Supportive Services for Veteran Families (SSVF) Webinar Series

1
Supportive Services for Veteran Families
(SSVF)Webinar Series

• Developing a Reasonable Plan for SSVF Veteran
  Families
• January 19, 2012

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Presenters

• Robert Thompson, VA SSVF Regional Coordinator
• Melany Mondello, Technical Assistance
  Collaborative
• Marge Wherley, Abt Associates
• Stephanie Nagy, Abt Associates

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Webinar Format

• Webinar will last approximately 2 hours
• Participants phone connections are automatically
  muted due to the high number of callers

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Submitting Questions During the Webinar

• Questions can be submitted via email at
  SSVF_at_va.gov
• Questions will be answered either individually or
  through an update to the SSVF Frequently Asked
  Question resource.

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SSVF Hot Topics
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Objectives

• During this webinar we will review the following
• Requirements for SSVF Veteran Family Plans
• Elements of a Reasonable Plan
• SSVF Case Examples
• Examples of Reasonable Plans

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Whats Required?

• Case managers must adequately address
  participants needs.
• 62.31 Case management services
• Developing and monitoring case plans in
  coordination with a formal assessment of
  supportive services needed, including necessary
  follow-up activities, to ensure that the
  participants needs are adequately addressed.

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Whats Required?

• The plan must address the participants future
  ability to pay bills SSVF has paid
• 62.33-34 as a condition of providing payments
  for child care services (or rental assistance, or
  utilities), the grantee must help the participant
  develop a reasonable plan to address the
  participants future ability to pay for child
  care services (or rent or utility payments).

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Whats Required?

• The plan should address future housing stability
  if SSVF has assisted the participant to be
  re-housed or re-located.
• 62.34 As a condition of providing a security
  deposit payment or a utility deposit payment (or
  moving costs assistance), the grantee must help
  the participant develop a reasonable plan to
  address the participants future housing
  stability.

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What does Address Mean?

• Synonyms
• Tackle
• Focus on
• Concentrate on
• Deal with
• Attend to
• Antonym
• Ignore

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A Reasonable Plan

• .Tackles and deals with the issues
  contributing to the participants homelessness or
  risk of homelessness
• . Concentrates and Focuses on the
  participants poverty and personal issues
• .Does not ignore housing barriers

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A Reasonable Plan

• Does not guarantee that every plan will be
  successful
• Does not assure/ensure that participants will no
  longer be poor or rent-burdened
• Does not promise an end to future (longer-term)
  housing risks, housing crises or homelessness

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What does the Reasonable Plan Address?

• Housing Barriers that are economic/financial and
  which are currently threatening housing stability
• Housing Barriers that are due to a lack of
  information, a lack of skills, and/or
  self-defeating patterns of behavior (whether or
  not those behaviors are associated with a
  disability) if they are affecting housing
  stability

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PART ONE Addressing Financial/Economic Housing
Barriers

• Start by addressing our common assumptions
• People below 30 of Area Median Income cannot
  afford housing and
• People should not pay more than 30 of their
  income on rent
• Therefore, we should not accept participants
  with incomes below 30 of AMI unless we can
  assure them a deep, permanent housing subsidy.

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Challenging the Assumption

• Among households who rely primarily on public
  benefits for income, approximately 10 become
  homeless in a year.
• But that also means that 90 do not become
  homelesseven though only a small percentage have
  a deep rental subsidy.
• What? You dont believe it? Lets look at an
  example.

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Hennepin County, Minnesota

• 1570 families who entered a homeless shelter
  between 1/1/08-10/31/09
• 66 had incomes of 0-499/month
• 28 had incomes of 500-999/month
• Only 2 spent 35 or less of their income on
  housing (i.e. they had a deep rental subsidy)
• 93 spent 66-80 of their income on rent
• Head of household under age 22 29
• Head of household age 22-29 39
• Children age 0-6 years in family 93

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These households were at or below 15 of AMIand
yet

• Rapid Re-Housing Assistance was provided
• With help, they found permanent housing within
  about 30 days
• AND
• 95 did not return to homelessness within 12
  months of leaving shelter
• EVEN THOUGH
• Income increases for participants were minimal
  during 6 months of Rapid Re-Housing services
• AND EVEN THOUGH
• The great majority received neither an initial
  nor an ongoing rental subsidy

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Therefore.

