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Support Requirements and Accommodation Options for People in the ACT with High and Complex Service Needs Final Report

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Support Requirements and Accommodation Options for People in the ACT with High and Complex Service Needs Final Report Support requirements and accommodation options for people in the ACT with high and complex service needs Final report PREPARED FOR THE AUSTRALIAN CAPITAL TERRITORY GOVERNMENT, COMMUNITY SERVICES DIRECTORATE Authors Cameron Parsell Andrew Clarke Margarita Vorsina Christopher Ambrey Acknowledgements We thank the ACT Government for the opportunity to carry out this important research, and Housing ACT for its guidance and support. We also wish to acknowledge the contribution of the stakeholders from the ACT public and community sectors, as well as the people with lived experiences of homelessness or the risk of homelessness, for contributing their time and insights to the study—their input was invaluable. Prepared for ACT Government, Community Services Directorate Prepared by Institute for Social Science Research The University of Queensland Long Pocket Precinct Level 2, Cycad Building (1018) 80 Meiers Rd Indooroopilly Queensland 4068 Australia Phone +61 7 3346 7471 Email [email protected] Date prepared August 2018 ISSR Project number ISSR121932 Institute for Social Science Research Final report: Cohort Study CONTENTS Abbreviations........................................................................................................................... 5 Executive summary ................................................................................................................. 1 1 Introduction ................................................................................................................... 3 1.1 Homelessness in the ACT ................................................................................... 4 1.2 Conceptualising high and complex service needs ............................................... 5 1.3 Methodology ........................................................................................................ 6 2 Describing the cohorts ............................................................................................... 11 2.1 How many people have high and complex service needs in the ACT? ............. 11 2.2 The composition of the four cohorts ................................................................... 12 2.3 What is unique about people with high and complex service needs? ................ 20 2.4 Conclusion ......................................................................................................... 23 3 Understanding demand and unmet demand for services and accommodation in the ACT ....................................................................................... 24 3.1 Total needs met and unmet ............................................................................... 24 3.2 Needs for accommodation and tenancy sustainment services .......................... 24 3.3 Needs for health services .................................................................................. 26 3.4 Needs for social services ................................................................................... 28 3.5 Conclusion ......................................................................................................... 31 4 Accommodation and support services in the ACT: What is available and what are the gaps? ..................................................................................................... 32 4.1 Accommodation and support services for people in the ACT who are homeless or at risk ............................................................................................. 32 4.2 Gaps in homelessness accommodation ............................................................ 36 4.3 Gaps in support service provision ...................................................................... 41 4.4 Conclusion ......................................................................................................... 43 5 Systemic challenges .................................................................................................. 45 5.1 Backlogs and bottlenecks .................................................................................. 45 5.2 Conditionality and the staircase model of support ............................................. 53 5.3 Conclusion ......................................................................................................... 57 6 Supportive housing models for people with high and complex service needs ........................................................................................................................... 59 6.1 What is permanent supportive housing? ............................................................ 59 6.2 A needs assessment tool for the 21st century ................................................... 75 7 Conclusions ................................................................................................................ 78 7.1 Cohort population ............................................................................................... 78 7.2 Demand, met need and unmet need for services and accommodation ............. 78 7.3 System and resource gaps ................................................................................ 79 7.4 Experiences, perspectives and aspirations of key ACT stakeholders ............... 80 Page iii Institute for Social Science Research Final report: Cohort Study 7.5 Innovative data-linking opportunities .................................................................. 80 Appendices ............................................................................................................................ 81 Appendix 1: Data audit ................................................................................................. 81 Appendix 2: Qualitative component—additional information ........................................ 84 Appendix 3: Participant information sheets and consent forms .................................... 85 Appendix 4: Demand and unmet demand for services and accommodation in the ACT .............................................................................................................. 91 Appendix 5: Understanding demand and unmet demand for services and accommodation in the act—regression analysis ................................................ 95 Appendix 6: Comorbidity—regression analysis .......................................................... 101 Appendix 7: Specialist homelessness services in the ACT, 2017–18 ........................ 102 Appendix 8: A needs assessment tool—data available for integration ....................... 107 References ........................................................................................................................... 109 Figures Figure 1: Cohort segmentation .................................................................................................. 7 Figure 2: Cohort characteristics, 2011–12 to 2016–17, annual average (%) .......................... 22 Figure 3: The staircase approach to homelessness services ................................................. 53 Figure 4: Needs assessment tool infrastructure ...................................................................... 76 Tables Table 1: Number of people in each cohort in the ACT over the study period, adjusted for non- response .................................................................................................................................. 12 Table 2: Profile of the characteristics of people in the homeless HCSN cohort ...................... 13 Table 3: Profile of the characteristics of people in the homeless non-HCSN cohort ............... 15 Table 4: Profile of the characteristics of people in the at-risk HCSN cohort ............................ 17 Table 5: Profile of the characteristics of people in the at-risk non-HCSN cohort..................... 19 Table 6: Profile of the characteristics of people in each cohort (annual averages) ................. 21 Table 7: ACT social housing waiting times, May 2018 ............................................................ 46 Table 8: Housing models—responding to homelessness and housing need .......................... 73 Table 9: Average numbers of needs and needs met, 2011–12 to 2016–17 ........................... 91 Table 10: Total numbers of needs for accommodation and housing assistance services and the percentages of those needs provided for, referred only and unmet .................................. 92 Table 11: Total numbers of needs for health services and the percentages of those needs provided for, referred only and unmet ..................................................................................... 93 Table 12: Total numbers of needs and the percentages of those needs provided for, referred only and unmet ........................................................................................................................ 94 Table 13: Variable definitions and descriptive statistics .......................................................... 95 Table 14: Probit regression: dependent variable—need identified .......................................... 98 Table 15: Probit regression: dependent variable—need provided .......................................... 99 Table 16: Probit regression: dependent variable—need referred only .................................. 100 Table 17: Probit regression: dependent variables—mental health services provided and drug/alcohol services provided .............................................................................................. 101 Page iv 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