CASAColumbia Releases Final CASAHOPE Paper on NY/NYIII

January 28, 2014
Originally published on CASAHOPE's website.
PAPER OVERVIEW

Today CASAColumbia® has released the fourth and final project paper from CASAHOPESM (Housing Opportunities Program Evaluation). Public Service Use and Costs Associated with NY/NY III’s Supportive Housing for Active Substance Userspresents findings from CASAHOPE’s service utilization and cost analysis of New York/New York (NY/NY) III’s Housing First for chronically homeless individuals whose substance use is a primary barrier to housing. The NY/NY III agreement is an agreement between New York State and New York City to provide over 9,000 units of supportive housing between 2005 and 2015.

Using administrative data for both those who received housing and a comparison group of similar individuals who were eligible for housing but were not placed due to availability of units, CASAColumbia scientists in the treatment research and analysis division examined service use and associated costs across multiple publicly-funded systems.

STUDY FINDINGS

The study found that NY/NY III supportive housing for chronically homeless individuals whose substance use is a primary barrier to housing was successful in reducing tenant use of shelters, jail and medical services. Reductions in crisis service use were associated with considerable cost savings for tenants in the year after being housed, such that savings were approximately the same as the cost of the housing program.

To learn more about CASAHOPE and this paper’s findings please click here.

Chronic Homelessness in San Diego

Housing Authorities across the country are partnering to lead efforts to end homelessness. The San Diego Housing Commission (SDHC) recently issued a Request for Proposals for 150 sponsor-based vouchers for homeless and chronically homeless individuals in downtown San Diego.  The latest commitment of vouchers is part of the SDHC’s commitment to addressing homelessness in San Diego.

Last year, SDHC committed vouchers to Home Again's “Project 25” program, and their commitment was matched with additional resources from the County of San Diego Health and Human Service Agency along with the United Way of San Diego.  This enabled the launch of Project 25 as San Diego's first frequent user initiative which provides services and housing to at least 25 of San Diego’s chronically homeless individuals who are among the most frequent users of public resources.  One year into the program, results from the combination of long-term housing and supportive services are dramatic: total cost of public resources for project participants fell to $3.4 million in 2011 from more than $11 million in 2010; per person average was $97,437 in 2011, down from $317,904 in 2010; emergency room visits were down 77%; ambulance transports were down 72%, in-patient medical stays were down 73%, arrests were down 69% and jail days were down 43%.

I Love Living Here - From a Tenant's Point of View

"I can tell you exactly how much I love living here. First, let me ask you what your favorite food is,” Durrell inquired as we sat in a lounge at the Crawford Apartments in Bloomington, IN. “I sincerely enjoy lasagna,” I responded. “Exactly ─ living here is like eating the best piece of lasagna. I just love it,” he reported before taking me on a tour of the building that ended with showing me his own apartment.

Crawford Apartments is a 25 unit supportive housing apartment building that opened in September of 2013. Named after Mr. Frank “Road Dog” Crawford, a gentleman who passed away while experiencing homelessness in Bloomington, the development targets people who have faced chronic homelessness and multiple barriers. Among other things, LifeDesigns, the Shalom Center, Hayes-Gibson International Property Management, and their partners see this as a strong step toward never allowing another person to die on these streets.

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Durrell was proud to show me a number of building highlights, but none more than the blanket on his bed. He disclosed that he used to curl up under it while sleeping on the sidewalk near the old court house. It remains important to him as a symbol of how far he has come.

While serving a brief prison sentence for violating his probation, Durrell learned about and followed the progress of Crawford Apartments through the newspaper. While he had cycled through jail for drinking in public, Durrell had never been to prison before. The idea of potentially living in such a beautiful apartment building with support services helped him to feel hopeful while there. After his release, an outreach worker asked if she could help him move into Crawford Apartments as he qualified for this housing opportunity. He was delighted to say yes.

On the table in his family room he displayed a poster of the Indiana University Basketball team with several autographs. A few of the players came by to play basketball with the residents recently and Durrell was eager to tell the story of scrimmaging with these athletes.

While discussing his neighbors, Durrell commented that he was unsure as to why some of them still slept outside behind the dumpster. He went on to say that he was very happy to be able to sleep inside in his own home.

