Moderator: Jane Tobler
February 23‚ 2011
2:00 pm CT

Coordinator: Welcome and thank you for standing by. At this time all participants are in a listen-only mode until the question and answer session. Today’s conference is being recorded. If you have any objections you may disconnect at this time.

The Power Point presentation PDF version‚ the audio recording of the teleconference and a written transcript will be posted to the SAMHSA ADS Center Web site at www.promoteacceptance.samhsa.gov.

A presentation today will take place during the first hour and will be followed by a 30 minute question and answer session at which time you may press star 1 to ask a question.

I would now like to turn the call over to Jane Tobler. Thank you‚ you may begin.

Jane Tobler: Hello and welcome to Housing‚ Homelessness‚ and Social Inclusion: Essential Elements of Healthy Communities.

Today’s teleconference is sponsored by the Substance Abuse and Mental Health Services Administration’s ADS Center‚ also known as the SAMHSA Resource Center to Promote Acceptance‚ Dignity‚ and Social Inclusion Associated with Mental Health.

SAMHSA is the lead federal agency on mental health and substance abuse and is located in the U.S. Department of Health and Human Services.

The SAMHSA ADS Center promotes social inclusion and counteracts prejudice and discrimination by providing information and technical assistance to individuals and organizations looking to start‚ enhance‚ or become involved with social inclusion programs.

The views expressed in this teleconference do not necessarily represent the views‚ policies‚ and positions of the Center for Mental Health Services‚ the Substance Abuse and Mental Health Services Administration‚ or the U.S. Department of Health and Human Services.

Stable housing is an essential human need and is a key social determinant of both health and mental health. In the United States‚ an estimated 671‚869 people experience homelessness on any given night.

Today we have three experts who will look at civil rights issues and recent precedent setting court ruling that ensure appropriate housing choices are available‚ discuss current trends and practices in the field‚ and help us understand how a social inclusion framework is essential to developing programs and supporting people as they reenter life in the community.

As a staff attorney in the 1980s and the 1990s at the David L. Bazelon Center for Mental Health Law‚ Bonnie Milstein led the Consortium for Citizens with Disabilities Housing task force in amicus brief to the Supreme Court and pursued administrative advocacy with the Federal Department of Justice‚ Housing and Urban Development‚ Labor and Education.

She successfully pressed for the inclusion of people with mental disabilities in the drafting and passage of the Fair Housing Amendment Act of 1988‚ the ADA‚ and the Civil Rights Restoration Act.

Bonnie now serves as the Director of Housing Policy at the Bazelon Center. We welcome Bonnie who will address that being able to make choices about housing‚ school‚ and work is not a luxury‚ but a right that the Civil Rights laws guarantee to individuals with disabilities. Welcome Bonnie.

Bonnie Milstein: Thank you Jane and hello everyone. I’m very happy to be here. Now all I need to do is figure out to get to the next slide. There we go…okay.

So in the next 20 minutes it’s my task to give you the highlights of the Civil Rights laws as they apply to people with disabilities the Americans with Disabilities Act‚ the Fair Housing Act‚ and the Supreme Court decision in Olmstead versus L.C. And then I’ll wrap up with disability rights again‚ and how they differ from traditional civil rights.

So to start‚ disability rights’ principles apply no matter what the protected class. That is‚ our civil rights laws like international‚ human rights laws are based on the principle that everyone has the right to make her own decisions about her life and not have other people make decisions about her.

Unfortunately‚ society often makes decisions about individuals based on their race; on their color‚ on their gender‚ on their disability; whether they have a visible disability or an invisible disability.

One of the - there have actually been demonstrations by people with disabilities through the centuries. They are not particularly well documented.

One of the demonstrations that has been documented was a returning World War I veteran who marched through Washington complaining that they were not able to get jobs after they had fought in the First World War.

They were denied jobs because the prevailing attitude was that if you limped or if you were missing an arm or if you were blind then your focus should be on your disability and taking care of your health and it shouldn’t be on whether you had a job or went to school or got married and had children or had friends even.

So that started changing radically in the beginning of the ‘60s — the middle ‘60s — when the Civil Rights movement really took off.

And in the beginning of the ‘70s we had our first disability rights law that prohibited any entity - any police department or school receiving any federal financial assistance from discriminating against an individual in the delivery of benefits or services to that individual because that disability - because that person had a disability.

And from the very beginning people with mental disabilities were included at the same level as people with physical disabilities.

One of the critical elements in the disability rights movement was the participation in the movement by people with disabilities who were very clear about taking charge of their own lives‚ and so one of the first changes that we saw as a country was a change in language and no longer referring to people with disabilities as disabled people‚ but rather people who had personalities and a variety of elements to their personalities and their lives‚ which included their having a disability.

Often when — and this is still true — parents and siblings and providers look at people with disabilities and are concerned mostly about their safety; that they not get hurt.

Well this too changed with the civil rights actions and laws so that people with disabilities started talking about the dignity of risk; the dignity of being able to make your own decisions and accept the risk - accept the possibility of earning a degree in school and possibly getting hurt while going about it‚ but deciding for themselves that that’s what they wanted to do.

A world famous religious leader was asked why she didn’t ramp her healthcare facilities and her answer was‚ a couple of decades ago‚ was that it was a blessing to carry cripples.

And it’s that kind of attitude‚ as well-meaning as it might be that led people with disabilities to invoke the mantra‚ “Nothing about us without us. Don’t make our decisions for us.”

In 1999 — I’m sorry‚ okay — so in 1999 the Supreme Court decided the first decision under the - or the first case that was filed under the Americans with Disabilities Act was filed with the Supreme Court.

Let me just back up a second to say that in 1990‚ the Congress enacted the Americans with Disabilities Act. And one of the principles in the ADA which is probably the most well-known disability rights law in the world — certainly in this country — one of its primary provisions is as this slide says‚ “A public entity shall administer services‚ programs‚ and activities in the most integrated settings appropriate to the needs of qualified individuals with disabilities.”

So nine years later the Supreme Court decided Olmstead versus L.C. and E.W. L.C. and E.W. are the initials of two women who have mental illness and developmental disabilities who voluntarily signed themselves into a state mental hospital in Georgia because they decided that they needed the care that the hospital could provide them.

After spending a year in the hospital they and their healthcare team decided that they were ready to move back to their community. But because there were no appropriate housing facilities or services in the community for these two women‚ they stayed in the mental hospital.

So after being there for a year voluntarily‚ they ended up staying there for years involuntarily because of the absence of housing and services in the community.

Their lawyers filed lawsuits that reached the Supreme Court saying that once the ADA was enacted‚ that states could not keep people institutionalized if the states had programs and subsidized housing in the community‚ and were not releasing people they were keeping in institutions to the community.

And the Supreme Court agreed and required that Georgia immediately develop a discharge plan that would move people at a reasonable rate into housing and in the community where they would be provided services to help them with their recovery and enable them to continue their lives.

As a result of the Supreme Court’s decision in Olmstead in 1999‚ many things have happened. Lawyers have filed Olmstead lawsuits against board and care homes in New York‚ successfully arguing that the board and care homes which are funded by New York State has people with mental illness who either were in mental hospitals or who otherwise would have been in mental hospitals‚ have now grown so large that they house hundreds of people.

They are not mom/pop operations of‚ you know‚ half a dozen or eight people‚ but hundreds of people and they’re run like institutions. So people are forced to get up at six in the morning and forced to eat at specific times and not allowed outside the building without permission.

