The following detailed memo was provided by Mayor Joyce Craig to summarize where things stand as of the Otober 4 Board of Mayor and Aldermen meeting.
There is also information in this report about our community partners and the work that they are doing to address these issues as well.
MANCHESTER, NH — On September 7th, the Director of Homelessness Initiatives resigned from her position, and since that time, I, alongside City departments, non-profits, and national partners have been working together to determine the best way for the City to move forward. These efforts are ongoing, but we want to update you on progress that has been made.
We received feedback from stakeholders on both successes and areas in need of improvement as it relates to the position focused on addressing homelessness. Below are consistent comments we received:
- Because of the demographics of those experiencing chronic homelessness in Manchester, we need a person with expertise in not only housing development, but Substance Use Disorder (SUD) and chronic homelessness
- Overdoses are at their highest since 2017, and approximately 50 percent occur amongst those experiencing homelessness
- There is a need for additional support to both address immediate needs within the community (encampments, winter sheltering, etc.) as well as long-term planning
- The Fire Department is likely not the right department to be overseeing this work
- They continue to be very involved in winter sheltering planning through Emergency Operations, and involved with encampment outreach through Squad 1, but don’t have the expertise in housing to provide necessary oversight or collaboration
- We need to prioritize relationships with our non-profit service providers, identify and fill gaps in services and housing, and implement long-term solutions
- This includes establishing a more significant relationship with the Continuum of Care
Tackling Homelessness & Substance Use Disorder (SUD) together:
While not everyone who is experiencing homelessness also has SUD, and not all those with SUD are experiencing homelessness, there is significant overlap that cannot be ignored.
On August 17, we brought together City departments, non-profits, NH Department of Health and Human Services (DHHS), Center for Disease Control (CDC), and National Association of County and City Health Officials (NACCHO) to the Emergency Operations Center discuss best practices to address recent spikes in opioid overdoses as well as the recent request for grant application (RGA) put out by the State of New Hampshire from the Opioid Abatement Trust Fund.
This meeting resulted in:
- The Emergency Operations Center remaining open at an “enhanced monitoring level”
- The daily monitoring of overdose calls to the Manchester Police Department, which are then reported out to service providers and outreach teams.
- The creation of an Overdose Response Group (PHAST), that meets bi-weekly to discuss trends, outreach, and best practices around harm prevention
- This group includes care providers, law enforcement, outreach teams, state agencies, hospitals, etc.
- A $350,000 funding commitment from the NACCHO to the Health Department
- Health Director Anna Thomas submitted a logic model (attachment 1) on Friday, September 12 to fund the following initiatives:
- An individual to coordinate our response to the opioid crisis, who would work directly with our Director of Homelessness Initiatives on the prevention, treatment and recovery of those with SUD and Opioid Use Disorder (OUD)
- A ‘Strike Team’ as a next step to the opioid overdose notification system. This team would consist of relevant members of the Overdose Response Group to do outreach and harm prevention work following a spike notification
- Health Director Anna Thomas submitted a logic model (attachment 1) on Friday, September 12 to fund the following initiatives:
- The decision to apply for funding for the following two projects from the Opioid Abatement Trust Fund:
- Expansion of the Community Response Unit ‘Squad One’ operating hours from 36 hours per week to 72 hours per week, an addition of 36 hours. Funds will enable the funding of two firefighters (existing employees) to better meet the needs of persons experiencing Opioid Use Disorders and any co-occurring substance use disorders or mental health issues by bringing services to them in their place of need, not only on additional days per week, but with expanded hours of operation each day.
