permanent supportive housing mhsa webcast training series leslie wise program manager corporation...
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Permanent Supportive Housing
MHSA Webcast Training SeriesLeslie Wise
Program ManagerCorporation for Supportive Housing
October 13, 2005
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Our Mission
CSH helps communities create permanent housing with services to prevent and end homelessness.
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What Is Supportive Housing?
A cost-effective combination of permanent, affordable housing with services that helps people live more stable, productive lives.
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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.
Housing & Services
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Supportive Housing is for People Who:
Are chronically homeless Cycle through institutional and emergency
systems and are at risk of long-term homelessness
Are being discharged from institutions and systems of care
Without housing, cannot access and make effective use of treatment and supportive services
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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
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Models for Supportive Housing: Traditional Development
Creates a permanent asset to the community Involves acquisition and construction and the full
compliment of development activities, including finding capital funding.
Can take 2-3 years (or more) to develop Involves establishing on-going funding sources
and providers for operating and services
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Models for Supportive Housing: Accessing Existing Housing
Sometimes referred to as “Housing First” Also might be referred to as Scattered Site
Housing Integrates residents into the community Can “retrofit” existing affordable housing and add
services in a single site Once secure rental subsidy secured, can move
very quickly Involves establishing ongoing funding sources
and providers for operating and services
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Using existing apartments in the community Provider does not own units but might master
lease No rehabilitation or construction involved – take
apartments “as is” Owner of apartments typically private landlords
who own large and small apartment buildings or 2-4 family houses
Scattered Site: One Example
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The city of SF acquires sites for the DAH program through “master leasing”
Most units have private baths and shared cooking facilities
DAH housing presently includes:– The Camelot Hotel (51)– Windsor Hotel (78 units)– Star Hotel (54 units)– Pacific Bay Inn (75 units)– Le Nain Hotel (86 units)– Broderick Street Adult Residential Care Facility
(34 units).
Direct Access to Housing in CA
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Identifying privately-owned buildings that are vacant or nearly vacant where the building’s owners are interested in entering into a long-term lease
Negotiating improvements to the residential and common areas of the building prior to executing the lease
SFDPH contracts with one or more organizations to provide on-site support services and property management
Most buildings include a collaborative of two or more entities
Key Components of Master Leasing
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Dividing responsibilities – Property managers maintain health and quality of life in the
building as a whole– Support service providers work with individual tenants and
advocate on their behalf during periods of relapse Having mixed populations in buildings
– Ensures that not all tenants at a site require extensive support or have difficulties meeting terms of their leases
Offering alternative accommodations at other sites during relapse or crisis
Screening and structure can create supportive environments for those who agree to participation in treatment– This is minority of extremely long-term homeless
Strategies that Work
Housing Tenants with Severe Psychiatric Disorders or Substance Use Problems
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Consensus among experts and policy-makers Responds to documented needs and
preferences of consumers Documentation of supportive housing model(s)
and agreement on (most) key principles A growing body of evidence from research
Is Supportive Housing an Evidence-Based Practice?
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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
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A Cost-Effective Solution
Providing a mentally ill person with permanent supportive housing costs only $995 per year more than allowing that person to remain homeless
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Supportive Housing: It Works
summary of key findings from a range of studies
ER visits down 57% Emergency detox services down 85% Incarceration rate down 50% 50% increase in earned income 40% rise in rate of employment when employment
services are provided More than 80% stay housed for at least one year
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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:
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Outpatient primary and specialty medical care Some mental health services (e.g. case
management, pharmacy) Methadone (more consistent participation) Services to address substance-abuse problems,
including services delivered outside of traditional treatment programs
Vocational and employment services Probation
Supportive Housing May Increase Use of and Costs for:
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“Getting mentally ill people off the streets and into
supportive housing costs taxpayers only slightly more than leaving them to fend for
themselves…”
The Wall Street JournalMay 2, 2001
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To learn more about supportive housing
visit www.csh.org