“Housing-First” Models in Philadelphia. David Dunbeck, MSW Director of Homeless Services Horizon House, Inc . Philadelphia. November 30, 2005. What is Housing First?.
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