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Effective July 1, 2016, TJC’s Behavioral Health Care Accreditation Program will include standards for case management services provided to individuals being served in a Housing First program. The new standards are designed to assist individuals with serious mental illness, substance abuse disorders, and other behavioral healthcare issues. They are applicable only to TJC accredited behavioral healthcare organizations that provide case management services to clients in a Housing First program. They are not a requirement for accredited BH organizations to offer this type of service.

The hallmark of the Housing First program model is that homeless individuals are placed into private permanent housing without any requirement to participate in services except to meet with their case manager. Once the housing is secured, case management staff work with clients to help them access physical healthcare and behavioral healthcare services they may need.

The impetus for the Housing First model is the fact that a large percentage of homeless persons have a mental health or substance abuse disorder. SAMHSA estimates that 20-25% of the homeless population in the U.S. suffers from some form of severe mental illness. Often, the chronically homeless live in a cycle of surviving on the street, being admitted to hospitals, shelters, or jails and then going back to the street. Providing a home as the first step for someone who has been chronically homeless often gives that person the stability they need to begin the process of recovery. Indeed, research has shown that if the critical need for housing can be met for these persons, they are more likely to avail themselves of other types of support services such as physical and behavioral healthcare.

The key requirements of the new standards are as follows:

Care, Treatment, and Services Chapter

  • The organization places individuals served into housing that is affordable and readily available.
  • The organization places a minimum of contingencies on individuals served.
  • The organization offers an array of services to individuals who are receiving permanent housing support services.
  • A multidisciplinary team coordinates the provision of care, treatment, or services

Human Resources Management Chapter

Staff who provide services to individuals in permanent housing support services programs have specific competencies.

For the full text of the new standards and elements of performance, see the TJC website: Prepublication Standards – Requirements for Behavioral Health Care Permanent Housing Support Services.