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Responding to Homelessness

Police-Mental Health Collaboration (PMHC) Toolkit

Responding to Homelessness: Strategies for Law Enforcement and Partners

Officials from Sarasota, Florida discuss how implementing a Homeless Outreach Team in their community has helped them keep people out of the justice system and instead connect them with vital housing and services.

People who experience homelessness tend to have frequent (and often repeat) interactions with law enforcement. A key driver of these interactions is the prevalence of unmet behavioral health needs. PMHCs are well situated to intervene in these situations and help provide connections to care. However, they can also connect people to safe and affordable housing options, providing a longer-term foundation for both reduced justice involvement and improved behavioral health outcomes.

This section provides key context on the connections between homelessness and justice involvement, key strategies for leaders looking to develop housing outreach initiatives, and practical advice for officers and community partners to make connections to housing and services. It also provides examples of successful outreach efforts in several communities.

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Background:

Homelessness, Justice Involvement, and the Critical Role of Housing in Breaking the Cycle of Incarceration

Key Facts

There is an alarming overlap between people experiencing homelessness and people who are incarcerated:

More than half of people experiencing homelessness in the U.S. have been previously incarcerated.

More than half of people experiencing homelessness in the U.S. have been previously incarcerated.  
Source: Martha R Burt, et al., Homelessness: Programs and the People They Serve | Findings of the National Survey of Homeless Assistance Providers and Clients (Washington, DC: Urban Institute, 1999)

Recent homelessness among jail inmates is 7.5 - 11.3 times more likely than the general population.

Recent homelessness among inmates is 7.5 to 11.3x more likely than the general population. 
Source: Greg A. Greenberg and Robert A. Rosenheck, “Jail Incarceration, Homelessness, and Mental Health: A National Study,” Psychiatric Services 59, no. 2 (2008): 170–177, https://ps.psychiatryonline.org/doi/full/10.1176/ps.2008.59.2.170

Many factors contribute to this significant overlap, including the following:

 

Unsheltered Homelessness

In 2019, more than 200,000 people experiencing homelessness nationwide were unsheltered.

In 2019, more than 200,000 people experiencing homelessness nationwide were unsheltered. 
Source: HUD Exchange, The 2020 Annual Homeless Assessment Report (AHAR) to Congress. Part 1: Point-In-Time Estimates of Homelessness (Washington, DC: US Department of Housing and Urban Development, 2021)

These individuals are likely to have regular contact with law enforcement because their activities of daily living (sleeping, going to the bathroom, etc.) are often criminalized by local laws and ordinances.

Unmet Behavioral Health Needs

One in five people experiencing homelessness has a serious mental illness.

One in five people experiencing homelessness has a serious mental illness, which can interrupt three key areas of life: relationships, self-care, and work.
Source: U.S. Department of Housing and Urban Development, HUD 2020 Continuum of Care Homeless Assistance Programs Homeless Populations and Subpopulations (Washington, DC: U.S. Department of Housing and Urban Development, 2020), https://files.hudexchange.info/reports/published/CoC_PopSub_NatlTerrDC_2020.pdf.

People experiencing homelessness are more likely than the general population to have unmet behavioral health needs, placing them at higher risk of homelessness and incarceration.1

Racial and Ethnic Disparities

The U.S. has a long history of policies and practices that have perpetuated economic inequality, segregation, and residential discrimination across the country. In part, because of this, Black, Latinx, and Indigenous Americans are more likely to experience homelessness than their white counterparts.2 

Black, non-Hispanic individuals represent 13% of the U.S. population, but 39% of people experiencing homelessness.

Black, non-Hispanic individuals represent 13% of the U.S. population, but 39% of people experiencing homelessness. 
Source: “Homelessness and Racial Disparities,” National Alliance to End Homelessness, accessed May 4, 2021, https://endhomelessness.org/homelessness-in-america/what-causes-homelessness/inequality 

The Cycle of Homelessness and Justice Involvement

In addition to the global factors above, a number of dynamics at the intersection of homelessness and the justice system can lead to a self-perpetuating cycle.