In Connecticut an Olmstead suit was filed because of nursing home institutionalization.

In New Jersey‚ the State has five mental hospitals and the suit there has been requiring the State to step up its plan to release people into the community in appropriate housing with appropriate services.

The Justice Department’s suit in Georgia again‚ even though the original Olmstead lawsuit was brought in Georgia and the Justice Department achieved a remarkable settlement decree that requires Georgia to create 9000 units of affordable housing for people who are currently in institutions.

In Illinois‚ the lawsuit has to do with institutions of mental disease. And in California there have been a number of Olmstead lawsuits‚ including one against a nursing home in San Francisco that housed both seniors and non-elders with disabilities.

In fact in every state nursing homes house non-elderly people with disabilities because our Medicaid programs still guarantees funding for healthcare services inside nursing homes‚ but does not guarantee services in the community. That’s probably the topic for another Webinar.

But California is important for another reason and that is that shortly after the ADA was enacted‚ it like every state enacted Olmstead plans — Olmstead state plans — in which the state accepted it’s knowledge and adopted plans to reduce the population of peoples in institutions because of their disability rights guaranteed by the Americans with Disabilities Act and the Constitution‚ and to start fulfilling the need for affordable housing and supportive services in the community.

The states have had various degrees of success‚ and in spite of the serious budget crunch that the country is in‚ in New Jersey for example the current Republican governor has promised to continue fully funding the implementation of the Olmstead lawsuit there.

In all of the states‚ Democrat and Republic administrations have recognized that providing services and housing in the community is less expensive than running large institutions; paying for the buildings‚ the maintenance of the buildings‚ the staff necessary not to provide care but to keep the buildings going.

And with an adequate supply of housing and services in the community which we do not currently have‚ the rate of emergency room and hospital use has dropped everywhere.

Finally‚ one thing to say about the Americans with Disabilities Act is that it does not cover most housing situations. For that‚ the Fair Housing Act is the law that applies. It was passed by Congress originally in 1968‚ but it was amended in 1988 to include people with disabilities.

And as a result of the Fair Housing Act people with mental and physical disabilities have successfully acquired housing. More physically accessible housing has been built. More housing with no pet rules have learned about the Fair Housing Act and are now allowing companion animals and service animals.

And everyone is learning that having a disability may mean special protection by the civil rights laws — by the disability rights laws — but ultimately in housing everyone has to comply with the lease.

I was asked to put together some resources and so we have a couple of pages of resources. I will just briefly tell you that I selected the ones that I refer to often.

There are of course‚ many resources on the Americans with Disabilities Act and on Olmstead. I just list a couple. I bring your attention to the third bullet which refers to the Justice Department’s recent American with Disabilities Act regulations.

And in the next slide‚ one other document — the second bullet — refers to a question and answer document that the Departments of Housing and Urban Development and the Justice Department collaborated on and it continues to be one of the best explanations of reasonable accommodations that exist.

Reasonable accommodations is of course a critical element of all of the disability rights laws because it is simply not enough to say as it would be for race discriminations. We are not going to discriminate on the basis of disability‚ you can participate the same as anyone else.

For people with disabilities who might have psychiatric disabilities or who have mobility impairments‚ the provider has to provide more; has to provide a reasonable accommodation that will ramp‚ a step‚ or change the time of the exam or provide whatever kind of accommodations the requestor and the provider agree on in order for the civil rights laws to be implemented.

I’ll turn this Webinar back to Jane.

Jane Tobler: Thank you Bonnie. That was an excellent overview of housing choices and civil rights.

Our next presenter is Livia Davis‚ the Project Director for the SAMHSA Services in Support of Housing Technical Assistance Center at the Center for Social Innovation.

Prior to joining the Center‚ Livia had 14 years experience developing and operating homeless services and housing programs.

She grew up on her great-grandfather’s 300 acre farm in Denmark where up to 125 people who experienced homelessness could live‚ work‚ and belong to a community.

This gave her firsthand experience of a model that emphasized the social inclusion‚ consumer involvement‚ and supportive employment as the cornerstones for empowerment‚ and the development of independence for all who lived there.

Today Livia joins us to direct the central role of social inclusion‚ social connectedness‚ and social capital in homeless programs. Welcome Livia.

Livia Davis: Thank you so much Jane‚ and it’s a pleasure to be here. And I want to just briefly cover what I’ll be covering in my presentation which basically is all about answering the following questions.

Why should we care about social inclusion? What’s the difference between the concepts of social inclusion‚ social connectedness‚ and social capital? What are some of the challenges in addressing these needs? What are some strategies to build social connectedness‚ and what are some of the resources that are available?

So why should we care about social connectedness? Well we should care because as this slide indicates this quote; “The main reason homeless happens in someone’s life is due to not having a strong social network.”

Now there are many causes of homelessness that have been identified in the past that I know of and that we can probably all think of‚ and I knew that a lack of social support played a role‚ but I’m not sure that I thought it as a main cause of homelessness until more recently.

So if that’s the case it’s important that we consider this cause of homelessness if we want to develop a response to it; if we want to develop programs and strategies that effectively address homelessness.

If we want to do that then we need to consider the lack of social connectedness as a main cause.

Why else should we care? Well as this slide indicates‚ the availability of social resources is positively associated with recovery from stressful life events.

We can probably all think of stressful times in our lives when we needed a friend or social support or resources. So it certainly makes sense that an incredibly stressful life event like homelessness can also be overcome with social resources.

So as we are here today to talk about housing homelessness and social inclusion‚ it becomes important that we think about what social resources need to be made available to people to support them to overcome homelessness‚ and indeed all the many other stressful life events that often accompany that experience.

Lastly‚ we care — well there are other reasons — but we care because in order to exit homelessness‚ relationships‚ social networks are central importance as demonstrated through research.

This side — this slide‚ I’m sorry — compliments the previous two slides‚ but the emphasis is slightly different in that it indicates to us the importance of building relationships as a key strategy to overcome homelessness.

So we care for three reasons. We care because the lack of social support really is the main reason for homelessness. In order to recover from stressful life events we need social supports and social resources.

And in order to exit homelessness once and for all‚ relationships play a key role as they are centrally important.

Okay‚ so now what I will do‚ I’ll talk a little bit about the difference between some of the terms.

Social connectedness refers to the extent to which we feel connected to our community‚ and it’s very subjective. I might feel connected to my community because I’m a member of a book club and I have a good relationship with my neighbors‚ and with my mechanic.

You might feel connected because you live in housing that has a tenant council that is very active or that you’re engaged as a volunteer at an animal shelter and you have friends you can go to the movies with once a month.

So if we were to develop strategies to increase social connectedness‚ we need to remember that it’s not something that can be described or dictated by another person. Indeed‚ it’s subjective and we need to just be aware of that as we look to support this.

Social capital on the other hand refers to the collective value of all the social networks that we are part of. Those social networks‚ what we’re willing to do for each other in those networks‚ is what social capital is all about.

A quick example from my own life is that I know my neighbors pretty well and we are very willing to help each other to take care of our pets while we are on vacation.

So that network has some social capital for all of us. There is something of value that we give to each other. It’s reciprocal. There’s interdependence there.

To further clarify the concept of social capital I have included this example from a research article. The question on the slide is‚ “Which social network has greater social capital to Duane?”

Duane‚ a father of two is made homeless in a fire and he was living in a homeless shelter. He expressed interest in completing college to find a better job.

