Health, Human Services, & Homelessness
Transition Policy Committee Summary of Findings
Committee Name
Health, Human Services, and Homelessness
Committee Members
Serena Hollmeyer Taylor, Regina Bertholdo, Kate Byrne, Jordan Harris, Mike Libby, Melissa McWhinney, Hannah O'Halloran, Jay Nothoff
Key themes and trends:
All municipalities find themselves on a spectrum of direct-service provision. At one pole is a city that provides all direct social services to its constituents–a wholly public social service delivery system–and at the other lies a city that outsources all direct service to non-profit partners. Neither extreme optimizes efficiencies or positive impacts as each entity brings unique skills and capacities to bear. Cities, beyond the traditional addressing of collective-action failures, bring scale, cross-silo coordination, and legitimacy, while non-profit partners contribute cultural competency, subject matter expertise, and a nimbleness that allows them to pivot towards innovative solutions quickly. Rarely is this more applicable than in the areas of health, human services, and homelessness. Each of these alliterative terms contain multitudes and require a well-balanced public/non-profit partnership to address them, particularly in times of economic uncertainty. It is this group's view that Somerville has found success using these models in some aspects and is sorely lacking in others.
Key themes:
Homelessness has changed in both intensity and complexity over the past few years. Although the presence of unhoused neighbors has always been acknowledged, now a larger unhoused population is more visible and more impactful, which has resulted in greater awareness and tension with other city residents. Survey respondents share concerns about encampments and the safety and care of unhoused residents. They also share concerns about the safety of public spaces such as public parks where larger groups have gathered, and about their perception that when larger groups have gathered, other citizens are not able to use those public spaces.
While a subset of these larger groups may involve currently unhoused individuals, there is also a subset of individuals that are formerly homeless and who are now housed. Beyond these subsets there are also other individuals that may not be known to local residents, city representatives or nonprofit providers.
Official responses to these changes have included continuing and strengthening the ongoing partnership with The Somerville Homeless Coalition (SHC), helping them to access new sources of funding and including them in weekly inter-departmental meetings.
Given the recent radical policy changes on the federal level–shifting funding and support away from permanent housing towards shorter-term housing and treatment–formerly homeless residents currently in permanent supportive housing may be facing homelessness again in 2026. There could be an uptick in street homelessness from previously stably-housed families and individuals that will require a correlative increase in support from the City and service providers.
Inefficiencies and missed opportunities abound. Various departments in Somerville have direct-service staff whose remits often mirror what the staff of non-profit partner organizations do. Given the specialization of the partner organizations and their comprehensive service provision–things (appropriately) lacking in the City–staff in municipal roles often revert to simply acting as a referral service and redirecting people to the external organizations.
In this regard, Somerville's strengths lie in the unique ability to convene, support, coordinate, and liaise between service providers and funding opportunities, as well as creating synergies interdepartmentally as well as with external service providers and surrounding municipalities and statewide departments and groups. It is rare that an issue that was raised, both by the committee and the surveyed public, was simple and addressable by a singular entity within the City. Issues like substance use disorder (SUD), chronic homelessness, emergency management, and food security require intervention by myriad groups and departments. The incoming administration must encourage and create cross-departmental coordination as well as cross-sector partnerships (CSPs) to support these complex issues.
Somerville should look to its neighbors to collaborate on solutions. Regional cooperation and coordination will enable the sharing of best practices, services, and create solutions to issues that expand beyond municipal boundaries.
Disability: One quarter of Somerville's population has at least one disability, assuming it tracks our nation as a whole. An awareness and understanding of the needs and concerns of the disabled members of our community must be woven throughout any policies and practices relating to Health, Human Services, and Homelessness, and indeed throughout any of the Mayoral Administration's efforts.
Existing initiatives:
Partnerships with direct service providers–SHC, Housing Families, Youth Harbors, Community Action Agency of Somerville (CAAS) are working well, especially where the City is leveraging its strengths. These local providers have built decades of community trust and subject matter expertise which can be buttressed by the scale and reach of the City's capacities.
Some examples:
When SHC sought funding for its healthcare programming, the Prevention Team within HHS wrote the grant to access Mosaic Opioid Recovery Partnership funds.
The Emergency Management System provides essential cross-program support for residents affected by emergencies to minimize disruption from emergencies like house fires.
The addition of a social worker to the library staff, as well as the partnership between SHC and the Libraries leadership and staff has created a positive response to the use of library spaces by the unsheltered population.
