1. Supportive Housing Sharon Rapport, CSH

2. About CSH Improve the lives of vulnerable people
Maximize public resources
Build strong, healthy communities
Facilitator Guide
CSH is a national nonprofit with staff across the country.
At CSH, it is our mission to advance housing solutions that deliver three powerful outcomes:
Improve the lives of vulnerable people
Maximize public resources
Build strong, healthy communities

3. Consulting & Assistance
What We Do
Research-backed tools, trainings and knowledge sharing
Lending for capital funds, specialty loan products and development expertise
Lines of Business
Training
& Education
Policy Reform
Consulting & Assistance
Lending
Facilitator Guide
CSH has four major lines of business.
Training and Education with research-backed tools, trainings, and knowledge sharing.
Policy Reforms that includes systems reform, policy collaboration, and advocacy
Consulting and Assistance with custom community planning and cutting-edge innovations, and
Lending that provides powerful capital funds, specialty loan products, and development expertise.
CSH is a touchstone for new ideas and best practices, a collaborative and pragmatic community partner, and an influential advocate for supportive housing.
Custom community planning and cutting -edge innovations
Systems reform, policy collaboration and advocacy

4. Technical Assistance & Capacity-Building
Response to Homelessness
Assessment & Modeling
Coordinated Entry System
Homelessness Planning
Coordination & Streamlining Funding Sources
Capacity Building
Training for Developers, Service Providers, Property Managers to Build & Operate SH
Training for Staff Administering SH Programs Locally
Partnership Development
Bringing Health & Housing Systems Together
Partnering Developers & Service Providers
Accessing Additional Funding Sources
Addressing Outreach Needs & YIMBY Issues

5. Housing Interventions in Response Homelessness
Affordable Housing:
Prevents homelessness
Allows people who are homeless for economic reasons to exit
Newly homeless, working households
Rapid Re-Housing:
Allows people homeless for economic reasons to exit
Provides some services to increase household income sufficiently to stay housed
Newly-homeless, most families
Supportive Housing:
Allows people with significant barriers to housing stability (chronically homeless, cycling through institutional settings) to exit
Provides intensive services promoting housing stability.

6. Community Responses through Coordinated Entry: Coordinate Resources, Prioritize Housing
Assess Housing Needs, Coordinate Existing Resources
No Wrong Door: Any Entry Point
Communities are housing thousands of homeless people each year, but the inflow of people falling into homelessness is greater than people communities can house on their own, without State help
States successful in significantly reducing homelessness is partnership between state and local government in a coordinated response
Available Permanent Housing
Linked to Services

7. What is Supportive Housing?
Permanent
Affordable
Independent
Tenant-Centered
Facilitator Guide
…Is permanent, affordable, independent, tenant-centered, flexible, and voluntary.
Supportive housing combines affordable housing with services that help people who face the most complex challenges to live with stability, autonomy, and dignity.
In supportive housing, supportive services providers actively engage tenants in flexible, voluntary and comprehensive services, work with property and housing management to support tenant stability, and ensure that the housing remains a positive community asset for the long-term.
Flexible
Voluntary

8. “Three Legs of the Stool”
Services: Prop. 63 (Mental Health Servs. Act), County funding, federal grants.
Rental/operating assistance: Section 8, federal homeless Continuum of Care funds, local subsidy
Capital: 6-10 sources of federal, state, local funding.

9. Key Components of Supportive Housing
Targets households with multiple barriers
Provides unit with lease
Housing is affordable
Engages tenants in flexible, voluntary services
Coordinates among key partners
Outcome-driven
Facilitator Guide (Nicole)
Although there are many models of supportive housing in a wide range of geographic locations, all quality supportive housing includes these key components:
Targets households with multiple barriers – people who are homeless, at-risk of homelessness, or exiting institutions with challenges such as serious mental illness, substance abuse and/or chronic health conditions
Provides unit with lease - tenants are treated just like any other tenant with standard lease or sublease agreements
Housing is affordable - meaning that they ideally pay no more than 30% of their income
Engages tenants in flexible, voluntary services
Coordinates among key partners and brings together the key project partners such as the service provider and property manager to work together to help tenants achieve their goals
Supports connecting with community

