Continuum of Care for the Homeless


Many people still think of rescue missions as places where homeless people find housing, food and spiritual instruction. Yet, those of us who are involved in this field know that unless their deeper spiritual, emotional, physical, and social needs are addressed, homeless people will never attain stability in their lives. Many suffer from mental illness, addiction to alcohol and/or drugs, and various medical problems. Some cannot read, lack high school diplomas, and do not possess basic skills needed to find and keep a job. These and other complex problems keep people on the streets.

In 1995, after years of attacking homelessness by focusing on more affordable housing, the Department of Housing and Urban Development promoted a new system and philosophy, called a “continuum of care.” It involves a comprehensive approach with three fundamental components: emergency shelter, transitional housing with social services, and permanent housing.

By the time HUD began talking about a continuum of care approach to helping the homeless, rescue missions affiliated with the  Association of Gospel Rescue Missions  had already been leading the way by offering a broad spectrum of innovative programs and services.

Outreach, Intake & Assessment

A continuum of care approach requires a case management strategy in which the needs of each homeless person seeking help at the mission are accurately identified. The intake and assessment process is essential in order to develop strategies to address these needs in a systematic and individualized fashion.

A written plan would involve creating a schedule of which mission services would be utilized at certain points during the individual’s stay. It would specify which staff members would work with the person and which outside agencies would be used. Specific outcomes that would signal the completion of each phase of the service delivery (i.e. the expectations that would need to be met before the client can move onto another program or set of activities).

Emergency Shelter & Transitional Housing

In a continuum of care approach, emergency shelter is only for a few weeks. It is most appropriate for those who have experienced a catastrophe, like losing a home to a fire, or are experiencing another sort of short-term difficulty. Transitional housing involves a longer stay at the mission. This component is intended to help individuals and families to address the life problems that led to their becoming and remaining homeless.

Supportive Housing

Any individual who applies for a longer term stay in the missions facilities should do so with the understanding that they must have a good reason for staying there. This is determined in the assessment and case management process. For some, the plan may be very simple, such as saving up enough money to get into their own housing. For others, it can be more complex, integrating addiction treatment, learning to read, completing a high school diploma, and working to enter into gainful employment.

If this process is adopted, the mission will move away from being a place that just provides a cheap place to stay. Instead, it is truly interventive; a place where homeless and troubled people can actually address some of the following issues during a longer-term stay in the mission’s facilities:

Mental health issues  — Some experts believe that up to one third of homeless persons suffer from some form of mental illness. Therefore a definite strategy must be in place to identify these individuals and develop plan to provide appropriate supervision and services in conjunction with community-based resources. In some cases, these individuals can attain a reasonable quality of living with minimal supervision which may involve a more permanent living arrangement. In some cases, missions have become agent payees for such individuals who are eligible for Social Security Disability Income, maintaining a more or less permanent arrangement to assist them.

Substance abuse  — Because addiction is a major cause of homelessness, identifying those with alcohol and drug problems is a vital component of the continuum of care strategy. To be truly interventive, drug testing should be mandatory for  all  who stay in the missions facilities on a long-term basis.

A test positive test would then be followed by an addiction screening. Then, if appropriate, they are then required to become involved in a program, either in-house or in the community, to address their addiction problems.

Two very good resources that can be utilized in this aspect of the mission’s programming are the Recovery Education Modules by Terrence Gorski (800-767-8181  ) and the ASAP computer-based addiction assessment and case management system (800-324-7966  ). The latter, based on the Addiction Severity Index is a very reasonably priced package with several different components for managing service delivery to addicted clients. Free demo disks are available.

Job training  – Formal employment programs, like WorkNet (818-855-5404  ), are being successfully used by rescue missions to assist homeless individuals to adopt healthy work attitudes, gain new job skills, and learn how to find a job that fits their unique skills and interests.

Family support  — Teaching of basic parenting and relationship skills, along with counseling for couples and family members, support and nurture the family unit. This might be an area where something could be developed that could be available to individuals in both the men’s and women’s in the latter stages of their stay at the mission.

Education  — I recommend that serious consideration be given to developing a Learning Center that provides basic literacy, English as a Second Language, and High School Completion (GED) instruction. The Nova Program, offered by Innovative Learning Systems (213-255-1883  ), is a computer-based approach that is being successfully utilized by almost fifty AGRM-affiliated missions. Some time needs to be spent in determining more definitely how these programs fit into the overall scheme of providing services to the mission’s clients.

Independent Living Skills  — Courses can be offered on such topics as money management, personal hygiene, and basic domestic proficiencies such as cooking, menu planning, shopping and sewing.

H.I.V/Medical Needs  — Many missions operate health clinics, often staffed by volunteer physicians and nurses. Be a basic health screening, followed by appropriate care, is an important starting point on the road to a stable life, it should be required for all who stay at the mission for a longer period of time.

Permanent housing

Mission programs are usually considered successful when formerly homeless residents return to society as productive citizens with their own homes. However, not everyone we work with can live independently. This is especially true of those who are mentally and physically handicapped and otherwise infirm. In response to this need, many missions now provide supportive housing on a longer term or permanent basis in what might be termed “adult foster care” programs.

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