CSH Medicaid Crosswalk for New Hampshire

The just released New Hampshire Medicaid Supportive Housing Services Crosswalk examines the extent to which services covered under New Hampshire’s Medicaid program align with supportive housing services for adults with significant needs. CSH conducted this Medicaid Crosswalk with funding from the New Hampshire Housing Finance Authority, in partnership with Families in Transition and the New Hampshire Department of Health and Human Services. Several best practices and recommendations are identified in the report. Among them, CSH recommends that:

  • a supportive housing services benefit be included as a Medicaid waiver or state plan amendment; new hampshire
  • supportive housing and case management services be covered and expanded to include individuals with substance use disorders;
  • resulting cost savings be redirected to behavioral health and housing systems;
  • training be provided to all stakeholder organizations (managed care organizations and health and housing providers) on the role of supportive housing as a health intervention.

Read more about the process, findings, and recommendations in the New Hampshire’s Medicaid Crosswalk.

Stakeholder education is already underway, through the Supportive Housing Medicaid Institute, funded by the Endowment for Health.

Additionally, CSH staff will present this week at New Hampshire’s Annual Homeless Providers Conference on the topics of health and housing innovations and Medicaid service funding opportunities around the country.

MA Pay for Success Milestone

Pay for Success initiative to reduce chronic individual homelessness successfully houses over 250 individuals in first year

The first-in-the-nation Pay for Success initiative to reduce chronic individual homelessness in Massachusetts has successfully placed over 250 individuals in stable, supportive housing, exceeding the minimum goal set by the Commonwealth for its first year by over 50 individuals and paving the way for significant cost savings in emergency room and inpatient care.

The Pay for Success initiative being implemented by the Massachusetts Alliance for Supportive Housing (MASH) for the Commonwealth of Massachusetts focuses on providing permanent, low-threshold supportive housing to those who would otherwise rely on costly emergency resources, enabling them to address their often complex health issues more effectively than they would on the streets or in shelters. MASH is a partnership of the Massachusetts Housing & Shelter Alliance (MHSA), United Way of Massachusetts Bay and Merrimack Valley and Corporation for Supportive Housing (CSH).

"Preliminary data suggests that by focusing on housing chronically homeless individuals and longterm homeless individuals who are high utilizers of emergency care, the Pay for Success initiative will have a significant impact on the utilization of emergency resources," said Joe Finn, President and Executive Director of the Massachusetts Housing & Shelter Alliance.

MASH conducted a comprehensive assessment of the individuals placed in permanent supportive housing this year through the Pay for Success initiative. It found that in the six months prior to entering housing, the 250 individuals housed through the Pay for Success initiative this year as of June 1, 2016, had accumulated:

  • 18,917 nights in shelter
  • 1,816 days in the hospital
  • 541 emergency room visits
  • 690 nights in detox treatment

Of the 250 tenants, 200 have been enrolled in the MassHealth Pay for Success Community Support Program for People Experiencing Chronic Homelessness (CSPECH) program, an innovation of the Massachusetts Behavioral Health Partnership and MHSA that is recognized nationally as a model for funding the support services component of permanent supportive housing with Medicaid dollars.

“The collaboration with our partners in the private sector to provide supportive housing to address chronic homelessness will greatly improve the quality of life for many of our most vulnerable residents while also saving the Commonwealth money,” said Secretary of Administration and Finance Kristen Lepore. “I applaud the early success of this initiative and am proud of the work by the Baker-Polito Administration and the Massachusetts Alliance for Supportive Housing to end homelessness in our state.”

"This Pay for Success initiative is enabling the Commonwealth to rapidly scale approaches such as the 'Housing First' model and MHSA's Home & Healthy for Good program at a rate that would not be possible without the upfront private capital and philanthropic investment of the partnership," said Jeffery Hayward, Chief of External Affairs at United Way of Massachusetts Bay and Merrimack Valley. "It is exciting to see models that are proven to work funded at a level that is providing dignity to some of our most vulnerable individuals, significantly reducing our state's chronically homeless individual population and creating potential savings in other costs like incarceration, shelter and emergency care."

The innovative Pay for Success initiative leverages a mix of philanthropic funding and private investor capital from Santander Bank, CSH and United Way to provide the upfront funding for social services. If the goals of the PFS initiative are met, the government compensates the investors for undertaking the investment risk. If the goals are not met, the government is not obligated to repay the investors.

