Frequently Asked Questions

The federal government’s definition of chronic homelessness consists of two separate, but related criteria:

Duration

• The first criterion is one of duration: the person must be homeless for a year or longer or have had four significant episodes of homelessness in the past three years.

Disability

• The second is the criterion of disability: the person who is homeless must have a disabling condition such as serious mental illness, substance abuse problem, HIV/ AIDS, and/or a physical illness or disability.

We estimate the number of persons who are chronically homeless in Miami-Dade County to be 800, and have sized our facility and have planned our treatment program and downstream housing requirements accordingly.

The goal of ending homelessness in Miami-Dade County is shared by the Homeless Trust and the agencies serving persons who are homeless or at-risk of becoming homeless. The goal of Camillus House is to end chronic homelessness in Miami-Dade County, while recognizing that persons who are chronically homeless are the most difficult to treat/rehabilitate and return to productive roles in our community.

The additional capacity at our new site will allow Camillus House (in conjunction with other homeless-serving agencies) to eliminate chronic homelessness as follows.

Reducing the prevalence (total number of cases) of chronic homelessness

• First, the additional capacity will allow us to treat more persons who are chronically homeless, thereby systematically reducing the prevalence, or total number of cases, of chronic homelessness.

Reducing the incidence (number of new cases) of chronic homelessness

• Second, as the number of existing cases is systematically reduced, our additional treatment capacity will also allow us, over time, to reduce the incidence, or number of new cases, of chronic homelessness once we admit and treat persons who, although they meet the disability criterion, have not been homeless for a year or longer or had four episodes of homelessness in the past three years (i.e., have not yet met the duration condition).

Advancing in this way, we will achieve our goal of ending chronic homelessness when persons with the disabling condition are no longer homeless.

We are not proposing that we will eliminate the disabling conditions of mental illness, substance abuse, HIV/AIDS or serious physical illnesses or disabilities, although we will substantially reduce them. We are proposing that (a) through effective treatment, job training and placement, and housing, persons who currently meet the dual criteria (duration and disability) of chronic homelessness will be able to sustain themselves in housing, and (b) persons who are at risk of becoming chronically homeless because they have one or more disabling conditions will have prompt access to treatment and easy access to temporary or permanent housing once they have completed their treatment and job training, if needed.

Addressing the larger question of ending homelessness (including chronic homelessness), requires a dual set of strategies:

Closing the front door

• …which entails efforts to prevent people from becoming home-less in the first place. This usually involves addressing systemic issues, such as increasing emergency rental assistance programs, and working with institutions such as correctional facilities and hospitals to improve their discharge planning so that persons being released have a place to live and are not released to the street. Currently, Camillus House staff are actively involved in efforts to prevent homelessness in Miami, and are planning to expand our homelessness prevention activities beyond providing rental assistance to forestall eviction of housed persons to offering other forms of financial support to help individuals facing unemployment to keeping a job or get another job.

Opening the back door

• …which entails getting people back into housing as soon as possible. The primary strategy here is to increase the stock of affordable housing, so that persons who have been homeless have somewhere to go when their situations are stabilized.

We recognize that the cure for homelessness is housing, and, over the next three years alone, Camillus House plans to open more than 200 new permanent housing apartments for formerly homeless persons at our new site, as well as on land we own across from our Somerville Residence, through community-based apartments and through home-ownership. We are currently developing strategies to make available an additional 300 scattered-site and Camillus-operated units throughout Miami-Dade County by 2013 to meet our Strategic Plan goal of housing 1,340 persons at a time.

Ending homelessnessmeans that persons at-risk of becoming homeless will not be reduced to living and sleeping on the streets. Such persons may still run into problems and lose their housing, but when they do, there will be available a system of services that willimmediately place them into temporary housing and then quickly move them into a stable living situation.Already, great strides have already been made in Miami-Dade County to eliminating the once common sight of entire families living in cars or on the streets. Through the active efforts of the Homeless Trust, now there are no families living in cars or on the streets of Miami-Dade County.

Camillus House has been providing services for persons with substance abuse problems for nearly 20 years, and currently receives funding from the US Department of Health and Human Services to operate (a) the Federally Qualified Health Center for the Homeless for Miami (through Camillus Health Concern), and (b) our substance abuse and mental health treatment services (through our Institute of Social and Personal Adjustment or ISPA). We also receive funding from the State of Florida for these ISPA programs. We have one of the highest (if not the highest) published success rates for serving persons with addictions and mental health problems (public or private) in the nation. Our treatment program is recognized statewide as the model program for treating co-occurring (addiction and mental illness) disorders.

We successfully graduate one person from our ISPA treatment program per year for each bed we operate. When we increase our treatment capacity to 128 beds, we expect to successfully refer to job training/employment/housing approximately 120 (formerly homeless) persons per year. As stated above, we estimate this number to be 800, and have sized our facility and have planned our treatment program and downstream housing requirements accordingly.

