Sarah Gallagher Named CSH Eastern Region Manager

Sarah Gallagher, who until today served as CSH Director of Strategic Initiatives, has begun a new role as Managing Director of the organization’s Eastern Region. As Managing Director, she will work with local directors, field offices, programs and stakeholders to facilitate and coordinate CSH efforts in Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Delaware, Maryland, District of Columbia, Virginia, North Carolina, South Carolina, Georgia and Florida.

Sarah has expertise in health/housing collaborations, data matching, homeless programs and justice reentry.

As Director of Strategic Initiatives, she oversaw CSH’s efforts to scale and replicate proven supportive housing models like Frequent User Services Engagement Program (FUSE)aimed at breaking the cycle of homelessness and incarceration for frequent users of jails and shelter, and Keeping Families Together-One Roof, a program that ensures stable housing and services are leveraged to keep children with their parents in their own homes. She also managed CSH internal work groups focused on generating population-specific ideas for the organization.

Prior to heading Strategic Initiatives, Sarah served as Director of CSH’s Connecticut Program, supervising all of CSH’s training, lending, technical assistance, and systems change work throughout the state. She worked closely with State agencies to increase the use of supportive housing as a public policy solution, including local project management of FUSE, and in assisting the State, and health care and supportive housing providers as they integrated health care and housing for vulnerable populations.

Sarah joined CSH as Director in Connecticut in 2010.  Under her tenure the size and scope of CSH work in the region grew with new contracts and groundbreaking approaches to products like the Medicaid Institute.  Ms. Gallagher also managed CSH’s increasingly successful project tied to the National Social Innovation Fund (SIF) healthcare award. With the backing of the federal government and philanthropic partners, the CSH Social Innovation Fund is integrating housing with health services to house, improve outcomes and reduce costs among those with complex health needs who are experiencing homelessness. These individuals are often high-cost consumers (frequent users) of publicly-funded healthcare services.

Before joining CSH, Ms. Gallagher served at the first Executive Director of Journey Home, the local homeless funding and planning body for the Capitol Region, where she assisted in the development and implementation of the community’s Ten Year Plan to End Homelessness. Sarah also was the Executive Director for Discharge Planning at the New York City Department of Corrections, where she focused on discharge planning programs at Rikers Island and worked with City agencies in order to overcome barriers that people face when leaving jail. 

Sarah holds a Master degree in Urban Policy and Management from the Milano Graduate School at the New School and a Bachelor of Arts in Sociology from the University of Connecticut.

 

Virginia Supportive Housing SIF PFS Feasibility Report

Read the complete Social Innovation Fund Pay for Success Feasibility Report for Virginia Supportive Housing by clicking here.

This new report released today summarizes the conclusions and next steps resulting from the Technical Assistance provided by CSH to Virginia Supportive Housing from June 2016 to March 2017. The feasibility report focuses on the following components:

Key component Successes Next steps Priority Areas
Pay for Success education and profile raising

 

Discussions with state and city entities Deeper engagement with potential end payer entities

 

High
Target population Priority population defined Detailed eligibility and enrollment criteria

 

High
Cost benefit analysis Local value case examples show compelling impacts using pre/post analysis Analysis of local health data if further health system involvement

 

High
Service design Framework for service design agreed

 

Deeper exploration of best practice through new awards for TA

 

Medium
End payer identification Interest from local healthcare systems Work with City officials to determine interest

 

Low
Payment terms Options for payment terms included in report Deeper exploration of metrics and terms following end payer commitment

 

Medium

CSH believes Virginia Supportive Housing, alongside its partner Homeward, has the opportunity to successfully finish designing, structuring and implementing a Pay for Success supportive housing project if there is commitment from the City of Richmond or a health system payer to making success payments for outcomes achieved.

CSH has documented a number of next steps for finalizing outcomes of interest, success metric payment terms and evaluation design for when an end payer is identified.

Access the full report here.

MeckFUSE Evaluation & Results Released

In 2012, Mecklenburg County (North Carolina) Community Support Services (CSS) leadership was researching effective jail diversion models that would reduce recidivism and save public dollars, and discovered CSH’s Frequent User Systems Engagement, or FUSE.

Based on what they learned from CSH, Mecklenburg County created a local FUSE initiative known as MeckFUSE – an interagency effort providing supportive housing to individuals that cycle between the criminal justice and homeless shelter systems in the County, home of the City of Charlotte.

