Merrimack Valley - Housing First

This case is about a 38 year old, single white male with a reported and verified history of chronic homelessness for twenty years between Lowell, Lawrence and Haverhill. Prior to referral to the MVRN, this client had been living in a tent in the woods along the Merrimack River for 10 years and had been hospitalized and/or utilized emergency room services 20+ instances in the 6 months prior to his being housed.

This client suffers from cirrhosis of the liver, alcohol dependency, depression, anxiety and schizophrenia and is currently prescribed 10 medications. He was referred to the MVRN by a homeless outreach clinician from Eliot Community Health Services as a potential referral into our program.

The MVRN case manager was brought to this client's campsite by the outreach clinician from Eliot CHS on the morning of 12/4/09, an assessment was completed by the MVRN case manager. The client had indicated at that point in time that he was willing to move into an apartment. The MVRN phoned a landlord that we had established a working relationship with and explained this clients' situation. The landlord agreed to allow this gentleman to move into his unit, the same day without having previously secured payment for first and last months rent. The client agreed to move and was housed by the end of the business day on 12/4/09. The MVRN case manager was able to pull together community resources to secure basic items, such as food, blankets, pillows, toiletries, to hold this client over for the weekend.

The following week, the MVRN case manager was able to secure a new rep-payee for this client to ensure that his rent and household bills are paid each month, as well as budgeting out spending money each month. His former rep-payee would mail this clients money to a local food store. While homeless, this client was living month to month, had secured a line of credit at a local store and would use his monthly check to pay back the store for his arrears.

Upon entry into his new home, this client had no financial resources, no food stamps and no money to pay for prescribed medications. The MVRN case manager contacted community resources for food supply and was able to procure an adequate food supply for this client to get him through the month. Since this client had no funds available to pay for his prescribed medication (refills), Eliot CHS was able to furnish this client with the necessary funds to secure the appropriate medication.

A referral was facilitated for furniture and household goods though the Lowell Wish Project. The client was able to obtain furniture; household items (pots, pans, dishes, sheets, towels, etc.) to outfit his new apartment.

After week one in his new apartment, the client reported to the case manager that he was feeling unwell. Although he had a scheduled appointment with his nurse practitioner, he felt that he could not wait for this appointment. Subsequently, went to the emergency room and was admitted to the hospital for one week.

Upon discharge from the hospital, new medications had been prescribed; he had no funds to secure his new medication. The client identified a community resource that he had used in the past and was able to procure funds for his newly prescribed medication. The MVRN case manager provided the use of cell phone and transportation to access this resource.

Since his discharge from the hospital, this client has followed up with his provider appointments, taking all medications that he is prescribed appropriately, the case manager meets with the client once per week to develop a schedule of tasks for him to complete each week (making appointments, fuel assistance, grocery shopping, etc.), developing a budget with his new rep-payee to be able to identify bills that must be paid each month. The client was able to secure a new cell phone and is now able to phone his case manager when he completes a task or is in need of encouragement or advice in resolving conflicts he might encounter (neighbors, orienting to time, place and direction).

Since he has been housed his monthly social security payment, his monthly food stamp entitlement has increased and he has applied for fuel assistance to subsidize his utility bills. Thus far, this client is able to remain stable and with MVRN case management and community supports, this client will be able to remain stable and has experienced a decreased need for emergency medical services and/or hospitalization.