Permanent Supportive Housing: The Basics

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Permanent Supportive Housing The Basics

• Kelly Kent
• Stephanie Hartshorn
• Corporation for Supportive Housing
• Presented June 24, 2008

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AGENDA

• Who we are and what we do
• What is Supportive Housing?
• Models of development
• Models of ownership structures
• Overview of Services in Supportive Housing
• Case Studies of projects serving homeless
  veterans

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Our Mission

• CSH helps communities create permanent housing
  with services to prevent and end homelessness

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Where We Work

• National offices in New York and Oakland.
• Local offices in Connecticut, Rhode Island, New
  York, New Jersey, Ohio, Michigan, Illinois,
  Minnesota, California, Indiana, Washington D.C.
  and Texas.
• Targeted initiatives in Kentucky, Maine, Oregon,
  and Washington.
• CSHs national teams assist supportive housing
  practitioners across the U.S.

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CSHs Core Services

• Project development and finance assistance
• Organizational/industry capacity building
• Advocacy/public policy reform

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Results of Our WorkCSH has

• Created 14,881 units, with 8,000 more in the
  pipeline
• Invested 95 million in project sponsors and
  service providers
• Ended homelessness for at least 17,000 adults and
  children
• Leveraged over 1 billion in federal, state,
  local public and private sector financing for
  capital, operating, and service costs

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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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Who Lives There?

• Formerly homeless individuals, families, youth,
  veterans
• People with serious, persistent issues substance
  use, mental illness, HIV/AIDS
• People being discharged into homelessness from
  the criminal justice system or other
  institutional settings

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A Distinctive Solution
Temporary Interventions
Supportive Housing

• Permanent
• Independent living
• Belong to a community
• Personal responsibility for
  behavior and rent

• Uncertain length of stay
• Program requirements
• Isolated
• Reinforce dependency

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Supportive Housing Types

• Dedicated buildings
• Rent-subsidized apartments
• Mixed-income buildings
• Long-term set asides
• Single family homes

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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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Solutions to Chronic Homelessness

• Low demand housing models have these 3 components
• Less complex application process for housing -
  simplify site visits, interviews, documentation,
  wait lists
• Do not require that applicants be housing ready
  in terms of medication, sobriety, money
  management, etc.
• No / few conditions that impinge upon resident
  autonomy
• The amount of preparation needed before entering
  housing depends on the type of housing available
• Change the housing options instead of focus on
  preparing people with greatest barriers to
  housing
• Low demand housing models work even for those
  with most severe psychiatric disorders or
  substance use problems

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Results of Supportive Housing

• 57 ? emergency room visits
• 85 ? emergency detox services
• 50 ? incarceration rate
• More than 80 stay housed for at least one year

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Framing The Issue
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Why are We Doing Work with this Population?

• Nearly 154,000 Veterans are homeless on any given
  night and nearly twice this many are estimated to
  be homeless over the course of a year
• Veterans account for nearly 1/3 of men who are
  homeless
• Veterans are twice as likely to meet the
  definition of chronic homelessness
• 45 suffer from mental illness
• 50 have substance abuse problems
• 67 served 3 or more years
• 33 were stationed in a war zone
• 25 have used VA services
• 89 received an honorable discharge
• A study by Charles Hoge et al found that 19 of
  soldiers who served in Iraq screened positive for
  a potential mental health disorder, including
  PTSD

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Increasing Veterans Access to Supportive Housing

• Veterans Lens
• Military discharge status- good paper
• Stand-downs
• Veteran-specific resources are available, but
  limited
• Homeless Services and Housing Lens
• Veterans may already be accessing
  homeless/housing services
• Outreach- identifying veterans at non-veteran
  focus service points increasing provider
  cultural competency relative to armed services
• Focus has been on transitional housing, not
  permanent, for veterans mostly due to funding
  source restrictions

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Veterans Specific Funding Used in PSH

• HUD-VASH
• Partnership between HUD and the VA
• Veterans who are homeless and mentally ill and/or
  those with substance abuse disorders
• Combines special set aside of HUD housing choice
  vouchers with community-oriented outreach,
  clinical care and case management
• 10,000 Vouchers allocated in 2008
• Potentially an additional 10,000 vouchers to be
  released in 2009.
• VA Supported Housing Program
• VA services for homeless Veterans focused on
  getting them housed and retaining housing

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Models of Supportive Housing

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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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Allegan County, Michigan

• 47 units
• Rural, multi-site
• For people with special needs
• On- and off-site services provided by consortium
  of local agencies

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LA No Fail Housing

• Lamp Lodge is the permanent housing component of
  LAMP Inc.s continuum of housing opportunities
  for people with mental illnesses in Los Angeles
• All are homeless when they arrive, and have a
  history of mental illness they may have
  substance use issues as well
• LAMP focuses on a philosophy of no fail housing
  and a non-linear case management model

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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, can move very quickly
• Involves establishing ongoing funding sources and
  providers for operating and services

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Scattered Site One Example

• 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

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Direct Access to Housing in CA

• 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).
•   

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Key Components of Master Leasing

• Identifying privately-owned buildings that are
  vacant or nearly vacant where the buildings
  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

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Collaborating in Developing Supportive Housing

• Ownerships Models To Be Considered

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Typical Ownership Models in Supportive Housing

• Single Owner Models
• Social service agency owner
• Nonprofit housing developer owner
• Shared Owner Models
• Turn-key
• Joint venture between existing organizations
• New jointly controlled corporation

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Typical Ownership Models in Supportive Housing
Single Owner

• Creates a single decision-making structure with a
  single mission.

