Housing & Home and Community Based Services

The Trust's Housing & Home and Community Based Services focus area concentrates on ensuring beneficiaries have access to housing and a continuum of services and supports that maximize independence in their home and community.

Housing is a critical component to the continuum. Housing First, an evidence-based practice, identifies that a person must have the safety and security of a place to live before they can commit to consistent treatment of health and behavioral health conditions, reducing or eliminating substance use, obtaining employment or education or meeting other goals.

• The National Alliance to End Homelessness identified that 41 percent of people who are homeless in the U.S. also experience a disability.
• 100 percent of chronically homeless individuals have one or more chronic conditions or disabilities (U.S. Department of Housing and Urban Development definition).
• A robust housing and homeless services continuum of care will include preventive services, emergency services like emergency shelter, tenancy supports, rapid rehousing, supportive housing, and transitional housing
• Supportive housing is designed for people who are homeless who have one or more chronic conditions or disabilities and need a range of support services to remain housed. People who are served through supportive housing have a history of institutionalization or are at risk of institutionalization.

Equally important, is having home and community based services (HCBS) that are person centered to achieve maximum independence, autonomy and dignity. HCBS assist a person with their activities of daily living (e.g., eating, bathing, toileting) and instrumental activities of daily living (e.g., making phone calls, paying bills, managing medication) or support the person to become more independent and engaged in their community.

• People of all ages use HCBS to live independently in their home and community. A person could be born needing support for their cognitive or physical functioning or that need may develop in childhood or adulthood. Support needs can occur from a sudden change like an accident or stroke, or they can slowly build over time as a chronic condition worsens or a body ages. Older adults are the largest group that uses HCBS.
• HCBS are expected to be used long-term. A majority of people using HCBS have a medical condition or disability that will need lifelong support. Some people use HCBS during rehabilitation to restore their physical or cognitive functioning so that they no longer need services. This can take several months or years.
• HCBS can prevent or delay a person needing institutional care from a skilled nursing home or intermediate care facility. People also use HCBS to move out of institutions or safely discharge from a hospital.
• Person-centered means that the person using the services is involved in decisions about how services are selected, designed, and delivered. Person-centered services and supports are customized to meet each person’s unique needs and preferences.

The work of the Trust aligns with Strengthening the System: Alaska’s Comprehensive Integrated Mental Health Program Plan (comp plan), that was developed in a partnership between the Trust and the Department of Health and Social Services in coordination with community stakeholders. The Comp Plan identifies priorities for the next five years to inform planning and funding decisions to meet the needs of  Trust beneficiaries. The intent is to strengthen the system of care to allow a comprehensive approach that quickly meets their needs.

Housing and tenancy supports are identified in the comp plan under Goal 3: Economic and Social Well-being, Objective 3.1: Alaskans have stable, safe housing with appropriate, community-based social supports to maintain tenancy.

Goal 7: Services in the Least Restrictive Environment supports the use of long term services and supports to reach Objective 7.2: Increase access to effective and flexible, person-centered, long-term services and supports in urban and rural areas to avoid institutional placement.