Hope Center TCE Project - The Hope Center, Inc. SAMHSA TCE: Special Projects Grant will serve 144 adult homeless men with substance use disorders (SUDs) or co-occurring mental health conditions and SUDs (CODs) over the 3-year project period with SUD/COD treatment in conjunction with transitional housing, harm reduction, tobacco cessation, peer recovery support and case management. The Lexington Homelessness Data Dashboard (https://lexendhomelessness.com/cs-data-dashboard/) reports that in the 4th quarter, 2024, there was a total of 901 homeless men in Lexington. Most (63%) were White, 34% Black, 3% American Indian/Alaska Native/Indigenous or Hispanic. Prior data (2021) from this source found that most homeless people in Lexington were proficient English speakers. 70% were male and 99.6% were adults. 34% had mental health problems, and 26% had SUD, including alcohol abuse. Most adults entering Fayette County shelters are low-income (99%), with 95% in poverty. According to the NSDUH, for 2023, 20.4 million adults aged eighteen years or older had any form of mental illness co-occurring with a substance use disorder during the past year, and 6.8 million had a serious mental illness co-occurring with substance use disorder. Homeless people have higher prevalences of SUD/COD. In 2024, Hope Center served 2,257 homeless men. 1,930 were men self-referred to its Emergency Shelter for Men. HC HMIS data shows that 38% had SUD, 12% COD, and 30% had serious mental illness. Service gaps for this highly vulnerable target population include lack of access to SUD/OUD treatment, including medication assisted treatment (MAT) and behavioral health care. Most residential SUD treatment facilities will not accept homeless people, and being homeless makes accessing outpatient treatment (including MAT) extremely difficult. Han et al (2021) concluded that ¾ of homeless people entering treatment do not receive the highest standard in evidence-based care, MAT. McLaughlin et al (2021) also found that homeless people have diminished access to evidence-based treatment, and require targeted approaches to improve engagement and retention; this research also found that housing support plays an important role in mitigating the disproportionate opioid-related morbidity and mortality among homeless people. Finally, lack of insurance is another service gap. Many do not have insurance, while many others have already used their maximum benefits for the year. Adult homeless men with SUD/COD are in dire need of short-term housing while engaged in SUD/COD treatment. Lack of housing impedes access to and success in treatment for this vulnerable population. For this project, Hope Center will provide transitional housing for adult homeless men who are receiving SUD/COD outpatient treatment at Hope Center, or have completed residential treatment and need housing and support services while maintaining early recovery and obtaining permanent housing. Using evidence-based practices, Hope Center will provide outpatient SUD treatment, and refer for COD treatment to a project partner. Hope Center will also provide screening and assessment for SUD/OUD and suicide, harm reduction, tobacco cessation, peer recover support, and case management. The goals and measurable objectives are to provide and document provision of the services described above, to document decreased SUD/OUD among participants, and to document effective project implementation and evaluation by conducting continuous quality improvement activities. Services will be provided to an unduplicated 48 participants annually, for a total of 144.