- Manchester Police Athletic League’s establishment of a full-time Juvenile Court Diversion Coordinator position. Funds will enable this position to move from part-time to full-time, which will allow adequate resources to support the use of diversion to promote desistance from crime. This coordinator position is key to connecting court-involved youth to appropriate resources outside of the criminal justice system. Similarly, this position will also work to connect resources to youth who are at risk of entering the criminal justice system due to deviant behaviors or being otherwise identified as at risk
- The recommendation that City leaders and Department Heads be trained in Incident Command Structure and Emergency Management Principals to be paid for by workforce development funding provided by the Health Department
Homelessness Initiatives Moving Forward:
Homelessness is an issue that impacts nearly every single department within the City of Manchester and requires collaboration and communication from all departments. On Tuesday, September 20, we brought together representatives from City departments to do an assessment of current City services related to homelessness and substance use disorder.
We mapped the information that we gathered from this meeting (attachment 2) to depict City operations as it relates to Homelessness and Substance Use Disorder.
After reviewing the existing Class Spec for the Director of Homelessness Initiatives position, we determined that the information outlined was consistent with our expectations of this role, and posted the job on September 23. As this position will work cross-departmentally, we will be establishing an interview committee consisting of the Director of Planning and Community Development, Fire Chief, Health Director, Welfare Director, Human Resources Director, and a representative of the Continuum of Care.
While the content of the Class Spec is in line with our expectations of the Director of Homelessness Initiatives using existing federal funding, we will likely look to move the position outside of the Fire Department. While MFD continues to play a significant role in encampment outreach and emergency management around winter sheltering, the bulk of the work around homelessness does not fall under the Fire Department, but rather under Planning and Community Development.
So, while we are moving forward with hiring a qualified Director of Homelessness Initiatives, we will likely recommend that this position be moved under PCD, with the CDC-funded position dedicated to SUD under the Health Department.
An alternative solution would be to establish a ‘Division of Homelessness Initiatives and Substance Use Disorder’, which would report directly to the Mayor, as with other Director level positions. This would allow for more streamlined communications and updates to the Board of Mayor and Aldermen, and could potentially allow the positions to work better across departments. Both of these models are used in communities of similar sizes across the country, and we are still in the process of developing a recommendation for the structure of the office within the City of Manchester.
However, regardless of the reporting structure for these positions, it is critical that they be located within the same office and that their work be happening collaboratively.
We also heard consistent feedback that one person is not enough to tackle both long- and short-term strategic planning and day-to-day operations. Because of this, we are exploring the possibility of funding a coordinator position to support the work with both the Director of Homelessness Initiatives and the federally-funded SUD position.
Below, I have outlined the different funding streams for this work. In addition to these requests, we have made requests to charitable organizations and foundations to further support this work.
|American Rescue Plan Act
|Director of Homelessness Initiatives
|Center for Disease Control
|SUD & OUD Director, OD Strike Team
|HUD – Emergency Services Grant
|Opioid Settlement Funding
|CARES Act Planning Admin
|Housing & Homelessness Administrative Support
|Center for Disease Control (ELC)
|Director of Homelessness Initiatives
We are scheduling a meeting with key non-profit partners to discuss Homelessness Initiatives moving forward. Ahead of that meeting, we have put together an overview of all of the service providers for housing and addiction currently operating within the City of Manchester (attachment 3), and we will be mapping their roles, similar to what we did for City services.
We are also currently looking at how we can bring in national subject matter experts to assist with strategic planning and evidence-based practices. We are scheduling a time to meet with the National Alliance to End Homelessness to better understand what technical assistance they can provide as we look to identify gaps in service, and how we can work together to fill those gaps.
Chief Cashin sent a brief update about current duties, but currently any issues with encampments are being managed by the Neighborhood Enhancement Team (NET) Coordinator. Issues can be reported through the Manchester Connect ‘See-Click-Fix’ application or at (603) 792-3859. I’ve also included the most up-to-date ‘Who to Call When’ information for your awareness (attachment 4)
Some of you may know that the State of New Hampshire recently allocated $5 million of funding toward emergency shelter services, and we wanted to give you an accurate picture of what this funding means for Manchester. The majority of this funding ($4 million) will go toward organizations with existing contracts with the State of New Hampshire. In Manchester, Families in Transition will receive approximately $955,000, which will be used to support existing operations only, and will not be used to expand shelter capacity.