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Typical Ownership Models in Supportive Housing
Shared Owner

• Turn-key
• Developer owns the project during the development
  process and develops it under contract with the
  service provider. After project is constructed,
  developer turns the key over to the social
  service agency. Specific time of transfer may
  vary.
• Joint Venture
• Two organizations co-own the project as general
  partners over the long term. Each organization
  can still be separately liable for the joint
  venture activities.
• New, jointly controlled corporation
• Two organizations establish a separate new
  nonprofit.

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Advantages and Disadvantages to Both Models
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Services In Supportive Housing
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Services are voluntary for the tenants not
the staff

• Tenants choose as much or as little services as
  they desire without having to move as their
  service needs change
• Engagement is an ongoing activity to establish
  and sustain relationships
• Begin with tenants practical needs and personal
  goals
• Help tenants recognize the connection between
  recovery and getting what they want out of life
• Housing is the base for engaging tenants in
  treatment and supports that can help achieve the
  primary goal of housing stability
• The tenant is the host service providers are
  guests

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Approaches SERVICES SIDE

• Services located on-site with housing
• Services located off-site and coordinated with
  housing
• Services formally coordinated and delivered by
  multiple providers
• Linkages to existing services in the community
• Set asides or priority for supportive housing
  project residents at service delivery location

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Support Services Considerations

• Standards
• Services are ongoing and meet tenants needs
• Tenants maintain stable residency in the
  community
• Tenants are maximizing their capacity to live
  independently
• Tenant support systems are formed and nurtured

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Support Services Considerations

• Responding to Different Populations and Levels of
  Need
• Homelessness
• Physical Disabilities
• Older Adults- Aging in Place
• Younger Adults
• Family Support
• Homeless Veterans

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Services to support tenants goals

• A broad array of services available
• Mental health and substance use management and
  recovery
• Vocational and employment
• Money management benefits advocacy
• Coordinated support / case management
• Life skills
• Community building and tenant advocacy
• Medical and wellness
• Match with Appropriate Resources

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Support Services Considerations

• Staffing Patterns
• Staff Specialists
• Evenings, Overnight and Weekend Staffing?

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Permanent Supportive Housing Projects For
Homeless Veterans

• Sample Case Studies

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Veterans Academy at the Presidio

• 100 SRO units for homeless vets located in 2
  adjacent buildings on the former Presidio Army
  base which has been converted into a national
  park
• Location in national park created unique
  challenge of having to go to federal court if
  they need to evict a tenant tripled legal fees
• Capital Bonds
• Operating Project Based Section 8
• Services HUD McKinney Vento SHP Permanent
  Housing for People with Disabilities

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Volunteers of America - Florida

• 25 scattered site units in Broward County for
  homeless veterans with co-occurring diagnoses of
  severe and persistent mental illness and
  substance use disorders
• Operating and Services are funded through the HUD
  McKinney SHP permanent housing for people with
  disabilities program.
• Fort Lauderdale/Broward County has a Veterans
  Affairs clinic that refers tenants to this
  project and provides services to them once they
  are housed

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Manteno Project

• Permanent Supportive Housing project created by
  the Illinois Department of Veterans Affairs
• 14 units for Veterans who are homeless and
  disabled
• Converted a former transitional housing facility
  to permanent supportive housing
• The building is located on state land adjacent to
  the Manteno Veterans Home

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Project Financing

• Capital
• Illinois Housing Development Authority Trust Fund
• HUD McKinney SHP
• Federal Home Loan Bank
• Operating
• HUD McKinney SHP Permanent Housing for People
  with Disabilities
• Services
• U.S. Dept. of Veterans Affairs Per Diem
• Access to services at the Manteno Veterans Home

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Replicable Model

• This is the first time a State Department of
  Veterans Affairs has used their Federal VA per
  diem in this manner
• Way that States can address the need of homeless
  Veterans
• Way that States can use existing resource to
  create new housing opportunities in a more
  appropriate residential setting

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How to approach development and financing of
affordable housing with services Additional CSH
Resources Publications - Not a Solo Act-
Between the Lines Legal Issues in Supportive
Housing- Laying A New the Foundation- Family
Matters- Developing the Support in Supportive
Housing- Supportive Housing Financing Sources
Guide
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Questions?

• Kelly W. Kent and Stephanie Hartshorn
• 203 N. Wabash, Suite 410
• Chicago, IL 60601
• P 312-332-6690
• kelly.kent_at_csh.org
• Stephanie.hartshorn_at_csh.org