Access: The TAC Blog

Beyond Pizza — How Communities Handle Compensation and other Practical Issues with Young Adult Partners

Communities working to end youth homelessness are increasingly bringing youth and young adults with lived experience of homelessness to the forefront of their planning and implementation efforts, often with the support of a HUD Youth Homelessness Demonstration Program award. Of course, the young people who contribute their energy and insights should be compensated for their time - but how, and how much? TAC Senior Associate Lauren Knott, together with consultant Lauren Leonardis, surveyed a range of Youth Action Boards (YABs) to find out how they handle this and other challenges. The results are available as The Gab on YABs, a collection of community fact sheets and topic spotlights full of useful information for any community committed to fully incorporating youth and young adult leadership.

Tools for Successful State Partnerships between Medicaid and Housing Agencies

From 2016 to 2018, sixteen states participated in a Centers for Medicare and Medicaid Services (CMS) Innovation Accelerator Program (IAP) State Medicaid-Housing Agency Partnerships track. The tools developed and used to provide technical assistance to these states, incorporating the work and expertise of many TAC colleagues, form the basis of a new State Medicaid-Housing Agency Partnerships Toolkit published recently to the LTSS website. The toolkit is designed to assist states as they consider systems-level changes that further community integration, including the intersection between health care and housing. It is available for states to download, use, and adapt.

Trainings for Trainers in a Unique Rapid Resolution Pilot Program for Veterans

TAC has recently hosted several three-day events focused on homelessness diversion and rapid exit strategies for Veterans. These "train the trainers" sessions, conducted in partnership with the Cleveland Mediation Center and Abt Associates, are part of our support for the Department of Veterans Affairs' Supportive Services for Veteran Families (SSVF) program. Over the past two years, TAC and our partners have provided a wide range of onsite, remote, and training technical assistance in the development and rollout of SSVF's "Rapid Resolution" initiative, the first nationwide federal effort of its kind - a pilot program that supports diversion strategies for Veterans who are entering homelessness or have only recently become homeless. The recent trainings teach critical diversion and rapid exit skills in the context of SSVF's program design and implementation, with an emphasis on giving practitioners the tools they need to transfer that knowledge to their home communities. The training effort is led by TAC Senior Associate Douglas Tetrault, with strong support from other TAC staff members and TAC partners, and project direction from TAC Senior Consultant Jim Yates.

STAFF ACTIVITIES

TAC staff members Jenna Espinosa, Ellen Fitzpatrick, Ayana Gonzalez, Lauren Knott, & Ashley Mann-McLellan have been facilitating convenings and providing TA for Youth Homelessness Demonstration Program communities in Iowa, New York, Massachusetts, and Maine; Associate Ellen Fitzpatrick and Senior Associate Ashley Mann-McLellan conducted a 3-part training for Boston agency directors to strengthen the role of housing navigators in their organizations, and is helping the Boston Public Health Commission with a strategic plan to make its 800-bed shelter more housing-focused; Ashley was also one of 350 volunteers in Boston's 40th annual homeless census - thanks, Ashley! Senior Associate Melany Mondello led a training for the Vermont Balance of State Continuum of Care on the definition and documentation standards of chronic homelessness; Senior Consultant John O'Brien spoke about the future of policy and payment at a Substance Use Disorder Action Forum hosted by the Medicaid Transformation Project; Senior Associate Rachel Post facilitated the first cohort of Housing and Healthy Communities Learning Network, with plans for a second round in the works; Senior Associate Tyler Sadwith launched a provider-to-provider pilot program to test an approach for delivering TA on medication-assisted treatment to California's Tribal health programs; and Tyler also joined Senior Consultant John O'Brien to share strategic planning advice at a roundtable for Pew Charitable Trust's Substance Use Prevention and Treatment initiative.

STAFF TRANSITIONS

TAC is growing! A warm welcome to Project Support Specialists Laura Harris and Ari Rogers; Communications Designer Jeff Nguyen; Associates Eric Gammons and Jenna Espinosa in our housing group; and Dayana Simons and David de Voursney, two new Senior Consultants in our human services group. Learn more about our new colleagues on the TAC staff page.

WHAT HAPPENS WHEN YOUNG PEOPLE who have directly experienced the challenges of homelessness or unsafe/unstable housing bring their expertise, passion, and creativity to the goal of transforming systems and ending youth homelessness?

