MHSA AND HOUSING: Understanding the Relationship Recognizing the Opportunities

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MHSA AND HOUSINGUnderstanding the Relationship
Recognizing the Opportunities

• MHSA Regional Training IICorporation for
  Supportive Housingwww.csh.org

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HOUSING AND SERVICES

• HOUSING
• PERMANENT Not time limited, not transitional
• AFFORDABLE For people coming out of
  homelessness and
• INDEPENDENT Tenant holds lease with normal
  rights and responsibilities.
• SERVICES
• FLEXIBLE Designed to be responsive to tenants
  needs
• VOLUNTARY Participation is not a condition of
  tenancy and
• INDEPENDENT Focus of services is on maintaining
  housing stability.

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Who Is Supportive Housing For?

• People who are homeless or
• at-risk for homelessness
• - and -
• face persistent obstacles
• to maintaining housing,
• such as mental health issues,
• substance use issues,
• other chronic medical issues,
• and other challenges.

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Supportive Housing Is For People Who

• BUT FOR HOUSING cannot access and make effective
  use of treatment and supportive services in the
  community and
• BUT FOR SUPPORTIVE SERVICES cannot access and
  maintain stable housing in the community.

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MHSA OVERVIEW

• The First Four Fiscal Years
• FY 2004/05 (Already completed!)
• 254,000,000
• FY 2005/06
• 683,000,000
• FY 2006/07
• 690,000,000
• FY 2007/08
• 733,000,000

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MHSA Fund Allocation Year 1

• Education/Training 45
• Capital Facilities/ Technology 45
• State Imp/Adm 5
• Local Plan 5
• Prevention 0
• CSS 0

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MHSA Fund Allocation Years 2-4

• Education/Training 10
• Capital Facilities/Technology 10
• State Imp/Adm 5
• Local Plan 0
• Prevention 20
• CSS 55
• (5 of Prev CSS for innovative programs)

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Capital and Technology

• Total estimated funds through year 4 325
  million
• State has yet to determine split between
  technology and capital facilities
• State has yet to determine allocation formulas
  and procedures

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MHSA Fund Allocation Years 5

• State Imp/Adm 5
• Prevention 20
• CSS 75
• (5 of Prev CSS for innovative programs)
• NOTE Capital Facilities is no longer a set
  aside but counties can choose to devote CSS
  funds to meet capital needs on an ongoing basis!

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One Time Funding

• In the current fiscal year only, every county
  will have access to One Time funds.
• These are Community Service and Support funds.
• They can be used in a variety of ways.
• They can be used for capital expenses but should
  not be confused with Capital Facilities and
  Technology set aside funds

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What Does MHSA Have to Do With Housing?

• Lots of agreement among consumers and family
  members, county mental health directors and other
  stakeholders
• Safe, affordable, stable housing is a foundation
  for recovery, resiliency, and wellness
• Reducing homelessness is a major focus of MHSA
  implementation and performance measurement
• Consumers and families need a range of housing
  options

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Preliminary Findings from the AB2034 Housing
Strategies Evaluation
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Purpose of Evaluation

• Identify the range of housing strategies
  implemented by the 34 counties that have received
  AB2034 funding
• Determine if there is any correlation between the
  housing strategies or range of strategies that a
  county (or program within a county) employed and
  successful housing outcomes for AB2034
  participants
• Begin to calculate the immediate and projected
  long-term costs associated with each housing
  strategy.

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Major Findings

• Housing is Really Important!
• If you give consumers housing, they are MUCH more
  likely to stay enrolled in the program.

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Major Findings

• Consumer Preferences
• Most consumers want their own apartment without
  roommates
• Majority of consumers dont want the structure
  and rules associated with clean and sober
  housing, but program staff think consumers need a
  mix of housing models (including clean and
  sober and low demand housing)
• Nearly all counties report that there is not
  enough affordable housing available in their
  community

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Major Findings

• Housing Outcomes
• Programs that enroll more challenging consumers
  (those that have had longer histories of
  homelessness or more barriers to housing
  stability) are not getting worse results in terms
  of housing outcomes, in fact sometimes the
  results are better
• Housing readiness is not a good predictor of
  housing outcomes

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Major Findings

• Housing Makes a Very Big Difference
• There is wide variation among counties/programs
  in the proportion of ever-enrolled consumers who
  are now in stable housing. The range is 11 to
  62.
• There is a very strong correlation between having
  a high proportion of ever-enrolled consumers who
  are in housing and having a very low proportion
  of consumers who dis-enroll.

