Report on the Model of the Inner City Youth at Risk Project Social Policy Research Centre Report Series
Never Stand Still Arts Social Sciences Social Policy Research Centre
Jane Bullen kylie valentine
Prepared for: South Eastern Sydney Local Health District March 2015 Research Team – Social Policy Research Centre, UNSW Australia Jane Bullen kylie valentine For further information Jane Bullen, Social Policy Research Centre, UNSW, Sydney NSW 2052 T: (02) 9385 7800, E: [email protected] © UNSW Australia 2015 ISSN: 1446-4179 ISBN: 978-1-925218-30-5 SPRC Report 2/2015 Suggested Citation Bullen, J. and valentine, k. (2015). Report on the Model of the Inner City Youth at Risk Project for South Eastern Sydney Local Health District. Sydney: Social Policy Research Centre, UNSW Australia. Contents
Executive Summary...... 1 1. Introduction...... 3 1.1 Method...... 3 2. How it works...... 4 2.1 Structure...... 5 2.2 Strategies and activities...... 7 2.2.1 Joint outreach sweeps and data collection...... 7 2.2.2 Brokerage funding...... 8 2.2.3 Coordinated case management...... 10 2.2.4 Long term supported housing...... 11 2.2.5 Sector development initiatives...... 11 3. Replicating the Inner City Youth at Risk model...... 13 3.1 Essential elements...... 13 3.2 Key principles...... 13 3.3 The service environment...... 14 3.4 The coordinator position...... 14 3.5 Establishing committees and partnerships...... 14 3.6 Operational, financial and sustainability issues of the service model...... 15 4. Client journeys and outcomes...... 16 4.1.1 Case Studies...... 16 5. Appendix A: ICYAR Partnership Agencies and Terms of Reference...... 19 6. Appendix B: Project documentation...... 22 6.1 Project Coordinator position description...... 22 6.2 Sweeps data collection form...... 23 6.3 Brokerage protocols...... 24 6.4 Entry assessment for Supported Housing Packages...... 29 7. Appendix C: History and features of the project...... 31 7.1 Experiences of participating agencies...... 32 7.2 Financial implications of participation for partners...... 32 7.3 Strengths of the model and opportunities for improvement...... 33 8. Appendix D: Findings from the literature review...... 34 8.1 Young people at risk in the Kings Cross and inner city area...... 34 8.2 Needs of youth at risk...... 34 8.3 Service responses...... 35 8.4 Service fragmentation: a barrier to service utilisation...... 36 8.5 The potential of multi-agency working to address fragmentation...... 36 8.6 Models of integrated services for young people at risk of homelessness...... 37 8.7 Barriers and facilitators to effective integrated service delivery...... 38 8.8 Key findings and implications of the literature review...... 39 9. References...... 40
Social Policy Research Centre Report i Report on the Model of the Inner City Youth at Risk Project Executive Summary
The Inner City Youth at Risk (ICYAR) project Findings from the literature was a partnership project which was managed The literature indicates that young people by South Eastern Sydney Local Health District who become homeless often have high (SESLHD) Child, Youth, Women and Families support needs, with coexisting emotional and Health portfolio. This portfolio provides strategic behavioural issues, substance abuse and leadership for local services in children’s health, physical health problems. The review also found early parenting, youth health, women’s health, several characteristics of effective models of homelessness health, domestic violence, and integrated service delivery for young people with the health needs of families. The project drew very high support needs. together 21 government and non-government organisations to target and respond to During interviews conducted for this project, young people (12-25 years) experiencing stakeholders indicated that the ICYAR model homelessness and/or risk of homelessness in has these characteristics, including strong leadership, clear lines of responsibility, effective the inner city. communication, strong planning and monitoring This is the third report on the ICYAR project mechanisms, and good working relationships. written by researchers from the Social Policy Research Centre, UNSW. Previous research Key elements of the ICYAR service on the project outcomes found that the project was reaching its target group of highly model The key elements to the ICYAR structure are: disadvantaged young people. In the two year period from July 2010, 487 clients were provided • Steering Committee, which is responsible for with 1,145 instances of brokerage funding, and the overall project governance and providing during this time a high proportion of ICYAR high level strategic support to the project; clients experienced unstable accommodation • Outreach Coordination Committee, which and multiple presenting issues. While the project considers applications for brokerage funding is no longer funded, this report outlines the and enables an informal assessment and development and implementation of the ICYAR case coordination function; and service delivery model for replication in other • Project Coordinator position responsible for areas. maintaining and managing the partnership, This report draws on a review of the literature administering brokerage, supporting effective and interviews with ICYAR stakeholders. collaborations between diverse stakeholders, data collection and management To duplicate the successes of ICYAR, it is essential to ensure that the committees have effective membership and the coordinator has specific skills and expertise. The key ICYAR activities are outreach sweeps, brokerage funding, coordinated case management, long-term housing, and sector development activities.
Social Policy Research Centre Report 1 Report on the Model of the Inner City Youth at Risk Project Outreach sweeps are conducted on a quarterly (HPV) vaccine; the development of a responsive basis to gather standardised data on the website with maps, phone numbers and other demographic characteristics and service use of information to assist young people to find young people in the areas. accommodation, health and other services; and Brokerage funding provides goods and services facilities tours that offer orientation training for to clients that would otherwise be unavailable. new staff in all the agencies. Brokerage is managed in four tiers: • Up to $500 can be provided to a partner Replicating the service model agency to meet a young person’s crisis/ The views of ICYAR stakeholders provide an emergency costs overview of key principles and steps to take in • Up to $5,000 can be used to support a case replicating the model elsewhere. plan for a young person receiving case management Key principles • Up to $35,000 is available to provide wrap • Utilise the existing service network around services to clients in high need supported housing tenancies case managed • The lead agency should not deliver services by ICYAR services or receive brokerage • Up to $20,000 can be provided to initiate a • Brokerage funds should purchase services, project if two or more organisations in the area not fund positions identify a gap in service delivery and develop • Decision making needs to be joint with all a targeted response to address that gap. partner agencies involved For the ICYAR project, the sweeps, outreach and brokerage program data were recorded in a Key steps and processes central data base, which enabled the project to • Ensure sufficient time for planning: up to 6 monitor outcomes. months before commencing Coordinated case management: ICYAR • Conduct service mapping strengthens the quality of case management provided by partner organisations. It does • Establish a Steering Committee with key not provide case management directly. This decision makers is regarded as key to its success: rather than • Employ a skilled, experienced coordinator duplicating the services provided by partner agencies, ICYAR provides a coordinating role • Establish an Outreach Coordination across service provision agencies. Committee consisting of key decision makers from organisations that work with the target For the ICYAR project, long-term housing was group provided through supported housing packages for high needs young people. These packages • Ensure representation from agencies with were provided in partnership with St George strengths in case management Community Housing and Metro Community • Develop service memorandum of Housing and tenanted by the most vulnerable understanding and joint case management young people in the area. protocols Sector development activities: partner agencies • Include adequate brokerage funds as part of developed a number of new projects including clinics for young people outside the school the service model system to receive the Human Papillomavirus • Maintain data on brokerage expenditure
Social Policy Research Centre Report 2 Report on the Model of the Inner City Youth at Risk Project 1. Introduction
The Inner City Youth at Risk (ICYAR) project was • an overview of how to establish a project such a partnership project which was led by South as this in any other geographical location. East Sydney Local Health District (SESLHD). In addition, we conducted a review of relevant It drew together 21 government and non- evidence-based and current literature relating to government organisations to target and respond young people with complex needs. The literature to young people (12-25 years) experiencing review covers youth homelessness issues, youth homelessness and/or risk of homelessness health issues (including primary health, mental in the inner city. While the project is no longer health, drug and alcohol) and any context funded, this report outlines the development and issues for young people in the areas specific to implementation of the ICYAR service delivery the inner city of Sydney. It also covers barriers model for replication in other areas1. to service utilisation by young people that are This is the third report on the ICYAR project caused by service fragmentation and evidence written by researchers from the Social Policy on the potential of multi-agency working to Research Centre, UNSW (SPRC). Previous address fragmentation. research on the project outcomes found that The report draws on qualitative and quantitative the project was reaching its target group of data from previous research on ICYAR (Eastman highly disadvantaged young people. In fact, et al., 2013; Eastman and valentine, 2012; analysis of the ICYAR database for the period Petersen and Janssen, 2007). 1st July 2010-30th June 2012 found that during that time: 1145 instances of brokerage For this report, we also conducted interviews were provided to 487 clients, including 190 with nine ICYAR partner agency representatives, food vouchers, 157 housing set-up costs, the Project Coordinator, the SESLHD Youth 142 instances of emergency accommodation Health Coordinator and another stakeholder and 116 contributions towards education and closely involved in establishing the project. Six of vocation (Eastman and valentine, 2012). A these interviews were arranged and conducted high proportion of ICYAR clients experienced through ICYAR and interviewees consented to unstable accommodation and multiple their use for this report. The remaining three presenting issues. interviews were conducted by the SPRC. Interviews with partner agencies included both agencies participating in the Steering Committee 1.1 Method and agencies participating in the Outreach This report is designed to provide: Coordination Committee. • qualitative data on project partners’ Ethics approval to undertake the project was experience of working within the ICYAR obtained from the UNSW Human Research Ethics model; Advisory Panel on 9 October 2013 and from the • perceptions of the critical success factors SESLHD Northern Network Human Research and limitations of the ICYAR model; and Ethics Committee on 12 November 2013.
1 For this reason, references to the ICYAR project in inner Sydney are in the past tense as that project is finished; however references to the service model are in the present tense
Social Policy Research Centre Report 3 Report on the Model of the Inner City Youth at Risk Project 2. How It Works
The history of the inner Sydney ICYAR project Benefits for clients: is important to the development of the service • Client choice: because ICYAR provides case model. The project was initially set up as the management through partner agencies, Kings Cross Youth at Risk Project, following a clients can continue to work with their case review of youth services in the inner city, which manager if they have one, or can be provided identified that services were erratic and poorly a choice of agency. coordinated, and risked young people becoming • Tailored support: clients can receive support long-term homeless. from multiple agencies who together can Work to establish what is now ICYAR started work outside their usual parameters of in 2001 when four organisations working with individual service delivery to address the young people in Kings Cross were asked individual needs of the young person. by the NSW government to work together to • Coordinated services: ICYAR’s core strength develop a joint project. A Steering Committee is multi-agency service delivery in which was established to oversee the project and agencies work together in a coordinated way review youth services in the Kings Cross area. creating a streamlined process for clients. It commissioned an independent consultant, Edwina Deakin, to map and review services for Benefits for agencies: young people at risk (12–25 years) operating • Peer support/review and shared expertise in the broader Kings Cross area. The resulting • Opportunities for joint training and skills report, completed in 2004, found that service development provision was erratic and coordination between agencies in the area was poor. • Multi-agency service delivery and case coordination, which improves the quality of The review proposed a number of joint support they provide and maximises the measures between existing providers including impact of existing resources the establishment of a coordination committee, • Access to brokerage funds to enhance and the introduction of outreach sweeps and the extend existing services establishment of a brokerage fund. Appendix C details the history of the project. • For social housing providers: streamlined application and assessment process with one The project grew over time, and eventually 21 point of referral instead of multiple agencies; organisations were involved (see Appendix A). provision of flexible, ongoing support to This growth was driven by the benefits a large clients placed by the project. and diverse partnership offers clients and partner organisations.
