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.

Celebrating SIF Success in CT

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L-R: John Merz, Executive Director, AIDS-CT; Dannel Malloy, Governor, State of Connecticut; Sarah Gallagher, Director of Strategic Initiatives, CSH; Damian Thorman, Social Innovation Fund Director, CNCS; and Larry Oaks, New England Director, CSH

The successes and impact of the CSH Social Innovation Fund (SIF) initiative were highlighted during the Connecticut Integrated Healthcare and Housing Networks (CIHHN) Awards Dinner and Celebration held at the end of March in Hartford. Honored guests at the Dinner were Connecticut Governor Dannel Malloy, Director Damian Thorman of the Corporation for National and Community Service Social Innovation Fund, Richard Cho of the U.S. Interagency Council on Homelessness, SIF participants, and the four providers receiving awards for their work on SIF: Journey Home, Columbus House, Supportive Housing Works and New London Homeless Hospitality Center.After being introduced by Master of Ceremonies and Executive Director of AIDS-CT John Merz, CSH Director of Strategic Initiatives Sarah Gallagher welcomed everyone and spoke about the progress of SIF in Connecticut and nationally. Calling housing “a crucial piece of the healthcare puzzle,” she summed up SIF by saying it “brings together the best of what we know works in ending homelessness—data driven targeting and a housing first approach to supportive housing—with some of the most innovative solutions for improving health outcomes— care coordination, patient navigation, and direct linkages to integrated primary and behavioral health care.”

Sarah cited impressive outcomes to spotlight SIF’s progress to date:

  • SIF participants have a 92% retention rate in supportive housing.
  • 90% are actively connected to a primary health care provider.
  • 91% are actively connected to mental health care.
  • 89% to specialty care.
  • As a result, hospital emergency department use as the main source of care is decreasing for SIF participants and other service utilization patterns are trending in a positive direction.
  • Overnight hospitalizations dropped from 8.5 before housing to 2.7 in the 12 months post supportive housing placements.
  • Emergency department visits decreased from 13 pre-housing to just 5 in the 12 months post supportive housing.

In addition to positive individual outcomes, SIF’s cross-systems work has been cited by the Centers for Medicare and Medicaid Services and the U.S. Department of Housing and Urban Development as helping to advance the direction of federal policy.

Sarah also introduced a new video featuring partners, providers, funders and participants in Connecticut’s SIF initiative.

Governor Malloy praised SIF in his address, noting that without housing and access to primary healthcare services, individuals are forced to cycle through various high-cost and crisis-care public systems, costing government significant amounts of money without any improvements in personal well-being. He reiterated his Administration’s commitment to ending homelessness and said SIF is contributing to his goals of helping the chronically homeless and those veterans in need of a home and support services.

Governor Malloy said there is now a vibrant safety net in place to quickly access housing and services for any vulnerable veteran lacking a place to live.

He also pointed out the infrastructure created through SIF will ensure that when Connecticut ends chronic homelessness, the state will already have in place new models replacing the costly and ineffective ways of addressing homelessness with newer ones that provide ongoing, coordinated, and multi-disciplinary care with the appropriate housing.

Recognizing the progress SIF has made bridging gaps between housing and healthcare, Governor Malloy acknowledged that stakeholders around other vulnerable populations need to be brought together to think about the role of housing in improving outcomes through cost-effective interventions.

L-R: Sarah Gallagher, Director of Strategic Initiatives, CSH; Damian Thorman, Social Innovation Fund Director, CNCS; Alicia Woodsby, Executive Director, Partnership for Strong Communities; and Janice Elliott, Executive Director, Melville Charitable Trust

Corporation for National and Community Service SIF Director Thorman spoke to the group about how their work is fostering greater collaboration and cooperation amongst public and private providers, breaking down the “silos” that usually exist when different agencies and levels of government focus exclusively on their own goals. He noted “SIF is reducing risks and increasing the impact of government resources by using data to drive progress…all while improving people’s lives.”

Director Thorman concluded by saying that “without SIF… programs wouldn’t be making the impact they are today.”

In addition to the remarks offered by Sarah, Governor Malloy and Director Thorman, two panel discussions, one comprised of just SIF participants and the other of general stakeholders, were incorporated into the evening. The stakeholder panel was moderated by CSH Director in New England, Larry Oaks, and included: Alicia Woodsby, Executive Director, Partnership for Strong Communities; Janice Elliott, Executive Director, Melville Charitable Trust; Steve DiLella, Director of Individual and Family Support Program Unit, Connecticut Department of Housing; and Nancy Navarretta, Deputy Commissioner of the Connecticut Department of Mental Health and Addictions Services.

The ceremony commending the four providers receiving awards was moderated by Susan Lampley of the Melville Charitable Trust. Read the introductions of the four award winners by clicking here.

Ohio Institute Finale

The Supportive Housing Institute in Ohio brought together teams from across the state to learn about creating and operating quality supportive housing for people experiencing homelessness, those prioritized by local Continua of Care and Mental Health and Addiction Service Boards, and adults with developmental disabilities transitioning from institutional settings.