Later during my visit, I met one of the gentleman Durrell had described. He explained that he kept his things nice and dry inside, and came in if it was cold or if he felt like it, but that he has spent many nights sleeping under the stars since moving in two months ago. He went on to say that he loved having a home and knowing he could come inside at anytime, though he has been sleeping outside for years and it may take a little while to fully adjust to sleeping inside.  The staff members offering support at Crawford Apartments champion his right to transition into living in his home at his own pace. After all, their harm reduction approach ensures that tenants are able to move in the direction of change as they feel comfortable doing so.

305_Durrell_13When asked if he would be willing to take a photo, Durrell said that he would be glad to do so and that it should include his brand new crock-pot, as he loves to cook. So he graciously posed in his kitchen as I imagined what it must be like to live in a place that is just as amazing as the best piece of lasagna ever made. It sounds like an ideal place to call home.

 

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Sisters of Charity Foundation Recognized by HUD

CSH joins Enterprise Community Partners in congratulating Sisters of Charity Foundation of Cleveland for their well-deserved recognition by HUD. The Cleveland and Cuyahoga County community has seen a drop in chronic homelessness and the tenants in the beautiful Housing First supportive housing projects are experiencing great success with housing stability. Bravo Sisters of Charity Foundation and Leslie Strnisha, Senior Program Manager on the project! Click here to read more about Sisters of Charity and their award.

2014 Indiana Permanent Supportive Housing Institute Application

CSH is excited to announce its fifth Indiana Permanent Supportive Housing Institute. The 2014 Supportive Housing Institute will exclusively address ending homelessness for Veterans, families, and those experiencing chronic homelessness. This series will help non-profits learn how to navigate the complex process of developing housing with support services and is expected to reduce the time it takes to obtain funding for homeless housing by improving the planning and application process. Consideration will be given to both integrated housing (with 25% of the housing set aside for supportive housing) and 100% supportive housing developments. Please review the application by clicking on this resource.

The 10th Decile Project: Impressive Early Outcomes in Los Angeles

Popeye has been a fixture in Pasadena on the freeway off-ramp for the past 15 years. Popeye, 53, suffers from chronic health issues, mental health issues, and severe alcoholism, all of which has landed him in the hospital consistently. Today, Popeye lives in his own apartment, has quit panhandling and gets regular visits from Housing Works (a homeless service provider) to help him shop, cook, and keep clinic appointments. This month, Popeye celebrates his nine-month anniversary in his new apartment.


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SE and SIF 10th Decile Projects

In April 2011, with funding from the Conrad N. Hilton Foundation and the UniHealth Foundation, CSH launched the Frequent Users Systems Engagement (FUSE) pilot to connect hospitals to homeless service providers and community health centers to target and permanently house the highest-cost, highest need individuals in supportive housing—and surround them with supportive medical and mental health homes.

In mid-2012, funding from the Social Innovation Fund (SIF) of the Corporation for National and Community Service (CNCS) allowed CSH to expand the FUSE pilot through a SIF 5-year initiative, to reach more communities and many more chronically homeless frequent users.

To date, we have enrolled 170 frequent users in the top 10% of hospital high utilizers in the county from fifteen partner hospitals in nine Los Angeles communities. Each participant has been enrolled with our network of nine experienced community-based homeless service and six healthcare providers.

Evaluation Shows Substantial Public Cost Reductions

The Economic Roundtable’s recently released evaluation of FUSE and SIF, Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients , shows that there is a strong return on investment in this program.

  • For the first 89 participants enrolled, the average 12-month public cost avoidance totaled $47,977 per person.
  • Every $1 dollar in local funds spent to house and support 10th decile hospital patients is estimated to reduce public and hospital costs for those who are housed by $2 in the first year and $6 in subsequent years.

The full evaluation report looks in-depth at participant demographics and health, as well as implementation questions around enrollment and attrition. Finally the evaluation makes recommendations for how to refine and ultimately scale up the 10th Decile Project.

A Win-Win: Healthcare + Housing Navigation

Chronically homeless frequent users come to hospitals because they are the only places that do not turn them away when they were in need. The Triage Tool allows hospitals to quickly recognize which patients are most costly and most in need of supportive housing.