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Major Findings

• Housing Strategies
• Some strategies are being used by nearly every
  county and offered to virtually every consumer.
  These include
• Advocacy on behalf of individuals to help them
  find and get housing
• Supportive services to help people keep housing
• Back-up problem-solving help for landlords

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Major Findings

• Housing Strategies, contd
• Other widely implemented housing strategies
  include
• Assist consumers to apply for housing subsidies
• Provide short-term subsidies or help with move-in
  costs
• Provide long-term rent subsidies to some
  consumers
• (This strategy may have negative cost
  implications over the long term, particularly if
  Section 8 becomes less available.)
• Provide temporary or transitional housing to get
  people off the streets and/or for respite/crisis

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Major Findings

• Housing Strategies, contd
• Some strategies are used in about half of the
  counties/programs
• Actively recruiting landlords, systematically
  finding available units, making arrangements with
  landlords to secure the next vacant unit
• Master-leasing buildings or apartments within
  buildings and sub-leasing units to consumers
• Use AB2034 funds to secure dedicated or set-aside
  units for consumers

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Major Findings

• Housing Strategies, contd
• Strategies more likely to be implemented in
  large/urban counties
• Administer Section 8 or Shelter Care rent
  subsidies that are available to consumers
• Partner with Housing Authority or other public
  agencies that control rent subsidies
• Work with other supportive housing providers

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Major Findings

• Housing Strategies, contd
• Strategies more likely to be implemented in
  smaller/rural counties
• Offering maintenance or cleaning either ongoing
  to help tenants keep housing or when tenants move
  out to keep landlords willing to rent to other
  consumers

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Major Findings

• Housing Strategies, contd
• A small, but growing number, of counties/programs
  are getting involved in developing or operating
  permanent supportive housing.

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Major Findings

• Overall Focus of Housing Strategies
• About a third of counties/programs report that
  the primary focus of their housing activities is
  on helping INDIVIDUALS
• About two-thirds report that their housing
  activities focus on BOTH helping INDIVIDUALS and
  EXPANDING HOUSING OPPORTUNITIES by working to
  develop housing and/or build partnerships with
  landlords

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What is Most Needed?

• More affordable housing
• Permanent supportive housing
• Landlords and property managers who are tolerant
  and understanding of consumers
• Wet/Damp and Harm Reduction housing models
  for people with substance use problems
• Support for both landlords and tenants
• Wide range of housing options

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The Financial Structure of Supportive Housing
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Priority Populations for Housing

• Adults/older adults with serious mental illness
  who are homeless or inappropriately housed in
  restrictive settings
• Youth and young adults diagnosed with SED/mental
  illness who are at risk of homelessness
• Families with children/youth diagnosed with SED
  who are experiencing housing instability or
  homelessness that interferes with treatment and
  recovery / resiliency

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What is Supportive Housing?6 Dimensions of Best
Practice

• Housing Choice
• Housing and Services Roles are Distinct
• Housing Affordability
• Integration
• Tenancy Rights / Permanent Housing
• Services are Recovery-Oriented and Adapted to the
  Needs of Individuals

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Strategies for Creating More Housing Options for
Consumers

• Development of new buildings
• Acquisition and renovation of existing buildings
• Long-term lease agreements with private landlords
  for single units or entire apartment buildings
  (master-leasing)
• Identifying private landlords who rent directly
  to consumers
• Rent Plus strategies

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Three Types of Financing for Supportive Housing
Costs

• Capital (land or buildings)
• Operating costs (or rent subsidies)
• Services
• MHSA Capital facilities funds may be used for
  capital costs and/or for capitalized reserve for
  operating costs of capital projects
• MHSA Community Services and Supports funds may be
  used for operating costs and/or services (and in
  years 5 may be used for capital)

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The Three Fundamental Elements of Capital
Facilities
Create Housing other Facilities
Manage the Asset
STAYS
WORKS
Support Tenants / Clients
EFFECTIVE
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The Three Flavors of Money
Capital
Operating
Services
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Targeting Investments to Change the Equation
ADDING HERE
Reduces Costs Here
Capital
Operating
ADDING HERE
Services
Can leverage debt
Here can be a magnet for capital and operating
funds.
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Capital Facilities Costs May Include (Proposed)

• Purchasing land or buildings
• Construction or rehabilitation costs for
  buildings or office / meeting spaces
• Adequate reserves for projects to cover gaps in
  operating costs in future years
• Related soft costs for development including
  strategies to build community acceptance for
  projects

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Guiding PrinciplesThe Same Goal Transformation

• Decisions about how to use MHSA funds for capital
  facilities must be guided by the MHSA Vision and
  Guiding Principles
• Investments in capital facilities should help
  achieve desired outcomes of MHSA
• Safe and adequate housing reduction in
  homelessness
• Timely access to needed help, including times of
  crisis
• Reduction in involuntary services and
  incarceration

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Guiding PrinciplesThe Same Goal Transformation

• Countys proposed uses of these funds must be
  aligned with planning for Community Services and
  Supports
• Meet identified mental health needs in the
  community
• Focus on unserved and underserved individuals and
  reducing ethnic disparities
• Support implementation of identified strategies