This series helped teams navigate the complex process of developing housing with support services and concluded in January with a finale event that included a presentation by each of the participating teams.

Teams

300_SteeleValley_16The Youngstown team includes the Help Hotline, Crisis Center, Mahoning County Mental Health and Recovery Board, CSN, a part of North Coast Behavioral Health Care, Meridian Community Care, and Flying High Inc. Their project proposal is for a 15 unit development made up of one-bedroom apartments for frequent/super utilizers of hospitals.

The Cherry Court Campus team hails from Canton and includes ICAN Housing, Coleman Professional Services, and the Recovery Board of Stark County. This team is working on the design of a new construction development including 14 one-bedroom units and 10 studio units on two adjacent lots with a central park and urban farm.

Gallia County Children’s Home plans to develop 8 one-bedroom units and 4 two-bedroom units as a gut rehab project for individuals and families experiencing homelessness and impacted by mental health conditions.

305_Akron_16The Stoney Point Commons team from Akron is made up of Stock Tober Development, NCR, and Community Support services, along with development consultant John Stock and supportive housing consultant Ted Jones. They have proposed a 68 unit development targeting people facing homelessness including those experiencing chronic homelessness.

The Archives Apartments proposal out of Cleveland is a collaboration between Testa Companies, Welcome House, Inc., and EDEN. This team is working towards applying for funding for a gut rehabilitation project of 24 one-bedroom units for people with developmental disabilities coming out of foster care with one unit for a live-in manager to oversee the two buildings. The adjacent structure will be developed into commercial space and 4 market rate units.

300_BuckUps_16The team from Dayton includes Foundation for the Challenges, UP Development, and the Montgomery County Board of Developmental Disabilities. This development team plans to create a 40 unit single-site building with a 25% set aside for adults with developmental disabilities. Other target populations include people experiencing chronic homelessness and adults with mental health and substance use conditions.

The Muskingum team from Zanesville includes Muskingum Economic Opportunity action Group Inc., Muskingum Behavioral Health, and Fairfield Homes. Their project is a 32 unit single site apartment complex targeting people with substance use disorders, and will be located near downtown Zanesville.

The development team from Mansfield, OH includes Trek Development Group, Mary McCloud Bethune Intervention and Enrichment Center, and the VA. Future projects will include creating scattered site townhomes as well as Veteran focused affordable and supportive housing.

300_MudHens_16The Lincoln Place team from Toledo consists of TASC of North West Ohio, Gould Development and PHRL Development. Lincoln place will include 60 one-bedroom units in a single site project in Central Toledo. The target populations include those exiting the criminal justice system with great barriers sand people facing chronic homelessness with co-occurring mental health and substance use disorders.

 

Sponsor

The Institute is made possible by the support received from the Ohio Housing Finance agency, Ohio Department of Mental Health and Addiction Services, and the Ohio Capital Corporation for Housing.

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.

NWI Veterans Village Opens

NWI vets village

U.S. Secretary of Veterans Affairs Robert McDonald, Indiana Lt. Governor Eric Holcomb, and Gary, Indiana Mayor Karen Freeman-Wilson today officially opened the North West Indiana (NWI) Veterans Village supportive housing project.

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Mayor Karen Marie Freeman-Wilson of Gary, Indiana, welcomes veterans & their families to the opening of NWI Veterans Village

CSH director in Indiana, Lori Phillips-Steele, joined Secretary McDonald, Mayor Freeman-Wilson and Lt. Governor Holcomb on the dais and noted the Village is the first supportive housing in the country to receive funding, in the form of a pre-development loan, from the CSH Supportive Housing Solutions Fund.

The estimated $10.1 million Village includes 44 units of supportive housing for Veterans, along with a computer room, exercise room, roof garden, and a restaurant that will be open to the public and serve as a training ground for those interested in pursuing a career in culinary arts.

Broadway Area CDC is the developer of this blockbuster project.

Broadway completed the Indiana Supportive Housing Institute in 2011, sponsored by the Indiana Housing and Community Development Authority and supported by CSH, and has created attractive and much-needed apartments for those who served our country.

CSH Indiana's Lori Phillips-Steele joins Gary Mayor Freeman-Wilson at NWI Veterans Village

CSH Indiana’s Lori Phillips-Steele joins Gary Mayor Freeman-Wilson and Indiana Lt. Governor Eric Holcomb at the celebration of the new NWI Veterans Village

Penn Place Opens in Indy

305_Kelsey and Tenant_16As the temperatures dropped low enough in Indianapolis for outreach workers to scour the streets in search of people sleeping outside to invite indoors, a new supportive housing development named Penn Place opened to serve people facing chronic homelessness and those who are frequent users of emergency services.

This 38-unit housing first apartment complex is the story of a large group of committed partners collaborating to identify and house the most vulnerable people experiencing homelessness in Indianapolis.

