Silos to Systems: Preserving and Strengthening Families and Children Experiencing Recurring Child Welfare System Encounters and Housing Crises

2011

This paper takes a closer look at the characteristics and service needs of this subset of extremely vulnerable families that frequently are involved with both the homeless and child welfare systems, describes early evidence about effective models of serving this population, and outlines the opportunities available and systems changes necessary to bring these interventions to scale.

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CSH’s Social Innovation Fund Sparks a National Movement

What if we could decrease Medicaid spending, lower other public costs and improve the health and lives of our most-vulnerable neighbors? At CSH, we know that we can. And to prove it, we’ve launched a national initiative to create solutions that link supportive housing and healthcare.

For the last few years, CSH’s Innovations and Research team has kept a watchful eye on research findings that show supportive housing’s promise in dramatically improving health, mental health and substance use outcomes for tenants. Take a look at these numbers:

  • 43% of tenants have improved mental health outcomes
  • 15-30% tenants use less alcohol and drugs
  • 50% report improve health status
  • Higher survival rates, higher T-cell counts, and lower viral load among people living with HIV/AIDS
  • 24% to 34% fewer emergency room visits
  • 27% to 29% fewer hospital admissions and nights
  • Decreases up to 87% in use of detox services and decreases in psychiatric admissions
  • Reduction in Medicaid costs: 41 to 67% decrease in Medicaid costs.

You’re reading that right. When it comes to the highest-cost users of publicly funded services, supportive housing can improve health outcomes while actually lowering public costs.

There’s real promise in these numbers, and CSH is on a mission to prove definitively that supportive housing is not just a roof and a bed, but a cost-effective healthcare intervention and a solution for health policy.

We’re leveraging our $2.3 million Social Innovation Fund grant from the Corporation for National and Community Service to start test programs in communities across the country. CSH was one of just 16 organizations selected by the federal government for this honor—and we’re dedicated to using this opportunity to its fullest potential. The supportive housing and health programs that are part of this initiative will leverage the original SIF grant, as well as a dollar-for-dollar match raised by CSH and an additional match raised by subgrantees.

There’s no time better for this initiative than now. One of the most pressing problems states and communities face today is spiraling Medicaid spending--spending that is in large part caused by a small subset of people with complex health conditions (often referred to as the “5:50” population: the 5% that comprise 50% of Medicaid costs). We’re going to demonstrate how supportive housing can be an integral part of states’ strategies to bend the Medicaid cost curve--not to mention improve the health of some of their most vulnerable and poorest citizens.

Our RFP review process is in full swing and we’ll announce the communities and nonprofits who we’ll be working with in just a few weeks. Together, selected grantees and CSH will implement housing and health solutions for the “5:50.”

To be successful, we’ll need to get creative. Supportive housing is traditionally run by specialized organizations focused on homelessness or housing. But our initiative calls for cutting-edge models that build new kinds of partnerships between housing providers and health services. We’re going to link supportive housing with care management and health services—creating an integrated model that we believe could be the future of supportive housing. A rigorous evaluation will test the effectiveness of these models, so we can take a close look at how to build solutions that work best.

We’re on the precipice of an exciting period of discovery—and we are thrilled with the response from potential subgrantees, partners and funders for this effort. Thousands of RFPs were downloaded off of csh.org, and we’re engaged is conversations with funders from around the country.

Given this tremendous and widespread response, we see real potential to expand our demonstration beyond the first set of subgrantees and are currently exploring ways to generate the resources to support a larger initiative.

CSH and the Social Innovation Fund have sparked a new movement, and we can’t wait to see where it leads. You can be sure that we’ll let you know, so keep an eye on CSH as we explore how the integration of supportive housing and health services can become a new solution that eases the burden on our public pockets and improve improving the lives of some of the most vulnerable men and women in our country.

learn more about the csh social innovation fund initiative

CSH Seeking Research Partner

CSH is seeking a research partner to conduct an evaluation of our Social Innovation Fund (SIF) initiative.  This initiative seeks to implement models of supportive housing linked to coordinated primary and behavioral health services targeted towards low-income men and women experiencing homelessness and who are high-users of publicly-funded emergency health services.

We are issuing a Request for Qualifications from organizations with demonstrated capacity and experience to conduct a multi-year, multi-site, quasi-experimental evaluation of the CSH SIF demonstration program.  The RFQ includes a description of the demonstration program, an overview of the objectives and goals of the evaluation, a draft scope of services and tasks, and guidelines and timeline for submission.

