Scaling Supportive Housing through Systems Integration
CHARTING OUR COURSE
Six years ago, our strategic plan challenged CSH to look beyond housing stability and broaden the application and innovation of supportive housing by piloting new models, testing new assumptions, and pushing our own understanding of supportive housing as a solution. Three years ago, we challenged ourselves to move beyond experimentation. We set our sights on replication and scaling that uses data and evidence to inform where, how, and how much is needed. We proved and affirmed supportive housing’s role and impact across multiple systems.
Our clarion call is making sure that all people, particularly those with the greatest needs, have a place in the community and the support they need to thrive. CSH has pursued this goal by advancing supportive housing, a simple and elegant combination of affordable housing and community-based services. Our commitment to this supportive housing model and its impact is unchanged. However, after a quarter century spent elevating supportive housing from an exception to an accepted solution, the need continues to outpace the progress. To move the needle, we have to engage the broader systems that drive the need and fully involve them in the problem we are trying to solve.
That is why, with this strategic plan, CSH is refocusing our work with supportive housing to be more than a model, a new building, another lease, or a singular reduction in a homeless count. We are advancing supportive housing as an approach for change that: leans in to address the root causes of inequity; breaks down silos; creates smarter and better-integrated systems; and builds more resilient communities. This vision can only be achieved when all members of the community are seen as assets and are supported to reach their full potential based on their individual strengths, goals, and ambitions. We are calling for true integration of housing and services through a multi-sector approach that levels the playing field for people who have traditionally lacked opportunity and access.
CSH has long been a champion for people with different abilities, people caught in cycles of crisis and institutional care, and people experiencing abject poverty. A supportive housing approach moves beyond the individual lens to create opportunity for all members of the community—especially those who have historically been marginalized, ignored, or disadvantaged. Today we are calling for a fundamental shift toward equity as a framework to put these ideas into action. And because people of color are over-represented in all the vulnerable and at-risk populations CSH serves, racial equity must sit at its heart.
At its most fundamental, the model of supportive housing is a proven solution that helps vulnerable individuals and families live in the community with dignity and autonomy. CSH remains committed to advancing supportive housing as a high-quality model that delivers results and working to promote quality, better define services, and better document the impact that will help drive the field. Supportive housing as a multi-sector approach enhances its potential to help us achieve the promise of equitable systems and communities with a place for everyone. That is our goal.
In the 1980s when it first began, supportive housing was envisioned as a more effective response to the homeless crisis that was gripping America. The focus was on strengthening the links between affordable housing and the essential services needed to keep residents in housing. It served as a bridge, albeit a more limited one than today. Mostly as single-site projects attached to co-located services, supportive housing was funded and instigated from within the homelessness response infrastructure and stood alone from mainstream systems.
During the 1990s, communities continued to create supportive housing, primarily from within the homelessness response system. It was during this decade that CSH began challenging the locus of supportive housing as a program limited to the homeless sector because we recognized this was inadequate. Our response and the adoption of supportive housing needed to shift upstream. Mainstream systems had to become partners in our work to successfully address long-term homelessness and prevent future homelessness.
With this knowledge, CSH has been building larger and better bridges between public sectors, working hard to demolish siloes, and aiming to address the root causes of homelessness and housing instability. We focused on creating greater connections between affordable housing and mainstream service systems. Our work with local providers and communities grew to include a vast portfolio of affordable housing and community-based services blended to complement community assets, provide choice, and meet the needs of tenants.
As our vision sharpened, the cause-effect relationship of systemic racial discrimination on housing injustice and inadequate or nonexistent access to services came into focus. This was especially true as we complemented justice reform efforts through our Frequent Users of Systems Engagement (FUSE) and prioritized tribal engagement within our Native American Indian Supportive Housing Initiative (AISHI).
When these realities and the true potential of supportive housing were being unmasked and unleashed, CSH pivoted upstream to increase awareness, buy-in, and resources by helping communities bring new partners like hospitals, Managed Care Organizations, criminal justice agencies, advocates for the aging, and child welfare and youth providers to the table. We also fully embraced the importance of accessible and quality community-based services, which in many ways are as vital as the housing itself.
