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

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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.

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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.

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Who is CSH?

• CSH helps communities throughout the country
  transform how they address homelessness and
  improve peoples lives through quality supportive
  housing.
• Project Assistance and Lending
• Public Policy and Systems Reform
• Industry Leadership and Capacity Building

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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.
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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

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CSH National Initiatives

• We pair our national initiatives and expertise
  with our on-the-ground knowledge and influence.
• Keeping Families Together
• Returning Home Initiative
• FUSE
• CSH Charrettes
• Social Innovation Fund Initiative

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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

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CSH Across the Country
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What is Permanent Supportive Housing?
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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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What is Supportive Housing?
Housing Affordable Permanent Independent
Support Flexible Voluntary independent

Coordinated Services
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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

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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.

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Variety of Supportive Housing Types

• Scattered Site
• Single Family Homes
• Apartments
• Single Site
• Rehab or New Construction
• Integrated
• Rehab or New Construction
• Master Leasing

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Adaptability A Solution in Multiple Policy
Sectors
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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

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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 ones 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

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Why Permanent Supportive Housing?
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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

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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

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The Institutional Circuit of Homelessness and
Crisis
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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

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A Strategy That Works for People

• Housing is Healthcare
• Even when services are not a condition of
  tenancy, tenants participate at high rates
• 81 health care utilization
• 80 mental health treatment
• 56 substance abuse services

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A Strategy That Works for Public Systems
(Portland, ME)
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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 dont
  meet conventional criteria for housing readiness

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Good Tenants
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Supportive Housing as Evidence Based Practice
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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

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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)

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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

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National Context Around Homelessness
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McKinney Vento Act, remember 1987?
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What is the HEARTH Act?
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The Past What the Homeless System has looked
like historically
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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?

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Key Elements of HEARTH

• 1) Federal Strategic Plan
• 2) Modified Definitions of Homeless and At Risk
• 3) Program Changes
• 4) Administrative Changes
• 5) Performance Measures

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Opening Doors Federal Strategic Plan to End
Homelessness
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Call to Action

• Transform homeless services into crisis response
  systems that prevent homelessness and rapidly
  return people who experience homelessness to
  stable housing.

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HEARTH Act Roadmap
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Old versus New Competitive Grants

• McKinney-Vento (Old)

• HEARTH Act (New)

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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

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Key Changes Mandated Activities

• An emphasis on performance measurement and
  outcomes, measured by data.

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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 thats
  not possible through rapid rehousing or permanent
  supportive housing

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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

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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

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Creating Supportive HousingServices, Operating
and Capital
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Five Elements of Successful Supportive Housing
Projects

• ? People
• ? Place
• ? Support Services
• ? Money
•   ? Organization

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Supportive Housing Making the Pieces Fit
?People
? Services
? Organization
? Place
? Money
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The Development Process

• Can be confusing!
• Not necessarily linear
• No standard model
• Tasks are interdependent
• Multiple players

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Five-Phase Development Timeline
ONE Concept
Go?
TWO Feasibility
No Go? Go?
Go?
THREE Dealmaking
No Go? Go?
FOUR Construction
FIVE Operations
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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?

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Phase 1 Concept Phase Threshold

• Financing sources identified
• Capital, operating, and services
• Assessment of organizational capacity
• Core development team identified

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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

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Phase 2 Feasibility Phase Thresholds

• Detailed development and operating budgets
• Solidify market data
• Identified financing sources and constraints
• Finalize development team

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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

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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 owners representative / construction
  manager who is a licensed contractor or architect

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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

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Whos 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.
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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

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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?

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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?

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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

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Whos On the Team?
LONG-TERM INTERESTS
SHORT-TERM INTERESTS
Developer Development consultant Architect/enginee
r(s) Attorney(s) Contractor Surveyor Environmental
investigator Marketing consultant Community
relations specialist
Owner Property manager Service provider Neighbors
Building residents Funders/lenders Licensing/regul
atory agencies
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Selecting Key Partners

• 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

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Selecting Consultants

• Experience
• Similar projects
• Same funding sources
• Integrating services with housing
• Track record
• Time/cost/communication
• Style/approach
• Knowledge transfer
• Funder Requirements

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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

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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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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.

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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.

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Examples of Permanent Supportive Housing
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Rebecca Johnson Apartments
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Learning Center
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Humanities Curriculum
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Rebecca Johnson Apartments
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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
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Alethiea Houses Avondale Gardens

• 64 2, 3, and 4 bedroom units in Birmingham
  Alabama
• Began developing housing when graduates of their
  Substance Abuse program couldnt 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.

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Massac County Mental Health
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Crane Ordway Integrated Housing

• St. Paul, MN
• 70 affordable Units, 14 for people who are
  chronically homeless
• Harm reduction service model

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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

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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
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Housing Opportunities for Women

• 250 units of Scattered Site Housing
• Serve single individuals and families
• Combination of HUD (HOPWA, SC,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

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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

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Resources
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http//store.samhsa.gov/product/Permanent-Supporti
ve-Housing-Evidence-Based-Practices-EBP-KIT/SMA10-
4510
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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

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Weve talked about PSH, how to create it,
Evidence Based Practice, National context and
impact.
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• I dont know what I would do without the services
  here.
• -Denise,Supportive Housing Tenant