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ANNEX A
PROGRAM COMMITMENTS
PATH PROGRAM
NAME OF AGENCY: _______________________
CONTRACT NUMBER: _____________ CONTRACT TERM: ___ / ___ / ___ TO ___ / ___ / ___
BUDGET MATRIX CODE: BUDGET MODIFICATION NO:
(0 = Original) ________
1. Total number of homeless individuals who will be outreached.
2. Number of New Enrollees and Transfers.
3. Of all New Enrollees total number of homeless clients with co-occuring
mental health and substance use disorders.
Individual Group
4. Number of face-to-face on-site contacts with or on behalf of clients.
5. Number of face-to-face off-site contacts with or on behalf of clients.
6. Expected aggregate number of telephone hours with or on behalf of clients.
7. Total number of enrolled clients successfully linked to non-mental health programs in the following areas:
a. Financial e. Medical/Dental
b. Housing Placement Assistance f. Mental Health
(Long-Term Housing)
c. Relevant Housing Services g. Job Training
(Temporary Housing) (Habilitation/Rehabilitation)
d. Drug/Alcohol Program
Individual Group
8. Units of Service will be provided. (Sum of lines 3 and 4)
HOMELESS INDIVIDUAL: Any individual who suffers from serious illness and who lacks a fixed, regular and adequate nighttime residence or an individual whose primary nighttime residence is a homeless shelter or transitional housing (without regard to whether the individual is a member of a family).
HOMELESS PERSONS WITH CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER: A homeless individual who suffers from serious mental illness and who also has a substance use disorder (a period of active substance use that affects his/her functioning or recovery from substance use and continues to require support).
FACE-TO-FACE CONTACTS: Refers to direct contact with or on behalf of the consumers for 15 continuous minutes. If a contact exceeds more than 15 continuous minutes, count as multiple contacts. If one staff member serves between two and six clients simultaneously, count as one group contact per client (group contacts of seven or more clients are not reportable). Travel time is to be excluded from overall contact time.
TELEPHONE CONTACTS: Aggregate phone time with or on behalf of the consumer.
ON-SITE: Means services provided at the agency offices.
OFF-SITE: Means services provided in any location other than the agency offices.
UNITS OF SERVICE: Sum of items 4 and 5.
OUTREACH: Means any staff contact with a homeless individual in order to introduce the program or staff, establish a relationship, assess the individual, or attempt to engage and enroll the individual in the PATH program.
ENROLL: An individual is considered as enrolled when he/she has agreed to allow PATH to provide a service and an intervention is made on their behalf. (Enrollment is accomplished by opening a case record (completing a USTF, basic demographic information, documented eligibility, and agreed upon service to be provided).
FINANCIAL: Income supports that are financial supports that can be used at the consumers discretion and are not limited to specific uses. Examples include: Social Security Income (SSI), Social Security Disability Income (SSDI), Temporary Assistance for Needy Families (TANF), and pensions, including Veterans pension. Income supports are not earned income (e.g., wages), non-cash benefits, (e.g., Supplemental Nutrition Assistance Program (SNAP), nor temporary financial assistance (security deposits, rental assistance, utility assistance, energy assistance).
Housing Placement Assistance (LONG-TERM HOUSING): Permanent housing (apartment, rooming house, with relative, etc.) or Permanent Supportive Housing program.
Relevant Housing Services (TEMPORARY HOUSING/SHELTER): Motel/Hotel placement, transitional housing, Safe Haven, temporarily doubled-up with family/friends and not on the lease/mortgage.
DRUG/ALCOHOL PRORGRAMS (TREATMENT SERVICES): Alcohol and Drug Treatment Services: Services including linkages to detox, drug/alcohol rehabilitation, 12-step programs, or partial care treatment programs for co-occurring mental illness and substance use.
MEDICAL/DENTAL: Medical care that is overseen by a licensed medical primary care provider or licensed dentist.
MENTAL HEALTH SERVICES: Community-based supports designed to stabilize and provide ongoing supports and services for individuals with mental illnesses/co-occurring disorders or dual diagnoses. Examples of community-based mental health services include: Outpatient Psychiatric and Counseling Services, Partial Care, Medication Monitoring, Intensive Case Management Services (ICMS) and Supportive Housing Services.
job training (HABITATION and REHABILITATION): Community-based employment and educational services designed to promote maximum functioning, a sense of well-being, and a personally satisfying level of independence for individuals; such as Work First, Supportive Employment and other vocational services.
3-10-15 ANNEX A: PATH Programs , Program Commitments Page 1of 2
6/07 ANNEX A: PATH Programs
3-10-15 ANNEX A: PATH Programs, Program Commitments Page 2 of 2
PATH PROGRAM
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