Vet’s Dream Comes True in Hartford, CT

Fran Cosgrove served in Korea in the United States Army back in the 1950’s. After he came home from Asia he pursued a successful career in real estate and acquired several rental properties. Eventually he ended up owning a large lot on Wethersfield Avenue in Hartford’s South End.  Over the years he had come across a number of veterans, some with combat records, who were homeless or in need of better housing to accommodate their families. He hoped that something positive for veterans could happen on his Hartford site.  In 2010 he approached Chrysalis Center with a proposal to buy his large lot which was zoned for 24 units and create housing for veterans experiencing homelessness. Now – thanks to Chrysalis Center, The Connecticut Interagency Council on Supportive Housing, and CSH – that hope has now become a reality.

On September 30, Chrysalis hosted a dedication and Open House at the newly constructed building, to be called Cosgrove Commons. Consisting of 24 one bedroom units, the three story structure sits prominently on Wethersfield Ave.  Paul Bailey, the architect of many supportive housing developments in Connecticut, incorporated elements of design found in the surrounding neighborhood. Chrysalis came up with the idea to create a “forest garden” on the rear of the site to provide food for their culinary arts program and Fresh Place, a source for locally raised food for neighborhood residents.

“We are really proud to help Fran realize this dream,” said Sharon Castelli, Chief Executive Officer of Chrysalis, at the ceremony. “The veterans who we house here deserve to live in decent, safe, affordable housing and that’s what we’ve created  …”  Ms. Castelli led guests, including Anne Foley, Under Secretary of the Office of Policy and Management, Department of Housing Commissioner Evonne Klein and Eric Chatman, Executive Director of the Connecticut Housing Finance Authority, on a tour of the building. She pointed out that the apartments are all fully furnished and each contains a unique work of art. A large community room with a kitchen is on the main floor.  The building will have service-enriched housing for veterans as well as for youth aging out of foster care.

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Cosgrove Commons was developed through the Connecticut 2011 Permanent Supportive Housing Initiative. The Initiative provided capital financing for construction, operating subsidies to make the rents affordable, and services funding to help ensure that tenants get all the support they need to remain housed. CSH provided acquisition and pre-development financing.

Meet MISHA – the Medicaid Institute for Supportive Housing Agencies

Several provisions in the Affordable Care Act are intended to expand access, utilization and delivery of health care and health related services to low-income populations. With an emphasis on home and community based services, and direct efforts to incentivize and support care coordination and systems integration, advocates around the country are working to create new sources of funding for the delivery of supportive housing and homeless services.

While it is no mystery that efforts are underway in several states around the country to capitalize on Medicaid expansion to create new mainstream sources of funding for services, just exactly what may be in store for service agencies can be more bewildering. The majority of agencies providing supportive housing services have no experience as Medicaid providers. The labyrinth of Medicaid programs, unfamiliar business model, administrative requirements, terminology and different orientation to services creates some trepidation, and many questions: How exactly does Medicaid work? What services are supported, or not? What would our agency need to bill Medicaid services? How do we become accredited? What training and credentialing is required for our staff? Will this medicalize our service model? Will Medicaid require a culture change in our agency?

In Connecticut CSH is leading an effort to answer these questions, to demystify Medicaid, and especially to support agencies to prepare to maximize the opportunities that may be available to them through emerging Medicaid programming. With the generous support of the Melville Charitable Trust, CSH is sponsoring the Medicaid Institute for Supportive Housing Agencies (MISHA). Eight agencies[1] that provide supportive housing services in CT were selected through a competitive application process to participate in Round One of MISHA.

CSH has enlisted the Technical Assistance Collaborative to assist in the development and delivery of a comprehensive curriculum that includes seven full day sessions of information, instruction, and guidance from key individuals and agencies around the state. MISHA guests have included the CT State Medicaid Director, Kate McEvoy, providing an overview of the entire Medicaid system, programs and services; representatives from the two major Medicaid Administrative Services Organizations; state agency administrators of CT Medicaid waiver services; CT Medicaid policy experts; and the services administrator of the CT mental health waiver.

