10 Year Plan

Southwest Oklahoma Continuum of Care 10 Year Plan

I.  Mission. 
Organize and deliver housing and services to meet the specific needs of people who are homeless as they move to stable housing and maximum self-sufficiency.


II.  Consortium of Care Strategy

For those who are already homeless or for whom homelessness cannot be prevented, the Continuum will employ a Consortium of care strategy.  The Consortium of care approach will seek to assist persons to exit homelessness as quickly as possible by placing them in permanent or transitional housing and linking them to needed services.  This approach assumes that the factors that have contributed to the homelessness can best be remedied once the individual/family is housed.  It also accepts that for some lifelong support may be required to prevent the reoccurrence of homelessness.  Hence it seeks to maximize utilization of mainstream resources.  But for most, the model seeks long-term self-sufficiency, promoted through a wraparound service philosophy.

This approach allows for an Interim Housing model (Transitional Housing) to be established in which short-term housing is provided for the minimum time needed to access permanent housing, with services focused on an immediate and comprehensive needs assessment, resource acquisition (i.e., public benefits and other forms of assistance), and housing placement.

Within this Consortium of Care model, the principle that will define our permanent housing is Choice regarding the location and type of housing.  Accordingly, the form of permanent housing will vary according to the needs and desires of each household.  For some, permanent housing will mean a Single-Room Occupancy (SRO) unit within a project-based development with on-site supportive services.  For others, permanent housing will be an individual apartment unit/house with a temporary rent subsidy, monthly case management, and facilitated access to community supportive services.  For still others, the type of permanent housing may change over time.

Ten-Year Consortium of Care Strategic Initiative
Over the next ten years, SWCOC must undertake three efforts simultaneously in order for its new Consortium of Care approach to be successful.  It must expand the availability of affordable permanent housing; increase its accessibility; and facilitate the Consortium of Care Strategy.

A.  To expand the availability of affordable permanent housing we will:

1.  Create new project-based permanent supportive housing units for persons with serious and persistent disabilities.
2.  Expand permanent supportive housing subsidies for persons with serious and persistent disabilities who can live independently in market rate housing with appropriate supportive services.
3.  Expand transitional rent subsidies for households who can be placed in community-based permanent housing with integrated services, in which the tenant holds the lease or assumes the lease over the period of the transitional subsidy.

B.  To increase the accessibility of affordable permanent housing, we will:

1.  Develop an affordable housing clearinghouse that will be used to link households in interim housing with appropriate market housing.
2.  Expand and increase coordination of street outreach for persons who are homeless and not requesting services to provide assessment and linkage to engagement housing and permanent supportive housing.

C.  To facilitate the Consortium of Care System, we will focus on three emphases:

1. Prevention.
It has long been argued that the most humane strategy for addressing homelessness for those at imminent risk is to prevent its occurrence in the first place.  Prevention efforts include strategies such as one-time or short-term rent or mortgage assistance, legal assistance programs, representative payee and direct payment programs, and housing placement services.  They also include more systemic strategies that seek to prevent homelessness by ensuring that people leaving institutions such as jails, prisons, or treatment facilities are not discharged to the streets or shelter system, as well as strategies that seek to forestall homelessness in cases of family crises such as domestic violence.  By far the most common prevention approach is the provision of one-time or short-term financial assistance.

Ten-Year Prevention Strategic Initiative
Over the next ten years, SWCOC will significantly increase resources directed to prevention efforts as the first line of defense in its strategy to combat homelessness.  Through this initiative, the Continuum will expand the breadth of current efforts, increase their immediate accessibility, and improve their long-term effectiveness.

a.  To expand the range and availability of prevention strategies, we will:
1.  Better coordinate and expand legal assistance and housing resources available for one-time, short-term and transitional financial assistance that can be used to avert eviction.
2.  Increase linkage to permanent housing and services for persons leaving institutions.

b.  To increase timely access to prevention resources, we will:  Establish a 24 hour prevention and referral Hotline, coordinated with 2-1-1.

c.  To improve the long-term effectiveness of prevention strategies, we will link households assisted by prevention programs to ongoing community resources to support their sustainability.

2.  Wraparound Services.
In many respects, housing stability is a function of a household’s ability to access fundamental resources and supports that assure that, when a crisis occurs, it does not threaten the security of that housing.  For all of us, these supports include affordable healthcare with mental health and substance abuse services; livable wage employment and/or other income supports; and for families, childcare.  These supports are all the more critical for poor households, for whom a crisis often means choosing between addressing essential needs for housing, food, or medical care.

The SWCOC is dedicated to ensuring that households have access to a full range of resources and services to protect the stability of their housing.  This will be accomplished through the implementation of a wraparound services approach.  Wraparound services refer to a comprehensive service provision model that guarantees that any and all services needed by an individual or family are integrated through a cohesive, individualized service plan that guides all service provision.  The SWCOC will infuse this service approach across all components of its homeless service delivery system – prevention, interim housing, and permanent housing.

