1. Housing Families: Strategies for Enhancing Family Stability through Supportive Housing Partnerships NADCPs 17th Annual Training Conference July 18, 2011 Devra Edelman Director of Programs Hamilton Family Center DEdelman@hamiltonfamilycenter.org DEdelman@hamiltonfamilycenter.org

2. 1 Rebuilding Lives ~ Ending Homelessness The mission of Hamilton Family Center is to break the cycle of homelessness and poverty. Through a Housing First approach, we provide a continuum of housing solutions and comprehensive services that promote self-sufficiency for families and individuals, and foster the potential of children and youth. Project Potential: Child and Youth Services Hamilton Family Emergency Center Hamilton Family Residences Hamilton Family Transitional Housing Dudley Apartments Supportive Services First Avenues: Housing Solutions

3. 2 HFC opened Hamilton Family Transitional Housing Program (HFTP) in 2000. Hamilton Family Transitional Housing Program (HFTP), provides families with the structure and support necessary to address critical issues contributing to their homelessness and to assist families in developing skills necessary to acquire and maintain viable permanent housing and family stability. HFTP is a project-based transitional housing facility centrally located in a residential neighborhood of San Francisco HFTP provides housing and support services to 20 families in individual, furnished apartment units. On-site services include case management, child and family therapy, child and youth programming, life-skills workshops, employment, training and housing search assistance, a computer lab and community building activities. HFTP residents pay 30% of their income toward program rent and save 20% of their income, to ensure that adequate resources are on hand for use in moving to permanent housing upon program completion. Hamilton Family Transitional Housing Strategically targeting resources to maximize opportunities for homeless families

4. 3 Pre 2006 As a HUD funded program, the maximum stay in transitional housing is 24 months. HFTP was originally structured as an 18 – 24 month program. Completion of HFTP time based and the majority of families remained in the program for 18 – 24 months. Eligibility for HFTP focused on homelessness, with other presenting issues being secondary. The majority of families referred to HFTP were from emergency shelter and THP often seen as next step for families who could not find housing during shelter stay. Post 2006 HFTP adjusts program to be informed by Housing First philosophy and intensifies program focus to assist families with obtaining viable permanent housing as rapidly as possible. HFTP becomes a 12 month program, with the possibility of monthly extensions, based upon individualized family needs. HFTP assessment for eligibility focuses on Barriers to Housing and Family Stability in order to identify families with specialized needs for acceptance into the program. HFTP supportive services focus on income and asset building along with overcoming barriers to housing. HFTP develops collaborations with systems and service providers working with specialized populations, including the San Francisco Dependency Drug Court. Hamilton Family Transitional Housing Strategically targeting resources to maximize opportunities for homeless families

5. 4 5. Strategies Prioritize homeless families in the DDC system for placement in HFTP Establish a multi-disciplinary team that meets regularly (DDC, HFTP staff, Child Welfare, Homeless Pre-natal Program) with parent(s) Provide staff with additional training and resources to be effective Increase on-site therapeutic services focused on child-parent attachment Expand children and youth resources and funding, including developmentally appropriate programming. 6. Assumptions A collaboration w/DDC & BHC will meet specialized targeting of services as prioritized by the SF Continuum of Care. DDC & BHC family reunification rates will improve with prioritization and the longer stay associated with transitional housing Targeting this specialized population will demonstrate the cost effectiveness of transitional housing, in comparison to the costs associated with DDC & Child Welfare cases 4. Influential Factors DDC & HFTP form partnership to address interim housing shortages program encountered (February 2008) Partnership w/DDC expands collaborative relationships & resources for HFTP while offering DDC participating families transitional housing SF Superior Court (DDC) funding supports additional therapeutic services, staff training and client support at HFTP. 3. Outcomes Increase permanent housing for the identified population Increase funding partners in transitional housing programs Alignment w/local funding priorities Support collaborative to increase the rate of family reunification, decreasing length of time to family reunification, and reducing the number of children who re-enter the child welfare system 1. Problem Statement Transitional housing has come under increased scrutiny for its cost effectiveness Funding priorities include targeting a more specialized population for this type of housing assistance Family transitional housing providers are under pressure to identify and secure funding from sources other than HUD McKinney Exits into permanent housing remain the primary expectation and goal with specialized populations in transitional housing 2. Community Needs HFC THP begins to seek partnerships with service providers who work with specialized populations (August 2007) Superior Court of CA, County of SF Dependency Drug Court opens new program to improve reunification outcomes for parents involved in the dependency system SF CoC Five Year Strategic Plan (May 2008) prioritized transitional housing for those with an identified need, with case management to address individualized needs and emphasize economic stability and exits to permanent housing. Hamilton Family Transitional Housing Strategically targeting resources to maximize opportunities for homeless families

6. 5 Length of Program Stay In 2003, 95% of families stayed 13-24 months In 2005, shift in focus towards rapid transition to permanent housing; led to shorter lengths of stay in the program From 2006 - 2009, the average length of stay reduced to about one year. Overall, 32% of families stayed at HFTP for 13-24 months – 68% exited the program in 12 months or less Since 2005, an average of 80% of families successfully completed the program Among families who successfully completed the program, 95-100% exited to permanent housing since 2006 Hamilton Family Transitional Housing Strategically targeting resources to maximize opportunities for homeless families

