CoLEAD provides person-centered, trauma-informed, harm-reduction-oriented services to unhoused adults, lodging participants in motel and hotel rooms in an interim housing approach to stabilization. This approach allows participants to follow COVID transmission guidelines and minimize social contact while addressing their varying needs including physical and behavioral healthcare, primary care, and access to medications, social services, and employment or education opportunities.

Addressing the basic needs of participants, CoLEAD provides life-stabilization services as an alternative to punitive measures commonly associated with behaviors of vulnerable populations (low-level law violations or sustenance crimes). From these interim settings and through intensive case management, CoLEAD supports participants in identifying short and long term goals as part of planning for longer-term stability and housing options while connecting them with immediate and necessary health and social services.

CoLEAD employs a shift-based, seven day a week, staffing model. A team of outreach responders (case managers) provide intensive on-site support and focused, person-centered relationship-based case management. CoLEAD shift leads work closely with outreach responder staff to provide a team-based approach, along with a healthcare provider, at temporary lodging sites. Public Defender Association lodging liaisons (CoLEAD Operations Manager) acts as the communications bridge between CoLEAD staff and hotel employees.

Shift leads supervise each outreach responder shift team based on hotel locations, with overnight on-call shift leads and supervisors available every day, around the clock. Overnight safety teams make rounds at all hotels/motels, responding to on-call staff with any urgent situations.

CoLEAD medical providers work with outreach response teams on-site, assessing the healthcare needs of participants, offering related care including prescription and pharmacy coordination.

CoLEAD employs a multi-cultural team of individuals, valuing that most have relevant lived experience. Many of our teammates come from marginalized communities with lack of access to resources and histories of living in extreme poverty and with the inherent oppression of racism, sexism, trans and queerphobia or the stigma of former incarceration, drug use recovery, homelessness, or violence. Many have struggled and overcome mental health conditions. The CoLEAD team also brings considerable academic experience and clinical training to field operations. Teams include credentialized behavioral health specialists and those with formal training in healthcare, behavioral health, and the criminal legal system.

The COVID-19 pandemic creates a dynamic and changing scenario in Seattle, Burien, the country, and the world. The CoLEAD response to the inherent challenges has taught us much in regards to operations, current issues, and emerging concerns.

From our earliest lessons, we know that lodging liaisons are key to the success of the program. Also, ensuring that participants have full awareness of the lodging agreement and its implications is a necessity. On-site medical assessment and care are vitally important as is the provision of food to address immediate medical needs and food insecurity.

We have found harm-reduction measures and responsive support for meth users–in particular stimulant substitution therapy, and medication-assisted-treatments–are effective and often necessary.

LEAD-oriented prosecutorial liaisons (for CoLEAD our prosecutorial liaisons are from the Seattle City Attorney, the King County Prosecuting Attorney, and the Burien City Attorney) provide critical understanding and appropriate strategies to address the complex legal situations of participants with a goal to distance individuals from the far reaching entanglements and barriers of the criminal legal system. In addition, incentives for financial independence and employment programs are effective in reducing further legal involvement and violations.

A diversity of staff, with varied backgrounds and expertise in a range of experiences and modalities, has been highly effective. The shared lived experiences of many of the CoLEAD outreach responders has enabled a non-judgmental, down-to-earth approach to case management.

Regular frustration and limitations with Medicaid-funded behavioral health systems is ongoing and particularly acute amidst the ongoing COVID-19 crisis.

The CoLEAD Entry & Services Manager matches a placement property to a referred participant’s needs. All CoLEAD participants sign and adhere to the CoLEAD lodging agreement. The agreement for temporary lodging outlines the rules and requirements of the participant’s interim housing. No participant is placed without this agreement.

As issues arise, participants are coached and supported to better understand the lodging agreement.  CoLEAD staff will issue verbal or written warnings for  non-adherence with the lodging agreement if behavior continues while also working on creative solutions to best support participants to remain in lodging. Continued or escalating behavior such as unauthorized guests, room damage or violence can lead to an exit from CoLEAD lodging.

Separate dedicated staff procure motel and hotel rooms and act as property liaisons between CoLEAD case managers and hotel or motel staff.

Participants for the CoLEAD program are referred through various processes including JustCARE community referrals in site-based encampments and referrals from local law enforcement. Referrals who become participants in CoLEAD are COVID-19 tested upon program entry and each participant is required to read, sign, and affirm a lodging agreement. CoLEAD maintains community and neighborhood communications channels for referrals directly from neighborhood businesses, residents, and others who identify individuals likely to commit law violations without stabilization and support.

CoLEAD participants are highly marginalized, unsheltered individuals faced with complex healthcare and trauma histories and challenging behaviors. CoLEAD participants are those who commit, or are at high risk of committing, law violations related to income instability and behavioral health challenges. A significant majority of CoLEAD participants would remain unsheltered due to personal characteristics or behaviors that generally preclude entrance or acceptance into shelter facilities.
Most CoLEAD participants live unsheltered in tents or vehicles and are largely marginalized due to substance use, untreated mental health conditions, and extreme poverty. All participants have substance use issues. Most CoLEAD face significant physical health challenges. CoLEAD provides services to marginalized individuals in streets, shelters, and parks.