Stable Homes, Brighter Futures: 2nd Year Evaluation Report

CSH is pleased to share the 2nd year report of our Stable Homes, Brighter Futures initiative, a three-year demonstration project to better understand supportive housing for youth and young adults, ages 18-24, also known as transition age youth (TAY).  With support from the Conrad N. Hilton Foundation, the W.M. Keck Foundation, and The California Wellness Foundation, the Stable Homes, Brighter Futures initiative contributes to broader systems-level efforts to:

  • Increase the capacity of organizations in Los Angeles County to develop and operate high-quality supportive housing for transition age youth in areas of high need.
  • Create a safety net of housing and services for TAY that includes health, mental health, education, and employment.
  • Collaborate with government agencies and partner organizations to secure adequate and coordinated public funding mechanisms.

While the first-year report provided a level of initial baseline data and immediate impacts of supportive housing, this second-year report provides a more comprehensive understanding of the service needs of TAY in supportive housing, factors associated with their level of risk of long-term homelessness, the longer-term impacts of living in supportive housing, and a descriptive look at TAY who exited supportive housing.

It’s clear that supportive housing providers are serving young people who face significant barriers to accessing and retaining housing:

  • More than half of the youth were literally homeless prior to living in supportive housing, and 40% of those youth were homeless for over one year.
  • About 70% of youth in supportive housing report mental health challenges that interfere with their daily living and ability to live independently.
  • 18% of youth in supportive housing self-reported substance abuse challenges.
  • supportive housing providers are serving young adults who have incomes significantly below the poverty threshold and have lower levels of educational attainment compared to the general youth population.

This report also explores the impact of supportive housing from the perspective of preventing adult chronic homelessness.  Through the utilization of the TAY Triage Tool, a predictive tool that identifies a young person’s risk of experiencing five or more years of homelessness, the report provides a snapshot of how many youth and young adults in supportive housing were on a trajectory to becoming chronically homeless adults.

  • 72% of youth in supportive housing had at least one lifetime experience that doubled their risk of experiencing 5 or more years of homelessness.
  • 10% of youth tenants were at a high risk of experiencing long-term homelessness, as indicated by the endorsement of 4 or more experiences itemized on the TAY Triage Tool.
  • Youth who reported mental health challenges were at a high risk.
  • Youth who experienced the foster care and juvenile justice systems were at a high risk.

The report offers recommendations that not only reflect data findings, but also reflect discussions with providers learned through our TAY Learning Community, and the voices of TAY tenants.

“They try to get us out of survival mode and do little events to learn how to deal with life… learn how to be around other people besides ourselves.” – Youth Tenant, Age 21

Overall, this second year report presents quantitative and qualitative data that inform how the supportive housing model has evolved to serve homeless youth and young adults, and how it can further adapt to improve the operation of, and service delivery in, supportive housing for youth and young adults.

To download the full report, click here.

A New Atmosphere in San Diego

It was a proud day for Wakeland Housing and San Diego yesterday as the community came together to break ground for the Atmosphere, a new construction affordable housing community located in an infrastructure-rich area of the downtown. The 205 affordable housing residences (studios, one-, two- and three-bedroom units) will be a model for integrating residents and includes 51 apartments set aside as supportive housing for those with special needs.

CSH was instrumental in making this project happen with predevelopment and construction loans, and the technical assistance provided by our San Diego office.

Slated for completion in 2017, this urban infill will revitalize a vacant partial city block with a vibrant new housing community to meet the strong need for affordable family housing while also providing homes for special needs individuals. The apartments are for individuals and families earning up to 60% of the area median income (AMI), with some units restricted to 30% AMI and below.

Residents at the Atmosphere will have access to Wakeland’s comprehensive Resident Services programming plus an array of on-site and off-site supportive services focused on special needs.

Stable Homes, Brighter Futures Evaluation Report – Year 2 Interim Report

As part of a broader effort to address the unique needs of highly vulnerable homeless TAY and build supportive housing capacity in diverse regions of Los Angeles County, CSH launched Stable Homes, Brighter Futures, a three year demonstration project supported by the Conrad N. Hilton Foundation, the W. M. Keck Foundation, and the California Wellness Foundation.

