Scattergood Foundation

Advancing Innovative Strategies for Change in Behavioral Health

The Scattergood Program for Applied Ethics of Behavioral Health Care

Name of Innovative Program: 
StreetChange
Sponsoring Organization
The Scattergood Program for Applied Ethics of Behavioral Health Care
Name of Innovative Program Lead: 
Andrew Siegel, Michael Brody
E-mail Address of Innovative Program Lead: 
siegel.drew@gmail.com
Physical Address of Innovative Program: 
Not Applicable
Project Description: 

StreetChange has the potential to be a transformative force for engaging and assisting street homeless adults in need of permanent housing. By facilitating transactions between homeless individuals, passersby, and organizations wishing to assist them, this project can help them in the short and long terms.
Homeless clients undergo a brief intake assessment in which short-term material needs and long term goals are identified. Short term material needs are translated into a “registry” of items toward which passerby donors can direct funds. Each client receives an iBeacon proximity sensing device that transmits via low energy bluetooth a unique identifier allowing donors using the StreetChange mobile phone app to quickly and securely donate to one or more items to the client

How does the innovative program work to improve behavioral health access?: 

StreetChange provides an opportunity for homeless services agencies that provide and facilitate behavioral and medical healthcare to engage clients previously resistant to social and health services.  Homeless outreach agencies in Philadelphia, including Project HOME and the Mental Health Association, engage their own medical and behavioral health personnel and work closely with Philadelphia’s Department of Behavioral Health and Disability Services, to help clients obtain healthcare and other services for which they are eligible.  Unfortunately many street homeless individuals remain unconnected with City social services, and according to a recent study of homeless decedents in Philadelphia, are at increased risk of significant health consequences, including death.  StreetChange provides a new means of engaging homeless individuals resistant to more traditional services and previous service attempts and linking them to the healthcare services they desperately need.

How does the innovative program work to improve behavioral health quality? : 

 By engaging street homeless clients through providers that either directly provide or otherwise facilitate behavioral and medical care, StreetChange provides an opportunity to improve the quality of healthcare accessed by its clients.  Street homeless individuals, especially those disconnected from social services, are more likely to have substance abuse disorders, mental health issues, and serious medical issues than other, even shelter homeless populations.  They are also more likely to neglect caring for acute minor conditions than other populations, and as a result incur emergency room visits and inpatient hospital stays.  The social service agencies working with StreetChange specialize in finding appropriate and accessible healthcare for previously service-resistant individuals that facilitate regular preventive and acute care that avoids more costly and disruptive hospital visits. 

How does the innovative program work to address behavioral health costs? : 

StreetChange’s approach will both directly and indirectly reduce healthcare costs incurred by its clients.  First, StreetChange will increase the number and consistency of interactions between homeless individuals and health care providers. Homeless individuals participating in the program will be provided healthcare resources and treatments. They will also be monitored- with consent- for followup and assistance with chronic conditions, and such careful, person centered, preventative care has been shown to lower health care costs, by helping homeless individuals to avoid use of emergency departments and other acute care settings.  Second, StreetChange aims to move clients toward Permanent Supportive Housing, which has repeatedly been shown to reduce total healthcare costs as a result of fewer emergency room and inpatient hospital visits.

Creativity and Innovation: 

We are aware of no other smartphone app designed to assist homeless individuals, while also satisifying donors that resources are being used for appropriate healthcare costs or other basic needs.

Leadership: 

No other products of which we are aware exists to meet this need.  With the support of an innovation award, StreetChange will be able to hire marketing personnel to develop this message of market leadship to attract partner organizations, scaling up the utilization of the application. 

Sustainability: 

StreetChange has a received instiutional and financial support from the Mental Health Association of Southeastern PA and the Barra Foundation. These commitments, when leveraged with additional support from the Scattergood Foundation, will allow for a stable launch and continuation of the program. 

Replicability: 

Because StreetChange leverages an existing infrastructure of social service infrastructure, we expect the program is highly replicable.  Of course, we are conducting rigorous outcome and process evaluation during this pilot before scaling outside of Philadelphia.  For initial implementation, StreetChange will activate the accounts of 10 registered homeless clients to allow StreetChange app users to make donations to their registries. We will monitor application use, donation amounts and frequency, and engagement between homeless individuals and homeless service providers, in real time, with more formal evaluations 7, 14, 30, 60, 90, and 180 days after initial implementation. This timeline will present opportunities to tweak and refine the program as problems arise and opportunities exist while placing performance in short- and long-term trends.

Results/Outcomes: 

 While there are programs that similarly provide street homeless individuals access to technological opportunities, none have the explicit mission of connecting those people to social services and long-term housing. Therefore, there are no opportunities to compare StreetChange to similar programs. We will, however, use metrics standard in evaluating programs seeking to alleviate street homelessness in measuring success. Specifically, we will track:

  1. How many street homeless individuals participate in the program, and of them
  2. For how long do StreetChange clients remain involved with their social service provider
  3. How many clients are able to end their homelessness, through Transitional or Permanent Supportive Housing, or other means
  4. The amount of money raised, both in absolute terms and relative to stated goals
  5. How many people provide funds to street homeless individuals through the application
  6. Total amounts raised
  7. Average donation amounts
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