The Department of Criminal Justice & Criminology at the University of North Carolina at Charlotte has now thoroughly evaluated MeckFUSE and today released the results of its study.

The three-year process and outcomes evaluation demonstrated improved housing stability, reduced rates of jail and shelter utilization, and reduced hospital charges. Overall, MeckFUSE is deemed successful in reducing system utilization costs among participants.

Key findings of the MeckFUSE evaluation conclude:

  • Nearly all (98%) of MeckFUSE participants had an adult conviction record with a mean of approximately 13 adult convictions.
  • Over 90% of participants reported spending more than 12 months in a homeless shelter or other place not meant for habitation. Of those, the mean time of homelessness was approximately 11 years.
  • MeckFUSE participants demonstrated a 90% two-year housing retention rate.
  • MeckFUSE participants demonstrated significant reductions in shelter usage (87%), ambulance service charges (24%), and hospital charges (43%).
  • Housed participants were arrested significantly less than a comparison group (4.5 vs. 9.3 arrests) and had much longer average times to re-arrest post-housing.
  •  A majority of participants indicated that MeckFUSE had significantly improved their lives and relationships with their families.  For example, 57% of the participants indicated that the program helped them improve relationships with their children.

The evaluation, which followed program participants for two years and used a quasi-experimental matched comparison group design, is noteworthy because there are few studies that follow participants longer-term. One such study reviewed New York City’s FUSE program.

Together, the studies make a strong case for continuing to serve frequent users of high cost systems, and to providing housing and supportive services with no pre-conditions for entry into the program.

Mecklenburg County plans to continue the MeckFUSE program, operated through a contract with Urban Ministry Center, an interfaith community agency working to end homelessness.

Final MeckFUSE Outcome Evaluation Report Sept 2017 (002).pdf

MeckFUSE One sheet evaluation summary FINAL VERSION 2017.pdf

Improving Health: Better Targeting of Supportive Housing

By CSH New York Program Director Kristin Miller, MSW, and Associate Director Pascale Leone, MPP

New York has demonstrated a strong commitment to addressing social determinants of health. At the center of this effort is supportive housing, which combines stable, affordable housing with services to meet the needs of homeless individuals facing multiple complex challenges like serious mental illness, substance use disorders and chronic medical conditions. Significant investments by both the State and City of New York over the past five years have greatly expanded the use of supportive housing to improve health outcomes and reduce public spending.

Read more by clicking here.

Health Talk: Examples of Medicaid funding services to sustain and expand supportive housing capacity

Let’s remind our readers again, that the CSH analysis regarding supportive housing indicates that we need 1.2 million units of supportive housing to meet the need of vulnerable Americans.  While a pipeline of tax credits and other financing mechanisms exist for affordable housing development, the road to funding the supportive services component of supportive housing is not as clear.

CSH has developed a summary of state strategies we believe can lead to sustainable pipelines of services funding for many communities.  These strategies illuminate how states are using Medicaid financing mechanisms to expand supportive housing capacity, sustain programs with more long-term sources of service funding and better serve supportive housing tenants who have changing service needs over time.  All are esteemed goals.  As health care and particularly Medicaid is different from state to state, some of these strategies might apply, others might not.

CSH has developed the following summary highlighting state strategies we believe can lead to sustainable pipelines of services funding for many communities.  These strategies illuminate how states are using Medicaid financing mechanisms to expand supportive housing capacity, sustain programs with more long-term sources of service funding and better serve supportive housing tenants who have changing service needs over time.  All are esteemed goals.  As health care and particularly Medicaid is different from state to state, some of these strategies might apply, others might not.

In this blog post, we will highlight the Community Support Program for people Experiencing Chronic Homelessness or CSPECH program.  Massachusetts  has used CSPECH services to increase their supply of supportive housing and work towards ending chronic homelessness for their state. Massachusetts began using Medicaid resources to fund services in supportive housing in 2006, in a partnership between the state’s Medicaid Plan, the statewide Behavioral Health Managed Care Organization and the Massachusetts  Housing and Shelter Alliance or MHSA.  MHSA used a number of strategies that CSH recommends as supportive housing advocates use as they engage their state Medicaid plans.

Those strategies include:

  1. Make the Business Case.
    Now more than ever, state Medicaid departments are looking for ways to save money. A solid business case analysis can win over skeptics such as key legislators and state Budget Offices.