This interim report focuses on the first two years of the initiative and describes the young adults served and their experiences in supportive housing. This report provides a better understanding of the housing needs of TAY, factors associated with their level of risk of long-term homelessness, the impact of living in supportive housing, and a descriptive look at TAY who exited supportive housing.

Willow Housing Shovels in Ground

CSH is a proud supporter of the new Willow Housing Apartment Project located on the grounds of the Veterans Affairs (VA) healthcare complex in Menlo Park, California. CSH Senior Loan Officer Toby Lieberman recently attended the ground-breaking ceremony and was recognized for our pre-development loan of $500,000 and technical assistance. The residence will provide affordable, high-quality supportive housing for homeless and at-risk veterans, obviously in close proximity to a wide array of VA health services. In-house supportive services also are included in the plans and will promote wellness, vocational training, self-sufficiency and self-determination.

A key priority in the design of the site is to coordinate with the surrounding development patterns and the design standards of the community, as well as the existing VA hospital’s historic facades. The attractive site design preserves mature heritage oak trees and includes serene outdoor recreation space for residents. The land is made available through the VA’s BURR Initiative, which contributes underutilized land and buildings toward the goal of ending veteran homelessness.

In addition to CSH, other financial partners include the City of Menlo Park, County of San Mateo, VA, and the California Tax Credit Allocation Committee’s Federal, State LIHTC programs, LISC, Silicon Valley Bank and National Equity Fund.WillowGrove_CA_GroundBreaking_Vets

 

Willow Housing FAQs

Owner: Willow Housing, LP
Sponsor: CORE Affordable Housing
Investor Limited Partner: National Equity Fund, Inc.
Address: 605 Willow Road, Menlo Park, CA
Number of Units: 60 units
Construction Start:  December 2014
Property Management: EAH, Inc.
Architect: VTBS Architects
General Contractor: Core Builders
Square Footage: Approximately 44,300 sf

Hilton Foundation Announces Continued Partnership with CSH

hilton_logo

After helping create 4,000 housing units over the last ten years, a $12 million investment from the Hilton Foundation will spur innovative investments in supportive housing

speak_up_graduation

Supportive Housing Community Advocates from Los Angeles celebrate at their graduation ceremony

The Conrad N. Hilton Foundation announced today that after ten years of collaboration they are deepening their partnership with CSH in order to accomplish even more. With a total $12 million investment, half in grant form and half as a loan, the Hilton Foundation and CSH will ramp up efforts to increase the supply of supportive housing throughout Los Angeles County, California, helping thousands of long-term, chronically homeless individuals to build new lives with a strategy proven to be effective. Read the full announcement here.

Read more about our long standing partnership with the Hilton Foundation.

 

Enhanced Supportive Housing as an Alternative to Skilled Nursing Facility Care- Guest blog by Joshua Bamberger

Joshua Bamberger, MD, MPH,  is the Associate Clinical Professor Family and Community Medicine, UCSF and Chief Medical Consultant for Mercy Housing

In San Francisco, the Department of Public Health has invested heavily in permanent supportive housing using local government funds.  The Direct Access to Housing program of SF DPH opened its first master leased, renovated single room occupancy hotel in January 1999 providing permanent supportive housing for 86 formerly homeless adults.  Since then there has been a rapid expansion of housing with approximately 150 new units being developed annually resulting in 1700 units of housing for homeless adults with a majority of units in new construction apartment buildings designed specifically to serve adults with a history of mental illness, substance use and chronic medical problems.  With the expansion of access to health insurance in the majority of states in the United States following the roll-out of the Affordable Care Act, there is increased interest in evaluating the DAH program to assess if supportive housing can help to achieve CMS’s Triple Aim (reduced cost, improved measurable outcomes, improved patient experience).  In collaboration with CSH, Tenderloin Neighborhood Development Corporation and the NYU School of Public Health, the SF DPH is evaluating a random assignment trial of permanent supportive housing targeting chronically homeless adults.  Now in its second year, we continue to collect data with the hope of reporting preliminary outcomes in the next 12 months.  Outcomes to be measured include housing stability, mortality, tenant satisfaction and change in healthcare status and cost.