The remaining $1 million was divided by county, based on point-in-time counts from January of 2022, with Hillsborough County being allocated $245,000.00. There will be only one recipient per county, so these funds will need to support the winter sheltering needs of all the communities in the County, including Manchester and Nashua. While in some counties, the County Government stands up an emergency winter shelter, this is not the case for Hillsborough County.
Service Providers of Housing, Mental Health & Addiction Services
1269 Café: 1269 Cafe is a food pantry and clothing closet for those in need in Manchester. They provide food to meet basic nutritional needs and clothing, as well as spiritual support through worship services. They are open 8am-5pm, Monday through Friday.
211 New Hampshire: 211 New Hampshire offers a centralized directory of community resources in the state, referring NH residents to the best resources located near them and that meet their specific needs. Specifically, for houseless folks, they can refer them to the best shelter, warming center, and other necessary resources in near proximity. 211 also has an online directory of services where people can search for the resources they need and get a better sense of what is available near them.
AmeriHealth Caritas NH: AmeriHealth Caritas NH is a mission-driven Medicaid managed care organization serving NH Medicaid members. They cover substance use disorder (SUD) services provided through a wide range of options, from community mental health centers to methadone clinics, opioid treatment programs, and peer recovery programs. AmeriHealth Caritas covers both outpatient and inpatient mental health services, and offers a flexible recovery benefit for members who have completed a non-hospital SUD residential treatment stay. They can also connect you to resources in your community that provide support for interpersonal violence, food and housing insecurity, as well as transportation to work, school, and appointments.
Amoskeag Health: High-quality, comprehensive, and family-oriented primary health care and support services
Child Health Services: Providing health services for at-risk youth from low-income families including bio-psychosocial health care, social services, nutrition services and behavioral and mental health services. Free or discounted medical care and treatment to children in the Greater Manchester area regardless of their families’ financial situations.
Catholic Medical Center: Behavioral Health Services at CMC is an adult outpatient program that assists in patient medication evaluation; symptom management and skill development. Our program offers a range of high-quality, specialized behavioral and substance misuse services emphasizing support to patient and family, while ensuring a high level of confidentiality and privacy. We offer board-certified psychiatrists /APRN; licensed therapists/ substance abuse counselor who are able to evaluate and treat behavioral health/substance misuse issues.
Catholic Medical Center, Roots to Recovery Program: A program to provide addiction treatment and recovery services to pregnant women in the greater Manchester area. The Roots for Recovery program is open to qualified, pregnant women with substance use disorders.
Dismas House: Four-phase, residential, 90-Day, low-intensity alcohol and drug treatment center and transition/re-entry program assisting women with substance use and mental health disorders who have been previously incarcerated at the NH Corrections Facility for Women or Shea Farm Transitional Unit and have been released within the last year. Dismas Home assists residents with transforming their lives through a nurturing, treatment environment that identifies opportunities, provides acceptance, emotional support, and a certain level of material support with an expectation of personal and community accountability with the primary goal being to transition/re-enter the community successfully.
Do you Know Him? Ministries: Spiritual organization focusing on providing food to neighbors in need. They have breakfast on Saturday and Sunday at the Salvation Army on Cedar St. and at the 1269 Cafe on Chestnut St.
Easterseals – The Way Home: Easterseals serves youth with disabilities and other special support needs, such as substance use disorder and sexual abuse/trauma. They also offer support to veterans by connecting them to resources like benefits and services, counseling, substance use disorders, crisis intervention, housing stabilization, employment, parenting, childcare, disability services, transportation, and emergency financial assistance.
Elliot Health Systems: Elliot Health Systems provides Substance Use Disorder (SUD) Services, which include assessing, treating, and supporting individuals with SUD who are in recovery or seeking recovery. SUD staff includes licensed mental health and substance use clinicians, psychiatric providers, RNs, case managers, and recovery support staff. Elliot Health Systems offers different treatment options, ranging from a Partial Hospitalization Program, to an Intensive Outpatient Program, and the Maternal Opioid Misuse Program.