The agency working with the homeless shelter tried to connect him to the local welfare-to-work program to assist him in meeting the goal. However‚ Duane believed his family and friends that the program lacked allowances for childcare; although it did not‚ and refused the agency’s advice‚ potentially loosing an avenue to a better quality of life.

Some relationships - some of our networks carry greater social capital than others. In this example Duane’s relationship with friends and family carried greater weight than agency staff.

It’s important to pay attention to the level of social capital various networks and relationships have in your life because they influence the decisions you make. And if you are trying to make transitions or if you’re supporting people who are then you need to pay attention to the level of social capital.

Okay oops‚ sorry‚ I need to go back one.

Social inclusion is the last term that I’ll just briefly describe. Social inclusion refers to the process which communities use to make it possible for people — all people — to participate in key activities for society.

It’s about making sure that everybody is welcome‚ that anybody who is on the outside‚ quote‚ unquote‚ or on a fringe‚ that they are welcome; that they deserve the community’s full support.

It’s about making sure that you intentionally try to ensure that everybody can participate in key activities of society.

Now in recent years the Substance Abuse and Mental Health Administration has convened two panels to provide input on how to further the understanding and adoption of the concept of social inclusion in the U.S.

And I know that a report is being developed and it’s not yet available‚ based on the panels and some other research‚ but I certainly encourage you to be on the lookout for that.

Okay‚ so I’m going to switch gears just a little bit and I’m going to talk about some of the challenges.

As we discussed earlier‚ people who have experienced homelessness they often lack social support so they need some support and assistance to re-link to other people if that’s what they want to do and they want to be part of their communities or have networks.

This slide indicates that it’s important to be proactive in supporting people; to re-link to other people as they move into housing.

So much of the focus now is on getting people into housing which is so important. But I think it’s really important to remember that it’s equally important to focus on the development of social connectedness.

Now in talking to some of the providers and programs in the field‚ they’ve shared that they don’t feel that they are always proactive enough in responding to social isolation or even how best to go about that.

Some of them are still grappling with the question of whether clinical staff should support people to re-link to others‚ or whether how they can support consumers to address this themselves and connect to community agencies that may support them.

So some of the questions you might want to ask yourselves right now are; is social connectedness something that you talk about to anybody? Do you think about how you can build relationships to avoid social isolation?

Who do you think would be good partners of people to help you re-link or think about how to do this?

The other challenge is that homeless service providers often become the de-facto community for many consumers when they first enter into housing. And although that’s acceptable as a starting point‚ the ultimate goal of course is to expand those networks and make sure that consumers are able to move in to community agencies and networks.

And we’ve heard from some providers that‚ you know‚ yes it is true that often they become a community of sorts to consumers when they first move into housing‚ and they grapple with how best to support consumers to re-link to a community.

What are some of the practices and strategies in evidence-based practices that are available? Well‚ there aren’t a lot of evidence-based practices that specifically address social isolation‚ but one of the few ones that we know of is the Critical Time Intervention‚ although there are others such as housing first and motivational interviewing that also gets at combating social isolation.

So Critical Time Intervention is a time limited based intervention in which case managers’ work with persons who are newly housed.

It was originally designed to help people transition from institutions to community living‚ but now it’s broadened to include other types of transitions whether it’s from the street to housing or from one level of housing to another one.

It is time limited; it’s nine months. And that’s why it’s important if you want to look at using this model‚ that you can consider that or that you may have to adapt some of the models.

The goal during Critical Time Intervention is to connect the consumer to informal supports as well as formal supports and to make sure that those formal/informal supports form a larger network that’s available to the consumer once CTI is over — Critical Time Intervention.

Now CTI as a model focuses on the establishment of a relationship between a consumer and provider where things other than the person’s illness are of central importance.

That is‚ as a reciprocal relationship with emotional investment greater than most usual provider consumer relationships‚ that’s key. And it’s also about building on that foundation to set up comparable relationships in the community.

I also want to share a few strategies from the field that we have learned about as we have worked with programs around the country.

Community Connections in Washington‚ DC is — provides a lot of different services and also housing. And one of the things they do is — for their program where they have people who’ve experienced chronic homelessness move into permanent supportive housing is they make sure that those tenants move in to buildings where the housing units are all part of one building and one cluster so to speak. And then they make sure that each of those buildings have tenant councils.

Now the tenant councils have a very active role in the development of sense of pride and ownership in the building and also they are very involved with making sure that there are recreational opportunities.

And they’re very involved with the interview process for new tenants moving in and to help orient new tenants so that they feel part of the community and know where to go to get the bus and so forth.

So that’s one way to build social connectedness that Community Connections has worked out.

Project Renewal is in the Bronx in New York City. And what they did is they have people who are living in permanent housing‚ permanent supportive housing in scattered site units which means that there are lots of different buildings with different units in each building.

And so what they found that the one place where everybody would come sooner or later would be the program office where staff would have their offices and where consumers would come once in a while.

And so what they did is they remodeled their office and expanded it to include two previous apartments so that it could have a kitchen; it had a dining room‚ and it had a place to really be where people could enjoy each other’s company.

And so they took physical space and remodeled it in order to build a platform for social connectedness to take place.

And Cook Inlet Housing Authority in Alaska — they’re in Anchorage — they serve American Indians and American Alaskan - I’m sorry‚ Alaskan natives. And what they found in their program there is that it’s very‚ very important if you are to help people to recover‚ to make sure that they have a sense of connecting to their culture if they want to do that.

And because a lot of Alaskan natives share a common culture‚ reconnecting them or re-linking them with those cultural resources or their elders or recreational activities or cultural activities have become very important.

It is for their program and they integrate it into the service and support they provide.

And I know from some of the outcomes they have around social connectedness that they have very high outcomes; very good outcomes with regards to how socially connected that their participants feel.

I also want to talk just about two programs that use a farm community model. Because a farm community; I think most of us have a sense that‚ you know‚ that there’s a real need for everybody to contribute when you work on a farm and you live on a farm.

You have to take care of animals and livestock and you also have to take care of plants and each other. And so two programs that we know of that are use farm community model is Moltrup in Denmark‚ and Green Oak Ranch Ministries in California.

Now in Denmark it is a 300 acre farm. And when you come there you can stay there for one week and you can stay there for the rest of your life. There’s an independence that’s at the core of this model that which also results in a feeling of social inclusion and social connectedness.

Your contributions are necessary; they’re needed‚ they’re valued‚ they matter and they’re recognized. You become part of something that’s bigger than yourself. There’s a rhythm to living on the farm‚ both in daily activities and the changing of the seasons.

There are animals and plants that depend on you to survive‚ so there’s a real sense of interconnectedness that really helps to build independence.

Also they have a lot of different social enterprises that people work in so it’s not just farm activities. And indeed there are about 4000 people that come and visit the place each year because it’s very beautiful and it’s very big.

And what they do there is they’re basically tour guides and they sell their food there in secondhand shops.

The other one is in California and its Green Oak Ranch Ministries. And what they do is they - people agree to live there for a minimum of nine months and it’s the same thing. They have a big emphasis on making sure that everybody contributes to the operation and upkeep of the farm. And indeed without the contributions it would not be able to survive.

And they also are very active in the social premise enterprises including an RV park and a camp; a conference center‚ a retreat center‚ and it’s all about making sure that there’s independence in working side-by-side with each other and with staff‚ all in one community.

Okay‚ I’ve got to go back just one slide - oh sorry‚ too fast here. I’ll let you do it.