“So many vulnerable people have been helped already; it is certainly an achievement that this initiative has exceeded its minimum goal for the first year," said Deborah De Santis, President and CEO of CSH. "But even more impressive is the scope of the providers they have attracted to the table as partners, particularly the healthcare and managed care organizations that recognize we can reduce costs and improve the health of vulnerable people through the stability that comes with supportive housing."

“These first-year results demonstrate how important it is for the public and private sectors to work together to create innovative, results-based strategies to address chronic homelessness,” said Gwen Robinson, Managing Director, Corporate Social Responsibility, at Santander Bank.
The Pay for Success initiative, led by the Massachusetts Housing & Shelter Alliance, United Way of Massachusetts Bay and Merrimack Valley and CSH, will provide at least 500 units of stable, supportive housing for up to 800 individuals, reducing the Commonwealth's number of chronically homeless individuals by half over six years.

Leaders in New England Discuss Solutions to Opioid-Heroin Epidemic

Today, public and private sector leaders from throughout New England and upstate New York will convene at the invitation of CSH to focus on the addiction epidemic in their region. This event will provide an opportunity for state and local officials and providers from NY, CT, RI, MA, NH, VT and ME to come together to discuss and learn the various responses to the opioid crisis.  This convening also will explore how treatment and supportive housing systems can coordinate and collaborate to help people struggling with substance use.

WHAT:            New England Convening on the Heroin-Opioid Epidemic

WHEN:           Tuesday, July 19, 2016, 10am – 3:30pm

WHERE:         The Boston Foundation Headquarters, 75 Arlington Street, 10th Floor Boston, MA. Convening sponsored by Santander Bank.

WHO (Main Speakers):

Convening Welcoming Remarks

  • Dr. Jim O’Connell, CSH Board Member and President, Boston Health Care for the Homeless Program

Convening Keynote Speaker

  • Marylou Sudders, Secretary, MA Executive Office of Health and Human Services

Multi-State Panels

  • Miriam Delphin-Rittmon, Commissioner, Connecticut Department of Mental Health and Addiction Services
  • Barbara Cimaglio, Deputy Commissioner, Alcohol and Drug Abuse Program, Vermont Department of Health
  • Rebecca Boss, Acting Director, Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals
  • Timothy Rourke, Chair, New Hampshire Governor's Commission on Alcohol and Drug Abuse Prevention and Director of Substance Use Grantmaking, New Hampshire Charitable Foundation
  • Dr. Monica Bharel, Commissioner, Massachusetts Department of Public Health
  • Tracie Gardner, Assistant Secretary for Health, New York State Office of the Governor

White House Office of National Drug Policy Presentation

  • Katherine Klem, Senior Policy Advisor, White House Office of National Drug Policy

Housing and Treatment Panel

  • Hal Cohen, Secretary, Vermont Agency of Human Services
  • Becky Vaughn, Vice President for Addictions, National Council for Behavioral Health
  • Melissa Skahan, Vice President of Mission Integration, Mercy Hospital

Harvard Releases Supportive Housing Report

Building on Success: Strengthening Provider Capability to Provide Permanent Supportive Housing (Publication of the Joint Center for Housing Studies, Harvard University)

Building on Success: Strengthening Provider Capability to Provide Permanent Supportive Housing

MASH-PFS Provider Learning Collaborative

The Commonwealth of Massachusetts, in partnership with CSH, Massachusetts Housing and Shelter Alliance, the United Way of Massachusetts Bay and Merrimack Valley, and Santander Bank, launched the Massachusetts Pay For Success Initiative in June of 2015. Sixteen participating housing and service agencies across the state of Massachusetts are aiming to house 500 to 800 chronically and “high-use” homeless individuals with an 85% continuous sustained housing rate over five years.

deb and joe

CSH CEO & President Deb De Santis with MHSA President & Executive Director Joe Finn

One year later, providers participating in the Initiative have housed half of the initial 500 person goal and continue to outreach and engage additional chronic and high-use individuals experiencing homelessness.

The Pay For Success Initiative leverages significant public and private funding along with the Massachusetts Housing and Shelter Alliance’s (MHSA) Home & Healthy for Good (HHG) housing and service model. HHG demonstrates that providing housing and supportive services to chronically homeless individuals through a low-threshold, Housing First model is less costly and more effective than managing their homelessness and health problems on the street or in shelter. Additionally, roughly three quarters of the Pay For Success tenants are enrolled in the Community Support Program for People Experiencing Chronic Homelessness (CSPECH) program. CSPECH was designed by the the Massachusetts Behavioral Health Partnership (MBHP) and MHSA, and is a proven model of Medicaid reimbursement that help funds permanent supportive housing for chronically homeless individuals.

