Committee Minutes

City of Grand Forks
10-Year Plan to End Long Term Homelessness
Minutes from Meeting #4 – Thursday, November 15, 2007; 11:30 a.m. to 1:30 p.m.
The Link Community Center, 300 Cherry Street

Present:
Peggy Kurtz, Urban Development Jessica Thomasson
Todd Fahrni, UD InternMeredith Richards, Urban Development
Terry Hanson, GF Housing AuthoritySuAnn Frasier Wood, Community Foundation
Pat Berger, United WaySusan Houser, Job Service
Eliot Glassheim, City CouncilJohn Johnson, Options
Pete Haga, Mayor’s OfficeDave Sena, Northlands Rescue Mission
Gerri Anderson, NEHSCKeith Gilleshammer, Centre Inc.
JoAnn Brundin, St. Vincent de PaulMary McConnell, Prairie Harvest
Kathryn Allery, Development Homes, Inc.Amanda Lupien, CVIC
Andrea Brudvig, CVICRachel Hafner, Prairie Harvest
Craig Knudsvig, GF Housing AuthorityTerri Keehr, GF Public Health
Tami Byzewski, NEHSCLindy Beauchamp, The Salvation Army

Peggy welcomed everyone to the meeting. Jessica said we scheduled this meeting in order to continue the great discussions that were started at the last meeting. She referred to the two handouts that were distributed via e-mail prior to the meeting: (1) Meeting 3 “wall notes” and (2) Version 2 of the draft strategic framework. Jessica said we need to keep our sharp focus on the population we are trying to address; i.e., about 25 people on any give night who have been homeless for a long time, mostly single adults, with some type of disabling condition.

Pat Berger asked about “Homeless Connect” and Jessica said this is a one-day walk-in “event” for local homeless people that brings together community service providers who typically address homelessness, along with atypical services such as haircuts, eye exams, and personal care services. She reported that when Fargo held their event, they planned for 100 people but attendance was over 300. Their attendees were homeless people, people who were at risk of becoming homeless, and veterans. Keith Gilleshammer added this is similar to VA “stand down”, where the VA has many types of services available in one place for walk-ins. Jessica said this type of event connects traditional and nontraditional services in unique way.

Jessica started the discussion with #4 of “What Can Be Done” on the revised draft framework – “Coordinate services to provide rapid access and individualized treatment”. The stakeholders broke out into small focus groups for about 15-20 minutes. Pat Berger said we probably have the core basic services, but didn’t know to what extent they were coordinated with each other or if they were readily available when a person makes a decision to seek help. Dave said there are some agencies, such as the VA, that have a regular presence at the Mission. Gerri agreed that most services are available except for a social detox, including rep payees, med monitors, substance abuse treatment, jobs skills training, transportation, in-home support, help with daily living skills, education (GED), spiritual support, employment placement, recreational opportunities/social, food, furniture, rent, extended family support, and health care. Gerri added some may be available but in a limited capacity with X number of slots. Terry Hanson said we have transportation available but maybe not the transportation a homeless person would need; such as door-to-door, for example. We have the basics but need to expand or customize or individualize them to address the specific needs of this population. Terri Keehr said that Medical Assistance will not pay for taxi’s to get to services (doctor, grocery store). Jessica said that transportation comes up in the top two needs; i.e., you have transportation opportunities (bus, etc.) but still have a gap, so what’s missing. Terri asked where the equity was for other small segments of society like refugees. Jessica replied if we address the services to this specific population, it should free up resources for other segments. There are different types of interventions for different populations. She said Mary Magnusson’s e-mail of this morning contained new ideas for using Medicaid funds.

Craig said we need to keep our focus on who we are addressing with this plan. There is a new program where the “money follow the person” for people in institutional care (nursing homes, group homes) with the idea of moving them back into community by having services available for independent living. In this case, we are talking about elderly or challenged individuals. Transportation is a very big issue – how do they get back home from the nursing home. We are probably, at some point, talking about the same pot of money so we need to make sure to identify a way to use those dollars. That could lead to “one plus one equals free”. Keith Gilleshammer asked if there was a hot line in town and Pat Berger said there was a “call for help” line at United Way. Also, there should a 211 line – where do I go for help – coming soon to this area or maybe it’s already here. So we need to talk about getting the word out. Keith said we must include volunteers in our solution – short and long term mentoring. If there are people in the community who are willing to mentor, how we can get a volunteer program publicized. Jessica said there was a similar concept in Denver where the Mayor challenged the faith community to “adopt a homeless person”. Terri said there are 83 churches in this area, but only 3-4 are active in volunteering. Keith said first, they need to be aware of the opportunities, perhaps through a volunteer coordinator or website for homeless issues. Gerri said First Link is available in Grand Forks but they don’t find volunteers, they coordinate people who contact them that want to volunteer. Pat Berger said their job is to get out in the community to promote volunteerism and can then get e-mails about volunteering opportunities. Jessica asked what services we don’t have. Pat asked if it was hard to find furniture and JoAnn Brundin said they have lots of furniture.