Criminal of Survival Behaviors

Difficult Exit from the Justice System

Barrier to Obtaining Housing

Risk of Supervision Failure

 


The Critical Role of Housing in Breaking the Cycle of Incarceration

Stephen Baker shares a powerful story of how housing has transformed his life and helped him break the cycle of homelessness and incarceration.

 

Access to permanent housing is central to breaking the cycle of incarceration and homelessness for many people. Therefore, it is important for law enforcement and community partners to understand the types of housing options available in their community, both to build working relationships and referral mechanisms with housing providers as well as to connect people experiencing homelessness to the most appropriate options during their interactions. Below are the main housing program models to help connect people to safe and affordable housing.

Housing Program Models

 

The Housing First Approach

Programs using a Housing First approach are particularly well suited to people experiencing homelessness who have behavioral health needs and previous involvement in the justice system, as they focus on quickly connecting people with permanent housing with as few barriers to entry as possible. The core philosophy is that housing is a basic need that, once met, provides a foundation for community stability and a platform for achieving other goals, including treatment engagement and recovery. Therefore, Housing First programs typically do not include mandated sobriety and treatment engagement as preconditions. They do, however, offer services assertively once people are housed.

Housing First: The Research Evidence

One study of people leaving prison in Ohio found that program participants were 40% less likely to be rearrested and 61% less likely to be reincarcerated than a peer comparison group.

One study of people leaving prison in Ohio found that program participants were 40% less likely to be rearrested and 61% less likely to be reincarcerated than a peer comparison group. 
Source: Jocelyn Fontaine et al., Supportive Housing for Returning Prisoners: Outcomes and Impacts of the Returning Home-Ohio Pilot Project, (Washington, DC: Urban Institute Justice Policy Center, 2012), https://www.urban.org/sites/default/files/publication/25716/412632-Supportive-Housing-for-Returning-Prisoners-Outcomes-and-Impacts-of-the-Returning-Home-Ohio-Pilot-Project.PDF

 

One evaluation found that, among people who were frequently cycling between the justice, health care, and emergency shelter systems, 91% were able to remain housed after 12 months, and 86% after 24 months.

One evaluation found that, among people who were frequently cycling between the justice, health care, and emergency shelter systems, 91% were able to remain housed after 12 months, and 86% after 24 months. 
Source: Angela Aidala et al., Frequent Users Service Enhancement ‘FUSE’ Initiative: New York City FUSE II Evaluation Report (New York: Columbia University Mailman School of Public Health, 2013),  
https://www.csh.org/wp-content/uploads/2014/01/FUSE-Eval-Report-Final_Linked.pdf

One NYC study found that the average costs averted in emergency systems of care per person was more than $25,000 per year.

One NYC study found that the average costs averted in emergency systems of care per person was more than $25,000 per year.
Sources:  Dennis Culhane, Stephen Metraux, and Trevor Hadley, “Public Service Reductions Associated with Placement of Homeless Persons with Severe Mental Illness in Supportive Housing,” Housing Policy Debate 13, no.1(2002),  
https://shnny.org/uploads/The_Culhane_Report.pdf; CSG Justice Cetner staff analysis using “CPI Inflation Calculator,” U.S. Bureau of Labor Statistics, https://www.bls.gov/data/inflation_calculator.htm


For Leaders:

Building Partnerships and Designing an Approach

Building Leadership-Level Partnerships

An effective response to unsheltered homelessness requires sustained cross-system collaboration, dedication of resources, and alignment from partners with sometimes competing priorities and a limited history of working together. Therefore, early and ongoing engagement of law enforcement, behavioral health, and homeless service system leaders is essential to this effort. The following strategies can help leaders achieve these goals.

Build a strong foundation

Justice and homelessness service system leaders can lay the groundwork for a successful cross-system partnership by establishing and formalizing its foundations, including through statute, Memoranda of Understanding (MOUs), or other written agreements.

