Opinion: Can Denver case managers solve homelessness?

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Mayor Mike Johnston repeatedly has said that case management will determine the success of his multi-million dollar All in Mile High campaign, which began last year to end homelessness in Denver.

But are case managers up to the challenge? Do they have the tools that they need?

I recently sat through three online training sessions for homeless shelter case managers in Denver. I thought readers might find interesting what the case managers learn. The training is provided by Denver’s Department of Housing Stability, or HOST, to the many non-profits that provide case management in Denver.

Denver’s methods of providing services to people experiencing homelessness have greatly improved even since I was homeless in 2019-2020. For example, many shelters now are open 24 hours, which means people who work the night shift can also use them. Back when I was homeless, you had to line up for shelters beginning around 4 p.m. You then either were let inside or bused to another shelter site around 6 p.m. You were not allowed to come to the shelter after 6 p.m., which means people experiencing homelessness could not work nights and stay in a shelter. You could not leave and come back. You were thrown out about 6 a.m.

The case of Homer

In the first online training session for case managers, the instructors, Mel Davis Campbell and Patrick Casey, use the example of a client named “Homer.” Homer works nights so he needs a low-barrier shelter that will allow him in late in the evening. Other shelters require life skills classes three nights per week. An individual who works nights would not be allowed to stay at that shelter.

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Case managers are taught that Denver’s homeless services system is “imperfect” and clients often express frustration. They are told not to take those frustrations personally.

What case management is

I have written before about the great expectations placed on case managers. In April, Housekeys Action Network Denver, a homeless advocacy group, had this to say about case managers for the city’s rapid rehousing efforts. “Case managers, who were supposed to be helping these residents over these past two years, were given no resources to connect them to, told misinformation (including telling residents that they should not worry because they should be getting a long-term housing voucher at the end of the time), and the turnover rate for these case managers was so high making it near impossible for them to provide consistent assistance,” HAND said in a news release. “Instead, individuals are blamed and told they should have gotten their lives together in the last two years to be able to afford the $1,000 to $2,000 a month rents.”

Rapid rehousing is when someone goes from an encampment to a lease. The idea is they get a few months’ free rent and by the end of that time they will have a job. That’s often not what happens, however.

Not enough case managers

The problem with putting the onus for finding permanent housing on the case managers is that there aren’t enough of them. Pay is so low that case managers and other employees at Colorado Coalition for the Homeless, for example, are attempting to unionize. Case workers for the Coalition make between $20.64 and $25.14 per hour, according to Zip Recruiter.

But case managers for the city’s All In Mile High Shelter program, where unhoused people are housed in hotels and tiny home villages, do receive training such as the three seminars I watched online. Case managers are taught that everything they do should ultimately help find their clients housing. They should work to minimize “turnaways” (sending people back because they don’t qualify for services) and “DNRs” (do not returns, people banned from the shelters), the trainers emphasized.

Causes of homelessness

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Case managers learn what causes homelessness. The trainers emphasize that most people do not become homeless because they are lazy, or don’t want to work. Reasons for homelessness range from mental illness to racial income inequality and systemic racism, to job loss, to housing prices being out of sight. The recent Point in Time Count by the Metro Denver Homeless Initiative showed that relationship and family problems top the list of reasons contributing to homelessness. Sometimes domestic violence forces someone out of their home.

What case management isn’t

Case management is not “just Googling resources or handing someone a resource guide,” Casey told the trainees. It’s also not “doing everything for your client” or “using tough love to motivate folks.” He said it’s important to remember that case managers are not responsible for their clients’ success or failure.

Essential case manager skills, Casey said, include active listening, setting boundaries, de-escalation, realistic goal setting, knowledge of resources, being non-judgmental and purposeful.

Case managers keep copious notes

In a second online training session, case managers are taught to keep copious notes about what they discuss with their clients. This is so other providers can access that record in the Homeless Management Information System, or HMIS. The HMIS is a database of facts about homeless individuals, from where they slept last night to who is providing mental health services. The database is maintained by the Metro Denver Homelessness Initiative. Trainers in all the sessions stressed the importance of case managers entering data into the HMIS. That’s how the city will be able to track whether their efforts are successful. “Every conversation should lead back to housing goals,” Davis Campbell said during the training. “Data is essential to understanding how successful we are.” She said HMIS data entry is critical to “the bigger picture of solving homelessness.”

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Patience, fairness a must

Davis Campbell tells case managers during the training session that they must be patient with their clients and realize progress is not always linear. “It’s a process not a destination,” she said. Other tips included: Express empathy, not sympathy. Promote independence. Empower and prioritize client choice. Accommodate to the individual’s/family’s needs. Be transparent and cordial.”

Training also included warning new case managers not to abuse their power. “We do hold a level of power, and we don’t want to use that as something we hold over the heads of people,” Casey said.

Can I trust my case manager?

That may lead some to wonder, “Can I trust my case manager?” I do trust my case manager. Very much. But I’ve had the same case manager for four years, which is unusual. Case managers are expected to keep your confidential information quiet and can get into trouble if they don’t. But people experiencing homelessness should now that judges can subpoena case manager notes. So, anything you share with your case manager potentially could be shared with other agencies. That’s probably something to keep in mind when determining how forthcoming you want to be. But at the same time, your case manager cannot help you if you are not honest about what your issues are.

Ultimately, climbing out of homelessness can only occur if the unhoused person makes it happen. A case manager’s job is to vigorously help them attain that goal. But deciding to no longer live on the street rests with the individual.