Craig Knudsvig agreed that we need detox or substance abuse services. Jessica said, since substance abuse (SA) and mental illness (MI) are such big issues, we need a continuum of services available, from detox, in/out patient, half way house, harm reduction, etc. Keith Gilleshammer said he was meeting with NE about the possibility of a detox facility here in town. He has operated a detox in Fargo since 1990 and it is a critical part of their homeless continuum and offered a tour of his Fargo facility to anyone who would like one. One issue is NIMBY - no one wants a detox facility by them. But, he added, if you have a detox facility around your house, it’s actually very safe because staff and police are there all the time. There are two models of detox - medical and social; the medical model costs about 4x more. You need a budget of $400,000 per year for a social detox. Fargo has around 1700 admits per year and they figure they save the local hospitals a lot of money because they only send someone to the hospital if they are having physical withdrawal symptoms. They have a good relationship with ambulances, hospital, police, etc. Keith said people can stay until they are sober or can be released to a responsible adult. They have rooms with easily cleanable surfaces and a locked door similar to a jailhouse doors with a pass-through. They administer breath tests to determine how long someone will be there. They distribute Gatorade and sandwiches and have secure storage for valuables. It is funded by the City of Fargo, and they have contracts with Human Services, West Fargo and law enforcement agencies. 13% are homeless vets and staff from the VA respond when called. Keith added they have problems with less 1% of the population. Dave Sena said this is a big gap for the Mission. Terry Hanson asked how this contributes to ending chronic homelessness and Keith replied because people that need help can access the services. If they need help, all they need to do is ask and staff will call the services to them. 25% are repeaters. Craig asked how many are homeless. Keith said that HUD’s definition of homeless and not having a permanent address are two different things; about 50% don’t have a permanent address. Right now in Fargo, they have a homeless shelter that was shut down which the City purchased and is rehabbing; it will have 20-30 homeless beds and they are also expanding their detox and putting it next door to the shelter. It’s a huge cost savings to the city in terms of law enforcement to be next door to a shelter; locating close is more cost effective. Jessica asked how a detox ends homelessness. Keith said it’s partly outreach, whether they have asked for it or not; plus it takes the pressure off other providers – kind of a relief valve. Dave Sena added that it also keeps people alive until you can get them services. Jessica asked about in versus outpatient treatment. Gerri Anderson said we don’t have inpatient services in Grand Forks; the closest place is a private facility in Crookston. Also, Grand Forks has a waiting list to see an addiction counselor so if someone decides to get sober, maybe they won’t be able to see an addiction counselor for two weeks or more. Eliot said they lost medical reimbursement from the State. Keith said they are seeing the same thing all over North Dakota - insurance companies have basically shut down inpatient care; there is a waiting list for psychiatric treatment at Southeast Human Services. Gerri added that licensed addiction counselors are in short supply. Terry felt that help “right now” is important. Gerri said they can hook someone up with AA until they get into treatment, but sometimes that’s not appealing; it’s a motivation issue. Dave added that they do transport people out of the area for that reason, but with mixed results – if they have trust with the Mission then have to go somewhere else for treatment, they lose motivation.

Jessica asked about outpatient treatment. Keith said it is helpful, but the question is “where is that person at and what intensity of care do they need”. Gerri said inpatient is every day, and outpatient might have contact 2 days a week. Keith felt with SA treatment, you never know when it’s going to work – will it be the first experience or the 20th experience. This is difficult for the public to accept. And there some people who never get it and they die. Gerri said we are also not looking at typical alcoholism anymore; we are looking at meth or MI or combinations. Jessica said this is a key issue. Keith said that Housing First is a new way to look at this; it will empower people to be successful. Unfortunately, it’s the unsuccessful that get the publicity. Jessica said she listened to the video story that Peggy e-mailed which was a good example of what we’re talking about. Keith said if we are only just offering a safe place to be, this offers motivation. In defining success, we can’t apply accepted definitions to this – we are seeing an 8% success rate. Eliot asked if 8% was considered good and Keith replied, for this population, it is. If ten years from now, someone is sober, then they are successful.