10. Key Components of Supportive Housing
Targeted to people with barriers to housing stability
Starts with target population
“Screens In” Tenants
Facilitator Guide (Nicole)
What’s different about supportive housing?
Starts with target population - Supportive housing starts with a target population – often tenants many “private” landlords would deny.
“Screens In” Tenants - Property management and supportive services staff need to work together to “Screen In” those who will benefit from the housing.
Coordinated Entry – is an organized system for providing access to housing and supportive housing resources in a community and targeting the appropriate resources for those with the most significant needs and barriers. So where does choice fit with coordinated entry? Wherever possible, an individual will be provided with choice of housing type, location, and owner. With limited resources, it is difficult to provide choices when supply is short. However, coordinated entry procedures should include opportunities to turn down one offering and while being offered another when it is available.
Coordinated Entry Referral Into Housing

11. Key Components of Supportive Housing
Supportive Housing is for people who are…
Cycling through systems
Chronically homeless:
Definition may be more difficult to meet in rural areas
Exiting institutions
Facilitator Guide (Nicole)
Supportive housing is for people who:
Are chronically homeless
At risk of homelessness
Cycling through institutional and emergency systems and are at risk of long-term homelessness
Exiting institutions and systems of care.
Supportive housing is for people who are highly vulnerable, like those that are chronically homeless. Someone experiencing chronic homelessness has lived on the streets, in his or her car, in a shelter or somewhere not meant to be lived in for an extended period of time.
Supportive housing is also an effective intervention for those who cycle through institutions, such as emergency rooms, psychiatric facilities, jails, and hospitals, for example. In fact, we know that some people who are chronically homeless are those that are cycling through institutions.
It’s really for people who without housing, are not able to secure the treatment and supportive services available to them. Because supportive housing provides the stability that we hope everyone can have, somewhere where they can call home, it allows people to start to access non-emergency services like primary health care, mental health care, public benefits and others.

12. Key Components of Supportive Housing
Leases in Supportive Housing
Tenants have a clear understanding of their rights and responsibilities.
Housing Unit Choice.
The application process should be as barrier-free as possible.
Facilitator Guide (Nicole)
Housing Unit Choice - Supportive Housing ensures that tenants are offered opportunities to live in the type of housing that best suits their needs and desires and supports their ability to participate in the community. Tenants are offered a choice between multiple units of housing, and if possible are also given choices between housing models and locations. Staff understand tenant’s needs and support them in the process of searching for and selecting a unit.
Identical to tenants in non-supportive housing - All tenants have a lease or sublease identical to those of tenants who are not in supportive housing. Ideally the term of the lease should be one year.
Tenants have a clear understanding of their rights and responsibilities – Staff walk through the lease agreement with the tenant, clearly explaining their rights and responsibilities. The tenant is given a copy of their lease and they are notified of the process for lease violations and the grievance or appeals procedure. Tenants should also be supported in requesting and obtaining any reasonable accommodations in order to successfully continue their tenancy.
No service participation agreements - Like tenants in other non-supportive housing buildings, tenants should not be evicted for choosing not to participate in services, for not taking medication, or for not being sober. Supportive housing strives to prevent eviction, but when it is necessary to evict a tenant, it should only be for a lease violation, such as failure to pay rent. Staff will not remove a tenant from housing without going through the legal eviction process.
No service participation agreements.

13. Key Components of Supportive Housing
Access through Affordability
Projects Under Development
Operating budget points directly to affordability.
Work with funders to obtain operating subsidies.
Projects Currently Open
Providing ways to keep the housing affordable to tenants.
Payment plans or work programs for missed/late rent.
Representative payee if appropriate.
Facilitator Guide (Nicole)
This is typically accomplished through a housing subsidy.
In projects under development:
Operating budget points directly to affordability
Work with funders to obtain operating subsidies
In projects currently open:
Providing ways to keep the housing affordable to tenants
Payment plans or work programs for missed/late rent
Representative payee if appropriate
Education on keeping down utility costs or assistance with utilities
Education on keeping down utility costs or assistance with utilities.