The first MISHA cohort has met six times for a full day beginning in March through September, 2014.  Through ongoing consultation and feedback, MISHA agencies have completed internal needs assessments and developed comprehensive Medicaid Business Plans to either become a Medicaid billable organization or develop strategic partnerships with Medicaid providers in order to increase capacity of supportive housing services. MISHA agencies have also created plans to ensure Medicaid enrollment and reauthorization for the population they are serving.

As the final session of MISHA Round One approaches, most MISHA agencies are now crafting applications for Capacity Building grants. These awards of up to fifty thousand dollars, also provided through the generosity of the Melville Charitable Trust, will provide the critical resources needed for agencies to realize the objectives laid out in their Business Plans.

Feedback on MISHA Round One has been overwhelmingly positive. CSH is busy designing the delivery of MISHA Round Two to commence in early 2015.  CSH will continue to support MISHA Round One participants who will also play a key role in Round Two, advancing our effort to prepare the entire network of supportive housing providers in Connecticut to enhance our collective efforts to deliver the high quality and effective services needed to end homelessness in our communities.

 


 

[1] Columbus House, CHD, Immaculate Conception Shelter and Housing, My Sister’s Place, New London Homeless Hospitality Center, Newreach, St. Vincent’s Behavioral Health Services, The Connection

CSH Launches Pilot to Identify Homeless Youth in CT

Two experienced youth-serving providers in Connecticut underwent training to launch a new effort to identify homeless youth at the greatest risk of experiencing long-term homelessness. The Youth Continuum in New Haven and The Connection, Inc. in Hartford will deliver a questionnaire to at least 120 youth, with the goal of utilizing the data to inform housing and services capacity planning for youth transitioning out of state care or otherwise experiencing life on the streets.

On October 9, 2014, both agencies received training from Dr.Eric Rice in the Transition Aged Youth (TAY) Triage Tool, which until this point has only been administered in California. The TAY Triage Tool is a youth-specific set of  non-invasive questions that can be quickly delivered to determine whether a homeless young person is on a trajectory to experiencing five of more years of homelessness.

The tool consists of a six point scale, with the recommendation that homeless youth with a score of 4 or higher should be prioritized for supportive housing.  For communities seeking to create or increase their inventory of supportive housing for youth and young adults, the TAY Triage Tool provides a mechanism for collecting targeted data to inform the planning process.

In 2012, CSH began working with Dr. Eric Rice, Associate Professor at the University of Southern California School of Social Work, to develop the TAY Triage Tool. The participation of Youth Continuum and The Connection, Inc. will contribute to the development of a rigorous, multi-site dataset to further establish generalizability of the TAY Triage Tool.

Learn more about the TAY Triage Tool.

CSH would like to extend thanks to Dr. Eric Rice, USC for his passion and dedication to the homeless youth population, and to recognize the efforts of Paul Kosowsky of Youth Continuum and John Lawlor of The Connection, Inc. and the staff at these agencies for their time and for their commitment to this project.

Peer to Peer Focuses on Improving Housing Outcomes for Youth

Yesterday, CSH brought together child welfare agencies, service providers, and public and private funders from three states to visit two New York City based housing programs focused on improving outcomes for young adults experiencing homelessness and youth aging out of state care. The group visited Lantern Organization’s Vicinitas Hall, a 68 unit supportive housing development in the Bronx for youth aging out of the foster care system, and also West End Residence’s 30 unit True Colors Residence, New York’s first and only permanent supportive housing development for LGBTQ youth with a history of homelessness.

