Housing First - Provincie West-Vlaanderen

Housing First❱❱Psychiatric services❱❱Health care❱❱Drug and alcohol services❱❱Social work support❱❱Education, training and employment relatedservices❱❱More intensive support with social isolationOne large American research review suggestssome core components that are a necessary partof any HFL service 116 :❱❱Settled housing should be provided immediately.Homeless people have a right to housing andwithout housing in place successful and sustainedexits from homelessness will not be possible.❱❱Housing provided should be affordable, adequateand located in a suitable neighbourhood.❱❱No requirements or conditions about staying inhousing.❱❱Housing and mobile support services areseparate.❱❱Support staff are a mobile team, they arephysically separate from where service userslive.❱❱Choice in housing options for service users.❱❱Housing provided should be integrated withhousing for non-service users (i.e. it is scatteredacross a community and not within oneapartment block, this is not an approach followedby all HFL services).❱❱Housing is long term or permanent.❱❱Normal tenancy agreements are used.❱❱Housing does not look any different from housingaround it (appearance fits with neighbourhood).❱❱Service users have privacy (own front door).❱❱Individualised and flexible social support.❱❱24/7 crisis cover.❱❱Services are nearby.❱❱Shared decision making, i.e. person-centredplanning and person-centred delivery of services,which involves homeless people in the choicesmade about the services they are offered andprovided with.This list of minimum requirements does not list theduration of the service, which in the case of PHFand CHF models is not fixed. Alongside the otherelements necessary to deliver an HFL service,setting no limit on the time for which formerlychronically homeless people can have support mightalso be included as an essential part of an HFLservice.What does an HFL service cost?HFL services do not exist in one form and havenot been subject to extensive systematic evaluation,which means that it is difficult to be precise aboutcosts 117 . The direct cost of providing an HFL servicecan be quite low, as the service provision centreson a mobile team of support workers, which meansthat an office base, salary costs, administrativesupport and a travel budget are the main formsof expenditure. Unlike a PHF service, HFL doesnot directly employ highly qualified staff such aspsychiatrists or nurse practitioners and unlike aCHF service, there is no expenditure on developingor renovating a specially designed building in whichto house homeless people and support services.An HLF service will however also generate additionalcosts for other services. Service brokerage byHFL services enhances access to health, socialwork, drug and alcohol services and a widerange of other service provision for homeless andpotentially homeless people, raising the expenditurefor those services. There is the potential that anHFL service may still reduce total expenditure byother services, because service brokerage is beingused, rather than expensive emergency provision.For example, it is cheaper for health services foran HFL service to enable access to a family doctorfor a homeless person through service brokeringthan to have a homeless person seek treatment in116 Tabol, C. et al (2010) p.448 op cit. This work reported a concern that HFL services in the USA were not consistent andsought to describe what were thought to be the key components of a successful service.117 Tabol, C. et al (2010) op cit37