• It is reasonable to plan that a household can
  obtain and maintain housing
• even if they are extremely low income
• even if they cannot and do not secure a deep
  rental subsidy

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What is possible for some to achieve may not be
reasonable to expect for many

• Data from the first year of HPRP showed that only
  6.2 (of over 200,000 households) increased their
  income during the program. The vast majority,
  70.3, showed no change in income.
• 25.7 entered HPRP with no income and 22.6
  exited with no income.
• Is it reasonable to set expectations/goals and
  develop case plans that focus on a significant
  increase in income during SSVF?

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A Reasonable Plan for Addressing Income Barriers

• The goal is any increase in income that is
  available to pay rent.
• Many approaches (especially in combination) can
  accomplish this
• Secure Additional Benefits Income supports
  (e.g. VA Benefits, Disability Lump Sum and
  Monthly Payments), Energy Assistance, Food
  Supports, Unemployment Compensation, Workers
  Compensation (e.g. Payment of medical bills or
  payouts for permanent partial disability), Earned
  Income Tax Credit
• Increase Earned Income Temporary Work, Day
  Labor, Additional Hours, Increased Pay Rate,
  Overtime/Holiday Work, Advertise to do Odd Jobs
• Reduce Expenses Rent Subsidies, In-Kind
  Commodities, Budgeting Strategies, Decrease
  Utility Usage, Subsidized or Relative Childcare
  Relocating to a Less Expensive Housing Unit,
  Home-Sharing.

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PART TWO Addressing personal housing barriers

• Start by addressing some common assumptions
• People with personal problems and/or disabilities
  cannot achieve or maintain stable housing
• UNLESS
• Programs take a holistic approach that addresses
  and includes all needs in all life areas.

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Challenging the assumptions Hennepin Countys
Rapid Re-Housing Data 1/07-2/08

• Level 2 Families Moderate Barriers
• Chemical Use has resulted in housing loss 3
• Mental Health has resulted in housing loss
  2.9
• Domestic Violence has resulted in housing loss
  61.8
• Felony 1.6
• Level 3 Families Moderately Severe Barriers
• Chemical Use has resulted in housing loss
  10.0
• Mental Health has resulted in housing loss
  36.7
• Domestic Violence has resulted in housing loss
  26.3
• Felony 13.3

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Hennepin Countys Rapid Re-Housing Data 1/07-2/08

• Level 4 Families Chronically Homeless
• Chemical Use has resulted in housing loss
  16.0
• Mental Health has resulted in housing loss
  53.5
• Domestic Violence has resulted in housing loss
  38.2
• Felony 11.6
• Level 5 Families Very Severe Housing Barriers
• Chemical Use has resulted in housing loss
  19.0
• Mental Health has resulted in housing loss
  50.00
• Domestic Violence has resulted in housing loss
  33.3
• Felony 32.5

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1 The Decision to Assist

• AUDIENCE POLL
• How many of you would accept Level 4 Veteran
  Families (Chronically Homeless) for assistance in
  your SSVF program?
• __YES __NO __NOT SURE

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2 The Decision to Assist

• AUDIENCE POLL
• How many of you would accept Level 5 Veteran
  Families (Very Severe Housing Barriers) for
  assistance in your SSVF program?
• __YES __NO __NOT SURE

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Rapid Re-Housing Program Components

• Initial barrier level assessment, within 3-5 days
  of shelter admission
• Housing search, landlord/lease negotiations,
  move-in
• Housing start-up costs application fees,
  security deposit, first months rent, moving
  costs
• Landlord and tenant supports for 6 months

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Rapid Re-Housing What was NOT provided

• No rental subsidies were attached to the program.
  Any subsidies participants were able to secure
  were obtained via referrals to community
  programs.
• No treatment for CD, MH or DV was provided.
  While treatment was sometimes encouraged, it was
  not required. Any treatment participants chose
  was offered via referrals to community programs.
• The case plan was not focused on resolution or
  improvement in life areas that were unrelated to
  getting and keeping housing. A participant
  could, if they wished, add such goals, but the
  case plan was not structured around life domains.

