Practical Considerations
Hiring persons with homeless histories and disabling conditions, while challenging, can bring tremendous
benefits and rewards to employee and employer. Nonetheless, there are potential obstacles that should not
be underestimated. To paraphrase one behavioral health agency leader: it is relatively easy to teach technical
skills or job duties, it is nearly impossible to teach engagement skills that will come naturally to persons with
lived experience. It is not easy to shortcut a process of building relationships that may take a professional
many months to develop.
Barriers to Employment
Hiring persons in early recovery does have challenges. Heartland Alliance developed a comprehensive
resource that identifies common employment barriers specific to certain populations (homeless youth, older
adults, families with children, ex-offenders, and veterans) and strategies on how to address issues that arise.
http://nationalinitiatives.issuelab.org/resource/populations_experiencing_homelessness_diverse_barriers
_to_employment_and_how_to_address_them
Within the In House Employment resource, we have included: “Barrier Busters,” a practical tip sheet for
overcoming specific barriers to work (e.g. clothing, glasses, transportation, etc.)
Concerns about the Impact of Earnings on mainstream benefits
The most common concern expressed by supportive housing tenants about re-entering the workforce is that
earnings will jeopardize SSI or SSDI benefits and health insurance provided through Medicaid or Medicare.
However, earned income almost always produces a higher income than that of SSI, and the Social Security
Administration offers numerous incentives for people to return to work without losing all their benefits
and/or health coverage. This important topic is further explored in the document here.
Boundaries and workplace ethics challenges
Supportive housing tenants or former tenants and those they work with may encounter role confusion and
ethical dilemmas that are important to be understood upfront and by all parties. It also is advisable that
employees be prepared to distinguish roles, circumstances, etc. For example, a recovery coach with lived
experience can quickly connect and offer support or prompting to someone in early recovery or precontemplation. However, they should not diagnose, serve as a “sponsor” in an AA/NA setting, or offer
opinions that conflict with professional team member recommendations. Defining roles and responsibilities
as well as an exploration of potential ethical challenges is an important responsibility for those developing or
expanding employment opportunities for persons with lived experience in their organization.
1
William L. White and the PRO-ACT Ethics workgroup authored: “Ethical Guidelines for the Delivery of
Peer-based Recovery Support Services,” which provides a thorough examination of the legal, ethical, and
clinical issues, and offers guidance based on the collective experience of its authors.
http://www.bhrm.org/recoverysupport/EthicsPaperFinal6-8-07.pdf
It has also been recommended that, whenever possible, residents should work outside the facility in which
they live. A resident manager or front desk clerk may make observations, come across confidential material,
or experience conflicts related to execution of his/her job duties that can make it difficult to maintain
professional boundaries during off hours. Separation of one’s residence from their workplace is also helpful
in avoiding housing loss if the job does not work out.
Supervision tips
In general, practitioners have emphasized the importance of integrating in-house hires as regular employees
with the same rights and responsibilities. Tenants who become employees should have access to Employee
Assistance Programs, time off to address medical or mental health needs, and workplace protections or
reasonable accommodations that are provided under the Americans with Disabilities Act and Occupational
Safety and Health Administration.
For tenants serving in peer support, peer specialist, or recovery coach roles, supervision should be
accompanied by clinicians. This can either be a separate supervisory relationship with a licensed
professional, or if the direct supervisor is also a clinician, it can be accomplished by the same person. More
information on Peer Workforce strategies is found here in this document.
Consistent with the advice that individuals should not live where they work, case managers or other service
providers of the resident should not serve as supervisor of the tenant employee. The caring relationship
must remain separate and distinct from the employee/employer relationship.
Tips from the National Association of Mental Health Program Directors on peer supervision strategies can
be found at http://nasmhpd.org/search/node/peer%20support, including a recording and slides from a
June 15 webinar entitled “Strategies for Supervising/Growing Peer Workforce”
Partnering with Job Coaches
Ongoing support is critically important to ensure tenants are able to maintain employment and overcome
common on-the-job conflicts. In a high fidelity IPS/Supported Employment program, dedicated job coaches
carry a caseload of 20 or fewer and provide these supports. Many local Mental Health and Addiction boards
employ job coaches and can partner with housing programs to provide this service as tenants enter the
workforce.
Recovery-Related Workplace Issues
People entering the workforce in early stages of recovery may need to take time off to attend medical and
behavioral health appointments and support groups. Some employers will take a person’s personal health
circumstances into consideration when scheduling shifts – a practice that is applied to all employees,
regardless of their housing and recovery history. For example, if an employee is evidently struggling with
health issues and/or stress, they may cut back on the number of shifts that week to allow the employee to
engage in wellness activities and self-care. It is important to review and consider agency policies governing
paid time off, reasonable accommodations, and criminal background checks. Agencies may also want to
think in advance about the impact that a relapse would have on a person’s job status.
2
SAMHSA has produced a helpful guidebook that explores housing and workforce protections related to
persons with substance use histories. This resource can help employers and employees understand their
rights and responsibilities as it relates to past and ongoing substance use.
Specific protections for persons in recovery:
http://store.samhsa.gov/shin/content/PHD1091/PHD1091.pdf
3