Complete RFQ available here

Submissions are due to CSH by 5:00 p.m. PT on February 29, 2012.

All questions pertaining to this RFQ should be  emailed to Jacquelyn Anderson, Senior Program Manager. 

CSH Partners with the National Association of Counties (NACo)

CSH has begun a collaboration with NACo, the national organization that represents counties in the United States.  The goal of our partnership is to foster and strengthen efforts to end the cycle of homelessness and incarceration in county jails through placement in supportive housing. We have formed a workgroup of member counties, and are providing technical and advisory assistance around forming criminal justice supportive housing initiatives.

We're focusing on the population of frequent users of (usually) county-funded public services, such as jails, hospital emergency services, mental health servces and shelters. These men and women have chronic health coniditons that cause them to cycle in and out of crisis sytems of care and homelessness--at great public expense and with limited positive human outcomes.  Placing these people in supportive housing will improve their life outcomes, more efficiently use public resources, and likely create cost-avoidance in crisis systems.

CSH is very excited about the opportunity to work with counties in states all over the country, from Florida and Georgia to Nebraska, Oregon, Texas and beyond.  Expanding our FUSE supportive housing model, which has demonstrated positive human and cost outcomes in several ongoing evalations, will help promote systems change in the criminal justice and emergency response systems.

Financing Supportive Housing with Tax-Exempt Bonds and 4% Low-Income Housing Tax Credits

October 2007

Tax-exempt bonds partnered with 4% Low-income Housing Tax Credits have been widely used by affordable housing developers.  It has taken longer for this financing structure to be used by permanent supportive housing developers since most assume their projects cannot support debt service on the bonds.  In recent years, a number of states have devised strategies to address the debt service issue and non-profit sponsors of supportive housing have become increasingly sophisticated in the use of these financing tools.  This approach can expand the funding sources available for supportive housing, especially in those states and localities lacking dedicated capital programs for supportive housing and where competition for every affordable housing dollar is intense.  This report is intended to introduce this technique to local and state officials considering bond financing, presenting several case studies and answering some of the most commonly asked questions.

Protect a Vital Housing Finance Tool

The Low Income Housing Tax Credit is the single largest source of capital for the development of supportive housing nationally.  CSH is a member of the A.C.T.I.O.N. Campaign and has been working with our partners to ensure this credit is protected and to improve it whenever possible.

In addition to protecting the Housing Credit during tax reform and deficit reduction conversations, the Campaign is also working to ensure the Credit is fully utilized and that the marketplace operates in a stable environment.  In December, Senators Maria Cantwell (D-WA) and Olympia Snowe (R-ME) along with Congressmen Pat Tiberi (R-OH) and Richard Neal (D-MA) introduced legislation (S. 1989 in the Senate, and H.R. 3661 in the House) to set a minimum credit rate of 9 percent for new construction and substantial rehabilitation projects, and 4 percent for acquisition projects.  This legislation will help secure the private investment equity needed to make supportive housing and other affordable rental housing developments financially feasible.  We need your help to ensure this legislation is passed.

Call your Senators and Congressmen, particularly if they are members of the Senate Finance Committee or the House Ways & Means Committee and urge them to cosponsor S. 1989 or H.R. 3661.  More information on this legislation is available here.

Exceeding Our Goal: 150,000 Units in Ten Years!

Ten years ago, CSH dedicated itself toward an ambitious goal: to help communities create 150,000 units of supportive housing in the next decade. As we kick-off 2012, we are incredibly proud to report that we have reached this goal. Thanks to our work with communities across the country, there are over 154,000 new units of supportive housing operational or in development.

In 2002, CSH brought together a cross-section of supportive housing providers, advocates and public officials from around the country, to build on the momentum that was growing nationally to end—not just manage—homelessness. This group of leaders convened in Columbus, Ohio, to discuss promising approaches in ending homelessness, building political will and attracting investment opportunities, and to develop a plan to bring supportive housing across the nation.

The result was the Compact to End Long-term Homelessness. Among other goals, the Compact called for “a focused, committed national initiative to end long-term homelessness over the coming decade by creating 150,000 units of permanent supportive housing targeted to families and individuals who are homeless for the long-term and by preventing more people from joining their ranks.”

