Housing Pathways

Moving Individuals Experiencing

Homelessness from Shelter to Housing

Recommendations

Subgroups of the Homeless Population

A large group of individuals comprised of providers (shelter,

outreach, mental health, and physical healthcare), advocates

for persons experiencing homelessness, and CSB met with

the intended purpose of describing the individuals being

served by shelters and homeless outreach providers.

Each subgroup (initially called segment) was created to

represent a subset of the larger homeless population.

Each subgroup primarily describes the most frequently

occurring challenges and barriers individuals typically face in

getting and maintaining housing, taking into account the

shared histories and common strengths that subgroup

members also possess.

2

Housing Pathways for each Subgroup

A smaller group of individuals comprised of providers (shelter,

outreach, and mental health), advocates for persons

experiencing homelessness, and CSB met with the intended

purpose of identifying and recommending viable housing

options and associated resources and supports for each

subgroup with the primary focus on obtaining and maintaining

housing.

The Housing Pathways were vetted with the larger group that

worked on creating the Subgroups of the Homeless

Population.

3

Resource and Aftercare Needs for each Subgroup

The Navigator Workgroup worked to develop and finalize a

set of generalized recommendations around targeted

Resource and Aftercare Needs for each subgroup as the final

component of the work.

The finalized product was vetted and approved by the Core

Team in the Single Adult Crisis System Redesign.

The framework is being piloted with the Navigator Program. It

is intended to be used as a practical training tool and guide for

navigators in the development of individualized housing

stabilization plans.

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11 Subgroups of Individuals Experiencing Homelessness

Military Service - Eligible for VA Benefits

Military Service - Ineligible for VA Benefits

Physical & Behavioral Health Barriers – Eligible for Homeless Designated PSH in USHS

Physical & Behavioral Health Barriers – Not Eligible for Homeless Designated PSH in USHS

Criminal Justice - Has history of stable housing

Criminal Justice - Has no history of stable housing

Criminal Justice - Has disabilities; could be TAY

Criminal Justice - Sex Offenders

Real Options & Manageable Barriers - Adults

Real Options & Manageable Barriers - TAY

Situationally Homeless

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Subgroup: Situationally Homeless

Have historically sustained housing

Has some support system

May be any age (though likely to be working age)

No existing long term barriers; motivated to get out

of shelter

Can be quickly housed/stabilized

Traveling worker who has come to find housing

Interventions:

• quickly move toward

housing/stabilization

• support the identity as a

stable, housed person

Resources:

• temporary resources and

referrals

DESCRIPTORS

6

Subgroups: Real Options and

Manageable Barriers*

Marginally employed

Undereducated

No rental history

No disabilities that prevent housing

Capacities/strengths recognized

May have behavioral health, AoD,

or trauma issues but not needing

long-term rehab

DV survivors

Group A: Adults No verifiable disabilities;

employment-related homelessness

(recently or temporarily employed);

underemployed

Group B: Younger Folks TAY; aged out of foster care; under

the age of 25 and employment-

related homelessness (recently or

temporarily employed);

underemployed & no disability; on

the streets/in shelter with multi-

system connections; lethality

concerns may be present (especially

in LGBTQ youth); no employment *these folks are at high-risk for

becoming chronically

homeless

DESCRIPTORS

7

Subgroups: Criminal Justice*

Legal barriers impede

ability to be housed

Experience justice-related

issues: felons, re-entry,

long criminal history, all

tiers of sex offenders

Group A Has history of stable housing

Group B Has no history of stable housing

Group C Has disabilities; disability (MH, AoD,

physical) unlinked & untreated at

shelter entry; no income or benefits;

other than honorably discharged from

military; behavioral health issues;

could be TAY

*Interventions: primarily to

deal with legal barriers to

housing and employment

issues

Group D Sex Offenders – all tiers and all pre-

Adam Walsh status

DESCRIPTORS

8

Subgroups: Physical and Behavioral

Health Barriers

Physical or behavioral health disabilities

High users of physical and/or behavioral health services

Group A: Eligible for Homeless

Designated PSH in USHS SSI/SSDI application pending and no other

income; disability (MH, AoD, Physical)

unlinked & untreated at shelter entry; no

income, no benefits; severe mental health –

connected or disconnected from services;

severely mentally ill – on/off meds, non-

compliant; behavioral health concerns –

mental health disability with no treatment,

no insight, very hard to engage, could by

TAY

Group B : Not Eligible for

Homeless Designated PSH

in USHS High utilizers of health services; physically

disabled; mental health (axis II) multiple

crisis/multiple service providers &

interventions; youth adults with multiple

traumas; do not qualify for PSH/USHS

because their homeless history does not

meet criteria

DESCRIPTORS

9

Subgroups: Military Service

Military service with pre- and post-

service issues that impact their

homelessness, including possible

trauma and traumatic brain injury

Possible relationship disruption

Lethality concerns may be present

Re-entry and re-integration into a non-

military culture support needed

May have anger management issues

Gender considerations, mental health

concerns and AoD concerns may be

present

Legal issues may be present

Group A:

