Housing Opportunity: Chronically Homeless Individuals Using a Social Impact Bond to Support a Broader City Homelessness Strategy

2 HKS SIB Lab Colorado/Denver Connecticut Illinois Ohio New York Massachusetts South Carolina Michigan Chicago

Overview of SIB Process  The City and State received 43 requests for information, more than any jurisdiction to date.  Three primary areas were further analyzed based upon the RFI responses: early childhood, disconnect youth, and homelessness.  The response from the Denver Crime Prevention and Control Commission, addressing chronic homelessness, was identified as the top candidate for the City to pursue. 3 Outreach Request for Information (RFI) RFI Evaluation Internal Decision- Making FEU SIB Analysis with Local & National Partners JulyAug.Sept.Oct.Nov.Dec.Jan.Feb.Mar.AprilMayJune Over the course of the last eleven months, the City has conducted a rigorous process for identifying possible areas for a Social Impact Bond and evaluating the feasibility of proposed applications.

Target Population  High Utilizers (“Front-End Users”)—Individuals, typically chronically homeless, who are frequently before the court, in jail and habitually using a spectrum of resources. – Frequent usage of emergency rooms, detox, and ambulatory services. – High level of public safety usage (i.e. arrests, jail admissions and discharges). Low-level offense types: Public nuisance (22%), Alcohol (30%), Panhandling (4%), Trespass (19%), Drug (11%), Other (14%) Chronically Homeless High Utilizers 4 We are currently paying for costly, ineffective emergency and penal services.

High Utilizers: Service Usage 5 Average Usage Per High Utilizers (2013) Top 100Top 150Top 200 Arrests Cite & Release Custodial Justice System Jail Days Court Dates Medical Expenses* Detox Visits8.2 ER Visits2.1 Other Medical Visits 1.8 On a given year, the High Utilizers can touch multiple systems at extremely high rates … High Utilizers may have high and low years, but they have high multi-year averages … (Target group = those who spent more than 7 days in jail in 2010) 2010 Target Group Average over Average Total Bookings8.08 Yearly Average Bookings2.7 Average Total Jail Days170 Yearly Average Jail Days57 *Cannot be reduced to individual level given privacy restraints

High Utilizers: Top 300 Averages 6 On average, the top 300 High Utilizers use a lot of government resources …  14,000 days in jail,  2,400 visits to detox,  1,000 arrests, and  600 emergency room visits. It is an extremely ineffective and expensive system, costing taxpayers over $11 million per year.

Proposed Intervention Intensive Case Management 7 By properly serving this population, the City can both reduce costs and create long-term solutions… Housing  Housing First and Permanent Supportive Housing.  Single-site buildings dedicated to serving high-need populations ( units), and/or  Scattered-site housing (10-30 units at a site).  Services delivered on location and off-site (e.g. behavioral health, substance abuse, physical health treatment), or  Mobile teams that meet individuals wherever they might be located.

Combination Model 8 Housing Subsidy Enhancement Mobile Service Teams Year Housing Rehab or Const. Site-Based Service Teams Year Total Individuals 150 Total Individuals A combination model would allow the City to begin the program in the short-term and move towards a long-term strategy that adds additional housing capacity to the Denver region…

Combination Model  Housing Type (options): 1)Participants receive voucher and find on own or live in a property with a relatively small (5 – 10) number of units sub-leased, master leased or otherwise set aside for program participants 2)Participants live in one of three properties designed solely for FEU population and ongoing housing operations are funded through direct payment or vouchers  Ongoing Total Costs: $13,000 - $18,000 per individual  Timeline of Program Scaling: 9

10 SIB Project Concept Funding Elements Medicaid eligible component Non Medicaid eligible component Services Enhanced Rental assistance or operating subsidy Upfront capital costs of preparing housing for program participants Housing Medicaid expansion allows fed gov’t to support 90%, State 10% Get as much of program into Medicaid as possible DHA, CoC, DOH for rental assistance CHFA, DOH, City and private lenders for housing capital Social Impact Bond that addresses likely program and rental support gap by capturing jail and health savings Integrated delivery of services and housing for target population Pre SIB Funding Strategy Pre-SIB Funding Need Outcome The SIB Project is an opportunity to add new resources to supportive housing and demonstrate the benefits of combining multiple existing sources of funding…

New Housing Finance Model A SIB project can combine new investment dollars with existing funding streams to promote better strategic programs and fill the funding gap that other cities have filled through municipal levies, state programs and federal resources… Eastlake (Seattle) Opportunity for Creative Investments Opportunity for SIB Financing

Current Project Partners Social Impact Solutions – Mary Wickersham & Ken Weil have a combined several decades of high level policy development, financing and implementation experience. Through SIS, they are leading Pay for Success / Social Impact Bond efforts throughout the state. They support clients in positioning successful programs for innovative finance through feasibility studies, financial modeling, identification of funders and structuring deals. 12 Corporation for Supportive Housing—For 20 years, CSH has been the leader of the supportive housing movement, demonstrating supportive housing’s enormous potential for improving lives of very vulnerable individuals and families. CSH has been a national leader in designing and supporting programs that address similar populations to Denver’s FEU initiative. Enterprise Community Partners—For more than 30 years, Enterprise has introduced solutions through public-private partnerships with financial institutions, governments, community organizations and other partners that share their vision that one day, every person will have an affordable home in a vibrant community, filled with promise and the opportunity for a good life. Enterprise has worked with community-based nonprofit organizations to develop over 240,000 affordable homes and invest over $9 billion throughout the United States. Social Impact Solutions

National Technical Assistance  Homelessness, Olmstead, Youth Aging out of Foster Care 13 Other Organizations Include: Enterprise Community Partners, Social Finance, Institute for Child Success, National Council on Crime and Delinquency, University of Utah David Eccles School of Business PFS Lab, Nonprofit Finance Fund  Joint-Initiatives between Governments (e.g. City & State)  Government-Side Technical Assistance  Asthma-Related PFS Projects and Technical Assistance to Healthcare Organizations and Nonprofits