“Housing-First” Models in Philadelphia. David Dunbeck, MSW Director of Homeless Services Horizon House, Inc . Philadelphia. November 30, 2005. What is Housing First?.
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David Dunbeck, MSW
Director of Homeless Services
Horizon House, Inc.
November 30, 2005
Tanya Tull, Shelter Now, LA
Bring chronically homeless street and shelter dwelling individuals with co-occurring substance abuse and mental illness disorders into permanent independent housing with intensive behavioral healthcare support.
24/7 Hour Availability and Coverage
Small Caseloads: 1:10 staff:client ratios
The team provides all treatment except inpatient
Assertive OutreachEssential Ingredients of Assertive Community Treatment
Lachance, K., & Santos, A.B. (1995). Modifying the PACT model: preserving critical elements. Psychiatric Services, 46:601-604 .
Two ground rules for housing:
37 were entered in OESS database before 2000.
27 were homeless for over 10 years.
Averaged 15.5 inpatient admissions* over last 5 years (3 per year), ranging from 0 to 68.
* detox, rehab, or psychiatric inpatient treatment
After engagement by ACT team, there was an almost 60% reduction in inpatient admissions.
After housing, there was a 78% reduction in inpatient admissions.Home First Outcomes
Co-location of facilitiesHousing First Challenges
Good cop/bad cop
DamagesHousing First Challenges