Tacoma Pierce County Coalition to End Homelessness Provider Meeting Minutes – February 15th, 2019

 

Welcome

·         James Pogue, Comprehensive Life Resources

·         Hope the snow wasn’t too bothersome

·         Lots of energy Friday evening last week – working hard to try to serve the housing needs of everyone

·         Impressively, Nativity House ran with 90 people over capacity (and is still running with some 90-100 over capacity –ed.). 

·         People ask why we don’t do inclement weather every day.  It is because Inclement weather means shoving bodies in every office and hallway, and really anywhere there is an open bed space. 

·         The overnight shelters were amazing.  So far, we know of only one individual who died because they didn’t seek shelter.

·         Coordination has been great this year

·         Transportation was a challenge.  Had trouble getting folks into shelter from distal areas like Bonney Lake.  Want to figure out how to do that next time. 

 

Legislative Update

·         Maureen Howard - maureenhowardconsulting@gmail.com

·         5882 – new bill in senate – will restrict all homeless housing and feeding of homeless people over 1,000 feet from schools and child care locations.  Washington Low Income Housing Alliance – is coordinating testimony.  https://app.leg.wa.gov/billsummary?BillNumber=5882&Initiative=false&Year=2019  

·         All bills have to clear the committee they are being heard in by next Friday.  Then everyone breathes – some bill that get public hearings will not go out of committees. 

·         There are 10 or more tenant bills and they are all moving – e-mail me for more into

·         Seth Dawson has a weekly update on mental health legislation, if you are interested.

·         Call today from Washington Low Income Housing Alliance (https://www.wliha.org/ ) – will send out a full of legislation list after the call

·         Continuum of Care meetings next Wednesday morning – this group is federally mandated - they are doing the State document recording fee plan to address homelessness and housing.

·         If you want to be on Maureen’s Musings, just e-mail me - maureenhowardconsulting@gmail.com

·         28th of February – Housing and Homeless Advocacy Day – Washington Low Income Housing Alliance - https://www.wliha.org/housing-and-homelessness-advocacy-day  

·         21st of February - League of Women Voters – Democracy Advocacy Day - https://lwvwa.org/event-3100942

 

Amerigroup

·         Nataly Renteria, Amerigroup - Community Relations and Marketing Representative, nataly.renteria@amerigroup.com

·         Value added benefits/member benefits for Medicaid

o   Amerigroup is one option under Washington Apple health – here since just 2012 – but growing

o   We encourage whole person care.  Help folks be a better person – look at social determinates of health (in care you’re not familiar with Social Determinates of Health, the Center for Disease Control and Prevention – CDC – has a useful explanation at https://www.cdc.gov/socialdeterminants/index.htm -ed).

o   Benefits

§  No-cost eye glasses – up to $100 per year for adults

§  GED testing fees – if you are part of an agency that helps folks get their GED, we’ll provide a voucher to cover the folks costs.

§  Acupuncture – up to 3 session per year (wonder why acupuncture has just one c in “acu”, but Accurate has two c’s in accu?  I did.  Acupuncture comes from the latin acus – “needle” - and the word puncture, whereas Accurate is from latin ad – “to” and the latin curare – “towards a cure”.  Which somehow gets smooshed into accurate.  Anyway, I always thought acupuncture was “accurate puncturing”, but it really means “needle puncturing”.  Which makes sense, especially, since you probably don’t need to be accurate with acupuncture- some studies have shown you can just stick acupuncture needles nearly anywhere to get results - https://thebrain.mcgill.ca/flash/capsules/experience_bleu08.html -ed.)      

§  Youth – no-cost boys and girls club member fees.  Provides transportation from school to the club.

§  No-cost Sports Physicals – for members 7-18.

§  Rewards program for mothers –

·         Get $75 gift card at Riteaid or Walmart (no Tabaco, alcohol or firearms purchases, though)..

·         Breast pump     

·         Male Circumcision (there is an ongoing, sort of benign debate between folks for and folks against circumcision.  For some reason, I find opinions on this fascinating – mostly because many of my friends had no opinion on circumcision until the doctor asked what their plans for their son’s foreskin was, and they had to decide, and weren’t sure what the “right” answer was.  If you didn’t know the debate existed, I recommend this somewhat-not-safe-for-work article that does a good job presenting the pros and cons of male circumcision - https://sciencebasedmedicine.org/circumcision-what-does-science-say/ -ed). 