• They bring reality-based understanding to existing homelessness efforts about the unique needs of youth in a given community.
• They model a core commitment to inclusion and equity that can be a struggle for older adults and more traditional systems of decision-making.
• They form an accepting, empowering community that strengthens the youth who participate.
• All this and more!

Across the U.S., rural, suburban, and urban communities that have made a commitment to end homelessness are learning how to understand and address the specific needs of youth and young adults. Just as with other populations in need of services and resources, the insights of those most directly affected — in this case, young people with lived experience of homelessness — are essential to finding solutions. This is why one of the key first steps is for a community to form a Youth Action Board that brings youth and young adults to the forefront of planning and implementation efforts.

Over the past few years, TAC has worked closely with many communities on their plans to end youth homelessness. At the center of each engagement has been the YAB, a decision-making entity made up of youth and young adults who have experienced or are experiencing homelessness. YABs provide leadership and guidance in partnership with other key stakeholders in the process of developing and implementing a plan to end to youth homelessness in the communities where they operate.

Every community is different, but there has been a great deal of interest in “what works” for others, and communities often have questions about best practices nationally for YABs. TAC has encountered YABs at all different stages — some well-established, some that have met formally for a short time, and others that have two or three core members identified, but haven’t yet taken the next step. So TAC decided to gather a sampling of YAB expertise as a guide for communities at all stages of YAB development.

Working with Lauren Leonardis, an independent consultant specializing in youth homelessness issues and a founding director of the large and active Boston YAB, we surveyed seven YABs, seeking to capture a snapshot of each one. The communities were asked about the big picture — their strengths and challenges — as well as the small details that push them forward like facilitation practices, budget, and recruitment efforts.

The results are fascinating and inspiring as they show diverse strategies, challenges, and opportunities in each unique community at the specific moment when the survey was answered. To share them, TAC has created The Gab on YABs: a series of fact sheets with an overview of each community, to be followed soon by a “topic spotlight” series looking at patterns and trends in areas of interest like compensation, structure, recruitment, and more.

We hope these resources will answer some of the questions communities have about how other YABs are making it work. No matter what stage your community has reached, The Gab on YABs can help you bring the voices and power of youth and young adults with lived experience of homelessness directly into all planning and implementation decisions.

Improving Homelessness Response Systems in California’s Counties

Under a new contract with California’s Department of Housing and Community Development, TAC is providing capacity-building technical assistance (TA) to help California’s communities enhance their homeless crisis response systems. First, TAC staff traveled with state officials and TA peers to meet with homeless system representatives from around the state, learning about their needs and introducing potential TA resources. Since then, TAC has been engaged by several communities, including Butte County where we are helping with disaster recovery after the devastating 2018 Camp Fire.

In Vermont, a Focus on Ending Youth Homelessness

Through the U.S. Department of Housing and Urban Development, the Vermont Balance of State Continuum of Care became an official Youth Homelessness Demonstration Program site in the summer of 2018. This award provides support to the CoC and its Youth Action Board (YAB) as they develop a plan to prevent and end youth homelessness in 13 of Vermont's 14 counties. TAC Associates Lauren Knott and Ellen Fitzpatrick are helping CoC leaders to develop and drive the planning process - focusing especially on strengthening youth voice, analyzing local data, and defining the CoC's vision for the initiative. With the CoC's written plan to HUD submitted and now approved, TAC is now helping with project selection and the implementation process. TAC staff members were also fortunate to participate in a two-day Youth Collaboration training facilitated on-site by True Colors United and including both YAB members and CoC leaders. TAC has supported the Vermont Balance of State CoC as it incorporate takeaways from this training and creates a system in which authentic youth collaboration is at the forefront of all planning to prevent and end youth homelessness in Vermont.

TAC Staff in Action

STAFF ACTIVITIES

More than 700 leaders and managers from Supportive Services for Veteran Families (SSVF) grantee organizations attended five regional meetings in January, focused on rapid resolution — with TACsters Phil Allen, Ellen Fitzpatrick, Marie Herb, Ashley Mann-McLellan, Naomi Sweitzer, Douglas Tetrault, and Jim Yates providing coordination and giving presentations; Associate Ashley Mann-McLellan presented on “Designing Coordinated Entry Systems and Prioritization to Better Serve Individual Adults” at the Solutions for Individual Homeless Adults conference sponsored by the National Alliance to End Homelessness (BONUS: Check out Ashley’s blog post on what’s working in coordinated entry!); and Senior Associate Rachel Post led two sessions on Assertive Community Treatment and intensive case management at the Fairbanks (AK) Symposium on Homelessness.