Permanent supportive housing has also been proposed as a cost effective alternative to long-term care in a skilled nursing facility (SNF).  Enhanced supportive housing that includes high quality architecture, on-site nursing and/or adult day health care and robust case management can provide a clinically appropriate alternative for some formerly homeless seniors at a fraction of the cost.  However, the health reimbursement system in the US has been hesitant to invest in permanent supportive housing as an alternative to SNF care in part because of the restrictions on how Medicaid funds can be used and because the long term return on investment has rarely  been reported.  This is despite the fact that interpretation of the American for Disabilities Act in the Olmstead decision requires that governments offer the least restrictive housing environment for all people with disabilities.  In a recent manuscript published by the San Francisco Federal Reserve Bank[1], we report on the healthcare utilization for a group of 51 formerly homeless seniors (over the age of 61) placed at a Mercy Housing’s Mission Creek Apartment.  Mission Creek is located adjacent to San Francisco’s professional baseball stadium overlooking San Francisco Bay.  In addition to providing permanent supportive housing for 51 formerly homeless seniors, it provides housing for 77 low income seniors with rental support from HUD’s Housing Choice program (formerly Section 8) and 11 units for seniors living with HIV through HUD’s funded from the HOPWA program.    In this study, we report on the housing stability and healthcare utilization for the 51 formerly homeless seniors over the past seven years since Mission Creek opened its doors in 2006.

Homeless seniors placed in Mission Creek had a dramatic reduction in hospital and SNF costs after placement.  In fact, the total cost for hospital and SNF care among these 51 seniors in the seven years since opening the facility was less than the hospital and SNF costs in just the one year prior to entering the housing.   An estimated 16,433 days of SNF care was avoided by placing the 12 seniors who moved directly from a SNF into enhanced supportive housing at Mission Creek.  The estimated cost avoided by having these 12 formerly homeless adults exit the SNF was greater than the total cost of on-site services, rental subsidy and hospital based care for all 51 seniors placed in the facility over the past 7 years.

This small study adds to the ever expanding body of work that documents the economic value of placing long-term, frail homeless adults into permanent supportive housing.  Local healthcare systems that are finding ways to use healthcare dollars to guarantee access to and continue support of on-going costs of enhanced permanent supportive housing will be able to provide a cost effective treatment for the conditions that often bring seniors to homelessness in the first place and be able to do so at considerable less expense than paying for a skilled nursing facility.  Achieving the two most scrutinized components of the triple aims (reducing cost and improving outcomes) is a great accomplishment but achieving the last component of the triple aims- improving patient experience- is why many of us have committed our careers to serving chronically homeless adults.  As one man placed from San Francisco’s Healthcare for the Homeless clinic reported when he moved into Mission Creek, “I try to play the lottery every week but I never win.  Now that I live in Mission Creek, I am finally a big winner.”

The fear that healthcare dollars will be used to solve all societies’ social ills is a reasonable concern.  However, framing housing as a medical treatment for a narrow, targeted subset of the population who are living with chronic medical and psychiatric conditions can help to assuage these fears.  As the homeless population ages, the need to provide less expensive alternatives to skilled nursing facilities will only continue to grow.  Enhanced, permanent supportive housing can meet that need and, if used judiciously, can contain healthcare costs and the size of government.  Mission Creek Apartments in one example that hopefully will entice large healthcare delivery agencies such as United Healthcare, Aetna and Kaiser to come to the table to pay for access to and services in housing to assure cost containment and improved quality of care for their members.



[1] http://www.frbsf.org/community-development/publications/working-papers/2014/july/long-term-cost-effectiveness-homeless-seniors-permanent-supportive-housing/

Exciting opportunity to expand housing opportunities in the South Los Angeles region for Transition Age Youth

Planting Seeds for Transformation: Exciting opportunity to expand housing opportunities in the South Los Angeles region for Transition Age Youth (TAY)!

Applications now available online and are due Thursday, July 31, 2014. 