§  Web-based portal – called myStrength – will help with no-cost memberships to many organizations – you can try it with a provider code to see what you clients will be able to use.   if you’d like to try it out email me for a code - nataly.renteria@amerigroup.com

§  No-cost cell phones are available (limited monthly minutes, though).

§  Peer support specialist registration and renewal program – for client who want to participate in peer support

§  Life transition kit – for members discharged or who are homeless.  Blanket, gift card, first-aid kit – just call member services to tell them where to deliver it. 

§  Light box for Seasonal Affective disorder – for the Seattle blues or whatever – (I’m a bit of an Seasonal Affective Disorder denier – based on studies like this one - https://www.scientificamerican.com/article/study-finds-seasonal-affective-disorder-doesn-t-exist/ -ed)

§  Weightwatchers (I’m no denier of weightwatchers – it is a super effective program –ed)

§  Fitness Coach program

§  One-time Non-medical transportation benefits – $50 orca lift card in King County or a $50 gas card – can be used for anything.  State covers non-emergency medical transportation.  Every member can get that (family of 6 could get 6 gas cards).

§  National Call Center will send it out to you

·         American Indian and Alaskan Native Group – try to partner with other healing methods.  - we cover costs, for smudging (I’d never heard this word before - https://en.wikipedia.org/wiki/Smudging -ed), sweat lodge, storytelling and talking circles – although many are free, we will help with costs.

·         Amerigroup Foundation – Anthem Amerigroup foundation.  If you have project that you’d like to apply for funding – present the proposal to the foundation.  Will do sponsorships.  Done some sponsorships for homeless events (someone needs to take them up on this funding opportunity. –ed).

·         Go to http://myamerigroup.com/  – enter zip code to learn about community. 

·         Emily – how aware are the health care providers in the community about these resources?  Nataly -  we are working to present to providers to let them know about it. 

·         Carolyn – this coverage includes surgeries and such.  Nataly – these are just the value added benefits.  Medicaid covers the usual medical needs.  The member handbooks have more information about what medical stuff is provided. 

·         Maureen – can you print information in other languages?  Nataly – sure.

·         James – do you ask which MCO your clients have? 

o   Molina and Coordinated Care attend these meeting – they can inform you about the differences in these program. 

o   Next is Foundational Community Supports, which can offer services of PSH wherever someone is living in the County. 

·         Foundational Community Supports  (Presentation is attached. –ed)

o   Jacob Avery, Foundational Community Supports Manager - Jacob.Avery@amerigroup.com

o   This program is separate from the Amerigroup Health Plan.  This is for almost everyone on Medicaid, not just Amerigroup members

o   This program comes out of the 1115 Medicaid Waiver – an agreement between Washington Health Care Authority to use medicaid funds for different things.  One part is foundation community supports.  One is supportive housing and the other is supportive employment (more info at https://www.hca.wa.gov/about-hca/healthier-washington/medicaid-transformation -ed)

o   Many of the services aren’t that different from what your agencies do.

o   Supportive Housing Benefit – covers the cost of services with help filling out applications, help finding housing, housing retention, dispute resolution. 

o   Doesn’t cover rent, move-in, furniture, utilities, application payments (don’t want to make it too easy...-ed).

o   This is a pilot program 1/1/2018 through 12/31/2021.  The real opportunity for this program is to pair with other funding that is out there. 

o   I want agencies to see how they can leverage this funding.

o   This doesn’t solve homelessness, but is a new funding stream

o   Supportive Employment – about 2/3 of the programs are doing this

§  Outreach to employers

§  Employment assessments

§  Job retention

§  Help filling out applications

o   Who is eligible – not everyone on Medicaid qualifies.  But you do need to be on Medicaid to qualify.

§  Any of the 5 managed care organizations works fine.

§  You can be dual eligible with Medicare or tribal health

§  Exceptions –

·         Medicaid plans entirely paid for by the state of Washington – if they don’t use federal funds, they are excluded

·         Folks on spend down

·         Folks only using Medicaid part B

§  Age limit of 18+ for housing

§  Age limit of 16+ for employment

§  Must have a health needs based criteria and a risk factor –

·         Medical Need

o   Substance use or mental health diagnosis

o   Needing assistance with activities of daily living

o   Being homeless with a disability

o   On Housing and Essential Needs (HEN) or Aging, Blind or Disabled Case Assistance (ADB)

·         Risk Factors

o   Frequent stays in crisis setting (2+ per year)

o   Others

o   Chronically Homeless – can accept attestation – meaning enrollees can self-declare their chronic homelessness. 

