September 12, 2024, The Illinois Interagency Task Force on Homelessness

The Illinois Interagency Task Force on Homelessness

September 12, 2024

10:00 AM - 11:30 AM

Virtual and In-Person in Chicago

In-Person:

555 W. Monroe

4th Floor, Chicago Conference Room

Chicago, IL 60661

Agenda:

1. Welcome & Introductions 
2. Office to Prevent & End Homelessness Updates 
3. Medical Respite in Illinois 
4. Public Comment 
5. Grants Pass v Johnson, Implications for Illinois 
6. Closing

Meeting Minutes:

1. Welcome & Introductions 
   1. Members of the Task Force present: 
      • Sameer Vohra, Illinois Department of Public Health 
      • Marc Staley, Governor's Office of Management and Budget 
      • Glenda Corbett, Illinois Department on Aging 
      • Kate Ulmer, Illinois State Board of Education 
      • Representative Kevin Schmidt 
      • Deana Schenk, Illinois Community College Board 
      • Evan Ponder, Illinois Housing Development Authority 
      • Gabriela Moroney, Illinois Department of Healthcare and Family Services 
      • Carrie Thomas, Illinois Department of Employment Security 
      • Representative Lilian Jimenez 
      • Mackenzie Hess, Illinois Department of Commerce and Economic Opportunity 
      • Secretary Dulce Quintero, Illinois Department of Human Services 
      • Delrice Adams, Illinois Criminal Justice Information Authority 
      • Kristin Faust, Illinois Housing Development Authority 
      • Margo Watson, Illinois Department of Veteran Affairs 
      • Christine Haley, Illinois Office to Prevent and End Homelessness 
   2. Guests asked to sign in through the chat
   3. Agenda overview 
2. Office to Prevent & End Homelessness Updates 
   1. Home Illinois Plan to Prevent and End Homelessness FY25-26 will be released in October 
   2. Racial Equity Roundtables 
      1. Latino Roundtable invitations to join have been sent. First roundtable will convene in November. 
      2. Black Homelessness Report Release Events. If your agency is interested in hosting an event, please contact Chief Christine Haley. 
   3. FY25 Work Groups 
      1. We welcome participation in the following work groups from members of your agency. 
         1. Morbidity and Mortality Report Response (2 -3 meetings total) 
         2. Public Benefits Access (monthly meetings, 6 - 9 month) 
         3. Homeless Services and Housing Work Force (monthly meeting, 9-12 months) 
         4. Communications/Public Narrative Change Campaign ( 2X month meetings, 3- 6 months) 
         5. Home Illinois Summit (1- 2X month meetings, 4 months) 
            1. If any agencies are interested in cohosting a half day for the Summit please let us know. 
3. Medical Respite in Illinois by Director Vohra and Colleen Mahoney
   1. Our focus is to introduce a report that IDPH published in partnership with the University of Illinois at Chicago in late July, our Illinois homeless morbidity and mortality report. We are only the second state in the country that completed a report like this. 
      1. In the framework of the Home Illinois plan is to close the mortality gap that exist between people experiencing homelessness and the general population. To better understand the mortality gap and the drivers of it. To develop the report, we used six years of hospital and the certificate data to get a better understanding. 
      2. Going into this we recognized that homelessness and health have a bidirectional relationship: 
         1. Poor health increases household's risk of homelessness. 
         2. Experiencing homelessness is linked to rapid declines in health. 
      3. To improve health, work is needed to prevent entrances to homelessness, strengthen systems of care for people currently experiencing homelessness, and strengthen system capacity to support exits to housing. 
      4. The report draws on a long history of local and community groups doing homeless mortality reporting as systems change tool. Excited about looking at opportunities to improve population health. 
      5. Mortality data: 
         1. Years of life lost: Average age at the time of death was almost 20 years younger among PEH compared to the general population. 
         2. Sharp increase in mortality: overall increase of 36.6% in deaths of PEH since March 2020. 
      6. Disproportionate contributing causes of death 
         1. Death-related overdoses: 32.9% of PEH deaths vs 3.4% 
         2. Traumatic injuries inc. homicides: 12.3% of PEH deaths vs 3.6%. Homicides PEH 2.9% vs 1% 
         3. Cold deaths: 3.8% of PEH deaths vs .1% 
      7. Housing status and hospital utilization: 
         1. During years a person had at least one hospital visit coded for homelessness, they had an average of 7 emergency department visits and 2.5 hospital admissions. 
      8. Strengthening Systems of Care: 
         1. The HMMR highlights the need for improved hospital discharge options for people experiencing homelessness. The majority of PEH were discharged to home or self-care. Discharge to medical respite programs have demonstrated some success in limiting readmissions, but most patients are discharged to other settings. 
