comprehensive services for homeless families, the Department has embarked on two other initiatives: the Lead Agency Residential Stability Program and the Homeless Management Information System.

• The goals of the Lead Agency Residential Stability Program (LARSP) are to provide a coordinated intake, assessment, and referral system for all homeless and at-risk families in an identified region of the Commonwealth; maintain families in permanent housing; shelter homeless families on a temporary basis; secure permanent housing for homeless or at-risk families; and provide services and linkages to services and other available funds, both public and private, to expedite the transition of families from homelessness to residential stability. Since the department’s focus is to rapidly rehouse families so as to minimize their shelter stay, this new collaborative service delivery system—partnering state and local resources to combat homelessness—will address the full range of housing needs within the Commonwealth. DTA has issued a Request for Information and based on a review of the response will issue a Request for Proposals to implement the LARSP.
  
• In fiscal 2001 Congress directed the U.S. Department of Housing and Urban Development to require jurisdictions to have client-level data on homeless individuals and families. In response to this requirement, DTA is designing and will implement in mid-2005 a statewide Homeless Management Information System (HMIS) which will be made available to all shelter providers. The development of this system, customized to the needs of Commonwealth and its shelter providers, is being funded by savings achieved in the family shelter system. The Commonwealth, its service partners, and clients will benefit from this information in the following ways:
  • access to better and more timely information on the needs of this population
  • analysis of usage patterns
  • identification of gaps in services
  • coordination with other initiatives, such as to increase participation in the food stamp program, and provide links to resources and other referral information
  • streamlining the intake process, resulting in improved referrals, case management, and service coordination
  • managing operations more efficiently.

Costs and Benefits

Implementation of the LARSP is anticipated to be cost neutral; it will be funded by reprogramming current program investments. The actualized benefits of the LARSP will be greater accountability of providing agencies, and improved coordination of services, which will minimize duplication.

Development costs for the implementation of the HMIS is approximately $1.4 million, paid for by savings achieved through the aforementioned Shelter to Housing initiatives. Long-term financial benefits include the elimination of costs to individual shelters, whether funded by the Commonwealth or not, for the implementation and the maintenance of the HMIS system.

Obstacles

With extensive and ongoing outreach to community-based organizations, providers and the advocate community, DTA does not foresee any major obstacles.

Potential for Replication

Components of the Shelter to Housing initiatives (such as assessment centers, intensive case management, access to mainstream services, and regional coordination of resources) can be replicated. In fact, Massachusetts was featured in a recent federal colloquy on effective homeless strategies to provide other states with assistance in duplicating DTA’s successful efforts.

Both the LARSP and the HMIS can be replicated in any state or local government. Copies of the Request for Information and Request for Proposals can be accessed by interested parties at https://www.ebidsourcing.com. Since these are public procurement processes, they can be replicated by any municipality.

Conclusion

A thoughtful, considered response to the issues of family homelessness requires a multifaceted strategy. DTA has focused on ways to truly reinvent government to serve the dual purpose of providing seamless services to homeless families while looking to increase efficiency in the way these services are delivered. Family homelessness affects the most vulnerable of the Commonwealth’s residents. Responses to the many barriers to regaining and maintaining family stability will be furthered by DTA’s newest initiatives, the Lead Agency Residential Stability Program and the Homeless Management Information System.

About the Department of Transitional Assistance

The mission of the Massachusetts Department of Transitional Assistance, formerly known as the Department of Public Welfare, is “to serve the Commonwealth’s most vulnerable families and individuals with dignity and respect, ensuring those eligible for services have access to those services in an accurate, timely, and culturally sensitive manner, and in a way that promotes clients’ independence and long-term self-sufficiency.”

A part of the Executive Office of Health and Human Services, DTA ensures that the emergency and transitional needs of the individuals and families of the Commonwealth are met through a combination of federal and state funded programs which include: transitional aid to families with dependent children; emergency aid to the elderly, disabled and children; supplemental security income; food stamps; and housing and homelessness services for individuals and families.

John Wagner was appointed Commissioner of the Department of Transitional Assistance in April 2002 and in September 2004 was named the Assistant Secretary for Children, Youth, and Families for the Executive Office of Health and Human Services.

The department has worked in partnership with the Massachusetts Interagency Council on Homelessness and Housing, a council of agencies across the executive branch, all focused on more effective management of programs and services to the homeless.

Endnotes

1. Section 8 housing vouchers are issued by the U.S. Department of Housing and Urban Development. These vouchers are used by residents to offset the rental cost of market rate units.
2. The Massachusetts Behavioral Health Partnership (MBHP) manages mental health and substance abuse services for more than 320,000 MassHealth members across the state. Working collaboratively with members, their families, advocates, state agencies, and providers, MBHP has created a community-based system of care that integrates mental health and primary care for members.**