Social Policy Research Centre Report 4 Report on the Model of the Inner City Youth at Risk Project overall project governance and providing high 2.1 Structure level strategic support to the project. Decisions The key elements to the ICYAR structure are made by this committee include those regarding the Steering Committee, Outreach Coordination ICYAR membership, policies and finances. (OC) Committee, and Project Coordinator The Steering Committee also considers issues position. To duplicate the successes of ICYAR, impacting on young people at risk and the it is essential to ensure that the committees homelessness sector more broadly. have effective membership and the coordinator In addition, the Steering Committee is specific skills and expertise. responsible for final decisions about brokerage A key element of the structure is that the lead applications that involve high expenditure agency is based outside the direct service outside the general costs and for decisions system. This means that the roles of the about brokerage that involve providing additional coordinating and service delivery organisations staffing hours to support clients (Figure 1). This are always clear and distinct. function recognises a potential for conflict at the OC Committee level in deciding which agencies The Steering Committee provides strategic can increase their staffing hours or receive planning, governance, and oversight of the larger amounts of funds. partnership; and identifies systemic problems and opportunities in service delivery. It is The Steering Committee also works to maintain therefore critical that members have sufficient joint decision-making and ensure one agency seniority and expertise to inform the strategic cannot dominate or lead the project in a direction and review of the partnership, and to direction that was not agreed. If day to day make decisions. matters that would normally be dealt with by the OC Committee (see below) need to be elevated, The OC Committee has operational responsibilities for the partnership, including the Steering Committee deals with these. Early assessing and approving brokerage applications in the project, the Steering Committee was also (and recommending decisions for larger assessing referrals through ICYAR for long term applications, Figure 1). It is therefore critical housing with St George Community Housing. that members work closely with clients and Later, this was done by the OC Committee. know the services that are available in the area. Appendix A lists the terms of reference of both Project Coordinator committees. The Project Coordinator was based in the inner city to work across the 21 partner agencies The Project Coordinator works with both to implement the provision of brokerage, committees and must have expertise in youth supported community housing, coordinated services, health, homelessness policy and case management, joint service planning, data planning as well as service coordination. collection, and administration of the project. The Steering Committee position reported to the SESLHD Youth Health Coordinator and the Steering Committee. For the ICYAR project, governance was through a Steering Committee consisting of When interviewed for this research, ICYAR representatives from SESLHD, including its partners emphasised the importance of the Youth Health Coordinator and the Kirketon Road coordinator’s role in resourcing the model, Centre, Family and Community Services ,Oasis and the importance of the coordinator position Youth Support Network run by the Salvation being located outside the service system, and Army, the Kings Cross Local Area Command therefore bringing an independent perspective. (NSW Police),City of Sydney, Yfoundations, The Coordinator ensures the stable functioning St George Community Housing and Juvenile of the project by: Justice. • recruiting relevant organisations to ICYAR To ensure effective operations, the committee and explaining and promoting its work; must meet regularly. In inner Sydney it met • ensuring and streamlining information monthly, for example. It is responsible for the sharing and communication, thus enabling
Social Policy Research Centre Report 5 Report on the Model of the Inner City Youth at Risk Project relationships between diverse organisations and Juvenile Justice, is very important to the which would otherwise be more time functioning of the OC Committee: a group made consuming; up only of non-government organisations could • administering the brokerage and making sure not achieve as much and would risk replicating there is joint agreement on how money is the work of other interagency groups. spent; In the service model, the OC Committee has • negotiating in cases of disagreement; two primary roles. It considers applications for • ensuring that all young people are being brokerage, and enables an informal assessment appropriately assisted, including transferring and case coordination function. Participating them to a different agency or bringing in services discuss the needs of clients and additional assistance where appropriate; potential clients of services, including those who are ‘service hopping’ and those who are new • assisting new partners or new staff to to the area. OC Committee members discuss become involved and well oriented to the how they can best support new and potential range of participating agencies; clients, and whether brokerage funding would • managing the response to issues that occur be useful. The services in contact with young in the ICYAR properties (in partnership with people ask them to provide written consent Community Housing providers); for this collaborative planning to occur. Young • being responsible for data collection and people give permission for their information to reporting; and be shared in this setting, and they also have the • monitoring and developing the project. right to nominate agencies they do not want to have access to their information. The Coordinator needs to have a good understanding of young people’s needs and the OC Committee members identify which service/s youth sector, as well as skills to work with diverse already have contact with the young person; people and organisations and bring them who could offer case management; and who together to meet joint goals. The Coordinator might offer other assistance, for example, also needs strong negotiation skills to be able showers, food, and support in specific areas to raise difficult issues with partners to resolve such as physical and mental health, sex work, these issues, and the ability to develop creative injecting drug use, and parenting. Usually one solutions. organisation is assigned as the lead agency by the OC Committee to assist the young person The Outreach Coordination Committee although in many instances one organisation The Outreach Coordination (OC) Committee for could provide the primary assistance, with the inner Sydney project was formed in 2005, others also providing some services in a and consisted of the Project Coordinator and coordinated way. Young people are supported to the government and non-government service engage in ongoing assistance with a key worker providers who work directly with young people rather than visiting multiple agencies. in the Kings Cross area. Initially the Steering OC Committee meetings are also an opportunity Committee had proposed that only organisations for services to discuss the ongoing support that participated in outreach be a part of the needs of those clients who are living in ICYAR’s OC Committee, but in order to achieve ICYAR’s long term housing (see Section 2.2.4), and goals, there was a need for organisations which how these support needs can be met through provide a full range of responses. Membership service coordination and referrals. was therefore expanded to include other key OC Committee meetings are also an opportunity services, in particular those offering case to share information and discuss common issues management. The group also included other between services, including service initiatives diverse services such as Shopfront youth legal and training opportunities. service, alcohol and other drugs services, crisis services, and adult support agencies for When interviewed for this research, stakeholders clients with complex needs. The participation from the ICYAR project said that the OC of government agencies, especially SESLHD Committee was responsible for improved
Social Policy Research Centre Report 6 Report on the Model of the Inner City Youth at Risk Project coordination between providers. This took time Kings Cross area, and a lack of data about the to achieve, but as the organisations shared numbers and needs of these young people. information and developed trusting working The data collection process started from the relationships, OC Committee members came to commencement of the former Kings Cross Youth understand the extent to which problems with at Risk Project, and produced data covering a service coordination were adversely affecting nine-year period. assistance to young people, and became fully Data is collected to monitor the number of committed to working together. young people coming into the area. Data is also collected from the clients in the project 2.2 Strategies and activities who might be accessing either emergency or case managed support. The data includes The service model’s key activities of outreach demographic information and tracks young sweeps and data collection, brokerage funding, people through ICYAR showing case plans coordinated case management, long-term and how funds are spent. It shows the cost of housing, sector development activities, and supporting a young person and any changes the collection and management of data, are all in their support needs over time. Detailed local linked to ICYAR’s core functions: planning and data of this type is not available from other delivering coordinated services and housing to sources, so this dataset is a very useful resource highly vulnerable young people. in identifying needs and service gaps. • Outreach sweeps inform service planning by For the ICYAR project, sweeps were initially gathering information on the number of young conducted on the last Saturday night of people in the area and their service needs. each month, but from 2009 were conducted • Data from outreach sweeps and clients quarterly due to financial and human resource informs planning by providing standardised constraints. Sweeps were also conducted on information over time. rotating weeknights each quarter to capture • Brokerage funding enhances service data from Monday to Friday. On the nights of the delivery by providing goods and services to outreach sweeps, four experienced outreach clients that would otherwise be unavailable. workers from participating agencies and the Brokerage also facilitates service ICYAR coordinator surveyed young people on coordination through joint decision making the streets of Kings Cross and surrounding and by allowing staff from different agencies areas. They worked from 6pm to midnight on to share their knowledge of services and weeknights, and from 8pm to 2am on Saturdays. skills. The area covered by the sweeps was identified • Brokerage funding also enables rapid and reviewed through consultation with outreach responses in crises because of the capacity providers. This total area was divided into two to approve and process brokerage quickly sections, with a team of two workers surveying and to have access to emergency funds each area. when needed, including after hours. The outreach workers walked in pairs around • Sector development activities build networks the area in order to conduct a brief survey across agencies and ensure sustained with young people assessed as potentially engagement with the partnership. experiencing a risk factor, such as appearing to be drug affected or sleeping rough. They did not 2.2.1 Joint outreach sweeps and seek to interview young people visiting the area data collection to party or go to strip clubs. The survey collected Joint outreach sweeps are conducted on a information about the number of vulnerable quarterly basis to gather standardised data. young people in the area, their age, gender, They commenced in part as a response to the cultural background, usual suburb, income and findings of the Edwina Deakin report that led employment status, reasons for being in the to the establishment of the ICYAR Project. This area, accommodation on the night, time since report found that there were widely differing stable accommodation, and use of services estimates of the number of young people in the (Appendix B).
Social Policy Research Centre Report 7 Report on the Model of the Inner City Youth at Risk Project 2.2.2 Brokerage funding the client and an application for this funding. The coordinator circulates the application A brokerage fund was attached to the ICYAR to OC Committee members and it can be Project and, as described above, was allocated approved on the basis of agreement by through the OC and Steering Committees five members. This process also provides (Figure 1). The brokerage fund originally an opportunity for OCC members to make received $200,000 over a 2-year period of suggestions about alternative assistance or brokerage, which was increased to $400,000 resources for the young person. per year. This increase was consistent with the additional services offered by ICYAR. • Supported housing brokerage is a nominal amount of up to $35,000, which is available Brokerage funding enables services to enhance to provide wrap around services to clients their work and supports initiatives that respond with high needs in supported housing to the unmet needs of the target group. This tenancies case managed by ICYAR services is achieved through a process of assessing (described below). These funds can be individual needs, identifying service gaps at the used to purchase goods or services such as local level, and developing a tailored response furniture, whitegoods or resources to support to these issues. Initiatives can include a range their health, education or employment of interventions such as provision of social outcomes, Funds can also be used to housing, assistance with other accommodation, increase the number of staff hours from a food, medical and vocational needs to support support service’s usual allocation per client to young people at risk. Brokerage can also be an increased level required by a high needs used to support programs which build capacity client; e.g., funds paid to an organisation in the service system and lead to improved inter- can be used to backfill the case manager’s sectoral responses. position while they are supporting the young Throughout the project, approximately 11 person. These funds are allocated according brokerage applications were made each day. to a case plan and application process that The amount of spending, however, varied is ongoing throughout the young person’s depending on the number of young people in support. Staff support hours are paid the area and the needs of those young people and approved monthly depending on the at the time. changing needs of the client. The benefits of There are four tiers of brokerage: coordinated service delivery has meant that no client of the project has required access • Emergency brokerage enables an to the full amount of funding available to organisation to apply for up to $500 to them to address their support needs. support a young person at risk. This does not need approval by the OC Committee but • Project brokerage is available where two can be approved as needed by the manager or more organisations in the area identify a from the service where the young person has gap in service delivery, and consequently sought assistance. It could cover items such want to initiate a project that fills that gap or as emergency accommodation, transport addresses that need. The organisations can for a young person in crisis, or obtaining apply for brokerage funds of up to $20,000 identification documents. This funding also to put a project in place which enhances operates as a bridge to support young ICYAR and service delivery in the area. people to start accepting case management The development of a responsive website from services as further financial assistance that functions as a mobile youth services is dependent on receiving case management. directory (see Section 2.2.5) is an example of an initiative developed through project • A young person receiving case management brokerage. may be allocated up to $5,000 in brokerage. This could be in one application, e.g., for The coordinator manages the brokerage housing setup, or several applications for applications, which involves checking details and smaller amounts over a period of time. A coordinating approvals from at least five of the service needs to prepare a support plan for OC Committee members. Unless the application
Social Policy Research Centre Report 8 Report on the Model of the Inner City Youth at Risk Project is complex and therefore requiring the OC b. No young person is to be given money Committee to make the decision in a meeting, directly; the service provider must purchase the application is submitted electronically. The the resources required. case manager who made the initial application c. Brokerage should not be used to purchase is subsequently informed of the outcome by the resources readily available through existing Project Coordinator (Figure 1). avenues. Brokerage funding is provided within specific d. The utilisation of brokerage will be tailored to guidelines, which are part of an overall protocol address the particular needs of the individual (Appendix B): being considered. a. Brokerage is to be seen as a tool in the e. Accommodation placement accessed via provision of intensive support, whereby the brokerage should be assessed based on brokerage funds will be readily available to the individual client’s age, exposure and the client to purchase services, material, and experience, and only to be used if there is no resources that will help in their empowerment. other option available.