These foundations include:

  • Setting shared goals. Unite cross-system partners around shared public health and safety goals, such as reducing unsheltered homelessness or connecting people to housing and services.
  • Facilitating data sharing. Understand relevant privacy laws and necessary data-sharing safeguards, and specify which data will be shared, with which people/agencies, and under what circumstances.
  • Establishing metrics. Assess progress toward shared goals by ensuring partners track key metrics, such as disposition of calls for service or connections to care, and by matching data as feasible across systems to identify and focus on people who most frequently use the systems.
  • Defining roles. Establish the most effective and appropriate roles for the partners involved (i.e., who lead outreach efforts), with decisions focused on what works best for facilitating access to permanent housing and supportive services.

Identify resources

Determine the resources each system can contribute to the collaborative effort, including:

  • Staffing for outreach efforts based on the needs of the community and capacity of each agency (including outside agencies)
  • Planning and data analysis staff support
  • IT infrastructure
  • Vehicles and equipment

Enlist champions to elevate the issue

Another hallmark of a successful collaboration is engagement of high-profile champions—such as elected officials or community leaders—to build public support for the partnership and its goals.13 Such a champion can help to:

  • Broker community connections to build new agency and community partnerships
  • Advocate for increased resources from partner agencies, or outside sources such as government or philanthropy
  • Ensure the collaboration continues in the face of external pressures such as changes in the political environment

Ensure cross-system representation

Housing/homelessness services and justice system leaders should actively participate in each system’s planning bodies, such as Criminal Justice Advisory Boards or Interagency Councils on Homelessness, enabling them to:

  • Understand the available resources and constraints of each system
  • Share information, such as data on frequent utilizers of these and other public systems to target outreach efforts – with appropriate privacy and legal safeguards
  • Leverage and connect with evidence-based outreach, housing, and other program models across sectors

Implement protocols to connect people to housing and services

These resources are vital to guide officer interactions with this population.14 As these interactions may include on-site assessments of behavioral health, housing, and other needs, law enforcement should develop protocols in partnership with leaders from the homelessness services and behavioral health systems to ensure they are evidence-based. Law enforcement leaders should also partner with leaders in these systems to provide training to staff to ensure these protocols are faithfully implemented in the field.

Change policies that criminalize behaviors associated with homelessness

Working with local policymakers, law enforcement and homelessness services system leaders can examine how local ordinances and laws may contribute to high rates of arrests among people experiencing homelessness without a clear public safety rationale. This is especially important given the 2019 decision of the Ninth Circuit Court of appeals that stated people experiencing homelessness cannot be penalized for sleeping outside if there are no adequate alternatives available.15

Continuums of Care: Vital Partners in Making Connections to Housing and Services

Continuum of Care (CoC) is a local, regional, or state-level planning body (depending on the jurisdiction in question), charged by HUD to allocate federal homeless assistance funding to local housing and supportive service programs. This funding often represents the majority of such resources available in many communities. Justice system leaders should look to build partnerships with their community’s CoC to help connect people in reentry or who may be at risk of involvement in the justice system with housing and services. One long term way of strengthening this partnership is by becoming members of the CoC Board.

HUD also requires CoCs to implement a community-wide system to prioritize people for the housing and services they fund. This prioritization takes place via a standardized intake and needs assessment process known as Coordinated Entry. Intake into the system can happen at different access points, which typically include agencies such as shelters or behavioral health providers, as well as community-wide hotlines. However, justice system leaders can deploy their homeless outreach staff to make these connections when they are needed most, either conducting this intake directly or making referrals for the people they encounter.

Implementing an Effective Homeless Outreach Approach in Your Community

Law enforcement and their community partners encounter people experiencing homelessness often, and in varying ways, including after someone has called 911 for help or during routine patrols. Because of this, they are uniquely positioned to connect people experiencing homelessness to the resources they need. One effective way of connecting people to needed resources is through regular, targeted outreach efforts. These efforts help officers and their community partners get to know people experiencing homelessness in their jurisdiction, understand their needs, and build the trust and relationships needed to establish connections to permanent housing and supportive services—all with the ultimate goal of diverting people from the justice system whenever feasible.

Officers Nate Schweithale and Matthew Lowe of the Wichita, Kansas Police Department Homeless Outreach Team prepare to conduct outreach at an encampment along the Arkansas River
Officers Nate Schweithale and Matthew Lowe of the Wichita, Kansas Police Department Homeless Outreach Team prepare to conduct outreach at an encampment along the Arkansas River.