Lastly I want to talk about Housing First Assertive Community Treatment. When you combine Housing First models and Assertive Community Treatment models it integrates permanent housing with supportive services.

Now in a 2010 study by Dorieke Wewerinke who is from Amsterdam titled‚ “The Strength of Supportive Networks in the Struggle against Social Exclusion‚” the author looks at Housing First services on the social position of the chronically homeless‚ and she did a research at the Homeless Outreach and Stabilization Team in Alameda County in California.

And‚ you know‚ ACT Teams - Assertive Community Treatment teams are mostly just for the teams that provide the majority of services in community where Housing First tenants live.

In ACT team they often include a psychiatrist‚ nurse‚ case manager‚ employment or benefits specialist‚ peer specialist‚ and substance treatment specialists. They all share equal responsibility to care for all of the team’s clients.

So Housing First is a model that rather than moving people through different levels of housing‚ whereby each level moves them closer to independent housing if they are deemed‚ quote‚ unquote ready‚ instead moves the person directly from the streets or homeless shelters into their own apartments as a first step.

So to invest in their relationship with consumers whom the Homeless Outreach and Stabilization team refers to an approach as partners‚ staff assists partners in clarifying their post personal motivation for change and in determining their own goals for recovery.

Then ACT staff members show that they are willing to do whatever it takes to help partners in the achievement of their goals. Their whatever it takes approach is not merely practical support‚ but also emotional support and an emotional connection and investment.

That emotional investment means the development of a social network with the partner which then becomes the foundation to support partners to re-link or develop other social connectives in the community.

So online Critical Time Intervention which is a time limited intervention‚ Housing First ACT teams provide support in housing in an indefinite duration.

So this combination of models is another option for people to consider as they look to address social connectedness.

And‚ in the few minutes I have left I just want to just briefly go over some resources that I also thought would be helpful to people who want to dive in more about into this subject.

Again there are two pages‚ but I want to just on the last bullet here‚ there is an article by Padgett‚ Henwood‚ Abrams‚ and Drake and it really talks about the social relationships around persons who’ve experienced serious substance abuse and homelessness as it refers to implications for recovery.

And so I certainly encourage people to take advantage of that and learn some more about what does the research say about social connectedness and some of the practices and interventions.

And on the last slide‚ if you look down on the fourth bullet‚ it says Wewerinke‚ The Strength of Supportive networks in the Struggle Against Social Exclusion‚ so that’s the study that I just referred to where you can find out a lot about some of the strengths of Housing First enact models in addressing social isolation.

And then I again would certainly make sure that you look out for the report from SAMHSA when it comes out because I’m sure they’ll have a lot of good information as well.

And with that I’ll turn it back over to you‚ Jane.

Jane Tobler: Excellent Livia. Thank you so much for sharing that valuable information on the importance of social inclusive homeless programs as well as the great examples from the field.

Our final presenter today is Michael Kelly‚ a formerly homeless person who works with housing for New Hope’s Projects for Assistance in Transition from Homelessness Program or PATH as an outreach worker and certified peer support specialist.

Michael is a founding member of the National PATH Consumer Provider Network and he is proof that the continuum of care and supportive housing works.

In the last few months he picked up both his four years of clean time key tag and the keys to his new Habitat for Humanity home.

Michael shares his journey of recovering a full life with others to help them understand how homelessness can happen to anyone‚ and today to talk about the best way to go from spare change to real change. Welcome Michael.

Michael Kelly: Well thank you. Good afternoon everyone‚ my name is Michael Kelly and I’m a Certified Peer Support Specialist and Housing Support Specialist with Housing for New Hope in Durham‚ North Carolina.

I’d like to think that am proof that homelessness can happen to anyone‚ but I am also proof that anyone can recover their life with the proper assistance and support.

The real key is that the person has to really want to change the way they think and do things in order to recover. I had lost faith in the human race and felt like an outcast with no hope left.

I had disconnected from society and was living in a shelter that I’d built in the woods and did not even trust my homeless friends.

The PATH team planted seeds of hope in me by explaining that there was help available even for me. I am proof that the continuum of care in Durham‚ North Carolina is in place and does work well.

If you would like to read information about me and others like me‚ go to www.housingfornewhope.org and explore the site. They’ve been reworking the site so if you can’t get through‚ keep trying.

Housing for New Hope has a federally funded street outreach program called Projects for Assistance in Transition from Homelessness — or PATH for short — that reaches out to the local homeless population by going out into the woods looking for camps‚ under bridges‚ down alleyways‚ abandoned houses and other places looking for where homeless people sleep or just hang out.

PATH meets the homeless where they are. They first make friends with someone and try to form a bond of trust by helping with simple items like hygiene kits‚ food‚ clothing‚ and other simple needs.

PATH can help people get their identification or social security cards replaced if they have lost them. The PATH Outreach Team helps everyone understand that there is help available to them‚ linking the homeless to available services whenever they ask for assistance.

If they need emergency housing we are willing - and are willing to go the local homeless shelter or mission‚ PATH will help them get there.

PATH helps people find permanent housing whenever possible. They found me living in homemade shelter made out of sheets of plastic‚ tarps‚ two by fours‚ bamboo sticks and any other materials I could find‚ beside the railroad tracks just off Main Street here in Durham.

I was a chronic alcoholic and was suffering from depression and other drug use. I felt like an outcast from the real world and no one wanted me any more

I was at the point to where I felt like no one cared about me and I no longer cared about myself. I had no power or control over my life any longer and thought maybe drugs and alcohol would numb the misery of my life and ease the pain of my death.

I actually felt like I’d be better off dead and wondered what people would do with my dead body when they found it.

I can remember the first day I met Alphonso and (Reggie) from Housing for New Hope. I had lost any hopes of getting a real job and had no income other than begging for change.

I had tried to apply for partial disability because of my broken arm and I could not work‚ but I was told that I still had one good arm and didn’t qualify. I think they told me that because I looked like a homeless bum trying to apply for money instead of a productive citizen laid off from work due to an injury.

The fact remains that I was partially disabled with a broken wrist and unable to work. The doctors even signed papers for me and I was still turned down.

I didn’t like begging for change or we call it panhandling‚ because many people say rude things to you‚ but it was the only way I could get money for my cigarettes and beer. So I learned how to do it and I actually became very good at it.

I was panhandling at a local place and a Cadillac pulled up and two dudes got out wearing all this jewelry and I thought; cha-ching‚ here comes some money.

They didn’t go inside‚ they just came towards me and I put out my best‚ “Good morning” and figured I’d make some money giving out directions.

But they didn’t want directions‚ they just asked me my name and about my situation and where I was staying.

I got afraid they might be cops so I asked who they were and why they were being so nosey. I wasn’t bothering anybody.

They said they were Alphonso and Reggie and they worked for Housing for New Hope and they could help me get my life back together. There were places I could go and learn to live life the right way; get a job and start my life over again‚ but I had to stop drinking.

I told them that I’d been to the shelter and mission before and I didn’t like it there. I was fine right where I was at. Thanks but no thanks.

You see many people do not like confusion and chaos because of so many people at the shelter. That is why Housing First is so important because the confusion wreaks havoc on people with mental issues.

They asked me if me if I - they asked if they could come back and check on us every now and then and they wanted me to meet some lady called Dian. I said‚ “Whatever‚ it’s a free world. I can’t stop you.”

