Facts & Media > Notes from Supportive Housing Teleconference
Notes from Supportive Housing Teleconference
Posted: 3/11/2005
(All times EST)
2-2:05 NCHV Welcome and Intro (Melanie Lilliston)
2:05-2:10 Welcome and Introduction of Panelists (Nancy McGraw)
Supportive housing is a successful, cost-effective combination of affordable housing with services that helps people live more stable, productive lives.
From CSH's perspective, a supportive housing unit is:
§ Available to, and intended for a person or family whose head of household is homeless or at risk of homelessness and experiencing mental illness, other chronic health conditions including substance use issues, and/or multiple barriers to employment and housing stability;
§ Where the tenant pays no more than 30%-50% of household income towards rent, and ideally no more than 30%;
§ Where the tenant has access to a flexible array of comprehensive services, including medical and wellness, mental health, substance use management and recovery, vocational and employment, money management, coordinated support (case management), life skills, household establishment, and tenant advocacy;
§ Where use of services or programs is not a condition of ongoing tenancy;
§ Where the tenant has a lease or similar form of occupancy agreement and there are not limits on a person's length of tenancy as long as they abide by the conditions of the lease or agreement; and
§ Where there is a working partnership that includes ongoing communication between supportive services providers, property owners or managers, and/or housing subsidy programs.
There are a range of housing models that can be used within a program.
While there may not be a single perfect model, there are a number of preferred housing models for supportive housing. The housing setting will vary dramatically and be based on a range of factors including the tenant's preference, the type of housing stock available, and the norms and history of a local community's real estate market.
Some of the housing models we typically help create are:
§ Apartment or single-room occupancy (SRO) buildings, townhouses, or single-family homes that exclusively house formerly homeless individuals and/or families
§ Apartment or SRO buildings, or townhouses that mix special-needs housing with general affordable housing
§ Rent-subsidized apartments leased in the open market
§ Long-term set asides of units within privately owned buildings
2:10-2:35 ARCH Presentation (Jeffrey Gilbert and Kellie Gage, with intro
provided by Katrina Van Valkenburgh, Associate Director, CSH – IL)
Jeffrey Gilbert has been with Thresholds (A Mental Health agency dedicated to the recovery of individuals with mental illness) since 1994. He has shared in outreach work w/ individuals w/ co-occurring disabilities on the west side of Chicago. Jeff has implemented Assertive Community Treatment as a supervisor for 8 years. He is currently the Team Leader for the Chicago Collaborative Initiative (A.R.C.H. - A.C.T.
Resources for the Chronically Homeless) and has been so since its inception. He has a Bachelors of Science and has worked in the social service field for 16 years.
Gage, Kellie. M.S. Psy. Edu./M.S. Human Services Administration, has been employed with the Illinois Department of Human Services-Division of Alcoholism and Substance Abuse since August 2001 and serves as the Gambling Specialist for the State's Gambling Treatment Initiative as well as the Project Coordinator for the A.C.T. Resources for the Chronically Homeless (ARCH) Project. She has been in the field of Addictions/Human Services for the past 14 years as a Counselor/Supervisor and Trainer.
History
In 2003, the Chicago Continuum of Care responded to the federal NOFA for the Collaborative Initiative to Help End Chronic Homelessness. This NOFA, for the first time, combined funding from HHS, HUD, and the VA to create housing resources for single individuals who meet the federal definition of chronic homelessness. Chicago's successful application resulted in $3.4 million dollars in federal money to create a harm reduction model of permanent supportive housing for 59 long-term homeless individuals in the city over a five-year period (2004-2009). This project is called ARCH (ACT Resources for the Chronically Homeless)
The application process was coordinated by the Corporation for Supportive Housing as the Co-Chair of the Chicago Continuum of Care's Chronic Homelessness Task Group. The Task Group created an ad hoc NOFA subcommittee to work on the application. Four different agencies were selected to apply for the federal funding sources in the NOFA.
§ The Chicago Department of Human Services was the lead applicant for the NOFA and applied to HUD for the $1,996,140 for 59 Shelter Plus Care subsidies for five years.
§ The Illinois Division of Alcoholism and Substance Abuse applied for the HHS SAMHSA funding for the project which resulted in: $700,000 for year one; $490,000 for year two; and $280,000 for year three. This funding will support most of the service team staff. Local and state government and philanthropy will provide additional funds as this grant decreases annually and will have to fully fund this section of the collaborative in years four and five.
§ Heartland Health Outreach applied to HHS HRSA for $900,000 for the project over three years to provide primary health and dental care to non-veteran tenants.