A common approach to this targeted outreach is through law enforcement-led Homeless Outreach Teams (HOT), staffed by specialized and trained officers. These teams may also include key community partners such as case managers, clinicians, or health care workers. However, in some communities, outreach efforts may be led by community agencies themselves, with law enforcement playing key supporting roles.

These two approaches are not mutually exclusive; law enforcement, social service agency, and political/community leaders may choose to employ each in different geographic areas, with a variety of populations, or in varying circumstances. For instance, they may decide to conduct routine outreach and put processes in place to also respond to crisis situations that involve people experiencing homelessness or situations where a crime may have occurred.

Key considerations in choosing an approach include:

  • Available budgetary resources
  • Mechanisms and personnel to make connections to housing and supportive services
  • Level of trust and existing relationships between law enforcement, partners, and the community

The following sections discuss these two approaches in greater detail, outline the considerations for designing outreach efforts, and provide different community examples.

Approach: Law Enforcement-Led HOTs

Law Enforcement-led Hot Approaches

A law enforcement-led HOT can take many forms, but it is typically focused on using specialized officers to build relationships with people experiencing homelessness, check on their welfare, and provide connections to housing and supportive services as its primary responsibilities. While these teams are led by law enforcement, they still require cross-system partnership with community-based organizations such as behavioral health providers. Indeed, many of these teams utilize a co-responder model, so that they have dedicated case management and/or clinical staff to provide real-time screening and responses to behavioral health needs and they are able to enhance the team’s capacity to make service connections. For jurisdictions that choose to implement law enforcement-led HOTs, there are four core elements that should be included in their development and implementation (see below).
 

 

Aligning Outcomes of the HOT Approach with PMHC Outcomes

The HOT approach aligns with the four key outcomes of PMHCs, discussed further here. Grounded in key law enforcement and partner data, these outcomes are focused on facilitating connections to care for people with behavioral health needs, and when possible, diverting them from the justice system. Outreach and connections to housing and services for people experiencing homelessness help PMHCs achieve these outcomes in the following ways.

Icon of electric plug and house

1. Increased connections to resources:

The primary aim of any homeless outreach effort is connecting people to care and permanent housing and diverting them, when possible, from the justice system. By establishing lasting relationships with people experiencing homelessness, a HOT can go beyond isolated referrals and make stronger linkages through housing and behavioral health partnerships.

icons of repeat sign and pause sign

2. Reduced repeat encounters with law enforcement:

Ideally, as PMHCs connect more people to resources, HOT officers would likely also see a reduction in the number of repeat encounters because people experiencing homelessness are provided the care needed to reduce or prevent future crises. There may also be a reduction in minor offenses related to activities of daily living, such as sleeping or urinating in public.17 Trust built through the HOT approach can also help improve the disposition of encounters with law enforcement that do occur.

icon of handcuffs in a circle with line through it

3. Minimized arrests:

With an increase in the availability of community resources and services, officers have a greater set of options and primary interventions other than arrest when responding to calls involving people experiencing homelessness. Since one of the primary goals of a PMHC is to connect a person to mental health services, having more of these options should ideally result in a lower rate of arrest over time.

Icon of Lifesaver

4. Reduced use of force in encounters with people who have mental health needs:

With training and a comprehensive PMHC in place, law enforcement officers are better able to manage and de-escalate encounters with people experiencing a mental health crisis. In addition, HOT officers typically provide training and support for patrol officers and can promote further shifts in organizational culture away from an enforcement-first approach. 18

Addressing Encampments through a Focus on Housing

People experiencing homelessness form encampments for a variety of reasons, but the root cause is due to a shortage of affordable housing. Requirements or conditions in local shelter systems can also be a factor. For example, some communities may not have enough shelter beds, while others have beds that go unused because either their restrictions are incompatible with potential clients’ needs or clients do not feel safe staying in the shelter. Additionally, sometimes people prefer the autonomy, privacy, and sense of community encampments afford19  Regardless of the reasons they exist, however, addressing encampments is a case where law enforcement’s public safety and outreach roles can be in conflict and challenging to balance. Encampments can pose public health and safety risks, but if not handled carefully, efforts to mitigate these conditions can interrupt ongoing HOT engagement efforts, rupture trust, and disrupt the stability and “family” that encampments provide. These efforts can also run into significant legal obstacles, including those established by the 2019 Martin v. Boise decision.20