 

  1. Align your ‘ask’ with your state’s priorities.
    Massachusetts had made addressing the homelessness crisis a state priority, so the requests and their priorities aligned. What are your state’s priorities?  Addressing Chronic Homelessness? Downsizing state institutions? Criminal Justice Reform with a focus on Re-Entry? Supportive housing is a solution to all these challenges.

 

  1. Join key stakeholder groups for your state’s Medicaid plan.
    Did you know that federal Medicaid law requires a public stakeholder committee that supportive housing providers should be represented on? There are often a variety of subcommittees as well that while time-consuming will often expand your network to key advocates and stakeholders in your state.

 

  1. Propose a pilot program that is set up to succeed.
    Your goals in the pilot are not only to serve your new tenants but to document success. Success is defined in housing stability but also proving decreased health care costs and positive health outcomes. The evaluation component of your pilot will be as key as your services. Targeting your supportive housing to those with the most challenging health care needs will set you up to succeed and to document health savings.  Consider partnering with local universities or other research experts to execute your evaluation and use the data to recommend expansion in the coming years.

 

Massachusetts’s plan was executed using their state’s 1115 Medicaid Research and Demonstration waiver and fit well with the priorities of their state and their Health Care Delivery System.  In the coming, weeks we will highlight other state’s efforts that matched with their state priorities and Health Care Delivery Systems.

Please see the short brief and infographic on the MHSA for more details.  If you have any questions, on this project, please contact Marcella Maguire, CSH Director of Health Systems Integration at Marcella.Maguire@csh.org  or Joe Finn, MHSA’s Executive Director at JFinn@mhsa.net.  We look forward to hearing from you.

INCREASING HOUSING OPPORTUNITIES FOR FORMERLY INCARCERATED

New York Governor Andrew M. Cuomo last week announced pilot projects at three public housing authorities to help formerly incarcerated New Yorkers safely reunite with their families under a new pilot program. These authorities in the cities of Schenectady, Syracuse, and White Plains have heeded a call from the United States Department of Housing and Urban Development to allow carefully screened and monitored people with convictions to live in public housing with their families.

“Stable housing drastically reduces the risk of recidivism and, under this initiative, qualified individuals who meet careful screening and monitoring guidelines will be able to be reunited with their families,” Governor Cuomo said. “This pilot program will help break down barriers, aid in their reintegration into society and increase public safety.”

In an effort to aid the authorities’ efforts, the New York State Department of State is providing funding for case management that will track these individuals, and the Department of Correction and Community Supervision will monitor participants through their parole officers and undertake home visits as part of the normal course of supervision as well as any other time that the housing authority requests they do so.

Public housing authorities supported by the United States Department of Housing and Urban Development, including all of the urban housing authorities in New York State, have the lawful discretion to screen housing applicants with past criminal behavior on an individualized basis – excluding sex offenders and methamphetamine producers. However, many authorities refuse to give applicants this fair assessment. This results in people who present little risk to society being separated from family members, and forced into unstable housing or homelessness at the expense to themselves and our communities.

A 2016 study by the Vera Institute showed that reuniting carefully screened individuals with family members living in public housing is safe for the community.  Not one of the 85 individuals who participated in an ongoing housing pilot program in the New York City Housing Authority has been convicted of a new crime since enrollment.

The Governor’s Council on Community Re-Entry and Reintegration introduced these results to other housing authorities, and these three authorities decided to pilot the approach. Schenectady County Community Action, Inc., PEACE, Inc. of Syracuse, and the Westchester Community Opportunity Program will provide the case management services to enrollees and their family members. These public housing authorities will have the ability to review a number of important factors to ensure any participant does not pose a public safety concern to residents. These include an individual’s criminal background, their path to rehabilitation, and family structure. At the end of the pilot program, successful participants may be added to the household on a permanent basis.

Richard Homenick, Executive Director for the Schenectady Public Housing Authority, said, “In Schenectady, we are excited and optimistic about this opportunity to reunite and strengthen families, empower individuals, and increase public safety. We look forward to providing a fresh start for returning citizens through a supportive network.”   

William J. Simmons, Executive Director for the Syracuse Housing Authority, said, “The Syracuse Housing Authority is happy to participate in the Family Reunification Pilot program’. The case management support is a critical element in the successful return of the participants to their communities.”

