PROGRAM METHODOLOGY

Best practice methods utilized to overcome the multi-layered problems associated with homelessness begin with:  

1) a thorough intake, evaluation and assessment,

2) development of an Individual Client Plan (ICP)

3) ongoing case management to monitor progress and follow-through.

Each step is carefully structured to move a man or woman towards stabilization, rehabilitation, empowerment and self-sufficiency.  Best practice methodology is holistically designed:

• Comprehensive intake, assessment and orientation
• Rehabilitation Requirement and Physical Examination
• Behavior modification, Skill-building, Education and Training, Support System Plan
• Employment/Income Plan
• Permanent Housing Plan

Comprehensive intake and assessment begins with application review by staff and an initial client interview with the Program Manager to establish that client meets program criteria, and understands—and is willing to abide by—rules and regulations.  Clients must make a commitment to change his/her life! 

Once accepted into the program, each client completes the Rehabilitaion Requirements Questionnaire and schedule a physical examination.  The RRQ is a simple checklist to measure the legal/financial situation, self-knowledge, functional skills, and identify the most immediate training and service needs.

During the first week of occupancy, case managers work with each new client to develop an Individual Client Plan (ICP).  ICP components—“Physical, Mental, Emotional, Social, Fiscal, Rehabilitation, Education/Training, Skill-Building, Behavior Modification, Reunification and Housing”—are holistically designed to maintain focus, track accountability and measure accomplishments.  The ICP tool helps clients establish short-term and long-term goals, and create an action plan and timeline. 

Psych evaluations are done by an agency clinician as soon as possible if the client has never been seen by a mental health care professional (homeless people cannot negotiate public mental health care systems and often “fall through the cracks”).  Clients who have been previously treated sign release forms to allow IFSN to access records and coordinate services accordingly.  Once evaluated, a corresponding treatment plan is developed for weekly, or bi-weekly counseling and therapy sessions, and applicable groups (Behavior modification, Relapse Prevention, Skill-building, Re-entry (Education) and Training, and Support System development).  Participation is usually voluntary, or mutually agreed upon by the client and Case Manager; however, groups are sometimes mandated according to client need. 

All clients with substance abuse problems must:

1) attend a minimum of three 12-step meetings per week,

2) get a “sponsor,”

3) attend Relapse Prevention groups,

4) develop a Relapse Prevention Plan, and

5) meet with a Recovery Coach weekly.

(An agency Memorandum of Understanding (MOU) with the Drug Abuse Alternatives Center (DAAC) enables clients to attend additional substance abuse prevention, education and training sessions when intensive treatment is warranted.)

Counseling and therapy are critical treatment components for abused, victimized and traumatized men and women. Without this key supportive service ingredient, homeless men and women often repeat behavioral patterns and continue to “recycle” through the shelter systems (or the streets).  Supportive services address present educational, skill-building and rehabilitation needs, but counseling addresses the root causes of homelessness and supports clients through the arduous but necessary process to examine, understand, resolve and come to terms with the past.  Counseling provides a safe, confidential environment and restores mental health, trust and self-esteem.  

Employment and income plans depend upon the client’s health, stability and skill level.  Clients without income are accepted into the program, but are required to register for Sonoma County General Assistance (GA).  Once stabilized, clients accessing GA have a 90 day window of opportunity to secure employment; assistance is provided through Employment Preparedness Training and community resources (e.g. Job Link and Voc Rehab).  If a client is temporarily disabled, GA provides funding until the end of the disability; if the disability is chronic or permanent, GA provides funding until SSI/SDI benefits are secured, however it is a long and tedious process which requires advocacy.  The staff clinician and MFTI’s advocate for clients in need of permanent disability benefits.

The Permanent Housing Plan—the final, most important and often the most difficult step in a client’s transition to self-sufficiency and independence—is exacerbated by the extraordinarily high cost of housing in Sonoma County.  To overcome this challenge, clients who qualify are directed to apply for Section 8 vouchers or encouraged to consider shared housing.  Effective Communication, Problem-Solving and Mediation skill-building groups improve a client’s ability to develop the resources necessary to successfully maintain shared housing.

Service collaborations, specifically two new programs offered by local service providers, are currently available to assist low-income and formerly homeless individuals to obtain adequate housing.  “Rent Right” and “Rent Up” provide ongoing educational orientations; topics include budgeting, rent negotiation, proper application completion, credit clean-up, interviewing techniques and other pertinent information.

Last year, 58% of our clients graduated to permanent housing!

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