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Rapid Re-Housing Successful Outcomes (No return
to homelessness within 12 months of leaving
shelter)
BARRIER LEVEL Agency A Agency B
Level 2 (Moderate) 97 99
Level 3 (Moderately Severe) 97 97
Level 4 (Chronically Homeless) 92 88
Level 5 (Very Severe) 88 93
Total All Families (N 1635) 95 95
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A Reasonable Plan for Addressing Personal Barriers

• Goals/Strategy
• Change the environment to reduce demands to a
  level the participant can manage
• AND/OR
• Teach new skills that allow the participant to
  manage demands more successfully
• AND/OR
• Reduce behaviors that threaten the participants
  ability to get and keep housing

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Lets Talk About Personal Change

• Many of our problems can be thought of as bad
  habits. Habits are behaviors, thoughts and
  emotional reactions that do not require any
  conscious attention.
• Stopping old, bad habits takes more than just
  willpower those habits are created, reinforced
  and sustained by neurotransmitters. Dopamine
  circuits constantly calculate reward
  opportunities and drive us toward short-term
  rewards.
• This makes sense from a survival perspective, but
  doesnt help much when youre trying to avoid
  busting your budget or blowing up at your
  landlord!

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More Reasons Why its Tough to Change

• Stress, whether physical or emotional, activates
  another neurotransmitter (serotonin) that causes
  production of more dopamine. Stress thus makes
  you more likely to go on autopilotand continue
  or revert to old habits.
• There is a genetic component to thisa deficiency
  in a particular dopamine receptorthat makes some
  people more likely to become addicted, obese or
  suffer from PTSD i.e. to develop patterns of
  behavior, thoughts and emotional responses that
  can be maladaptive but hard to change.

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And if thats not enough.

• Lack of exposure to opportunities for rewards in
  your life generally diminishes drive and
  motivation (dopamine). Reduced dopamine reduces
  the excitability of other neurons that are
  supposed to put the brake on drives toward
  short-term rewards. In other words, if youve
  lacked chances to make your life better, you are
  more likely to impulsively (and unconsciously)
  seek immediate gratification.
• Short-term rewards may be enough to escape a
  blizzard or eat a meal. But they arent enough
  to assure longer-term housing stability!

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What does it take to get rid of old, maladaptive
habits and form new and better ones?

• Change beliefs, values and expectations about
  short vs. long-term rewards
• Connect the habit to long-term ltnegativegt
  consequences
• Pre-plan for high-risk situations where the habit
  may re-emerge or be reinforced
• Avoid high-risk situations when possible and have
  alternative solutions ready if/when the trigger
  occurs
• Interact with people who value what we want to
  value

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What does it take to get rid of old, maladaptive
habits and form new and better ones?

• Remove secondary gains/reinforcement for
  maladaptive habits
• Enrich your livescreating a reward-rich
  environment
• Train competing good habits and practice,
  practice, practice
• Develop a sense of control
• Take care of stress eat and sleep right, pace
  yourself, develop cognitive flexibility and
  problem-solving ability

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And, even then.

• Self-regulation in one domain reduces
  self-regulation in other domain(s)
• In other words, while successfully managing one
  new habit, you are less able to perform any other
  new habit.
• BTW providing glucose (sugar) reduces brain
  fatigue caused by self-regulation of Habit 1 and
  may help you deal with Habit 2! (But only on a
  short-term basis.)