o   Maureen – are you the only program in Pierce County using this part of the Medicaid waiver?  Jacob – for this program, we are a third party administrator.  Agencies all over the state provide these services.  We contract and credential .  James – 8 agencies do one of the two programs.  Sea mar, MDC, CLR, CCS (King county) and more. 

o   James – folks can get this no matter what MCO they use. 

o   We measure outcomes and do tracking to see if it is effective.  If it is effective, it will be transferred into all the MCO programs. 

o   The program has been in the implementation state for years.  Signed in 2017. Went live in January of 2018. 

o   Pierce County was one area we needed help – still trying to grow our provider area here.  If your agency is interested, contact me. Need from you a Tax ID, Medicaid ID, National Provider Identifier and a Business License.

o   Currently contracted:

§  MDC, GLMH, Share and Care House, Northwest Integrated Health, many that do supportive employment – Goodwill isn’t on yet.  Compass career, CLR. 

§  Current enrollment is around 3,000.  Only some 200 in Pierce County. 

§  Anyone can refer a potential enrollee.  The best way can be to refer directly to the provider.

§  We refer to a local provider and they have 5 days to reply – to get situated quickly, call us to get the best response

o   Maureen – you said at the beginning you were surprised at the number of supportive employment was higher than supportive housing.  Why?  Is that county specific?  Jacob – state was surprised too.  Since housing wasn’t funded directly, it is tough to take on clients they can’t house.  Employment agencies had an easier time.  Housing funding is very complicated – housing providers are cautious in signing up for housing that may supplant existing funding. 

o   Rates – a case load of 20 looks sustainable.  The per diem rate is challenging for housing providers. 

o   We have a process to request an exception to request more hours for a client – just want to know why a client needs more

o   Medicaid is the payer of last resort. 

o   Can get HEN and Medicaid services at the same time. 

o   Division of Behavioral Health and Recovery (DBHR) support teams are available for:

§  On-site trainings and technical assistance for housing and employment –

§  Coordinating between behavioral health organization and fCS providers and provide shared learning opportunities. 

o   Aging and long term care is a partner

§  Give us referrals – aging and long term care will send referrals

o   Provider website and resource guide available

o   Al – minimum qualifications for providers?  Jacob – 1-2 years and AA or BA in an appropriate field, or 1-2 years in supportive housing or supportive employment.  We contract all our agencies as faculties – they don’t bill us as individual providers

o   Al – was fantasizing over here and I wanted to hire folks who received your service to provide that service to other folks, could I hire someone on your program as a peer support to provide those services.  Can hire folks receiving services, but they need to be completely separate from the employment – separating clinical files from HR files. 

o   David – clients challenged by Mental Health and Substance Use – and then diabetes or neuropathies and fibromyalgia – I struggle working with community health care clinics.  Because of the place she is at, there are lots of bad activities in the building.  Trying to work with a community health care clinic.  How can a care coordinator.  Jacob – Foundational Community Supports is a good match, but sometimes when there are a lot of different needs, it isn’t clear where to turn.  James – these services are a great place to get a case manager from this program. 

o   Larry – you talked about a 16 year old needing supportive employment – what would a typical 16 year old in this scenario be like?  Jacob – we didn’t start out with many under 18 enrollees – but have seen that change in the last 6 months.  Community Youth Services – in Olympia - has a lot of young people in the program.  Larry – should alternative high schools talk to you?  Jacob – the funding stream often doesn’t work very well. 

o   Kelly - Boys and Girls Club – does this cover childcare?  Jacob – talk to boys and girls club or Nataly

o   What is the 3rd waiver?  1115 – agreement between HCA of WA and federal govt. 

§  Initiative 2 – long term care

§  Initiative 1 – ACH and integration of services

§  Initiative 3 – supportive employment and housing

o   Maureen – the # of options for support can be overwhelming for providers – is there anything in the funding that will allow for outreach workers that a clients.  Is coordination of services covered?  Jacob – yes, it is in the contract.

o   Al – are you coordinating with the ACH in this county?  Jacob – not directly – but with individual county approaches.  We talk to folks on the ACH, but most of them are a little separate.  

o   James – client come in for Mental Health, often need employment.  We can take them to Valeo – and when we get them there, we find out t the client sis  ready.  Comes back to Comprehensive Life Resources – where they can work on getting employment ready.  Ge them ready by talking to Greg about what they need. Then give them back to Valeo when they are ready to work.

o   James – it is skill building, helping them access housing.  Allows us to add more housing and employment case managers.  Maybe shelter providers call CLR when a client is ready to move in – they start navigating the client. 

o   Inclement Weather – no updates. 