The Office of Housing Stability has innovative solutions to housing insecurity including the Municipal Voucher Program (MVP) - a Somerville subsidized housing program where eligible families pay 30% of their earnings towards rent. This program allows the city to support a more diverse group of residents than by using more traditional funding sources. A mix of funding including the American Rescue Plan Act (ARPA) has subsidized 27 units for ~4-5 years. We are heading into year 3. Additionally, OHS runs the Emergency Hotel Program supporting families/individuals with no place to live while transitioning to a shelter or permanent housing.
Community Health Workers (CHW) work across the city in areas where other services are being offered (eg: SHC and Connexion) to share information about available resources (eg. SNAP and MassHealth) and support in enrolling/accessing services.
A Seasonal Warming Center operated by Housing Families at the Cummings School provides a critical sheltering resource during cold weather.
The Prevention Team within HHS utilizes harm reduction strategies to support residents with SUD (Narcan and test strip distribution, overdose prevention training, and public health vending machines) while addressing public health and safety issues through sharps disposal kiosks and partnering with the Department of Public Works (DPW) who collect any needles found in public.
Cross-sector partnerships, like the Office of Food Access and Healthy Communities amplify the work of partner service providers. Their convening power, including collaboration with the Somerville Food Security Coalition, is used to gather data on what needs are unmet, and they respond with direct and indirect funding opportunities and participation in regional conversations. Additionally, they serve as a central source of information for residents who are seeking support, not by providing direct services but rather by directing them to the appropriate resources.
Community Conditions and Response. Continue hosting weekly interdepartmental huddles focused on community conditions and response, convened by the Mayor's Chief of Staff, bringing together DPW, SHC, HHS, SPD, 911/311 leadership, and outreach teams as needed to review citywide conditions related to homelessness, SUD, public disorder, public health hazards, and crime. The group identifies emerging hotspots and coordinates cross-departmental responses to the issues raised. Over time, this forum could be broadened to incorporate structured community feedback, particularly in situations where 311 or 911 calls may not be warranted. In the future, the group could also make its findings and coordinated responses publicly available through a brief weekly summary (see resources - Community Conditions and Response).
Gaps:
Overlap between City and Partner organizations leads to inefficiencies:
When the City adds roles to its departments that overlap with community partners there is often a wage differential, with the City often able to pay more than the partner agencies. This has resulted in both a talent drain on the agencies and lost hiring opportunities. In some cases, when the City attempts to provide direct services to constituents they end up redirecting them to the direct service providers.
Lack of facilities and services for unhoused residents: While the addition of a portable toilet in Seven Hills Park has made a difference for both housed and unhoused residents, it is removed seasonally. The delay in construction of Portland Loos has left Somerville without a year-round solution to an everyday need.
A Cooling Center: A warm weather corollary to the Warming Center is necessary. Unhoused residents can use public spaces like the libraries to cool themselves in the summer but this is neither a sustainable nor an overnight solution.
Specialized Courts: The City lacks specialized court initiatives including a mental health court and a community court. Cambridge has a very successful model that aims to address barriers to greater stability experienced by defendants who are homeless or at the risk of becoming homeless. Members of the SPD and staff of partner agencies have spoken in support of similar courts being created in Somerville.
Substance Use Disorder (SUD): This continues to be a huge problem in Somerville. Survey respondents spoke favorably of reinvigorating the implementation of plans for a safe consumption site as well as expanded treatment options. There is an ongoing lack of SUD treatment beds and delays in getting people to treatment when they are ready. Depending on the partner organization, residents entering treatment are offered transportation in a variety of ways: SHC, CHA, and others have limited transportation resources and the next administration should ensure that there is consistent and adequate funding.
The Board of Health: The Board of Health (BOH) is an underutilized resource in the City. The services and programs it operates range from Emergency Preparedness to restaurant inspections, and the promotion of public health through the creation and enforcement of regulations and policies. The BOH carries a lot of power in the city, and it works closely with the leader of the HHS department to determine the direction of public health in Somerville.
The Board of Health needs a strategic plan in order to be proactive and not merely responsive. The BOH should be expanded from its three members to a five-member Board, in order to cover more ground in the City. The BOH receives no funding from the state, rather, it is funded through tobacco dollars, opioid dollars, and other sources.
Geographic inequity in health and human services distribution: Health and human services resources are not equitably distributed across Somerville's neighborhoods. East Somerville, in particular, experiences significantly reduced access to critical services compared to other parts of the city. Vaccine clinics and other public health interventions are less frequently offered in East Somerville, creating barriers to preventive care for residents. The Community Health Worker (CHW) presence, while effective where deployed, has been inconsistent and inadequately funded in East Somerville–exemplified by the forced cessation of CHW services partway through 2025 due to ARPA funding sunset. Residents facing homelessness, mental health crises, and SUD in East Somerville encounter fewer accessible resources and longer response times compared to residents in more centrally-located neighborhoods. This geographic disparity in service provision undermines the City's stated commitment to equity and leaves vulnerable residents in underserved neighborhoods without adequate support systems.
