Transcript Slide 1

Supportive
Housing 101
Ryan Moser, CSH
•
Katrina Van Valkenburgh, CSH
Annual Conference
Georgia Supportive Housing Association
November 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
Consulting
• Planning
• Research and
Evaluation
• Policy Work
• Program
Design
Lending
• Loan
Products
• New Market
Tax Credits
(CDFI certified)
In everything we do, CSH collaborates with public, private and
nonprofit stakeholders to create solutions for communities’
toughest problems.
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-theground knowledge and influence.





Keeping Families Together
Returning Home Initiative
FUSE
CSH Charrettes
Social 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?
Case
Management
Mental
Health
Services
Employment
Services
Housing:
Affordable
Permanent
Independent
Affordable
Housing
Substance
Abuse
Treatment
Support:
Flexible
Voluntary
independent
Health Care
Coordinated
Services
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
Who is Supportive Housing 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.
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
Corrections/
Criminal
Justice
Employment
Supportive
Housing
Health/
Hospitals
Veterans
Affairs
Aging
Behavioral
Health
Child Welfare
Who Creates 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
Principles of Best Practice







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
Why Permanent
Supportive Housing?
Why 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
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
Jail
Shelter
Psychiatric
Hospital
Detox
Emergency
Residential
Program
Emergency
Room
Supportive Housing Reduces Use of
and Costs for:






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
A Strategy That Works
for People
Housing is Healthcare

Even when services are not a condition of
tenancy, tenants participate at high rates:
o
o
o
81% health care utilization
80% mental health treatment
56% substance abuse services
A Strategy That Works
for Public Systems (Portland, ME)
Consistent Findings
Housing + Services Make a Difference





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”
Good Tenants
Supportive Housing as
Evidence Based Practice
Why Implement Evidence Based
Practices?
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
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
 Access
integration and rights of tenancy
to housing and privacy
 Flexible,
voluntary, and
recovery-focused services
National Context Around
Homelessness
McKinney Vento Act, remember
1987?
What is the HEARTH Act?
Homeless
Emergency
Assistance and
Rapid Transition to
Housing
Passed in 2009
2011 & 2012
New Program
Regulations and
Community
Planning
Expectations
2010
USICH created
Federal Strategic
Plan to End
Homeless
The Past: What the Homeless
System has looked like historically
Shelter
Transitional
Housing
Permanent
Housing
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)
2)
3)
4)
5)
Federal Strategic Plan
Modified Definitions of Homeless and At Risk
Program Changes
Administrative Changes
Performance Measures
Opening Doors: Federal Strategic
Plan to End Homelessness
Finish the job of ending chronic homelessness in 5 years
Prevent and end homelessness among Veterans in 5 years
Prevent and end homelessness for families, youth, and
children in 10 years
Set a path to ending all types of 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
Governance
and Structure
Centralized
Intake
Performance
Evaluation
Systems
Mapping
Right Sizing
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




Services
Organization
Place
People

Money
The Development Process

Can be confusing!

Not necessarily linear

No standard model

Tasks are interdependent

Multiple players
Five-Phase Development Timeline
ONE: Concept
Go?
TWO: Feasibility
No Go?Go?
Go?
THREE: Dealmaking
No Go?
Go?
FOUR: Construction
FIVE: Operations
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?
LONG-TERM INTERESTS
SHORT-TERM INTERESTS
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
Selecting Key Partners

Owner: the buck stops here
–

Developer: from idea to occupancy
–

Very different from management and services
Property manager: real estate operations
–

Long-term control and legal responsibility
Lynchpin of financial and physical viability
Service provider
–
The “support” in supportive housing
Selecting Consultants

Experience
–
–
–

Track record
–

Time/cost/communication
Style/approach
–

Similar projects
Same funding sources
Integrating services with housing
Knowledge transfer
Funder Requirements
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
250 units of Scattered Site
Housing
 Serve single individuals and
families
 Combination of HUD (HOPWA,
S+C,SHP) Section 8 and City
subsidies
 Units are scattered across
several neighborhoods on the
North side of Chicago
 Case Managers meet with
tenants in their homes
 Tenants pay rent to Property
Management staff
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/PermanentSupportive-Housing-Evidence-Based-PracticesEBP-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.
1
Listeners’ Goal
I don’t know what I
would do without the
services here.
-Denise,
Supportive Housing
Tenant