Relief efforts for the homeless no longer focus on food and shelter; they now emphasize permanent solutions to homelessness. In the New Orleans area, Unity for the Homeless now coordinates this effort. Since 1994, Unity has overseen the local response to homelessness and distributed money from the U.S. Dept. of Housing and Urban Development (HUD) to more than 60 local agencies.
These agencies have moved thousands of people off the streets, out of the shelters, and into their own places. Thanks to their work, housing for the homeless has tripled, from 1,000 spaces in 1994 to 3,000 spaces today. This is good news. It means that, for most homeless people, our existing system can end their homelessness.
Yet these efforts do not offset the large number of newly homeless. As soon as someone leaves a local shelter for permanent housing, another person fills that bed.
As Gambit Weekly recently reported ("Dumping Zone," Sept. 3), too many of this city's homeless are being "dumped" onto the streets, entering homeless shelters directly from medical and mental hospitals, jails, foster homes, and public housing. The problem is nationwide and directly linked to the overall problem of homelessness: a few years ago, the state of Massachusetts discovered that nearly 60 percent of those in its homeless shelters had recently been institutionalized.
At the time, Philip Mangano served as head of the Massachusetts Housing and Shelter Alliance. His organization and others in that state began emphasizing "discharge planning" -- anticipating and guiding the exit of anyone from an institution. The success of those efforts is one of the reasons why Mangano is now executive director of the U.S. Interagency Council on Homelessness, which coordinates the activities of 18 cabinet-level federal agencies that deal with homelessness.
In his new post, Mangano pushes discharge planning on a national level. Without such planning, he told Gambit Weekly, cities are "bailing a leaky boat." And cities that don't wise up could find themselves with empty pockets. The federal government now demands discharge planning for all municipalities that receive federal homeless-assistance funding from HUD. That's about $11 million a year for the City of New Orleans and local nonprofits. Planned legislation would tie discharge planning to funding from other federal sources, such as the Department of Health and Human Services, the Department of Justice, and the Department of Veterans Affairs.
As part of its annual application for those funds, the City of New Orleans certified in February that it would "develop and implement, to the maximum extent practicable and where appropriate, policies and protocols for the discharge of persons from publicly funded institutions or systems of care in order to prevent ... homelessness."
Now, the city would do well to keep its word. Discharge planning addresses the complex needs of chronically homeless men -- those who are most often seen sleeping on the streets of this city. It also identifies those who are teetering on the brink of homelessness. Both of those populations routinely pass through social-service, correctional and health institutions. "We found [in Massachusetts] that the homeless were far from being anonymous people who fell on hard times," Mangano says. "These people were, at the time of intake, already well-known to systems of care and incarceration systems."
This is no secret to homeless agencies in New Orleans. In January, Unity's advocacy committee identified discharge planning as one of the top priorities for the year. Their meetings have already begun to produce results. Within the past few months, Charity Hospital implemented a high-risk registry for frequent emergency-room patients, many of whom are homeless. Charity case workers intensely track these high-risk patients -- by scheduling tests, providing transportation, coordinating pharmacy visits for medications, and making follow-up calls to shelters and drop-in centers to remind patients of upcoming appointments. Other hospitals, both public and private, should follow Charity's lead.
At Orleans Parish Prison, Sheriff Charles Foti oversees vocational training and treatment for addictions, both crucial to discharge planning. His social workers could play an integral role in arranging transitional housing, ensuring that medications are dispensed on time, and in re-applying for Social Security Income (SSI) for departing inmates who lose SSI during longer stays. Central Lockup should also begin delivering homeless inmates directly to a shelter upon their release.
The Louisiana Office of Community Services is currently working to determine why teens from this state's foster system are landing in Covenant House and similar agencies. The next step in discharge planning is to change the question at hand from "Where can we put this person next?" to "What is the next step toward independence for this person?"
As a top business executive, Mayor Ray Nagin helped in the initial planning of Unity for the Homeless in 1994. He should now put his administration's muscle behind effective discharge planning citywide. Given national trends, doing so would be economically prudent. In human terms, it's also the right thing to do.