The full-day learning exchange provided an opportunity for participants to engage in open dialogue not only with clinical and program staff at both programs, but also with each other to strategize ways to influence policy and replicate the models across the tri-state region. Pamela Cranford, a Program Manager at the CT Dept. of Children and Families (DCF), commented that the sites “did not look like a place to just stay, but a place to live.” Cranford went on to reflect, “The positive exchanges and sharing of ideas from our sister states was invaluable. We need to keep this going.”

Mary Adams of Lantern Organization in New York conveyed, “Although so many of us have been doing this work for so long, there is still much we gain from events like this.  Most importantly though is that there seems to be new and invigorated momentum about the work that can be done with young adults, as well as the confidence that this work will pay off with long-term, sustainable, positive outcomes.”

Participants included representatives from the State of Connecticut DCF, Dept. of Mental Health and Addiction Services (DMHAS), DMHAS – Young Adult Services division, Dept. of Housing, and Office of Policy and Management, as well as the CT Housing Finance Authority, Melville Charitable Trust, Youth Continuum, Inc. – New Haven, and True Colors (CT). Representatives from Covenant House New York, Covenant House New Jersey, the New Jersey Department of Children and Families, and the New York City Administration for Children’s Services also participated, bringing a range of relevant experiences to the table, and all are committed to continuing the dialogue across the region.

Medicaid Institute for Supportive Housing Agencies in CT – Apply Now!

CSH is sponsoring the launch of the Medicaid Institute for Supportive Housing Agencies (MISHA) in Connecticut. Representatives from approximately 8-10 selected supportive housing in CT will meet seven times for a full day beginning from March through September 2014. CSH is working in conjunction with the Technical Assistance Collaborative (TAC) to deliver MISHA, in which participating agencies will learn about: the range of Medicaid services and programs providers of supportive housing are or may be eligible for beginning in 2014 and beyond; service model and primary care/prevention approaches; the processes for becoming eligible for Medicaid programs; how service agencies can assist participants to become eligible and maintain Medicaid eligibility; assessing needs and impact of Medicaid coverage for populations not previously covered; conducting self-assessments to determine if they should consider becoming a Medicaid provider or a referring/supporting organization; successful approaches to being full service partners with Medicaid providers for the benefit of supportive housing participants; and developing business plans to either become Medicaid billable organizations or developing strategic partnerships with Medicaid providers in order to increase capacity of supportive housing services. Application Due Date: February 13, 2014

Medicaid Institute for Supportive Housing Agencies RFA (Word Version)

Medicaid Institute for Supportive Housing Agencies RFA (PDF version)

Medicaid Institute for Supportive Housing Agencies Application

Supportive Housing Provider Medicaid Self-Assessment

First Match of State Medicaid and Homelessness Data Reveals Opportunities To Improve Health Outcomes, Reduce State Costs

Many of Medicaid’s highest cost beneficiaries are individuals with complex and co-occurring health and behavioral health challenges experiencing homelessness and housing crisis. For these individuals, homelessness exacerbates chronic illnesses by increasing exposure to trauma and high-risk behaviors and, in turn, results in social isolation and difficulties accessing the coordinated primary and behavioral health services needed to manage and expedite recovery.

The interaction between homelessness and complex health conditions often times results in the frequent use of costly emergency health services, like detox and emergency departments, as well as repeat avoidable hospitalizations. Research shows that these costs can be avoided through a combination of stable housing, health care coordination, and community-based service delivery.

In January 2012, CSH helped to facilitate a data match between the CT Homeless Management Information System (HMIS) and CT Department of Social Services to better understand the Medicaid utilization of homeless high utilizers in CT.  This match identifies a cohort of 419 people who are homeless, high utilizers of Medicaid services who could benefit from permanent affordable housing coupled with support services to better connect them to care and improve outcomes.

Bank of America Charitable Foundation Grant Supports CSH Work in CT

CSH would like to thank Bank of America for supporting our Connecticut office with a grant of $7,500. As we work to develop housing solutions to end homelessness and address the needs of the most vulnerable in CT, Bank of America’s investment will enable us to  build local capacity to provide quality supportive housing, develop new  units of supportive housing, as well as well foster systems change to engage mainstream systems to invest in and embrace supportive housing for the most vulnerable individuals and families in CT.