Mental Health Services: The combination of substance use disorder, homelessness and mental health issues are intricately entwined. This makes treatment difficult to access. One of the reasons the Housing First model works so well is that it takes one major problem out of the picture, leaving potential for service providers to assist with options for treatment. While there may be adequate beds for mental health treatment in the city/region there need to be corollary resources dedicated to outreach and referrals. Not all people with mental health issues need to be hospitalized. Adding psychiatry and social work to street outreach and home visits may actually prevent the need for hospitalization.
Rats: These continue to be an endemic problem. The city needs to get residents and businesses involved in all attempts to contain rats. While this is a constant in urban areas there needs to be proactive work. When residents feel that they can not use their yards due to rats, it is an untenable situation. This is reality in areas of the city where development is rampant.
Lack of Consistently-staffed City Leadership on Systemic Causes of Homelessness: Currently, there is no single city office or designated staff person working directly and comprehensively on the topic of homelessness in Somerville. When it comes to addressing homelessness, multiple city departments and community partners must coordinate to have conversations regionally and respond to the systemic issues that are making homelessness worse in the city. This fragmented approach creates inefficiencies, gaps in coordination, and unclear lines of responsibility. While Somerville has strong partnerships with local service providers that are already providing excellent direct services, the lack of a centralized city presence means there is no consistent municipal voice for strategic planning, regional coordination, policy development, or cross-departmental alignment on homelessness issues.
Opportunities:
A Department of Community Partnerships with a focus on homelessness would serve as a single initial point of contact for direct service partners. Rather than reaching out to many different departments to coordinate a new project or solve complex issues, a non-profit leader could contact the Director who would then liaise with the city departments, saving time and resources. This office would not provide direct services–which are more effectively delivered by specialized non-profit partners–but would instead operate similarly to the Office of Food Access and Healthy Communities, serving as a convener, coordinator, and strategic partner. Just as the Office of Food Access and Healthy Communities addresses the complex intersection of food systems, safe neighborhoods, green spaces, healthcare access, and affordable housing through cross-sector partnerships and strategic coordination, a Department of Community Partnerships focussing on homelessness would work on:
Convening city departments, non-profit partners, regional stakeholders, and community members to ensure alignment and collaboration
Developing long-term strategic plans to address homelessness, including prevention, response, and systems-level solutions
Serving as Somerville's primary liaison for regional homelessness initiatives, ensuring the city participates in coordinated regional responses and accesses regional resources and best practices
Facilitating cross-departmental coordination between HHS, DPW, Police, Office of Housing Stability, and other city departments
Gathering and analyzing data on homelessness trends, service gaps, and outcomes to inform policy and practice
Identifying funding opportunities and supporting access to grants and resources for both the city and partner organizations
Advocating for Somerville's interests and needs at the county, state, and federal levels
This role would enhance rather than replace the expertise and relationships that community-based providers have built over decades. By serving as a single point of municipal contact, it would streamline communication and reduce the burden on non-profits that currently must navigate multiple city departments. Establishing clear municipal leadership on homelessness would position Somerville to address this complex issue through coordinated, strategic, and sustainable approaches that complement and support the vital work of community partners.
The City should support the continued work of interdisciplinary/interdepartmental efforts like the development of a “Belongings Protocol.” The Department of Public Works and the Inspectional Services Department are working with HHS Community Health Workers and Somerville Homeless Coalition to ensure that personal belongings that are found in public spaces are tagged, stored (when appropriate) and disposed of when necessary.
Another example of this partnership is the nascent Community Outreach Help and Recovery (COHR) team, currently embedded within the Somerville Police Department. The team consists of clinicians and case managers that work alongside the police and other mental health stakeholders to identify individuals in crisis and support them. Through expansion the COHR team can be formalized into a co-response model. COHR staff respond to behavioral-health, substance use, and homelessness-related crises, in addition to coordinating with nonprofit providers, tracking service gaps, and case coordination. Ideally this team would have clearer guidelines and closer partnership with the Somerville Police Department and the Community Health Workers.
The City should support the development of a Regional Board of Health. A multi-municipality group can gather and create more complete data sets, collaborate to reduce overhead costs, and align on common priorities. A Regional Board would also speak with a more powerful voice when addressing state-level opportunities and leaders, coordinating efforts on issues like better access to substance use treatment resources.