Farnum Center: Medical detoxification; residential; outpatient and intensive outpatient; family services; Suboxone clinic.
Families in Transition: Intensive outpatient program and outpatient services for substance abuse; affordable housing; family emergency shelter; permanent supportive housing; transitional housing.
Groups: Recover Together: Combines the use of Suboxone and weekly group counseling to individuals battling opiate addiction. Treatment is offered at an affordable price.
Granite Pathways Manchester (Doorway): Provides screening, assessment and referrals for mental health and substance use disorders resulting in the right level of service.
Harbor Care: Harbor Care is a network of nonprofit health care, housing and human services helping adults, children, and families of New Hampshire find solutions to substance use disorder, HIV/AIDS care, veteran services, employment support, and support to individuals and families who are experiencing or at risk of homelessness. Harbor Care creates and provides supportive services to individuals and families who are experiencing homelessness and/or living with behavioral health disorders. Harbor Care provides crisis housing, transitional housing, permanent supportive, and income-based rental housing. They support veterans through a combination of housing, employment and other services for veterans and their families. Mental Illness support includes crisis management, outreach, housing and medical interventions and services.
Healthcare for the Homeless: Clinic services include primary medical care, mental health care, addiction counseling, nurse case management, health education, social services, and assistance with entitlements such as food stamps, Medicaid and disability applications. In addition, dental care and eye care is available on a limited basis. Insurance: No one is turned away due to an inability to pay.
Hope for NH Recovery: Hope for NH Recovery is for people interested in recovery. We offer a safe judgment-free space and peer support to those who are seeking recovery, family and friends of, or those who are in recovery themselves that know the importance of giving back what was freely given to them. Our focus is to help people learn to get comfortable in their recovery utilizing a non-clinical peer to peer based approach. Helping people learn how to have fun in their recovery so they wish to remain in recovery is our priority. We offer telephone recovery support, social events, 12 step and other mutual aid meetings, and several groups throughout the week.
Helping Hands Outreach Center: Alcohol/drug recovery related transitional housing — sober living environment offered to men aged 18 and up.
JobCorps: A no-cost education and vocational training program administered by the U.S. Department of Labor that helps young people ages 16 through 24 improve the quality of their lives through vocational and academic training.
Liberty House: Substance-free housing for veterans transitioning from homelessness. Employment and housing assistance, food pantry and clothing closet.
Manchester CTC: Methadone-assisted treatment/evaluation; group outpatient
Manchester Housing and Redevelopment Authority: Manchester Housing and Redevelopment Authority offers public housing for families, the elderly and disabled, and low- income residents who meet the income limits criteria. They also offer emergency housing and housing choice vouchers.
Merrimack Valley Assistance Program: The Merrimack Valley Assistance Program provides support for NH residents living with HIV or a child exposed to HIV through perinatal transmission whose gross annual income is at or under 500% of the Federal Poverty Level. Their services include psycho-social case management, housing assistance including help with rent, mortgage, or utilities, locating new and affordable housing, paying a security deposit or 1st month’s rent, and deposits for utility hook-ups. Other support includes reimbursement for medication, doctor visits and tests, mental health services, substance use disorder treatment, dental services, and home-based care services; insurance coverage including insurance premiums, pharmacy copays and deductibles, premiums for private insurance, Medicare and COBRA. Merrimack Valley Assistance Program also offers transportation vouchers, food pantry services and grocery store gift cards.
Manchester Metro Treatment Center: Methadone assisted treatment.
Mental Health Center of Greater Manchester Cyprus Center: High-quality, 24-hour, 16-bed short-term inpatient crisis stabilization program. Our approach is to: reduce acute mental, emotional, physical, and social distress (suicidal thoughts or actions); support an individual treatment plan that reflects each person’s recovery goals and builds strength and capabilities; work cooperatively with coexisting treatment providers or assist in connecting with needed resources; offer a program of planned individual and group activities that promote recovery and wellness; short-term inpatient crisis stabilization program; withdrawal management and relapse prevention. Insurance: The Cypress Center accepts most insurances and works with patients to cover costs when there is a need.