As they were leaving I asked them if they had any change to spare and Alphonso reached into his pocket and pulled out this huge wad of cash and held it up and said‚ “If it’s money you want I’ve got plenty of that. But the kind of change I have for you‚ you really have to want it‚” and smiled this big old smile of his and left. I’ll never forget that.

When Housing for New Hope - when the Housing for New Hope people found me they included me in my own process from the start because they asked me what I wanted to do about my situation.

They asked me what I thought I needed to do to get out of the woods and back to a normal life and how I thought they might be able to help me do it.

A normal life means having a job with a decent income and health benefits; a place to live and return to being a productive member of society.

I was being socially included from the very start through consumer involvement just by being asked those simple questions. I was encouraged to feel as if I still had some control over what I thought I had lost control over.

They were planting seeds of hope in my and returning regularly to water those seeds and nuture any sprouts of hopefulness I may show. They said they could help me regain control of my life and it could get better‚ but I had to want it for myself.

They explained to me that they thought the best process would be for me to go through detox and through a recovery program‚ but only I could make that decision and they could continue visiting with me in the woods until I decided for myself.

That is what I think is the most important part of Housing for New Hope’s PATH Outreach Program‚ the fact they use recovering people to outreach other homeless people.

We can relate so well with someone else because we have been there ourselves and we lead by example by showing others that if we can do it‚ anybody can.

The PATH team continued to outreach me and Dian Wilson began to visit with me for over a year before I got sick and almost died in the hospital.

Now there has been a lot of discussion about how getting homeless people into housing is more cost-effective and saves the taxpayers money.

My hospital bill totaled over $40‚000 for several stays without insurance. But someone had to pay that bill for me. Multiply that amount by the number of homeless people in your area; the expense of me being in supportive housing for four years‚ did not cost nearly that much.

Well I asked them to come and get me because I was ready to go to detox and begin trying to recover my life. Dian took me from the hospital to the local detox center.

Now a detox center is a place where someone that has been dependent on drugs or alcohol needs to go stay for their safety and welfare while their body cleanses out all the drugs and alcohol from their system.

A person can go into seizures or convulsions while their body detoxifies. Sometimes medical detoxification can be necessary because of someone’s body being so dependent on the substances they have been using.

After detox there were no immediate openings so I just stayed in transitional housing until I could enter into Phoenix House Program.

I entered the Phoenix House which is a one year program that offers job search assistance within 30 days. I would go out daily to apply for jobs and return at a certain time to discuss my progress.

We had daily house chores that gave us responsibility to the house‚ and weekly house meetings to discuss each other’s progress and issues so the other guys could offer suggestions and support to the new guy.

We were told that the guys that lived there were responsible for running the house‚ and that staff were only there to provide guidance. The staff had an office in the house so whenever I needed to talk to someone about something they were right there for me.

They encouraged us to make our own decisions and if we did the right thing for the right reasons‚ the next right thing will always come along.

The house motto was‚ “freedom through responsibility” which means that as we learned to be responsible in all areas of our lives‚ we will gain more freedom in those areas of our lives by being responsible.

I had a productive life before my downfall and now I had hope of regaining a meaningful life again.

I was happy to have a daily routine that was based on accomplishing daily goals. I never like my daily homeless routine but I had gotten used to it just to survive.

I was not proud of what I did to survive when I was homeless‚ and now I was proud of being able to change for the better. Transitional housing helped me to believe there are people that care about me and my place in life.

Housing for New Hope helped me begin to believe in humanity again‚ and believe in myself.

When I finally got a job I began paying 30% of my income for rent and was encouraged to save the rest for a nest egg when I graduated. There were weekly classes on proper nutrition‚ money management‚ and other life skills‚

We went to 12-Step meetings every day and were encouraged to get a sponsor. 12-Step meetings empower and teach people how to live life without drugs.

Sponsors are people who are further along in the recovery process. My sponsor offered his experience‚ strength‚ and hopes to support me‚ and was available to answer my questions.

You see when someone is recovering from substance abuse it’s a good thing to have someone to call at any hour to seek support and encouragement.

Each man would take a turn cooking supper for the residents to learn us how to cook nutritional meals. We would prepare meals for the homeless shelter once a month.

We would participate in community projects like the Crop Hunger Loss which is an annual event to raise funds to feed hungry all over the world and other fundraising events.

We were encouraged to think of our house and our brothers as our own little community that we were responsible for. And when we went out into the community we were representing the Phoenix House as a responsible part of that community.

As I went through the process or new guys came into the house‚ I was encouraged to help the new guys as much as I could as a mentor. We were taught that we were all brothers in our recovery and we should give back what was so freely given to us.

Dian would let me volunteer with her in the PATH program when she needed help doing certain things‚ but she would not let me go back into the streets doing outreach with her yet‚ because she wanted to make sure I’d been clean for a year first so I would not be put at any risk.

I did so well in the Phoenix House that when the Housing for New Hope finished building the second building in Andover Apartments‚ they allowed me to transition early from the Phoenix House into an apartment there to become the night watch. That was when I first began working for Housing for New Hope.

Andover Apartments is one of Housing for New Hope’s permanent supportive housing apartment complexes and has 20 affordable efficiency units. They are affordable housing that only charge 30% of your income for rent and utilities.

They want you to have a case manager to work with you while you live there‚ and a Wellness Recovery Action Plan or a WRAP Plan to ensure that you have the proper support.

The residents there have created their own tenant’s association. They have monthly resident’s meetings —resident’s meetings — with management to discuss resident’s progress‚ and for residents to speak with the staff about any issues they may have.

The property manager has an office in the complex so whenever I needed to talk to staff about something‚ they were right there for me.

They have regular life skills and money management classes there also. We have holiday functions including holiday meals and cookouts for tenants that have no family to visit and spend time with for the holiday.

Housing for New Hope tries to instill the feeling of being an important part of the community in every step of their programs.

As the night watchman I would walk around the property and through the hallways each night and call out that it was just me walking through. I was not trying to be security in that sense of the word‚ but more of a presence to help residents feel safe and secure.

I can remember standing one night and looking at the sculpture of the Aurora at Andover which is the sign of a new beginning‚ and thinking about how the Phoenix is a legendary bird.

I just stood there and thought‚ thank you God because I have been truly reborn from the ashes of my own destruction‚ just like the legend of the Phoenix‚ and I have a new beginning here at Andover.

Then I thought about all the other people that have the same opportunity and wondered if they felt the same as I do.

During my first year at Andover‚ Dian Wilson allowed me to start working as a peer specialist with her in the PATH Outreach Program because I had over one year of clean time.

And since the other homeless people in the area knew me when I was homeless‚ she thought it would be a good way to lead by example to go back out there and show my old friends that if I could do it anyone can.

I was now working three part-time jobs and still saving my money because I wanted to buy a car. Alphonso Williams was my case manager from the Phoenix House and he took me to the auto auction and helped me buy a good car for cash.

I then took the title to my car to my credit union and took out a small personal loan to help build my credit record. I had learned to do that from the credit counseling classes we had during my stay in the Phoenix House‚ and Alphonso encouraged me to do it to help build my credit.

Dian was aware I was working three part-time jobs and did not want me to become too stressed‚ so she spoke with Terry Hollabach and they decided to give me more hours working with Dian and the PATH Outreach team so I could leave my job at the nursing home and become a fulltime employee with Housing for New Hope.

The one thing I admire about Housing for New Hope is that they like to employ people that have experienced homelessness to help other homeless people‚ because we are the been there done that people that can relate so well with people we work with.