As a member of the Massachusetts Alliance for Supportive Housing, and investor in the Initiative, CSH provides advisory services and best practices to enhance service providers’ performance, and the success of the initiative overall. CSH developed a multi-year, multi-level, logic-model driven Provider Learning Collaborative, which kicked off in February 2016. The Provider Learning Collaborative supports participating providers in developing and strengthening their networks, sharing best practices, and building their capacity. Case Managers, supervisors, and provider leadership have gathered to discuss their participation in the initiative, challenges, and successes. Specific sessions have addressed housing search and placement, eviction prevention, and motivational interviewing.

To date, over 80 professionals across the 16 participating agencies have attended and contributed to collaborative discussions and peer-to-peer learnings.

CSH will continue to convene learning collaborative sessions throughout the Initiative, covering topics ranging from addressing active substance use, to self-care and preventing employee burnout.

CSH also is launching an online community where participating providers can connect between sessions to share content and ask questions.

CSH will continue to provide local and national best practices and guide discussions around opportunities for change and improvement as our Massachusetts partners work to house those in need of housing and services.

When Seasons Change: A Tribute to Barbara Geller

A few months back, we paid tribute to Barbara Geller, then retiring as the long-time Director of the Statewide Services Division within the Connecticut Department of Mental Health and Addiction Services (DMHAS).

We don’t often publicize retirements, but Barbara was a special consideration. To us and many others, an exceptional person.

For more than 20 years, she had been a partner with CSH and a dedicated champion of programs meeting the diverse, unique mental health and addiction services needs of her state’s most vulnerable people, including those facing homelessness and other forms of housing instability.

We knew her passion, wisdom, the quality of her efforts, and the extent of her good works. She amazed us with her foresight and impact. Innovative, tireless and cheerful, her mission mattered to her and those she reached.

In her role at DMHAS, Barbara was one of the original leaders of the movement to establish supportive housing as the solution for chronic homelessness in Connecticut. She was instrumental in establishing Connecticut’s Harvard Ash Institute award-winning supportive housing funders collaborative, and helped ensure that DMHAS contributed state dollars for services in supportive housing year after year. Under her leadership, roughly 5,000 units of supportive housing were created statewide.

A visionary, Barbara also helped advance housing first and supportive housing as a solution to some of Connecticut’s most complex problems such as how to better serve super-utilizers of costly crisis and emergency care. She always emphasized long-term, lasting solutions over short-term gains.

Barbara was a vanguard among state behavioral health officials‎ in seeing housing as critical to the mission of behavioral health agencies, even at a time when this nexus was not as accepted as it is today.

Her work not only improved the lives of many individuals and families in her own state, she is regarded as a national leader and true advocate for those most in need.

Barbara really cared about the people she served. She was more than a friend to supportive housing; she was one of those rare human beings who gave her heart and soul to making a difference for the thousands who benefitted from her drive and advocacy.

So when we learned this week that Barbara had passed from this life, our hearts were filled with deep sadness.

Our spirits, however, are lifted in the knowledge that she succeeded in building better lives for all around her and those she touched.

We are reminded that for everything there is a season.

We take great pride in having known and worked with Barbara, and in calling her our friend, and even greater comfort in knowing she lived every season to the fullest – leaving behind an incredible legacy of purpose and accomplishment transcending her time with us and the boundaries of her beloved State of Connecticut.

 

Barbara's lifetime of achievement is conveyed in her biography, published when she received a CSH Champion Award in 2014.

At the service honoring her life, Barbara was described as a "Woman of Valor" as conveyed in this poetic passage.

OSF Grants $150,000 to CSH for FUSE Replication

OSFThe Open Society Foundations (OSF) U.S. Programs initiative supports efforts to advance equality, fairness, and justice with a focus on the most vulnerable and marginalized communities and the most significant threats to open society in the United States today. OSF works to further a vibrant democratic society in which all people can meaningfully participate in its civic, economic, and political life and to ensure that the core institutions of civil society are effective and accountable to the public.

Areas of particular emphasis in U.S. Programs’ grant-making and other activities include:

  • The advancement of effective and fair criminal justice and drug policies,
  • Support of the rights of racial minorities and other vulnerable groups;
  • Support of institutions and practices that advance a more informed and engaged public and responsive and effective government.

OSF’s recent contribution of $150,000 to CSH to promote a scaled replication and the sustainability of the FUSE (Frequent Users/Utilizers Systems Engagement) model will help ensure that more people leaving our jails and prisons will have a real chance to become a part of the communities in which they live. Because of the generosity of OSF and others, CSH is able to recreate FUSE in more communities across the country.

