Demonstrating a Case Management Approach to Economic Self-Sufficiency Programs for the Homeless I. TOPIC Homeless Opportunity Project II. LOCATION Mid-Coast Maine III. SUBJECT Demonstrating a Case Management Approach to Economic Self-Sufficiency Programs for the Homeless IV. SUMMARY Coastal Economic Development Corporation (CED) and Tedford Oasis Programs (Tedford) formed a partnership to develop the Homeless Opportunity Program (HOP) to demonstrate an integrated, case management approach to social service delivery. The partners received a two-year Demonstration Partnership Project grant from the U.S. Department of Health and Human Services' Office of Community Services to conduct the test project. HOP provided homeless people with referrals to social service programs and case management through follow-up assessments and referrals. The homeless participants received a range of services from CED, Tedford, and other service providers in the mid-coast Maine area. Services included emergency and other housing assistance, job training and placement, adult education, weatherization, fuel assistance, food assistance, child care, crisis assistance, mental health counseling, and residential and outpatient services for people with substance abuse problems. At the end of the two-year program, participating agencies noted a much greater degree of inter-program coordination. Evaluation of the project showed that participants who received case management and ongoing referral services had greater access to services than participants who received only initial case assessment and referrals. V. SUCCESSFUL PRACTICE Developed a Demonstration Partnership Project that showed the benefits of an integrated case management approach to the delivery of social services and changed the way services are delivered in mid-coast Maine. VI. CONTACT Jessica M. Harnar, Executive Director Dana Totman, Project Director Coastal Economic Development Corporation (A Community Action Agency) 39 Andrews Road Bath, Maine 04530 207-442-7963 207-442-7963 (FAX) VII. CASE STUDY The Problem: The social services available to low-income individuals and families in mid-coast Maine lacked integration and a case management approach. Coastal Economic Development Corporation (CED) is a Community Action Agency serving low-income families in Lincoln, Sagadahoc, and northeastern Cumberland Counties of mid-coast Maine. CED provides direct services to 5,000 low-income families through a broad range of programs. Several other local and regional service providers in the 850 square-mile region offered additional, and sometimes duplicative, services to the 97,000 residents. The Approach Adopted: CED and Tedford Oasis Programs (Tedford) formed a partnership to develop the Homeless Opportunity Project (HOP) to demonstrate an integrated, case management approach to social service delivery. HOP established a job-focused, community-wide system of integrated, case-managed services that help homeless people secure employment at wages sufficient to obtain housing and live independently. HOP focuses on what happens to clients after their immediate shelter needs have been addressed. HOP's overall goal is to enable homeless people to achieve economic self-sufficiency to the extent that they can compete in the private housing market. How They Implemented The Approach: CED and Tedford, the primary partners in HOP, assembled a group of community partners to provide either funding or services. Tedford operates a homeless shelter that would serve as the client intake center. CED's services include emergency and other housing assistance, job training and placement, adult education, weatherization, fuel assistance, food assistance, child care, and crisis assistance. The additional partners included Shoreline Mental Health Systems (mental health counseling), the Addiction Resource Center (residential and outpatient services for people with substance abuse problems), and the United Way of Mid-Coast Maine (a major non-governmental social welfare and philanthropy provider in the region). In 1992, CED and Tedford received a Demonstration Partnership Project (DPP) grant from the U.S. Department of Health and Human Services' Office of Community Services to initiate HOP. The two-year grant totaled $672,092. Participants in HOP came from Tedford's homeless shelter and had to fall into one of six program eligibility categories: (1) persons who are completely homeless; (2) persons in overcrowded housing; (3) persons living in housing with structural problems that pose a threat to health or physical safety; (4) persons who have been evicted; (5) persons living in a family conflict or other violent situation; and (6) persons who rely on public assistance to meet their basic needs. After intake screening, HOP divided eligible clients at random into two groups for project evaluation purposes: a comparison group of 42 people and an experimental group of 55 people. Participants were assigned to case managers at CED. Case managers provided comprehensive case assessments and referrals to appropriate services for members of the comparison group. This group did not receive formal case management intervention or follow-up. Members of the experimental group received comprehensive assessments and referrals. They also received reassessments every two months and were eligible for monetary stipends if their case managers thought it would help their progress toward self-sufficiency. The participants' progress toward employability and self-sufficiency was measured by the Handicapped Employability Scale (HEAS), an evaluation instrument that was also being demonstrated in this project. The HEAS had been employed in many projects involving dependent populations, but it had never been used in evaluating projects designed for homeless people. HEAS measures participant status changes in a set of employability readiness fields as determined by HOP case managers. Case managers conducted scheduled two-month reassessments of their clients in the experimental group and recorded their status on the HEAS instrument. Case managers also recorded reassessments of members of the comparison group if they happened to locate them or encounter them in another CED program. Results: At the end of the two-year program, service providers and independent evaluators noted a significant degree of inter-program coordination that was non-existent in mid-coast Maine before HOP. Homeless persons had been almost entirely absent from CED's vocational programs before HOP, and homeless persons using CED's housing services had not been referred in any systematic way to other CED services. Similarly, programs for the homeless provided by other project partners had been in no way integrated with CED's or any other provider's programs. The 42 members of the comparison group received an average of 14.8 services after their initial assessment and referral. The 55 members of the experimental group received an average of 19.9 services. As expected, those receiving more comprehensive case management benefited from more services. Because the comparison group did receive initial assessments and referrals, and follow-up reassessments and referrals in some cases, the difference between the two groups' average number of services was not extreme. The HEAS evaluation showed that 75 percent of HOP's 97 participants improved their employability rating by the end of the project period. Employment also increased; 46 percent of participants at the project's beginning, and 59 percent at the end, were either employed or receiving unemployment. Participants' self-image also rose. At first assessment, 46 percent had a positive self image, while 59 percent reported a positive self image at last assessment. HOP was also successful in finding housing for the homeless. Three percent of the participants had safe, affordable housing when they joined the program, and 66 percent had housing at the end. The success of HOP's integrated case management approach has changed the way social service agencies in mid-coast Maine serve their clients. Referrals and case management ensure that clients get what they need and providers make the most efficient use of their time and resources. VIII. KEY WORDS Adult Education Case Management Child Care Community Action Agency Counseling Demonstration Partnership Projects Department of Health and Human Services Fuel Assistance Handicapped Employability Scale Homeless Housing Job Training Office of Community Services Partnerships Self-Sufficiency Social Services Weatherization ref: hop.L4doc