         2. Medical respite: short-term, post-acute care for people experiencing homelessness who are too ill or frail to recover from an illness or injury on the street or in shelter, but who do not require hospital level care. Increasing the availability of medical respites would improve individual health outcomes, strengthen hospitals, and shelter systems, and prevent unnecessary nursing home placements. 
   2. Illinois Medical Respite Capacity Building Initiative by Jess Lynch, The Boulevard, and BEDS Plus 
      1. Convened and administered by the Illinois Public Health Institute (IPHI) 
      2. Medical Respite Care definition: post-acute care for people experiencing homelessness who are too ill or frail to recover from an illness or injury on the street or in shelter, but who do not require hospital level care. 
      3. Illinois Medical Respite Capacity Building Initiative Projects: 
         1. Medical Respite Capacity Building Awards 
         2. Statewide Medical Respite Learning Collaborative 
         3. Cook County Medical Respite Network (CCMRN) 
         4. Medicaid 115 Waiver Stakeholders' Engagement 
         5. Gap Analysis 
         6. Communications & Outreach Campaign 
      4. Medical respite care sits with the National Health Care for the Homeless Council (NIMRC). Medical respite care is to move to better systems of care to disrupt the cycle of homelessness. There are standards for medical respite care. There are different models for medical respite. 
      5. NIMRC resources and additional information can be found at https://nimrc.org 
      6. We have 6 counties across Illinois where medical respite is up and running. The numbers of beds have more than doubled since 2022. 
   3. The Boulevard's mission is to provide high quality, cost-effective medical care, holistic support, and housing services to help ill and injured adults experiencing homelessness and break the cycle of homelessness to restore their health and rebuild their lives. 
      1. We have 64 medical respite beds in a congregate setting. The organization promotes the adaption of evidence-based interventions across all of its programming, striving to coordinate internal and external partners to ensure comprehensive clinical support to participants. Some of our organization strategies include engaging in housing focused services in which engagement begins immediately upon entry into shelter or program. Access to medical respite care is targeted towards individuals needs, recognition of safety, and seeking balance of power dynamics. We do offer different types of services. We offer medication management, transportation, behavioral health services, and on medical call support. 
   4. BEDS Plus is a leading homeless services provider in the Southwest Suburban Cook County, IL. Our mission is to help vulnerable individuals stabilize their lives through housing and supportive services. Our vision is to end homelessness. 
      1. We have 24-hour programming staff on site. We have a low -barrier medical clinic and peer management. We start the process of housing upon clients entering the program. We offer medication management and transportation for clients. 
   5. The 1115 Medicaid Waiver: Bringing Medicaid authority and a funding match to bear on medical respite services was the Medicaid's agency's charge and commitment in the plan to prevent and end homelessness. 
      1. We have spent a lot of time to secure authority under section 1115 of the Social Security Act, to demonstrate the value of medical respite services for individuals experiencing homelessness or at risk of experiencing homelessness. Our department's commitment to working with the stakeholders and providers has been our drive. All of our effort has been to inform a proposed protocol on how we will operate this benefit under this program. And to continue to drill down into implementation specifics and understand how we can bring the Medicaid authority online for this benefit. 
4. Public Comment 
   1. N/A 
5. Grants Pass v Johnson, Implications for Illinois by Bob Palmer and Arturo Hernandez 
   1. Background on Johnsons v. Grant Pass 
      1. In June the Supreme Court made a decision that local government could have the power to ban camping, therefore people experiencing homelessness can be arrested and fined for sleeping outside even when there are no safe alternatives. 
      2. Known Local Ordinances: Passed and Proposed 
         1. Passed prior to supreme court decision: Alton, Glen Carbon, Godfrey, Granite City, St. Jacob, Wood River, Brighton 
         2. Passed since supreme court decision: East Peoria, Morton, Pekin, O'Fallon, Rosemont, Troy 
         3. Introduced: Elburn, Peoria, Springfield 
      3. Of the ordinances that have passed they seem to be based on two different models. Alton ordinance is very broad camping band. We know that there was push back from the community and they did win multiple protections in terms of lowering and changing the fine structure and requiring warning and more outreach from social service agencies. Illinois Municipal League Model Ordinance has its own model of the ordinance. It focuses more on criminalization penalties, higher fines, the possibility of incarceration, fewer protections in terms of warnings or connecting people to resources. 