Eligible for VA

Benefits

Group B:

Ineligible for VA

Benefits

DESCRIPTORS

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11 Subgroups of Individuals Experiencing Homelessness

Military Service - Eligible for VA Benefits

Military Service - Ineligible for VA Benefits

Physical & Behavioral Health Barriers – Eligible for Homeless Designated PSH in USHS

Physical & Behavioral Health Barriers – Not Eligible for Homeless Designated PSH in USHS

Criminal Justice - Has history of stable housing

Criminal Justice - Has no history of stable housing

Criminal Justice - Has disabilities; could be TAY

Criminal Justice - Sex Offenders

Real Options & Manageable Barriers - Adults

Real Options & Manageable Barriers - TAY

Situationally Homeless

11

Housing Options

HOUSING OPTIONS

Private Landlord

Senior Housing

Family & Natural Support

PSH/USHS

Shelter Plus Care

Transitional Housing

HUD VASH

Returning Home Ohio

ADAMH Supportive Housing (upstream area)

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Housing Options by Subgroup HOUSING OPTIONS BY SUBGROUP

Situationally

Homeless

Real

Options,

Manageable

Barriers

Adults

(Group A)

Real

Options,

Manageable

Barriers

Youth

(Group B)

Criminal

Justice

History of

Stable

Housing

(Group A)

Criminal

Justice

No

History of

Stable

Housing

(Group B)

Criminal

Justice

Disabilities

(Group C)

Criminal

Justice Sex

Offenders

(Group D)

Physical &

Behavioral

Health

Barriers

Eligible for

Homeless

Designated

PSH in

USHS

(Group A)

Physical &

Behavioral

Health

Barriers

Not Eligible

for

Homeless

Designated

PSH in

USHS

(Group B)

Military

Service

Eligible for

VA

Benefits

(Group A)

Military

Service

Not

Eligible for

VA

Benefits

(Group B)

Private

Landlord X X X X X X X

X

(limited) X X

Senior

Housing X X X X X X X X X X

Family &

Natural

Support

X X X X X X X X X X X

PSH/USHS X X

(limited) X X X

Shelter Plus

Care X

X

(limited) X X X X

Transitional

Housing X X X X X

HUD VASH X X X X X

Returning

Home Ohio

X

(prison)

X

(prison)

X

(prison)

X

(prison)

ADAMH

Supportive

Housing

(upstream

area)

Upstream

Area

(contact

CHN for

current

options)

Upstream

Area

(contact CHN

for current

options)

Upstream

Area

(contact CHN

for current

options)

Upstream

Area

(contact CHN

for current

options)

Upstream

Area

(contact

CHN for

current

options)

Upstream

Area

(contact

CHN for

current

options)

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Resource Need by Subgroup General Services

Resources Situationally

Homeless

Real Options,

Manageable

Barriers

Adults

(Group A)

Real

Options,

Manageable

Barriers

Youth

(Group B)

Criminal

Justice

History of

Stable

Housing

(Group A)

Criminal

Justice

No History

of Stable

Housing

(Group B)

Criminal

Justice

Disabilities

(Group C)

Criminal

Justice

Sex

Offenders

(Group D)

Physical &

Behavioral

Health

Barriers

Eligible for

Homeless

Designated

PSH in

USHS

(Group A)

Physical &

Behavioral

Health

Barriers

Not Eligible

for

Homeless

Designated

PSH in

USHS

(Group B)

Military

Service

Eligible for

VA Benefits

(Group A)

Military

Service –

Not Eligible

for VA

Benefits

(Group B)

DCA X X X X X X X X X X

Furniture

Bank X X X X X X X X X X

Application

Fees X X X X X X X X X X

Housing

Specialist X X X X X X X X X X

Employment

Assistance X X X X X X X X X X

GED

Assistance X X X X X X X X X X

Replacement

Documents X X X X X X X X X X X

14

Resource Need by Subgroup Additional Supports

Resources Situationally

Homeless

Real

Options,

Manageable

Barriers

Adults

(Group A)