Delivered in partnership by CSH and Communities in Motion, Planting Seeds for Transformation is a specialized housing institute focused on expanding the array of housing solutions in South Los Angeles.  The goal is to increase the capacity of South Los Angeles Transition Age Youth (TAY) housing providers to cultivate sustainable housing solutions that are tailored to meet the diverse needs of youth and young adults in South Los Angeles.   Planting Seeds for Transformation will involve a selection of providers who operate Independent Living programs and/or Transitional Housing/Living programs that currently serve TAY, ages 18-25.  Once selected, providers will be assisted in identifying and developing a housing plan through a tailored institute that will increase their leadership and technical capacity to develop and operate an array of high-quality housing solutions for TAY in South LA. 

Planting Seeds for Transformation will select 4-8 agencies in South Los Angeles that currently provide independent living and/or transitional housing programs.  Download the Full Application below to view eligibility requirements.  The housing institute will take place from August 25, 2014 to December 11, 2014.  Selected agencies will participate in the following components of the institute:

  • A housing assessment conducted by CSH to evaluate the agency’s current housing capacity and potential readiness for conversion and/or expansion to rapid-re-housing and supportive housing.
  • Identification of a Housing Project based on the results of the housing assessment that will strengthen and/or expand the agency’s capacity to provide targeted housing for TAY.
  • Technical assistance tailored to support the housing project selected by the agency.
  • A monthly Learning Community for interactive training sessions involving all selected agencies, promoting peer learning and increasing TAY housing knowledge.
  • Creation of a Housing Project Plan that will position the agency for potential expansion and funding for TAY housing.
  • Presentation of Housing Project Plan to a panel of experts, developers, and funders to provide an opportunity for feedback on the project.


Deadline:  To apply, download and complete the application below and submit by Thursday, July 31, 2014. 

                                                                                                                                                Application Instructions and Submission: 

  • UPDATED Full Application
  • UPDATED Application Form to Download and Submit
  • FAQs 
  • Announcement Flyer 
  • Applications will only be accepted via email.
  • Many of the questions are open-ended and have word limits that must be met.  Information that exceeds the word limits will not be considered in the application.
  • Complete application and required attachments (listed under ‘Part IV’ of the application) must be emailed to gweltman@communities-motion.com with the subject line:  “<Agency Name>__PST Completed Application”. 

Questions:  Please contact Grace Weltman at (424) 254-8604 or via email at gweltman@communities-motion.com.  FAQs will be posted online after the information session scheduled for June 20, 2014.

 

TIMELINE

June 10, 2014 Application Release
June 20, 2014 Information Session
July 31, 2014 Applications Due
August 15, 2014 Announcement of Accepted Institute Participants

 

Come to the information session scheduled for June 20, 2014.  The information session is an opportunity to hear more about the Planting Seeds for Transformation housing institute, walk through the application process, and address questions you may have.  Participation in the information session is highly recommended, but not required to apply.  FAQs will be posted on the CSH and Communities-Motion websites after the information session.

Planting Seeds for Transformation Information Session
Friday, June 20, 2014, 1:00 pm to 3:00 pm

CSH
800 S. Figueroa Street, Suite 810
Los Angeles, CA 90017

CSH is unable to validate parking.  However, CSH  is located one block from the 7th street Metro Station (on 7th Street between Figueroa and Flower Street), and a number of buses stop in front of the office. There are also parking structures and surface lots in the immediate vicinity.

Supportive Housing Symposium in Los Angeles Focuses on Transition Age Youth

On April 7, 2014, over 50 supportive housing providers, public agencies, advocacy and philanthropic organizations came together to hear the year-one results of CSH’s Stable Homes, Brighter Futures initiative, a three-year evaluation of the supportive housing model for transition age youth (TAY).

Molly Rysman, CSH Los Angeles Director, and Maria Joyce, SVP at Bank of America Community Development Banking, provided welcoming remarks that focused on supportive housing as an intervention to prevent vulnerable youth and young adults from becoming chronically homeless adults.  Supportive housing has been shown to be an effective intervention for chronically homeless adults, and we know that many chronically homeless adults were homeless as transition age youth.

