HEART Alliance for Sustainable Families Preliminary Evaluation Findings

This report provides interested stakeholders with a preliminary overview of the outcome
and process evaluations for the HEART (Housing, Empowerment, Achievement,
Recovery and Triumph) Alliance for Sustainable Families. HEART is one of five
national demonstration sites funded by the Children’s Bureau of the Administration of
Children and Families with the United States Department of Health and Human
Services. HEART is a five year demonstration project from October 1, 2012 through
September 30, 2017. This report covers two years of HEART research study data.

HEART is a collaborative community-based supportive housing initiative designed to
assist 50 high risk and high need families in Broward County, Florida achieve family
strengthening as well as housing and economic stability. HEART represents an alliance
of 15 child welfare, housing, legal, health, and social service organizations collectively
working to improve child protection as well as family permanency and well-being.
HEART provides clinical case management, subsidized housing, economic selfsufficiency,
life coaching, legal counsel, health/behavioral health support, and domestic
violence prevention. HEART employs evidence-based interventions such as
Strengthening Families, Trauma-focused Cognitive Behavioral Therapy, and the Center
for Working Families.

Using a Housing First model, HEART seeks to stabilize families involved with the child
welfare system who are at risk of/or experiencing homelessness. To gauge this impact,
Kids In Distress, Inc. (KID) subcontracted with Barry University researchers to conduct
the five-year evaluation of HEART.

Housing the First 100

The Orlando Housing First initiative, “Housing the First 100”, is a collaborative undertaking in the City of Orlando and tri-county area. The project connects high cost, high need, homeless frequent users to housing and services. Read our latest Housing and Healthcare profile.

Orlando’s Housing-Healthcare Connection

A Joint Blog by Deb De Santis and Orlando Mayor Buddy Dyer

When CSH and the City of Orlando began our partnership, Orlando had already realized that great cities not only engineer and sustain vibrant business districts; they also uplift the most vulnerable among us.

Working with regional partners such as Orange County Mayor Teresa Jacobs, the community recognizes there isn’t a “one size fits all” approach to address the many faces of homelessness. Through the Central Florida Commission on Homelessness and the Homeless Services Network, local leaders are learning from the successes of Houston and Salt Lake City and taking meaningful steps to forge innovative approaches that produce results.

A little over 18 months ago, citing strong commitments from Orlando and Orange County, the Florida Hospital announced a $6 million pledge to address homelessness in Central Florida. The resources from Florida Hospital served as the kick-off investment for the Central Florida Foundation’s “Homeless Impact Fund,” a public and private investment-solutions vehicle to help those facing homelessness.

These kinds of collaborations to address homelessness are catching on, but Florida Hospital’s eagerness to become an invested partner with local communities, and in such a big way, is something we need to see more of across the country.

As Florida Hospital’s CEO said when announcing the donation, “We all have a moral obligation to take a stand to end chronic homelessness.” There is no doubt in our minds that the impact would be significant if other hospitals and local officials took their cue from Orlando and Florida Hospital and formed strong working relationships.

We know housing is a determinant of health and in many respects the best medicine for injecting the stability into the lives of vulnerable individuals, raising the likelihood they will stay on top of their medical, mental and behavioral health needs. Because successfully housed people are more stable and tend to use costly crisis care (emergency rooms, detox programs) less frequently than those facing homelessness, it is in the interest of hospitals and other healthcare providers to be at the table.

Orlando’s civic, business and healthcare leaders have committed to tackling chronic homelessness together, rallying around “housing first.” This approach houses people as quickly as possible and surrounds them with the case management and support services they need to stay housed.

Thanks in part to Florida Hospital’s generous investment, Orlando can access case managers and the essential services to keep individuals off the streets. Through these efforts, just in the core of Orlando, 70 people have been housed in the last year.

And the City continues to build on the momentum by matching the Florida Hospital gift with over $4 Million of its own resources to expand access to affordable housing, and also by creating a high-level position within the Mayor’s Office to harness the authority, expertise and resources necessary to enhance housing options and transform how services are delivered to vulnerable people.

There is always more to do, but we have seen an unprecedented level of support from the community, providers, advocates and civic-minded organizations such as Florida Hospital.

We cannot and will not rest until those who need a home have one.

That passion is as much a part of Orlando’s vision as attracting new businesses and showcasing amazing entertainment experiences. Because, when you get right down to it, building a world-class city also means creating the opportunities and culture to take care of everyone in it.

Deb De Santis is the President and CEO of CSH

John Hugh “Buddy” Dyer is the 32nd and current mayor of Orlando, Florida, first elected in 2003.

