1. Presentation to NAMI National Convention – Affordable Housing Workshop Andrew Sperling Director of Legislative Advocacy National Alliance on Mental Illness Ann O’Hara Technical Assistance Collaborative June 22, 2007

2. Achieving The Promise: Mental Health Commission Report “The lack of decent, safe, affordable and integrated housing is one of the most significant barriers to full participation in community life for people with severe mental illness” The President’s New Freedom Commission on Mental Health, p. 31 “Many mental health systems….do not see housing as their responsibility” The President’s New Freedom Commission on Mental Health Subcommittee on Housing and Homelessness, p. 7

3. Homelessness and Mental Illness “Homelessness is the most visible manifestation of the housing and support services problems of people with mental illnesses” Housing and Homeless Subcommittee Report p. 1 A significant percentage of people who are chronically homeless report mental illness issues (self-reported 51% in Burt study) Federal definition of chronic homeless person: “an unaccompanied adult who has been continuously homeless for a year or more or has had at least four episodes of homelessness in the past three years” Federal goal to end chronic homelessness by 2012 Prevention of homelessness also extremely important

4. Housing and Recovery Consumers believe and studies strongly support permanent housing as a basis for mental health recovery. Consumers are much more responsive to accepting treatment after they have housing in place Housing choice and “housing first” approach preferred by consumers Flexible, mobile, and individualized support services are also necessary “Too few mental health systems dedicate resources to ensuring that people with mental illnesses have adequate housing with supports” The President’s New Freedom Commission Report p. 42

5. The Permanent Housing Approach – A Best Practice Consumers should have housing choices and – with appropriate supports – can successfully acquire and maintain permanent housing People deemed “difficult to serve” can be successful in permanent housing People do not have to pass through a linear set of preparatory residential services in order to be successful in permanent housing Housing should be decent, safe and affordable and include rights of tenancy for the consumer

6. Recent Permanent Supportive Housing Research Significant reductions in homelessness and hospitalizations (Susser et al., 1997) (Culhane et al, 2002) Pathways “Housing First” model –88% of homeless consumers stably housed in permanent housing over 5 years vs. 47% in more restrictive models –Results now being replicated in Washington D.C., Philadelphia, and Hartford CT

7. To Expand Permanent Supportive Housing, Mental Health Systems Need….. More access to government housing programs and successful partnerships with housing agencies at the State and local level; Housing expertise within the mental health system Mental health system investment to leverage affordable housing resources when ever possible Successful strategies to support consumers in housing

8. Priority Housing Issues Scarcity of affordable housing Housing Affordability “Gap” documented in new Priced Out in 2006 study Government affordable/subsidized housing programs essential for people with SSI level incomes While each state is unique, there is a common theme: More must be done by the affordable housing system and – based on emerging “best practices” more can be done

9. Priced Out in 2006: Understanding the Problem TAC study finds: –Nationally, people receiving SSI must pay 113.1% of monthly income to rent a 1 bedroom unit and 100.1% to rent a studio unit –Nationally SSI is less than 18 percent of median income, or 25% below the federal poverty level –http://www.tacinc.org/Pubs/PricedOut.htmhttp://www.tacinc.org/Pubs/PricedOut.htm –http://www.tacinc.org/Docs/HH/PricedOutIn2006.pdfhttp://www.tacinc.org/Docs/HH/PricedOutIn2006.pdf

10. Median Income 50% of Median Income 30% of Median Income SSI Income SSI Benefits 20% of Median Income

11. Key Housing Affordability Issues SSI = $603 monthly in 2006 30% of SSI = $189 per month for rent Estimated monthly rent = $500 Rent subsidy needed: $500-$189 = $311 each month Bottom line: Housing for people with disabilities at SSI income levels requires an on-going rent or operating subsidy!

