overdue for change the transformation of homeless housing and services needed in westchester
TRANSCRIPT
Overdue for Change
The Transformation of Homeless Housing and Services
Needed in Westchester
Crises Bring Radical Change
• Evolution lurches ahead when crises happen
• Our current budget crisis will force an evolutionary “lurch” in homeless programs
• Most of our homeless housing and services use models developed in the 1980s
• Few will exist in their current form by 2015
• Programs have two choices: evolve or die
THE CORE OF OUR CURRENT HOMELESS SERVICES
Not Housing-Ready Housing-Ready
Treatment-Ready
(1) Transitional Shelter
Highly structuredcongregate care
with 24/7 monitoring,and intensive support services
(2) Shelter Plus Care
High-demandpermanent housing
that requires ongoing treatmentutilization
for in-kind match
The Central Assumption
Not Housing-Ready Housing-Ready
Treatment-Ready
(1) Transitional Shelter
Highly structuredcongregate care
with 24/7 monitoring,and intensive support services
(2) Shelter Plus Care
High-demandpermanent housing
that requires ongoing treatmentutilization
for in-kind match
You cannot be “Housing-Ready”until you are “Treatment-Ready.”
The Central AssumptionMade Sense During the 1980s
Not Housing-Ready Housing-Ready
Treatment-Ready
(1) Transitional Shelter
Highly structuredcongregate care
with 24/7 monitoring,and intensive support services
(2) Shelter Plus Care
High-demandpermanent housing
that requires ongoingtreatment utilization
for in-kind match
Most local shelters were invented in the early 1980sduring the height of massive deinstitutionalization of the mentally ill and the sudden onset of the crack epidemic
System Change #1:
We need fewertransitional shelter beds
Why We Need Fewer Shelter Beds
• Biggest shelter cost is 24/7 monitoring
• 19 beds = 10 FTEs for 24/7 monitoring
• You don’t need 24/7 monitoring just because you fell behind on your rent
Reason #1: They are too expensive.
Why We Need Fewer Shelter Beds
Reason #2: The # of homeless people in Westchester is at record lows.
Why We Need Fewer Shelter Beds
Reason #3: We have more access to housing subsidies.
Why We Need Fewer Shelter Beds
Reason #4: We don’t need to “fix” every problem before we rehouse someone.
Why We Need Fewer Shelter Beds
Reason #5: Treatment readiness does not have to precede housing readiness.
Why We Need Fewer Shelter Beds
• Providing 24/7 monitoring makes substance use MORE problematic
• ANY substance use is intolerable in supervised shelters
• But only extreme or disruptive substance use prevents retention of private housing
Reason #6: Sometimes shelters are not a pipeline to housing, but a barrier to it.
Why We Need Fewer Shelter Beds
• HEARTH goal: rehousing in 30 days
• The more long-term transitional shelter beds we have, the more points we’ll eventually lose
Reason #7: HUD no longer values them.
System Change #2:
We need to invent
Fast Track shelters.
Fast Track Shelter Components
3-6 months3. Housing Stabilization
30 days?2. Housing Placement
1-2 weeks1. Rapid Assessment
DURATIONPHASE
Housing Stabilization Services
• Brief and time-limited
• Goal-oriented
• Establish key linkages
• Teach core competencies (budgeting, life skills, etc.)
Who Needs Fast Track Housing?• People recently evicted solely for non-payment of rent• People with a history of successful independent living• People who will not refrain from drug or alcohol use but who are
non-violent and unlikely to disrupt the neighborhood• People in early stages of mental health engagement who are too
afraid to stay in a congregate shelter• People who are too emotionally volatile to safely remain in a
congregate shelter• People unwilling to turn over income for congregate shelter who
would be willing to contribute to the cost of private transitional or permanent housing
System Change #3:
We need centralized
countywide or regional
housing search and placement.
System Change #4:
We need to change shelter funding mechanisms to reward rapid rehousing.
System Change #5:
We need to create amore complete continuum of housing retention services.
Continuum of Housing Retention Services Needed
No major mental health or substance abuse issues
Eviction Prevention Network
Other mentally ill or substance abusing people
“Housing Crisis Response Teams”
Selected substance abusers“Recovery buddies”
Severely mentally illCare Coordinators(ICM, SCM, ACT, etc.)
Target PopulationType of Service
Where will people find housing?
• Units open up with every eviction
• More HUD housing subsidies are available
• DSS now offers rent supplements for formerly homeless
• DSS now allows shared housing without penalties
• We need to upgrade substandard housing
System Change #6:
We need to link housing search and eviction prevention
programs. (Every eviction = a rehousing opportunity.)
System Change #7:
We need to re-establishuse of the Spiegel Act,
but this time do it with the cities.
How to Use The Spiegel Act
• The Spiegel Act allows DSS to withhold rents from substandard units until upgraded
• DSS should partner with cities to identify 1-3 most substandard buildings in each city
• DSS should withhold rent• City should impose fines for building and fire
violations plus penalties for back taxes• County, city and/or a CBO should offer HOME
loans for building improvement
System Change #8:
We need to expand our continuum of housing programs, looking at both housing readiness
and treatment readiness.
The New Housing Paradigm:
Distinguishing Treatment Readiness from Housing Readiness
THE KEY QUESTION:
Not
“Will You Completely Abstain From All Alcohol, Drugs and Sex?”
