cost of homelessness benefit of shelter plus care

8/14/2019 Cost of Homelessness Benefit of Shelter Plus Care

1/17


2/17

Cost of Homelessness: Benefit of Shelter Plus CareAnalysis of the Shelter Plus Care program administered by theDepartment of Health and Human Services, Office of Adult MentalHealth ServicesDecember 2008

Greater Portland

Department of Health and Human ServicesAdult Mental Health Services32 Blossom Lane

# 11 State House StationAugusta, Maine 04333-0011Tel: 207.287.4243Fax: 207.287.1022 TTY: 1.800.606.0215

Sheldon WheelerDirector of Housing ResourceDevelopment, Office of AdultMental Health Services

Adult Mental Health Services

An Office of the

Department of Health and Human Services

John E. Baldacci, Governor Brenda M. Harvey, Commissioner

Authored By:

Melany MondelloStatewide Coordinator, ShelterPlus Care and Bridging RentalAssistance Program: ShalomHouse Inc.


3/17

2

Why Study the Cost of Homelessness?

My life being more stable for myself & my

kids leaves me with a more positive outlookand able to use my everyday energy on otherthings besides if we are going to eat or

looking for a place to stay.

(Tenant quote from Quality of Life Survey)

Cost of Homelessness:Benefit of Shelter Plus Care


4/17

3

A single person with a disability looking for an apartment inPortland in 2007 is faced with a Fair Market Rent for a 1 bedroomapartment at $800 while receiving an SSI benefit of $637.

There is not a single housing market in the country where aperson receiving SSI/SSDI can afford to rent even a modest onebedroom apartment without some kind of rental assistance.

An estimated 20-25% of people who are homeless also strugglewith severe and persistent mental illness while up to 66% self

report problems with substance use or mental health problems.Many of these persons are eligible for, but not currently receiving,SSI benefits.

At the federal level today there is an 80% reduction in investment

in affordable housing compared with 30 years ago.

Why Study the Cost of Homelessness?

1

2


3


5/17

4


Shelter Plus Care (SPC) is a Permanent Supportive Housingprogram providing rental assistance and coordination of services topersons experiencing homelessness with a disability, principallypersons with a severe and persistent mental illness.

Rental assistance vouchers are funded by the U.S. Department ofHousing and Urban Development and administered by MainesDepartment of Health and Human Services-Office of Adult Mental

Health, Housing Division.

Shelter Plus Care (SPC) vouchers in Portland are tenant basedwhich combined with a Housing Firstphilosophy, allows therecipient choice, independence, and controlover where they live

andwhat services they will receive.

Introduction to Shelter Plus Care


6/17

5

Project Scope

This presentation focuses on 70 Shelter Plus Careparticipants within Maines Greater Portland area, whichincludes Maines largest city.

The data set utilized in this presentation was madeavailable from the Cost of Homelessness State of MaineGreater Portland September 2007.

Data presented represents the participants specificutilization and cost of services for one year of homelessnessand one year housing with the SPC program.


4


7/17

6

Average Annual Cost Per Person Before and After

Permanent Supportive Housing Placement

Shelter Plus Care - Greater Portland

$21,617

$12,808

$8,210

$0

$5,000

$10,000

$15,000

$20,000

$25,000

1 Year Before 1 Year After

Service Cost Housing Cost

Total $21,018

Housing plusservices using SPC cost lessthanservices alone while homeless


Average per personcost avoided

includingthe costs ofhousing: $600 or

$42,000 for the cohortof 70 persons studied

Average per personsavings in servicedollars: $8,809 or$616,630 for the

cohort of 70formerly homeless

persons studied


8/17

7

Cost of Health Care Services DramaticallyDecreases once housed with Shelter Plus Care

34% decrease in Health Care costs:$126,627 Savings

43% decrease in Mental Health Services cost:$114,506 Savings

49% decrease in Emergency Room costs:

$46,945 Savings

51% decrease in Ambulance costs:

$4,613 Savings



9/17

8


Cost of Health Care Services DramaticallyDecreases once housed with Shelter Plus Care