I also want to point out that the supervisors are the people that work with us‚ so they are aware of all of our stress factors. They will always ask how we are feeling and talk with us to make sure we are okay.

If we’re having a bad or stressful day they will tell us to go home; take time off to take care of ourselves.

Dallas Todd in the Phoenix House is the real key to recovery is to keep the focus on myself and my own recovery first.

Dian sent me to many different trainings. We went to conferences and I attended workshops to learn all I could about the work I was doing. We went to the Annual Homeless Conference in Washington‚ DC every year‚ and they invited me to go with them.

During this time was when I was asked if I’d like to share my story with others by doing some small speaking engagements. I was very excited to do it because I wanted people to know that homelessness can happen to anyone‚ and with the proper support anyone can recover to a better life than before.

I had been living at Andover for over two years and had been working on my credit‚ taking out small personal loans against the title of my car. I thought it was time to try to find my own home.

I wanted to move out of Andover so it would open up another spot for someone else to come in to the process of affordable supportive housing.

I had heard about Habitat for Humanity but didn’t know how it worked‚ so I asked my directors and they helped me find out who to talk to and I applied.

At first I was turned down because I had bad credit. I told them I’d been trying hard to fix my credit. The Habitat people explained that I had back unpaid child support that showed up on my credit report‚ and something like that will keep someone from getting approved.

I explained that I had been homeless and that’s what caused me to get behind‚ but I had been paying on my child support for over three years because I was in the Phoenix House and they taught me to be responsible and do things the right way.

The nice lady at Habitat referred me to the City of Durham Consumer Credit Counseling Service to get help with fixing this so I could get into a Habitat home.

I had to write a special letter to the Child Support Enforcement Agency to request that they review my payment history and report my payments to the Credit Bureau. Then I reapplied and Habitat accepted me and my process of becoming a homeowner began.

I attended homeowner training classes at the Durham Credit Counseling Service and went out to help build houses for Habitat every Saturday for about six months.

You see Habitat does not pay — make people pay a down payment for their homes; they do what is called sweat equity which is coming out and working on building homes for everyone.

Depending on how many people is in your family and how big a home you need‚ there is a certain amount of hours you have to work to earn your down payment.

Then when your home is built‚ all you have to do is pay the closing cost. That helps people like me that cannot save up a down payment find affordable home ownership.

I really enjoyed coming out and helping build houses because of the sense of community that helps build with the people. I met all of my new neighbors and we all worked together building each other’s homes.

That really creates a feeling of community interest and investment because I will watch over my neighbor’s property since I helped build it and they feel the same way about me and mine.

Then when the home is ready to move in to‚ Habitat has a ceremony called a House Blessing where we all get together and have a small ceremony where the keys and the Bible are given to the new homeowner.

I’ve seen many people cry with joy when they are given their new home — the keys to their new home‚ and I certainly was not alone the day I cried on my new front porch.

Alphonso may be gone now‚ but I know he was looking down and smiling that day. My Phoenix House brothers had helped me build my home and Terry Hollabach and other Housing for New Hope staff were at my Habitat ceremony cheering me on.

I had so much to be thankful for because I had done something I could not do myself in the entire first 50 years of my life‚ with my own ways of thinking.

I can still remember the day Alphonso held up that money and told me I had to want to change. I have gone from being homeless in the woods to being a homeowner in less than four years with the help of Housing for New Hope.

No that’s some real change. Thank you.

Jane Tobler: Thank you Michael. Thank you for sharing your personal story with us and thanks for helping us see that people who are homeless can work for real change.

Your contact information is up there for everyone to see‚ and I also want to point out there are some resources‚ some resource organizations on Slide 43‚ and Slide 44 and 45. There are additional resources also on this topic.

Additionally‚ we recently learned about the Homelessness Marathon‚ an annual 14 hour radio broadcast featuring the voices and stories of homeless people from around the United States.

The call will originate from Kansas City‚ Missouri starting tonight at 6:00 pm Central Time. And if you want to get more information on it you can go to the Marathon’s Web site at homelessnessmarathon.org.

We will now begin the take your questions. Please dial star 1 on your telephone keypad to be placed into the queue. Please give your operator your name which will be announced before your question. If you prefer to only have your first name announced‚ then only give the operator your first name.

Upon hearing the conference operator announce your name‚ please ask your question. After you’ve asked your question your line will be muted‚ offering the presenters an opportunity to respond.

Operator‚ do you have our first caller?

Coordinator: I do have a question from Corrina. Go ahead‚ your line is open.

Corrina West: Hi‚ this is Corrina West from Kansas City and I just wanted to talk about the Homelessness Marathon.

We’re here in Kansas City all revved up. There are a lot of homeless service organizations that are pretty excited about the marathon. It’s going to be from 6:00 pm tonight to 8:00 am tomorrow morning on 110 radio stations.

And I’ve been riding out on my bicycle and talking to homeless people out on the streets and giving them flyers and they all - and I say‚ “Well we’re listening to your stories.” And they all say‚ “Oh yeah. I’ve got a story.”

So listen all night to us on the radio and we’ll be talking from Kansas City about homeless people’s stories.

Jane Tobler: Thanks Corrina‚ we appreciate that and we appreciate you sharing that information with us.

Operator‚ is there another caller?

Coordinator: Yes‚ we have a question from Joe. Go ahead.

Joe: Yes hi‚ my name is Joe and I’m from the Philadelphia area and my question is what’s being done in the mental health community to help people that yes‚ they go to prison and‚ you know‚ the majority they lose their home while they are in prison and they’re released with no resources.

I know in Bucks County they implemented a program - a mentor program for not only disabled people but for people that were getting released and they would meet with a mentor that would help them with things such as‚ you know‚ giving them a ride to get their social security card‚ what have you.

But is there anything that peers are doing to‚ you know‚ establish a one-on-one basis with people that are due to get released so they have some kind of an idea of‚ you know‚ what and where they can go upon their release? That’s my question.

Jane Tobler: So Joe‚ this is Jane. So your question is‚ upon release are the speakers aware of programs available?

Joe: Yes‚ whether there are peer specialists that actually go in to prisons and‚ you know‚ meet with people that are due to get released and just to help them where they can get the‚ you know‚ the initial whether they are disabled or mentally disabled‚ where they can get their medication for instance‚ you know‚ things of that nature.

Jane Tobler: Great‚ thank you. Livia‚ could you share any suggestions you have?

Livia Davis: Well it’s hard to know what’s available in the different states. And there are certainly in Massachusetts‚ some regional centers that are available for people when they first get out of jail or the criminal justice system.

How numerous they are or how effective they are and if there are equivalent in other states‚ I’m afraid I don’t know. And I don’t know if either maybe Bonnie or Michael has some thoughts about that.

Jane Tobler: Michael‚ do you have any suggestions maybe through the PATH network that people could look in to?

And Michael if you’re speaking‚ you just need to star 6 or unmute yourself.

Michael Kelly: I apologize. I would suggest check for your local state PATH contact for the State because every state has a PATH - a state PATH contact. I’m not exactly sure which PATH contact would be for your area‚ but each State does have one. You could contact them.

And in our area we actually have a provider for when people are released from prison. The provider links with them because there was a big issue about stopping the revolving door where people were being released from mental institutions‚ hospitals‚ and jails and prisons and they would just go right back to the streets and end up right back in jail.

So in our area we do have some programs to assist‚ but I’m not sure about your area.

Jane Tobler: Excellent Michael. And that email or the Web site is SAMHSA’s Projects for Assistance in transition from Homelessness‚ PATH. And their Web site is pathprograms.samhsa.gov.