FUSE is a CSH signature accomplishment that helps communities identify and engage high utilizers of public systems and place them into supportive housing in order to break the cycle of repeated use of costly crisis services, shelters, and the criminal justice system. In the FUSE model, supportive housing serves to smooth the transition from institution to community, promoting a transformation that serves those released from jails and prisons, and the general population, by improving lives and public safety.

The critical support of OSF and our partners will allow CSH to aggressively pursue our vision to create additional policy and resource tools, such as FUSE, that encourage cross-system collaboration and allow innovative responses to complex social problems.

 

CSH Helps Cambridge MA Address Homelessness

“We’re working to develop a set of recommendations on what we can actually do about homelessness,” Ellen Semonoff told a gathering of about 20 people at the Cambridge Community Center Thursday evening, June 25. Ms. Semonoff is Assistant City Manager for the City of Cambridge's Department of Human Service Programs.

The meeting was the second of two held last week that are part of a CSH process called a charrette, a multi-stage community effort to gather opinions and recommendations about a single issue from people who have a stake in the outcome. In this case the stakeholders include residents, consultants, City officials and staff as well as people experiencing homelessness and those who work with them.

The earlier of the two meetings was at noon on Wednesday, June 24. The organizer for both events was Shelly Chevalier, Planning and Development Manager for the Cambridge Department of Human Service Programs. The charrette process is part of a collaborative effort launched by the City to create a plan for addressing homelessness, she said; participants include multiple local government departments, nonprofit partners, and the Cambridge Homeless Continuum of Care.


"We get it," Ms. Chevalier noted at Thursday’s meeting. "We have to try and do things differently, and it requires pushing beyond what we know."


Leadership for the project is organized through a 15-member Charrette Steering Committee composed of representatives from a cross-section of community organizations.

Acting as moderator Thursday evening was Larry Oaks, CSH director in New England. CSH promotes supportive housing as a way of addressing chronic societal problems and is the facilitator for the City’s planning process, according to Ms. Chevalier.

Mr. Oaks introduced two participants in the evening’s discussions, both of them members of the Charrette Steering Committee:
--Sean Terry of the New England Center for Veterans described the organization’s housing services and its work with homeless veterans.
--Liz Mengers of the Cambridge Department of Human Services noted that this is the second month of the “brainstorming” process and said that further discussions during the summer will be followed by another round of meetings in September.

“This meeting is part of a larger city planning process,” Oaks said. “Our mission is to make sure that issues relating to housing and homelessness remain front and center in that process.”

 

CSH Facilitates Implementation Meeting for Boston Mayor’s Action Plan

CSH facilitated an intensive Implementation Planning Meeting in Boston, MA to effect the innovative solutions presented by Mayor Martin J. Walsh’s Task Force on Individual Homelessness. Two members of the Mayor's Task Force are well-respected experts from CSH.

For the planning meeting, staff from CSH's New England and Texas field offices worked with over two dozen dedicated local housing and service providers and City representatives to translate strategies and recommendations of the Task Force into a comprehensive structure to get the work done, and place homeless individuals on a path to permanent housing.

Heather Muller, CSH Program Manager in Houston TX; Larry Oaks, CSH Director in New England; and Chelsea Ross, CSH Program Manager in New England, facilitated the implementation event in Boston.

Hosted by the City of Boston’s Department of Neighborhood Development, the day focused on restructuring the Homeless Response System. Building on existing strengths and the great strides the City has already made in reducing homelessness, CSH supported the implementation team leaders in designing a plan tailored to the unique needs of Boston proper.

After an address by Boston Chief of Health & Human Services, Felix Arroyo, the team worked in-depth on building the framework for a Front Door Triage System and the implementation of Coordinated Access. The group explored steps necessary to expand and better coordinate existing programs, and fill the gaps in Supportive Housing identified by the Task Force with technical assistance from CSH.

Earlier in the year, Boston welcomed several CSH staff from Texas to share knowledge gained from Houston’s successful change of their Homeless Response System to better address the needs of vulnerable populations. Following their system redesign, supported and staffed in part by CSH, Houston has seen a dramatic reduction in chronic homelessness, and became one of the first large cities in the country to announce they have ended veteran homelessness.

Keep up on CSH work in Texas and Massachusetts to tackle homelessness here and here.

Interested in how CSH can help your community prevent and end homelessness through effective coordinated access and systems change? Contact us at consulting@csh.org.

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