Figure 1: Brokerage approval process
Client applies for brokerage through OC Committee member agency Emergency applications under $500 Emergency applications over $500 forwarded to Coordinator for approval of forwarded to Coordinator for approval and reimbursement payment processing
Outreach Coordination Committee Approves (in principle) case managed Approves emergency applications over applications over $1,500 or applications $500 with a staffing component
Steering Committee
Provides final approval for Case Managed Provides final approval for Case Managed applications over $1,500 applications with a staffing component
Project Coordinator forwards payment details to Brokerage Administrator
Administrator processes payments under $500 within 2 working days Administrator processes payments over $500 within 7 working days
Social Policy Research Centre Report 9 Report on the Model of the Inner City Youth at Risk Project f. Brokerage used for emergency people make a successful transition to housing. accommodation is only a short-term option Services also reported that brokerage enabled until the client is accepted into supported or the process of stabilising and moving forward private rental accommodation. The ongoing to happen more quickly, and that having better affordability of the accommodation is to be quality furnishings and more reliable whitegoods considered. contributed to more sustainable outcomes for g. Brokerage used for groceries is not to include clients. Overall, this meant that services were alcohol or cigarettes. Only vouchers will be able to support an increasing number of young provided. people. h. Access to brokerage is limited to Brokerage can also streamline case organisations who participate in the OC coordination. If the young person’s first service Committee and for items or interventions not provider cannot provide everything they need, covered by existing services at this time. the service provider can access services offered ICYAR partner agencies emphasised that by another agency through brokerage. brokerage both assists young people and Brokerage also contributes to the strength encourages and sustains the participation of and cohesiveness of the partnership because services. it provides an incentive for organisations to Over the life of the ICYAR Project, brokerage become involved. Brokerage is beneficial to funding came from several government sources, organisations because it is not limited by the set including crime prevention, health, local criteria of other government funding programs government and homelessness funding. The regarding, for example, client age, time limited amount of funding required in different locations access to services, identified issues to be would depend on the size of the community and addressed. the numbers of young people to be assisted. The brokerage program has also maintained Interviewees suggested that other possible a central data base on the young people who sources of funding for brokerage could include access brokerage. This enables ICYAR to track philanthropic foundations and major businesses these young people over time and monitor (particularly in smaller towns). In smaller outcomes. communities it is possible that other agencies such as schools and Police and Citizens Youth Some organisations actively participate in clubs could be involved, which may influence the ICYAR but require only very small amounts of areas of government that could be approached. brokerage. This indicates that the benefits of collaborating through ICYAR are broader than The supported housing component of the ICYAR only the access to brokerage funds. project was based on a housing first model, so the first priority with brokerage was to stabilise 2.2.3 Coordinated case management accommodation, and then to address other needs such as physical and mental health, and ICYAR does not provide case management drug and alcohol issues. Case management directly; rather, it strengthens the quality of case was always client-centred, but individual management provided by partner organisations. organisations negotiated with clients to ensure When working with young people, one agency that brokerage expenditure was consistent with assumes the lead role and coordinates the these priorities. other services involved. This could involve, Brokerage benefits young people both directly for example, a service that provides case and by improving the work of services. Being management coordination with other services able to provide bond assistance and purchase providing legal, health, and educational new furniture and household items quickly services. The strong relationships that have enables young people to move in to their homes been formed between ICYAR services assist faster and has enabled staff to spend more time coordinated case management to work well and providing structured support to ensure young allow young people choices and options.
Social Policy Research Centre Report 10 Report on the Model of the Inner City Youth at Risk Project Information sharing between services also for young people in these properties enables means that at times agencies that are not intensive support to be provided to establish the lead for an individual client may be able stability. to opportunistically intervene with that client. Young people moving to these properties are This can happen when clients disengage or considered permanently housed. The properties are difficult to contact and is the result of a have a low turnover and ICYAR agencies provide commitment from partner services to work with ongoing support. A small number of clients clients across a range of settings. have subsequently moved to independent accommodation or into a general tenancy 2.2.4 Long term supported housing arrangement where they are not required to In 2010, 10 supported housing packages for have support to continue living in their property. high needs young people were funded under Many clients will continue to need support into the Nation Building Economic Stimulus Plan the future, when they are no longer eligible to and NSW Homelessness Action Plan. These access youth services. In order to address packages were provided in partnership with St this issue, agencies that work with an adult George Community Housing and tenanted by population are also key to the ICYAR service the most vulnerable young people in the area model and were key to the ICYAR project. who have experienced homelessness along with Examples include New Horizons and Neami, a number of other health and social issues. organisations that provide adult mental health St George Community Housing provides the support services. tenancy management, which includes provision Interviewees for this project stated that having of support and advocacy for clients. St George long-term housing had a very positive effect on Community Housing recognises that these clients who need intensive support. They noted young tenants may not initially have all of the that many of these clients could not sustain knowledge and skills to maintain a tenancy, tenancies without intensive support and would and therefore works with them to ensure they likely be in the corrective services system or the are aware of their rights and responsibilities as health system if they were not housed through a tenant. They also work to develop a positive ICYAR. They noted that while the brokerage relationship of trust so that there is a good allocated to these young people was high, the basis to deal with any tenancy issues that cost should be viewed in this context, and that arise. An ICYAR partner agency provides case having ongoing ICYAR housing and support was management to each client while other partners a highly effective approach to assisting them. In generally provide specialist assistance such addition, the majority did not use the full funds as legal or disability support. This partnership available. is crucial in assisting young people to maintain long term tenancies, and there is a high level 2.2.5 Sector development initiatives of communication between the organisations involved, particularly if the young person’s ICYAR partner agencies established a number behaviour is an identified risk to the tenancy. of new projects that develop the youth sector and its ability to respond to the needs of young Additional properties were sourced through people at risk. Metro Community Housing for the project and were specifically targeted to young Aboriginal These projects include: people. • Clinics for young people outside the school OC Committee member organisations nominate system to access the Human Papillomavirus young people for vacancies in these properties, (HPV) vaccine. While there is a national and the OC Committee bases decisions on the school-based vaccination program for HPV, current vulnerability of applicants so that those many vulnerable young people have not had in the most need gain access to properties access to this; (Appendix B 6.4). The brokerage provided
Social Policy Research Centre Report 11 Report on the Model of the Inner City Youth at Risk Project • The development of a responsive website • Facilities Tours run twice a year to offer that functions on both desktop and mobile orientation training for new staff of all the devices as a directory of services. This agencies. These tours were an investment of website includes, for example, maps and time and resources into engaging staff. Up phone numbers to assist young people to to 22 workers from ICYAR services visited 10 easily find accommodation, health and other services in a day. These tours enabled new services. This project recognises that many staff to the concept of working together and young people already use mobile devices as provided information about other agencies. a key source of information; Orientation DVDs featuring an overview of • A range of resources, which all the agencies partner agencies were produced and shown can access, have been purchased. These to staff as an orientation tool and to clients as include, for example, car seats for babies an engagement strategy. which agencies can use when transporting young parents;
Social Policy Research Centre Report 12 Report on the Model of the Inner City Youth at Risk Project 3. Replicating the Inner City Youth at Risk model
In this section we have summarised the views of • Develop service memorandum of ICYAR stakeholders to provide an overview of understanding, protocols for young peoples’ steps to take in replicating the model elsewhere. access to services, confidentiality and consent policies, and joint case management protocols. 3.1 Essential elements • Include adequate brokerage funds as part • Ensure sufficient time for planning and of the service model. This funding allows for engagement prior to commencing any rapid responses to client needs and provide activity: allow up to 6 months before an incentive for agencies to become involved commencing. in the partnership. • Conduct service mapping to identify what • Ensure brokerage guidelines are flexible and is currently provided and any gaps or transparent, and allow for timely release of duplication in services for young people at funds. risk. • Maintain data on brokerage expenditure • Establish a Steering Committee with key by category, outcomes achieved, and the decision makers from relevant government demographics of young people accessing and non-government agencies. the program. Disseminate information to all • Employ a coordinator who has a broad range project partners and key stakeholders to of skills in youth services, case management, inform future service delivery. health and/or homelessness, and well developed negotiation skills. • Establish an OC Committee consisting of key 3.2 Key principles decision makers from organisations that work • Utilise the existing service network rather with the target group. Ensure the committee than establishing and building a new service. includes specialist youth services, specialist • The coordinator should work from an homelessness services, early intervention independent agency who does not benefit services, housing providers, and health directly from access to brokerage funds. services. These services will review and • Brokerage funds can be used flexibly to jointly approve applications from partners for purchase a broad range of services and brokerage funds. to extend support, and should not be used • Led by the coordinator, both committees to set up new housing or support worker should establish terms of reference, positions. brokerage procedures and outreach sweep • Ensure the brokerage guidelines allow for protocols. flexibility and immediate availability of funds. • Ensure representation from agencies with • Decision making needs to be joint with all strengths in case management. partner agencies involved. • Ensure representation from agencies of sufficient size to change staffing FTE on a temporary basis as needed.
