'We had concerns': Social services leader previously heard about housing fraud issues

NINA MOINI: Housing, social workers, and advocates are facing the fallout of the Department of Human Services move to terminate their housing stabilization services program due to alleged fraud. DHS found 77 providers with credible allegations of wrongdoing, and requested from the federal government to cancel the program.

By law, the Medicaid-backed program can only be canceled by the federal government. But there are hundreds of other organizations that were using the program in earnest to help Minnesotans find housing. Local organization Avivo helps thousands of Minnesotans get into stable housing. John Tribbett is a service area director in Avivo's Ending Homelessness division. He spoke to MPR News's Chris Farrell about his reaction when he heard the state was asking for the housing stabilization services program to be shut down.

CHRIS FARRELL: I just want to start off asking you, what was your reaction when you heard the program was being shut down because of alleged fraud?

JOHN TRIBBETT: Well, I think the biggest thing is concern and an overall concern because it's just one piece of a larger situation where we're seeing decreased funding and access to services that are really helping people to find and sustain housing that are really dealing with a lot of acuities and issues in their lives that present challenges to housing.

CHRIS FARRELL: Yeah, and I want to go into that into more detail because that's absolutely a critical point. But I am curious. I mean, did you have any idea that there were bad actors in this program? What was your experience?

JOHN TRIBBETT: Well, I think number one, there's lots of organizations that are doing high quality work and really have used that funding stream and that program in innovative and helpful ways. I will say that we were also aware of bad actors that were, in some cases, actively seeking to recruit people who were apparently or who were experiencing homelessness. And we were hearing, anecdotally, that there just was not follow-up with people. And so we did have concerns.

CHRIS FARRELL: So are you now in a period of tight and tighter resources?

JOHN TRIBBETT: Nina Moini Yeah, definitely. And I think what we see and what we've seen for a long time, in particular in the ending homelessness sphere and working with people that are struggling to sustain housing, is that there's really cascading impacts. And so when any one program shuts down, or is underfunded or provider leaves the community for whatever reason, we see more pressure on other providers that are trying to provide services to folks.

And so it's the classic, please do more with less, at a time when we're seeing more people struggling with mental health issues, more people dealing with substance use disorder issues, more seniors on the street, veterans. While we've made great progress in Minnesota, there continue to be veterans on the street. And so all of these realities have these impacts that just grow over time.

CHRIS FARRELL: I hear that expression a lot-- you got more with less. And yet sometimes it just seems like you can do less with less.

JOHN TRIBBETT: You can do less with less. Yes, absolutely.

CHRIS FARRELL: Yeah. So did you use the housing stabilization program, I mean, did that work for you?

JOHN TRIBBETT: Well, we had initially piloted it in a couple of our programs and for really more internal reasons and preferred ways that we were getting funding to pay for our staffing model, we chose not to continue to use it. But we did. We have continued to work with other agencies that were using, again, that service, particularly in the space of people that were exiting homelessness.

And in many cases, there were some really great successes. And we think about what the role did for providers that were actually providing the services. They were helping people to find and locate housing. They were helping people who were at risk of being put into institutions, which are A, probably not the best for the individual, and, B, much more costly to taxpayers.

And so people were really actively helping people get into housing and then keeping their housing. And so helping them mediate issues with landlords or neighbors or funding stream changes or challenges, working with complicated paperwork that's required to keep someone in housing. And so the loss of people that really act as navigators in a very complicated system is going to have knock down effects and will put increased pressures on the system.

We're seeing it all over. We know the public hospital in Hennepin, HCMC, is struggling. We are already seeing regionally. I just got a notice that a group of technical assistance that was coming out of some of the universities in the Midwest that was funded by a SAMHSA grant, lost their funding, and that was specifically helping folks that were dealing with opioid use disorder in rural parts of the Midwest. And so, again, we're kind of seeing this all really coming to fruition at a time that has just bee-- it's been really tough.

CHRIS FARRELL: And it sounds like that this is happening at a time. The setback is happening at a time when you've been gaining some knowledge, experience, success in moving people from homelessness into shelter-- into a home.

JOHN TRIBBETT: Right. And so we often say in the field, shelter saves lives and housing and homelessness. And so if we are going to be serious in the face of some of the attacks that are coming, particularly on the federal level, we really need to look at the evidence-based modalities and processes and the programs that have actually worked.

And so we see these attacks on a federal level around Housing First has to go. Well, Housing First just simply says that an individual needs to be in a safe, stable place-- the same kind of place that you and I want. I want to lock on a door. I want a bed. I want a place where I can have respite, I can have peace, that I can use the bathroom in privacy, have a friend over.

Before I can start to even think about some of the higher-order things in my life that I want to take care of. And so when we have a federal messaging that says basically these very effective and human based and actually long term, much more fiscally responsible responses, saving taxpayers' money, being attacked, we get concerned. And then we have this issue with HHS now likely going away. And again, it's just these cascading impacts that are going to put pressure on the community. And we'll pay for it.

I mean, we will-- there's a human cost, which is always first. That's primary. What kind of Minnesota do we want? But the other reality is we pay for these costs regardless. If people are sick and they end up going to the ER, that costs a lot of money.

If people are subject to law enforcement actions, if any number of costs, we pay no matter what. And so do we want to pay strategically in a way that supports people, helps them move forward, helps them, hopefully one day seek employment and be able to move on with their lives, or do we want to just pretend that we can get tough on stuff and it'll somehow go away. That's really where we're at right now.

CHRIS FARRELL: So the situation you described, what's your priority? Where do you, your organization-- I mean, where do you see you need to be spending more time and resources on?

JOHN TRIBBETT: Well, we are part of a larger ecosystem here in Hennepin County around the homelessness services. And so, all of our providers, there's some really great people out there working really hard on issues, and everybody has a bit of a specialty.

At Avivo, we really are working to serve the people that have some of the highest issues and complexity, meaning they have some kind of chronic health issue. Maybe it could be something like cancer. It could be a heart issue. It could be diabetes. And also then dealing with potentially chemical health issue, a substance use disorder. And in addition to that, maybe having a mental health issue.

And so Avivo is going to continue, as our part of this larger system, to really lean into working with folks that have some of the highest challenges to getting off of the street, to stabilizing, to getting into housing, and most importantly, becoming the person, hopefully closer to who they want to be in their own lives and feeling like they're a part of the community.

We've lost a lot in terms of what it means to be part of a community and who we include in that tent. And Avivo is going to continue to say, if you feel like you've been pushed out, we want to talk to you. We want to help you.

CHRIS FARRELL: Well, thank you very much for your time. I really appreciate it.

JOHN TRIBBETT: Well, thank you so much. We really appreciate you paying attention to this important issue. And we look forward to continuing to make the world a little bit better, hopefully.

CHRIS FARRELL: Right. And we'll continue this conversation, I'm sure, many times in the future. John Tribbett works in the Ending Homelessness division with Avivo.