Livia Davis: And the other resource that you might want to consider — this is Livia again — is that any - in many states and many communities‚ there are a continuum of cares. These are planning‚ coordinating bodies that really look at what services need to be in place to address homelessness and they receive funding from the Housing and Urban Development and they are called continuum of cares.

And for each continuum of care there is a contact and that’s usually a very good first contact for a community to find out what resources are available. And many of those continuum of cares they do look at addressing people coming out of jails in order to avoid them going right into homelessness.

Joe: Very good. Thank you.

Coordinator: Our next question is from Eugene. Go ahead‚ your line is open.

Eugene: Yes‚ I was wondering‚ what is going to happen if the Olmstead Act is not going to be decision - is not going to be implemented by all the states?

What if there are some states that refuse to even bother doing it because of the budget crunches that they’re having?

Jane Tobler: Thanks Eugene. Bonnie‚ could you respond please.

Bonnie Milstein: Sure. You know Eugene; one of the really interesting things about Olmstead is that the governors who are most interested in cutting costs and reducing their state deficit are the ones who have embraced Olmstead.

So when Governor Schwarzenegger was governor and he was the Republican governor of California for two terms‚ he issued two Executive Orders. And although advocates in California will tell you that not nearly enough has been done‚ he was one of the first governors to jump on the bandwagon and start promoting the cost savings of paying for housing and services in the community rather than paying for institutions.

Much more recently the current governor of Indiana who is also a Republican — Governor Daniels — has submitted a proposal to the Legislature — this sort of goes back to the earlier question but has Olmstead implications — his proposal to the Legislature is to reduce prison funding and to not just restore but increase funding throughout Indiana for drug treatment programs and for mental health services.

Because all the studies that he’s looked at though that doing the latter‚ that is implementing useful programs in the community that helped people live their own lives‚ cost a quarter to a third as much as putting people in institutions. And prisons are some of the most expensive institutions.

So‚ you know‚ it’s advocacy that we all need to do. The problems‚ I don’t think will ever full go away. And we have to connect as Livia says‚ when likeminded advocates‚ regardless of their political parties‚ will understand both the cost benefits and the social benefits and the human benefits of promoting integration and independence and freedom to live our lives the way we want to.

Jane Tobler: Excellent‚ thank you so much for sharing that‚ especially the cost information which I think is of great interest to many people.

Operator‚ next call please.

Coordinator: Our next question is from Rachel. Go ahead‚ your line is open.

Rachel: Thank you. I just wondered with funding cuts state-wide in federal‚ how that’s going to impact at the local and state levels‚ or what are the projected impact to local services that are currently provided?

Jane Tobler: Livia‚ do you want to address that?

Bonnie Milstein: Well I can start.

Jane Tobler: Sure.

Bonnie Milstein: It’s pretty frightening. Even President Obama’s proposal to reduce spending for the community services block grants is going to result in less affordable housing being built‚ fewer funds - less funds to help people buy furniture and put a security deposit when they find an apartment that’s affordable.

It will mean less funding for Medicaid‚ although the Republicans seem determined to reduce the Medicaid program which of course is critical for paying for lots of healthcare services in the community.

And if ever there was political advocacy that was necessary on all of our parts to promote‚ you know‚ Governor Daniels’ Republican idea of saving money by putting money into community services‚ now is the time to do it.

But as I said at the beginning‚ it’s pretty frightening.

Livia Davis: I would agree with that‚ with what you’re saying Bonnie. I do want to also mention that if you are in a position of providing services‚ you may want to look at aligning yourself with friendly‚ qualified health centers; so community health centers because there are some money coming into those systems that can help to provide for some of those services that many people need in the community.

Now how that’s going to fare with some of the new budget numbers‚ I’m not sure. But looking into the federally qualified health centers - community health centers is something that people should do‚ no matter what’s happening right now.

Jane Tobler: Excellent. Thank you for that - those very good resources and that information which I think is very valuable to us.

Operator‚ next caller please.

Coordinator: Our next question is from Sunny Dailey. Go ahead‚ your line is open.

Jenny Dailey: Hi‚ is that Jenny Dailey?

Coordinator: Yes‚ Ms. Dailey‚ your line is open.

Jenny Dailey: All right‚ thank you. First of all I wanted to say thank you to Michael for sharing your personal story. That was so inspirational and that’s‚ I think‚ what gives us all hope‚ not only if we’re working on our own recovery‚ but if we’re working with individuals in recovery‚ so thank you for that.

And then just a comment for the individual in Philadelphia; I work in Pennsylvania myself and there are forensic peer support services available and forensic case management services available. You want to contact your County and HMR Office to find out what’s available in Bucks County.

Thank you.

Jane Tobler: Thank you so much‚ we really appreciate that. Next caller‚ please.

Coordinator: Our next question is from Moreland Matthews. Go ahead‚ your line is open.

Moreland Matthews: I wanted to say thank you. My question is‚ are there any - do you have any additional thoughts on preventing or helping homeless students in college? Thank you.

Jane Tobler: Okay‚ any suggestions around preventing homelessness in college students? Michael or Livia‚ do you want to answer that?

Livia Davis: Well‚ preventing homelessness around college students; I know that colleges have looked at the dropout rate with regards to first year students‚ the potential of which don’t come back the second year.

And there was a bigger number than I had thought of - I can’t remember what it is but I have not seen a lot of work or information or resources to address homelessness among college students.

There certainly are a lot of youth homelessness that are being addressed in various ways‚ but I would have to look in to any responses to college - homelessness among college students in order to be able to provide a good answer.

Michael Kelly: I don’t really — this is Mike — I don’t really have much of an answer about homeless college students either. I do know that we have helped homeless people get into the homeless shelter and then they would get linked with a college and get Pell Grants to begin going to school. But that’s helping them get back into the system and start getting an education and working towards being able to become a productive member of society.

So we’ve helped homeless people get into the homeless shelter and then find affordable housing in the opposite direction to help them regain.

Livia Davis: Yes‚ and there definitely are a lot of emphasis being placed on youth homelessness. And one place to go to find out more information about that is SAMHSA’s Homelessness Resource Center which is a Web site.

And there are a number of expert panels that were done and resources on this subject that may be a great first way to learn more about this and find out what some of the resources are‚ both nationally and in the state that you are in.

So I would go there as a first resource‚ that’s the Homelessness Resource Center.

Jane Tobler: Thank you very much. And we just got a note; this is Joe of Bucks County Pennsylvania.

You had asked about the local programs‚ so once you go to the pathprogram.samhsa.gov — and this is for you but for anyone‚ if you’re interested in getting more information about these services in your state; in your organization‚ once you go to pathprogram.samhsa.gov‚ click on the Grantee tab.

And the Grantee tab on their PATH Web site homepage will give you more information in your area. So many thanks the Project Director of the PATH Program for that.

Operator‚ could we go to the next question‚ please?

Coordinator: The next question is from Karen. Go ahead‚ your line is open.

Karen: Thank you. First off I wanted to thank Michael because Michael you have brought so much humanity to the whole presentation. You used recovery language which I can really appreciate.

But my question is; how is it that people fall into homeless? I just don’t understand how you can go from being a member of society to becoming so isolated and losing belief in humanity.

Michael Kelly: Well for me; and I can only explain my perspective on it‚ is that I formerly was a productive member of society‚ but I was also a functional alcoholic which means every - in my opinion‚ the average American male is conditioned to believe - I mean‚ you work all day long‚ after work it’s “Miller time;” weekends were made for Michelob.