Social Policy Research Centre Report 13 Report on the Model of the Inner City Youth at Risk Project participating services in order to help them 3.3 The service environment form positive working relationships so that no The ICYAR model is premised on having some individual organisation dominates or benefits diversity of services offering different types more from collaboration but the focus remains of assistance to ensure a range of expertise. on ensuring the best outcomes for young ICYAR’s local area has a high level of services people. including: case management, alternate The person selected for the position needs to education programs, driving programs, young have skills and expertise to coordinate and to parents programs, crisis accommodation, the get along well with others, and to negotiate medically supervised injecting centre, a youth relationships and outcomes for the project. legal service, welfare and drop in services, adult care coordination services, juvenile justice, and a service for young people of diverse genders, 3.5 Establishing committees and sexualities, and sexes. While other localities partnerships do not have the same number and diversity of Interviewees stressed that having all the key services found in inner Sydney, this does not services represented on the Steering Committee necessarily mean that the model could not be and OC Committee was important. This means adapted. In areas where there are much smaller being clear about the roles of each committee numbers of formal services, for example in rural and selecting appropriately; not excluding or regional areas, there may be other strengths less skilled organisations; and ensuring each such as a very high level of willingness to work organisation selects the right representative together, and draw together skills from within to attend. Representatives need to have services and the local community more broadly. sufficient authority to represent the organisation, One ICYAR participant suggested that the lack which often means members need to be at of legal services for young people in some areas management level. would be challenging as this is a vital service However, in the early phases of a project, for the target group. Another participant thought smaller committees may be more effective that the ICYAR model could potentially be even than those that engage all key services. For more useful where services were more spread example, when the ICYAR project commenced, out than where they were in close proximity, housing providers were not represented on the and that where fewer services were available, committees, and this changed over time, as the there would be a greater need to rely on each project developed. . other. There would, however, be more challenges for clients accessing services across greater The ICYAR project’s experience in establishing distances. committees and partnerships was that it took time for each organisation to move beyond what some participants referred to as ‘territory’ [Int_8] 3.4 Project Coordinator position or ‘ownership of clients’ [Int_7]. The first step Interviewees stated that the coordinator position had been to identify the joint work being done was vital to the operation of ICYAR, and that by organisations and consider how they could the activities undertaken by ICYAR would not enhance that work. One interviewee recounted happen without the work of the coordinator. how, in an early OC Committee meeting, it During the life of the ICYAR project, the became apparent that some young people coordinator’s role was a busy full-time position. were accessing multiple agencies without It may be that in a small community, a project their knowledge, and that this realisation had assisting fewer young people and involving been key in organisations understanding how fewer organisations could operate with a part- important it was for them to collaborate. time coordinator, at least initially. Interviewees said that ICYAR worked well Participants emphasised that the coordinator because of a shared understanding between position needs to be from a neutral agency, the partners that they are all trying to achieve external to the participating services. This the best possible outcomes for young people. enables the Coordinator to negotiate between The extra time and work that services contribute
Social Policy Research Centre Report 14 Report on the Model of the Inner City Youth at Risk Project is offset by the benefits to their clients by being and overall, receiving inadequate help. Its involved. Interviewees said that if services structure addresses issues that sometimes viewed ICYAR as a way to access funds for their cause poor outcomes in projects involving joint services, the model would not work. Partners working arrangements (Section 8.5), such as need to come together with the agreement poor communication and information sharing, that funds are provided to support young ambiguity of role demarcation and responsibility, people’s needs. The work of establishing the lack of resources, failure to deal with staff model therefore involves a focus on relationship turnover and training needs, problems with building and trust. Interviewees mentioned participation, and issues relating to program that this process was assisted by, for example, fidelity and compliance. While the model may socialising at Christmas or meeting for a coffee need adapting in other communities, the key to build good relationships. This made it easier features are sound and provide a strong basis to discuss difficult issues. Interviewees also for developing similar projects. noted that the high level of commitment was The primary challenge facing a service model of evident from the fact that committee members this type is the uncertainty of ongoing funding prioritise the meetings and attend consistently. for the project and for the services involved. The ICYAR project, including the coordinator position, was funded through a series of short- 3.6 Operational, financial and term arrangements, the shortest of which was sustainability issues of the service three months. Because it does not provide model services or case-management directly, the ICYAR addresses issues of lack of coordination service model does not always fit funding in services for vulnerable young people, priorities. The ICYAR project benefited from a including services being ‘siloed’ or unaware highly committed and skilled coordinator, but of the work of other agencies; young people insecure funding does make it more difficult in being passed between services with no service general to attract and retain quality staff. Equally, taking responsibility, having to retell their the funding for individual services is also often story, not developing trusting relationships, precarious.
Social Policy Research Centre Report 15 Report on the Model of the Inner City Youth at Risk Project 4. Client journeys and outcomes
ICYAR provides a means for agencies to them and make sure we’re not doubling up adapt their response so that young people … It’s been amazing to see the positive effect are assisted to access the services they need that having long-term housing can have on a in a coordinated way with ‘no wrong door’. client … [Int_9] ICYAR members report that this wrap-around In the past when organisations weren’t availability of services enabled young people working well together, if a young person went with very high support needs to gain very to an organisation and they didn’t like it or positive outcomes. didn’t like the workers and left that service In particular, from 2010-2012, the retention there wasn’t really any opportunity for that rate in ICYAR housing was 80% (Eastman and organisation to refer them to another service. valentine, 2012: 29). ICYAR participants who Whereas now with all those orgs around the were interviewed noted that this comprised table through ICYAR and with young people a major achievement because these young giving consent to share information between people had not had stable accommodation those orgs we are able to ensure that young for a significant period, if at all, and many had people will receive support in one form alcohol and other drug use and/or mental health or another rather than being sent away or problems. In addition, because of their young banned. [Int_3] age, many had not previously managed their Over the 8 years that ICYAR had operated own tenancies. ICYAR has also housed other we’ve had young people resolve crises, move young people through community housing or into houses, in TAFE, a supported housing private rental properties. ICYAR brokerage has client has applied for funds to go to university assisted young people to access and remain in next year to study welfare which is wonderful housing. considering where that client was 5 years Young people also received brokerage ago. The project has brought all of these assistance in other key areas that support organisations together and is actively making positive outcomes, including education and them work together I think egos and agendas vocational activities, health needs, baby needs, are something we leave out of the room when and legal support (Eastman and valentine, we meet ... [Int_3] 2012). Some young people who came to inner city Sydney from other areas were assisted to 4.1.1 Case Studies return home. Two illustrative case studies were provided Partner agencies interviewed for this report by the ICYAR project providing examples of commented on the positive impact that ICYAR the work made possible by the ICYAR service has had on client journeys and outcomes: model. … [in the past] we were finding that a Alice lot of clients were going from service to Alice arrived in Sydney from rural NSW with service to meet their needs but no one was her mother. Alice has been homeless for some communicating about it. So given we can talk years and has long history of sexual exploitation, about the clients the committee has meant mental health issues, family breakdown, that we get the service that’s most suited to experiences of extreme physical violence from
Social Policy Research Centre Report 16 Report on the Model of the Inner City Youth at Risk Project others, and alcohol and poly drug misuse. with anger management, violent relationships, She had fallen through the gaps of many and transient and unsuccessful tenancies. services due to her ongoing issues, and Alice’s Sarah was identified as a client having high and engagement with services was not sustained for complex needs and received coordinated case long periods of time. management through ICYAR at the age of 20. Alice became known to the ICYAR committee Services provided included: when she engaged off and on with some of • referral to the Shopfront Legal Service the services, including The Crossing. She • a tenancy in an ICYAR Supported Housing then engaged in long-term intensive case property and intensive wrap-around case management and was nominated for an ICYAR management support provided by Oasis supported housing property through St George Youth Support Network Community Housing as well as other wrap- • brokerage to provide new furniture and white around services from the committee which goods for the unit included: • brokerage to purchase items required to • Drug and Alcohol assistance from Kirketon prepare for her second child Road Centre & the Medically Supervised • referral to the Oasis Young Parents Program Injecting Centre to assist with building parenting skills with • Clothing and drop-in at the youth space at the goal of having her first child restored and Wayside Chapel keeping her second child in her care. • Referral for immediate furniture and white goods from Oasis, the Salvation Army Sarah gained some stability once she was in her new accommodation, but after the • Legal Support from Shopfront Legal Services removal of her second child, her alcohol abuse • Health screening through the Kirketon Road increased, and her mental health declined. Centre She spent a short period in custody, struggled • Funding from ICYAR for housing set-up (2 with reintegration into the community and was weeks rent, bond and furniture), medical admitted to hospital, requiring additional support needs, groceries, extended support from from her case manager. While in hospital, ICYAR Case Workers, clothing, and TAFE enrolment brokerage protected her tenancy from being fees and materials. placed at risk due to rental arrears incurred The collaboration of ICYAR partner agencies when she was unable to report to Centrelink. led to improved support for Alice through the Sarah received a suspended sentence relating sharing of information and coordination of to previous offences, and subsequently began assistance across agencies that had specific to make some positive changes in her life. She expertise. Direct assistance was also provided completed a number of short courses, obtained by a range of local services who were available supported employment in landscape and to assist her while her Case Manager was on maintenance and has been working consistently leave. for over 12 months. She has maintained regular Sarah contact with her children and continues to work towards her goal of having more contact. Sarah Sarah left home at 13 years due to abuse has also been engaging with her counsellor and domestic violence. She disengaged weekly for almost a year. During this time, in from mainstream school and presented at addition to housing and case management, an ICYAR partner agency after a period of ICYAR assisted with: rough sleeping and stays in refuges. She had two pregnancies and births (the second • brokerage to purchase travel tickets to attend when she was engaged with ICYAR) and both training and on occasion to transport Sarah children were removed from her care. Sarah interstate to see her children and maintain had a history of alcohol abuse, physical health contact arrangements problems, involvement with the legal system, • addressing physical health concerns at unaddressed mental health issues, difficulties Kirketon Road Centre
Social Policy Research Centre Report 17 Report on the Model of the Inner City Youth at Risk Project • Driving 4 Employment program managed by begin to address her needs. The long term Oasis (P1 licence). and consistent support from services has meant that Sarah has formed therapeutic and All these achievements were unimaginable trusting relationships with workers, which has for Sarah prior to living in ICYAR housing, significantly contributed to her progress. The with her main goal at the time being to simply collaboration and relationship between agencies stay out of jail. ICYAR supported housing has that was developed through the OCC Meetings provided Sarah with a stable platform to finally have enabled this support.
Social Policy Research Centre Report 18 Report on the Model of the Inner City Youth at Risk Project 5. Appendix A: ICYAR Partnership Agencies and Terms of Reference
Membership Steering Committee terms of reference Salvation Army, Oasis Youth Support Network (written 2009) South Eastern Sydney Local Health District Role Kirketon Road Centre A Steering Committee has been established to oversee a 3-year project focusing on improving Mission Australia, The Crossing the planning and coordination of services Reconnect across the government and non- government Salvation Army Street Outreach Service sectors for young people with complex needs in Kings Cross and surrounding areas. The role of The Wayside Chapel the Steering Committee is to provide high-level The Come In Centre coordination and strategic support to the Inner City Youth At Risk project and to oversee the Juanita Neilson Centre Youth Program review process of the project. Medically Supervised Injecting Centre Juvenile Justice Principal Functions The Inner City Youth At Risk Steering Community Services Committee will: Kings Cross Adolescent Unit 1. Meet monthly for 1½ hours over a 3 year St Vincent’s Hospital Program for Early period; Intervention and Prevention of Disability 2. A quorom of five members is required for a Sex Workers Outreach Project meeting to take place; Neami 3. Develop an implementation plan in response to the recommendations contained in the Centacare, Alive Program NSW Homelessness Action Plan (related to New Horizons the Inner City Youth At Risk Project); Shopfront Youth Legal Service 4. Provide strategic and, where appropriate, operational support to the Inner City Youth At Twenty10 Risk Project Coordinator; Yfoundations 5. Monitor project progress against the NSW Police, Kings Cross Local Area Command performance indicators and analyse and report on outcomes and the achievement of St George Community Housing targets to South Eastern Sydney Illawarra City of Sydney Health (SESIH), NSW Health and the Regional Homelessness Committee; 6. Regularly review and assist in identifying areas for reform in relation to the delivery of youth services in the Inner City;
Social Policy Research Centre Report 19 Report on the Model of the Inner City Youth at Risk Project 7. Establish connections and forge linkages to other government, non-government, Outreach Coordination Committee terms committee processes and initiatives relating of reference (written 2009) to young people at risk or in crisis to complement the initiatives and reforms; Role 8. Oversee the review of initiatives and An Outreach Coordination Committee has outcomes from the Inner City Youth At Risk been established to actively participate in the Project, including but not limited to, the planning and coordination of government and Brokerage Fund, Joint Outreach Sweeps and non-government services for young people with Support Housing; complex needs in Kings Cross and surrounding areas. The Outreach Coordination Committee Membership will provide case managed and coordinated responses to young people at risk and in crisis in In March 2004 a Kings Cross Youth At Risk Kings Cross and surrounding areas. Project Steering Committee was established. From October 2009 this committee will be The project and the committee will support two known as the Inner City Youth At Risk Steering major initiatives, a Brokerage Fund to assist Committee. individual at risk young people, and resources to support regular, late night Joint Outreach The committee includes representatives from Sweeps. the following government and non- government agencies: Principal Functions • Inner City Youth At Risk Project Coordinator The Outreach Coordination Committee will: • SESIH Area Youth Health Coordinator 1. Meet monthly for 1½ hours for the duration of • Department of Community Services (DoCS) the project; • Housing NSW 2. Provide timely approval of case managed • Salvation Army Oasis Youth Support Network brokerage applications distributed by email; • City of Sydney Council 3. Provide operational support to the Project • NSW Police, Kings Cross Coordinator; • Kirketon Road Centre 4. Participate in Outreach Sweeps where • Youth Accommodation Association required; • Department of Juvenile Justice 5. Regularly review and assist in identifying areas for further reform in Kings Cross and The position of chair will be performed by the surrounding areas; Area Youth Health Coordinator (SESIH). 6. Establish connections and forge linkages Each agency is required to nominate a key to other government and non-government, and an alternative agency representative committee processes and initiatives to the committee. Should an agencies key relating to young people at risk or in crisis representative be unable to attend a scheduled to complement the projects initiatives and meeting, the alternative representative should reforms; attend in their absence. 7. Participate in the review of initiatives and outcomes of the Inner City Youth At Risk Method of Evaluation Project; Steering Committee members will be asked to 8. Identify young people (10 per annum) and complete an evaluation of the meetings annually. approve applications related to social housing tenancies and support.