14. Key Components of Supportive Housing
Sources of Affordability
Continuum of Care Formerly Shelter + Care (S+C) and Supportive Housing Program (SHP)
Housing Opportunities for Persons with AIDS (HOPWA)
Veterans Administration Supportive Housing (VASH)
Housing Choice Voucher (HCV)
HOME Tenant Based Rental Assistance (TBRA)
State/Local rental subsidy program
Tenant paid rent (limited to 30% of income)
Others…
Facilitator Guide (Nicole)
Some examples of sources to maintain affordability in supportive housing are listed on the slide. It’s important to know that there are existing sources to make supportive housing affordable for highly vulnerable people and that it is one key component of supportive housing.

15. Key Components of Supportive Housing
Voluntary services
Participation in services is not a condition of tenancy.
Services are voluntary for tenants...not staff.
Staff must work to build relationships with tenants.
Emphasis is on user-friendly services driven by tenant needs and individual goals.
Facilitator Guide (Diana)
ANIMATION
What are voluntary services?
Participation in services is not a condition of tenancy.
Services are voluntary for tenants...not staff and Staff must work to build relationships with tenants
Emphasis should be on user-friendly services driven by tenant needs and individual goals
We cannot compel individuals to get better or to improve. This means services plans should be based on tenant’s needs and desires. It means we give tenants time to heal from the source of trauma that contributed to their current situations and barriers.
How do we actively engage with tenants and make services irresistible?
Use Outreach and engagement strategies
Constant engagement, informal engagement
Use Motivational interviewing or Harm Reduction
Build trusting, respectful relationships with tenants

16. Key Components of Supportive Housing
What do we know about voluntary services?
Tenants value the services available and the autonomy to decide which services to participate in.
Tenants participate at high rates.
The “low-demand” model is much more likely to house and retain formerly homeless people.
In rural areas, services are often more difficult to coordinate, require lower case manager-to-tenant ratio
Facilitator Guide (Diana)
What do we know about voluntary services?
Even when services are not required as a condition of tenancy, tenants participate at high rates.
Tenants value the services available to them, as well as the autonomy to decide which services to participate in.
“Low demand” model is much more likely to house and retain formerly homeless people, especially those with significant disabilities and long homeless histories.

17. Key Components of Supportive Housing
Strong partnership between property management & services staff
Property/ Housing Management Staff
Supportive Services Providers
Tenants sustain stable housing
Facilitator Guide (Nicole)
Coordinated means Property or Housing Management staff work closely with service providers and landlords to ensure tenants sustain stable housing.

18. $219,792 Core Outcomes 99% Savings in Shelter Cost 14% Savings in ER
Supportive Housing works for people who need it.
99% Savings in Shelter Cost
14% Savings in ER
95% Savings in Incarceration
32% Savings in Ambulance Transportation
Total Savings for 6-month Period:
$219,792
($1,348 average per person)
Facilitator Guide (Nicole)
SH reduced costs:
99% Savings in Shelter Cost
14% Savings in ER
95% Savings in Incarceration
32% Savings in Ambulance Transportation
ANIMATION
The total cost savings for the six month period was $219,791, or an average of $1,348 per person.

19. Examples of Supportive Housing in Rural Areas & Small Counties
Challenges:
Developer capacity
Services providers
Low administrative capacity
Typical Models:
Single family homes through shared housing
Duplexes to four-plexes
Smaller projects
Intensive services offered offsite

20. Shared Supportive Housing
Two- or more bedrooms in each apartment/home
Each tenant has own lockable bedroom with own lease, and access to common areas
To extent possible, tenants choose own roommates
Services provided in home or with easy access to home
Good outcomes for tenants without acute needs and who do not want to live alone
Heather Glen Apartments Marysville, Sutter/Nevada Counties

21. New Potential Funding Sources for Services
Health Home Program: Medi-Cal benefit providing services to link people to SH and keep tenants stably housed, starting Jan. 2018
Whole Person Care Pilots: $1.5B in services funding through Medi-Cal for 5 years

22. Further Resources: Dimensions of Quality
Facilitator Guide (Nicole)
What does quality supportive housing look like? The CSH Dimensions of Quality Supportive Housing were developed based on conversations with providers across the country in communities that ranged in size and geographic location. Although quality supportive housing projects are diverse, CSH worked to distill the common elements into four primary components of a project.

23. Further Resources: Supportive Housing Training Center
A Better Platform

24. Sharon Rapport: C: (323) 243-7424 sharon.rapport@csh.org