Spreading the Power of FUSE

CSH convened a special peer-to-peer site visit earlier this month in Charlotte, North Carolina, that brought together a group from Iowa City, Iowa, and Mecklenburg County, North Carolina, to explore the structure and success of MeckFUSE, a housing program for homeless men and women with behavioral health issues who have been frequent users of Mecklenburg’s jail, street camps and shelters. FUSE stands for Frequent User Systems Engagement, a proven national supportive housing model from CSH.

This peer-to-peer was designed to assist Iowa City as it continues to build the foundation for its own FUSE initiative as a CSH start-up grantee. CSH is able to expand FUSE throughout the country due, in part, to generous support from the Open Society Foundations and Capital One. Both funders also help underwrite our new and free FUSE Resource Center.

While diving deeper into FUSE, participants in this peer-to-peer learning experience visited a single site supportive housing apartment building that houses the once chronically homeless.

The apartments, Moore Place, are provided as a HousingWorks supportive housing program of the Urban Ministry Center. Through the HousingWorks program, the Urban Ministry Center seeks to fulfill its mission of ending homelessness by giving the most vulnerable what they so desperately need: a home.

HousingWorks has three pathways to housing for chronically homeless individuals: Moore Place, an 85-unit apartment building that opened in February 2012; Scattered Site apartments (45 units); and, in MeckFUSE, a partnership with Mecklenburg County providing an additional 45 community-based apartments.

The HousingWorks approach is simple: give chronically homeless individuals what they need most – a safe, stable, affordable home – and then provide the wrap-around support to help them remain housed and regain lives of wellness and dignity. A team of social workers, therapists, a full-time nurse and a part-time psychiatrist provide supportive services to help each HousingWorks tenant manage the transition from long-term homelessness to housing, and to help individuals meet personal goals to ensure they never become homeless again.

HousingWorks specifically targets those individuals who have been homeless the longest, are the most vulnerable and are the most frequent users of emergency rooms, jails, shelters and other costly crisis services.

In addition to seeing Moore Place and how it transforms lives, the group from Iowa City spent two days:

  • Increasing their understanding of the core components and day-to-day operations of a FUSE program;
  • Discussing strategies for building community support for new developments and ways to maintain on-going community engagement/support of FUSE programs;
  • Better understanding MeckFUSE financing for operations, rental assistance and supportive services;
  • Learning the development process, funding sources, roles of partners and design considerations for FUSE tenants; and
  • Understanding the needs of FUSE tenants when they move into housing: service needs, apartment preferences, amenities, move-in needs and types of housing support.

To learn more about CSH FUSE, please click here.

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.


CMS Issues Bulletin on Using Medicaid for Supportive Services

CMSThe Centers for Medicare and Medicaid Services (CMS) Center for Medicaid and CHIP Services (CMCS) has released an Informational Bulletin intended to assist states in designing Medicaid benefits, and to clarify the circumstances under which Medicaid reimburses for certain housing-related activities, with the goal of promoting community integration for individuals with disabilities, older adults needing long term services and supports (LTSS), and those experiencing chronic homelessness. Consistent with statute, CMS/CMCS can assist states with coverage of certain housing-related activities and services.

Read the full CMS/CMCS Informational Bulletin here.

For more information on how states are currently using Medicaid in supportive housing, see CSH’s four new resources, released earlier this month.

Read our joint statement with the National Alliance to End Homelessness, the Technical Assistance Collaborative and the National Health Care for the Homeless Council.

OrgCode, Community Solutions & CSH Launch Next Step Tool for Youth

The Next Step Tool for Homeless Youth

The Next Step Tool for Homeless Youth, or Next Step Tool, integrates the TAY Triage Tool, developed by the Corporation for Supportive Housing (CSH) through research by Eric Rice, PhD, Associate Professor at University of Southern California, with the VI-SPDAT, created by Community Solutions and OrgCode Consulting, Inc.

The TAY Triage Tool predicts which youth are most likely to experience long-term homelessness, essentially on a trajectory to becoming chronically homeless adults. The VI-SPDAT helps understand current vulnerabilities and risks to future housing stability, in order to support youth in ending their homelessness.

The Next Step Tool carefully merges all of these tested ideas together. Through a closed-ended survey where youth provide a yes, no or one-word answer, service providers have a better understanding of the intensity of supports to begin with when supporting the youth.  You can download the Next Step Tool at http://www.orgcode.com/product/vi-spdat/


The Youth SPDAT

To complement the launch of the Next Step Tool, OrgCode has also created a modified version of the Service Prioritization Decision Assistance Tool (SPDAT) for use specifically with youth. The Youth SPDAT was developed based on feedback from many communities using the SPDAT who identified the need for a complete assessment tool that emphasized the unique issues faced by homeless youth.

