# Presentation: 034706

## What Works:  Effective Housing Strategies

- Ann V. Denton
- Advocates for Human Potential

## Strategies to End Chronic Homelessness

- In general terms, recommended strategies to end chronic homelessness include:
- Effective discharge planning
- Outreach and effective engagement of people who become homeless
- Permanent Supportive Housing (PSM)
- Evidence based and exemplary practices
- Access to mainstream services

- Advocates for Human Potential, Inc.

## Strategies to End Chronic Homelessness

- None of these strategies will be effective alone, and must be adopted as part of an overall action plan.
- Today, we will consider the development of a specific Permanent Supportive Housing action plan.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- Permanent Supportive Housing is a concept that includes all forms of housing for people with disabilities.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- Permanent Supportive Housing includes the development (construction) of housing for this purpose.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- Permanent Supportive Housing includes the use of housing subsidies either to operate housing that is constructed/operated for this purpose, or to provide tenant based rental subsidies for scattered site options.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- Permanent Supportive Housing includes funding for supports and services needed and voluntarily accepted by residents of housing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- One definition that encompasses these multiple activities under one umbrella was offered by *Opening Doors, * from the Technical Assistance Collaborative and the Consortium of Citizens with Disabilities.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- “... decent, safe and affordable community-based housing that provides residents with the rights of tenancy under state/local landlord tenant laws and is linked to voluntary and flexible supports and services designed to meets residents’ needs and preferences.”
- Opening Doors, January 2003, Issue 20

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- PSH is important to many groups—the Olmstead Supreme Court decision stated that the clinically unwarranted segregation of people with disabilities is a violation of the Americans with Disabilities Act.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- PSH is effective for people—there is new research validating the importance of housing for people with mental illnesses and co-occurring disorders.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- Finally, PSH is important as part of the plan to end homelessness in our communities.
- PSH is a vital part of recovery for people with significant functional impairments.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- PSH can include a full range of activities including:
- Construction of housing (using both integrated and congregated approaches)
- Operation and support for the housing (on-site management or emergency support for landlords)
- Subsidies to make housing affordable in congregated and scattered site models.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Concepts and Definitions

- How, when, and where to implement permanent supportive housing, and the form that housing should take in YOUR  community, can be determined by the housing market, leadership within the community, and the wishes of tenants, providers, families, and other stakeholders.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- PSH can be provided in many ways, but the unifying steps include a way to make the housing affordable, a real link to services and supports, and a genuine choice.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- The key to PSH is strategic partnerships that cross agency boundaries at State and local levels to create increased numbers of PSH units.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- Partnerships focused on housing for people with serious mental illness have taken many forms, including:
- Service providers manage or develop housing
- Advocacy groups manage or develop housing
- Parents develop housing
- Consumers manage or develop housing
- Non-profit sponsors develop housing
- For-profit companies develop housing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- Every strategic partnership is different—based on local need and the personalities and organizational agendas involved.
- If you’ve seen one, you’ve seen one!

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing: Best Practices

- Building Communities Collaborative
- Columbus, Ohio
**Partners:**
- City of Columbus, Columbus Board of Realtors, Lutheran Social Services, St. Stephen’s Community House, Public Children Services Assn of Ohio, Franklin Co. Dept of Human Services, Ohio Dept. of Human Services, The Enterprise Foundation.
- Projects developed by the Columbus Housing Partnership (a non-profit CDC) and managed by Ebner Real Estate Management.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Building Communities Collaborative
- Columbus, Ohio
**Program or Project:**  Mwanza Place
- 24 units in 12 duplexes
- Each unit has three bedrooms
- Each unit and the entire complex was rehabilitated by the Columbus Housing Partnership.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Building Communities Collaborative
- Columbus, Ohio
**Target Population:**  Households of low income with “multiple dysfunctional issues”.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Mental Health Housing Development Corporation
- Ft. Worth, Texas
**Description:**  Non-profit community development corporation developed under the leadership of the Mental Health Association of Tarrant County.
**Partners:**  MHHDC, the Ft. Worth Housing Authority, MHMR Services of Tarrant County, the Mental Health Association of Tarrant County.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Mental Health Housing Development Corporation
- Ft. Worth, Texas
**Project or Program:**
- Hanratty Place – 32 unit apartment building renovated with conventional financing and leased with rental assistance from the PHA.
- Spanish Gate – 98 unit apartment building renovated with HOME and Housing Trust Fund dollars.
- Pennsylvania Place – 125 unit apartment building constructed using tax credit financing, HOME funds and conventional financing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Mental Health Housing Development Corporation
- Ft. Worth, Texas
**Project or Program:**
- All properties managed or owned by MHHDC are operated as integrated settings.  No more than 50% of the units are leased to people with mental illness.  Up to 50% of the units are leased to low income residents of Ft. Worth.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Shore-Easy
- New Jersey (four communities in coastal area)
**Description:**  State-led effort to end abuses in unlicensed and run down boarding homes.  Included State purchase of boarding homes, State funded renovation of selected boarding homes, increased funding for monitoring and enforcement, funding for planning, and a commitment of $25 million in “bridge” funds for permanent housing and related services, ongoing commitment of funds previously used to support a State hospital, capital development bond funds, and Section 8 resources.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Shore-Easy
- New Jersey (four communities in coastal area)
**Partners:**  NJ Department of Human Services, NJ Department of Community Affairs, NJ Governor’s Office, NJ Housing and Mortgage Finance Agency, NJ Department of Health, numerous providers, consumer groups, resident councils, family groups, neighborhood groups.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- Shore-Easy
- New Jersey (four communities in coastal area)
**Project or Program:**
- Five rooming houses purchased, residents relocated, structures demolished.
- $68 million dollars (funds from closed state hospital) were spent to develop PACT teams, intensive case managements, make direct placements, provide supportive housing, fund self-help centers, etc.
- $14.9 million capital bond funding resulted in 281 new “placements”
- 157 Section 8 certificates provided to eligible individuals