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Why am I telling you all this?

• When we, human service people, assess a problem,
  we want to DO SOMETHING RIGHT NOW!
• People cannot change all their maladaptive
  behavior patterns and bad habits simultaneously
  (and possibly not even sequentially) in the
  short-term. Its a neurological no-brainer!
• SSVF is not designed to achieve long-term
  behavior changenor are we clinically competent
  to do so!
• So what is a reasonable plan to address
  personal barriers to housing stability?

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So, What Should You Do?

• Use reasonable planning principles to address
  behavior, thoughts and emotional responses that
  threaten immediate (and, often, long-term)
  housing stability
• Prioritize your perspective Not every problem
  or need is directly and immediately related to
  housing stability (e.g. increasing parenting
  skillsunless the participant has been evicted
  for the behavior of her/his children).
• What is most urgent and most relevant from your
  point of view?

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So, What Should You Do? (cont.)

• Prioritize based upon the participants
  perspective Hopefully s/he agrees with you
  about the most urgent changes needed to stabilize
  housing, and/or has additional insights about the
  causes and solutions for the housing crisis.
• Select a limited number of priorities (after all,
  thats the point of prioritizing!)

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So, What Should You Do? (cont.)

• Gauge the level of expertise needed to achieve
  priority goals. You are most likely to be
  effective at providing information about leases
  and the soft expectations of tenancy, teaching
  basic skills (budgeting, threshold levels of home
  maintenance, household budgeting, income-
  enhancing or expense-reducing resources),
  offering strategies for dealing with conflict
  between the participant and landlord/tenants,
  etc.
• Develop action steps for the goals you will
  directly support.
• What will you do?
• What will the participant do?
• When will it happen?
• How will you both monitor progress?

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So, What Should You Do? (cont.)

• Everything else can and should be
• POSTPONED
• and/or
• REFERRED TO A COMMUNITY RESOURCE

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Know your VA and Community Resources!

• Know exactly what is offered, by whom
• Who has the resources and the expertise?
• Know the target population and admission criteria
  for every relevant service
• Know the application process
• Know the gatekeepers who can influence the
  success of a referral
• Know the average wait list/time to obtain an
  appointment

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Case Scenarios

• Were going to consider two actual case
  scenarios recently submitted to the Regional
  Coordinators by SSVF grantees
• Case A. Homeless Veteran (Category 2)
• Case B. Veteran Being Evicted (Category 1)
• Where information was not available, it was
  added (for clarity) and names were changed. The
  Veterans housing situation, barriers, plans and
  outcomes are real. The case consultation
  discussion is entirely fictitious but represents
  the kind of team decision-making that any SSVF
  program can utilize.

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Case A Henry

• In the past year, Henry, age 62, has spent 344
  nights in the local homeless shelter. He has
  zero income.
• He was referred to SSVF by a Veteran
  representative at the shelter. During
  eligibility screening, SSVF verified his status
  as Under Honorable Conditions. His income is
  below 50 AMI and he is literally homeless
  (Category 2). He is eligible for SSVF.

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1 The Decision to Assist

• AUDIENCE POLL
• How many of you would accept Henry for assistance
  in your SSVF program?
• __YES __NO

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If You Voted NO

• AUDIENCE POLL
• Why?
• Pick the answer that was most important to your
  vote - choose only 1 answer
• We dont work with people who have zero income
  (screening policy)
• We dont work with people who are experiencing
  chronic homelessness (screening policy)
• I dont think we can help him within the time
  limits of SSVF Temporary Financial Assistance

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2 How to Assist (What is a Reasonable Plan?)

• Housing Is it reasonable to find housing for
  someone who has zero income? What kind of
  housing is reasonable?
• Income Is it reasonable for Henry to secure
  income from employment? What public benefits
  could he reasonably obtain?
• Can this be accomplished within the limits of
  SSVF rental assistance? If not, will Henry be
  homeless again?