Social Policy Research Centre Report 20 Report on the Model of the Inner City Youth at Risk Project Membership • Juanita Neilson Centre Youth Program – City of Sydney Council; In March 2005 a Kings Cross Outreach Coordination Committee was established. • Medically Supervised Injecting Centre – From October 2009 this committee will be Uniting Care; known as the Inner City Youth At Risk Outreach • Kings Cross Adolescent Unit – Community Coordination Committee. The committee Services; includes representatives from the following • Program for Early Intervention and Prevention government and non-government outreach of Disability – St Vincent’s Hospital; services. • Sex Workers Outreach Project – Aids Council • Oasis Youth Support Network – Salvation of NSW Army; • NEAMI • Kirketon Road Centre – South East Sydney Membership may be reviewed by the Outreach Illawarra Area Health Service; Coordination Committee. New membership is to • The Crossing – Mission Australia; be endorsed by the project Steering Committee. • Rough Edges – St John’s Church; • Salvation Army Street Outreach Service; Method of Evaluation • The Wayside Chapel; Outreach Coordination Committee members will be asked to complete an evaluation of the • The Come In Centre – St Francis Social meetings annually. Services;
Social Policy Research Centre Report 21 Report on the Model of the Inner City Youth at Risk Project 6. Appendix B: Project documentation
6.1 Project Coordinator position description
Position Title: Project Coordinator
Position Summary: The key responsibilities of the Project Coordinator are to implement the Inner City Youth At Risk Project including: • facilitate collaboration between youth service providers and government agencies • coordinate an integrated service network that provides a case management response for low, moderate and high needs young people in the Inner City • collect and report on data related to the project • coordinate and participate in quarterly outreach sweeps
Essential Criteria: • Relevant tertiary qualifications/relevant experience • Proven experience in a project officer/management role • Experience in service development and service planning • Ability to work within tight time frames and budget constraints • Sound leadership, analytical and problem solving skills • Excellent oral communication skills including demonstrated interpersonal, negotiation and conflict resolution skills. • High level written communication skills with proven experience in producing detailed reports and briefs • Computer literacy in Microsoft Office • Sound knowledge of the Children and Young Persons (Care and Protection) Act 1998 • Knowledge and understanding of ethical practice, EEO, the charter of principles for a culturally diverse society, ethnic affairs priorities statement and OHS policies, practices and standards.
Key Performance Areas / Duties: • Create linkages and improve coordination between existing youth service providers to assist clients at risk or in crisis in the broader Kings Cross area. • Negotiate and problem solve with key stakeholders involved in the project • Facilitate meetings and identify and coordinate joint actions arising from: - the Inner City Youth At Risk Outreach Coordination Committee - the Inner City Youth At Risk Steering Committee
Social Policy Research Centre Report 22 Report on the Model of the Inner City Youth at Risk Project • Report monthly on project outcomes to the Outreach Coordination Committee and the Steering Committee. • Prepare quarterly project reports in accordance with NSW Homelessness Action Plan • Develop and implement the Brokerage Fund consistent with the guidelines and criteria established by the Inner City Youth At Risk Steering Committee. • Coordinate the provision of low/moderate support packages to 110 young people at risk per annum • Coordinate the provision of supported accommodation packages to 10 high needs young people at risk per annum. • Coordinate and participate in regular Joint Outreach Sweeps. • Coordinate and implement changes to the project in accordance with the project outline • Participate in professional supervision and participate in the SESIH performance management program, as required
Critical Aspects / Job Demands Summary (OH&S):
Demonstrate a commitment to both legislative and organisational requirements for ensuring a safe, healthy and hazard free work environment, particularly in regard to:
• safety and security issues (eg. handling aggression, whereabouts procedures) • driver and vehicle safety (eg. licence checks, monthly vehicle checks, driver safety) • manual handling (eg. moving stores and equipment, loading vehicles, keyboard operation) • infection control (eg. needle stick, contaminated waste, universal precautions) • incident and near miss reporting • hazard management (identification, assessment, control) • smoke free workplace policy.
Social Policy Research Centre Report 23 Report on the Model of the Inner City Youth at Risk Project 6.2 Sweeps data collection form
Inner City Youth At Risk - Data Collection Tool
Sector 1: Sector 2: Sector 3: Sector 4: Date: Time:
Sex: Male: Female: Transgender:
DOB:
Aboriginal: Yes: No: Cultural Background:
Are you currently homeless? Yes: No:
Suburb of current/last residential address?
If no longer in stable accommodation, when did you leave? Why did you leave? Family Breakdown Financial Difficulty Overcrowding Family Violence Other
What suburb are you staying in tonight?
Type of accommodation tonight? Boarding House Parents Place Rental House/Flat Shelter/Refuge
Street based Squat Friends House Other Additional Info: Friends/Other
Nights in Kings Cross in previous week? Monday Tuesday Wednesday Thursday Friday Previous Saturday Sunday All
Why do you come to Kings Cross?
What agencies do you access?
Have you completed this survey before? Yes No
What support was offered? Brokerage Referral Card Direct Referral None
Social Policy Research Centre Report 24 Report on the Model of the Inner City Youth at Risk Project 37
d. The client requires specialised intensive 6.3 Brokerage protocols support e. The client must be connected to the Kings 1. Brokerage – definition Cross or immediate area and at risk of one or Brokerage funding enables services to be more of the following: purchased or creative initiatives developed to • Are involved or at risk of being involved in address identified service gaps at the local level, substance abuse to help meet the needs of the target group. • Are homeless or at risk of becoming Brokerage describes the way a system or a homeless particular service or program facilitates a young • Are involved or at risk of being involved in person’s access to the pathways appropriate to underage and/or problematic sex work their needs. • Are leaving care or a Juvenile Justice Brokerage is designed to provide access to setting sustainable solutions to a problem, using a • Are experiencing mental health issues or strategic approach and has the following long- physical health issues term objectives: Other Criteria • Engaging existing services and funding in a a. Family and Relationship Difficulties coordinated, holistic way to support young people ‘at risk’ in the Kings Cross area. b. Employment or Educational Difficulties • Engaging key players both government and c. Involvement with Juvenile Justice, Probation and Parole &/or Community Services non-government in reviewing, evaluating and monitoring the project. d. Are parents or soon to be parents • Providing data to inform policy development 4. Aims of the Inner City Youth at Risk Project for the Inner City area. a. To improve access to housing for young Funds are available for: people at risk 1. Emergency brokerage b. To improve health and resilience for young 2. Case managed brokerage people at risk (including reduced drug and 3. Project brokerage alcohol misuse) c. To improve educational and employment 2. ‘At Risk’ Young People opportunities for young people at risk ‘At risk’ young people can be viewed as those d. To improve local coordination and who are vulnerable to, and affected by, a range infrastructure of factors likely to impede their successful e. To improve agency coordination and transition to a fulfilling adult life. information sharing The target group of young people should be f. To provide specialised intensive support considered vulnerable to one or more risk factors as outlined in the criteria: 5. The use of brokerage funds The Inner City Youth At Risk project offers 3. Criteria brokerage within the agreed guidelines: Essential Criteria a. Brokerage is to be seen as a tool in the a. Target age of 12-25 years of age, with a provision of intensive support, whereby the focus on the 18-25 year age range brokerage funds will be readily available to b. The client must be referred to or access the client to purchase services, material and at least one agency participating in the resources that will help in their empowerment. Outreach Coordination Committee (OCC) b. No young person is to be given money c. The client is not having needs addressed by directly; the service provider must purchase existing support systems resources required.
Social Policy Research Centre Report 25 Report on the Model of the Inner City Youth at Risk Project c. Brokerage should not be used to purchase e. Information shared with partner agencies resources readily available through existing should be relevant to assist with the avenues. brokerage application process. d. The utilisation of brokerage will be tailored to 7. Documentation address the particular needs of the individual a. Completed Brokerage applications are to be being considered. emailed/faxed to the Project Coordinator as e. Accommodation placement accessed via soon as the activity has been completed. brokerage should be assessed based on the individual client’s age, exposure and b. The Inner City Youth At Risk database is to be experience. And only to be used if there is no updated frequently and reviewed monthly by other option available. the Project Coordinator. f. Brokerage used for emergency c. All invoices for agency reimbursement must accommodation is only a short-term option be forwarded to the Project Coordinator at the until the client is accepted into supported or end of each month. Invoices forwarded late private rental accommodation. The ongoing may not be honoured by the Inner City Youth affordability of the accommodation is to be At Risk Project. considered. 8. Interagency Contact g. Brokerage used for groceries is not to include a. Intensive collaboration and integration alcohol or cigarettes. Only vouchers will be with existing services and resources is an provided. important aim of the Inner City Youth At Risk h. Access to brokerage is limited to organisations Project. There must be a clear capacity to who participate in the Outreach Coordination work in a collaborative manner in the best Committee and for items or interventions not interests of the young person. covered by existing services at this time. b. Referrals from other agencies may be facilitated through the Outreach Coordination General Working Principles Committee meetings.
6. Confidentiality 9. Transparency a. In order to promote and protect the privacy A transparency of areas of responsibility should of individual clients, this brokerage program always exist between the agencies involved. requires high standards of confidentiality. The Committee meetings and regular interchange referral agency will explain to the client the will be helpful to ensure this. The young person laws of confidentiality. The term confidentiality as well as the referring service has to be pertains to the safeguarding of information informed about the assessment procedure. relating to client matters within the bounds of The brokerage guidelines in this document have the relationship between worker and client. been developed to ensure that the brokerage However their case may be discussed with funding is equitable, transparent and responsive the Outreach Coordination Committee to to meeting the needs of young people ‘at risk’. assist with the application approval process. b. The client needs to complete the ‘privacy and Assessment Procedure consent’ form. c. Client and organisational information will not 10. Entry/Screening be made available to unauthorised persons a. Data Collection Information will commence during or following any person’s association once a referral is made to the brokerage with the brokerage program. Exceptions to program. The client must sign the privacy and this rule are strictly limited and apply only to consent form at this point. legal, safety matters &/or duty of care. b. When referrals come through individual d. For the purpose of evaluation de-identified services, the case manager/counsellor of client and support agency information may that service will take on the responsibility be used where ethics approval has been of monitoring the brokerage activities and provided. reporting back to the committee.