      4. The Supreme Court and Grants Pass addressed a very narrow issue which has found that anti-camping bands do not violate the cruel and unusual punishment clause of the 8th amendment of the United States Constitution. These anti-camping ordinances are not supportive approaches to addressing homelessness. Chicago Coalition to end Homelessness is working with various organizations to advocate for allocating funds towards permanent housing and supporting services. 
   2. Illinois Department of Human Rights (IDHR) by Alex Bautista, Deputy Director, and Betsey Madden, General Council 
      1. Would like to start with discussing the ecosystem of civil rights for people experiencing homelessness (PEH) in Illinois. Two of the protections for PEH are the Illinois Bill of Rights for Homelessness Act (protection from governmental abuse, misconduct, or mistreatment) and the Illinois Human Rights Act (provides that an individual cannot be discriminated against in many domains of life). The act gives the jurisdiction over areas such as employment, housing, financial credit, public accommodations, education environments, and entire marketplace. 
      2. IDHR ability to be assistance is very non direct. We are mandated to answer the call of individuals who reach out stating they are being discriminated in one of the sectors, please enforce my rights. We will investigate and then it goes to another body for a trial. The process is to address the harm and make the person whole. We are more secondary in nature. 
      3. Many of the protections are interrelated to homelessness. Various groups of people are at higher rates for homelessness, including but not limited to LGBT youth, persons with disabilities, persons with mental disabilities, people from certain countries or ancestries, people of particular races, and veterans. 
      4. There are other models where there is interventions and support. One being LEP, Limited English Proficiency. Every state has to be able to provide services regardless of a person's ability to speak English, see, or hear. It is an important model to consider as we are discussing meeting the needs of individuals experiencing homelessness. We are required to provided reasonable accommodations. It had been a big problem for some time where some cities passed ordinances that say if the police are called to a residence a certain number of times, then the landlord is required to evict the tenants because it is a nuisance address. This can cause issues with civil rights protections depending on the scenario. 
      5. Recently we added two areas to the Human Rights Act that could be helpful in this area. One, there no longer can discrimination on the basis of income in housing. The second is immigrant status protection, where there cannot be discrimination in providing housing based on immigration status. 
      6. We are excited to participate with OPEH. We have a standing initiative to look at the civil rights of persons experiencing homelessness. We are looking to ensure that we are enforcing the Human Rights Act holistically. We are reevaluating if we need to strengthen the bill of rights for the homeless and our own act. We are looking to validate a need to issue a statement to local municipalities. Revalidating our enforcement with homelessness. 
      7. In our society a lot of issues are being brought to the Supreme Court. There is a big move to requestion all of these things. This particular law is very narrow, and we still have the ability to expand our interpretation. 
   3. Is there anything that you think we can do, that would be organized in an effective way? Who is not at the table? Are there next steps from what we are doing today? 
      1. Would offer three themes: 
         1. Collaboration. Must address this collaboratively. 
         2. Knowledge. Generating knowledge so we have something to work with. 
         3. Look at your agencies. Each agency needs to examine the accessibilities and barriers for individuals experiencing homelessness.
      2. There were attempts to oversimplify the issue of homelessness. All of the reports will help to make sure this subject is not oversimplified. 
   4. We wanted to dive deeper with you all to understand the access points. With all of the programs the state manages, how do we address that comprehensively. This is the beginning of the conversation, and we are in it for the long haul. If there are members in your agencies who are specifically involved with PEH please let us know. 
   5. Our next Task force meeting is December 12th at 10am. Every year on December 21st there is a memorial service, the day to memorialize people experiencing homelessness. 
6. Closing

Meeting Recording:

September 12, 2024 Recording

Meeting Presentation:

September 12, 2024 The Illinois Interagency Task Force on Homelessness Presentation

Illinois Department of Public Health Presentation