Homeless services providers then work to break that cycle, by partnering with community health centers and mental health providers to move frequent users into permanent supportive housing, and establish individualized health homes. Through this system, they receive not only an apartment, but consistent medical care, social services, and other resources that comprehensively address their issues and help them get back on their feet.

Through programs linking health care and housing, Popeye and others can move forward from chaos, chronic homelessness, and chronic physical or behavioral illness, and find their way to a better future.

Bringing the project to scale so that there is a discernible reduction in the number of unhoused 10th deciles will make a striking reduction in the number of chronically homeless patients seen in hospitals, and avoided costs will become tangible savings for hospitals.

For more information, contact Susan Lee, CSH, susan.lee@csh.org

Targeting Health High Utilizers in Arizona and Michigan

CSH's  six-year frequent user pilot in California demonstrated that homeless clients who were connected to permanent housing experienced deeper reductions in ER and inpatient hospital stays than those not in supportive housing.  Since that initial pilot, we have expanded our FUSE work to other cities and counties across the country to connect individuals with supportive housing and health care in an effort to reduce overall hospital and emergency services costs. Maricopa County and Detroit are two examples of our FUSE work around health high utilizers.

In Maricopa County, Arizona, the Frequent Users Systems Engagement (FUSE) initiative is targeting 15 chronically homeless individuals who are the most frequent and costly utilizers of St. Joseph Hospital and Medical Center Emergency Room and county shelters. CSH assisted with the program development and will be conducting an evaluation of the program, which began housing people identified through a data match between St. Joseph’s and the county HMIS system in 2013. Clients are engaged in the hospital, respite care, or shelter setting by a Care Coordinator who coordinates service delivery between the hospital, mental health provider, and community health center.  The goal of the Maricopa FUSE pilot is to create a programmatic model that links the target population to supportive housing and to develop a sustainable financing model and mechanism to fund hospital in-reach, housing and service provision for this population, all while reducing the costly and unnecessary utilization of hospitals and homeless shelters.

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In Detroit, Neighborhood Service Organization (NSO), along with other local partners including hospitals, community mental health and homeless service providers are seeking to meet the needs of frequent users of hospital systems who are homeless.  Together, CSH and NSO have designed a 100-person FUSE Initiative.  With CSH and foundation support, this initiative intends to demonstrate the effectiveness of supportive housing and integrated care in reducing health care costs and improving outcomes. Participants are identified and recruited at area hospitals and randomly assigned to receive enhanced services and housing or to receive “services as usual”.  Utilization for the two groups will be tracked for two years to determine the effect of the FUSE intervention on utilization, cost and outcomes.  The rigorous research element of this initiative will demonstrate the efficacy of supportive housing with enhanced service coordination.  The FUSE service model provides subsidized housing and services provided by a Social Worker, Registered Nurse and Peer Support Specialist using Critical Time Intervention (CTI).  The focus of treatment will be to stabilize any health conditions, coordinate outpatient care and ensure housing stability.  The Detroit FUSE project began recruitment in May 2013 and to date has 8 enrollees.

Read more on our work in Maricopa County, AZ.

Read more on our work in Detroit.

 

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Acacia Network’s Mosholu Gardens Opens in the Bronx!

On Thursday, September 12, CSH joined Acacia Network in a ribbon cutting ceremony celebrating the construction completion and grand opening of its beautiful Mosholu Gardens development in the Norwood section of Bronx, NY. The $15M development will provide 64 units of affordable housing with 39 apartments set aside for individuals with mental illness who will be supported by services funded through the NYC Department of Health and Mental Hygiene (DOHMH). In addition, all residents will have access to Acacia’s extensive network of healthcare, housing, educational and social services. Special preference will be given to Veterans who apply.

CSH is proud to partner with Acacia Network, providing them with $1,382,000 in critical early-stage financing to help the organization acquire the site and pay for predevelopment costs such as architectural, engineering and environmental fees.  CSH provided this loan as an originator of the New York City Acquisition Fund.

Read the press release from the New York City Department of Housing Preservation and Development (HPD) here.

Read more about Acacia Network here.

