Kentucky Fights Chronic Homelessness

Service provider collaboration, peer support, and a Housing First approach help improve outcomes for people experiencing chronic homelessness in Kentucky.

Family Health Centers, Inc. of Louisville, Kentucky, was awarded a three-year SAMHSA Cooperative Agreement to Benefit Homeless Individuals (CABHI) grant in 2011, building upon a previous Services in Supportive Housing (SSH) grant received in 2008.

The announcement of the CABHI grant coincided with the planning of the City of Louisville’s involvement in the 100,000 Homes Campaign. The campaign identified, assessed, and selected participants for a registry of the city’s homeless population, especially those experiencing chronic homelessness. The registry was developed through the efforts of more than 100 volunteers who spent three days surveying and identifying this population.

Family Health Centers (FHC), through the FHC-Phoenix Health Care for the Homeless clinic, applied for the CABHI grant to develop the Louisville Housing First collaborative. They received notification of the grant award from SAMHSA just as the 100,000 Homes registry week came to a close. With a database identifying more than three hundred people experiencing homelessness and the resources ready to provide housing and services, FHC-Phoenix and its partners set out to engage and house those people. The project’s target participants were those that the 100,000 Homes effort deemed most vulnerable.

The first participant entered housing on January 27, 2012. Since then, the project has assisted 79 people who formerly experienced chronic homelessness to transition from the streets and shelters to independent living. The project anticipates housing many more throughout the life of the grant. The project also has a retention rate of 88% and participants have been housed for an average of 209 days.

With the help of SAMHA’s SSI/SSDI Outreach, Access, and Recovery (SOAR) program, the number of participants receiving disability income increased from 34.3% to 45.7%. Another successful endeavor is the peer support program that provides participants with one-on-one mentorship. Participants have spoken very favorably about this service and the attendance at the weekly peer support activities group is evidence of its success. Two of the five peer support specialists are participants in FHC-Phoenix’s original Housing First project, giving them a unique perspective on the needs of participants.

Another distinctive aspect of the Louisville Housing First Cooperative is its collaborative nature. By engaging a number of stakeholders in the community and including them in the planning process, the project has been able to create a large scale Housing First project with a comprehensive array of services. From peer support to disability benefits counseling, participants have a number of options for pursuing recovery and independent living. The project is also unique from others in the community in that it is intended for Louisville’s “most difficult to serve” population. By targeting the chronically homeless with the greatest number of vulnerabilities and implementing a Housing First approach, the project has been able to house and provide recovery services for people who have previously experienced years of homelessness.

The Housing First model ensures that participants experience as few barriers to housing as possible. Case managers, peer support specialists, and housing providers assist participants in locating and applying for a desirable housing placement, filling out all necessary paperwork, and moving them into the unit. An ongoing goal of case management is to ensure stability in housing. Case managers often work with landlords and housing provider agencies to assist the participant in any housing issues that may arise. The Louisville Metropolitan Housing Authority recognized the importance of the proposed initiative and allocated seventy Department of Housing and Urban Development (HUD) Housing Choice Vouchers for providing permanent supportive housing for collaborative participants. Additionally, the Louisville Metropolitan Department of Community Services and Revitalization and the Louisville Alliance for Supportive Housing committed to providing affordable housing to the target population.

Recovery support is provided by case managers and trained peer support specialists. Participants are encouraged to pursue recovery through consumer-driven approaches such as motivational interviewing. FHC-Phoenix’s first foray in employing peer support specialists was the result of its partnership with Wellspring, a leading provider of housing and supported housing options for adults with severe and persistent mental illness. Wellspring has provided peer support services since the 1990s. FHC-Phoenix provides five certified peer support specialists who work one-on-one with project participants on developing housing and recovery goals.

Participants are connected to inpatient and outpatient substance use and mental health treatment as well as rehabilitative services. The project employs a mental health therapist to provide access to counseling. Slots are reserved for participants at Bridgehaven Mental Health Services, a psychiatric rehabilitation day center, and Jefferson Alcohol and Drug Abuse Center, an inpatient and outpatient substance use treatment center. Recovery support group meetings are held every week.

The project also employs a full-time SOAR worker to assist disabled participants in accessing income and mainstream benefits. This includes applying for SSI/SSDI, Medicaid, and other entitlement benefits. Case managers provide support and resources for helping clients with finding employment, coaching and job training, food stamps, and health care.

As a Health Care for the Homeless provider, FHC-Phoenix provides people in permanent supportive housing with full access to medical, dental, and behavioral health services. Medical and mental health staff routinely provide home visits for those that wish to be treated in the privacy and comfort of their own homes.

Other partners include the St. Johns Center, Louisville Coalition for the Homeless, the Downtown Development Corporation, University of Louisville Hospital, and the Kentucky Housing Corporation. All have partnered with this initiative to provide support for individuals experiencing chronic homelessness. These partnerships have engaged new resources including the Louisville Alliance for Supportive Housing that will provide housing vouchers to house up to an additional 30 participants.

The project has gained strong recognition in the community as a recipient of the 2012 Center for Nonprofit Excellence’s Pyramid Award of Excellence for the Art of Social Innovation and a 2013 Triple Crown of Excellence Award in Housing from the Housing and Homeless Coalition of Kentucky.

Learn more about Housing First at the National Alliance to End Homelessness.

Access more behavioral health and homelessness resources.

Publication Year

Connie Campos
Last Updated: 09/09/2019