NEW YORK — The most recent New York State Comptroller Audit, Thomas P. DiNapoli, revealed that the New York City Department of Homeless Services (DHS) is not meeting the needs of homeless New Yorkers, especially those with mental health and substance abuse issues.
The audit looked at DHS screening and client placement and found that too often screenings were insufficient to determine when they had mental illness or substance abuse problems and people were placed in a shelter that could not provide them with the help they needed. While the audit did not establish a causal relationship between places where people are hosted and outcomes, it did find that appropriate placement in a specialized facility can reduce the risk to people inside and outside the reception system .
“The Department of Human Services needs to do a better job helping some of the most vulnerable people in the city,” DiNapoli said. “My latest audit shows that too often the department has failed to adequately place homeless people with special needs in appropriate shelters where they could receive the support they need to recover and move into stable housing. Deficiencies in DHS can have serious implications. I hope DHS uses the audit findings and recommendations to improve its operations.”
As part of DHS’s hiring process, clients are screened to help determine which of its five types of shelter best meet their needs: general, mental health, substance abuse, employment and seniors. Generic shelters do not offer specialized personnel or services, while the other options offer specialized personnel and services or amenities.
DiNapoli’s audit found problems with DHS’s complex evaluation process:
- addiction dAnd self-reports of mental health problems and substance abuseaS: DHS does not use all available data, and self-reported customer responses do not always reveal the true situation. As a result, the judgment of social workers greatly influences assessment and screening results.
- Lack of standardization in the evaluation process: Reviewers encountered instances where clients were screened and placed in shelters that did not match the information documented by social workers. There were also insufficient records documenting the rationale for placing clients in general shelters rather than specialized facilities.
- Delays in entering customers: DHS informal policy states that customers must be placed within 21 days of the assessment. The reviewers found that in the fall of 2021, 83 of the 359 clients staying in the assessment centers had waited more than three weeks to be located.
To try to understand the impact shelter placements can have on client outcomes, the reviewers analyzed background information on the 17,244 homeless people listed in the DHS Client Demographic Report and looked at current shelter placements. (eg, mental health, substance abuse, alcohol abuse) and medical diagnosis. Of these, the reviewers found 3,022 who had been diagnosed with serious mental illnesses that should have qualified them for mental health hospitalization. However, 26% (795) were not placed in a mental health shelter.
In several cases, people with known mental health diagnoses who were placed in a general population shelter instead of a specialist shelter caused injury or death to themselves or others, the report said.
The reviewers also found that clients with known substance abuse problems were routinely placed in shelters that lacked specialized staff or services. Of the 1,061 clients identified as having alcohol or substance abuse problems, 90% (956 of 1,061) were not placed in a substance abuse shelter.
Locations were also an issue in aged shelters. A large proportion of homeless seniors, 43%, were placed in general shelters for non-elderly people. DHS officials attributed this, in part, to a small number of beds available in aged shelters. However, the auditors found that aged shelter beds were not reserved for the elderly: 103 of the 368 beds (28%) were allocated to clients under the age of 65.
DiNapoli’s recommendations included that DHS:
- Create and implement standard operating procedures to ensure individuals are diagnosed, placed and/or transferred to the most appropriate shelter.
- Analyze client data to help identify clients who can potentially benefit from services that could be better provided in specialist shelters, helping to reduce the risk of clients causing harm to themselves and others.
- Review current customer positions; consider relocating clients to shelters that better meet their needs, as warranted.
- Consider what actions to take for users that may cause danger to themselves or others and that could materially interfere with the health, safety, welfare, care or comfort of other residents.
In their response, DHS officials generally disagreed with the report’s findings, attributing some negative impacts to precautions implemented during the pandemic and saying there is no causal factor between shelter placement and customer outcomes. .