You can’t watch a sporting event without lots of cold Budweiser‚ Old Milwaukee is for camping and fishing. You’ve got to have a foreign beer to attract pretty women. They’ve even got a light beer for people on a diet; go figure that one out.

The average American male is conditioned to believe that it’s okay to drink pretty regularly. And when I went through my divorce‚ that crisis in my life caused me to drown my sorrow with alcohol which caused me to just downward spiral further‚ to where I finally lost everything and ended up homeless in the streets.

As far as the point of view - that Housing for New Hope would take is that people sometimes choose behavior that creates homeless situations. It’s not that people want to be homeless; and for me I didn’t want to be homeless either. I basically lost everything through my divorce and then I lost the rest of it in the bottom of a bottle.

So once I learned to address my issues and learned to change my behaviors‚ I learned how to get back on my own two feet and become a productive member of society again.

So we try to focus on behavioral issues as usually the reason - and everybody faces crisis in their life at some point in time. And someone like me who was already weakened by alcohol and regular use of it‚ the old saying‚ “Everyone is a couple of paychecks and a few bad decisions away from being homelessness - homeless,” can come true very quickly for someone like me who drank regularly.

So that’s basically my position on it is it’s a behavioral issue.

Bonnie Milstein: Jane‚ this is Bonnie. May I just add one point to Michael’s eloquent answer?

Jane Tobler: Oh‚ please do Bonnie.

Bonnie Milstein: In addition to what Michael said‚ there - HUD has - HUD has published since 1980‚ a report called Worst Case Housing Needs. And what the report reflects are the numbers of households who pay more than 50% of their income in rent or who live in severely substandard housing or both.

And what the 2009 Report — I think that was the report that was just released — reflected was that between 2008 and 2009‚ there was a 20% increase in the numbers of homeless households.

And the report distinguishes households that include members with disabilities‚ members without disabilities‚ and then says that they - that their reports have undercounted the number of households with family members who have disabilities by between 40% and 60%.

So in addition to what Michael is talking about‚ we’re talking about individuals and families with children and elders who have found themselves homeless because of a combination of the recession‚ the lack of employment‚ or general economic conditions‚ and this country’s unwillingness to fund an adequate supply of affordable housing‚ ever.

So the - if you are an extremely low income individual which is to say your income is social security or SSI‚ your likelihood of getting a rental subsidy to be able to afford an apartment is one in three‚ which means that‚ you know‚ with all the monies that are going to fund affordable housing from the federal government or from the state governments‚ we are not meeting the housing needs of two-thirds of the people who would qualify for housing program.

And‚ you know‚ this is another reason why I’m very frightened about the deficit hawks and what they are proposing.

But I just - you know‚ an extremely good Web site to find out more information about affordable housing and homelessness is the National Low Income Housing Coalition Web site‚ so it’s nlihc.org. Thank you.

Jane Tobler: Thank you. We have received a question via email‚ and this question is‚ can the issue of a homeless person being able to retain housing be addressed - chronically homeless persons being able to retain housing be addressed?

I’m concerned about those persons who have lived decades on the street and may not know basic living skills such as budgeting‚ follow rules and regulations‚ property managers‚ etcetera‚ being able to succeed when they do get housing.

Michael‚ I would ask you and Livia to address this‚ please.

Livia Davis: Sure‚ this is Livia. Yes‚ the answer is yes. A lot of work has been done since the 1980s when homelessness really became something that was prevalent in the United States.

And originally some of the response that was put in place was really put in place because it was thought to be a crisis situation; something that would not last forever or for a long time even. And of course as we know‚ it has continued.

And so a lot of people who became homeless in the 1980s‚ many of them they continued to experience chronic homelessness and homelessness‚ but we know now‚ through a number of models and evidence-based practices and interventions that yes‚ people can move directly from homelessness and in to housing.

There is one model that I discussed a little bit in my presentation called Housing First. And by combining permanent supportive housing with the service and supports that people want‚ people can indeed overcome homelessness.

And by making sure that there are social connections; making sure that they have some meaning and value‚ making sure that consumer choices is up front and center‚ lots of people who‚ you know‚ would here the to experience chronic homelessness‚ are now living as contributing‚ valued members of their communities. So we have learned a lot and we continue to learn.

And so I would say that there are many models - and again if you want to go to the Homelessness Resource Center‚ that would be a good first step to find out more about some of those models.

The other program that SAMHSA has that I just briefly want to mention is the Service in Support of Housing Program. And that is a program that grew out of the chronic homelessness initiative which was started in 2003.

The Service in Support of Housing Program was put in place and funded by SAMHSA for the specific purpose of targeting people who have experience chronic homelessness by putting them in permanent supportive housing by offering that and providing the necessarily supportive services to support them.

And the retention rate for people who move in to housing in that program is very high. And there is an annual report from last year - it’s the 2010 Service in Support of Housing Annual Report.

Again it’s available on the Homelessness Resource Center Web site‚ gives you all the numbers and the facts and the data and some of the profiles of the 62 grantees nationwide‚ the organizations that receiving funding to do this work‚ and some of the models they’re using.

So I would encourage you to go and read that report and learn more about it so that you can understand some of the strategies that are being used.

Jane Tobler: Excellent‚ thank you so much for sharing those resources.

Michael‚ did you want to address that at all?

Michael Kelly: Well basically she covered everything I could say. For me‚ when I went through the Phoenix House transitional house like I was explaining when I spoke‚ they have weekly meetings on life skills‚ healthy choices‚ budgeting.

And then Andover Apartments is supportive housing and they want you to have like a case management in place and Wellness Recovery Action Plan‚ and life skills as well.

So I’ve been through the process in transitional housing and the supportive housing‚ and that’s what they do is they have classes and workshops and stuff like that.

Jane Tobler: Excellent‚ thank you. And Michael we will have you be the last word on that for today.

If we have people who have additional questions‚ please feel free to follow-up with our presenters whose contact information is listed on Slide 47.

And our speaker’s biographies who stayed with us today and presented today are on Slide 48 through 50.

Tomorrow you will receive an email request to participate in a short anonymous online survey about today’s training which will take about five minutes to complete. Please take the survey and share your feedback with us.

Survey information will be used to help determine what resources and topic areas need to be addressed in the future.

This conference has been recorded and the audio recording and transcription will be available in late March on the SAMHSA ADS Center Web site.

If you enjoyed this training teleconference we encourage you to join the ADS Center listserv to receive further information on recovery and social inclusion activities and resources‚ including future teleconferences.

We also encourage you to join the 10 x 10 Wellness listserv to learn more about promoting wellness and increasing life expectancy with persons with behavioral health problems.

Finally‚ you could sign the Pledge for Wellness to promote wellness for people with mental health problems by taking action to prevent and reduce early mortality by ten years over the next ten year time period.

You can contact the SAMHSA ADS Center at promoteacceptance@samhsa.hhs.gov or the phone number and address listed on Slide 54.

We’ve come to the end of the time today. Bonnie‚ Livia‚ and Michael I want to specifically thank you so much for your hard work on this important issue and for sharing your personal and professional experiences and insights with us and the callers today.

Also‚ thank you to all of our listeners for caring about this topic and taking time out of your afternoon to learn more. And I thank you in advance for completing our survey.

Coordinator: That does conclude today’s conference. Thank you for participating‚ you may disconnect at this time.