We are about to break ground on a 90 unit permanent apartment complex just south of our Somerville Residence due West of Interstate 95. The new Camillus House campus that is the subject of this request will include 80 permanent apartments. The Camillus House strategic plan contemplates the development of approximately 300 more units, whether in community-based units, home ownership, privately developed units or Camillus-operated facilities. With the concurrent development of housing by the other fine organizations in Miami-Dade County (e.g., Habitat for Humanity, Carrfour Supportive Housing, Citrus Health Network and others), we believe that there will be sufficient permanent housing to accommodate the population we are committed to serve once they complete treatment and job training (when necessary).

The new Camillus House 340-bed facility will be located on NW 7th Avenue between 15th and 17th Streets, NW (at the turn-off to the Westbound Dolphin Expressway [SR 836] from Interstate 95 South). This location puts the new facility in close proximity to Jackson Memorial Hospital and the County Jail. Both of these institutions receive and discharge homeless persons, whom we will be better able to serve post-discharge.

We estimate that, once fully operational, we will serve approximately 4,500 individuals per year at our new site, including medical and behavioral health treatment clients, persons on job training/search and other homeless persons and persons at-risk of becoming homeless.

Not likely. According to the Miami-Dade County Homeless Trust, that among persons who are chronically homeless in this community: 37.5% (or 3/8) have lived in Miami-Dade County all of their lives; 37.5% (3/8) have lived here for 5 years or longer; and only 25% (1/4) have lived here for less than 5 years.

As these statistics demonstrate, persons who are chronically homeless generally do not tend to be geographically mobile. This observation was recently addressed by Miami City Commissioner Tomas Regalado, who is also a member of the Miami-Dade County Homeless Trust, who stated that persons who are chronically homeless tend to not relocate to Miami from other parts of Florida or from other states.

While there is a general movement away from overnight shelters toward the “housing first” model in which homeless persons are immediately placed into permanent housing, at this time there are several advantages to maintaining our current level of overnight shelter care.

First, there are not enough “housing first” apartments in Miami-Dade County to accommodate persons who are homeless. Without overnight shelter beds, more homeless persons will be sleeping on the streets of Miami, in automobiles and abandoned automobiles with no remedy because of the provisions of the Pottinger Agreement. Signed in 1997, the Pottinger Agreement allows homeless persons in Miami to live on the sidewalks and in parks, except when a bed is available for that person in a homeless shelter and the person refuses to accept the available bed. See Attachment A for more information on the Pottinger Agreement.

Second, many persons who meet the criteria of chronic homelessness, especially those historically served by Camillus House, are not ready to benefit from immediate placement in a temporary or permanent housing assignment. Many of these persons are socially isolated, suspicious of others and cognitively disoriented. Experience in our newly established “Pavilion Program,” that permits persons to spend the night and day in our covered Atrium and Pavilion demonstrates that short stays in the Camillus House overnight shelter or courtyard allow our “guests” to become familiar and comfortable enough with our staff to become open to accepting participation in the many additional programs in our comprehensive program to break the cycle of homelessness. These services include housing, medical, mental illness and substance abuse treatment, GED classes, job training and job and housing placement.

Permanent housing refers to what the US Department of Housing and Urban Development (HUD) calls permanent supported housing, which provides affordable housing tied to supportive services, such as ongoing addiction or mental health treatment, case management and help with life skills. It is called permanent because there is no time limit on how long people can stay in their permanent housing setting.

In contrast, HUD and other funding sources tend to place strict time limits on how long a person can live in emergency or transitional housing(usually 90 days and 6–9 months respectively).

Because there is no time limit, permanent supported housing is restricted to those persons who have some type of disabling condition that makes it difficult or impossible for them to live without additional supports. At Camillus House, we generally see two types of people in permanent supported housing:

Persons in recovery

• … from substance abuse tend to need a controlled, supportive environment while they learn to live on their own. These persons tend to move on into other “non-supported” housing after they have become comfortable in their sobriety and employment. For example, at our Somerville Residence (47 families) the average length of stay for a family is two years, after which time most of them move on to independent housing.

Persons with conditions that will make it difficult for them to live on their own

• …such as a mental illness or a physical disability may live in a supported housing program for the rest of their life. For example, at our Brownsville Christian Housing Center (72 singles) most of the clients suffer from some form of mental illness or physical disability. We expect that many of them will never be able to move out.

The Miami-Dade County Homeless Trust was created in 1993 by the Board of County Commissioners to: 1) to administer the proceeds of a one-percent food and beverage tax; 2) to implement the Miami-Dade County Community Homeless Plan, the local continuum of care plan; and 3) to serve in an advisory capacity to the Board of County Commissioners on issues involving homelessness. The Trust is not a direct service provider. Instead, it is responsible for the implementation of policy initiatives developed by the 27-member Miami-Dade County Homeless Trust Board, and the monitoring of contract compliance by agencies contracted with the County, through the Trust, for the provision of housing and services for homeless persons. Camillus House is one of these agencies.