Mack Carter, Executive Director for the White Plains Housing Authority, said, “The Mayor, Board of Commissioners, Residents, Management and Staff look forward to the reunification of family members re-entering their homes and their communities, and for some families this time could not have come soon enough. The White Plains Housing Authority have been asked for many years to be more tempered and considerate of family members who have been incarcerated and barred out of Public Housing we believe we are answering that call.”
 
Secretary of State Rossana Rosado, Chair of the Governor’s Council on Community Re-Entry and Reintegration, said, “Governor Cuomo has been a champion of the formerly incarcerated by offering them opportunities that will help them succeed in becoming productive members of our State.  Housing is a vital first step that can reunite these individuals with their families and this pilot will foster an environment where they can prosper.”
 
Anthony J. Annucci, Acting Commissioner of the NYS Department of Corrections and Community Supervision, said, “I applaud Governor Cuomo for once again having the foresight to recognize that a key facet in reducing crime is helping people leaving incarceration reenter society and successfully become law abiding citizens. Several years ago the Governor created the Reentry Council to address issues such as housing, employment and access to health care for those on parole. This latest program will most certainly further his vision.”

New York State Homes and Community Renewal Commissioner RuthAnne Visnauskas said, “Research shows that stable housing and family connections help to reduce repeated recidivism and homelessness, yet individuals who have been incarcerated often face direct and tacit discrimination when applying for housing.  This pilot program, coupled with our agency’s efforts, will expand access to housing for the formerly incarcerated, allowing families to reunite and stabilize. Governor Cuomo’s continuing initiative to break reentry barriers provides the key to opening these doors, bringing families back together and setting the example of how to create a fairer and more forgiving society.”

Governor Cuomo’s Council on Community Re-Entry and Reintegration
 
This pilot expansion is preceded by several other recent reentry-focused housing reforms through Governor Cuomo’s Council on Community Re-Entry and Reintegration, all of which are now underway and making a substantial impact.

In 2015, the Governor announced that he was accepting and directing the State to implement several initial housing-related recommendations from the Council.  As of today, these recommendations have led to thousands of additional housing options available for eligible people with criminal convictions.

These housing-related recommendations have already begun to have a positive impact, and in 2016 alone:

  •    Less than one percent of the 16,755 applicants for New York State-distributed Section 8 rental assistance were denied because of previous convictions.
    ·    Six organizations recently received conditional awards in the Empire State Supported Housing Initiative to create 86 units statewide of supported housing that is targeted specifically at the formerly incarcerated.
    ·    100 supportive housing units for the formerly incarcerated who are mentally ill are currently being built in New York City.
    ·    Close to 200 individuals with domestic violence histories have been allowed to live with partners with whom they have no history of violence, changing prior exclusionary practices that left them homeless in many instances.

Nicholas Turner, President of the Vera Institute of Justice, said, “We commend Governor Cuomo for supporting public housing authorities across New York State to expand access for people reentering society from prison. As our New York City Housing Authority Family Reentry Pilot shows, housing and supportive services are fundamental to success after incarceration. By reuniting more families in public housing, we can improve public safety and strengthen family ties.”

Kristin Miller, CSH Director in New York, said, “What we have seen from our hands-on experience is that everyone wins when those reintegrating into communities are reunited with family in a home that promotes stability and strong connections to supportive networks.  Thanks to the Governor’s support, we are confident White Plains, Syracuse and Schenectady will realize the same positive outcomes we witnessed with the New York City pilot: successful reintegration for those leaving incarceration; stronger family bonds; reduced costs and a safer environment for everyone, including neighbors residing in and around the public housing.”

David Condliffe, Executive Director of the Center for Community Alternatives, said, “Governor Cuomo and Secretary of State Rosado once again lead the way in demonstrating that supportive reentry services make our communities safer.  The support of family and stable housing provide the platforms on which we all depend to succeed.”

The Boston Foundation Releases Report on Homelessness

The report was prepared by Westat with data from the Massachusetts Department of Housing and Community DevelopmentHomelessness Report 2017 cover

The Boston Foundation, in partnership with the independent research firm Westat and the Massachusetts Department of Housing and Community Development (DHCD), has released a report analyzing nine years of data on homelessness assistance in Massachusetts. The research, which was shared at a forum last week attended by CSH staff, sheds light on the number of families who need Emergency Assistance—in the form of direct shelter or programs that help them remain housed outside of the shelter system.
Access the full report by clicking here.