The natural trajectory of our work took us beyond the rudimentary connections between housing and services and into redesigning the entire system of care to be more effective and equitable. We doubled down on realizing supportive housing’s full potential and aligning systems for scale.
We also turned our attention to better understanding supportive housing needs. Two years ago, CSH unveiled the first national needs assessment for supportive housing, which estimated a need of approximately 1.2 million supportive homes for individuals and families. The analysis made it clear that communities faced unprecedented challenges and CSH was simply not on pace to meet the need. This realization and the work that followed has led us to refocus our efforts.
THE PATH FORWARD
The 1.2 million households in need of supportive housing may seem daunting when we think of housing as a boutique system in which an individual accesses an apartment with built-in case management and other specialized supports bridging to the broader systems needed to maintain a place in the community. The math changes, however, when we consider supportive housing as an approach and call on broader systems to play their rightful role in supporting people with vulnerabilities. The burden on supportive housing interventions is lightened as systems are aligned and better able to support the individualized needs of people in the community. The pressure on systems is similarly relieved as they become less reliant on costly and ineffective crisis and institutional models of care and more focused on prevention.
One of our enduring passions has been embedding of work integrating supportive housing approaches with health and human services, the connections between these systems are often completely disjointed with conflicting definitions of success, little to no interoperable data, and inefficient overlaps. Our experience has made it clear that CSH needs to push harder to develop more multi-sector partnerships and identify ways to make those connections more efficient and effective. CSH sees the potential to build on innovations like coordinated entry and integrated administrative data to bring more partners and resources to the table and more nimbly address community need.
Similarly, scaling supportive housing through systems integration can ensure housing for vulnerable people while creating a community-based infrastructure for health and human services. Too often people with special needs are left out of discussions related to economic development, community development, and critical infrastructure planning until long after the resources have been allocated and plans are set. Planners at every level must do better to ensure that community infrastructure incorporates supportive services and deeply subsidized affordable housing. This can have benefits beyond the individual project. Illustratively, a supportive housing project with onsite educational supports can address the needs of perhaps dozens of children, but if those services are aligned as part of an educational plan to provide mobile supports to families experiencing housing instability, the impact can be extended to promote stability and growth across a neighborhood. When done proactively, this can also be an effective tool to address inequity and promote inclusion.
Over the next three years, CSH will prioritize six critical systems as we work to develop the multi-sector leadership and capacity needed to scale investment: Health care; Justice; Families, Youth, and Children; Aging; Intellectual and Developmental Disabilities; and Affordable Housing. We see those sectors as a tipping point that collectively represents over 75 percent of our national supportive housing need projection. We also see them as major players in three perennial issues that lead to poor outcomes.
A State of Perpetual Crisis
Emergency rooms, emergency medical services, addiction treatment, detox, shelters, and jails can be a labyrinth where people without adequate access to preventive services and housing move from one dead end to another in a cycle of perpetual crisis. Sadly, the cycle not only damages the people involved in the system but also causes tremendous collateral damage for families and communities. This repeated failure comes with a high price tag that puts strain on public resources. Integrated data and redesigned services aligned with housing offer a way to break the cycle.
Overreliance on Institutional Models
Overreliance on nursing homes, group homes, state hospitals, and prisons represents a failure to reinvent outdated systems of care and increase community-based services to prevent unnecessary institutionalization. Many people in institutional care settings can thrive in the community at less public cost when systems are able to realign resources to provide the necessary supports. Disproportionate representation of people of color, people in poverty, and people with different abilities demonstrates institutional bias that we cannot afford to ignore from either a financial or moral perspective.
Investing in Failure by Ignoring Prevention
Child welfare involvement, experiences of homelessness among children and housing instability, foster care placement, and juvenile justice involvement are all leading indicators for diminished academic achievement, reduced potential income, and future involvement in adult crisis systems. It is our responsibility to ensure that the lessons we learn are actively used to prevent homelessness and housing instability for future generations. This means that we must do more to address the needs of children, youth, and young adults by helping communities build and connect systems that keep people in housing through a community-based approach. Until we can address these front door problems, we will not be able to make lasting impact to reduce the national need for supportive housing. CSH sees the relationship between affordable housing and health and human services as the foundation for change. Over the next three years, we will work to further engage the affordable housing sector as a full partner in this work by bringing critical housing infrastructure to bear, applying innovation to efforts to reduce systemic barriers to housing, increase sustainability, and reduce the cost of housing development. CSH will also be increasing our advocacy and education to help shift service funding from institutional and crisis models toward more sustainable and effective community-based models that have long been underfunded.
