Missouri Housing Summit 8-7-13

1. Building the Future:Enhancing Missouri’s commitment to Special Needs Housing through the Development of Supportive Housing Missouri Housing Summit 8-7-13

3. 1 Listeners’ Goal

5. Agenda • What is Supportive Housing? • Why is it needed? • What is it’s Impact? • How CSH Works • National Context • Examples of Supportive Housing Projects

7. Permanent Supportive Housing

8. Supportive Housing is the Solution Supportive housing combines affordable housing with services that help people who face the most complex challenges to live with stability, autonomy and dignity. Employment Services Parenting/ Coaching Life Skills Case Management Housing: Affordable Permanent Independent Support: Flexible Voluntary Tenant-centered Affordable Housing Substance Abuse Treatment Primary Health Services Mental Health Services Coordinated Services

9. 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

10. \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\Supportive Housing Models\\\\\\ • Scattered Site • Single Family Homes • Apartments • Single Site • Rehab or New Construction • Mixed-Tenancy • Rehab or New Construction

11. Community Integration • Supportive Housing integrates safe, decent, affordable housing with voluntary, client centered services to help people thrive and live in the community • Supportive Housing services include assisting tenants to connect to resources and amenities in their community

12. Principles Guiding Supportive Housing • Providing Opportunity to live independently in the most appropriate, integrated setting • Expanding housing access to a full range of housing options • Ensuring that access to services is both voluntary and widely available • Ensuring and promoting tenant and consumer choice as paramount

13. Child Welfare Involved Families Supportive housing provides essential support to families that present a high cost to society. CSH’s Keeping Families Together pilot demonstration in NYC • annual public cost $3/day • child welfare involvement declined • children were reunited with their families from foster care • average school attendance improved  Child Welfare and Supportive Housing Resource Center • provides technical support • facilitates information-sharing • assists in capacity-building • encourages and supports peer learning

14. Criminal Justice Involved Many people who are released from jails and prisons cycle between homelessness and incarceration for months or years at great public expense and with tragic human outcomes.  CSH’s Returning Home Initiative is designed to: • improve the lives of tenants • make more efficient use of public resources • align and coordinate public and private resources and policies to create supportive housing • generate cost offsets in crisis systems like jails and shelters • reduce recidivism and the use of costly emergency services

15. High Utilizers Communities spend billions of dollars on services that bounce vulnerable people between crisis services. CSH's FUSE model helps break that cycle while increasing housing stability and reducing multiple crisis service use. Policy and Systems Reform Data-Driven Problem-Solving Targeted Housing and Services Convene multi-sector working group Create supportive housing , develop recruitment process Cross systems data match Troubleshoot housing placement and retention barriers Recruit and place clients into housing, stabilize with services Track Implementation Measure outcomes, impact and cost effectiveness Enlist policymakers to bring FUSE to scale Expand model and house additional clients

16. Need for Supportive Housing

17. Why Supportive Housing? • Single night in January 2012: 630,000 people were experiencing homelessness • As many as 250,000 American households have nowhere to call home for years on end • For decades, communities have “managed” homelessness without addressing the underlying causes • Emergency and institutional systems are significant sources of care and support, yet they discharge people into homelessness • Government is spending hundreds of millions of dollars per year, yet homeless rates are growing

18. Missouri

19. 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

20. Homelessness as an institutional circuit

21. Systems Using Supportive Housing

22. Impact of Supportive Housing

23. Supportive Housing Works for Tenants and the Taxpayers: • ER visits down • Emergency detox services down • Incarceration rate down • Earned income increased • Rate of employment when employment services are provided rose • Tenants still housed after a year: more than 57% 85% 50% 50% 40% 80%

24. High Utilizers of Health Services with Poor Health Outcomes • Billings’ (2006) analysis of NYC Medicaid claims data found that: • 20% of adult disabled patients subject to mandatory managed care account for 73% of costs • 3% of patients accounting for 30% of all costs for adult disabled patients

25. A Strategy that Works for Public Systems (Portland, 2007)

26. Impact Reduces Stress onEmergency Systems Serves as a Tool for Economic Development Provides Housingfor People Leverages Other Resources Supportive Housing RevitalizesCommunities

27. How we work

28. CSH CSH advances solutions that use housing as a platform for services to improve the lives of the most vulnerable people, maximize public resources and build healthy communities.

29. Improving Lives

30. Maximizing Public Resources CSH collaborates with communities to introduce housing solutions that promote integration among public service systems, leading to strengthened partnerships and maximized resources. Public Systems Maximized Resources

31. Building Strong, Healthy Communities Locations where CSH has staff stationed Locations where CSH has helped build strong communities

32. What We Do CSH is a touchstone for new ideas and best practices, a collaborative and pragmatic community partner, and an influential advocate for supportive housing. Powerful capital funds, specialty loan products and development expertise Research-backed tools, trainings and knowledge sharing Custom community planning and cutting-edge innovations Systems reform, policy collaboration and advocacy

33. CSH Products and Services • Consulting • Planning • Research and Evaluation • Policy Work • Program Design • Lending • Loan Products • New Market Tax Credits • (CDFI certified) Tools • QAP Survey • Housing Options • Financial Modeling • PHA Toolkit Training • Quality • Technical Assistance • Supportive Housing Institute In everything we do, CSH collaborates with public, private and nonprofit stakeholders to create solutions for communities’ toughest problems.

34. 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

35. National context

37. HEARTH Act

38. Housing First Approach

41. Olmstead Supreme Court Decision

43. Examples of Permanent Supportive Housing Models

44. \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\Supportive Housing Models\\\\\\ • Scattered Site • Single Family Homes • Apartments • Single Site • Rehab or New Construction • Mixed-Tenancy • Rehab or New Construction

45. SERV – Mixed-Tenancy: New Jersey • 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.

46. Crane Ordway – Mixed-Tenancy: Minnesota • St. Paul, MN • 70 affordable Units, 14 for people who are chronically homeless • Harm reduction service model

47. Thomas Place – Mixed-tenancy: Illinois • 80 units affordable for 55 and older • 8 units of these are Statewide Referral Network Units • Housing Authority of the County of Cook provided vouchers for SRN units

48. Mayor’s Manor – Single Site: Illinois

49. Leland Apartments – Mixed-Tenancy: Illinois 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.

50. Located in Chicago, Illinois 42 units of permanent supportive housing New construction Serves single male ex-offenders who are homeless Partnered with Lakefront Supportive Housing, an experienced supportive housing developer Operated by St. Leonard’s Ministries Fannie Mae Maxwell Award Winning Project Recidivism rates decrease from 50% to 20% for participants in their programs St. Andrews Court – Single Site: Illinois