Jessica said the consensus is most of the needed services are here, but whether they are available to people is the question. The upshot is we don’t have to create many new services. Effective SA and MI treatment is a huge issue. She asked if we the ability to do job skill training and employment placement. Pat Berger said there are job training and placement facilities but the question is “are there jobs where people can afford food and housing”. We are 25% behind national wages here. Costs for housing, health care, and childcare are huge. So whether a job has a living wage is an issue. Jessica agreed, but maybe not for this group of long term homeless, whose employment is probably more likely to become part time with an income that supplements other benefits. She asked if there was capacity in Job Service to take a person with challenges and match them up with jobs. Tami Byzewski said they use Success Unlimited, Prairie Harvest, and MBAW in Minot. Craig said we have a training program and have had people in that program who are homeless but not a lot – don’t know how it would fit. Gerri felt that having a job is the least of their issues; they are more apt to be eligible for Social Security because of their inability to work over long period of time. So rather than focusing on employment, we need to focus on finding other money – SSI, etc. There’s much work to be done before they can start to look for jobs. Jessica said that 40-50% of LTH listed themselves as working or employed in the PIT. Craig said, in his program, people come in on their own schedule and that structure after a while seems to be beneficial. Gerri said, rather than work, maybe say purposeful activity or maybe they can work seasonally. Meredith Richards said it seems like there is not a shortage of employment opportunities, but the population we’re trying to reach doesn’t fit the requirements.

Pat said, when trying to get into housing, there is a need for start up costs - deposits, rent and utilities. Jessica asked if housing placement was an issue, if someone was in detox or at the Mission. Meredith Richards replied it was. Jessica said that Prairie Harvest has a one-page sheet they review with their clients that stresses the importance of permanent housing. Gerri added we need “second chance” housing for people with criminal backgrounds or who have burned bridges (or even fifth or sixth chance housing). Eliot said that something that might be successful might be guaranteeing landlords against losses and maybe we could tie renters education in somehow. If we’re talking about a small number every year, maybe we could get money for this. Terry said there are landlords in Grand Forks who are willing to rent to hard-to-house people with bad backgrounds. Terry asked if we are going to house pedophiles and felons and Jessica said the simple answer is yes, we need to. Meredith said the alternative would be to have them on the streets so housing is the better option. Keith said this is a tough pill for any community to swallow, but it’s true - we want someone in a place where we know where they are. Jessica said this is a very challenging issue; one where maybe the Department of Corrections becomes the landlord. Keith said the percentage of high-risk offenders is low when compared to the total number of offenders. There should be different levels of sex offender treatment for different levels of offenders. Terry said if we know someone is an offender and problems exist after they get out of prison, that means there is a failure in the penal system so we must go back to them and say they are letting the wrong people out and hold them accountable. Maybe the laws have to be re-written. Jessica reiterated that we are not going to ignore this population; we just can’t address it in this process.

Jessica asked for feedback on targeting tax credit projects where at least some of the units serve extremely low-income people. Terry said we could do that, but in order to afford the rents, a person must be assisted. If you have a family project, you can only put people with vouchers in 20% of the units. Jessica said another option is to put enough grant dollars in to lower the cost. Terry said that Grand Forks Homes was awarded HOME funds to acquire a four-plex to be used for permanent supportive housing. Their goal is to get the entire facility funded with grant dollars so that any revenue generated will go towards maintenance. If they have to service a debt, they can’t do it. Pat asked about the new apartments downtown. Terry said this is a Low Income Housing Tax Credit project which is also receiving City HOME funds. Not all units are tax credit units but the ones that are must serve people at less than 60% of the median income. There is a very limited cap on what rents can be charged. Jessica recapped that the focus is more on maintaining existing subsidized housing through vouchers rather than new construction. Gerri said there used to be priorities for homeless, elderly, etc. Terry said that some agencies like the Housing Authority have the authority to determine preferences locally, adding that maybe we should give chronically homeless individuals or families a preference in the provision of our services. He said the Housing Authority can put a roof over everyone’s head, but how to keep them housed is the problem. Keith said, we if we have an IDDT team here in town, that’s our connection. Jessica said Grand Forks used to have crisis intervention team but not it’s not in service any more and maybe we could bring that back in lieu of IDDT. Gerri said the team didn’t have a lot of power to change things, but the idea needs to be explored. Craig said that everyone comes to the table as an independent contractor, so we need to focus on connecting services and people and we need to be on same page on how all the pieces are tied together to end homelessness. It must be an emergency team. Gerri said also sometimes we didn’t have immediate resources so the idea is good, but we have work to do to get it to work. Eliot said his impression is that we have many services but the issue is case management; i.e., staffing. Terry said a problem is there is a 2-3 week waiting list to get services because the resources aren’t there to the agency providing them. Jessica asked if there was a role for a LTH coordinator. Terry said if we’re talking about Housing First and have a facility with 24/7 staff to address any issue that comes along, then they can get in contact with the service provider. What’s missing is the ability to address immediately because of processes already in place. We need service providers to be able to assign a preference to chronically homeless and put them at the top of the list. And that’s unfair for all others, but we’re meeting today to solve the problem of LTH. Eliot asked if we would need agreements signed between all directors of all agencies and Terry replied we probably would.

Jessica thanked everyone for coming and adjourned the meeting at 1:35 p.m. She said the next meeting will be November 28th at City Hall.

Keith Gillshammer stayed after the meeting to talk with people about the “housing first” model in Fargo and Homeless Connect for vets.
Respectfully submitted by Peggy Kurtz, Office of Urban Development