But
“Do You Need Expensive24-Hour Monitoring?”
A New Paradigm of NeedsNot Housing-Ready:
Needs Monitoring and Support
Housing-Ready:
Needs Only Support
Treatment-Ready:
Needs and Accepts Treatment
(1) Transitional Shelter
Highly structuredcongregate care
with 24/7 monitoring,and intensive support services
(2) Shelter Plus Care
High-demandpermanent housing
that requires ongoing treatment utilizationfor in-kind match
NotTreatment-Ready:
Does Not Need orAccept Treatment
SUPERVISED CONGREGATE CARE
(Provides Monitoring)
SUPPORTIVE INDEPENDENT LIVING
(Provides Privacy)
TWO MODELS OF SUPPORTIVE INDEPENDENT LIVINGFor Individuals Who Are NOT Treatment-Ready
But ARE Housing-Ready (i.e. Do Not Need Supervision)Not Housing-Ready:
Needs Monitoring and Support
Housing-Ready:
Needs Only Support
Treatment-Ready:
Needs and AcceptsTreatment
(1) Transitional Shelter
Highly structured congregate carewith 24/7 monitoring,
and intensive support services
(2) Shelter Plus Care
High-demand permanent housingthat requires ongoing treatment utilization
for in-kind match
SUPPORTIVE INDEPENDENT LIVING
Housing Ready: needing
Mid-Intensity Support
Housing Ready:needing
Low-Intensity Support
NotTreatment-Ready:
Does Not Need orAccept Treatment
SUPERVISED CONGREGATE CARE
(4) Housing First:SRO Style
Low-demandtransitional or
permanent housingwith mid-intensity support services
for life skills,crisis intervention,
and housing retention
Examples: YMCAs,Windham Hotel,Broadway Manor
(3) Housing First:Scattered-Site
Low-demandtransitional or
permanent housingwith low-intensity
mobile support servicesfor life skills
and housing retention
Examples: Pathways,RAP for Singles,
WestCARES
TWO MODELS OF SUPERVISED CONGREGATE CAREFor Individuals Who Are NOT Treatment-Ready And NOT Housing-Ready (i.e. Need Supervision)
Not Housing-Ready:
Needs Monitoring and Support
Housing-Ready:
Needs Only Support
Treatment-Ready:
Needs and AcceptsTreatment
Not Housing-Ready:
Needs Monitoring and Support
Housing-Ready:
Needs Only Support
SUPERVISED CONGREGATE CARE
Unstable:Frequent High-Cost
Emergency Service* User
Stable:Infrequent
Emergency Service* User
NotTreatment-Ready:
Does Not Need orAccept Treatment
(6) Safe Haven
Low-demandpermanent housing
with 24/7 monitoringand high-intensity
mobile support servicesfor life skills,
crisis intervention,housing retention, and
Community Liaison forpublic nuisance reduction
Example:None exist yet in
Westchester
(5) EmergencyShelter
Low-demandtemporary drop-in shelter
to meet basic human needsand avoid public places
becoming de factoshelters of last resortplus facility-basedongoing efforts at
needs assessment andinitial service linkage
Example:Warming centers,Drop-In Shelters
SUPPORTIVE INDEPENDENT LIVING
*High-Cost Emergency Service (costly emergency service costs that are wholly or partially county-funded,e.g. detox stays, emergency room visits, psychiatric hospitalizations, jail, etc.
A NEW HOUSING PARADIGM:An Efficient, Flexible and Cost-Effective System
That Addresses Different Levels of Individual Need
Not Housing-Ready:
Needs Monitoring and Support
Housing-Ready:
Needs Only Support
Treatment-Ready:
Needs and AcceptsTreatment
(1) Transitional Shelter
Highly structured congregate carewith 24/7 monitoring,
and intensive support services
(2) Shelter Plus Care
High-demand permanent housingthat requires ongoing treatment utilization
for in-kind match
SUPERVISED CONGREGATE CARE SUPPORTIVE INDEPENDENT LIVING
Unstable:Frequent High-Cost
Emergency Service* User
Stable:Infrequent
Emergency Service* User
Housing Ready: needing
Mid-Intensity Support
Housing Ready:needing
Low-Intensity Support
NotTreatment-Ready:
Does Not Need orAccept Treatment
(6) Safe Haven
Low-demandpermanent housing
with 24/7 monitoring,and high-intensity
mobile support servicesfor life skills,
crisis intervention,housing retention, and
Community Liaison forpublic nuisance reduction
(5) EmergencyShelter
Low-demandtemporary drop-in shelter
to meet basic human needsand avoid public places
becoming de factoshelters of last resortplus facility-basedongoing efforts at
needs assessment andinitial service linkage
(4) Housing First:SRO Style
Low-demandtransitional or
permanent housingwith mid-intensity support services
for life skills,crisis intervention,
and housing retention
(3) Housing First:Scattered-Site
Low-demandtransitional or
permanent housingwith low-intensity
mobile support servicesfor life skills
and housing retention
*High-Cost Emergency Service (costly emergency service costs that are wholly or partially county-funded,e.g. detox stays, emergency room visits, psychiatric hospitalizations, jail, etc.)