Social Policy Research Centre Report 26 Report on the Model of the Inner City Youth at Risk Project c. At the time of referral, it is important to obtain 11.1 Emergency brokerage funding as much information as possible regarding guidelines the client. Contact details of both the client a. These funds are only available to agencies and referring agency need to be obtained. that actively participate in the Outreach d. Referrals to the brokerage program will be Coordination Committee. tabled for approval at the monthly Outreach b. These funds can only be used to assist Coordination Committee meetings. Where young people ‘at risk’ in the Kings Cross, or there are time constraints and approval is immediate area or young people linked into needed before the monthly meetings the agencies participating in the OCC. Restricted coordinator of the project will distribute to those aged between 12 and 25, with a the request to OCC member agencies for focus on the 18-25 year age range. approval. When a minimum of 5 agencies c. These funds will only be available if all other agree to the proposed activity the lead avenues of possible funding have been agency can proceed. investigated without success. Proof of the e. Brokerage requests over $5000 or steps undertaken to investigate other options applications with a staffing component will will need to be provided. need both OCC and steering committee d. These funds must be used to ensure an approval. immediate response to high needs ‘at risk’ f. All applications that contain staff support youth with a positive outcome. hours will be provided in advance for OCC e. These funds are limited to a total of $500.00 approval and steering committee sign off. per individual. g. Each referral to the brokerage program is f. These funds will only be available to to be recorded in the ‘Program Referral’ file individuals once, although the same as well as on the Inner City Youth At Risk individual may be eligible for funding through database by the Project Coordinator. other forms of brokerage, such as case h. Each client is to be informed about the entry managed brokerage or supported housing and screening process by the referring funds. agency. g. If the proposed activity exceeds the i. Whether the application to the program is emergency brokerage limit on a weekend, accepted or denied, a response will be made the applying agency must contact the Project to the referring agency as to the outcome. Coordinator for approval. The coordinator j. Each person not accepted into the program will then seek retrospective approval from is to be informed about alternative services, the OCC the following working day. When the and wherever possible referred onto a coordinator is unavailable please contact the service better suited to their needs. The alternate representative as discussed at the young person will be entitled to be given OCC for approval. specific reasons why their application has been turned down. 11.2 Process for accessing these funds All applications administer are to be faxed/ 11. Emergency Brokerage Funds scanned to the coordinator as soon as possible The Kings Cross Youth At Risk report (2005) to ensure those ‘service surfing’ are identified highlighted a need for an emergency brokerage immediately. Agencies with access to petty fund for crisis intervention for young people ‘at cash will forward a copy of the receipt to the risk’ in the Kings Cross area. coordinator for record keeping. These could include: Those agencies without access to petty cash systems will contact the coordinator for a a. Transport reimbursement of emergency funds spent. b. Pathways to crisis accommodation c. Food, clothing and medication d. Other support crisis interventions.
Social Policy Research Centre Report 27 Report on the Model of the Inner City Youth at Risk Project 12. Case Managed Brokerage Funding h. Brokerage applications which include a staffing component will need to be approved The main aim of the case managed brokerage by the Steering Committee. fund is to provide sustainable outcomes for young people ‘at risk’ in the Kings Cross and i. These funds will only be provided if the immediate areas. Ensuring the system, service Outreach Coordination Committee and/or or program facilitates a young person’s access the Steering Committee agree the proposed to pathways appropriate to their needs. expenditure has merit and will result in real As each young persons needs are different the outcomes for the recipient. case managed brokerage program has been j. These applications will be tabled and designed to cater for a range of interventions, assessed once a month at the Outreach some examples of this include support with Coordination Committee meeting. Urgent educational and vocational needs; the provision requests will be assessed by the Project of funds for involvement in positive activities or Coordinator and members of the Outreach assistance with housing set up costs. Coordination Committee via email. When 5 12.1 Case managed brokerage funding agencies have approved the activity the lead guidelines agency can progress. a. These funds are only available to agencies 12.2 Process for accessing these funds that actively participate in the Outreach An application form and case management plan Coordination Committee. form will be provided and each document must b. These funds can only be used to assist be completed by the lead agency with the young young people ‘at risk’ in the Kings Cross, or person applying for brokerage. immediate area or young people linked into agencies participating in the OCC. Restricted These applications will be assessed by the to those aged between 12 and 25, with a committee on a monthly basis and if approved focus on the 18-25 year age range. lead agencies are required to invoice ICYAR for c. These funds will only be available if all other brokerage to implement the planned activities. avenues of possible funding have been Agencies who have taken on the responsibility investigated without success. Proof of the of case managing the individual brokerage steps undertaken to investigate other options plan will be required to give timely updates will need to be provided. on the progress of the plan and the outcomes d. These funds will only be available to an achieved. agency that is case managing the individual client and identifies as the young persons 13. Project Brokerage Funding lead support agency. Brokerage funding may be available for one e. These funds are limited to $5000.00 per or more organisations who wish to provide individual and if additional monies are a project or program which addresses the required the involved agency will need to needs of young people ‘at risk’ in Kings Cross. seek OCC approval to extend support. Examples of such projects may be joint agency f. These funds are limited to $5000 per recreational activities or group training that individual receiving case management. improves the capacity of organisations to Funds are not subject to the $5000 limit service the target group. where the client has been identified as a high needs client accessing ICYAR supported A project proposal template will be provided social housing. and the applications will be tabled at the g. Application requests exceeding $5,000 Outreach Coordination Committee meetings, if will have to be approved by the Steering supported at this forum the proposal will then Committee after (in principle) approval by the be tabled at the Steering Committee meeting for OCC. endorsement.
Social Policy Research Centre Report 28 Report on the Model of the Inner City Youth at Risk Project 13.1 Project brokerage funding guidelines 13.2 Process for accessing these funds a. These funds are only available to agencies These guidelines have been developed to participating in the Outreach Coordination ensure that the brokerage funding is equitable, Committee. transparent and responsive to meeting the b. These funds will only be available if all other needs of young people ‘at risk’. avenues of possible funding have been A project proposal template will be provided, investigated without success. Proof of the when completed this should be submitted to steps undertaken to investigate other options the Outreach Coordination Committee. After will need to be provided. approval from the Outreach Coordination c. These funds will only be made available if the Committee the proposal will be forwarded to proposed activities meet the aims of the Inner the Steering Committee for approval. Following City Youth At Risk Project. this approval the lead agency will be required d. These funds will only be made available after to invoice ICYAR for the brokerage to administer final approval from the Steering Committee. the activities. e. These funds are limited to innovative and new initiatives rather than extensions of existing projects/programs.
Social Policy Research Centre Report 29 Report on the Model of the Inner City Youth at Risk Project
6.4 Entry assessment for Supported Housing Packages
Identified Risk Category Support Additional Required: Comments (List and please identify which agency you consider appropriate to provide this support) Accommodation Low: At Risk of Y Low Homelessness Moderate
Mod: Homeless (less than 12 High months) N High: Long Term Homeless (more than 1 year) Type of Homelessness Low Low: Tertiary Moderate Mod: Secondary High High: Primary Physical Health Low: Health issues – Low receiving GP support Y Moderate Mod: Health issues – no GP High support High: Serious health issues – N no GP – non-compliance Drug and Alcohol Issues Low: Not daily use, not IDU Y Low Mod: Daily problematic/multi Moderate use N High High: IDU, poly drug user Mental Health Issues Low Low: Mild condition Y Moderate Mod: Disabling condition High High: Chronic or multiple N conditions Risk of Self Harm Low: No suicide plan or Y Low ideation Moderate Mod: Personal harm risk N High behaviours High: Suicide plan, suicidal behaviours Involvement with JJ or PP Low: Known to police/No JJ or Y Low PP contact Moderate Mod: One or less occasions in N High JJC or prison High: Multiple incarcerations in JJ and/or prison (Further score of 5 if recently released) Legal issues Low: Legal issues and fines – Y Low has legal representation Moderate Mod: Legal issues and fines - High no legal representation N High: Multiple legal issues with no representation
Social Policy Research Centre Report 30 Report on the Model of the Inner City Youth at Risk Project 44
Income Low: Has regular income Y Mod: Eligible for Centrelink Low benefits but breached or not Moderate receiving High High: Not eligible for N Centrelink benefits Education/Employment Low: Recent/current Low involvement in Y Moderate education/employment High Mod: No recent/current N involvement in education/employment High: Not work/study ready Risk of Isolation/Risk of Safety Low Low: Some social supports, Y Moderate able to identify some risks and High access support N Mod: Unable to identify risks to personal safety and socially isolated High: Social Isolation greatly affects mental health and personal safety Risk of Aggression Low: Irritable, verbally Y Low aggressive Moderate Mod: Property damage N High High: Assaults other people Score: Add total score for Lower risk = Moderate risk = High risk = each category Low risk = 5 Moderate risk = 10 High risk = 15
This assessment was adapted from the Vulnerability Index Tool, developed in the USA to target the most vulnerable, and used in homeless programs around the world (Parsell & Davis, 2011). It was adapted for use with young people in consultation with project partners.
