Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director –...
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![Page 1: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/1.jpg)
Informed Tenant Choice of Case Manager in Supportive Housing
Stacy Matuza, Program Director – Schermerhorn/575 5th Avenue
Aaron Levitt, Director of Research & Project Evaluation
Noemi Baez, Case Manager – 575 5th Avenue
Vancito Naar, Tenant – 575 5th Avenue
Center for Urban Community Services (CUCS), New York, NY
(Principal Investigator: Dr. John Jost)
![Page 2: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/2.jpg)
History/Background (Stacy Matuza)
•Strengthening the recovery focus in CUCS supportive housing
Wellness Self-Management
Supported Employment
TENANT CHOICE
{Person Centered Service Planning}
![Page 3: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/3.jpg)
Goals of Tenant Choice
•Increase the opportunity for tenants to make choices that would enable them to have more control over their treatment and recovery.
•Obtain the best possible match between tenant and case manager (CM).
![Page 4: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/4.jpg)
The Pilot Setting
•The Schermerhorn, a supportive housing site located in Brooklyn that opened in February, 2009
Tenants
Formerly street homeless adults
Diagnosed with serious and persistent mental illness and/or HIV
Services
Permanent, lease-based housing
On-site case management
On-site primary medical care
On-site psychiatric services
![Page 5: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/5.jpg)
The Pilot Setting, cont.
•The Schermerhorn was chosen for the Tenant Choice pilot because
Both tenants and staff were relatively new to the program
Relationships were less well-established and long-standing than those at the other CUCS supportive housing sites
![Page 6: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/6.jpg)
Elements of Tenant Choice
•Short professional biographies of each CM provided to all 82 tenants
•A “meet and greet” event held with all CMs
•Tenants were asked to submit their top 3 choices from the 6 available CMs by the following week
•Tenants who chose not to attend the meet-and-greet were given the choice form and asked to submit it within one week
•CMs were asked to submit the names of up to five tenants with whom they would particularly like to work
![Page 7: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/7.jpg)
Tenant Choice Protocol
•All tenant choices and CM preferences were to be viewed only by the Schermerhorn Program Director (PD)
•The PD first identified a subset of high-need/high-priority tenants.
•These tenants were to be matched to their first choice CM unless the PD believed that person’s skill set was not sufficient to meet the tenant’s needs
![Page 8: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/8.jpg)
Protocol, cont.
•Non-high-priority tenants would be matched to their first choice CM with two additional potential exceptions
If assigning a tenant to his/her first choice CM would result in an unbalanced caseload (e.g. many more HIV positive tenants than other CMs), the PD would match the tenant to his/her second or third choice CM
If the caseload of the tenant’s first choice CM was already full, the PD would match the tenant to his/her second or third choice CM
![Page 9: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/9.jpg)
Participation
•58 of 82 tenants submitted choice forms, and 33 attended the “meet and greet”
•All but one tenant chose to remain with his/her current CM
•Tenants who did not submit a choice form remained with their current CM
•None of the exception procedures within the protocol were triggered
![Page 10: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/10.jpg)
Refinements to Tenant Choice
•The meet and greet event has been eliminated
•On the day of a new move-in, the new tenant meets with one of the supervisory staff who explains the elements of Tenant Choice, reviews the biographies of the available CM choices, and introduces the tenant to those CMs
![Page 11: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/11.jpg)
Refinements, cont.
•The new tenant meets with on of the potential CM choices to complete move-in orientation
•The tenant is asked to submit his/her choice of CM approximately one week after move-in
•The Program Director or Assistant Program Director now meets with existing tenants to address requests to switch CMs
![Page 12: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/12.jpg)
Take Away Points
•The pilot reinforces the importance and practicality of providing consumers of mental health services with more control over their services and providers
•It is important to consider when and how consumers are asked to choose their service providers
•At programs with lower pre-existing satisfaction, Tenant Choice may result in more change in caseloads, which could impact staff morale and other aspects of program operations
![Page 13: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/13.jpg)
The Qualitative Study (Aaron Levitt)
•Research Questions How satisfied were tenants with their choices/matches?
How well-informed were tenants’ decisions?
To what degree did tenants value the option of choosing their own workers?
How did staff members experience Tenant Choice?