TAY_Symposium_GroupSymposium attendees participated in activities aimed to experience the data and lessons learned so far through the evaluation.  Harder+Company Community Research presented tenant- as well as organizational- and system-level data.  The average age of youth at entry was 22, indicating that the majority of youth in supportive housing are past the age of eligibility in the child welfare system and the resources available.  The data shows that 40% of youth reported being current or former foster youth, so the majority of youth did not even have access to resources and services targeting child welfare-involved youth.  Over 50% of youth were literally homeless prior to entering supportive housing, 34% were in transitional housing programs prior to supportive housing, and 11% were couch-surfing.  A little over 70% of youth reported mental health challenges.  Interestingly, data collected so far shows about 50% of youth in the supportive housing units score 0-1 on the TAY Triage Tool, spurring a discussion about what this could mean and what the possible implications are of targeting even more vulnerable homeless youth.  CSH will continue to look at this data throughout the evaluation, to better understand the service utilization and outcomes of the young people in comparison to their triage tool scores.

Symposium attendees also heard directly from a panel of supportive housing providers for TAY.  Leadership from CRCD, Jovenes, KYCC, Step Up On Second, and WORKS shared their insights from operating supportive housing for youth and young adults.  The discussion honed-in on the importance and challenges of engaging youth in services; the pros and cons of providing different services in-house; the need to increase mental health support services; and strategies to better coordinate a “warm hand-off” with service providers whom the youth are connected to prior to entering supportive housing.  When asked about their vision for the youth they serve in supportive housing, panelists expressed they wanted to help youth regain hope, peace, and stability; foster the young person’s independence, and self-sufficiency; and most importantly, help them develop their own vision for themselves, their future, and their success. TAY_Symposium_Presentation

Perhaps the most impactful at the symposium was the featured speaker of the morning, Ms. Aleah Guillory.  Aleah is a young mother living at the 28th Street Apartments, a supportive housing community for formerly homeless adults and TAY in the Vernon-Central neighborhood of South Los Angeles.  Aleah shared her story of becoming homeless due to depression after losing her grandmother, and the challenges she faced while being on the street.  She tried a number of transitional housing programs, but they were not a good fit for her.  Aleah found support through her case manager at My Friend’s Place and counseling through Children’s Hospital of Los Angeles.  She moved into the 28th Street Apartments in December 2012, and was able to complete a Certificate in Cosmetology at Marinello School of Beauty last year.  Aleah is now a Supportive Housing Community Advocate, and recently went up to Sacramento for CSH’s California Lobby Day to educate legislators about the importance of key bills to end homelessness, particularly the Homes and Jobs Act.

 A big THANK YOU to Bank of America, for their support of the TAY Supportive Housing Symposium.

The Stable Homes, Brighter Futures initiative was made possible through the support of the Conrad N. Hilton Foundation, the W.M. Keck Foundation, and The California Wellness Foundation.
THANK YOU!!

 

To access the data presentation and other materials from the TAY Supportive Housing Symposium, click on the links below:

Agenda

Year-One Evaluation Presentation

Two-Pager of Evaluation Findings

The full year-one report of Stable Homes, Brighter Futures can be found here.  

Transitional Housing Assessment and Recommendations Report – San Diego, CA

CSH conducted an analysis of transitional housing across the San Diego region.  The transitional housing assessment provides a comprehensive analysis of program level readiness for conversion to permanent supportive housing, rapid re-housing, or high performing transitional housing .  These transitional housing projects volunteered to participate in this process and took advantage of a unique opportunity to consider conversion and/or programmatic changes. CSH’s recommendations focus both on opportunities to convert projects as well as the need to re-tool the programmatic aspects of housing for homeless people.

CSH thanks the agencies involved in this assessment for their willingness to devote the time and energy to participate, as well as Funders Together to End Homelessness in San Diego for supporting this work.

San Diego Transitional Housing Analysis

CSH conducted an analysis of transitional housing across the San Diego region.  The transitional housing assessment provides a comprehensive analysis of program level readiness for conversion to permanent supportive housing, rapid re-housing, or high performing transitional housing .  These transitional housing projects volunteered to participate in this process and took advantage of a unique opportunity to consider conversion and/or programmatic changes. CSH’s recommendations focus both on opportunities to convert projects as well as the need to re-tool the programmatic aspects of housing for homeless people.

CSH thanks the agencies involved in this assessment for their willingness to devote the time and energy to participate, as well as Funders Together to End Homelessness in San Diego for supporting this work.

Download a copy of the report.