45
Social Policy Research Centre Report 31 Report on the Model of the Inner City Youth at Risk Project 7. Appendix C: History and features of the project
The ICYAR Project was managed by the South Community Solutions funding was provided for Eastern Sydney Local Health District (SESLHD) two years from February 2003. It was intended Child, Youth, Women and Families Health. to ‘help older youth who have become involved Research on the ICYAR project outcomes in high risk Kings Cross lifestyle [focussing between July 2010 and June 2012 (Eastman on] coordinating services, working with youth and valentine, 2012: 1) found that the project in crisis and ensuring service availability after was reaching its target group of highly hours’ (Petersen, 2007). disadvantaged young people, with the majority DOCS established a Steering Committee to (82.9 per cent) of clients experiencing unstable oversee the project and review youth services in accommodation, approximately one third having the Kings Cross area. This committee consisted mental health issues, almost a third having drug of representatives of SESIH, including its Area and alcohol issues, and the majority having Youth Health Coordinator and the Kirketon multiple presenting issues. A quarter of all Road Centre; DOCS (including the Kings Cross clients identified as of Aboriginal and/or Torres Adolescent Unit); the Department of Housing; Strait Islander background. Through ICYAR, the NSW Premier’s Department; and Oasis Youth 1,145 instances of brokerage were provided Support Network run by the Salvation Army. to 487 clients. This report found that partner This Committee commissioned an independent agencies regarded the model as both effective consultant, Edwina Deakin, to map and review and efficient. services for young people at risk (12–25 years) The development of the ICYAR project began operating in the broader Kings Cross area. in 2001 when the NSW Government initiated a The resulting 2004 report, Improved Services new funding program. The Community Solutions for Young People in Kings Cross, found that and Crime Prevention Fund was established service provision was erratic and coordination as a result of the 1999 NSW Drug Summit. It between agencies in the area was poor. This was intended to assist community development resulted in a lack of sustainable outcomes for and crime prevention initiatives in high need young people in situations of crisis. This, in communities across NSW, including Kings turn, placed vulnerable young people at risk of Cross. Kings Cross and surrounding areas long-term homelessness. The review found a attract significant numbers of young people need to increase collaboration and joint activities who are at risk of long term homelessness, between existing services, and recommended problematic substance use, mental health, the remaining Community Solutions funding be violence, problematic sex work, criminal activity, allocated over two years to support the Kings and self-harm. Four organisations working with Cross Youth at Risk project. It also proposed young people in Kings Cross – the Department a number of joint measures between existing of Housing, the Department of Community providers including the establishment of a Services (DOCS), South Eastern Sydney coordination committee, the introduction of Illawarra Health (SESIH) and the Salvation outreach sweeps, and the establishment of a Army – who were all interested in developing brokerage fund. initiatives under the program, were asked by the In response to the review, the existing Steering government to work together to develop a joint Committee formed the basis of the new Kings project. Cross Youth at Risk Project Steering Committee,
Social Policy Research Centre Report 32 Report on the Model of the Inner City Youth at Risk Project which in January 2005 recruited a Project The agencies were able to seek assistance from Coordinator commencing with the following each other and to develop different approaches responsibilities: not limited by any one service’s brief. • to establish the Kings Cross Outreach Because of the brokerage component, there Coordination (OC) Committee; is flexibility to meet the needs of the clients. • to coordinate regular joint outreach sweeps Therefore, the client does not need to fit the to determine and monitor the numbers and criteria of a particular service to access profiles of young people at risk in the Kings brokerage; instead, the brokerage addresses Cross area; and their issues. For example, if the client requires • to establish and implement the brokerage more than 6 hours case managed support program and monitor its outcomes and per week, and an organisation’s policy is to impacts. only offer a maximum of 6 hours per week, the organisation can apply to ICYAR for Given that a key concern behind the supplementary funds to provide the additional establishment of the project was that multiple support. Another example is that, before ICYAR agencies were working in the area but not was established, when a young person found communicating well, an initial task for the new housing, there was no clear avenue to secure coordinator was to contact these agencies, funds for the bond, furniture, and whitegoods. inform them about the project and encourage Support workers would spend lengthy periods them to meet and discuss their clients. This of demoralising effort trying to secure furniture group became the OC Committee. As a result and (sometimes inadequate) second-hand items of these meetings, the OC Committee members for the new home. The availability of brokerage realised the extent to which young people were has meant that young people are in crisis for a ‘service surfing’, or using multiple services in shorter time, and because services can assist an uncoordinated way, often without having their more quickly, they are able to work with more key needs met. young people. Services stated that with the assistance of ICYAR a lot of young people had 7.1 Experiences of participating been housed, received assistance to resolve agencies crises, maintained their tenancies, and started their studies. For this project, we asked participating agencies about their experiences of the project and what they viewed as its key benefits. 7.2 Financial implications of Stakeholders stated that there are a large participation for partners number of agencies in the Kings Cross area While partners acknowledged that participating that provide services to young people, but in ICYAR involved time and effort from each before the establishment of ICYAR, their work service, they assessed the benefits as lacked coordination. By bringing these agencies outweighing the costs. Firstly, the availability together, ICYAR has enabled them to enhance of brokerage and the quick decision-making their assistance. processes for most brokerage applications enabled them to provide assistance that they Bringing services together to support the young could not previously provide, or that had been person means that they can draw on each time consuming and difficult to provide, as other’s strengths. It was also found that ICYAR described above. Services reported that the assisted them in reviewing their approaches and quality of assistance had improved as a result processes because they are usually constrained of cooperation and communication between by what their service is funded to provide. ICYAR services. Where services worked together and enabled them to look beyond barriers linked to assisted each other, they came up with better territorial ideas of ‘my client’, servicing specific solutions for working with young people. goals, and individual service philosophy in order to together focus on supporting young people Further, services reported that receiving new to achieve their goals and live independently. furniture and receiving better support meant that
Social Policy Research Centre Report 33 Report on the Model of the Inner City Youth at Risk Project young people felt proud of their homes, looked • client data: ICYAR has generated quality data after them better, and were more likely to remain on numbers, demographics and needs of housed. young people in the inner city; what services When ICYAR started, a small amount of are needed and provided; and where there brokerage funding was available to each young were gaps in services; person. ICYAR has worked to expand this • social housing properties and packages for funding. However, organisations have continued high needs young people: provide safe long- to be frugal with brokerage funds and have term housing and stability that underpins their spread the brokerage money much further than ability to achieve their goals. was intended by the government. The brokerage These features combine together to form what costs of assisting young people are less per one interviewee referred to as ‘a gestalt’ [Int_1]: year than was anticipated by government and success from the combined work of all the therefore more young people are assisted. A key agencies, which is greater than if the work reason that the funding can be spread further had been performed separately by individual is because of the effect of a group of agencies agencies. ICYAR is able to go beyond ‘bandaid’ cooperating to provide an expanded range of [Int 5] solutions for homeless young people to activities to assist young people. assist them to get out of homelessness and look forward to a stable future for themselves and 7.3 Strengths of the model and their children. opportunities for improvement The most significant limitation that was identified Interviewees were unanimous in their view that was the uncertainty of funding for the project ICYAR had proved extremely useful in assisting and for the services involved. The project, the provision of services to homeless and at risk including the coordinator position, was funded young people in inner Sydney. through a series of short-term arrangements, The most important components were identified as: the shortest of which has been three months. Furthermore, while the ICYAR project benefited • the independent coordinator: having the from the stable presence of a highly committed coordinator positioned outside of the and skilled coordinator, uncertain funding does agencies involved means that this person make it more difficult in general to attract and is not influenced by the needs of any one retain quality staff. agency, and is able to educate new ICYAR members about collaboration, manage The information provided by ICYAR participants negotiations and relationships, as well as be indicates that features of this model do address responsible for the administrative side of the issues of lack of coordination, which the literature project. If one organisation had ownership of review (see following section) identified as the committee through the coordinator, other common in this area. These include services members would lose enthusiasm; being ‘siloed’ or unaware of other agencies; • partners who are committed to working and young people being passed between together collaboratively and outside the services with no service taking responsibility, scope of their usual operations to assist having to retell their story, not developing trusting young people: this cooperation prevents relationships, and, overall, receiving inadequate service isolation and duplication; and help. The evidence suggests ICYAR currently increases agencies’ flexibility and their ability does address issues that sometimes cause poor to provide a service’; outcomes in projects involving joint working • brokerage: assists agencies to engage with arrangements such as poor communication and provide immediate and long-term help to and information sharing; ambiguity of role young people that meets their needs; attracts demarcation and responsibility; lack of resources; and enables services to operate in partnership failure to deal with staff turnover and training rather than in isolation; and provides for a needs; problems with participation; and issues flexible model of service delivery; relating to program fidelity and compliance.
Social Policy Research Centre Report 34 Report on the Model of the Inner City Youth at Risk Project 8. Appendix D: Findings from the literature review
sex work, or drug dealing. Sixty-three per cent 8.1 Young people at risk in the received Centrelink payments. Forty-one per Kings Cross and inner city area cent reported they were homeless or living in The Kings Cross area has been an epicentre unstable accommodation, and one in three were of Australia’s sex and illicit drug industries for staying in temporary accommodation or were many decades (Petersen and Janssen, 2007; unsure where they would stay that night. Southgate et al., 2005; Van Beek, 2003). This Multiple health and welfare services operate in area, and inner city Sydney more generally, Kings Cross, and their presence assists young attracts homeless, transient or disconnected people to sort out legal, health or welfare issues people, including young people, from other (Petersen and Janssen, 2007; Robinson, 2002; parts of the city and elsewhere in NSW Southgate et al., 2005). These services include and Australia (Petersen and Janssen, 2007; accommodation, support, counselling and Robinson, 2002). The sex and drug industries welfare services, many aimed at marginalised in Kings Cross provide young people with an groups, including young people. Services used opportunity for survival and engagement in by young people include (Petersen and Janssen, a community outside the mainstream as well 2007; Robinson, 2002): as excitement and entertainment (Robinson, • crisis accommodation; 2002). Local police report issues including ‘… the presence of homeless and drug dependant • emergency department hospital services; persons, visible drug dealing on the streets, • services for people injecting drugs visible alcohol related crime particularly in the including needle exchange, injecting room, form of street assaults, street prostitution, youth detoxification and rehabilitation programs; related crime ...’ (Reynolds et al., 2002: 2). Some • other health services including free general, researchers use the term ‘street-involved youth’ sexual, and mental health care and rather than ‘homeless youth’ to describe young assessment; people in this situation These terms are used on • specialised counselling services; the basis that some of these young people may • street outreach; have transitional lifestyles that involve fluctuation • special needs education programs; between living in refuges, or in the homes of • other basic services such as food, showers, friends and family, but may not involve long washing facilities, ‘hang out’ places, leisure periods of living on the street (Connolly and Joly, activities, courses, internet use, job search 2012). facilities, and assistance at night; and Sweeps conducted by ICYAR of young people • other support services. at risk in the Kings Cross area (Eastman et al., 2013: 1) found that of those surveyed, 60 per cent were male and the average age was 20 8.2 Needs of youths at risk years, although the Aboriginal people surveyed Research highlights a number of interacting tended to be younger and were more likely to risks that restrict young people’s transition to be female. Of those who gave information about independence and are associated with their income and employment, 29 per cent reported becoming street-involved or homeless (Barker they were working, mainly in retail, hospitality, et al., 2012; Cameron, 2009; Rachlis et al.,
Social Policy Research Centre Report 35 Report on the Model of the Inner City Youth at Risk Project 2009). These include family breakdown (conflict, neglect, and abuse), mental health issues, 8.3 Service responses unemployment, poverty, alcohol and other The younger a person is when they first become drug issues, crime and other socio-economic homeless, the more likely they are to become disadvantages (Barker et al., 2012; Johnson homeless for a longer period (Johnson and et al., 2008; National Youth Commission, 2008; Chamberlain, 2008). While early intervention Quilgars et al., 2008). While resolvable family is important in preventing or reducing youth conflict is the cause of family breakdown for homelessness (Barker et al., 2012), young some young people, violence and abuse are people who have been homeless for longer frequently the cause of homelessness (Quilgars tend to return to conventional accommodation et al., 2008). Indeed, family physical and sexual if they have long term support (Johnson and abuse and a dysfunctional past are highlighted Chamberlain, 2008). as key experiences of homeless young people, Because of the range of issues that young resulting in trauma, grief, and the experience homeless people may face, service responses of being outside of mainstream society need to cover multiple areas, including shelter, (Robinson, 2002, 2005, 2010). Young people food, and clothing; physical health needs; case who become homeless may have had their education disrupted, for example through being management, counselling and other mental suspended or excluded from school (Quilgars et health services; and skill-building, vocational al., 2008). Particular population groups are also training and employment readiness (Thompson over-represented in the homeless population et al., 2006). While there is a lack of evidence and are at increased risk of homelessness, about the effectiveness of specific interventions including young people who have been in state with homeless young people (Altena et al., care and protection, young people of Aboriginal 2010), research has identified that young people and Torres Strait Islander descent, new arrivals themselves value service providers that listen to Australia, and refugee young people (Barker to them and are respectful, non-judgemental, et al., 2012; National Youth Commission, 2008). empathic, encouraging, caring, and appropriate to their needs (Darbyshire et al., 2006; de Winter Young people who become homeless or are and Noom, 2003). Young people have negative street-involved often have high support needs, views of services that are perceived to label or with coexisting emotional and behavioural issues, stigmatise them; that give only cursory attention, substance abuse, and physical health problems information or explanation; or where they lack (Cauce et al., 1994; Quilgars et al., 2008). They personal control (Darbyshire et al., 2006). are at high risk of developing negative health, social, and economic outcomes in addition to While outreach activities are recognised as the problems that initially led to homelessness a first step in connecting young people who (Barker et al., 2012). These include susceptibility are on the street to interventions to help them to substance abuse and dependence, mental avoid or minimise these risks, engaging and health problems, medical problems, violence maintaining a quality relationship is central to as perpetrators and victims, dealing drugs, providing effective services (Barker et al., 2012; stealing, exploitative and/or unsafe sex work, risky Connolly and Joly, 2012; Farrow et al., 1992). sexual behaviour, sexually transmitted infections, Trusting and respectful relationships with service malnutrition, and disengagement from traditional providers are highlighted in literature as being of social institutions and forms of support including particular importance to young homeless people family, school and community groups (Altena et whose past experiences may cause lack of trust al., 2010; Barker et al., 2012; Connolly and Joly, in other people and services (Barker et al., 2012; 2012; Quilgars et al., 2008). Homeless and street- Connolly and Joly, 2012). Receiving thorough involved young people experience high rates information about services is also important of trauma and Post Traumatic Stress Disorder (Connolly and Joly, 2012). In addition, young as a result of both events before leaving home homeless or street-involved people also need and events on the streets, as well as depression, services that respond to the high incidence of anxiety, and other mental health issues (Bender et trauma in their lives (McKenzie-Mohr et al., 2012; al., 2013). Robinson, 2005).
