There are a few levels of care that OSN provides its clients. Beginning with walk-in intakes, appointment based case management for housing ect, drop in clinic hours in our Wellspring Drop In Center and at the Mercy Family Health Center. We provide street outreach via walking rounds and van sites throughout the city of Pittsburgh each day. In addition to all that, there are High Risk Rounds. These rounds are done by a combination of driving and walking. The goal of High Risk rounds depends on the individual. Sometimes it is to just be sure that they are okay, to bring them food and build rapport in the hopes that one begins to trust the services and people of OSN. Other times, it is to help people get to important medical appointments or meetings with housing programs. I have done High Risk rounds a few times with the outreach workers during the day. Each time we meet with someone, we ask them where they will be the when we want to see them next. Essentially all we know when we set out to find someone is their general location – most of the time. It is a lot of luck and probably some sort of divine intervention when we are lucky enough to find the people we want to see. Some of the clients we see on high risk rounds are waiting to find housing placement or have medical conditions which cause us to believe they need to be checked on. Often, these clients are not willing to go to drop in hours or van outreach, thus it is the role of the outreach worker and his team (often medical students but sometimes me!) to continue to build rapport and to help them get where they need to be. The ultimate goal is housing, but the barriers to housing are many. Many people with addiction or mental illness are housing resistant for a myriad of reasons. Some feel they do not deserve it, some have no income to support housing, some are held back because of mental illness or criminal history. This list is not at all exhaustive and many clients are faced with one or all of these barriers. One solution to these barriers is our housing first model living program Trail Lane Apartments. This is one of my service sites, and more and more I am realizing we need dozens more apartments like this program. Everyone wants to have their clients stay at Trail Lane..and why wouln’t they?! Its peaceful, beautiful and everyone who works there cares deeply for the well being of all the residents. There are few rules and many resources for support – the perfect equation for chronically street homeless.