Currently, service referral is a component of most homeless service provision, but in the absence of more active and integrated case management, referral-based case management often results in fragmented care.  The implementation of a wraparound services approach will mean that case managers across agencies must work together to develop one plan of action for each client, with each agency contributing, according to its strengths and resources, to support the individual or family in achieving housing stability and long-term self-sufficiency.  Because service intensity is determined based upon client need, this may also mean that initially an agency provides daily or weekly case management, which may shift to monthly or on-call assistance over an extended period of time.  For some, services will always remain an integral part of the residential environment.  For others, this support will be transitional, sufficient to ensure that employment and community-based resources, such as health care, schools, social services, civic organizations, and communities of faith, are secured.

a.  Ten-Year Wraparound Services Strategic Initiative.

Over the next ten years, this initiative will simultaneously strengthen community supports and safety net systems for persons at-risk of homelessness and for those who are being re-housed, and increase their accessibility.  This will be accomplished by providing transitional services that ensure linkage to these community resources, and increasing the availability and awareness of formal community supports.

b.  To ensure linkage to available community resources, we will:

1.  Expand the provision of community-based case management services that embody a wraparound services approach.
2.  Develop formal systems integration strategies between the Consortium of care system and mainstream service systems, such as public entitlements (TANF, Medicaid, Social Security, and Food Stamps), employment training and placement, public health, community mental health, and substance abuse, to ensure that formerly homeless households have streamlined access to the array of formal supports available in the community.

c.  To increase the availability and awareness of formal community supports, we will:

1.  Identify alternative resources to fund targeted supportive services for persons placed in permanent supportive housing.
2.  Implement follow-up strategies to work with households assisted with basic prevention strategies to increase their housing stability and reduce their future risk of homelessness.
3.  Develop a broadly disseminated community education program on various factors that contribute to homelessness and methods to mitigate their impact.  (For example a campaign on the cycle of violence could promote options for addressing spousal abuse, elder abuse and other forms of domestic violence so that they do not result in homelessness)

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3.  System Infrastructure.

The two initiatives described above will require an underlying system-level infrastructure in order to be effective and efficient.  To support the planned activities for each of the initiatives, we will:

a.  Implement a Homeless Management Information System (HMIS) with information and referral, case management, and benefits screening functionality to collect information about the people who become homeless, improve the effectiveness of service delivery, and understand the relationships between service utilization and client outcomes over time.  The affordable housing clearinghouse can also be seamlessly linked with the Homeless Management Information System (HMIS).

b.  Consolidate housing assistance resources into a Housing Assistance Fund that can be coordinated centrally, with minimal overhead, and serve prevention, housing placement, and long-term subsidy purposes.


III.  Plan Implementation.  The Ten-year plan presents a framework for implementation through the Prevention, Consortium of care, and Wraparound Services strategic initiatives.  Each of these elements must be developed in lockstep with one another.  Without implementing prevention strategies, there will continue to be an intense need for emergency shelter.  Without expanding the availability of affordable housing, it will be hard to assist people to leave the system quickly.  Without developing employment strategies, it will be difficult to keep people in permanent housing.  Equally as important, the transition process must be carefully managed to ensure that people who are homeless do not experience any interruption in services or additional hardship, as a result.  We envision three stages to the implementation process:

a.  Assessment & Preparation.  The SWCOC has begun the analysis that will be used to develop a “roadmap” for change.  Assessment activities will include a detailed examination of the current system, which will consider how programs are currently structured, how resources are now used, and the nature of existing resources and their regulatory constraints.  During this stage, the Continuum will also concretely define program standards, develop education materials on the new approach, identify ways to efficiently model the transition to maximize the impact and minimize the challenges of each change, and build public understanding and support for the new approach.
bTransition.  The Continuum will manage a well-organized transition process that supports a dual-operating system that will incrementally evolve from the current model to the new one over a period of several years.  This transition will be guided by the analysis and plans developed during the evaluation of plan models throughout the transition period.  Technical assistance resources will need to be an integral part of this process to ensure that the transition is effectively managed, and that people and agencies are not displaced in the process.  Initial steps in the transition phase will include creation of key infrastructure elements required to support the new system; commitment of additional resources for the development of permanent housing and expansion of mainstream services; and proactive outreach to other housing and human services to begin systems integration efforts.
c.  Full Implementation.  This final stage represents the complete implementation of the plan.  By this point, the Continuum should experience reductions in the numbers entering the interim housing system, and an increase in the number of households exiting the system to permanent self-sufficiency.  As a result, significant reductions in the homeless population will be observed.


IV.  Evaluation.  Evaluation will be an important part of plan implementation.