Strengthening our Approach
As we look for solutions to these challenges and to engage public and private partners in the work, CSH sees three key drivers that strengthen our approach and help us achieve more real and lasting impact: a framework of equity; a focus in thriving; and harnessing the power of data to generate results.
A Racial Equity Framework
As we have progressed in our journey, we have realized that racial inequity is a strong and constant undercurrent in all of these challenges, and there is a starkly disproportionate representation of people of color experiencing homelessness and institutionalization. We believe supportive housing can be a lasting and equalizing force that recognizes structural racism and addresses systemic policies that maintain these disparities. Racial equity, and an intentional focus on it, is essential to broader progress. The work demands that CSH look internally as well as externally through our work and our partners, make uncomfortable topics and conversations the norm, bring marginalized voices and perspectives to the table, and ensure that they have a real stake in charting the path forward. While we understand that race is just one element of inequity, we believe that if we can focus there and make progress, it will pay dividends for all and help address broader structural inequities. We also believe that people with lived experience are our most important stakeholders. We are committed to expanding our SpeakUp! program to create a larger and broader platform to impact local and national conversations by providing an opportunity for those who are closest to the root problems to set the course for the solution.
A Focus on Thriving
CSH has long focused on the need to look beyond housing stability to gauge the success of supportive housing. We have done work to promote employment, recovery, autonomy, social connection, moving on from supportive housing to other independent settings, and more. We have made progress, but the quality and funding for supportive housing does not always provide the support that residents want to be able to pursue their goals. We want to ensure that supportive housing is never a place where people are warehoused. We want to ensure that we, along with the communities and partners with whom we work, are responsible in developing pathways for recovery and independence. We want to ensure that supportive housing residents have access to the healthy foods, community participation, education, and income that are the foundation for growth. To that end, CSH is developing a Thrive Framework to engage communities in planning for services that can help people thrive in and beyond supportive housing.
Harnessing Data to Generate Results
At CSH we are led by our vision and our values, but we believe that results are more important than intention. Supportive housing is evidence-based, research-backed, and focused on results. That focus is as critical as ever as we continue to broaden the application of housing and services to meet new demands and bring new systems and partners to bear. To that end, CSH is developing an Impact Framework to align data, analytics, and research around the role of housing and community-based services as a social determinant. We will be working to identify key areas that need further research while also exploring analytics and big data as ways of developing a clearer vision of supportive housing’s impact. We will also be investing in staff and technical capacity to ensure that CSH can remain a leader in helping communities use data to drive systems change.
A THREE-YEAR INVESTMENT TO LAY THE FOUNDATION
Scale Multi Sector Leadership & Investment
Develop the Leadership & collaboration to enable scaled multi-sector investment in supportive housing.
Advance High-Impact Solutions
Build capacity for systems, communities & providers to deliver high-quality housing & service solutions to meet the need
Expand Organizational Capacity
Strengthen CSH's infrastructure, staffing & resources in order to meet or exceed the 2019-2021 strategic plan goals
Engage and educate leadership in public, private, and non-profit sectors
Design new policy solutions that shift resources from crisis and institutional care to create the community-based services needed for people to thrive.
Expand the SpeakUp! platform to equip and encourage people with lived experience to use their systems expertise to positively impact local and national conversations about housing and services.
Develop and promote exemplary models of accountable, data-driven systems coordination.
Develop a roadmap to mainstream supportive housing into community, economic, and infrastructure planning.
Develop and advance a framework to promote integrated housing and services as a critical infrastructure for resilient and equitable communities.
Accelerate investment in multi-sector housing and service solutions
Protect federal resources and pursue state policy to realign funding to advance housing and service solutions.