CSH has a long-standing partnership with the Bank of America Charitable Foundation. We have received grants from the foundation at both the national and local levels, which allow us to work toward realizing our mission in Connecticut and across the country.

 

Peer Reviewers in Connecticut Support Quality at the Provider and Systems Level

CSH’s Connecticut Supportive Housing Quality Initiative is a partnership with the Connecticut Department of Mental Health and Addiction Services and supports a sustained focus on quality improvement at both the provider and systems level.  The Initiative employs multiple strategies to help providers better serve tenants and to align program operations with identified supportive housing principles and practices.

One strategy the Initiative uses is a program quality review that includes peer providers as part of the review team.  Although each review is led by CSH staff, trained peers conduct chart reviews and staff/tenant interviews.  They also develop recommendations and participate in a follow-up meeting to discuss results with providers.

Feedback from program directors show how the tone and nature of reviews is enhanced by peer reviewers.  Including peers makes the reviews feel less punitive and more supportive.  One program manager stated, “The process was extremely inclusive. Peer reviewers are so valuable because they know we have shared experiences.”

Peer reviewers value the connections that are made with other providers.  “Everything I learned was helpful in strengthening my own programs.  I made connections with people that carried over beyond the review process.”

Another peer reviewer feels the process helps providers better understand and overcome barriers. “It’s interesting to see the different challenges in the different areas of the state (transportation or program availability).  At the same time it’s refreshing to see that there are similar statewide challenges as well.”

In addition to building a sense of community, including peer reviewers creates valuable learning opportunities for all parities involved.  The process encourages knowledge exchange and provides an opportunity for peers to provide and receive technical assistance during the review process. One reviewer emphasized, “being a peer reviewer has been a wonderful learning experience which has given me more confidence in performing the essential responsibilities of my job.”

CSH Receives $1.3 million Grant from State of Connecticut

Governor Dannel P. Malloy yesterday announced the award of $13.8 million in grants to spur community development and create affordable and supportive housing in Connecticut. CSH Connecticut received a $1.3 million grant for its Integrated Supportive Housing Initiative to create the Connecticut Supportive Housing Loan Fund.

CSH was one of eleven grantees  and the only program funded that specifically focuses on ending homelessness. Grant money will be used to provide gap financing for projects being developed with mainstream affordable housing resources and will act as an incentive for developers to include permanent supportive housing in their projects.

The majority of supportive housing in Connecticut is developed through structured supportive housing initiatives but CSH has been actively seeking ways to encourage integrated supportive housing development. Creating incentives through the  state’s Qualified Allocation Plan(QAP), and encouraging inclusion of supportive housing in all state-assisted affordable housing projects have resulted in the creation of approximately 35-50 additional units of supportive housing per year. This year CSH began an evaluation of supportive housing units created through mainstream affordable housing financing in Connecticut and preliminary findings indicate that additional financial incentives for developers are key to the proliferation of integrated supportive housing units in Connecticut. “This fund will add two important tools for encouraging supportive housing in integrated projects: very flexible gap capital for development and short term rental assistance to stabilize homeless tenants while seeking long term rental subsidies.” said Sarah Gallagher, CSH CT Director. We’re excited by this new partnership with the state and look forward to increasing the number of supportive housing units in Connecticut through the program”.

CSH has partnered with Supportive Housing Works in Bridgeport who will do outreach to developers and assist them in applying for funds. CSH will underwrite projects and move them through an approval process similar to that used for CSH’s $40 million National Loan Fund.

Nick Lundgren, Director of DECD’s Office of Housing and Community Development, “We’re thrilled to have this opportunity to partner with one of the leaders in the effort to end homelessness in Connecticut.”