A Nevada Community Mobilizes to End Youth Homelessness

In 2017, Southern Nevada tallied the third highest rate of unaccompanied youth homelessness in the nation. Recognizing the urgent need for a dedicated response to this crisis, the community, which includes the city of Las Vegas, issued a national request for technical assistance proposals. Through this competitive process, TAC was selected to facilitate a robust and inclusive planning effort, and ultimately to draft the first-ever Southern Nevada Plan to End Youth Homelessness.

From April to October 2018, TAC consultants Lauren Knott, Ellen Fitzpatrick, and Ashley Mann-McLellan worked with the community to create decision-making groups, analyze data to identify areas of need, articulate goals and strategies, and strengthen the active involvement of "Young Adults in Charge" (the Southern Nevada Homeless Continuum of Care's official Youth Action Board) in guiding the development of the Plan.

This engagement culminated in a Summit to End Youth Homelessness, a packed and lively event at which the Plan was officially launched. Rounding out presentations by members of the planning group, TAC consultants facilitated brainstorming sessions for Summit participants on implementation of the Plan, focusing on next steps with identified strategies. Service providers, educators, law enforcement, policymakers, funders, faith groups, and business leaders were all in attendance, demonstrating this community's broad commitment to the shared goal of ending youth homelessness in Southern Nevada.

Meeting the Challenge of Expanding Access to Integrated Physical Health and Addiction Care

With support from the Melville Charitable Trust, TAC Senior Consultant John O'Brien assembled teams of experts to produce two new papers exploring the ways care integration is being practiced - and paid for - in a rapidly changing U.S. health care environment.

Rather than searching for a uniform set of requisite elements in the integration of substance use disorder (SUD) treatment and mainstream medical care, the authors of "Integrating Substance Use Disorder Treatment & Mainstream Medical Care: Four Ground-Level Experiences" decided to showcase a few very different groups of providers that have each moved in this direction. In each case, they asked the same key questions, including "What is the context in which your integrated care effort occurred?" "Why and how did the shift to integrated care come about?" and "What more should we know about integrated care?" A condensed version of this paper was published on the AcademyHealth Blog.

From 2000 to 2014, the rate of deaths in the U.S. from drug overdoses increased by 137 percent, yet access to treatment services for people with SUDs continues to lag. Expanding the capacity of primary care providers to assess and treat addiction is critical to filling this gap, especially given the stigma associated with seeking treatment in specialty settings. "Exploring Value-Based Payment to Encourage Substance Use Disorder Treatment in Primary Care," a joint publication project with the Center for Health Care Strategies, describes how several states and health plans are exploring value-based payment to promote SUD treatment in primary care, and offers considerations for others who might want to implement these models.

TAC Staff in Action

STAFF ACTIVITIES

Executive Director Kevin Martone moderated a plenary panel on "The Health of Housing: State and Community-Based Approaches" at the National Association of Medicaid Directors' fall conference (to see the panel, start at about 31:00), delivered the keynote address at the 20th anniversary gathering of the Supportive Housing Association of New Jersey, and led a workshop on Mainstream Housing Choice Vouchers at the National Association of Housing and Redevelopment Officials (NAHRO) conference; Senior Consultant John O'Brien has been named a distinguished adviser at the Pew Charitable Trusts and was recently interviewed by Pew on "How Health Care Payers Can Help Stem the Opioid Crisis"; Subcontractor Naomi Sweitzer led a well-attended event to promote the homeless preference in multifamily housing, held at Austin (TX) City Hall and hosted by Mayor Steve Adler; Associate Ashley Mann-McLellan facilitated workshops and leadership conversations with the Suburban Cook County (IL) CoC on maximizing the impact of rapid re-housing to end homelessness; Ashley also volunteered at Boston's annual Surge to End Chronic Homelessness event; Senior Consultant Jim Yates, Associate Phil Allen, and other partners from the Rural Supportive Housing Initiative traveled to Fairbanks, AK to help the community establish new permanent supportive housing units and house more families and individuals through a robust rapid re-housing program.

