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Key elements in drawing up an effectivebudget for a local homelessness strategy

Dick Reinking,Municipal Health Centre Utrecht

Brussels, May 28th. 2009

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An effective budget for a strategy or an effective strategy to

get a budget?

What I will not address:

• Effective budgetting, contracting and

accounting

• Costs and cost effectiveness

• Budgetairy constraints, cuts and complaints

WhatWhatWhatWhat is the is the is the is the problemproblemproblemproblem????

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What will be addressed here

• An analysis of financial requirements

• Vital financial coalitions

• What happened financially

• NB The city council took initiative with a Hfl 25 million

investment plan, starting in 1998

ProblemProblemProblemProblem analysisanalysisanalysisanalysis

• Integral budgets for integral policies: Homelessness as

a challenge for public health, welfare housing ànd

safety issues. Differentiate between output and

outcomes, use two track policy

• Not only local budgets: Homelessness exceeds local

tasks,responsibilities: f.i. with regard to psychiatry,

addiction care, privatized services and products

• The municipality ‘owns’ a problem that requires shared

financial commitment at the local, regional and national

level

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WantingWantingWantingWanting partnerspartnerspartnerspartners

• Envisaged financial partners:

• Internal

• DebtDebtDebtDebt guidanceguidanceguidanceguidance

• SocialSocialSocialSocial securitysecuritysecuritysecurity and and and and vocationalvocationalvocationalvocational rehabilitationrehabilitationrehabilitationrehabilitation

• Public Public Public Public nuisancenuisancenuisancenuisance

• External

• PrivatizedPrivatizedPrivatizedPrivatized housinghousinghousinghousing companiescompaniescompaniescompanies

• The The The The regionalregionalregionalregional office office office office forforforfor exceptionalexceptionalexceptionalexceptional medicalmedicalmedicalmedical expensesexpensesexpensesexpenses (AWBZ: (AWBZ: (AWBZ: (AWBZ:

long term care)long term care)long term care)long term care)

• Health care Health care Health care Health care insurersinsurersinsurersinsurers

• Goals / ambition:

• Vital financial coalitions

• Shared financial direction on homelessness dossier

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VitalVitalVitalVital financialfinancialfinancialfinancial coalitionscoalitionscoalitionscoalitions

• Sense of urgency (action is needed)

• A shared vision, mission and action plans (what makes you

run, tasks, responsibilities, business cases / CE-analyses)

• Shared financial commitment (invest in relations, knowledge,

mind sets and collaboration strategies)

• Short lines of communication and decision making

(programming, budgetting, contracting, mutual facilitation)

• Unconventional approaches (dare to invest and take risks)

• Political commitment and back up

2002–2006 Integral policy outline

• A financial covenant with the Regional AWBZ-office

• A 10 point city wide shared service provision plan

• Municipal investments in (financial) access to care

• Substitution of services from local to external budgets,

maintaining the municipal budget in the system and

allowing for friction costs

• An investment plan with privatized housing companies for

hostel development

• Care provision as contribution to public safety

• Start of shared financial direction on co-financed services

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Results 2002 – 2006

Extra services planned and realized, a.o.

• 3 care centres for addicted homeless

• 8 hostels with 24 hours guidance for addicted

homeless (both planned and realized)

• Financial reallocation for other long term housing

projects from municipal to national budgets

• 500 homeless elegible for care entitlements

according to the AWBZ (outreach, ACT and other)

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2006: Plan 2006: Plan 2006: Plan 2006: Plan forforforfor socialsocialsocialsocial reliefreliefreliefrelief

• G4 and Gouvernment, targets a.o.

• For 10.000 homelessness in the G4 there are integral personal

trajectories

• A reduction of evictions with 30% in three years,

• A reduction of public nuisance to 75% of 2005

• 12 instruments for local action plans identified

Budget: + € 180 million from AWBZ and added

municipal budgets

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Results

• Local action plans, covenant between municipalities and

health care offices

• Shared contracting and shared financial direction

• Reallocation national budgets homelessness

• Results 2008 (G4):

• > 6437 homeless in personal trajectory

• Rough sleepers in G4 nearly disappeared

• Housing evictions decreased with 20 – 45%

• 40% decrease in public nuisance (Utrecht)

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Conclusion

• LackLackLackLack of money is of money is of money is of money is alwaysalwaysalwaysalways a a a a problemproblemproblemproblem

• Combine long term (Combine long term (Combine long term (Combine long term (actionactionactionaction) plans / ) plans / ) plans / ) plans / covenantscovenantscovenantscovenants in short in short in short in short

term term term term orientedorientedorientedoriented conflict conflict conflict conflict drivendrivendrivendriven environmentsenvironmentsenvironmentsenvironments

• Have a Have a Have a Have a financialfinancialfinancialfinancial strategystrategystrategystrategy thatthatthatthat exceedsexceedsexceedsexceeds the the the the locallocallocallocal level level level level

and and and and locallocallocallocal budgetsbudgetsbudgetsbudgets

• Be Be Be Be accountableaccountableaccountableaccountable: show : show : show : show successessuccessessuccessessuccesses onononon output and output and output and output and

outcomeoutcomeoutcomeoutcome levellevellevellevel

• InvestInvestInvestInvest in partners, in partners, in partners, in partners, externalexternalexternalexternal financialfinancialfinancialfinancial coalitionscoalitionscoalitionscoalitions

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Challenges

• New New New New healthhealthhealthhealth care care care care insuranceinsuranceinsuranceinsurance actactactact

• ShiftingShiftingShiftingShifting focus focus focus focus fromfromfromfrom care and shelter care and shelter care and shelter care and shelter totototo preventionpreventionpreventionprevention and and and and

rehabilitationrehabilitationrehabilitationrehabilitation: : : : causingcausingcausingcausing shiftsshiftsshiftsshifts and links and links and links and links totototo newnewnewnew partners, partners, partners, partners,

newnewnewnew budgets budgets budgets budgets ––––oftenoftenoftenoften frozenfrozenfrozenfrozen duedueduedue totototo the the the the economiceconomiceconomiceconomic crisescrisescrisescrises----

• RedefinitionRedefinitionRedefinitionRedefinition financialfinancialfinancialfinancial strategiesstrategiesstrategiesstrategies requiredrequiredrequiredrequired: : : : newnewnewnew partners, partners, partners, partners,

newnewnewnew plans, plans, plans, plans, scarcity.scarcity.scarcity.scarcity.

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