Cross-System High Utilizers Initiatives Summary

January 29, 2020

The City of Columbia, Boone County, the 13th Judicial Circuit Court, MU, and the VA have been working
collaboratively to decriminalize mental illness and homelessness in order to improve community and
individual outcomes for high utilizers of justice, public safety, healthcare, and human services systems.

Homelessness

What we’ve done…

Our community is leading the way in Missouri in the effort to address homelessness. Our efforts have
resulted in a leveling of the number of people experiencing unsheltered homelessness and a reduction
in the overall rate (per 1,000) of homelessness in Boone County:

This is in contrast to the national trend of rising levels of homelessness and has been accomplished
through a variety of strategies and initiatives:
• Through the coordinated entry process our community built and utilizes, we now know the exact
number, name, and risk levels of all sheltered an unsheltered persons experiencing
homelessness. The Functional Zero Task Force comprised of multiple human services and
housing providers, convenes every two weeks to case conference people into housing, with
those of highest risk first.
• The City continues to strategically purchase social services to address homelessness, including:
emergency shelter, mental health services, and housing case management.
• The City coordinated, supports, and participates in the Columbia Street Outreach Team, which
provides street outreach to unsheltered individuals.
• The City has coordinated with the faith community to develop and sustain the Turning Point day
center and the Room at the Inn winter emergency shelter.
• The City facilitates access to significant levels of federal funding for homelessness services and
housing including ESG, EFSP, and CoC funding.
• The City coordinates the annual point in time count of persons experiencing homelessness.
• The City is a key partner in our community’s bi-annual Project Homeless Connect events.

Challenges…
• A lack of infrastructure for the coordination of efforts to address homelessness.
 • A lack of access to healthcare (including mental health and substance use disorder treatment)
due to Missouri opting not to expand Medicaid.
• A lack of affordable housing and a high housing cost burden.

What we need…
Realistic
• A City position dedicated to coordinating homelessness initiatives.
• A 24/7/365 safe haven (homeless drop-in center/shelter).
Stretch
• A 24/7/365 mental health access center.
• A significant increase in supportive hosting.
• Medicaid expansion in Missouri.

Cross-System Initiatives

What we’ve done…

• Through a federal Social Innovations grant, the City and County, in partnership with the
University of Chicago, developed and implemented a data tool to merge jail and homelessness
data in order to identify cross-system high utilizers.
• The City, County, and Columbia Housing Authority partnered to obtain HUD 811 housing
vouchers used to provide additional supportive housing for chronically homeless individuals.
• The City, County, and community partners participated in a two year NACO/NLC Advancing
Cross-System Partnerships Leadership Lab, funded by the Arnold Foundation.
• The County has facilitated two Sequential Intercept Mapping exercises with the City, the 13th
Judicial Circuit Court, and community partners to identify strengths and gaps in the justice
system. A co-responder program and a justice coordinator position were identified as the top
needs.
o We are developing a grant to the VU Foundation to fund a justice coordinator position.
Positions like this have proven to be effective in communities addressing cross-system
high utilizers.
o We have submitted grants to the National Institutes for Health (NIH) and the Robert
Woods Johnson Foundation to fund a co-responder program to be administered by the
City/County Public Health and Human Services Department.
• The 13 Judicial Circuit Court has implemented treatment and veterans courts.
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• The City Municipal Court established a community support docket to divert persons experiencing
homelessness and veterans from the justice system by linking with healthcare, human services,
and housing.
• The County has implemented the use of a brief mental health screener at jail intake, increasing
our understanding of mental health needs at the individual and populations levels.
• The City, County, and Burrell Behavioral Health have partnered to have a Community Mental
Health Liaison position dedicated to Boone County, to be housed in the Columbia Police
Department.
• Through its Children’s Services Fund, the County has:
o Developed the Family Access Center as a key strategy in diverting children, youth, and
families from the justice system.
• In partnership with all Boone County schools and MU, implemented a youth behavioral health
screener conducted bi-annually with all school age children in Boone County. This facilitates the
implementation of mental health interventions at the if individual and population levels.
Challenges…
In addition to the challenges outlined above:
• A lack of infrastructure for justice system coordination.
• A lack of interest and participation by hospital systems.

What we need…
In addition to the needs outlined above:
• A position dedicated to justice system coordination (grant pending).
• A co-responder program (grants pending).