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Goals for the Plan

• Housing Goals Find housing, using SSVF for
  deposit and bridge rental assistance.
• Income Goals
• Obtain Section 8 (non-VASH) rental subsidy (Henry
  is on a waiting list for Section 8)
• Obtain VA benefits (Henry has had a VA
  Compensation and Pension case pending for nearly
  a year but his case has not advanced)
• If both goals are met, Henry will have affordable
  housing and discretionary income. Research
  continues to show that a permanent housing
  subsidy is the most effective method of achieving
  long-term housing stability.

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Action Steps to Achieve Henrys Goals

• Case manager will contact Housing Authority to
  identify any means of improving access to Section
  8. Henry did not identify himself as a
  Veteranthis could gain him priority.
• Case manager will contact VA to identify status
  of Comp and Pension case. Case manager will
  obtain any additional documentation needed.
• Case manager will assist Henry to obtain low-cost
  housing while housing subsidy and VA benefits are
  pending.

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Outcomes

• Henry received a Section 8 voucher. The voucher
  was for another city that is still within the
  SSVFs catchment area. The case manager assisted
  in a new housing search, the Housing Authority
  conducted the housing inspection and the SSVF
  program provided the security deposit. Henry
  obtained his housing.
• Henry was awarded a Non-Service Related VA
  Pension of 1,021, beginning December 1.

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What Additional Supportive Services Could be
Offered to Henry to Maintain Housing?

• With Henrys consent
• Offer some level of mediation/intervention to
  landlord, for xxx period of time, in case of
  conflict, lease violation or non-payment.
• Offer tenancy and budgeting supports to Henry,
  including home visits to look for red flags.
• Offer assistance in securing mental health
  services for Henry -- if needed and wanted.

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Case B Robert

• Housing Crisis
• Roberts common law wife passed away in August,
  2010, but she left her estate (her home) to a
  friend/neighbor.
• After months of conflict between Robert and the
  Beneficiarys family, Robert was given an
  eviction notice. He must move out but has no
  resources, plan or support network.
• Robert meets the SSVF eligibility criteria a
  Veteran, very low-income, living in permanent
  housing but imminently homeless (Category 1).

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Roberts Barriers

• Robert is extremely low incomebelow 30 AMI.
  His monthly income is 709 (619 from Social
  Security and 90 from VA).
• Robert has no rental history or experience being
  responsible for rent, utility bills and living
  expenses.
• Robert is a registered sex offender.

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• Should SSVF assist Robert to find new housing?
• This is a team decision.

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• What is the initial plan for housing search?

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• Team Review New Plan Needed

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• Team review Another Plan

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• Outcome

58

• Follow-up Services

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Summary Goals in a Reasonable Plan

• The goal for all SSVF participants is immediate
  permanent housing.and, when necessary, increase
  the participants income available to sustain
  housing.
• The Plan may include intermediate objectives. An
  intermediate objective brings the household to
  the final goal, but can be changed when
  necessarye.g. the initial intermediate objective
  for Robert was low-cost rental housing. When
  that was not possible, the new objective was
  shared housing.
• Intermediate objectives are based upon the
  familys situation, preferences and information
  initially availablee.g. Robert did not want
  permanent supportive housing, so that was out.

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Summary Action Steps in a Reasonable Plan

• Action steps are discrete activities that the
  family and/or the case manager can perform now to
  move the household toward the intermediate
  objective and ultimate goal.
• Action steps must resolve immediate housing
  barriers. E.G. if a landlord refuses to rent to
  a participant with serious housing barriers, the
  action step might involve the case manager
  negotiating with the landlord to see if a larger
  deposit or follow-up response for participant
  lease violations might overcome the landlords
  resistance.
• Action steps are subject to ltsometimes frequentgt
  change as they are accomplished, added or
  discarded or as new information or situations
  emerges

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A Simple Housing Plan Example Roberts Initial
Plan

• Goal Permanent Housing
• Intermediate objective 1 Secure an efficiency
  or one-bedroom apartment with rent that Robert
  can pay with his current income.
• Intermediate objective 2 Explore options for
  increasing SS or VA income
• Intermediate objective 3 Review household
  expenses and create a budget so Robert has as
  much discretionary income as possible for rent.
• All SSVF participants should have this goal

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Roberts Initial Plan (cont.)