Real

Options,

Manageable

Barriers

Youth

(Group B)

Criminal

Justice

History of

Stable

Housing

(Group A)

Criminal

Justice

No History

of Stable

Housing

(Group B)

Criminal

Justice

Disabilities

(Group C)

Criminal

Justice –

Sex

Offenders

(Group D)

Physical &

Behavioral

Health

Barriers

Eligible for

Homeless

Designated

PSH in

USHS

(Group A)

Physical &

Behavioral

Health

Barriers

Not Eligible

for

Homeless

Designated

PSH in

USHS

(Group B)

Military

Service –

Eligible for

VA

Benefits

(Group A)

Military

Service

Not

Eligible

for VA

Benefits

(Group B)

Aftercare Services

Aftercare Services X X X X X X X X X

Case Management

(More Intensive) X

Justice and or Legal Services Probation Officer X

Re-Entry Services X X X X

Legal Overlay X X X

Special MH Docket

Court X X X X

Special Veterans

Docket Court X X

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Resource Need by Subgroup Connection to Other Systems and/or Services

Resources Situationally

Homeless

Real

Options,

Manageable

Barriers

Adults

(Group A)

Real

Options,

Manageable

Barriers

Youth

(Group B)

Criminal

Justice

History of

Stable

Housing

(Group A)

Criminal

Justice

No History of

Stable

Housing

(Group B)

Criminal

Justice

Disabilities

(Group C)

Criminal

Justice

Sex

Offenders

(Group D)

Physical &

Behavioral

Health

Barriers

Eligible for

Homeless

Designated

PSH in

USHS

(Group A)

Physical &

Behavioral

Health

Barriers

Not Eligible

for

Homeless

Designated

PSH in

USHS

(Group B)

Military

Service

Eligible

for VA

Benefits

(Group A)

Military

Service

Not

Eligible for

VA Benefit

(Group B)

Mediation X

Programming

Around Family

Mediation

X

Huck House X

Starr House X

Community

Mental Health X X X X X X

AoD Treatment X X X X X X

Medical

Treatment X X X X X X

Payeeship X X X X X X

Connection to

Benefits X X X X X X

Benefit Bank X X X X X X

Veterans

Administration X X

Veterans

Service

Commission

X X 16

Aftercare Needs by Subgroup Components

of Aftercare

Note: Case

Management (CM)

Situationally

Homeless

Real

Options,

Manageable

Barriers

Adults

(Group A)

Real

Options,

Manageable

Barriers

Youth

(Group B)

Criminal

Justice

History of

Stable

Housing

(Group A)

Criminal

Justice

No History of

Stable

Housing

(Group B)

Criminal

Justice

Disabilities

(Group C)

Criminal

Justice

Sex

Offenders

(Group D)

Physical &

Behavioral

Health

Barriers

Eligible for

Homeless

Designated

PSH in

USHS

(Group A)

Physical &

Behavioral

Health

Barriers

Not Eligible

for

Homeless

Designated

PSH in

USHS

(Group B)

Military

Service

Eligible

for VA

Benefits

(Group A)

Military

Service

Not

Eligible for

VA Benefit

(Group B)

Apartment

Checks

(safety &

maintenance)

X (combined with

client meeting

below)

X X X X X X

X (combined with

client meeting

below)

X (combined with

client meeting

below)

X (combined

with client

meeting

below)

X

Client Meeting X X X X X X X X X X X

Linkages X X X X X X X

(ensure firm

linkage with CM)

X (ensure firm

linkage with CM)

X (ensure firm

linkage with

VA CM)

X

Employment X X X X X X X

Benefits X X X X X X X

Community

Supports

(faith-based & self)

X (may get while in

shelter)

X X X X X X X

Life Skills

Training X X X X X X

Maintain Landlord

Relationships X X X X X X X

Timing/Duration

1 – 5 Ranking

(1 lowest Level to 5

highest level)

1 2 3 2 3 3 3 1 1 1 3

Length of

Aftercare

1 check

within 30

days

Up to 3

months

Up to 6

months

Up to 3

months

Up to 6

months

Up to 6

months

Up to 6

months

PSH = 1 check

within 30 days

Assumption in

PSH, if not

see Group B.

PSH = 1 check

within 30 days

Community

CM = 1 check

in 30 days

No CM = Up to

6 months

1 check

within 30

days

Up to 6

months

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