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Capital Facilities Priorities

• Produce long-term impacts with lasting benefits
  for clients, such as reduction in
  hospitalization, incarceration, and the use of
  involuntary services, and increase in housing
  stability
• Increase the number and variety of
  community-based facilities supporting integrated
  service experiences for clients and their
  families
• Support a range of options that promote consumer
  choice and preferences, independence, and
  community integration

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Capital Facilities Priorities

• Invest in options that will be available for the
  long-term, such as housing that will be
  affordable and dedicated to consumers for many
  years
• Leverage additional funding from other local,
  state, and federal sources and support projects
  that are financially viable

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Other Capital Facilities PrioritiesHousing is
essential but not the only need

• Consumer / peer operated wellness recovery
  support centers
• Family Resource Centers
• Crisis stabilization, residential treatment, and
  other alternatives to hospitalization
• Mental health services co-located with
  community-based services including schools,
  primary care clinics, and supportive housing
  sites

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MHSA Funds Can Leverage Other Sources of Funding
for Capital Facilities

• Resources available for housing include
• MHP Supportive Housing and Special Needs Programs
  (Prop 46 Housing Bond) administered by Department
  of Housing and Community Development (HCD)
• Special needs loan program from California
  Housing Finance Agency (CalHFA)
• Low Income Housing Tax Credits
• Federal funding from US Department of Housing and
  Urban Development (HUD) including Homeless
  Assistance Programs coordinated through local
  Continuum of Care and resources administered by
  public housing authorities (PHAs)
• Other resources controlled by City and County
  governments, which may be coordinated through
  10-Year Plans to End Homelessness or other
  inter-agency collaborations

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Governors Initiative to End Chronic Homelessness

• State Departments of Mental Health, Housing and
  Community Development, and California Housing
  Finance Agency come together to leverage housing
  and services funds
• Up to 40 million from Prop 46 Housing Bond
  funding redirected to provide loans to housing
  developers
• 3.1 million from States share of Prop 63 MHSA
  funds for rent subsidies

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Key Challenges

• NIMBY, community acceptance fair housing
• Timelines for developing housing or other
  facilities
• Risks related to future costs to sustain new
  facilities
• Partnerships that effectively leverage resources,
  skills and experience of different organizations
  public agencies
• Solutions Will Require Changing Systems

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A Few of the Building Blocks Where to begin

• Collaborative Planning
• Investment and Leveraging Resources
• Coordination, Streamlining, and Integration of
  Funding
• Building Provider Capacity

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Expect Resistance

• The tools of System Change are meant to unsettle
  old systems while building new ones.
• Old systems will resist they exist because they
  have survived pressures and onslaughts before.
• Services Housing are not just separate systems,
  but (many) separate cultures, disciplines, and
  sets of values.

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Who Creates Supportive Housing
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Who Creates Supportive Housing

• A wide variety of entities can create and operate
  supportive housing
• The deciding factors include the type of SH and
  the population to be served, the organizations
  experience and capacity, the competitive
  environment, and even the funding sources
• Partnerships are also prevalent in SH creation
• Project specific partnerships
• System wide partnerships to build capacity

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Who Creates Supportive Housing

• Mental Health and other Service Providers
• Homeless Service Providers
• NFP Affordable Housing Provider
• Public Housing Authorities
• Private Developers and Private Landlords
• SH providers who only create and run SH

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Models for Supportive Housing Traditional
Development

• Creates a permanent asset to the community
• Involves acquisition and construction and the
  full compliment of development activities,
  including finding capital funding.
• Can take 2-3 years (or more) to develop
• Involves establishing on-going funding sources
  and providers for operating and services

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Models for Supportive Housing Accessing
Existing Housing

• Also might be referred to as Scattered Site
  Housing
• Integrates residents into the community
• Can retrofit existing affordable housing and
  add services in a single site
• Once secure rental subsidy secured, can move very
  quickly
• Involves establishing ongoing funding sources and
  providers for operating and services

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Developing Supportive Housing Additional CSH
Resources Publications Not a Solo ActBetween
the Lines Legal Issues in Supportive
HousingLaying A New the FoundationFamily
MattersWEB resources On-line financing
summaries (via Resource Library link) MetLife
Toolkit to End Long-term Homelessness
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Making the Pieces Fit
?People
? Services
? Organization
? Place
? Money
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Housing Collaborative Training-2006

• Who writes your Housing Element (google)?
• Who controls HOME funding?
• Is there a Redevelopment Authority?
• Who participates in your Continuum of Care?
• Who allocates CDBG capital dollars?
• Is there affordable or workforce housing in
  your community?
• Find partners through NPH, SCANPH and SDHF

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To learn more about supportive housing visit our
website www.csh.org