Social Policy Research Centre Report 36 Report on the Model of the Inner City Youth at Risk Project There are multiple barriers to service utilisation experience frustration in being referred from by young homeless or street-involved people service to service, trying to navigate the varying (Rachlis et al., 2009). Traditional services may approaches of different providers, dealing with be unable or unwilling to address their needs bureaucracy, and having to retell their story (Cauce et al., 1994), and young people may and fill in forms with multiple service providers lack knowledge of services or be distrustful of (Cameron, 2009; Keys et al., 2004). While services and authority figures, particularly if they young people may initially find it difficult to tell have experienced abusive behaviour from adults their story to a stranger, they may establish the (Thompson et al., 2006). Rigid or unrealistic foundations of trust with the first interaction, service rules also create barriers, for example but find it more difficult to retell their story rules that impose rigid curfews regardless of (Darbyshire et al., 2006). Homeless young the circumstance, such as an evening job, or people may not persevere in the face of these prohibit young people from returning to their obstacles (Cameron, 2009). accommodation after smoking or drinking Where young people do use uncoordinated (Garrett et al., 2008; Keys et al., 2004). services, this results in piecemeal interventions Similarly, staff attitudes that are experienced where the total context of their situation may as disrespectful or ignorant, for example staff be overlooked (Kurtz et al., 1991). Addressing who do not understand the difficulty of keeping one area of need in isolation from other needs important documents while homeless or who is not as effective as an intervention that view young homeless people as troublemakers, addresses multiple overlapping needs (Barker constitute barriers to service use (Darbyshire et al., 2012). Fragmented service provision et al., 2006; Garrett et al., 2008). Exclusion or with referral from one service to another is an expulsion of young people from services as a obstacle to young people developing trusting result of a range of factors including mental relationships with service providers, and feeling illness or behaviour may prevent service use, as that they have been listened to, and that they may services’ location, waiting lists, operating matter (Darbyshire et al., 2006). Fragmented hours, maximum capacity and age restrictions service provision is more likely to be associated (Garrett et al., 2008; Ombudsman, 2004). For with cursory rather than holistic assistance example, research with young homeless people (Darbyshire et al., 2006). in inner city Sydney in 2002 found widespread service exclusions on the basis of high Research about young homeless people in substance abuse or mental illness (Robinson, inner-city Sydney that was conducted prior to the 2002). establishment of ICYAR noted that: The chaotic nature of young people’s lives and 8.4 Service fragmentation: a barrier their often multiple needs usually mean that to service utilisation young people circle between services, at times healthy, at other times seriously at risk. So for A key barrier to service utilisation by young young people drawn to the inner-city, aside from people who are homeless is the fragmented the central mental and physical health, emotional or siloed nature of the community services and legal issues they face, trying to coordinate sector, that is, where services are often offered help and prioritise their needs often leads them by separate groups in an uncoordinated way to feel overwhelmed, particularly in a context in (Barker et al., 2012; Cameron, 2009). A lack of which further complications and problems arise coordination between services is also a barrier daily (Robinson, 2002: 8). to addressing the concurrent, multiple, and complex needs of young homeless people (Australia’s Homeless Youth, 2008; Barker et 8.5 The potential of multi-agency al., 2012). Young people may rotate between working to address fragmentation services (Robinson, 2002), or be passed Multi-agency working is widely suggested between services, and miss out on receiving as a way of addressing the problems of lack services because no agency takes responsibility of coordination and obstacles to effective (Cameron, 2009; Friedman, 1986). They may engagement and service provision, including
Social Policy Research Centre Report 37 Report on the Model of the Inner City Youth at Risk Project for young homeless people (Atkinson et al., 2007; Barker et al., 2012; Darbyshire et al., 8.6 Models of integrated services for 2006; National Youth Commission, 2008; young people at risk of Phillips et al., 2011). Indeed, increasing homelessness cross-agency collaboration is central to both Service models which offer place-based co- the Commonwealth and NSW government located services for young people are one approaches to homelessness (Australian approach to service integration that has been Government, 2008; NSW Government, 2009) found to be successful: these include youth although integration is not as coherently set out hubs or one-stop-shops, located in schools or in Australian policies on young people (Bond, other central locations, and offering a community 2010). Multi-agency working may include ‘joined access point for a range of programs, services, up working, partnership working, multi, cross and activities for young people in a particular and inter-agency working, multi-professional area (Bond, 2010; Deakin, 2013). In the United and multi-disciplinary working, integration, Kingdom and the United States, programs such networking, collaboration and coordination’ as the UK’s Extended Schools and Aiming (valentine and Hilferty, 2012: 3), and may range High policies and the US full-service schools from minimal cooperative relationships through and Wraparound models have been developed to active collaboration (Flatau et al., 2013; to deliver more integrated services to young valentine and Hilferty, 2012). people (Beek and Gilmour, 2000). Some of Generally, managers feel integration is these projects are specifically targeted to worthwhile. Although there are some costs young people who are homeless or at risk of involved in collaborating, it enables their service homelessness. These include the Frontyard to have greater impact than it could on its own, model of collocated services in Melbourne and to better meet the needs of clients (Flatau et (Cameron, 2009; Konrad, 1996), and foyer al., 2013). As well as offering benefits for service models that provide housing and integrated providers and systems, service integration services to young people (Bond, 2010). In the also offers benefits to clients as it creates a US, The Door (The Door, 2013) in New York was more seamless system of care and support for created to demonstrate the effectiveness of meeting their needs (Flatau et al., 2013; Konrad, providing comprehensive, integrated services 1996). under one roof to young people, including to young ‘homeless and runaway’ people. It is argued that young people who become In the UK, Centrepoint (Centrepoint Soho, homeless or street-involved need integrated 2013) is an example of a different model, and intensive services because of their multiple where a single large organisation is able to and high needs (Cauce et al., 1994; Kurtz et provide and coordinate a range of different al., 1991). Local cross-sectoral communities services from multiple sites to young people. of services have been suggested to support Centrepoint services include short to longer collaboration and co-ordination at a community stay accommodation services, floating support, level (Australia’s Homeless Youth, 2008). a dedicated health team, and education and Similarly, it has been suggested that service training programs. providers need to develop connections with each other, and with institutions in the broader Internationally, there are, however, only a community, in order to create a web of support small number of examples of services for for young people who are homeless (Wilks et al., young homeless people where joint working 2008). is provided using a model that uses the same service model as ICYAR: where a number of different organisations collaborate in order to provide seamless services. London Youth Gateway (London Youth Gateway, 2013) is funded by London Councils to offer pan-London services to young people in housing need. It involves a partnership between four established providers of services to young people to
Social Policy Research Centre Report 38 Report on the Model of the Inner City Youth at Risk Project provide accommodation advice and support, Joint working is a means, not an end (Phillips homelessness prevention, education, training et al., 2011). Some barriers are systemic or and employment, and emotional and physical entrenched and could only be resolved by wellbeing services. policy responses rather than changed working arrangements by services (valentine and Hilferty, 2012). Furthermore, problems in areas other 8.7 Barriers and facilitators to than joint working, such as service quality and effective integrated service program design, impact on outcomes, and the delivery imperative to resolve fragmentation may obscure Despite the evidence of poor outcomes caused the benefits of specialisation and professional by fragmentation, and although some literature autonomy and the complex tensions between does identify benefits for service users (Kennedy service roles of surveillance (such as mandatory et al., 2001), joint working is not necessarily reporting) and support (valentine and Hilferty, a simple remedy for these problems, and the 2012). While joint working is intended to assist literature does not overall demonstrate that joint with building trust, the blurring of surveillance working results in better outcomes for people and support roles may undermine trust. using services (Atkinson et al., 2007; valentine There is some evidence available about factors and Hilferty, 2012).Even where integration that enable successful joint working (Phillips et is increased, clients still report barriers to al., 2011). In particular, the literature highlights accessing services, suggesting that further work the importance of strong leadership and a clear is required (Flatau et al., 2013). mission, with these factors carrying more weight Problems with joint working may include: poor than structural or administrative arrangements communication and exchange of information (Corbett and Noyes, 2004; Jones et al., 2007). within and between services; ambiguity of Successful models have been found to have role demarcation and responsibility between emerged as a result of local initiative and services; failure to provide additional resources leadership (Corbett and Noyes, 2004). to support joint working; staff turnover and Australian research lists trust and commitment; training; challenges in maintaining program planning, monitoring and evaluation; allocation fidelity; challenges in achieving a balance of responsibility; multi-level interventions; between mandated and voluntary participation; shared infrastructure; and adequate time and and compliance with new systems and resources for change management as important structures (valentine and Hilferty, 2012). In factors in success of joint working (Jones et al., particular, the costs and difficulties of joint 2007). In addition there is evidence that good working in terms of financial resources, time, choice of both formal and informal integration expertise, role clarity, and scrutiny are frequently strategies and tools to suit the particular context underestimated (Phillips et al., 2011; valentine and goals are important (Phillips et al., 2011). and Hilferty, 2012). Even in service systems Similarly, international research suggests where joint working was judged to be effective, enablers of joint working are committed staff, issues such as resource constraints and lack of good working relationships, role demarcation, understanding of each service’s role continued trust, communication, a clear demand, common to present challenges, and some young understandings, shared aims and goals, people still fell between the gaps in service expertise, the availability of funding, adequate responsibility (Quilgars et al., 2008). Further, staff and time, senior political support, a flexible integration projects are reportedly difficult to and reflexive approach, and being developed sustain and replicate (Corbett and Noyes, 2004). at an operational rather than a policy level The use of ‘market mechanisms’ and fostering (Atkinson et al., 2007; Kennedy et al., 2001). of competition within the public sector have also been argued to limit interagency working and collaboration (Kennedy et al., 2001).
Social Policy Research Centre Report 39 Report on the Model of the Inner City Youth at Risk Project integrated service delivery, internationally, 8.8 Key findings and implications of there are few services for young homeless the literature review people that use the same service model as There are several implications for service ICYAR. delivery models from the literature review: • Multi-agency working is widely suggested Findings relating to young people as a way of addressing problems of lack of coordination and obstacles to effective • Young people who are homeless or street- engagement and service provision, but it is involved often have high support needs , not necessarily a simple remedy for these with coexisting emotional and behavioural problems and joint working does not always issues, substance abuse, and physical health lead to better outcomes for people using problems. services. • Young people may be at risk as a result of • In order to deliver services effectively, interacting issues such as family breakdown integrated service models need to address (conflict, neglect, violence, and abuse), the factors that can cause problems with mental health issues, unemployment, poverty, joint working, such as poor communication alcohol and other drug issues, crime and and information exchange, ambiguity of role other socio-economic disadvantage. In order demarcation and responsibility between to make an impact on their housing and other services, failure to provide additional outcomes, services may need to address resources to support joint working, staff each of these issues. turnover and training issues, program fidelity • Young people will not receive adequate challenges, and compliance assistance if service provision is fragmented, inaccessible, or gives only cursory help. Findings relating to service delivery: • Although many service models aim for
Social Policy Research Centre Report 40 Report on the Model of the Inner City Youth at Risk Project 9. References
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