Pennsylvania Medicaid Supportive Housing Services Crosswalk

As evidence continues to establish supportive housing as an intervention that stabilizes people with chronic illnesses, providers and states are exploring ways to ensure Medicaid programs cover the services that supportive housing residents need. To this end, CSH has worked in many jurisdictions, including Pennsylvania, to maximize use of Medicaid resources for services. In an effort to increase the availability of services to formerly homeless Pennsylvanians and expand access to supportive housing, the PA Housing as Health Coalition partnered with CSH to explore ways to make intense services like substance use treatment and mental health recovery more available and accessible. The newly released Pennsylvania Medicaid Crosswalk provides the State, managed care entities, and service providers with a valuable tool that could help them access additional resources to support programs that are proven to help those experiencing homelessness attain stability and life-long success. Read the blog about the Crosswalk posted by the Pennsylvania Health Access Network.

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

CSH Testimony to Gov's Task Force on Combating Heroin in NY

Written Comments of the Corporation for Supportive Housing (CSH)

Governor's Task Force to Combat Heroin and Prescription Drug Abuse

Submitted by Kristin Miller, Director of CSH Metro Region

Lieutenant Governor Hochul, Commissioner González-Sánchez, members of the Governor's Task Force. Thank you for the opportunity to submit testimony to this important and distinguished group of policymakers and advocates.

CSH has offered similar testimony to the New York Senate Task Force on Heroin and Opioid Addiction and applauds the efforts of New York Governor Andrew Cuomo and the Legislature, including Senator Terrance Murphy who serves on this Task Force as well, for elevating this issue and keeping it in the spotlight where it belongs.

CSH has a 25-year track record of innovation and investment in New York. Since 1991, CSH has made nearly $140M in loans to supportive housing developers for the creation of over 15,000 permanent supportive and affordable housing units in this state. Through our promotion of supportive housing, we are intimately familiar with the housing and services needs of residents who struggle with substance addiction and desperately seek stable lives to pursue recovery.

As you have undoubtedly heard again and again as you travel throughout the state, heroin and opioids are destroying people’s lives and damaging families and neighborhoods. My testimony is focused on supportive housing, a proven solution and valuable tool in our fight to stem this epidemic.

CSH this year released Supportive Housing’s Vital Role in Addressing the Opioid Epidemic in New York State , which provides a background of the opioid epidemic in New York communities and cites research showing supportive housing as a solution for individuals facing substance use disorders. Supportive housing combines affordable housing and services that help people facing complex challenges live with stability, autonomy and dignity. It has been demonstrated that through the stability found in supportive housing, people using heroin successfully avail themselves to the treatments that address their substance use disorder.[1] In fact, a study published in 2014 by the National Center on Addiction and Substance Abuse found that supportive housing was successful in reducing the use of, and costs associated with, substance abuse and crisis care services, including shelters, detox centers, jails and medical care (hospitalizations and emergency room visits). The findings suggest that individuals actively using substances can be housed successfully and stabilized without forcing treatment requirements on them.[2]

New York, too, knows supportive housing is an answer. Governor Cuomo and New York City Mayor Bill de Blasio have publicly committed to creating a combined total of 35,000 new supportive housing units in the City and throughout the rest of the state within the next 15 years.

CSH congratulates the Mayor and Governor for taking these important steps to house our most vulnerable New Yorkers. We urge this Task Force to help us ensure these new units are realized as soon as possible, and that people and communities living with the opioid epidemic have access to them and the important services they will need to achieve substance use recovery.

Housing is essential as an anchor of stability. Home forms a firm platform from which individuals can pursue the services they need. It is our responsibility to make sure our most vulnerable New Yorkers have access to the services as well as a home. That is what supportive housing provides. A person consumed by addiction can have access to the best treatments in the world, but recovery is highly unlikely if they are living on the street or in a shelter.

Without supportive housing, many individuals with opioid or heroin addiction will continue to cycle endlessly between homelessness and expensive public services delivery systems including inpatient hospital beds, psychiatric centers, detox services, jails and prisons, at an enormous public and human cost.