7. 6 Assessing Needs / Fit for Program Family Needs are identified through an in-depth application and assessment process, including service provider referrals, two family interviews and the use of HFCs Housing Assessment Matrix (HAM) tool to determine the best housing fit for the family. Assessment Indicators include: HUD Definition of Homelessness; history of homelessness (episodic); moderate to high-need based upon history; limited lease history; young head of household; extended families; domestic / intimate partner violence within past 12 months; child welfare involvement in past 12 months and/or planned reunification; low education level; criminal justice history; pregnancy; childcare needs; mental health needs; etc. Families who are referred by DDC are prioritized. These families have been identified as a good fit for transitional housing based on needs (child dependency cases and substance abuse history). Transitional housing has been found to be a resource for supporting family reunification and stabilization prior to permanent housing for these families. The HAM tool is used to assess the housing needs of families and identify extent of fit for transitional housing and/or other housing options: Hamilton Family Transitional Housing Strategically targeting resources to maximize opportunities for homeless families

8. Housing Assessment Matrix: http://hamiltonfamilycenter.org/latest- news/promising-practices/

9. 8 Partnership with the Court System Collaboration with Dependency Drug Court (DDC) initiated in 2008 to prioritize referrals of families working with the court Up to 10 DDC referred families accepted in the program at any given time (out of 20 total units) Other referrals continue to be accepted from Emergency Shelters, Domestic Violence Programs, Treatment Programs, etc. An average of 75% of the families who enter the program have histories of child welfare involvement, substance use, mental health or other specialized needs. Approximately 55% of the families served have CPS involvement, 60% of whom have been referrals from DDC; Of the 16 families served through this collaboration to date ~ 9 successfully completed and exited to permanent housing, 2 left the program and 5 are currently in the program. Hamilton Family Transitional Housing and SF Dependency Drug Court

10. 9 TRANSITIONAL HOUSING PROGRAM Case Manager / Housing Liaison Therapist Childrens Programming Developmental Screening Parent Education COLLABORATIVE JUSTICE COURT: Commissioner Coordinator Court-Appointed Social Worker CHILD AND FAMILY SERVICES Protective Services Worker INTENSIVE SUPPORT SERVICES Homeless Prenatal Program Team Manager Case Manager Parent-Child Specialist TREATMENT PROVIDERS Outpatient Services ATTORNEYS AND COUNSEL Policy Counsel – City Attorney Parents Attorney

11. 10 Hamilton Family Transitional Housing and SF Dependency Drug Court Snapshot of Families Prioritized through DDC Child Welfare and Dependency Court-involved Multiple Children Lost to the System History of Substance Abuse Often co-occurring Mental Health Issues: esp. Bipolar Disorder, PTSD, Depression, Anxiety Dual Parent Households (58%) Enter after completing Residential Treatment programs Enter while engaged in Outpatient Treatment programs

12. 11 Hamilton Family Transitional Housing and SF Dependency Drug Court National Family Treatment Drug Court Evaluation 4-year study of Family Treatment Drug Courts (FTDCs) completed in 2007 Improved Child Welfare Outcomes FTDC children spent significantly less time in out-of-home care than did comparison children FTDC children spent a greater percentage of their case in their parents care FTDC children were significantly more likely to be reunified with their parents than were comparison children. (Reunification rates were up to 50% higher than the rates for comparison children at some sites.) Improved Treatment Outcomes FTDC parents much more likely to enter substance abuse treatment FTDC parents spent significantly more time in treatment and more likely to complete treatment

13. Challenges and Solutions Team provider perspectives often differ – some more focused on sobriety while others more focused on harm reduction; often housing ready versus housing first DDC clients are beholden to CPS requirements, which usually require sobriety – i.e. if there is a relapse, child custody is at stake; Program will not deny services due to relapse, but if children are removed, parents may become ineligible for program due to definition of a family. Key is collaborative communication regarding providers definitions of success and expectations and team decision making with the client involved HFC recently agreed to do oral drug testing on site (saliva) with caveat that results will not affect program eligibility (unless they lead to ineligibility for other reasons – such as child removal)

14. Summary Points Identifying families for whom Transitional Housing is a good fit is Key – ex. going from highly structured to unstructured setting; families who need a stepping stone; assessed for outpatient treatment but need housing to reunify; need for time-limited intensive services to support long-term stability and independent living When you serve families with increased barriers you need to also think strategically about how services are provided and how this can happen – changes in programming and philosophy are often necessary Future Considerations: increasing recovery focused services on-site (most are provided through out-patient programs currently); allow families time to stay in program and reunify if children are removed (currently 14 day allowance / increase would require negotiations with funders)

15. Contact: Devra M. Edelman Director of Programs Hamilton Family Center 415-409-2100 x122 dedelman@hamiltonfamilycenter.org www.hamiltonfamilycenter.org