§  Youth is ending it

§  Other agencies ending it Sunday night

o   Al – Hospital Charity Care – would you like that presentation in this group.  Everyone – yes.

o   James – trainings - Had Point in Time county training- have had the crisis management system to identify the crisis lines. If there’s is a spot we need training – that would be great.

 

Good of the Order

·         Kelly – at goodwill, We are doing free taxes for folks under $60k.  e-mail or call me directly to schedule you for an appointment - KellyB@goodwillwa.org

·         Dawna – another SOAR Training is scheduled – come and get it - dbryant@cmhshare.org

·         Youthbuild – starting in April – for clients aged 18-24.  flyers are available (info at https://www.goodwillwa.org/training/programs/construction/ -ed.) - MichaelaW@goodwillwa.org

·         Reach center February 28th - black history month – event for 16-24 year olds, grab a flyer (event is February 28th, 2019, from 1pm-4:30pm at REACH – 714 S 27th St, Tacoma, WA.  –ed).

·         Charleen Fitzgerald – Health and Wellness event , Saturday, March 13th (somehow I missed the flyer for this – sorry). 

·         http://www.pchomeless.org/  - info about this meeting

·         http://PierceCountyResources.com/ - give access to folks newly homeless to get at the resources they need.  Give us feedback on that.

·         Martha – we all ran some training – and we opened up a shelter at a church –all by volunteers who were trained in the shelter253 training program.  If you have volunteers that need training, we can make that happen.    

 

Coming Attractions

·         March 1st – Joint meeting with Partnership for Transition Solutions

·         March 8th – Census 2020 – how to help make sure everyone is counted

·         March 15th – Topics focused around youth homelessness 

·         March 22nd – Do more people need to hang out in Wright Park before we get food carts there, or do we need food carts to get more people to hang out in Wright Park?  Listen to our panel of experts (including 2 hot dog vendors and little Carly who spends more time on the swings than really seems healthy for a 9 year old), hear the arguments and then lets figure out how to get a popcorn vendor there. 

 

Restaurant Review

All this talk about legislation at the Capitol has me thinking of the fine places to eat in Olympia.  If a lobbyist is footing the bill, there are lots of places to spend serious money on a great meal.  That said, there are lots of good options for those of us paying our own way.  One favorite is Wagner’s European Bakery and Café (1013 Capitol Way S, Olympia, WA - http://www.wagnersbakerycafe.com/ ).  They do breakfast and lunch, and have a pretty darn impressive pastry case.  My usual scenario for visiting Olympia involves bugging some legislators, and then feeling a bit like I need to get out of all the grandeur and suits and ingratiation, and wandering the Capitol grounds, then heading the 2 blocks down the hill to Wagner’s.  If it is lunch time, I’ll get a grilled sandwich– why is cheese so much better when it is melted?  I like the Italian melt, although the grilled vegetarian was a mainstay for years.  They have decent salads, too.  But the bakery is what the place is known for.  A post-advocacy sweet always goes down well, somehow.  They do everything from simple carrot cake (which they are known for) to some impressive wedding cakes.  And tarts and donuts and pies and cookies and eclairs – I do like the eclairs.  The atmosphere is spot on – a nice, open, welcoming space, with plenty of charm.  It is also an easy spot to bring the kids – they are welcome and accommodated.  The Olympia Children’s Museum used to be like a block away, so this was always a destination not just post-lobbying, but post-play as well.  I’ve never disliked Tacoma’s Children’s Museum, but my kids never stayed engaged long there.  But the Olympia Children’s Museum is amazing – totally worth the trip; I could spend all day playing with their water table alone.  It seems like all of their exhibits appeal to lots of different ages, so you can tromp around with toddlers and 5th graders and each room has something that will engage them (and me too, thankfully).  Sadly, the Museum moved a good bit away from its original location, so it is a bit more than a walk to get from the museum to pastry nirvana.  But you could still make a stop on your way home.  Anyway, hitting Wagner’s after your Olympia work or play is done is a great way to inject some calm happiness into your afternoon.

 

Attendees & answers to question – what did you learn about shelter needs during the snowstorm? (sadly, I didn’t get everyone’s answer, and somehow a sign-in sheet disappeared, so I did my best. –ed.)

·         Greg Walker, Valeo Vocation – didn’t learn about shelter, but on Friday, I used social media to ask folks to take care of their neighbors.  Facebook asked if I wanted to run a fundraiser, and I added that in, and raised $300 towards one of the shelters.  Most of us are on social media – it is a great fundraising tool to go to a shelter’s budget.  Take advantage of what you can to help out.

