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Collaborating to launch a Housing First program: 5 keys to success

November 14, 2018
Participant in our care intervention with Camden Coalition staff holding a welcome gift of flowers at her new home

By Emily Spector

The impact of homelessness on our patients led the Camden Coalition to develop a multi-partner, citywide Housing First program. Our Housing First program follows a national model that takes a recovery-oriented approach to ending homelessness. The program centers on moving individuals experiencing chronic homelessness into permanent housing and providing support services without preconditions, such as sobriety or mandated treatment. Preliminary findings of our Housing First program show more than 60 percent reduction in inpatient visits and emergency room use for enrolled patients.

A core component of the Housing First model is that community leaders work collaboratively to ensure that a range of affordable and supportive housing options and models are available to meet local needs. With this in mind, we led a group of community partners to develop a citywide, multi-partner initiative. In addition to the Camden Coalition, there are four local organizations central to our Housing First program: Oaks Integrated Care, South Jersey Behavioral Health Resources (SJBHR), St. Joseph’s Carpenter Society, and Volunteers of America (VOA), each with different roles in the program. Community partners such as the local Board of Social Services, Life at Lourdes, and the Urban Health Institute also support clients in the program and provide assistance in overcoming barriers to housing entry.

Since implementation in 2015, we found five “keys to success” for collaboratively launching and maintaining our Housing First program. These findings are based on our ongoing, mixed-methods evaluation, which includes interviews with Camden Coalition staff and Housing First community partners.

  1. Set up strong communication and collaboration channels. Open and ongoing communication and collaboration are key to launching and sustaining a Housing First program, both within each community organization and among the organizations working together. One of our community partners asserted that not only is communication key, but also the program runs more smoothly if communication is open and honest.
  2. Establish clear roles and responsibilities early in the process. Openly defining expectations for each partner facilitates a sense of ownership and prevents duplication of effort. This point was made by one community partner who stated that having a firm understanding of his role has led to more structure in the way he provides services and better teamwork with his colleagues and outside partners.
  3. Share best practices among partner sites. For example, the Camden Coalition stipulates its care team staff be trained to use Narcan kits in case a patient requires an opioid overdose reversal. They shared these training protocols with SJBHR, who now carry NARCAN kits. The Coalition has also learned best practices from its partners. For example, VOA shared learnings on how to prevent eviction of Housing First patients with the Camden Coalition’s care team.
  4. Provide a seamless patient handoff between different providers and services. While the Camden Coalition worked with clients up until they were housed, the SJBHR care team took over case management services after they were placed in housing. Facilitating a smooth transition, such as debriefing external colleagues on the patient’s current health and social challenges, prevented clients from “getting lost in the shuffle,” as one community partner put it.
  5. Build a rapport and develop trust with patients. Finally, one community partner emphasized that since Housing First is patient-driven, it is highly important to take time to listen to patients and hear their personal stories before and after they move into housing. Emphasizing this patient-centered approach among all of the partners is important for creating a successful program that builds trust with patients and promotes continued client engagement in services. As another partner noted, when his clients feel trust and connection with him, they are more open to his suggestions for ways to improve their health.

 
While working collaboratively across organizations comes with challenges, there are best practices that Housing First programs can follow to achieve a more effective program than would be possible by working in silos. Above all, it is important to have every partner equally invested in the program’s success. As Bill Nice, the Camden Coalition’s Program Manager of Care Management Initiatives stated, “One of the challenges has been ‘is everybody equally bought into this process? Is everybody emotionally and organizationally invested in this project?’ And all of the other challenges will either become more or less difficult based on that.”

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