12. State Housing Agencies Concentrate on affordable housing development targeted to higher income households (40-60% of median income), elderly households, homeownership etc. May not have financial models that work for people with SSI-level incomes May not be aware/educated regarding new models of housing for people with disabilities State housing agencies control the largest source of affordable rental housing development, the Low-Income Housing Tax Credit (LIHTC)

13. Important Federal Subsidy Programs HUD programs –Section 8 vouchers – Now the most critical housing resource for people with disabilities (2.1 million vouchers administered by PHAs) –HUD Section 811 Supportive Housing program –HUD McKinney Vento Homeless Assistance programs Most states do not have subsidy programs, but some are initiating them in response to lack of federal subsidies

14. Section 8 Housing Choice Vouchers Provides a monthly rent subsidy to lease a unit in the private rental market 2.1 million vouchers administered by Public Housing Agencies No new vouchers have been provided by Congress since 2002 Budget issues since 2004 have limited # of “turnover” vouchers PHAs can issue PHAs can now project-based up to 20% of their vouchers Special set-aside vouchers for people with disabilities

15. Tenant-Based Vouchers Set Aside for People With Disabilities 62,000 vouchers nationally are set aside for non- elderly people with disabilities, 50,000 from Section 8 and 12,000 from the Section 811 “mainstream” program; Are these disability vouchers available in your community? http://www.c-c-d.org/task_forces/housing/OD25.pdf New disability vouchers available through the FY 2008 HUD budget? Stay tuned http://www.c-c-d.org/task_forces/housing/OD25.pdf

16. Section 811 Supportive Housing Program for People with Disabilities: Housing Development Component HUD’s “symbolic” disability program Provides funding for non-profit disability organizations to develop permanent supportive housing for people with disabilities including: –Independent living apartments –Group homes Also provides a 5 year renewable Project Rental Assistance Contract to ensure affordability Over 30,000 units nationwide

17. Section 811 Tenant-Based Assistance: Mainstream Voucher Program Under the Section 811 statute, up to 25% of the appropriation can be spent on tenant based vouchers for people with disabilities In 1997, HUD created the Mainstream Housing Opportunities for Persons with Disabilities voucher program The Mainstream program is operated under the Section 8 voucher program rules BUT HUD never issued Mainstream program guidance Currently there are 14,000 Mainstream vouchers administered by 189 PHAs and 40 non-profit organizations Because of HUD mismanagement, some of these vouchers may not be going to people with disabilities.

18. Status Report on Section 811 Severe budget cuts for the past 8 years – now down to $237 million for FY 2007 Reduced funding for new units from 3,000 units per year to less than 1,000 HUD attempting to eliminate the Section 811 housing production program Non-profits less interested in competing for Section 811 funding because of program’s bureaucracy Renewal cost of Mainstream vouchers now $75 million and climbing – more than 25% of entire appropriation

19. Saving Section 811 Bad news –Section 811 suffering from HUD neglect and attrition of funding for new units –Section 811 was poorly rated by White House Office of Management and Budget for High per-unit costs Lengthy development process Good news –Congress interested in supporting a “reformed” Section 811 program which leverages funding from other affordable housing programs –Bush Administration new “mixed-finance” demonstration proposal for Section 811 would encourage combining program with federal low income housing tax credits

20. Proposed Section 811 Demonstration Program Create incentives to combine Section 811 funding with other capital resources such as Low Income Housing Tax Credits, HOME funds, Affordable Housing Fund, local funds, etc. to reduce cost Provide more units for the same appropriation amount Eliminate the single purpose corporation component Would preserve the Project Rental Assistance Contract which is needed to ensure affordability Encourage the development of more integrated models of Section 811 housing similar to the NC Key program – Example: Set-aside of 10 units in a multi-family property

21. Promising Practices Georgia and Connecticut –State housing agency capital financing –State housing agency Section 8 Ohio –State mental health capital funding for housing –“Bridge” housing subsidies linked to Section 8 at local PHAs –Local non-profit housing agencies created by County mental health systems Hawaii –State mental health capital funding for housing development –Agreements with state and local PHAs –“Bridge” subsidies and Housing Support Teams

22. Promising Practices District of Columbia –Mental Health system capital funding for housing –Bridge subsidy funding –Memorandum Of Understand (MOU) with HFA and PHA –Set-asides of Section 8 for people who are chronically homeless Oregon –Trust fund for housing from state hospital sale –Bridge subsidies linked to Section 8 vouchers Rhode Island –Mental health capital program (Thresholds) administered through a Memorandum of Understanding with State Housing Agency Tennessee –Leadership and staff committed to housing –Regional housing coordinators linking projects to resources