In addition, the Somerville Board of Health needs a strategic plan in order to be proactive and not merely responsive. The BOH should be expanded from its three members to a five-member Board, in order to cover more ground in the City. The BOH receives no funding from the state. Instead, it is funded through tobacco dollars, opioid dollars, and other sources.
In parallel, the administration must prioritize coordination with regional partners addressing homelessness, health, and human services across municipal boundaries. Identifying and working in alignment with regional, state, and federal agencies and peer municipalities will help minimize duplication of effort, strengthen service delivery, and ensure Somerville is part of a unified, credible voice advocating for resources, policy alignment, and long-term solutions.
Leverage Somerville's State Delegation and advocacy resources. The City can serve as a conduit between service providers and the delegation to ensure needs are clearly understood, effectively advocated for, and connected to opportunities for additional funding.
Offer centralized training programs for non-profit partner agencies within Somerville. Many partners, following best practices, provide staff training in de-escalation, trauma-informed care, motivational interviewing, emergency preparedness, and more. Rather than each provider paying for one-off training for each new staff member as they join, the City can take advantage of economies of scale by coordinating growing knowledge by offering training and technical assistance to multiple service providers on a regular basis. Additionally, the City should provide support services for frontline staff from partner groups and hold appreciation events.
Commit to sustained, structured engagement with Somerville's community institutions. This engagement should include faith-based organizations; neighborhood councils such as the Davis Square(DSNC) and Union Square Neighborhood Councils (USNC); Gilman Square Neighborhood Council (GSNC); merchant and business associations; neighborhood organizations and associations including the Somerville Community Action Network (CAN), East Somerville Main Streets, Union Square Main Streets, and the Somerville Community Corporation (SCC); and issue-focused bodies such as the Davis Square Public Safety Working Group. The City should also actively encourage and foster the formation of comparable groups in neighborhoods where such organizing capacity is lacking, as a core strategy for radical transparency, public trust, and policies grounded in neighborhood-level lived experience.
The City should offer salary differentiation resources to partner agencies to help them “level up” their salary offerings to attract top-level talent and ensure longer-term employee retention. This would further bolster the effect of the inclusionary housing programs that prioritize residents who work within Somerville, perhaps by creating a specific carve-out for people working with non-profit partner agencies.
Expand the Guaranteed Basic Income Program–a 1 year pilot program that supported low income families and a few youth experiencing or at risk of being homeless with a $750 monthly income for a whole year. UMASS interviewed and followed participants. A report of the program will be released next year. That provided a safety net to all participants in the program. There is a network of other municipalities meeting about a universal income model and Somerville should be part of it.
There is a great deal of new learning about the role of innovative housing models, including Social Housing, and Single Room Occupancy. The City should dedicate staff time to the investigation and implementation of these and other models.
Lastly, we have appreciated the opportunity to gather to talk and create recommendations for the City to move forward. We believe it would be a benefit to the City and the community for these groups to continue to convene, perhaps quarterly, to continue to reflect on these topics, assess the status of these issues, and offer recommendations for mid-course corrections where necessary.
Recommendations for action:
Short term recommendations: easy early implementation (low hanging fruit)
Implement the Belongings Protocol currently in the final stages of development
Re-fund the CHWs working in East Somerville who were forced to stop work partway through 2025 due to the sunsetting of ARPA. This is an effective and established program that will require little to no set-up.
Bring staff back to the Board of Health offices, work will proceed with much more efficiency
Medium term recommendations: to be focused on during first year
Appoint a Community Partnerships Director who is a central source of information and support for CSPs.
Proactively allocate funding for the continuation of the Municipal Voucher Program.
Develop a strategic plan with the Board of Health, including potential expansion and researching regional options
Accelerate installation of Portland Loos
Open a Cooling Center for the summer months
Implement a regular cadence of training programs (as detailed above) available to non-profit staff in Somerville.
Allocate a pool of funds to be used to transport residents seeking SUD/MH treatment to facilities.
Long term recommendations: to be built into strategic planning over course of entire term
Expand Guaranteed Basic Income programming
Develop a city wide volunteer program that uses the talents of residents to meet some of the needs in different arenas of city work
The city, along with non-profit partners, needs to develop other streams of funding given the current cut backs by the federal government. This should be a collaborative process, not a competitive one.
We believe it would be a benefit to the City and the community for the transition advisory groups to continue to convene, perhaps quarterly, to continue to reflect on these topics, assess the status of these issues, and offer recommendations for mid-course corrections where necessary.
