The Cottages At Hickory Crossing Dallas’ Premier Model of Permanent Supportive Housing

1. The Cottages At Hickory Crossing Dallas’ Premier Model of Permanent Supportive Housing A Status Report January 2011

2. Partners • Metrocare Services: Behavioral health services, fiscal agent • Central Dallas CDC: Housing development • CitySquare: Case management, public relations lead • UT Southwestern: Program evaluation • Metro Dallas Homeless Alliance: Intake & referral • Dallas County Criminal Justice: Liaison to courts • Supporting Partners • Funding leadership: • W.W. Caruth, Jr. Foundation • Meadows Foundation • Project management: • Corporation for Supportive Housing

3. Project Objective The Cottages at Hickory Crossing: A model permanent supportive housing community • Goal: Develop and implement Texas’ premier model of permanent supportive housing, providing: • On-site access to most services …including high-quality healthcare and social services • Integration of services …a team approach to housing, healthcare and social services • Improved behavioral health and physical health outcomes …and quality of life of individuals served by the program • Cost savings to taxpayers …through reduced expenditures on public safety, behavioral health and healthcare • Ongoing research and evaluation …of program and clinical outcomes to guide future programs

4. Project Concept • Target Population: • Chronically homeless who are involved in the criminal justice system, mentally ill, and/or have substance abuse issues • Three-year Pilot: • 50 units of permanent supportive housing with continued operation thereafter • Evidence-Based Service Design: • Housing-first, integrated clinical and social services • Rigorous Evaluation: • Including housing stability, public costs, and behavioral health outcomes

5. Project Location and Site

6. Unit Design bcWorkshop has developed a model for sustainable urban living, balancing living space with open space.

7. Tenant Selection • Tenants will be referred by: • MDHA via The Bridge • The Dallas County criminal justice system • Selection criteria include: • Chronically Homeless • Severe and persistent mental illness • Schizophrenia, bipolar disorder • Usually complicated by substance use history • High cost to the public due to use of: • County jail • Homeless shelters • Emergency rooms

8. Pilot Project • W.W. Caruth, Jr. Foundation funded a transitional housing program that offered: • Immediate relief for overcrowding at The Bridge • An opportunity to pilot clinical approaches to this challenging population • Program Characteristics: • Duration: February 2009 to November 2010 • Total enrollments: 142 • Clients (“Phase 1” only = 97 clients): • Male - 73% • African American - 69%; Hispanic – 5% • Bipolar – 46%; depression – 42%; schizophrenia – 12%

9. Pilot Project Outcomes • Housing Outcomes: • Total permanent placements: 78 (55%) • Unsuccessful admissions: 47 (33%) • 60% of these were in program’s first six months • Left without being placed: 17 (12%) • Functional Outcomes: • Mental health symptoms decreased for all diagnoses • ER visits: down 67% at 120 days • Hospital days: down 67% at 90 days • Jail days: down 80% at 120 days

10. Pilot Project Outcomes • Financial Outcomes: • Cost per client served: $ 9,400 • Cost per successful placement: $17,000 • Comparison of average monthly program costs: • Pilot project: $ 1,400 • Jail: $ 1,950 • Hospital: $ 12,000 • Community feedback: • From CitySquare staff: “a marked difference between how well former COE residents are doing in permanent housing compared to the residents from shelters.”