supportive housing 101
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Supportive Housing 101
• Ryan Moser, CSH
• Katrina Van Valkenburgh, CSH
Annual Conference
Georgia Supportive Housing AssociationNovember 2012
www.csh.org
What Would You Like to Get Out of this Session?
Take 5 minutes Talk in small groups about what you want to be sure to get
out of this session. What do you want to know or understand when the session is over?
Report back on what you want to be sure we cover.
Agenda
CSH What is Supportive Housing? What is its Impact? PSH as Evidence Based Practice. What is the National Context around homelessness? How to Create PSH? Examples of PSH Projects.
Who is CSH?
CSH helps communities throughout the country transform how they address homelessness and improve people’s lives through quality supportive housing.
•Project Assistance and Lending
•Public Policy and Systems Reform
•Industry Leadership and Capacity Building
CSH Products and Services
Tools QAP Survey Housing
Options Financial
Modeling PHA Toolkit
Training Quality Technical
Assistance Supportive
Housing Institute
In everything we do, CSH collaborates with public, private and nonprofit stakeholders to create solutions for communities’
toughest problems.
Consulting• Planning
• Research and Evaluation
• Policy Work• Program
Design
Lending• Loan Products
• New Market Tax Credits
(CDFI certified)
How CSH Works
Driving Systems Change Influencing Government Affairs and Policy Advancing the Supportive Housing Industry Funding the Field Serving Vulnerable Populations Building Strong Community Partnerships
CSH National Initiatives
We pair our national initiatives and expertise with our on-the-ground knowledge and influence.
Keeping Families TogetherReturning Home InitiativeFUSECSH CharrettesSocial Innovation Fund Initiative
CSH Impact: By the Numbers
Catalyst for 143,000 units of PSH
Over 40,500 people living in CSH-backed PSH
Worked in 25 states 50,000 people trained in last
5 years
Over $200 million in loans Nearly $100 million in
grants $2.16 billion leveraged by
state and local policy efforts in the last 3 years
CSH Across the Country
What is Permanent Supportive Housing?
What Is Supportive Housing?
A cost-effective combination of permanent, affordable housing with services that helps people live more stable, productive lives
What is Supportive Housing?
Affordable Housing
Health Care
Mental Health
Services
Case Management
Substance Abuse
Treatment
Employment Services
Coordinated Services
Housing:Affordable
PermanentIndependent
Support:Flexible
Voluntaryindependent
Is Supportive Housing for Everyone?
Supportive housing is proven to work best for very vulnerable men, women and families.•Chronically homeless•Frequent users/multiple barriers•Chronic health issues•Substance Use Issues•Mental health issues
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.
Who is Supportive Housing For?
Variety of Supportive Housing Types
Scattered Site– Single Family Homes– Apartments
Single Site – Rehab or New Construction
Integrated – Rehab or New Construction
Master Leasing
Adaptability: A Solution in Multiple Policy Sectors
Social Services
Housing/Community
Development
Health/ Hospitals
Behavioral Health Child Welfare
Aging
Veterans Affairs
Employment
Corrections/ Criminal Justice
Supportive Housing
Mental Health and other Service Providers
Homeless Service Providers
Non-Profit and For-Profit Affordable Housing
Providers
Public Housing Authorities
Private Developers and Private Landlords
County and Local Governments
Who Creates Supportive Housing?
Housing costs must be affordable to the tenant (i.e. less than 30% of income towards rent)
Choice and control over one’s environment is essential Housing must be permanent as defined by tenant/landlord law –
and housing is “unbundled” from services Housing and services roles are distinct Housing must be flexible and individualized: not defined by a
“program” Integration, personal control, and autonomy Services are Recovery-Oriented and Adapted to the Needs of
Individuals
Principles of Best Practice
Why Permanent Supportive Housing?
Research indicates that approximately 10% of people who experience homelessness are chronically homeless
This 10% consumes more than 50% of all homeless services – leaving the homeless services systems struggling to effectively serve those who could exit homelessness relatively quickly.