• Action Steps
• Robert and case manager will meet at Housing Inc.
  office on Tuesday, November 1 at 100 to create a
  housing search plan.
• Robert will bring to the meeting a first draft of
  a monthly budget for his essential expenses to
  discuss how much rent he can pay.
• Case manager will have newspaper and electronic
  ads for vacant units at the meeting and Robert
  will select three or more apartments that appear
  suitable.
• These will be updated frequentlyprobably at
  every meeting with the participant.

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Roberts Initial Plan (cont.)

• With Roberts consent, case manager will
  immediately call landlord/caretaker(s) for the
  listings Robert selects -- to discuss apartment
  availability and their tenant screening process.
• If the landlord/caretaker is willing to consider
  Robert, the case manager and Robert will set (an)
  appointment(s) to see the unit(s) as soon as
  possible.
• By Friday, November 4, the case manager will also
  contact landlords who have provided housing to
  other SSVF participants with high barriers, to
  see if they have a vacant unit and would be
  willing to consider Robert as a tenant.
• Robert and case manager will meet again at
  Housing, Inc. on Wednesday, November 9 at 230 to
  review appointments and landlord reactions, a
  revised household budget, and next steps.

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Roberts Second Plan

• Goal Permanent Housing
• Intermediate objective 1 Shared housing, with
  Robert contributing toward hosts expenses.
• Intermediate objective 2 Explore options for
  increasing SS or VA income
• Intermediate objective 3 Review household
  expenses and create a budget so Robert has as
  much discretionary income as possible for rent.
• revised

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Roberts Second Plan (cont.)

• Action Steps
• Robert will visit his sister (by Monday, November
  14) and talk to her about the possibility of
  moving into her home. He would offer to continue
  to provide care for her (as he does now) and
  would also share household chores and expenses.
• If his sister is willing to allow him to share
  housing, Robert will contact his parole officer
  (by November 14) to get approval for relocating
  to his sisters home.
• Robert will continue to write down everything he
  spends, every day, so he knows where his money is
  going. This would include money spent on gas for
  his car, cigarettes and beer, etc.
• all are newreflecting progress toward some
  objectives and changes in others

66
Roberts Second Plan (cont.)

• Before leaving the office, Robert will sign
  Medical Release/Consent Forms so Housing Inc. can
  refer him to VA for review of his benefits.
• Robert and the case manager will meet Tuesday,
  November 15 at 230 to talk about what he learned
  from his sister and the parole officer.

67
Roberts Third Plan

• Goal Permanent Housing
• Intermediate objective 1 Shared property, with
  Robert contributing toward hosts expenses.
• Intermediate objective 2 Explore options for
  increasing SS or VA income
• Intermediate objective 3 Review household
  expenses and create a budget so Robert has as
  much discretionary income as possible for rent.
• Objective hasnt really changed, but Robert is
  now looking at a different host and a different
  living arrangement!

68
Roberts Third Plan (cont.)

• Action Steps
• Robert and case manager will meet with Roberts
  brother (William) to discuss ground rules for
  sharing the property, including utility costs,
  yard work, use of laundry, etc.
• Robert and case manager will search for a mobile
  home that is within Roberts budget and is
  suitable for Williams property.
• William will assist with transporting the mobile
  home, tie downs and utility hookups.
• all are newreflecting progress toward some
  objectives and changes in others

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THANKS FOR PARTICIPATING IN THIS WEBINAR!

• This PowerPoint will be posted on VAs SSVF
  Website
• www.va.gov/homeless/ssvf.asp
• Next months national call
• February 16, 2012
• 200pm 400pm