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Housing Strategies For the CSAT Treatment for Homeless Persons

Grantee Meeting June 2, 2003

Carol Wilkins

Corporation for Supportive Housing

carol.wilkins@csh.org

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MISSIONCSH helps communities create permanent housing

with services to prevent and end homelessness.

For more information and resources to help in your community

visit our web site www.csh.org

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Why Do People Become Homeless? Poverty Poor health Mental illness Drug use Multiple evictions Past abuse, domestic violence Little education Unemployed / Underemployed Children with behavioral problems

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People Disabled by Mental Illness and/or Substance Abuse Problems Are Priced Out of Housing

In 2000, people with disabilities receiving SSI needed to pay – on a national average – 98% of their SSI benefits to rent a 1-bedroom apartment

In 2000, there was not one single housing market in the country where a person with a disability receiving SSI benefits could afford to rent a modest efficiency or 1-bedroom unit

Because of their extreme poverty, the 3.5 million non-elderly people with disabilities receiving SSI benefits cannot afford decent housing anywhere in the country without some type of housing assistance

Source: Technical Assistance Collaborative Priced Out in 2000: The Crisis Continues

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WHAT IS SUPPORTIVE HOUSING?

Supportive Housing is PERMANENT AFFORDABLE HOUSING

combined with a range of SUPPORTIVE SERVICES

that help PEOPLE WITH SPECIAL NEEDS

live stable and INDEPENDENT

lives.

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COMBINES HOUSING AND SERVICES HOUSING

– PERMANENT: Not time limited, not transitional;

– AFFORDABLE: For people coming out of homelessness; and

– INDEPENDENT: Tenant holds lease with normal rights and responsibilities.

SERVICES – FLEXIBLE: Designed to be responsive to

tenants’ needs;– VOLUNTARY: Participation is not a

condition of tenancy; and– INDEPENDENT: Focus of services is on

maintaining housing stability.

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SUPPORTIVE HOUSING TYPES Apartment buildings exclusively housing

formerly homeless individuals and/or families. Rent subsidized apartments leased in open

market. Apartment buildings with mixed income

households, including the formerly homeless. Long-term set aside of units within privately

owned buildings. Services integrated within existing affordable

housing developments. Single family homes, including shared housing

environments.

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WHO IS SUPPORTIVE HOUSING FOR?

People who are homeless or at-risk for homelessness

- and - face persistent obstacles to maintaining housing,

such as mental health issues, substance use issues,

other chronic medical issues, and other challenges.

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SUPPORTIVE HOUSING IS FOR PEOPLE WHO:

BUT FOR HOUSING cannot access and make effective use of treatment and supportive services in the community; and

BUT FOR SUPPORTIVE SERVICES cannot access and maintain stable housing in the community.

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A range of services to support tenants in their goals

A broad array of services available– Mental health and substance use

management and recovery– Vocational and employment– Money management & benefits advocacy– Coordinated support / case management– Life skills– Community building and tenant advocacy– Medical and wellness

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“Services are voluntary for the tenants – not the staff”

Tenants choose as much or as little services as they desire – without having to move as their service needs change

Engagement is an ongoing activity to establish and sustain relationships

• Begin with tenants’ practical needs and personal goals• Help tenants recognize the connection between recovery

and getting what they want out of life Housing is the base for engaging tenants in treatment and

supports that can help achieve the primary goal of housing stability

The tenant is the host; service providers are guests

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Service strategies anticipate and help to manage the risks and consequences associated with substance use and relapse

Building or program design facilitates informal engagement with service providers and social activities that support recovery

Creating a strong and safe community to reinforce norms of behavior and hope for recovery and growth

Supportive housing tenants must pay rent and meet other lease obligations – Participation in services can help tenants meet their

obligations, solve problems, and avoid eviction– Evictions are for failure to pay rent or for problem behavior –

not for choices about participation in services

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Supportive housing provides opportunities for tenants to

Access appropriate care for and manage chronic health and mental health conditions

Take steps toward achieving and maintaining sobriety

Achieve housing stability Work Socialize Be leaders in their community Connect with the wider world Pursue goals and interests

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“The day I walked into Hudson View Commons with the keys to my own apartment was the first time I could see light at the end of a long, dark tunnel. Each day that light becomes brighter and brighter. Supportive housing is a true stepping stone.”

Mark Stavola, Tenant

Broad Park, CT

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“I have 2 years clean and sober, a steady job, I pay my own rent – all of which I could not have done without supportive housing.”

Charlie Miller, Tenant

Canon Kip, CA

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WHY SUPPORTIVE HOUSING? Current approach is not solving the problem for

many homeless people

This 15% consumes more than half of all homeless shelter services – leaving the homeless services systems struggling to effectively serve those who could exit homelessness relatively quickly.

Dennis P. Culhane, University of Pennsylvania

Research indicates that approximately 15% of people who experience homelessness are chronically homeless

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SUPPORTIVE HOUSING WORKS As documented by researchers across the country

80% of tenants coming from streets and shelters achieve housing stability for at least a year.

Emergency room and hospital visits drop by more than 50%.

Decreases in tenants use of emergency detox services by more than 80%.

Increases in use of preventive health care services, primary care and services to address substance abuse.

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SUPPORTIVE HOUSING IS COST EFFECTIVE

New York / New York Cost Study Study: The Impact of Supportive

Housing for Homeless Persons with Severe Mental Illness on Use of Public Services in New York City

The cost of homelessness for persons with serious mental illness was more than $40,000 per year – with 86% of costs in health care and mental health systems.