Unbarred

Improving Access to Stable, Permanent Housing for New Yorkers with Criminal Justice Histories

The high prevalence of mental health disorders in prisons and jails, the record numbers in our homeless shelters, and growing concerns over the predatory, unsafe three-quarter house industry demand that New York take a hard look at how it addresses the needs of people with a history of incarceration.Returning Home Ohio

For the third consecutive year, CSH has worked with several partner organizations representing housing, mental health, and legal services providers, academia and advocacy groups to focus on solutions that emphasize housing and services to keep people away from a destructive cycle moving them from incarceration into homelessness and then back to jail or prison.

This year, 17 organizations joined CSH to co-author recommendations that touch on improving access to supportive, affordable, public, and market rate housing for individuals leaving incarceration. Our efforts aim to:

  • Ensure people with criminal justice histories are considered for new City & State supportive housing resources;
  • Remove blanket bans keeping people with justice histories from accessing public, affordable, and market rate housing; and
  • Reduce and eventually end reliance on shelters and three-quarter houses.

If adopted, the policy reforms in this document would:

  • End the practice of relying on unstable and unsafe housing;
  • Improve access to supportive and other affordable housing for persons with mental health and substance use disorders; and
  • Reduce recidivism and improve public safety.

Implementation of these recommendations will mean thousands of New Yorkers will find stable and safe housing, reconnect with their families, transform their lives and avoid recidivism, which makes all of us safer.

Read the recommendations by clicking here.

CT Releases NoFA for Supportive Housing for Youth

The Connecticut Department of Housing (DOH) recently announced its first round of funding for non-time limited supportive housing for young adults experiencing homelessness, an intervention that CSH and national partners have recommended for youth who face the most significant challenges to a successful transition to adulthood. The funding announcement came after several years of collaborative planning around strengthening the housing continuum for young adults in Connecticut.  youth TAY

Several stakeholders in the state prioritized piloting a viable supportive housing demonstration project for this population after CSH hosted a peer learning exchange with two New York City based housing programs for young adults experiencing homelessness and youth aging out of state care.

Representatives from youth-serving agencies, the Connecticut Housing Finance Authority (CHFA), DOH, and the Melville Charitable Trust returned to Connecticut after the CSH-hosted event eager to move from planning to action by investing in an initiative providing the State with an opportunity to test multiple models that effectively meet the housing and service needs of high-risk young adults.

At the same time, several partners, including CSH, ramped up data collection to quantify information on Connecticut’s homeless young adult population. In 2015, the Connecticut Coalition to End Homelessness (CCEH) conducted the first ever statewide enhanced homeless youth count and found that of the 1,342 surveys that were completed, 585 (44 percent) of youth were homeless or in an unstable living situation.

Additionally, Connecticut piloted Dr. Eric Rice’s TAY Triage Tool to better understand the risk factors and vulnerabilities to long-term homelessness that face Connecticut’s young adults. These data helped shed light on the prevalence of homelessness among young people, who often are referred to as an invisible population given their transience and desire to stay “under the radar.”

These enhanced data collection efforts, combined with ongoing opportunities to learn from peers across the country, positioned public state agencies to commit to expanding supportive housing opportunities for youth and young adults experiencing homelessness.

The new funding announcement provides approximately $12 million in capital funding from the State DOH as well as annual funding for both services and operating expenses. The initiative is one strategy embraced in a statewide action plan to meet the goal of ending homelessness among youth and young adults by 2020.

New Hampshire’s Frequent Service Utilizers Issue Brief

NHIn 2016, communities in New Hampshire saw an increase in the number of individuals experiencing homelessness with significant health issues that often require a higher level of care. Advocates quickly realized that the current systems lacked the appropriate housing and services capacities to meet the growing needs. These gaps resulted in prolonged suffering for individuals faced with housing instability and chronic health conditions, and in significant financial costs for communities in the state.

Recognizing the problems required identification and a  policy strategy based on collaboration and cooperation, advocates joined together and created a report on high-utilizer case studies and possible solutions, including supportive housing.

The Frequent Service Utilizers Issue Brief illustrates the complexities in serving high-need populations, the financial implications of inadequate care, and highlights successful solutions seen across the country such as supportive housing.

Information and case studies were compiled by New Hampshire Coalition to End Homelessness, Mental Health Center of Greater Manchester, Families in Transition, and New Horizons for New Hampshire.

Read more about the case studies and findings by accessing the Frequent Service Utilizers Issue Brief.