Mental Health Center of Greater Manchester – Child & Adolescent Services: Flexible, family-centered approach that helps children and their parents find new ways of dealing with a variety of issues including: academic or social problems at school; relationship difficulties with parents, families or peers; fears, anxieties or depression; attention deficit or hyperactivity; anger management; behavioral problems and other family concerns; substance misuse. Meeting your needs through specially trained staff, flexible appointment schedule (including evenings and some weekends), home/community-based therapy, and 24-hour emergency coverage.
Mental health Center of Greater Manchester – Bedford Counseling Associates: Full range of outpatient counseling and psychiatric treatments for all ages that helps people cope in a positive and healthful manner with a variety of problems including family issues, substance misuse, anxiety, stress, school problems, child behavior problems, attention deficit disorder, relationship issues, life changes, medication evaluation and management. Flexible appointment schedules and 24-hour emergency coverage.
Mental Health Center of Greater Manchester, Community Support Services and North End Counseling: Wide range of individually tailored service plans for people whose mental illness seriously impacts their ability to function in their lives and community. Treatment plans may include: substance misuse services, illness management & recovery, medication management, trauma recovery, benefits planning, health & fitness services, housing support services, employment services, legal issues, community resource connections. Meeting your needs through: specially trained staff, flexible appointment schedule, home/community-based therapy, 24-hour emergency coverage.
New Hampshire Catholic Charities: NH Catholic Charities offers telehealth counseling services for those struggling with mental health matters, with substance use disorder and addiction being one of their specialty areas. Catholic Charities also offers substance-free transitional housing for veterans who are unhoused or facing housing insecurity (males only). They also work with struggling or homeless veterans providing them with assistance such as food, clothing, transportation, camping gear and community referrals. Catholic Charities is also a partner agency of the New Hampshire Food Bank, and distributes meals for those in need.
New Hampshire Healthy Families: NH Healthy Families offers affordable individual and family health insurance plans, including Medicaid and Medicare Advantage for those who qualify.
Program eligibility depends on your age, income, family size, and special health needs you may have.
New Hampshire Legal Aid: New Hampshire Legal Aid provides legal information and services in a range of areas, including housing (evictions, tenants’ rights, foreclosure relief, leases & security deposits, mobile homes, mortgages); state/federal benefits; and healthcare.
New Life Ministries of New England: Voluntary, residential treatment facility for women, specializing in the treatment of mental health and substance abuse.
On the Road to Wellness: Providing non-clinical, free-of-charge, peer support services for adults managing their mental health and recovery.
Pastoral Counseling Services: Clinical PCS offers a wide range of clinical services designed to provide emotional, mental and spiritual support, healing and guidance with compassion, respect, openness and inclusivity. PCS offers individual, couples, and family counseling to persons of all ages. Clinicians at PCS are trained in providing counseling services to assist with the management of and healing around many difficulties.
Real Life Giving: Real Life Giving offers support through Revive, a women’s support center in Manchester. The center is a safe, welcoming and non-judgemental space for women who struggle with substance use, abuse, and/or may have experienced sex trafficking and commercial sexual exploitation. The center has open hours on some afternoons with programming offered during the mornings and occasional evenings. Case management is available by appointment. They also offer assistance by connecting you to existing support services and resources, and program referrals, providing transportation when needed. Real Life Giving also provides support through street outreach, where trained volunteers offer snacks, bottled water and gift bags with personal care items.
Salvation Army: Community programs and services including Narcotics Anonymous, Senior Center, dance and drama classes, women’s group, bible study and church services. The Salvation Army of Manchester has limited funds for rent and utilities for those impacted by Covid-19. They also operate a food pantry at their Manchester location.
