The following list of recommendations are from the full report.
Recommendations for Improving the Program
While the Housing First program has been remarkably successful, we do have suggestions for improving it.
1- The success of Housing First programs is due in part to the ability of clients to readily access mental and physical health services. Case managers should have mental health training and clients should be able to meet with psychiatrists or counselors whenever they need to. This may require the establishment of a more formal relationship with a mental health center for Fran Conway House residents.
2- While most clients are on disability, a number express the need and willingness to work part-time. Case managers need to connect clients with jobs and with effective job training.
3- Clients who are not working need daytime and evening activities. These could include group trips and/or organized adult activities in the community as a whole.
4- Dental care is a special need that must be addressed.
5- All clients, even those who appear to be self-sufficient, need regular case manager visits, at least on a bi-monthly basis.
6- The scattered site apartment program run by Riverwood is working well overall. However, the program could use more high quality apartments. Maintenance problems, as well as drug/alcohol use and fighting are issues in a few buildings. Case managers must be vigilant to be sure that these problems do not lead to program exits.
7- Since many clients have been homeless for a long period of time, there is a need for life skills training, particularly to orient clients to apartment living.
8- There is a need for a more adequate furniture allowance since many clients do not have adequate furniture, nor access to funds to acquire it.
This Housing First supportive services program has been extremely successful. We believe that a program like this should be a crucial part of the answer to the problem of homelessness in Rhode Island. It is serving the intended population, chronically homeless single adults. Clients were very unhappy while homeless and are now generally very happy with their housing situation. They are very grateful for this program. Tremendous progress has been made with respect to client health, mental health, and ability to interact socially with family and friends. Clients have higher incomes due to the ability of program staff to get them onto disability support but few are working.
The program more than pays for itself. Cost savings due to reduced use of expensive facilities such as hospitals, emergency rooms, mental health facilities, and prison are dramatic, nearly $9,000 per client, over $420,000 for the 48 clients combined. The turnover rate of clients is relatively low at 22%. Much of the turnover that did occur was due to high initial turnover at the House of Hope program, where the congregate setting necessitated managing the resident mix to achieve long-term safety of the house residents. Riverwood Mental Health Services has used rapid re-housing methods to retain clients in permanent housing.
Our recommendation would be to expand this program to include more chronically homeless Rhode Islanders, a population estimated to be approximately 650 individuals. This would result in cost savings for the state and its citizens, and it would dramatically improve the lives of those benefiting from the program.