When developing a strategy to address encampments, communities should concentrate their efforts on connecting people with housing, using a Housing First approach to minimize barriers to access. Permanent housing options may not be immediately available; therefore, building local capacity for options such as low-barrier shelter and transitional housing are essential, with ongoing support to provide pathways to permanent housing. This work requires strong partnerships across the justice, housing, and behavioral health systems, particularly when facilitating access to housing/homeless assistance resources, such as the local Continuum of Care Coordinated Entry system. It also requires ongoing intensive outreach, a valuable role for HOT teams and/or community outreach staff who can build trust and relationships over time. Therefore, communities must ensure they set aside ample time to plan and execute this process, as well as to engage with other stakeholders with key concerns such as property owners, local business, and government.21 When, health, safety, or other concerns render the ultimate closure of an encampment necessary, communities that have done so successfully take this time to ensure that every resident has somewhere to go at the time of closing. When a closure is not immediately planned, HOT teams and partners can work with residents to conduct regular cleanings to mitigate environmental hazards.22 Regardless of the approach, when dealing with encampments, HOTs can play a critical role at the front end to reduce disruption to the lives of residents and advance connections to services and permanent housing.
 

For more information on effective strategies to address encampments, please see: United States Interagency Council on Homelessness, Ending Homelessness for People Living in Encampments.

Additional Resource: Santa Clara, California policies and procedures for addressing homeless encampments and related issues

Approach: Community-Led Outreach

Community-led Approaches

Community-led homeless outreach often involves clinicians, case workers, or other health and behavioral health professionals routinely engaging people in the community who are experiencing homelessness via street outreach and connecting them to needed services. Recognizing the absence of comprehensive crisis systems and an overreliance on law enforcement, some communities have also created community responder teams in which instead of law enforcement, “credible messengers”—including social workers, emergency medical personnel, and peer support specialists—are dispatched to nonemergency calls involving people experiencing mental health conditions, homelessness, and substance use disorders. As with law enforcement-led efforts, collaboration across multiple systems (health, behavioral health, housing, etc.) and agencies is still essential to maximize resources and meet housing and service needs as effectively as possible. People with lived experience with homelessness (employed directly or compensated appropriately for their time) are also highly valuable in these efforts as strategic partners and to build trust and engagement. 23

This use of community-led models in both outreach and response frees up law enforcement resources to focus on public safety concerns. Law enforcement partnerships with these providers can be particularly useful when engaging with populations where there is mistrust in law enforcement, including people who are chronically homeless and people identifying as Black, Indigenous, and/or people of color (BIPOC). Depending on community needs and dynamics, law enforcement may be part of the crisis and homeless response team, or responses may be fully community-led. In the case of fully community-led efforts, law enforcement can still play valuable supporting roles, such as providing information on where hard-to-reach people may be located, or support in times of emergency such as when people need to be moved due to public safety concerns like inclement weather or encampment clearing.

Resources: Core Elements of Effective Street Outreach to People Experiencing Homelessness 

Key Considerations for Designing Outreach Efforts

Regardless of who leads homeless outreach efforts, each member of the partnership brings important strengths, and leaders from law enforcement and their partner agencies have several factors to consider when deciding who should lead outreach efforts, what agencies should be involved, and the scope and scale of activities these teams should undertake. Below are key questions for these leaders to consider when developing such partnerships and outreach models:

 

For Practitioners:

Outreach Best Practices and Community Examples

Best Practices for Effective Outreach and Care Connections

Law enforcement and community-based responders will encounter people experiencing homelessness in both emergency and non-emergency situations. The goals of and best practices for navigating these encounters and making housing and service connections vary based on the situation, frequency of encounters, and the needs of the person.

