SAMHSA Homelesss Abstract
The applicant is applying for a "General "Treatment for Homeless-Services in Supportive Housing grant to develop and operate an Integrated Service Network (ISN) to engage individuals prior to release from the NYC Rikers Island Correctional facility, with a focus on assessment and referral for integrated treatment of co-occurring disorders (COD). Population to Be Served: The project will serve 50 individuals in the first year, with 80 individuals served annually afterward for a total of 370. The population is characterized as chronically homeless and serially inebriated African-American and Hispanic adults with SUD and co-occurring mental health problems (COD), including trauma and co-morbid medical problems, recently released from Rikers Island. The population will be representative of the overall Rikers population in that seventy-five percent will have been convicted of drug-related offenses and 25% percent will have been treated for a mental disorder. Ninety percent will lack a high school diploma or equivalent (DOHMH, 2007), and 75% will return to incarceration within a year (DOHMH, 2007) without intervention. Interventions: Both comprehensive case management and health navigation services will available via a "New York Model" decision matrix which will categorize individuals based on their separate co-morbid disorder severities and match them to the appropriate type and intensity of services. This model optimizes treatment decisions across multiple systems by clustering needs and COD services, then finding the fit between the client's housing need and each provider's housing resources. This total wellness service system will be coordinated by a comprehensive case management (CCM) team staffed and supervised by peers, and will include other interventions such as IDDT, WSM, Health Literacy, and SPECTRUM and RESPECT protocols. Affiliated Agencies: This project will be supported by the existing service delivery systems of the quadrant providers, including the applicant. Performance Assessment: Under the guidance of SAE’s evaluator the applicant will collect and report on the required performance measures, specifically the GPRA. Particular attention will given to understanding the needs of those served by the system; identifying and defining measures of success; enacting potential change strategies; planning, collecting, and using the data; and, testing and refining changes.