Dennis P. Culhane, University of Pennsylvania
Why Supportive Housing?
How Does Supportive Housing Break the Cycle of Homelessness?
Creates stability
Fosters self-sufficiency
Facilitates the process for securing and retaining employment
Helps tenants maintain and increase wellness and decrease harms through flexible, available, accessible and relevant services
Encourages peer support through tenant associations, peer support groups and other opportunities for community building
The Institutional Circuit of Homelessness and Crisis
Detox
Emergency Residential
Program
Jail
Shelter
Psychiatric Hospital
EmergencyRoom
Hospital inpatient care for medical and psychiatric conditions
Hospital emergency room visits – especially for the most frequent users of ER
Psychiatric emergency and institutional care Residential mental health & substance abuse treatment
– especially detox Jails and prisons Emergency shelters
Supportive Housing Reduces Use of and Costs for:
Housing is Healthcare
Even when services are not a condition of tenancy, tenants participate at high rates:o 81% health care utilizationo 80% mental health treatmento 56% substance abuse services
A Strategy That Works for People
A Strategy That Works for Public Systems (Portland, ME)
More than 80% of supportive housing tenants are able to maintain housing for at least 12 months
Most supportive housing tenants engage in services, even when participation is not a condition of tenancy
Use of the most costly (and restrictive) services in homeless, health care, and criminal justice systems declines
Nearly any combination of housing + services is more effective than services alone
“Housing First” models with adequate support services can be effective for people who don’t meet conventional criteria for “housing readiness”
Consistent Findings
Housing + Services Make a Difference
Good Tenants
Supportive Housing as Evidence Based Practice
According to the New Freedom Commission on Mental Health:
If effective treatments were more efficiently delivered through our mental health services system … millions of Americans would be more successful in school, at work, and in their communities.
— Michael Hogan, Chairman
Why Implement Evidence Based Practices?
The Evidence Supports Permanent Supportive Housing
Evidence of impact overall on resident stability: “the most potent intervention”
Evidence of greater impact over alternatives Evidence of cost benefits Evidence on the core principles (fidelity)
Dimensions of Permanent Supportive Housing Fidelity Scale
Choice in housing and living arrangements
Functional separation of housing and services
Decent, safe, and affordable housing
Community integration and rights of tenancy
Access to housing and privacy
Flexible, voluntary, and recovery-focused services
National Context Around Homelessness
McKinney Vento Act, remember 1987?
What is the HEARTH Act?
The Past: What the Homeless System has looked like historically
The Future: What the Homeless System will look like moving forward shifting
As providers shift their philosophy from managing homelessness to ending homelessness…– How do we change our models?
Key Elements of HEARTH
1) Federal Strategic Plan2) Modified Definitions of Homeless and At
Risk3) Program Changes4) Administrative Changes5) Performance Measures
Opening Doors: Federal Strategic Plan to End Homelessness
Call to Action
“Transform homeless services into crisis response systems that prevent homelessness and rapidly return people who experience homelessness to stable housing.”
HEARTH Act Roadmap
Old versus New Competitive Grants
McKinney-Vento (Old) HEARTH Act (New)
Key Changes & Mandated Activities
A change from a focus on individual programs to focus on coordinated local systems.– Coordination with other community plans– Coordinated or centralized intake
Key Changes & Mandated Activities
An emphasis on performance measurement and outcomes, measured by data.