·         David Venes, Point Defiance AIDs Project – substance abuse agencies were mostly open – many clients were required to get to places -  I got people where they needed to be.  A lot of folks just assumed they couldn’t get places, so a few folks fell backwards, but many continued on.  Glad so many places were still open.

·         Kelly Blucher, Goodwill – learned that taxes were cancelled. 

·         Dawna Bryant, Comprehensive Life Resources

·         Nathan Blackmer, Comprehensive Life Resources – it is possible to get someone with no ID through TSA

·         Greta Brackman, Comprehensive Life Resources

·         Richard Berghammer – Fellowship Bible Church – personal strategy – brought blankets to one family, and met a lot of folks waiting to get into a shelter who  need a blanket – I’ll carry more blankets

·         Bobby Ocasio, City of Tacoma

·         Kevin Marrow – community member – long time educator – have former student working in homeless community

·         Patricia Menzies, Tent City Tacoma, This snow was really heavy – as the rain came, I didn’t melt and come down, and slid off the roofs.

·         Michaela Woodmansee, Goodwill Industries

·         Michelle Sood, community member – volunteered at a shelter in Olympia – they often didn’t have enough volunteers (sorry I didn’t get your name properly – ed.)

·         William Stinson, Catholic Community Services – keep salt on hand

·         Byron Corzo, Comprehensive Life Resources – Should not have traded in my truck for a car.  Truck better.  Was working with a student who was not attending school at all and using.  We were able to connect them with Consejo counselling and an IEP (Individualized Education Program) and is not participating in  the RAIN program. 

·         CC Mendoza, Metropolitan Development Council – came home on Tuesday night at Amtrak – a young woman was homeless and was glad to tell her which shelters were taking everhone. 

·         Jacob Avery, Amerigroup – couldn’t leave my home for 3 days – still 1 foot of snow in my yard.  We aren’t a crisis service, and was happy to tell folks where to find shelters-thanks everyone for staying open

·         Nataly Renteria, Amerigroup – It kind of sucks for families that depend on services – they suffered this week.  Thinking about folks that couldn’t get at services made me sad. 

·         Emily Less, Tacoma Pierce County Health Department – appreciated all the drug and alcohol counselors were able to serve our clients

·         Martha Sheppard, Tacoma Salvation Army – part of the Citizen Emergency Response Team.  One thing they have is a 4x4 team – if you are essential city personnel – we could use that – our staff our essential to the community.  I also learned that we need lots of blankets.   And that buses don’t get you to the methadone clinics early enough on a snow schedule.  It is too hard to get folks there in the snow.  I have respect for the bus drivers, and for shelter staff.

·         Rev. Donald Pitchford, House of Prayer Foundation

·         Larry Seaquist, Molina Healthcare

·         Gerrit Nyland – Learned we need to work with the County Emergency Management Department to better communicate what shelter is available.

·         Charles Patton – from Ohio, but was in Connecticut (wow, I’m a bit embarrassed it took me 3 tries to spell Connecticut correctly –ed.).  Affordable housing doesn’t increase crime, and increases.  Working to improve our coordination – now I’m looking for some work.  I appreciate your hospitality.  I worked on some reporting – take a look at http://pschousing.org/news/2018-housing-data-profiles at the  housing data profiles – with data profiles about their local population, identifying who was cost burdened, who was limited from being patrons of their businesses.

·         Martin Tetloff, Associated Ministries

·         James Pogue, Comprehensive Life Resources

·         Bryan Green, Olive Crest – Safe Families for Children

·         Sarah Bellamy, Comprehensive Life Resources

·         Carolyn Read, St. Leo’s

·         Al Ratcliffe, I raise bonsais as a hobby several are under a tree and were nearly, but not actually, hit by branch that fell during the snow.

·         Maureen Howard, Housing Advocate – I saw mention of a woman who also died in the snow - 6th ave.   I learned that the city of Tacoma knows when my trash will be picked up, but they won’t tell me how to get shelter.  We need to ask cities and counties to have some sort of strategies for the survival of homeless people during an event.

·         Charleen Fitzgerald, Coordinated Care.

·         Pamm Silver, Molina Healthcare

·         Sheila Miraflor, Molina Healthcare

·         Kevin Morrow, Community Member

 

Gerrit F. Nyland

Director of Client Information Systems, SW

Catholic Community Services of Western Washington

gerritn@ccsww.org

Mobile: 253-304-5105