We ask members of this Task Force to help these individuals by ensuring that the recent commitments to new supportive housing in New York are realized, and that these resources are accessible to people struggling with substance use disorders, particularly heroin and opioid addictions.

_____________________

[1] Gray, Paul; Fraser, Penny. Housing and heroin use: The role of floating support. Drugs: Education, Prevention, and Policy. Vol. 12, Iss. 4, 2005.

[2] Neighbors, Charles; Hall, Gerod; et.al. Evaluation of NY/NY III Housing for Active Substance Users. The National Center on Addiction and Substance Abuse. 2014.

Celebrating SIF Success in CT

dinner2

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.

Supportive Housing Improves Addiction Recovery

Guest Blog by Charles J. Neighbors, PhD, MBA

charlie2

Charles J. Neighbors, PhD, MBA, Director, Health Services Research, CASAColumbia

In December 2015, the Corporation for Supportive Housing (CSH) released a paper on supportive housing as a component of a strategy to manage the heroin crisis for the chronically homeless. CSH estimates there is a need for over 30,000 new supportive housing units across New York State to reverse the ever-increasing numbers of people experiencing homelessness. About 35-40% of chronically homeless people suffer from severe substance use disorders.

New York communities bear substantial public costs for individuals experiencing substance use disorders and homelessness. The recent rise in opioid use has increased this strain. Finding a way to engage homeless persons for whom substances are a barrier to housing is critical to solving the problem. One potential approach is supportive housing—housing linked with social services- which provides the support that the chronically homeless need to stay in their homes.

Research by our Center suggests that supportive housing is an effective and cost-efficient intervention for homeless individuals struggling with addiction. We evaluated a program in New York State and City that offered supportive housing to individuals not willing to commit to abstinence. The program was successful in reducing use of shelters, jail and medical services. The reductions in crisis service use were associated with considerable savings, which offset the cost of the housing program.

Recently, New York Governor Andrew Cuomo made supportive housing a cornerstone of his State of the State address, committing to creating 20,000 new units statewide over the next 15 years. These units are in addition to the 15,000 Mayor Bill de Blasio announced for New York City in November. These plans exemplify a significant commitment to addressing the longstanding problem of chronic homelessness and severe substance use disorders, and benefitting individuals and the community.

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.

Pay for Success Advances in Denver

With the Denver City Council’s approval of two Pay for Success contracts, Denver will begin to provide new supportive housing and wraparound services to 250 chronically homeless individuals. Through a unique financing program called Social Impact Bonds, Denver will use funds from lenders to serve chronically homeless individuals who frequently use the city’s emergency services. CSH has been tapped as the project manager.

Mayor Hancock Announces Social Impact Bonds to Serve First 25 Participants at North Colorado Station (February 16, 2016)

Denver Pay for Success Summary & Denver Pay for Success Fact Sheet (February 16, 2016)

Denver Social Impact Bonds Pay for Success Contract

Denver Ready to Provide New Housing and Services to Homeless

Denver Homelessness Program Funded - The Denver Post


 

Denver Ready to Provide New Housing and Services to Homeless with City Council Vote Tonight

Social Impact Bond program to help 250 chronically homeless at lower cost

Denver, January 25, 2016 – With the Denver City Council’s approval of two contracts tonight, Denver will begin to provide new permanent supportive housing and wraparound services to 250 chronically homeless individuals in Denver.

Through a unique financing program called Social Impact Bonds, Denver will use funds from lenders to serve chronically homeless individuals who frequently use the city’s emergency services – police, jail, the courts and emergency rooms -- at a cost of approximately $7 million per year. The savings and benefits from reduced costs in the criminal justice system will be captured by the city and used to repay lenders for their upfront investment to cover the cost of the program.

“Through this innovative Social Impact Bond program, Denver is serving our most vulnerable population smarter and more effectively by getting these individuals out of a cycle of jail and hospital visits and into permanent supportive housing with wraparound services,” said Mayor Michael B. Hancock. “We’re addressing a critical need to expand affordable housing options and mental health services with this new program, which are priorities of my administration.”

A limited number of homeless individuals will begin moving into new apartment units this month and plans are underway to begin construction on new housing units this spring. Combined, the 210 planned new housing units represents the most ever built for Denver’s homeless in such a short period of time. Forty existing units will also be utilized to provide housing through this program.