Key Changes & Mandated Activities
A movement away from “housing readiness” and long periods of transitional services– Focus on homeless prevention whenever possible or the
quickest return to housing whenever that’s not possible through rapid rehousing or permanent supportive housing
HEARTH Performance Measures
Reduce average length of time persons are homeless Reduce returns to homelessness Improve program coverage Reduce number of families and individuals who are homelessness Improve employment rate and income amount of families and
individuals who are homeless Reduce number of families and individuals who become homeless
(first time homeless) Prevent homelessness and achieve independent living in permanent
housing for families and youth defined as homeless under other Federal statutes
Requesting HUD TA
For recipients: technical questions re: CoC Rule– www.hudhre.info: ask a question
HUD TA– www.hudhre.info: request TA– No specific TA provider guaranteed but can suggest
or pick relevant topics
Creating Supportive Housing:
Services, Operating and Capital
Five Elements of Successful Supportive Housing Projects
People
Place
Support Services
Money
Organization
Supportive Housing: Making the Pieces Fit
Organization
Services
Place
Money
Peop
le
The Development Process
Can be confusing!
Not necessarily linear
No standard model
Tasks are interdependent
Multiple players
TWO: Feasibility
ONE: Concept
THREE: Dealmaking
FOUR: Construction
FIVE: Operations
Go?No Go?Go?
Go?
No Go?Go?
Five-Phase Development Timeline
Phase 1 – Concept Phase Threshold
Project concept clearly defined
– Population to be served
– Scattered-site vs. project-based
– What types of services will be needed
– On-site services vs. off-site services
– What is the best location?
Phase 1 – Concept Phase Threshold
Financing sources identified– Capital, operating, and services
Assessment of organizational capacity
Core development team identified
Phase 2 – Feasibility Phase Thresholds
Site is selected based on size, location, cost, and environmental conditions
Analysis of regulatory restraints (zoning, etc.)
Schematic design – space allocations consistent with income projections
Cost estimates
Phase 2 – Feasibility Phase Thresholds
Detailed development and operating budgets
Solidify market data
Identified financing sources and constraints
Finalize development team
Phase 3 –Dealmaking Phase Thresholds
Negotiate financial commitments
Develop contract documents
Bidding, contractor selection and construction management procedures
Preliminary management plan
Preliminary service delivery plan
Phase 4 - Construction
The most expensive and riskiest part of the process
Limited control and the least involvement day to day
Mitigate risk by:– Insisting on detailed contract documents– Establishing clear owner, architect, and contractor
roles– Establishing construction period protocol.– Hiring an owner’s representative / construction
manager who is a licensed contractor or architect
Phase 5 - Operations
Open for business!
– Tenant selection and building lease-up– Begin services and property management functions– Work with tenants to build community, tenant
leadership opportunities– Refine plans, policies, procedures as needed– Monitor asset, budgets, and ensure compliance with
all funding sources
Who’s On the Team?
Development Team – a group of professional consultants, service vendors,
and other nonprofit organizations that collectively bring all of the skills,
expertise, knowledge, and experience to bear on the development and operation
of a project.
Key to Success: Partnerships
Developer Service Provider Property Manager
Strong partnerships between the Developer, Service Provider, and Property Manager are the key to a successful supportive housing project
Thinking Through Your Team
• What is my self-interest?• What outcome do we want from the collaboration?• What resources can our organization bring to the table?• What will my organization need from others?• Who will represent our organization in the collaboration?• What is our collaboration skill?• Who are the potential partners in the collaboration?
Exercise: Partnership Factors
Think of a partnership that you have participated in… – What are the factors that made it successful?– What were the challenges that made it
unsuccessful?– What can partners do to avoid difficulties?
Keys to Success?
Similar mission and goals Earn trust over time Everyone contributes to the partnership Clear and constant communication In it for the long-haul Sharing and collaboration Mutual respect
Who’s On the Team?