Read more about CSH’s partnership with the New York City Acquisition Fund here.

Read more about CSH’s loan products here.

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Crawford Apartments Open in Bloomington, Indiana

A new construction 25 unit supportive housing development called Crawford Apartments opened in Bloomington, IN on September 6th to a full house of new tenants, neighbors, and champions. Mayor Mark Kruzan welcomed the community to the grand opening of this development serving people who have faced chronic homelessness. All tenants were selected by using a vulnerability index to ensure that those with the greatest needs were screened into housing. Please click here to view additional pictures of Crawford Apartments and the Ribbon Cutting event for this development.

Crawford Apartments was named in honor of Mr. Franklin "Road Dog" Crawford. Those who knew Frank enjoyed his sense of humor and lively spirit. Cycling between the local hospital and streets, Frank suffered from many ailments and would have been an ideal tenant for this apartment complex. It was only discovered that Frank had passed away when a neighbor found his body in a dumpster. He had literately been thrown away. A group of providers joined together with a mission to never allow this to happen to anyone else in South Central IN by developing supportive housing for vulnerable individuals who have been on the streets for a very long time.

This team is led by LifeDesigns (developer) and the Shalom Center (supportive service provider) and includes Milestone Ventures (development consultant), Hayes Gibson International (property manager), Bloomington Housing Authority, IU Hospital, Positive Link, Kurt Buehler, a member of Genesis Church and community leader with a passion for serving those with the greatest barriers. This group completed the Indiana Permanent Supportive Housing Institute in 2011 and received a Pre-development Initiation Loan from CSH.

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Having developed quality affordable housing over the past six years, LifeDesigns opted to lend their experience to this worthwhile project. Executive Director, Susan Rinne, stated that "over the course of our involvement in the Supportive Housing Institute and planning for the project we became aware of the efficacy of this model and the high level of need in our community. We were pleased to be able to be part of the solution and this wonderful team of agencies and individuals working toward ending homelessness here in south central Indiana." She went on to say that "the Apartments will provide safe, affordable housing to a very vulnerable group of people. And when they have that along with greater access to services, we know will save our community money that can be redirected to other needs. A win, win that will ultimately improve the whole community."

Rodney Stockment, Indiana Housing Community Development Authority Research and Innovation Senior Associate had this to say: "Crawford Apartments is leading the way in developing a “Housing First” supportive housing development. Housing First represents a significant paradigm shift in addressing the costly phenomenon of homelessness. This strategy demonstrates impressive outcomes when people are supported in a permanent, housed environment, rather than targeted for intensive services in shelters or streets. Crawford Apartments will have a huge impact on individuals with long histories of homelessness by providing them with stable housing and access to services. Crawford Apartments happened because of the passion and courage the team has to provide the most vulnerable among us housing and dignity."

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CSH is proud to have been part of this journey and we look forward to staying involved as Crawford Apartments transitions from a development project to an operating supportive housing development that shines as an example of what can be done when a community believes that they can do better for those who are the most vulnerable. We believe that Mr. Crawford would have approved.

CSH Volunteer Opportunity in LA

CSH, in collaboration with Skid Row Housing Trust, A Community of Friends, and Housing Works, is launching a new supportive housing resident initiative in Los Angeles, the Supportive Housing Community Advocates Project. The goal of the Community Advocates Project is to provide a united and coordinated effort to train supportive housing residents to educate the general public, inform funders and policy makers on the solutions to homelessness and the impact of supportive housing. Using their own experiences, Advocates will address myths and stereotypes held by the general public regarding homelessness, the causes of homelessness and solutions.  The Community Advocates Project seeks to provide supportive housing residents with the knowledge and skills to use their personal stories to influence the political environment and public opinion.  Advocates will be trained to provide information about homelessness and the impact of supportive housing.

Volunteer coaches are needed to assist in training residents. Coaches should be interested in the issues around homelessness; compassionate and patient individuals with experience in public speaking, acting, editing, storytelling or spoken word. Coaches should also be able to donate between ten and fifteen hours per month, able to work with 3 to 5 residents, commit to one year of service (September 2013 – August 2014) and attend monthly training sessions.

Please click here to view the complete Volunteer Coach Opportunity

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