Through its policies and procedures, the Trust also oversees the utilization of the food and beverage tax proceeds dedicated for homeless purposes, as well as other funding sources, to ensure the implementation of the goals of the plan. Additionally, the Trust has served as lead applicant on behalf of the County for federal and state funding opportunities, and developing and implementing the annual process to identify gaps and needs of the homeless continuum. The Trust's annual budget is approximately $37 million, comprised of local food and beverage proceeds, as well as Department of Housing and Urban Develop (HUD) and state funding. Approximately $20 million per year comes through a competitive process via HUD, $11 million via the Food and Beverage tax, and the remainder through State funding and private sector contributions.

The Trust is a proprietary department and receives no general fund dollars from the County. The Miami-Dade County Homeless Trust Board is comprised of a 27-member, broad-based membership representing numerous sectors of our community.

Camillus House is an active participant in Homeless Trust activities, with Camillus staff holding a seat on the Trust’s Board of Directors and participating in the Trust’s planning and advocacy efforts. Camillus currently maintains 14 contracts with the Homeless Trust.

Community Partnership for Homeless, Inc. (CPHI), is a not-for-profit 501(c) (3) corporation, governed by a Board of Directors. The current Chairman is Robert E. Chisholm and the Founding Chairman is Alvah H. Chapman, Jr. The mission of CPHI is to operate two Homeless Assistance Centers (HACs) and to raise the private funding necessary to assist in the implementation of the Miami-Dade County Community Homeless Plan. CPHI is further committed to assisting the Miami-Dade County Homeless Trust in this implementation through encouraging private sector involvement.

HACs are intake centers for the Homeless Trust continuum of care. They are where most, but not all homeless men, women and children come in lieu of remaining on the streets. Camillus House also serves as an intake center for some persons who are homeless. HACs provide short-term residency, during which many services are provided to help these persons regain and restore their lives. In addition to food, clothing, showers and beds, there is a case management staff that works with each formerly homeless person. Each of the 700+ residents of the HACs has a “case plan” designed to lead him or her to being a productive member of society. The first HAC opened in 1995 in Miami and the second opened in 1998 in Homestead.

As with all participants in the Miami-Dade Homeless Trust’s continuum of care, Camillus House and the Homeless Assistance Centers refer persons who are homeless in Miami Dade County to each other’s programs as warranted by the needs of the clients. In addition, Camillus House operates an outpatient behavioral health program at the Homestead HAC. At this Airbase site, Camillus House also operates a transitional program for single men (St. Michael’s Residence) and for families (Mother Seton Village), two of the 13 Camillus House facilities housing more than 800 men, women and children throughout Miami-Dade County. Camillus House and the HACs work closely together that homeless persons have access to a coordinated and seamless continuum of care with services that complement, but do not unnecessarily duplicate, each other’s services (note: moved location of this sentence). On the day-to-day level, Camillus House’s extensive expertise in mental health, substance abuse and medical treatment results in the self- and other-referral of persons with medical and behavioral health problems to Camillus House for specialized treatment. In addition, because of its expertise, and its overnight shelter and inside dining programs for all who present themselves for a meal, Camillus House has for more than four decades been a safe portal into care for many of the persons who meet the definition of chronic homelessness.

In general, it can be said that Camillus House focuses primarily on treating persons who are chronically homeless, and therefore require much more intensive and longer term care, while the two HACs focus primarily on serving persons who are economically or episodically homelessness, and who therefore can be helped within the HAC’s standard 60-day time period. Each program plays a vital role in the community’s efforts to end homelessness, by meeting the unique needs of the subpopulations they are best equipped to serve and treat.

Very high. The Camillus House Institute of Homeless Studies (IHS) was established in 2003, and is positioned to become the nation’s third major clearinghouse dealing with issues related to homelessness. A research, training and knowledge transfer organization, the specific focus of IHS is on helping civic leaders, human service professionals and interested citizens in major cities to end chronic homelessness in their cities. The work of IHS was substantially advanced last November through a major grant from Bank of America.

To date, IHS: (1) has sponsored its first national symposium on the role of health professionals in eliminating chronic homelessness; (2) begun work on a curriculum for first-line staff working with persons who are chronically homeless; (3) published materials on the concept of hospitality as it applies to services for persons who are chronically homeless; (4) begun work on Forty Nights and Forty Days, a book and CD set highlighting, in their own words, the life experiences of persons who are currently chronically homeless in Miami: and, (5) provided to other programs serving persons who are chronically homeless printed materials on Camillus House’s treatment programs, staffing levels, job descriptions and policies and procedures. The Camillus House approach is being studied and replicated by funding and service agencies in several cities on a regular basis.