Housing and Health to End Homelessness
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Annual Report 2018 HOUSING AND HEALTH TO END HOMELESSNESS Mission Statement DESC works to end the homelessness of vulnerable people, particularly those living with serious mental illnesses or substance use disorders. Through partnerships and an integrated array of comprehensive services, treatment and housing, we give people the opportunity to reach their highest potential. At DESC, uncommon efforts produce uncommon results that eliminate homelessness one person at a time. Table of Contents Our Work. 4 Medication Assisted Treatment ......... 8 Meeting Medical Needs. 5 Peer Services ...................... 9 Partners in Health Care. 6 HOST and COAT. 10 Medication Monitoring . 6 SHARP .......................... 11 Substance Use Disorder Treatment ..... 7 PACT and SAGE . 12 2 HOUSING AND HEALTH TO END HOMELESSNESS TO AND HEALTH HOUSING Thank You Your support makes our work possible For every tenant safely housed in supportive housing, every guest accessing shelter and health care in an emergency program, everyone in crisis who needs immediate help, thank you for not looking away. All numbers cited in this report are annual totals from 2018 unless otherwise stated. All names of clients have been changed to protect their privacy. Crisis Solutions .................... 13 In-Kind Gifts. 16 Supportive Housing ................. 14 Volunteers ........................ 17 Survival Services. 15 Supporters. 18 Training and Consultation ............ 15 Financials ........................ 22 Awards. 16 Leadership and Program List . 23 3 HOUSING AND HEALTH TO END HOMELESSNESS TO AND HEALTH HOUSING 9,099 total clients Our Work served by DESC Thanks to decades of experience and research, we know what works for chronically homeless people: robust services that begin with a 3,345 “Housing First” approach: providing housing as new clients served a first step and then surrounding tenants with across DESC voluntary treatment and health services. Although participating in treatment programs 1,369 is not a requirement to stay in DESC housing, tenants in 75% of our tenants choose to enroll in additional supportive housing services with DESC once they’re housed. People want safe places 508 to live and they want to people connected improve their lives. to housing from homelessness The Next Frontier It’s hard to access preventative health care care much more easily, from people they services when you’re living without shelter know and trust. Routine treatments are given and with severe and persistent mental illness. before ailments become life-threatening. So, it’s not surprising that most people who Expensive emergency room visits and experience chronic homelessness get most of hospital stays are avoided. their medical care in emergency rooms, often after routine conditions have become matters We provide better care at a of life and death. lower cost, and emergency rooms can be used as There’s a better way. intended—for emergencies. Bringing health care services into our housing It’s a win-win-win for our clients and shelter programs allows people to access and our community. 4 HEALTH SERVICES HEALTH Meeting Medical Needs More than We’ve spent the last year heavily 200 people who investing in connecting housing and are receiving health care for our clients. nursing services from us would We created a new position to oversee nursing staff and be resistant to coordinate care. We’ve also added more nursing staff – receiving them more than doubling the number of Registered Nurses on staff over the last two years. We’ve added a pharmacy to elsewhere, which one of our clinics, and improved processes for tracking speaks to how clients’ medications to make sure clients are getting the important it is for medicine they need, including helping 140 people access service providers long-acting injections of psychiatric medications. to meet people where they are. 5 HEALTH SERVICES HEALTH DESC & Our Partners Harborview Partnering to provide DESC and our partners provide hundreds low-barrier health of medical services for our clients every day. care for 34 years and counting Harborview Medical Center We partner with Harborview to provide primary care in our main shelter, in our behavioral health clinic in Pioneer Square and at our 1811 Eastlake supportive 1985 Harborview begins housing program. They also provide health care for providing medical services residents at The Estelle, another supportive housing in DESC’s main shelter program where fifteen homes are set aside to be filled by Harborview. The partnership creates homes for people who are ready to leave the hospital but cannot be discharged because they don’t have a safe and 2005 healthy place to live. The partnership expands to our 1811 Eastlake Neighborcare Health supportive housing where Neighborcare health has primary care providers a nurse provides care for located at eight of our supportive housing buildings: DESC clients onsite Aurora House, Canaday House, Clement Place, Cottage Grove Commons, Interbay Place, Kerner Scott House and The Morrison. 