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:  Best Practices

- San Antonio Alliance for the Mentally Ill
- San Antonio, Texas
**Partners:**  San Antonio Alliance for the Mentally Ill, San Antonio Housing Authority, Urban Ministries, Inc., Center for Health Care Services
**Project or Program:**
- Three Section 811 projects constructed in San Antonio, no on-site staff, but services and supports provided by local mental health authority.  Units = 100.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices 

- An emerging concept within the Permanent Supportive Housing umbrella is what is known as “housing first” or “supported housing” activities.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- Housing First provides housing to individuals when they say they wish to have housing.  These activities can be identified by a high degree of choice, integration, and community inclusion.
- Housing First activities are identified by the use of scattered sites, often with private market landlords.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- Housing First activities typically provide housing to persons with significant functional impairments without requiring a demonstration of housing readiness.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Best Practices

- Permanent Supportive Housing is an important tool for communities in ending chronic homelessness.
- Indeed, it has been said that housing is a necessary (but perhaps not sufficient) condition to ending homelessness.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- CHOICE

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- Operationalizing Choice:
- Identifying Personal Preferences and Values – Where do you want to live?
- Alone or with family, friends
- Location and neighborhood type
- Size of unit
- Maintenance requirements
- Proximity to specific services, public transportation
- Maximum monthly rent and utilities.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- Operationalizing Choice - Identifying Support Needs:
- Apartment search, acquisition and set-up
- Landlord negotiations
- Credit, references, deposits
- Arrange utilities, phone, insurance
- Furnishings
- Housekeeping
- Food shopping and preparation
- Financial management
- Medication management
- Accessing natural supports
- Transportation
- Medical care.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- INTEGRATION

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- A key indicator of integration is mixing various populations – diversity in income and a mix of labeled and unlabeled people.  Mixed incomes as a guiding principle comes from the affordable housing industry.
- True integration is completely scattered site housing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- RECOVERY

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- Recovery is:
- An ongoing dynamic interractional process that occurs between a person’s strengths, vulnerabilities, resources, and the environment.
- It involves a personal journey of actively self-managing psychiatric disorder while reclaiming, gaining and maintaining a positive sense of self, roles, and life beyond the mental health system, in spite of the challenge of psychiatric disability.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Unifying Concepts

- Recovery is NOT:
- 	A Cure
- 	All Symptoms Removed
- 	All Struggling Ceased
- 	All Functioning Returned.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- The importance of safe, decent, affordable housing cannot be overemphasized as a key part of community strategies to end chronic homelessness.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- The facts include:
- People usually prefer to live in a place of their own
- Many people who are chronically homeless have disabling conditions
- People with disabilities often survive on Supplemental Security Income (SSI).

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Begin with the end in mind!
- What is your goal?
- Increased housing options
- Expanded residential treatment programs
- Transitional housing
- Permanent housing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Draw a map of housing needs within the population you want to serve.
- How many people do you want to serve?
- How many of those just need rental assistance?
- How many need residential treatment?
- Do any people need long term supervised care?
- How many can use rental assistance in combination with intensive supports and services?

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:
- What is the estimated size of the chronically homeless group?
- How many units of existing housing should you target?
- How many units would you like to develop for this group?

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:
- What is the estimated size of the Olmstead group?
- Number of existing housing units?
- Number of units for development?

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:
- What is the number of people in long term mental health services?
- How many need housing financial support?
- How many need housing and services?

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:
- What is the number of people in long term care systems?
- How many of those individuals need housing units through rental assistance or development?

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:  Estimation is the Key!

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Assessing Need:  Services and Supports
- Medicaid
- Medicare
- Mental health services
- Substance abuse services
- Independent living centers.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Resources for housing:
- HUD Continuum of Care, ESG, and HOPWA
- HUD mainstream programs (ConPlan, PHA)
- DOA housing programs
- Low Income Housing Tax Credits.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- HUD Continuum of Care, ESG, and HOPWA
- Continuum of Care:  Local planning process and state-level process designed to end homelessness.
- Emergency Shelter Grants:  Provide operations, maintenance, and services funding for emergency shelters.  Also used for homelessness prevention.
- HOPWA:  Housing for people with AIDS.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Department of Agriculture - Multi-family Housing Development
- Rural Rental Housing - Direct Loans (S.515)
- The Rural Housing Service makes direct, very low interest loans to developers of affordable rural multi-family rental housing.
- Rural Rental Housing Guaranteed Loan Program
- In this program, the Rural Housing Service guarantees up to 90% of the amount of a loan from a private lender to a developer of affordable housing.

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Department of Agriculture – Multifamily Housing Programs
- Farm Labor Housing
- Low interest loans and grants are made to public and non-profit organizations, or to individual farmers, for the construction of farm labor housing.
- Housing Preservation Grant Program
- Grants are made to non-profits, local governments, and tribes to renovate existing low-income multi-family units.  Funds can also be used to repair single family homes.
- http://www.rurdev.usda.gov/ok/

- Advocates for Human Potential, Inc.

## Permanent Supportive Housing:Action Plan

- Low Income Housing Tax Credits
- Excellent development tool
- Controlled by state housing agency
- Highly competitive process – look at adjusting provisions in the Qualified Allocation Plan (QAP) to increase chances for proposals serving lowest income groups.

- Advocates for Human Potential, Inc.