Provide $450 million in loans, grants, and equity investment to generate new supportive housing opportunities.
Invest in solutions that help tenants thrive including health services, food security, and employment.
Advance high-quality housing and service partnerships that promote resilient and equitable communities
Expand access to supportive housing for 120,000 people.
Embed supportive housing quality certification in state and local systems and certify projects.
Provide technical assistance and training to communities in alignment with CSH’s Thrive Framework.
Design and test interventions beyond supportive housing to address the broader range of housing and service issues facing CSH’s priority sectors.
Use data-driven systems change approach to help communities generate measurable results
Double the number of CSH data-driven housing initiatives across CSH’s priority sectors.
Utilize data to help communities identify, design solutions for, and address inequity and racial disparities.
Develop a CSH impact framework to demonstrate and improve supportive housing outcomes
Develop a national research agenda to demonstrate value as a social determinant and advocate for increased federal funding for related research.
Develop Racial Equity, Business, and Impact cases for all of CSH’s priority sectors to bring new partners and resources to bear.
Develop new innovative financing and models which promote performance-based funding and measurable outcomes.
Support CSH staff
Attract, support, and retain high-caliber staff, including attracting or developing nationally recognized leaders for priority areas.
Ensure that CSH maintains a high performing culture that reflects CSH’s values and commitment to staff.
Strengthen CSH systems
Develop and implement a racial equity action plan applied to all of CSH’s core management functions.
Ensure strong financial management and increased diversification of funding that will ensure growth of net assets and investment in strategic priorities.
Align CSH policies
Ensure organizational policies, structure, systems, and communications are effective.
Make the organizational investments that allow CSH to work much smarter.
CSH is an organization of innovators, leaders, and entrepreneurs. We have led the supportive housing industry for 27 years and are positioned to do so into the future. Our organization leverages national teams with unmatched, specialized knowledge paired with local teams that bring deep and adaptive on-the-ground expertise to every aspect of supportive housing. We are fluent across systems and appreciate the nuances and differences of each town, county, and state. We have never been happy with the status quo nor have we rested on our laurels. We are focused on tackling what is hard, pursuing what is next, doing better, learning and listening, and advancing solutions for the long term. Ours is a track record of success in generating and tailoring solutions to achieve concrete results. Our work is distinct across four lines of business but interconnected and interdependent in realizing results. This work is done with the goal of creating outcomes for people and communities, all in pursuit of a larger vision of change. Our work is tenant centered. We believe that supportive housing should focus on tenants above all, offering them opportunities for recovery, personal growth, community integration, and life-long success. We work to ensure that all people have a seat at the table. We believe that equitable communities are strong and resilient, and that only together can we achieve our goals.
We Are Accountable
Our work is evidence- based and research-backed, and we track our progress through thoughtful metrics. We are a performance- based organization, ever-mindful to be wise stewards of public and private resources. And we are determined to generate results for the most vulnerable people and the communities in which they live.
We Are Collaborative
We are part of a diverse and growing coalition of individuals, institutions, governments, and organizations that play a vital role in making communities healthy and strong.
We Are Committed to Equity
We believe that our work has the power to create more equitable communities and therefore improve the lives of people who have been historically marginalized. This means actively supporting a culture of equity within CSH and promoting equity-based solutions through all of our lines of business, beginning with a focus on racial equity and leading to greater equity for all.
We Are Dedicated
We believe in supportive housing. Residents become healthy and communities grow stronger. Those transformations inspire us and allow us to inspire others. After two decades dedicated to supportive housing, we know that broken systems can be made efficient and effective, and that struggling people can find hope.
We Are Entrepreneurial
We are creators and innovators. We see opportunities and we are always looking for new ways to solve old problems.
We Are Pragmatic
We understand realities of complex problems, and we see all sides of the story. We are not bound by theory but driven by what works for people who need supportive housing and what works to move communities toward solutions. Our work is grounded in data and we learn through innovating, testing, and evaluating.
We Are Strategic
We identify and assess systemic barriers and devise a plan of action to remove them. We work toward clear solutions with measured results, and we find the right partners to help us achieve our mission.