Southern New Hampshire Services: Southern NH Services offers housing assistance through the NH Emergency Rental Assistance Program (NHERAP), as well as Fuel and Electric Energy Assistance during the winter months. They also offer affordable senior housing, and subsidized housing for men who have completed a substance abuse program and are in need of a safe and supportive living environment.
Westbridge: Residential treatment program in Manchester, NH, provides evaluation, treatment, and support in a safe, home-like environment for adult men who experience mental illness with or without co-occurring substance use.
Men may enter Assertive Community Treatment (ACT) program directly or as a step-down from our residential program. ACT is an effective, evidence-based model. Men live independently in the local community with support from our transdisciplinary team ranging from two to 50-plus hours per week based on evolving individual needs, with 24/7 access to team members.
Services also include two respite beds in a residential program for ACT participants in need of additional support.
Waypoint: Serving adolescents, children, young adults, adults, pregnant or parenting women, and homeless individuals. Programs include parenting, assessment, care coordination, individual and group outpatient counseling, recovery support services, and transitional living program (18-21). Teen Center offers counseling for drug/alcohol use and severe depression.
Child Welfare Programs at the YMCA: The Granite YMCA is focused on working with kids whose lives are complicated by risk factors including poverty, exposure to violence, substance abuse, poor school performance, engagement in risk-taking behaviors, or significant social- emotional difficulties. The Youth Opportunities Unlimited programs provide support to students who would otherwise fall through the cracks including programs for youth who have been suspended or expelled.
YWCA: Advocacy and support services for domestic violence, sexual assault and substance use disorders including crisis support, emergency shelter, support groups and community education.
Scan for DPW website Scan for Manchester Connect Mobile APP WHO SHOULD I CALL? WHAT SHOULD I DO
The public and private businesses are the City’s greatest ally in the shared goal of creating and maintaining a beautiful, clean, prosperous, and orderly City for all to enjoy. This is a quick cheat sheet instructing the public and private businesses who to contact depending upon the situation.
TRASH, RUBBISH, AND REFUSE
If you see trash, rubbish, and refuse including discarded furniture, please call the Department of Public Works at (603) 624-6444 or connect via Manchester, NH Connect available at the City of Manchester website www.manchesternh.gov or by scanning the QR Code at the top Left or Right.
CRIME OR SUSPECTED CRIMINAL ACTIVITY – NON-EMERGENCY
If you see a person committing a crime or you think a person is committing a crime and it is not an emergency, please contact the Manchester Police Department via the business line at (603) 668-8711
CRIMINAL ACTIVITY OR SUSPECTED CRIMINAL ACTIVITY – EMERGENCY
If you see a person committing a crime or you think a person is committing a crime and it is an emergency, please call 911 immediately.
MEDICAL WASTE – NEEDLES
If you see medical waste or needles, please contact the Department of Public Works (DPW) at (603) 624-6444 or by scanning the QR Code at the top Left or Right.
PARK ISSUES – NON CRIMINAL
If you see a problem with a city park, please call the Department of Public Works, Department of Parks, Recreation and Cemeteries at (603)-624-6444 or by scanning the QR Code at the top Left or Right.
Local Criminal Justice Information
9th Circuit Court – Manchester Dist. Div. Prosecutors:
35 Amherst Street Pre-arraignment Manchester Police
Manchester, NH 03101 (1st court APP) (603) 668-8711
1 (855)212-1234 Post-arraignment – City Solicitor’s Office dates Jurisdiction: Misdemeanors, Violations, DVP Ordinances, (All other court dates) (603) 624-6523
Small Claims, Landlord Tenant, and Juvenile Offenses.
Hillsborough County Superior Court – North Prosecutors:
300 Chestnut St. Hillsborough County Attorney’s Office
Manchester, NH 03101 (603) 627-5605
1 (855) 212-1234
Jurisdiction: Felonies and associated misdemeanors, Misdemeanor Appeals
If you do not call or report, the city will not be able to try to address the situation. Please visit the City of Manchester’s website at www.manchesternh.gov/departments for a full list of departments, phone numbers, email links, and the Manchester, NH Connects app.