Learn More About: PATH

Learn More About: PATH

Why the program is critical to Nashville’s homelessness response

BY JUDITH TACKETT

In my years working with the city and in collaboration with nonprofits, I found that providers did not fully understand a program that offers many best practices for creating sustainable homelessness programs: the PATH program.

PATH stands for Projects for Assistance in Transition from Homelessness and is funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Each state receives a portion of this grant, and the Tennessee Department of Mental Health & Substance Abuse Services works with local/regional providers to implement sustainable programs.

As our community engages in conversations about a temporary, three-year $50-million plan to address outdoor homelessness, we need to focus on increasing sustainable funding sources and learn from best-practice programs such as PATH.

In a previous column, I already touched on Metro’s outdoor plan, but let’s recap quickly what we know so far. If approved by Metro Council, the $50 million will come out of the American Rescue Plan (ARP) funds the city received from the federal government as part of the continued response to the COVID crisis.

The city plans to spend $25 million to create new housing units and $25 million for support services. The temporary support services funding would be administered by the Metro Homeless Impact Division and go to the following areas (as presented by the Mayor’s Office at the August Homelessness Planning Council meeting):

• $9 million to implement an Assertive Community Treatment (ACT) team at nonprofits that are already set up to be reimbursed by Medicaid. This basically would serve people who qualify for Tenn Care to make the ACT program sustainable.

• $9 million to pay for temporary housing in three ways:

• A motel with 24/7 security (continuing a partnership with a motel that was utilized for Rapid ReHousing with previous federal COVID dollars).

• Mobile Housing Navigation Centers utilizing churches as temporary shelter spaces (expand and existing program).

• A 2-year micro housing community, which is new and would be set up as a pilot program.

• $7 million for what I would describe as community-based supports to work with landlords in the community. Of these funds, $ 3 million would be dedicated to expanding the Low Barrier Housing Collective, a landlord engagement program providing incentives to landlords working with Metro and/or nonprofits to rent to people transitioning out of homelessness. The remaining $4 million would be posted as Requests for Proposals (RFP) for community nonprofits to provide support services. After Metro Council has approved the $50 million in ARP funds, there will be more to dig into it as more details appear.

What is clear, however, is that outdoor homelessness is at the center of local political attention. It would be shameful to act as if providers have not been working to coordinate efforts to reduce outdoor homelessness all along. As outdoor homelessness has increased during the COVID crisis, shelter homelessness in Nashville has slightly decreased, and an annual snapshot count conducted on Jan. 27, 2022, actually showed a 5-percent overall decrease.

But do not let politically motivated talk make you believe that the provider community has not been calling for the politicians to step up for years. As we know, political will only seems to form when affluent communities organize to point out a problem while elections are looming. With Nashville mayoral elections next year, Mayor John Cooper will have strong competition with two candidates already declared (Council member Freddie O’Connell, and Matt Wiltshire who used to work in the Mayor’s Office and at MDHA) and others likely in the wings waiting to announce their candidacy. Homelessness will be one of the top political issues next year, and political candidates including those running for Metro Council know it.

When we look at the need for services, an outdoor survey conducted during that one-night count showed that 48 percent of unsheltered Nashvillians reported that they suffer from a serious mental illness and 39 percent reported having a substance use disorder.

Programs like PATH are imperative to assisting the people who transition out of homelessness and suffer from serious mental illness and/or substance use disorders.

PATH uses federal block grants that in Tennessee the Department of Mental Health & Substance Abuse Services administers. In Davidson County, the Mental Health Cooperative (MHC) implements the following services through the PATH grant:

• Outreach — PATH outreach specialists engage people experiencing homelessness on the streets, in encampments, and places not meant for human habitation. The MHC outreach team also provides in-reach to individuals as they utilize local libraries, day shelters, and stay at local shelters. The goal is to link and refer people to local providers with a focus on mainstream mental health and physical health services. MHC’s PATH outreach program serves Davidson, Wilson and Sumner counties. They work alongside community partners including monthly outreach in coordination with the Co-Responders Team that works with the Metro Police Department.

• Screening and diagnostic treatment — the PATH team conducts intake assessments, crisis assessments, and psychiatric evaluations. The MHC outreach team also completes the triage tool used for the Davidson County coordinated entry process.

• Community mental health — Davidson County’s PATH program consists of the following staff:

• 3 adults outreach specialist

• 1 Child and Youth outreach specialist

• 1 Peer Support Specialist

• 1 Primary Healthcare Coordinator

• 3 Care Manager/1 Open Care Manager position

• 1 Supervisor

• 1 Program Manager

• 1 Nurse

• Psychiatrist

• 1 Ryan White Mental Health Specialist (non- PATH Funded)

• Substance use disorder treatment – these services are non-PATH funded, but MHC provides a Medically Assisted Treatment (MAT) program to treat opioid addiction.

• Staff training — MHC staff provides training to other community agencies per request on topics such as street outreach, mental health and crisis de-escalation.

• Case management — PATH ensures people’s needs are met by coordinating and linking people with necessary health and mental health treatments. Coordination includes, but is not limited to, scheduling and transportation to appointments, medication deliveries, and accompanying people to appointments. Case managers serve as housing advocates and help locate housing, fill out forms and other paperwork, link with ongoing support services, refer to SSI/SSDI Outreach Access and Recovery (SOAR) programs to help link people with benefits, assist people with access to job training and educational services, etc.

At this point I support the $50-million plan, even though it shows clear gaps and is as of now unsustainable. But it will help a lot of people over the next three years, if our community learns to leverage programs like PATH, SOAR, and if we find ways to increase ongoing funding sources to support the services so many of our local nonprofits have been providing all along.