2010 Department of Veterans Affairs Harborview starts to Medical staff from the VA provide onsite care at DESC. provide care at DESC’s downtown behavioral health clinic Medication Management 2018 The Estelle opens with If you’ve helped an aging relative 15 rooms set aside for to take their pills at the right times Harborview patients each day then you know how critical DESC staff medication management can be. help clients Sometimes, a bit of help in this take prescribed medication an area means that a person can live 2019 average of independently instead of moving into a Harborview begins care at nursing home or managed care setting. The Lyon and The Union, 55x two of DESC’s supportive each hour housing programs in every day Pioneer Square 6 Responding to a National Crisis SERVICES HEALTH A lack of affordable housing is the key driver of homelessness in our region and across the West Coast of the US. Every day more than 130 people across the US die from an opioid overdose. Washington state is not immune – our overdose death rate is 34th out of 50 states. Local media seeking simple answers to the complex issue of homelessness have suggested that opioid use is a primary driver of the increased number of people experiencing homelessness in Seattle. Their numbers don’t add up. West Virginia has an overdose rate five times higher than Washington, yet their rate of homelessness is one fourth of ours. Substance Use 57 Disorder Treatment overdoses reversed by DESC staff using naloxone This opioid crisis demands a compassionate and evidence-based response DESC will never turn people away or deny services 4,181 because of their substance use disorders. substance use disorder counseling sessions We have expanded access to the overdose-reversal for individuals drug naloxone across the agency, and trained staff from other agencies how to use the drug effectively. Our treatment programs are voluntary, not coercive, 930 and are offered to people seeking this type of help substance use disorder across agency programs and locations. group-counseling sessions 7 HEALTH SERVICES HEALTH MAT Medication Assisted Treatment Medication-assisted treatment (MAT) is a promising way to treat opioid use disorder. 27 MAT combines the use of medication with counseling and clients behavioral therapies to support people in their journeys of recovery. received MAT treatment In 2018 we launched a MAT treatment program with the lowest barriers in King County. Our program is designed for people who can’t travel to the same location each day or use traditional clinics. Treatment is available to people in our emergency shelters, those in outpatient programs, and people in supportive housing. The program expanded in early 2019 so that we can provide services for even more people moving forward. 8 Integrated SERVICES INTEGRATED Services Several programs at DESC are 47,161 comprised of interdisciplinary teams individual case management sessions of mental health, substance use disorder and medical professionals. Working together, they interrupt cycles of 71% homelessness and instability. This work of DESC clients are provides smooth transitions to services and enrolled in multiple DESC programs housing and gives people the tools they need to stay housed. Peer Services Peer Pathfinder Team The more trauma you’ve Through consistent outreach efforts—going experienced, the more directly to wherever clients are—they can reach “You important it is to hear people who are unlikely to visit traditional service these words on your path providers. Many people won’t engage right away, are not to recovery. That’s why so team members visit repeatedly and share their we’ve grown our Peer own stories to build rapport and trust. alone.” Pathfinder team to serve more people in need. The team connects people to substance use disorder treatment, including MAT, helps to The tight-knit team of Substance Use Disorder place people in housing and connects them to Peer Specialists, who have experienced income, health care and food benefits. substance use disorders and homelessness in their own lives, reaches out to people who have Peer Counselors on the Pathfinder team and on recently overdosed to provide harm reduction other teams across the agency are an integral strategies and resources and encourage people part of DESC’s work, and a big reason we to stay hopeful, motivated, and future oriented. succeed in meeting people where they are. 9 INTEGRATED SERVICES INTEGRATED COAT Community Outreach and Advocacy Team DESC’s COAT team provides services for Trueblood class members— people unjustly impacted by legal competency services and the criminal legal system. Our team is composed of mental health HOST 1.5 professionals, referrals to HOST Homeless Outreach outreach case per business Stabilization and Transition day from 40+ managers, RNs community and a prescriber Our HOST team takes to the partners including who provide wrap- streets to deliver critical survival the Seattle Police around services and support services and intensive Department and and care.