§ The US Department of Veterans Affairs is receiving a total of $648,000 for the project over three years to provide supportive services to the veterans participating
Target Population
In order to address the needs identified by the Continuum of Care, ARCH focuses on the long-term homeless population on the south side of Chicago. The collaboration has a goal of housing 59 long-term homeless persons by January of 2005. Twenty percent of them are projected to be designated for veterans. The collaboration is centered around a new entity, called ARCH, which is based on the Assertive Community Treatment (ACT) Team model. The Chicago Continuum of Care's approach to this application was to have an inclusive and transparent process, a collaboration of nonprofit and government entities, a structure that emulates the Continuum structure, and one that addressed existing inequities in resource allocation.
Implementation
Each partner applied for a portion of the $3.4 million needed for the project to succeed. Taken together, this funding provides housing subsidies, supportive services, primary health and dental care and Veteran's services.
§ Service Approach. This is a housing first strategy with wraparound services. The housing is based on a harm reduction model of housing where long-term homeless individuals do not have to be sober, clean, or in mental health treatment to enter or to maintain their housing.
§ Service Delivery. Services are provided through the ACT Team. Staff includes a team leader, five case managers (dually trained in mental health and substance abuse), a VA case manager, a nurse, and a quarter-time psychiatrist. The service team does outreach, works with long-term homeless individuals to secure a unit using their Shelter Plus Care subsidy, provides supportive services to tenants in their housing, and works to connect the tenants to mainstream resources and services in the community in which they live. Additional medical services are provided by Heartland Health Outreach under the HRSA grant and by the VA for veterans. The service team uses the Shelter Plus Care vouchers to secure housing units and works to ensure that good relations are maintained between the landlord and the tenant.
§ Outreach. The ACT Team performs outreach to long-term homeless people who are living outside or in shelters.
§ Housing. Housing is provided in both scattered site and clustered unit configurations. The ACT team helps the tenant find a unit and arranges for the Shelter Plus Care subsidy to underwrite the cost of the unit. The YMCA and Catholic Charities provide clustered units at their buildings and scattered-site units are secured on the open market.
Important things to Remember
§ When working with multiple agencies you will have different policies and procedures to follow, specifically the VA has many policies because it is a government agency.
§ Not all individuals are ready for housing, you need to take into consideration the needs of the clients before you can make a plan for them (I think this statement was clarified in the Q&A session.) Some clients, especially those with serious mental illness, have difficulties in housing. We often have to be creative in how we deal with them as we do not want to take away the client's independence but also do not want to put them into a situation in which they cannot succeed. Flexibility is key, each client will need different things so their treatment plan will be based on their needs.
§ You must have good relations with the landlords and tenants for this housing approach to work.
§ There are a great number of veterans that need help but many are often difficult to engage. This can be due to distrust of bureaucracy and a perception of poor treatment in the past. Also, many veterans have difficulty accessing necessary VA services due to "bad paper".
2:35-3:00 Central City Concern Presentation, E.V. Armitage, Project Director
Central City Concern
232 NW Sixth Avenue
Portland, Oregon 97209
503-294-1681 | fax 503-294-4321
evarmitage@centralcityconcern.org
www.centralcityconcern.org
Also participating in the conference call:
Claudia Krueger, Program Manager in charge of Central City Concern's Interagency Council on Homelessness grants
Sam Brown, Homeless Veterans Reintegration Program Career Services Coordinator
Steven Carreker, Veterans Per Diem Program Resource Coordinator
History
The Community Engagement Program in Portland, Oregon is serving the long-term homeless population by pairing permanent housing with customized employment services for up to 89 individuals. The team stresses the benefits of employment to each individual's rehabilitation and recovery process. It is expected that the philosophy that employment promotes recovery will have a powerful influence on tenant self-expectations. The HVRP program is targeted at getting Veterans past employment barriers as well as finding them housing and employment.
Designed in response to the Department of Housing and Urban Development and Department of Labor Notice of Funding Availability titled "Ending Chronic Homelessness Through Employment and Housing," CEP-IV is a new team within the Community Engagement Program (CEP), a program of Central City Concern. Awarded in October 2003, CEP-IV represents a partnership between Central City Concern (a twenty-five year old comprehensive homeless service organization), Worksystems, Inc. (a nonprofit career placement and training organization), and the Housing Authority of Portland. The project is anticipated to be funded for five years, with funds diminishing beginning in year three. The Community Engagement Program includes several Assertive Community Treatment (ACT) teams focusing on serving homeless individuals with substance use issues, mental illness, and other severe disabilities.