CSH never lost sight of that commitment, and we’ve worked tirelessly in cooperation with our allies and partners to fulfill this important goal of the Compact. This joint success has a direct correlation to the dramatic drop in chronic homelessness.

Our calculations include units created through Federal policies that the entire industry fought hard to have created, passed and sustained, as well as those CSH directly helped create through lending, community work, technical assistance and the like.

At CSH, we’re now looking to the future and setting a course for supportive housing over the next several years. We began this exploration at the end of 2011 with panel discussions and an interview series featuring some of the industry’s most notable leaders. And we’re working now on our 3rd annual State of the Supportive Housing Industry Survey, which will help further inform where to from here. We’re also holding our Supportive Housing Leadership Forum this spring to cultivate even more ideas around the future of the field.

To be sure, CSH will continue to spark innovations that work hard for the supportive housing industry and the most vulnerable men, women and families across the country.

Ending Homelessness Among Older Adults and Seniors Through Supportive Housing

CSH and HEARTH, INC -  Policy Paper

This paper was created for the National Leadership Initiative to End Elder Homelessness.  It was largely informed by a national convening held in Alexandria, VA in the fall of 2011.  In this paper you will find:

  • Specific federal and state, and local policy recommendations necessary to increase development of high quality supportive housing
  • Information to help you host a convening of your own bringing together local housing and services entities to target resources to older adults and seniors experiencing homelessness
  • The essential elements of supportive housing as a model and what is needed to help older adults and seniors maintain housing

The New csh.org

If you're reading this, you probably know that CSH has a new website! We previewed the site before the holidays and now we’re excited to tell you all about what you can expect from csh.org.

The new site is designed to help our users take full advantage of all the supportive housing information, tools and industry insight that CSH has to offer.

  • Great New Look! The first thing you’ll notice is that the site has an updated look. We’re telling the story of supportive housing with a fresh new design that uses vivid photography and video stories to enhance your experience and help you navigate with ease.
  • Easy-to-Search Resources: You’ve always trusted CSH for research-based, evidence-backed tools, case studies, reports and templates to make it easier for you to develop, operate and run quality supportive housing. Now you can search our library of resources to find all those same materials and more! Fueled by the latest research and supportive housing best practices, everything we provide will help you prevent and end homelessness in your community.
  • Local Featured Pages: CSH makes a difference throughout the country with our work in the field. The new site includes special pages that feature our work in key areas across the U.S., so you can always find out what’s happening near you.
  • The Pipeline Blog: CSH’s new blog is your destination for all the latest news from CSH. In fact, you're reading it right now! From event announcements and publications releases to project openings and groundbreakings to grant announcements and job opportunities, The Pipeline covers it all.

 

It’s easy to get started at csh.org. Our homepage features links for answers to the top questions our web users ask us. Or, click on Getting Started in the navigation bar to find our most-useful links depending on your role in the industry. Still not sure how to find what you need? Every page of the site includes a search in the header—just type in your topic and go!

Bookmark the site, visit often, like us on Facebook and follow us on Twitter for even more from CSH!

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CSH Receives Grant from Starbucks and Opportunity Finance Network’s “Create Jobs for USA” Program

CSH is one of just 28 community development financial institutions (CDFIs) in the nation to win a grant in the inaugural funding round of the Create Jobs for USA Fund.

Starbucks and Opportunity Finance Network have joined forces to help create and sustain jobs in communities across the country with this bold initiative to spark new financing to community businesses so they can hire and preserve jobs.

The grant was made possible by a $5 million seed contribution from the Starbucks Foundation. The Fund expects to raise tens of millions of dollars more, according to a spokesman, and 100% of these donations will go to CDFIs to finance under-served community businesses, and help create and sustain jobs in under-served communities.

The Create Jobs for USA Fund is collecting donations at www.CreateJobsforUSA.org and at nearly 7,000 company-operated Starbucks across the country. One hundred percent of the donations will support organizations like CSH, by lending for job creation and retention across the U.S. CDFIs that are Members of Opportunity Finance Network (OFN) will compete for these funds on a rolling basis.

“Create Jobs for USA is making it possible for Americans who have $5 to share help people who don’t have $5 to spare by creating and retaining jobs in their communities,” explained Mark Pinsky, President and CEO of OFN. “CSH received this grant because it has demonstrated that it will provide financing that is good for community businesses and good for communities.”

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