Sources: Jay S. Levy, “Homelessness outreach: A pre-treatment guide” (webinar, National Healthcare for the Homeless Council, Nashville, September 26, 2019), https://nhchc.org/clinical-practice/homeless-services/outreach/ ; National Health Care for the Homeless Council, “Outreach & Enrollment Quick Guide,” (Nashville: National Healthcare for the Homeless Council, 2014), https://nhchc.org/wp-content/uploads/2019/08/outreach-enrollment-quick-guide.pdf ; USICH, Core Elements of Effective Street Outreach to People Experiencing HomelessnessPERF, The Police Response to Homelessness.

Making Effective Housing and Service Connections

Building connections to care and stable housing is the ultimate goal of any homeless outreach effort. Though successful outreach hinges on the slow work of client engagement and relationship building, outreach teams must have the capacity to make those critical connections once trust is established. The trust and engagement built over sustained outreach efforts places law enforcement and community outreach team members in a unique position to assess and respond to immediate care needs and make key connections to services, including permanent housing. This approach is particularly valuable in working with people who may at first be reluctant to engage in services. The list below provides an overview of approaches that outreach team members can take to make these connections in coordination with larger community planning efforts and resources.

 

Key Care Connection Approaches in a Cross-Systems Homeless Outreach Initiative

 

 

Resources:

Research & Results: Nine U.S. Localities Offer Human-Centered Approaches to Unsheltered Homelessness. These briefs provide further examples of comprehensive, collaborative community solutions to addressing unsheltered homelessness and connecting people with permanent housing and support services.

Examples of Outreach in Action

The following examples show the approaches four different communities have taken to implement successful homeless outreach initiatives, based on their local needs and partner agency capacity and strengths. Some of these programs are led by law enforcement, and in others, law enforcement serves as a key partner in efforts led by the community. All the programs highlighted below have a strong focus on data, problem solving, and/or interagency collaboration.

Sarasota, FL 25

Sarasota, FL
Shutterstock / Sean Pavone

Sarasota was once known as the “Meanest City in America” for people experiencing homelessness due to its enforcement-centered approach. But outreach efforts that leveraged strong relationships between law enforcement and community agency partners have now become a national model. Police leaders began this work by obtaining the support of the city manager, who now funds two part-time HOTs composed of an officer and a civilian case manager. HOT staff also spent significant time working with the CoC and other housing providers to develop mutual buy-in to set aside resources for people diverted from the justice system, as well as to prioritize those resources for people most in need. For example, the HOT has an ongoing partnership with the Salvation Army that guarantees up to seven nights of shelter and food for individuals that their personnel encounter. Case managers also provide connections to other housing resources, including referrals to CoC programming and vouchers provided by the Sarasota Housing Authority. These efforts played a central role in reducing Sarasota’s homeless population by over 50 percent in only 3 years (2016–2019).

 

Wichita, KS 26

Wichita Skyline
Shutterstock / Gary L. Brewer

The Wichita Police Department (WPD) has operated a HOT since 2013. The HOT, which consists of four full-time officers and a supervisor, is responsible for responding to all 911 calls regarding people experiencing homelessness. The HOT works to keep people experiencing homelessness out of jail, when possible, favoring diversion to services or shelters. In one-on-one settings, officers use an established set of questions that help guide them in connecting the individual to the proper resources. Because of this practice, officers are able to conduct proactive outreach, provide basic need items, educate people about available services and long-term housing, and connect them to resources when they are ready to engage. These resources can include food, shelter, clothing, employment, housing, connections to mental health services, and more. Since each program to which officers provide referrals operates differently, HOT officers are versed in most of the provider referral processes. They will often take people directly to the providers, share information via email or a phone call, or hand deliver referral documents to the individual. In addition, HOT officers assist with everything from resume writing and job referrals, to helping people move into housing, and they have flexible hours so that they can be responsive to the needs of the people they are supporting. As a further resource, WPD utilizes monetary donations from the community to support its Finding a Way Home program, which provides travel support to reunite people experiencing homelessness with their families in stable housing. Through these various strategies, the HOT helps connect more than 100 people annually to housing and helped decrease the number of people experiencing chronic homelessness in Wichita by 77 percent between 2013 and 2018.

