Street Outreach

Definition and Overview

• Street Outreach is the act of engaging people experiencing unsheltered homelessness where they are, which is often on the street, in encampments, or in other places not meant for human habitation. Street Outreach is non-facility based, meaning that services are offered where individuals are living as opposed to providing services in service provision offices.
• The goal of Street Outreach is to connect individuals to services, housing, healthcare, other resources, and essential survival tools. The initial strategy is often to build trust with individuals encountered during outreach so they are comfortable accessing available services, including housing. Trust is essential, as those experiencing unsheltered homelessness are often disconnected from community resources and may not trust systems or service providers. This mistrust may result from past experiences with homelessness response systems that have not worked or that have directly exacerbated traumatic experiences.
• By building trust with individuals living in unsheltered situations, outreach staff can work together with the individuals to connect them to services that resolve their homelessness. Rather than focusing exclusively on outputs (such as counting the number of meals served), providers should also focus on creating as many engagement opportunities as it takes that ultimately moves someone from unsheltered homelessness to safe, stable housing.
• Staffing best practices include having at least one peer and one additional staff member  conducting outreach together. As with all programs, staffing structure and model should center lived experiences of homelessness and related systems. Outreach programs may consider hiring nurses, clinicians, and other clinical or specialty professionals, but only if the program cannot secure the staffing through existing medical programs or partnerships as these positions can often be funded through Medicaid or other insurance or services funding.

Program Parameters

Supportive Services 

• Engagement and case management: Efforts to provide essential services to individuals experiencing unsheltered homelessness who are unwilling or unable to access emergency shelter, housing, or other services or programs. This includes: (i) making an initial assessment of services need and eligibility; (ii) assessing housing and service needs and arranging, coordinating, and monitoring the delivery of individualized services; (iii) coordinating with emergency shelter providers for immediate access to shelter options, including hotel/motel vouchers; (iv) providing crisis counseling; (v) addressing urgent physical needs, such as providing meals, blankets, clothes, or toiletries; (vi) actively connecting individuals to programs and services, including transportation to needed services; and (vii) other reasonable and necessary efforts to connect individuals to immediate support, intervention, connections with housing, homelessness assistance programs, and/or mainstream social services and housing programs.
• Services for behavioral health, mental health, substance use disorders, and medical care: Includes a continuum of behavioral health services, treatment, and crisis intervention that is provided in non-facility settings. Also includes coordination for access to healthcare-related services including primary care, substance use treatment, mental health care, vision and dental care, and emergency, crisis, and inpatient services. Emergency behavioral, mental, or physical health services funded under this activity may include direct outpatient treatment by licensed professionals operating in non-facility-based settings.
• Educational, vocational, and work-based learning opportunities: Efforts to connect individuals encountered through outreach with educational, vocational, and work-based learning opportunities that resolve a household’s homelessness as quickly as possible. A best practice is for outreach programs to create or connect to peer mentoring programs and hire peer mentors with lived expertise regarding homelessness to conduct outreach, as well as contribute to program design and improvement. 
• Recovery care and related residential programs: Efforts to connect individuals to community resources that offer recovery care and related residential programs, including the cost of transportation to such services and treatment.

Operations

• Operations: Efforts related to locating and delivering services to individuals experiencing unsheltered homelessness where they are living and building rapport with them. This may include (i) physically locating individuals residing in unsheltered situations; (ii) getting staff to those locations; (iii) ongoing communication (including cell phones for outreach workers during the performance of these activities); and (iv) and other reasonable and necessary efforts required to locate and build trust with those in unsheltered situations. Additionally, this can include mapping the location of unsheltered encampments as well as upgrading, enhancing, or customizing a database that can track real-time, geographic data about homelessness outreach efforts. 
• Grant Activities: Efforts focused on administering a specific grant or funding source may improve effective operations, as well as effective program implementation. Such efforts include planning and executing program activities, such as (i) general program or grant management, oversight, coordination, monitoring, and evaluation; (ii) salaries, wages, and related costs related to preparing program budgets; developing systems for ensuring compliance with grant requirements; developing interagency agreements; and preparing reports and other required documents or activities; (iii) accounting or other services; and (iv) other reasonable and necessary goods and services required to implement the grant program, such as evaluating program results against stated objectives, occupancy costs, and training on program requirements. 

Expected Outcomes for Street Outreach

• Outcomes typically focus on the number of engagements before an individual engages in housing or service connection (a higher number of interactions is not a negative outcome, as individuals may require time to build trust with programs and staff); improving safety for and reducing harm among people experiencing unsheltered homelessness; housing outcomes (all outreach should be focused on creating connections to permanent housing); and connections to community resources, which happen through a “warm” handoff from outreach staff to ongoing supports. “Warm” handoffs avoid blind referrals to community resources and ensure there is a gradual handoff to a housing case manager, such as but not limited to visiting individuals for a few weeks after obtaining housing. 
• Street Outreach programs play a key role in a community’s larger data system and quality measures that evaluate the number of individuals who move from unsheltered homelessness into safe, stable housing, as well as other community goals. One example of how Street Outreach may advance community housing efforts is through increasing successful Coordinated Entry System referrals (i.e., reducing the number of households who cannot be located, to increase households being matched to a resource).