Target Population
The target population for CEP-IV is individual adults in Multnomah County, Oregon (which includes Portland) who have been homeless for at least one year or who have had four or more episodes of homelessness over the last three years (HUD's definition of 'chronic homeless'), experience a severe disability, and who express an interest in employment. Working with this population, the program has three main goals:
§ Placement of up to 89 chronic homeless individuals into self-selected employment that provides earnings, benefits, and career advancement.
§ Movement of the same individuals into permanent housing under a tenant-based Shelter Plus Care subsidy.
§ Developing systems change strategies that bring the workforce development system and organizations serving homeless populations into closer alignment.
Program Structure
The CEP-IV program includes the following components:
1. Outreach and engagement;
2. Wrap-around services provided by multidisciplinary service teams modeled after the Assertive Community Treatment (ACT) teams;
3. Shelter Plus Care tenant-based housing subsidies; and
4. Customized employment services provided in conjunction with the One Stop Career Center.
Shelter Plus Care Housing Subsidies
The Housing Authority of Portland (HAP) provides 89 Shelter plus Care housing subsidies to approved program participants. The CEP-IV Housing Specialist helps program participants locate private market or community units in which to use these subsidies. The original funding proposal identified a combination of SROs, studios, and one- and two-bedroom apartments that are located close to services and employment opportunities.
Employment Services
The CEP-IV Employment Specialist (ES) is the lead staff person working with tenants on employment issues, assisting them throughout the employment process, including engagement, assessment, job search, job placement, and job training. Though the ES is part of CEP-IV and is involved with decision-making on treatment needs, the ES does not engage in case management activities. Prior experience has shown that if the ES is also responsible for case management, including the management of crisis situations, then the team loses the vocational focus. However, the ES will work collaboratively with the case management team while participating in treatment decisions.
Upon each tenant's entry to the CEP program, the ES completes a job development plan with the client using a person-centered, strengths-assessment approach that helps the tenant identify personal goals and strengths. The ES also creates a team of supportive individuals of the tenant's choice to share in whatever is needed to return to work. Beginning with identification of the tenant's interests, aspirations, and priorities, the ES and tenant, with the team, build a plan in which the tenant's strengths and resources are affirmed and connected to the sequence of steps that will lead to the consumer's selected employment options. The critical components of this plan are that it is:
- thorough, detailed and specific;
- updated on a regular basis in order to maintain an ongoing process;
- drafted in a conversational manner using the tenant's language;
- tenant paced; and
- accountable to the CEP.
Central City Concern also received a HVRP per diem grant from the VA. The goal of the Homeless Veterans Project is to assist Veterans in their return to mainstream life and self-sufficiency. Connections to support services, housing, medical assistance, mental health counseling and drug and alcohol treatment are provided. The Veterans Project has been in operation since 1998. In fiscal 2004, 406 Veterans received a variety of services, including 135 who were placed in full-time jobs.
This program just began in February and has 15 beds set aside for veterans. The target population of veterans comes from those individuals who come and ask for assistance, most of their clients come from referrals. Selection to the program is based on those demonstrating the greatest need as well as those who are most willing to utilize the services offered. So far the staff has seen that the power of an SRO is huge. This can make all of the difference in the veterans demeanor and presence. All services are based on the individuals need.
3:00-3:30 Question and Answer
Facilitated by Melanie Lilliston
With multiple treatment programs, how do you mange them all?
All plans are based on individual's needs. What a client needs will rise to the top. These programs try to weave the different treatment plans together to find the best fit for the client.
How did you receive the grant for the medical/dental/eye care?
There are two sources of that funding. One is from the VA for services to eligible veterans and then the programs collaborate with HHS and HRSA to provide the non veterans services.
How do you determine standards for self determination?
This is a goal of the program but there is little guidance on this. Central City Concern relies on a clinical holistic approach to make sure that all of the client's needs are covered.
How do you handle housing readiness problems?
The mentally ill tend to be the ones with the most problems. We often have to be creative in how we deal with them as we do not want to take away the client's independence but also do not want to put them into a situation in which they cannot succeed. Flexibility is key, each client will need different things so their treatment plan will be based on their needs.
Do you have any examples of rural area programs?
There are some examples on the CSH website. www.csh.org under resources and the toolkit link.
For more information on the two programs discussed during this call please visit The Corporation for Supportive Housing's website. Their Toolkit: Ending Homelessness provides profiles of programs across the county.
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