Owner
Property manager
Service provider
Neighbors
Building residents
Funders/lenders
Licensing/regulatory agencies
Developer
Development consultant
Architect/engineer(s)
Attorney(s)
Contractor
Surveyor
Environmental investigator
Marketing consultant
Community relations specialist
LONG-TERM INTERESTS SHORT-TERM INTERESTS
Owner: the buck stops here– Long-term control and legal responsibility
Developer: from idea to occupancy – Very different from management and services
Property manager: real estate operations– Lynchpin of financial and physical viability
Service provider– The “support” in supportive housing
Selecting Key Partners
Experience– Similar projects– Same funding sources– Integrating services with housing
Track record– Time/cost/communication
Style/approach– Knowledge transfer
Funder Requirements
Selecting Consultants
Funding to Develop Permanent Supportive Housing
Capital– Bricks and Sticks– One time funds
Operating– Funding to support building operations– Typically a Subsidy
Supportive Services– Grants to fund staff salaries
Services Make the Difference
Flexible, voluntary Counseling Health and mental health services Alcohol and substance use services Independent living skills Money management / rep payee Community-building activities Vocational counseling and job placement
Housing First
Philosophy: Safe, affordable housing is a basic human right and a prerequisite for effective psychiatric and substance abuse treatment.
Key components: – Simple application process that does not require numerous site
visits and excessive documentation; – Harm reduction approach in which tenants are not required to be
clean and sober in order to obtain or keep their housing; and – No conditions of tenancy that exceed the normal conditions under
which any leaseholder would be subject, including participation in treatment or other services.
Housing First Research
Research has demonstrated the effectiveness of this model, particularly among people who have been homeless for long periods of time and have serious psychiatric disabilities, substance use disorders, and/or other disabilities.
These studies of housing first models have a number of similar findings: – Housing First leads to higher rates of housing retention– There is very little difference in the level of tenant substance use and
psychiatric symptoms between Housing First and Non-Housing First models.
– Participation in services is still relatively high in housing first models, but lower than in non-housing first models where services are required as a condition of tenancy.
Examples of Permanent Supportive Housing
Rebecca Johnson Apartments
Learning Center
Humanities Curriculum
Rebecca Johnson Apartments
archi-treasures: Arts-based community development organization reducing social isolation by creating grassroots partnerships to build public spaces, empowering individuals to shaper their future and the future of their community
Alethiea House’s Avondale Gardens
64 2, 3, and 4 bedroom units in Birmingham Alabama
Began developing housing when graduates of their Substance Abuse program couldn’t access housing.
15% of the units are set aside for people who are homeless and are recovering from substance abuse or mental illness
Fannie Mae Maxwell Award winning project.
Massac County Mental Health
Crane Ordway – Integrated Housing
St. Paul, MN 70 affordable
Units, 14 for people who are chronically homeless
Harm reduction service model
SERV – Integrated Housing
Bergenline Ave (Union City, NJ) and Boulevard East (North Bergen, NJ)– Each building has12 units that include 5 PSH units and 7 affordable
units Guttenberg, NJ
– 14 unit property that offers 6 PSH units and 8 affordable units PSH units serve people with serious mental illness. All units serve
people at 50% and below AMI
Heartland Housing – Leland Apartments -- Chicago, IL
137 affordable units of which 50 are supportive housing.. Historic building. 17 types of funding.
25 PSH units are part of a federal safe haven for people leaving the streets needing support.
Developer - Heartland Housing
Service Provider Heartland Health Outreach – 2 Floors
Housing Opportunities for Women
Christian Community Health Center
300+ Scattered Site Housing on the South Side of Chicago
Serve individuals and families Harm Reduction Model More than 90% of their tenants remain housed
after 12 months FQHC look-alike Separate Case Management and Property
Management staff
Resources
http://store.samhsa.gov/product/Permanent-Supportive-Housing-Evidence-Based-Practices-EBP-KIT/SMA10-4510
CSH Resources
On the CSH Website: www.csh.org PHA Toolkit Dimensions of Quality Toolkit for Developing and Operating Supportive Housing Report on the State of the Supportive Housing Industry Publications and Toolkits Link to Stories of Home: Video Channel with Tenant Stories
We’ve talked about PSH, how to create it,
Evidence Based Practice, National
context and impact.
Listeners’ Goal1
I don’t know what I would do without the services here.
-Denise,Supportive Housing
Tenant
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