$367,978

$241,350$269,146

$154,640

$94,940

$47,996

$9,082 $4,469

$0

$100,000

$200,000

$300,000

$400,000

Health Care Mental Health

Services

Emergency

Room

Ambulance

Healthcare Costs ReducedShelter Plus Care Tenants - Greater Portland

1 Year Before Housing 1 Year After Housing N = 70


10/17

9

Utilization of Community Based Supportive ServicesDramatically Improves once housed with Shelter Plus Care

64% increase in Substance Abuse Treatmentcontacts: 134 more contacts

311% increase in Transportation servicescontacts: 709 additional rides

18% increase in Mental Health Service contacts:

427 contacts to 502 contacts

46% increase in Case Management contacts forthe same cost



11/17


12/17

11

Inpatient Hospitalizations - Costs and FrequencyDecrease once housed with Shelter Plus Care

53% decrease in costs for mental health inpatienthospitalizations from $145,562 to $68,758

35% decrease in frequency of mental healthinpatienthospitalizations from 17 to 11

82% decrease in costs for physical health inpatienthospitalizations from $166,661 to $30,113

62% decrease in frequency of physical healthinpatienthospitalizations from 13 to only 5



13/17


14/17

13

Findings

The American Association on Intellectual and DevelopmentalDisabilities (formerly AAMR) has determined that it costs 50-75percent lessto provide services in community-based housingrather than more institutional-type housing funded by Medicaid.

This study has determined that it costs 41% less to provideservices to persons using Shelter Plus Care (PermanentSupported Housing) rather than providing services to persons in astate of homelessness. This finding is documented by a servicessavings of $616,630 for this cohort of 70 formerly homelesspersons in Greater Portland, which includes Maines largest city.

The savings documented in this report represent a cost shifting:away from high intensity-high cost services (Emergency Room,Psychiatric Hospital, General Inpatient, etc.) towards moreappropriate Community Based services and PermanentSupported Housing.

5



15/17

14

Recommendations

Fund, develop, and recruit other state and federalresources that could support similar SupportiveHousing models.

Utilize existing data to develop Evidence Based BestPractices.

Examine other at risk of homelessness populations

(Discharges from Hospitals, Jails, Prisons) that maybenefit from Permanent Supportive Housing.

A Longitudinal Study of the existing cohort is alreadyunderway and needs support in the months and

years to come.



16/17

15

Acknowledgements

This presentation was made possible by the direct funding and staffsupport from Maines Department of Health and Human Services andthe Office of Adult Mental Health.

This presentation is based on a subset of data from the Cost ofHomelessness: Cost Analysis of Permanent Supportive Housing-Greater Portland, Mondello, Gass, McLaughlin, Shore, September2007. That study received initial funding and support from MainesDepartment of Health and Human Services, MaineHousing, and agrant from the Corporation for Supported Housing funded by the

Robert Wood Johnson Foundation.

The contents, findings, analysis, and recommendations of this report, Costof Homelessness: Benefit of Shelter Plus Care, have been developed,articulated, and presented by Sheldon Wheeler and Melany Mondello.



17/17

16

Footnotes

1 Ann OHara, Emily Cooper, Technical Assistance Collaborative Inc., Priced Out in 2004-The Housing Crisis forPersons with Disabilities, September 2005

2U.S. Department of Health and Human Services, Substance Abuse and Services Administration, Center forMental Health Services, National Mental Health Information Center, Publications, Homelessness-Provision ofMental Health and Substance Abuse Services

3Psychiatric Services, Mental Health Policy and Services Five Years After the Presidents Commission Report:An Interview with Michael F. Hogan, Lloyd I. Sederer, MD, November 2008 Vol. 59 No. 11

4 Cost Analysis of Permanent Supportive Housing-Greater Portland, Mondello, Gass, McLaughlin, Shore,September 2007.

5Eunice Kennedy Shriver, Ann OHara, Emily Cooper, et. al., Technical Assistance Collaborative Inc., PricedOut in 2004-The Housing Crisis for Persons with Disabilities, 2007.


Caring..Responsive..Well-Managed..We are DHHS

cost of homelessness benefit of shelter plus care

Documents