Key Program Documents:

HOT Team Community Resource Brochure

HOT Team Standard Operating Procedures

HOT Team Encampment Policy

 

Cambridge, MA 27

Cambridge Skyline
Shutterstock / Sean Pavone

The Cambridge Police Department (CPD) invests significant resources into community outreach efforts to best serve its neighborhoods and most vulnerable populations. Through its Family and Social Justice Section, officers are given specialty assignments working with youth, people with behavioral health needs, residents experiencing homelessness, or other populations with complex needs. CPD’s Homeless Outreach Unit is comprised of two officers whose work has expanded beyond the initial scope of transporting people to hospitals or shelters to a comprehensive problem-solving and case management approach. CPD also provides in-service and roll-call training on services and resources available to the vulnerable populations they encounter. These trainings help to give beat officers the tools needed to support the Homeless Outreach officers’ work and to build an agency-wide culture that centers around connections with these services and resources. In 2016, a group of Homeless Outreach officers founded the Multi-Disciplinary Outreach Team, which is a collaboration between CPD, Department of Human Service Programs, local service providers, and shelters. This group of public health and safety stakeholders meets on a weekly basis to review individual cases of people who repeatedly cycle between the behavioral health and justice systems and coordinates plans for outreach and service engagement.

The Central Square Business Improvement District also leads significant outreach efforts in an area of the city where many people experiencing homelessness are concentrated. This video provides a firsthand perspective of the successes and ongoing challenges faced by both law enforcement and community-led initiatives in Cambridge, during a time when leaders and the community are grappling with how to appropriately define their roles.

 

Philadelphia, PA 28

Philadelphia Skyline
Shutterstock / photo.ua

Nearly two decades ago, the city of Philadelphia adopted the intervention- and treatment-focused Sidewalk Behavior Ordinance, which formalized a partnership between the Office of Homeless Services (OHS) and the Philadelphia Police Department (PPD). This ordinance mandated that a person on the street in need of services be connected to housing and services, even if law enforcement is the first responder. The statute clearly defines each partners’ roles and responsibilities, including transportation protocols and training requirements.

Over the years, the partnership expanded to include behavioral health providers, including the city’s Department of Behavioral Health and Intellectual Disability Services and housing and service agency partners such as Project HOME. In 2018, the Center City District (CCD), which is the Business Improvement District for the Center City area, launched the Ambassadors of Hope initiative in which multidisciplinary teams consisting of officers with Crisis Intervention Team training, outreach workers, and a CCD community service representative partner to conduct homeless outreach in the central city district in the summer months. The inspiration for launching this program was the realization that the city’s resources did not allow for consistent and sustained relationship building between outreach workers and unsheltered individuals, which is a critical component in ultimately making connections with needed housing and services. The CCD provides vital resources by funding both the dedicated Project HOME and crisis intervention-trained police teams, and staff from all participating agencies engage in joint training together to ensure familiarity with all protocols.

All outreach is initiated by community responders, but law enforcement plays an essential role in de-escalation when needed. As evidence of the success of this approach, teams have issued no citations or code violations to date. Since its inception, more than 300 clients have accepted services, about 30 percent of whom had resisted services in the past. And in 2020, the partnership began deploying winter outreach teams without police officers, with the caveat that PPD officers are readily available to support as needed. 

The partnership has also taken innovative steps to address encampments, prioritize service provision, and provide direct connections to housing through dedicated beds. In 2018, the partners launched the Encampment Resolution Pilot to humanely respond to a concentration of encampments in the Kensington neighborhood. Outreach teams assessed the needs of people living in the encampments and found that 93 percent had substance use disorders and 65 percent had co-occurring mental illnesses. The partners recognized low-barrier emergency housing was essential to addressing these issues and would be critical to the pilot’s success. Therefore, they dedicated 90 low-barrier shelter beds to the Encampment Resolution Pilot, prioritizing the people residing in encampments for available housing. They ultimately connected 126 people to housing and/or treatment. The pilot could not have succeeded without intensive outreach, ongoing case management, and streamlined access to substance use treatment resources. Finally, in addition to these emergency housing-focused efforts, OHS has also committed to creating 100 units of permanent supportive housing focused on people with opioid use disorders, as well as increasing the supply of recovery housing.


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