“For the first time, the city is paying only for successful impacts on the lives of our homeless,” said Deputy Mayor and Chief Financial Officer Cary Kennedy. “By shifting the focus to preventive services, we can both provide better outcomes for this population, and save taxpayers money.”

Social Impact Bonds are a unique type of performance-based contract where private and/or philanthropic lenders loan funds to nonprofits to accomplish a specific social objective and are repaid based on whether the program achieves its goals.

The city will pay for specific performance outcomes, which if achieved, will measurably improve the lives of participants and generate reduced costs to the criminal justice and health systems. The total private investment of the program is expected to be nearly $8.7 million; while an additional $15 million in Federal resources will be leveraged over the next five years.

“This is not only an opportunity for us as investors to come together to help ensure 250 of our community's most vulnerable people receive services and housing, but it also allows us to participate in a public-private-nonprofit partnership to address homelessness in Metro Denver, support the nonprofit organizations doing the work and increase funding efficiencies,” said Kate Lyda, Philanthropic Services Director & Impact Investing Specialist at The Denver Foundation. “The Denver Foundation is thrilled to invest in this initiative and to offer our donors and fund-holders an innovative opportunity to invest along with us to change lives and our community.”

“The Social Innovation Fund is tremendously proud to have supported the development of this innovative project through its Pay for Success grant to the Nonprofit Finance Fund,” said Damian Thorman, Director of the Social Innovation Fund. “By deploying permanent supportive housing to 250 of Denver’s residents most in need, and the city only paying for outcomes, this project presents a unique opportunity to at once implement evidence-based solutions to improve outcomes, and at the same time, be the best possible stewards of taxpayer dollars.”

Denver currently spends about $29,000 for each chronically homeless individual who is frequently arrested and in need of medical attention, which includes jail, police, courts, detox, emergency room and other medical costs. Permanent supportive housing will help these individuals lead a more stable and productive life. And will save taxpayer money and free up room in the county jails.

The estimated repayment to investors will be $9.4 million if the program achieves a 35 percent reduction in the number of days that the population spends in jail and if at least 83 percent of all participants remain stably housed for 1 year or longer. The repayment will be less if these outcomes are not achieved.

The full contracts approved by Denver City Council can be found here.

Organizations that are assisting with oversight and coordination of the project include:

  • Corporation for Supportive Housing - CSH (Project Manager)
  • Enterprise Community Partners

The service providers involved in this contract include:

  • Colorado Coalition for the Homeless
  • Mental Health Center for Denver

The commitment of the investors is subject to board or credit approval and final loan execution. The investors involved in this contract include:

  • The Denver Foundation
  • The Piton Foundation
  • The Ben and Lucy Ana Walton Fund of the Walton Family Foundation
  • Laura and John Arnold Foundation
  • Living Cities Blended Catalyst Fund LLC
  • Nonprofit Finance Fund
  • The Colorado Health Foundation
  • The Northern Trust Company

“I thank the Denver City Council and our amazing organizational and lending partners for their support of this ground breaking solution,” the Mayor said. “Together, I believe we will make a meaningful impact on the lives of many vulnerable people and our city as a whole.”

Technical assistance and support to develop the initiative was provided by Social Impact Solutions. Denver also received support from the Harvard Kennedy School’s Social Impact Bond Lab, which provides pro bono technical assistance to state and local governments interested in pursuing Pay for Success and Social Impact Bond contracts.

The Opioid Epidemic & Supportive Housing

As New York State continues to weigh the benefits of increasing the number of supportive housing units, CSH has released a new brief: Supportive Housing’s vital role In Addressing the Opioid Epidemic in New York State. Although supportive housing as a documented solution to chronic homelessness is often touted, policymakers sometimes overlook its other positive impacts, especially its success rate in stabilizing those with severe substance use disorders such as heroin addiction, placing such individuals on a firmer path to recovery.

Supportive Housing’s vital role In Addressing the Opioid Epidemic in New York State

 

WordPress › Error

There has been a critical error on this website.

Learn more about troubleshooting WordPress.