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SUPPORTIVE HOUSING WORKS As documented by researchers across the country

Positive impacts on employment status.

Increases of 50% in earned income and 40% increase in rate of participant employment when employment services are provided in supportive housing.

Significant decrease in tenant dependence on entitlements.

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Roles in Supportive Housing DEVELOPER RENT SUBSIDY

PROGRAM MANAGERS

OWNER PROPERTY

MANAGER SERVICE

PROVIDER(s) TENANT COMMUNITY… 

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Approaches: HOUSING SIDE

Services linked to existing housing projects for similar target population(s)

Leasing housing units in the private market (tenant, sponsor, or project based subsidies or “master lease”)

Set asides of units within other projects Developing or purchasing housing

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Approaches: SERVICE SIDE Services located on-site with housing Services located off-site and coordinated with

housing Services formally coordinated and delivered

by multiple providers Linkages to existing services in the

community Set asides or priority for supportive housing

project residents at service delivery location

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Supportive Housing Models

Scattered-site Single-site Clustered Shared

housing Mixed

populations

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Housing Provider

Service Provider

Partnerships in Supportive Housing

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Benefits of Partnerships in Supportive Housing

Responds to the Need for Housing with Services in your Community

Capitalizes on the Expertise of Housing Providers and Service Providers

May Provide Access to Specialized Funding Sources

Opportunity for Creative Tension Between Service Provider and Property Manager

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The Challenges of Creating and Operating Supportive Housing

Finding and securing capital funding for projects with little or no excess cash flow to cover debt

Securing operating and service funding, or rent subsidies

Scarce resources & increasing competition

Financing Supportive Housing:

Piecing together several funding sources for one development – or to provide housing & services to the same person / target population

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The Challenges of Creating and Operating Supportive Housing

Sustaining Supportive Housing:

Maintaining and renewing operating and service funding over the long haul

Creating and fostering good working partnerships between property managers and service providers

Improving and adapting services to increase tenant access, needs and interest

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PHASES OF HOUSING DEVELOPMENT

CONCEPT PRE-DEVELOPMENT /

FEASIBILITY

DEVELOPMENT

OPERATIONS

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TYPES OF FUNDING:

1. PRE-DEVELOPMENT

2. PERMANENT - CAPITAL

3. OPERATIONS

4. SUPPORTIVE SERVICES

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DEVELOPMENT-OPERATING LOOP

DEVELOPMENT (1 - 4 years)

OPERATIONS(15 - 30 years)

SOURCES: Federal, State, Local,

Private, Other

USES:Site Acquisition; Construction,Permits, Professional Fees,

Soft Costs 

SOURCES: Tenants Rents, Reserves,

Rental Subsidies

USES: Maintenance & Repairs,

Taxes, Insurance, Utilities, Other

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SUPPORTIVE HOUSING AS A NATIONAL STRATEGY TO END CHRONIC

HOMELESSNESS

– Millennial Housing Commission Report– Continuum of Care and HOPWA Programs– 10-Year Plans to End Homelessness– US Conference of Mayors Recommendations– President’s Interagency Council on Homelessness and

Collaborative Initiative to Help End Chronic Homelessness

– President’s New Freedom Mental Health Commission– HHS Ending Chronic Homelessness: Strategies for

Action

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“As a nation, we must confront this problem and

work to provide shelter and assistance to those in need.

To enhance the quality of life for our citizens, my Administration remains

committed to ending chronic homelessness…”President George W. Bush

March 18, 2003

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Focus on Ending Chronic Homelessness

As defined by HHS, HUD, and the VA for collaborative initiatives:

An unaccompanied homeless individual with a disabling condition who has either been continuously homeless for a year or has had at least four (4) episodes of homelessness in the past three (3) years

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Expanding housing opportunities for people with mental illness and/or substance abuse problems

Eligibility criteria for the housing (or subsidies) targets people with disabilities and those who are homeless for the long-term

Outreach, marketing and tenant selection procedures and program rules facilitate access

Supportive services and property management practices are designed to help people achieve housing stability and reduce reliance on emergency care

Requires strategies for effectively engaging and housing people with ongoing or relapsing substance use problems

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CSH, National Alliance to End Homelessness, working with providers, state and local

governments, and advocates

are spearheading a national initiative

the Compact to End Long-Term Homelessness

that calls for the creation of

150,000 new units of supportive housing

nation-wide over the next 10 years.

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COMPACT TO END LONG-TERM HOMELESSNESS - GOALS

Creating and sustaining at least 150,000 units of permanent supportive housing over the coming decade for people who are experiencing long-term homelessness.

Ending the practice of discharging large numbers of people into homelessness from hospitals, mental health and chemical dependency treatment facilities, jails, and prisons; and

Secure investments in additional affordable and supportive housing alternatives from mainstream systems, so that supportive housing is available to those who are homeless, or would likely be homeless without it.

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COMPACT TO END LONG-TERM HOMELESSNESS - STRATEGIES

Renew – with predictability and stability – funding for rent or operating subsidies and services that sustain the supportive housing that now exists.

Focus resources from mainstream and targeted programs to create and sustain supportive housing.

Integrate and coordinate investments for housing and services to use resources efficiently and make it possible to take supportive housing to a much larger scale.

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COMPACT TO END LONG-TERM HOMELESSNESS - STRATEGIES

Increase resources to create and maintain supportive and affordable housing.

Invest in building the capacity of community groups and government to create and sustain high-quality supportive housing.