![Page 14: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/14.jpg)
Study Design
•Semi-structured interviews with 16 tenants who attended “meet & greet”
15 tenants who only submitted a choice form
nine staff members
•Baseline and six-month follow-up interviews
•Interviews were held with tenants who had been living at the Schermerhorn for no more than four months at the time of the “meet & greet”
![Page 15: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/15.jpg)
Findings: Five Themes
•Choice was valued regardless of whether it led to change
•Pre-existing satisfaction drove tenant choices
•Personal qualities were valued over professional training and work experience
•Staff concerns failed to materialize
•Tenants and staff disagreed regarding whether minimal contact versus extended contact leads to better choices and working relationships
![Page 16: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/16.jpg)
Choice Was Valued Regardless of Whether It Led To Change - Tenants
•“[Choice is] very important because I want to know that my choice is important, that I have a choice.”
•“Just to know that my voice counted. That's very important.”
•“It's empowering.”
![Page 17: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/17.jpg)
Choice Was Valued Regardless of Whether It Led To Change - Staff
“Having a choice makes tenants feel like, ‘Okay, I do have some control over what my future holds and who I work with and who provides me with services.’”
•“[Tenants] said that they never went into a place where they actually had a choice of picking who they wanted to work with.”
![Page 18: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/18.jpg)
Pre-existing satisfaction
Less surprising to tenants than staff.
•Most tenants had no doubt about wanting to remain with their current CM—some listed only one choice.
•Staff were somewhat surprised by the loyalty and appreciation they perceived from tenants—perhaps due to staff members’ initial anxiety of not being chosen.
![Page 19: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/19.jpg)
Personal qualities valued over professional qualifications & work experience
“Their credentials does not mean anything to me.”
•Qualities noted as important to tenants “a person that would go out of their way”
“the content of his/her heart and his/her mind”
“the feel you get with a person, the rapport”
“caring and understanding of my situations and circumstances”
![Page 20: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/20.jpg)
Staff Concerns Failed to Materialize - Concerns
•Increased or otherwise altered caseloads
•Not being picked
•Needing to ‘sell’ oneself in one’s biography “It could become a [beauty/popularity] contest”
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Staff Concerns Failed To Materialize - Reality
•There were no noticeable changes—Tenant Choice was smoothly piloted.
“It just happened.”
•Staff focused on stronger relationships with tenants as a result of Tenant Choice.
“I think it just assures us that our tenants are committed to working with us because our tenants could have bowed out.”
![Page 22: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/22.jpg)
Does Minimal Or Extended Contact Lead To Better Choices? - Tenants
Stressed the importance of getting to know a person and working with him/her over time.
•Emphasized the need to be able to communicate with and feel comfortable with a CM, and believe the CM was advocating for them.
“You really can’t tell until you meet the person and get to know them what they’re about."
![Page 23: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/23.jpg)
Does Minimal Or Extended Contact Lead To Better Choices? - Staff
Tenants should choose their CM as soon as possible after moving in.
• Minimize contact with CMs prior to clients making a choice — provide more of a “pure choice” and a better tenant/CM fit.
• New tenants almost always choose the person they first meet; doubt whether tenants consider their other options.
![Page 24: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/24.jpg)
Direct Service Staff Perspective on Tenant Choice (Noemi Baez)
•Experiences at CUCS The Kelly transitional services
No client choice of worker
The Schermerhorn
Participant in Tenant Choice pilot project
575 Fifth Avenue
Assisted with Tenant Choice implementation at this new supportive housing site
![Page 25: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/25.jpg)
Tenant Perspective on Tenant Choice (Vancito Naar)
•Borden Avenue Shelter Had a case worker
Was pleasant
Was fortunate enough to get a good worker
![Page 26: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/26.jpg)
Experience at CUCS
•Moved in June 2011
•Started working with a temporary worker
•Presented with the opportunity to pick your worker
•Felt empowered and in control of your life; didn’t feel like a number
![Page 27: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/27.jpg)
CUCS, cont.
•I chose worker because Worker was dedicated to us
Got a good vibe from worker
![Page 28: Informed Tenant Choice of Case Manager in Supportive Housing Stacy Matuza, Program Director – Schermerhorn/575 5 th Avenue Aaron Levitt, Director of Research.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649f155503460f94c2af58/html5/thumbnails/28.jpg)
Q & A
•You ask the questions, and we’ll do our best to answer!