Slide 1:
Housing Options for Ending Chronic Homelessness
Carol Wilkins
Director of Intergovernmental Policy
Corporation for Supportive Housing
www.csh.org
Slide 2:
People With Disabilities Are Often Priced Out of Housing
- In 2000, people with disabilities receiving SSI needed to
pay – on
a national average – 98% of their SSI benefits to rent a
1-bedroom apartment
- In 2000, there was not one single housing market in the country
where a person with a disability receiving SSI benefits could afford
to rent
a modest efficiency or 1-bedroom unit
- Because of their extreme poverty, the 3.5 million non-elderly people
with disabilities receiving SSI benefits cannot afford decent
housing anywhere in the country without some type of housing assistance
Source: Technical Assistance Collaborative Priced Out in 2000:
The Crisis Continues
Slide 3:
Federal, State, and Local Leaders are Making a Commitment
- To create 150,000 units of supportive housing to end long-term
homelessness in our country within 10 years
- To improve access to housing opportunities and choices for homeless
people and people with disabilities
Slide 4:
Strategies for Expanding Housing Opportunities and Choices
- Strengthen partnerships between agencies that finance and deliver
housing and services
- Target resources to create permanent housing for homeless and
disabled people
- Improve access to housing created or subsidized through “mainstream” housing
programs
- Enforce Fair Housing protections against discrimination and provide
reasonable accommodations
- Build community acceptance for housing for people with special
needs
Slide 5:
Supportive Housing = Housing + Services
- Housing
- Permanent: not time limited
- Affordable: generally tenants pay 30% of income for rent
- Independent: private living space and lease with normal tenant
rights & responsibilities
- Services
- Flexible and responsive to tenants’ needs
- Maximize independence and housing stability
- Participation is not a condition of tenancy
- Services + Property Management + Tenants =
Effective Partnerships
Slide 6:
Target Population(s)
- Individuals and families who:
- Are very poor;
- Have persistent health conditions or multiple barriers to
housing stability;
- Are homeless and/or do not have access to appropriate and
stable housing in the community; and
- Would be unable to access or retain housing without tightly
linked services
Slide 7:
Supportive Housing
for the people who
- But for housing cannot access and make effective use of treatment
and supportive services in the community; and
- But for supportive services cannot access and maintain stable housing
in the community
Slide 8:
A Range of Models & Strategies
- Apartment or SRO buildings developed by non-profit owners for
people with special needs
- Single family homes – may be shared
- Rent subsidized apartments leased in the private market
- Units set aside for people with special needs in mixed income
housing developments
- Units secured by project sponsors through long-term ‘master lease’ with
private owners
- Services integrated within existing affordable housing
Slide 9:
A range of services to support tenants in their goals
- A broad array of services available
- Mental health and substance use management and recovery
- Vocational and employment
- Money management & benefits advocacy
- Coordinated support/case management
- Life skills
- Community building and tenant advocacy
- Medical and wellness
Slide 10:
“Services are voluntary for the tenants – not the
staff”
- Tenants choose as many or as few services as they desire – without
having to move as their service needs change
- Engagement is an ongoing activity to establish and sustain relationships
- Begin
with tenants’ practical needs and personal goals
- Service strategies anticipate and help to manage the risks and
consequences associated with substance use and relapse
- Building a strong and safe community to reinforce norms of behavior
and hope for recovery and growth
Slide 11:
Supportive housing tenants must pay rent and meet other lease obligations
- Participation in services can help tenants meet their obligations,
solve problems, and avoid eviction
- Money management & representative payee services may be offered
- Evictions are for failure to pay rent or for problem behavior – not
for choices about participation in services
Slide 12:
Supportive housing provides opportunities for tenants to
- Achieve housing stability
- Access appropriate care for and manage chronic health and mental
health conditions
- Take steps toward achieving and maintaining sobriety
- Work
- Socialize
- Be leaders in their community
- Connect with the wider world
- Pursue goals and interests
Slide 13:
Expanding housing opportunities for people who are chronically homeless
- Eligibility criteria for housing (or subsidies) targets people
with disabilities and those who are homeless for the long-term
- Outreach, marketing and tenant selection procedures and program
rules facilitate access
- Supportive services and property management practices are
designed to help people achieve housing stability and reduce
reliance on emergency
care
- Requires strategies for effectively engaging and housing
people with ongoing or relapsing substance use problems
Slide 14:
Supportive Housing Works
as documented by researchers across the country
- 80% of tenants coming from streets and shelters achieve housing
stability for at least a year
- Emergency room and hospital visits drop by more than 50%
- Increase use of primary care and services to address substance
abuse problems
- Increase participation in work and employment services
Slide 15:
The Impact of Supportive Housing for Homeless Persons with Severe
Mental Illness on Use of Public Services in New York City
Dennis Culhane, Ph.D., Stephen Metraux, M.A., and Trevor Hadley,
Ph.D.
Center For Mental Health Policy & Services Research
University of Pennsylvania
- Study analyzed patterns of service utilization in shelters, state
mental health facilities, hospitals, VA, Medicaid, jails, and
prison – before
and after housing placement for 4,679 individuals
- The cost of homelessness for persons with serious mental illness
was more than $40,000 per year – with 86% of costs in health
care and mental health systems
- Costs of creating and operating supportive housing are offset by
savings in other public systems
Slide 16:
The Cost of Homelessness in NY
Service Provider |
Mean Days
Used (2-year
pre-NY/NY) |
Per Diem Cost |
Annualized
Cost |
NYC DHS - Shelter
NYC OMH - Hospital
NYC HHC - Hospital
Medicaid - Hospital Medicaid - Outpatient
VA - Hospital
NYS - DCJS - Prison
NYC DOC - Jail |
137
57.3
16.5
35.3
62.2 (visits)
7.8
9.3
10 |
$68
$437
$755
$657
$84
$467
$79
$129 |
$4,658
$12,520
$6,229
$11,596
$2,612
$1,821
$367
$645
|
Total |
$40, 449 |
Slide 17:
Savings in Services Use Per NY/NY Placement
Service |
Per Diem Cost |
Reduction (days) |
Annualized
Cost Reduction |
Municipal Shelter
Psychiatric Hospital
Municipal Hospital
Medicaid - Inpatient
Medicaid - Outpatient
Veterans Hospital
NYS Prison
NYC Jail
|
$67
$437
$755
$657
$84
$467
$79
$129 |
82.9
28.2
3.5
8.6
-47.2 (visits)
1.9
7.9
3.8 |
$2,819
$6,162
$1,321
$2,825
($1,982)
$444
$312
$245
|
Total
|
$12,145
|
Slide 18:
NY/NY Housing Costs and Savings
- Savings per unit from reduction = $16,282
- Annual Per Unit Cost of Housing for
Community Residence = $19,662
- Supportive Housing = $17,277
- Weighted Mean = $18,190
|