www.desc.org risk management in a housing first context greg jensen desc seattle, wa conference on...
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Risk Management In a Housing First Context
Greg JensenDESC Seattle, WA
Conference On Ending HomelessnessYakima, WA
May 21, 2014
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“The penalty for education is self-consciousness. But it is too late for ignorance.”
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What Housing First Programs Do Well In Managing Risk Housing people who would otherwise remain homeless
and at risk of dying or exhibiting out of control b/x in community.
Helping people living with major problems stay housed. Responding to client crises and restoring clinical stability
after a crisis. Keeping community safe. Reconnecting client to community through
work/volunteering.
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What Housing First Programs Do Less Well In Managing Risk
After a critical incident involving a HF participant, taking a step back and asking:
Why Didn't That Work?
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What Factors Increase Risk for DESC Housing First Programs?
Internal Factors That Increase Risk: Mission
Housing First Standards
Targeted to the most vulnerable. People are moved into housing directly from the street without
preconditions of treatment acceptance or compliance. Provider is obligated to bring robust services into the housing. Continued housing is not dependent on participation in services. Harm reduction approach rather than mandating abstinence. Residents have leases and tenant protection under the law. Can be implemented in either project-based or scattered site model.
Housing First Standards
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External Factors That Increase Risk Homelessness Leads to Contact With:
– Law Enforcement
– Criminal Justice System
– Hospitals
Difficulty Accessing Needed MH/CD treatment, due to disorganization, homelessness.
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Summary of Internal and External Factors
Can’t control all of the factors that increase risk
Have to accept risk as part of doing Housing First
Therefore, programs must
– Take responsibility and
– Prepare for risks
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Before Housing First...Who Accepted the Risk of Caring for Clients Living On Streets with Behavioral Health Disabilities?FamiliesStatesHospitalsJailsEmergency SheltersOther Congregate Care Settings (group homes, etc.)Cities/MunicipalitiesOrganizations serving homeless population
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What Are the Risks?• Injury to residents, community, and staff
• Public safety risk where programs are sited
• Financial liability for tragedies involving residents in our care
• Damage to agency reputation, loss of community support
• Loss of future housing opportunities for Housing First clients.
• Further stigmatization of homeless persons living with major behavioral health disabilities.
• Agency risk also puts others at risk: funders, City, County, State, etc.
• Others?
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How to Assess Risk:Managerial/Supervisory Oversight
– Pluses & MinsuesRisk Management Committee
– Structure & PurposeSafety CommitteeRisk AssessmentsCritical Incident DebriefingsRisk Champion
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Role of Risk Champion
Challenge Assumptions Through Inquiry
– Inquiring Minds Want To KnowBe A Limit Tester!
– Find Out What Is Possible/ImpossibleRaise Questions After Significant Crisis:
Why Didn't That Work?Be Prepared to Change Course When Conditions
Change or Risk Increases or Decreases
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Role of Risk Champion
Balance Risk Tolerance with Mission.When Facing Increased Risk, Seek Out
Innovation.
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A Housing First Risk Management ApproachEmbracing and preparing for risks clients present.
Can’t be true to Housing First Standards without taking risks.
No silver bullet.
There will always be situations you can’t predict.