Propelling Innovation to End Youth Homelessness

TAC consultants have been criss-crossing the U.S. this spring to help strengthen local youth homelessness prevention efforts. In Washington's Seattle/King County, our TA is an integral part of the Youth Homelessness Demonstration Program, a HUD initiative awarded to ten communities. So far, we've worked with Seattle/King County on flexible system design, engaging a Youth Advisory Board, compiling promising practices from across the country, analyzing data to measure the need for housing and services, creating landscape scans of current housing and service inventories, and developing continuous improvement strategies the community can use to evaluate and learn from implementation. Once the planning process wraps up in July, our focus will shift to creating an implementation "road map" for community stakeholders and providing training and capacity-building to Seattle/King County agencies working to end youth homelessness in their community. Learn more about TAC's TA with programs serving children and youth.

Sharing Strategies for Successful Community Integration

From May 1-2, HUD Section 811 Project Rental Assistance grantees from 25 states — including both housing and service providers — joined TAC staff members and officials from the Department of Housing and Urban Development (HUD) and the Centers for Medicare and Medicaid Services (CMS) in Washington, DC. Participants in this TAC-organized initiative shared successes and insights from their experiences implementing PRA to expand integrated supportive housing opportunities for extremely low-income people with disabilities.

TAC Staff in Action

STAFF ACTIVITIES

Policy Advisor Francine Arienti and TAC consultant Naomi Sweitzer were invited by the Vermont Youth Homelessness Prevention Plan Committee to present on federal/state resources and models of state plans around the country; Senior Associate Jonathan Delman gave the keynote address at Employment Matters! (annual conference of the Massachusetts Association of People Supporting Employment First); Jon's article on "Employer-based Strategies to Increase Employment Rates for People Living with Serious Mental Illness," co-authored with Senior Consultant Lynn Kovich and Executive Director Kevin Martone, has been published in Psychiatric Rehabilitation Journal; Associate Ashley Mann-McLellan hosted a community planning meeting in Denver to help advance the city's strategy on ending veteran homelessness; Ashley also met with HUD Youth Homelessness Demonstration Project grantees and TA providers at the CSH Supportive Housing Summit in May; and Associate Douglas Tetrault presented on "Community-wide System Assessment and Improvement" at the National Coalition for Homeless Veterans conference, while Senior Consultant Jim Yates presented on "Using Federal Fair Housing Guidance to Reduce Access Barriers to Housing" at NCHV's pre-conference Housing Summit.

POSITION AVAILABLE

TAC is seeking a Senior Associate/Consultant with expertise in behavioral health and Medicaid. Read the full description and application information.

Access: The TAC Blog is Launched!

With the addition of Access to TAC’s website, our senior consultants are now able to contribute their unique perspectives from the intersection of affordable housing, health care, and human services policy. Posts so far have included John O’Brien on “The Next Frontier: Care and Service Integration for People with Substance Use Disorders” and Kevin Martone asking “Can States Take On the Fiscal Responsibility that Federal Policymakers Are About to Hand Them?” Watch your email for monthly post alerts.

A New “Practice Profile” on In-Home Therapy

In the fall of 2015, the Children’s Behavioral Health Initiative (CBHI) Knowledge Center, in collaboration with MassHealth, began an extensive effort to develop a “practice profile” for providers of in-home therapy to Massachusetts children and youth receiving publicly funded behavioral health services. After conducting a literature review and a series of workshops with stakeholders, CBHI drafted the new resource and engaged TAC to help produce the final version. Publicly available, the In-Home Therapy Practice Profile offers in-home therapy providers easy-to-use guidance on best practices in cultural relevance, risk assessment and safety planning, engaging natural supports, and other key areas.

TAC Staff in Action

Staff Activities

Senior Associate Liz Stewart participated in the inaugural Winter Walk across Boston to end homelessness; Liz and Associate Lauren Knott joined a panel on “Improving Systems in Balance of State and Regional CoCs” at the National Alliance to End Homelessness’ Annual Conference on Ending Family & Youth Homelessness.

Staff Transitions

We’re happy to welcome Phillip Allen as a new Associate on the TAC housing team. Phil is helping Supportive Services for Veteran Families (SSVF) grantees and communities to develop and implement effective programs.