This robust team includes BWI Development, Insight Development, Indianapolis Housing Agency, Eskenazi Health Midtown Mental Health and Pedigo Health Center, Horizon House, The Pour House, The Indianapolis Housing Task Force, the Professionally Blended Outreach team,  the Indianapolis Continuum of Care and CSH.

Dr. Dennis Watson of the Center for Health Policy at IUPUI, in partnership with the Midwest Harm Reduction Institute, is delivering training and technical assistance services to Penn Place as part of a federally funded study. CSH is providing on-going technical assistance.

Special thanks to the funders supporting this community partnership including the Federal Home Loan Bank of Indianapolis (FHLBI) and their member bank Merchants, IHCDA, the equity partner PNC, Indianapolis Housing Agency, HUD, the City of Indianapolis, the Indianapolis Continuum of Care (CoC) , and Nina Mason Pulliam Charitable Trust.

Penn Place is truly a community effort – one that ensures barriers to a stable home are eliminated for those who have faced extreme challenges and trauma. We celebrate the partnerships that made it possible and the bright future for those who are finding new lives in their very own apartments.

Please click here to read more.

D.C. Task Force Working on Better Shelter Plan and Supportive Housing

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Download the “What Kind of Community Do We Want” pdf by Clicking Here

Kristy Greenwalt, Director of the District of Columbia’s Interagency Council on Homelessness, and Laura Zeilinger, Director of the City of Washington Department of Human Services, recently led a task force focused on how to replace D.C. General Emergency Shelter, which houses hundreds of homeless families in our nation’s capital.

As part of their Homeward D.C. plan, which lays out goals for making homelessness rare, brief and non-re-occurring, City leadership is committed to moving from antiquated, large, multi-family shelter settings, such as D.C. General,  to a system that is nimble, responsive and geographically dispersed in areas where individuals and families who find themselves homeless can better connect to natural supports and receive community-based services in their neighborhoods.

Stakeholders from across the city, including CSH, participated in the task force meetings to help develop better alternatives for families. Ideas discussed include a “bathroom in every unit” and enough room and common areas to ensure children have safe spaces to play and learn. The District leadership led the task force through the process of “costing out” different models financially, operationally and through the eyes of the men, women and children who would be in the housing and using the services.

Kristy, Laura and their teams have done a great job of balancing a vision of a “perfect” shelter system with one that would eventually end up being a small piece of the District’s overall plan to create more affordable and supportive housing resources.

The challenge they face is “the reality of the situation” as the District continues to develop its affordable housing, community-based supportive services, employment and childcare supports while moving to replace D.C. General. Sorting through these important considerations and difficult realities, the City must balance how to build a better emergency  shelter system as well as a more robust supply of affordable and supportive housing.

At a family stakeholder discussion, conducted by members of the task force, one resident best summed up what the City should be aiming for in its planning.  When asked about the need for having a “bathroom” in every unit, a mother who had been raised in a shelter setting herself said, “We don’t need shelters with a bathroom in every room, that’s too expensive…we need City dollars invested in affordable housing and supportive services…we don’t want our children to call this place (an emergency shelter) their home. We want real homes.”

 

NYC Maintaining Functional Zero Forum

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Kristin Miller, CSH director in New York, meets with colleagues to discuss maintaining functional zero in the metropolitan area.

Last week, CSH actively participated in the “Maintaining Functional Zero Forum” held in New York City.

Over 100 officials and providers from New York City, The U.S. Department of Housing and Urban Development, the United States Interagency Council on Homelessness, and the U.S. Department of Veteran Affairs attended to collaborate on ways to enhance systems that quickly address the housing and services needs of vulnerable people, including veterans, who are struggling through long-term homelessness.

CHS co-led a workgroup on Coordinated Entry & System Navigation with Rochelle Haynes, Chief of Staff for the New York City Department of Homeless Services.

CSH Supports “Project One For All” Proposal in San Diego

CSH joins with San Diego County Supervisors to unveil "Project One For All" proposal.

CSH joins with San Diego County Supervisors to unveil “Project One For All” proposal.

San Diego County officials have embraced an initiative – “Project One For All” – to create a partnership between communities, the local housing commission and nonprofit organizations to give homeless people facing mental illness access to housing and a full spectrum of services. Their goal is to create “head-to-toe services for homeless people with mental illness.”

County Supervisors say they are taking robust action now because homeless people with mental illness are the least likely group of people to get and keep housing without major help, and are some of the biggest users of emergency health care and law enforcement resources. San Diego County points to studies that conclusively show that providing housing and services is far more cost-effective than leaving people on the streets, where they are dependent on expensive crisis care and emergency services. (CSH – FUSE)

The new program builds on a plan announced in August to spend $10 million to house homeless people and Project 25, a pilot program between the county, the San Diego Housing Commission, the United Way and St. Vincent de Paul.

CSH has provided housing technical assistance to the County of San Diego Behavioral Health Services department, and worked with local partners to develop a five-year Behavioral Health Services Strategic Housing Plan.

CSH is supportive of the initiative and applauds the leadership of the County – including the County Behavioral Health Services department – the communities, housing agencies and local advocates involved in Project One For All.