You can download the Youth SPDAT at http://www.orgcode.com/product/spdat/


CSH Transition Age Youth (TAY) Triage Tool

The CSH Transition Age Youth (TAY) Triage Tool – A Tool to Identify Homeless Transition Age Youth Most in Need of Supportive Housing – can be accessed directly here.


Harvard Releases State of the Nation’s Housing 2015

The Joint Center for Housing Studies of Harvard University has released The State of the Nation’s Housing 2015 and this is what it says about our PROGRESS IN REDUCING HOMELESSNESS and the role supportive housing is playing, effectively getting people off our streets and keeping them housed:

“The lack of affordable housing in the United States continues to leave nearly 600,000 people homeless. More than a third are people in families, including 130,000 children under the age of 18. By comparison, chronically homeless individuals (those who have been without a place to live for at least a year or have had repeated episodes of homelessness over the past few years) account for a much smaller share (15 percent) of the homeless population. Recent increases in federal funding have aided progress in reducing both homelessness overall and among the most vulnerable groups. Indeed, the number of beds in permanent supportive housing expanded 60 percent between 2007 and 2014, to over 300,000. Beds for the chronically homeless accounted for just over half of this increase. As a result, total homelessness fell 11 percent in 2007–14, the number of homeless veterans dropped 19 percent, and the number of chronically homeless individuals was down by 30 percent. At the same time, however, the number of homeless people in families declined by only 8 percent.

But the national reduction in homelessness is not apparent in all markets. Rising rents and a dwindling supply of affordable rentals continue to put people at risk, especially in high-cost locations. Indeed, total homelessness jumped by 29 percent in New York and 40 percent in Massachusetts between 2007 and 2014. The increase in the District of Columbia was even larger, at 46 percent. Family homelessness is particularly acute in major cities, which were home to 45 percent of this population in 2014. New York City headed the list with 41,600 homeless people in families, or nearly 20 percent of the national total.”


New Markets Tax Credits Allocated to CSH

CSH Awarded $40 Million New Markets Tax Credits

Today, the U.S. Treasury Department’s Community Development Financial Institutions (CDFI) Fund announced it has awarded $40 million in New Markets Tax Credits (NMTC) to CSH as part of the 2014 round.

“The Department of Treasury has given us the tools to leverage even more resources to spur the creation of supportive housing,” said CSH President and CEO Deborah De Santis. “Not only will we be able to create the dynamic to house vulnerable people facing instability, this award will help us fulfill our goal of bringing healthcare services to hundreds more who need to access it.”

De Santis explained NMTC allocations can be used to develop facilities such as health care centers, which complement the medical and mental health services often made available to residents of supportive housing.

Thus far, CSH has used NMTC investments to leverage and add to other resources, which in turn have created about 200 units of supportive housing across the country, and enabled 15,000 healthcare visits for those facing homelessness and other forms of housing instability. In addition, CSH investments have generated approximately 800 high-quality permanent and construction jobs in communities.

To learn more about our use of NMTC to promote supportive housing, please see profiles of the Bell Building in Detroit, MI and Paseo Verde in Philadelphia, PA.

With the new award, CSH will address a number of supportive housing projects currently in the pipeline for development and estimates adding another 150 – 200 units of affordable housing, including supportive housing, and an additional 100,000 – 125,000 healthcare visits for those facing homelessness and housing instability.

“The investments made possible by today’s awards will have significant impact nationwide,” said Annie Donovan, Director of the CDFI Fund.

To learn more about CSH’s New Markets Tax Credit strategy visit our lending page or contact our Community Investment Team.

“CSH gets it when it comes to supportive housing and they are willing to work in partnership with developers to tailor their support and products to get the deal done.” Joe Heaphy, NSO (Bell Building) Vice-President of Real Estate Development and Management

Houston Ends Veteran Homelessness


CSH President & CEO Deb De Santis with Houston Mayor Annise Parker, Houston Coalition for the Homeless President & CEO Marilyn Brown, and officials from the US Department of Veterans Affairs and US Department of Housing and Urban Development.






Deb De Santis, President & CEO of CSH, speaks last September in Houston, Texas, lauding the community partnership that worked together to build an infrastructure to quickly and effectively address the housing and services needs of veterans experiencing homelessness.





“More so than in any community in this country, the people of Houston came together to end veteran homelessness. This milestone reflects the countless hours and hard work of those on the ground – the members of the Coalition for the Homeless of Houston/Harris County and The Way Home Campaign – who broke down barriers, built new relationships, innovated, and are now ensuring a future where no veteran will ever be shut out from housing or services again.” Deb De Santis, CSH President & CEO