Supportive Housing: Community and Economic Impacts couple on trauma informed care mostly focus on housing first and harm reduction services and principals. who should come? All staff responsible for permanent supportive housing developments Housing First and Harm Reduction are proven techniques for effectively housing community members who are struggling with substance use, mental health, and housing stability. The purpose of this workshop is to provide valuable information to developers, property managers, maintenance staff, housing authority staff, owners, and service providers on Housing First and Harm Reduction strategies. Housing First methods strive to quickly move people experiencing homelessness into independent and permanent housing, and then provide additional support and services as needed. You will learn the five core principles of Housing First, all based on the premise that people are better able to move forward with their lives if they are first housed. Additionally, you will learn the eight central principles of Harm Reduction practice, making clear that it does not attempt to minimize or ignore the real and tragic harm and danger associated with addiction and mental health needs. Discussion will focus on the spectrum of behaviors, criteria, and policies that constitute successful reduction of harm. While there is no “one size fits all” method for the Housing First and Harm Reduction principles, best practices and bottom-line analysis are increasing the prevalence of such models throughout the country Zoe LeBeau, President; LeBeau Development

Supportive Housing A combination of affordable housing and services intended as a cost-effective way to help people live more stable, productive lives. Permanent supportive housing is intended to be a pragmatic solution for assisting individuals and families to increase quality of life while reducing, to the extent feasible, the overall cost of care. Zoe

Supportive Housing Is widely believed to work well for households who have very low incomes and/or serious, persistent issues that may include substance abuse, addiction, mental illness, or other challenges toward obtaining/maintaining stable housing. Zoe

Permanent Supportive Housing Enables families and individuals to live independently, with improved health and greater participation in work and community. Saves the tribe/community money by shifting resources from costly emergency services toward cost-effective, long-term solutions.

Why Supportive Housing Reduces stress caused by doubled-up and overcrowding Reduces use of crisis and institutional services Significantly reduces recidivism rates Ends cycles of homelessness Produces better outcomes than the more expensive crisis care system

Who Lives Here? Families and Individuals who: Are homeless, including those previously living on the streets and in shelters Are living in overcrowded conditions and/or couch- hopping Are being discharged from prison or other systems of care Are living in places not meant for human habitation, i.e., cars, garages, abandoned buildings, etc. Zoe

Target Populations Homeless Long Term Homeless/chronic homeless Difficult criminal backgrounds Fleeing domestic violence Under educated Mental and developmental disabilities Generational poverty and homelessness Chronic alcoholic and/or chemical use issues Multiple detox admits Several failed treatment attempts Often been civilly committed Dual diagnosis Vulnerable

Desired Outcomes Reduces use of crisis and institutional services Produce better outcomes than the more expensive crisis management system Reduces recidivism rates Reduces stress caused by doubled-up and overcrowding Ends cycle of homelessness and increase housing stability

Benefits of Supportive Housing Reduces stress caused by doubled-up and overcrowding Reduces use of crisis and institutional services Produces better outcomes than the more expensive crisis care system Significantly reduces recidivism rates Ends cycles of homelessness Zoe

Supportive Housing Improves Lives Research has shown permanent supportive housing has a positive effect on: School Attendance Employment Retention Improved Physical & Mental Health Housing Stability Reduced Substance Use http://www.csh.org/supportive-housing-facts/evidence/

Benefits of Supportive Housing Affordable housing providers benefit lessening wear on housing stock, and creating opportunities for people Human service providers benefit because clients have stable housing, increasing retention and efficiency for accessing/delivery of services Local Government benefits because they increase housing stock and can save money by decreasing utilization of expensive crisis services

Supportive Housing Generates Significant Cost Savings to Public Systems Increasing research including 6 different states and cities has shown PSH associated with reductions in: Emergency Shelter Use Hospitalization Incarceration Other Social Costs (detox, policing, courts, emergency/crisis services, etc.) Journal of Behavioral Health Services & Research. Apr2010, Vol. 37 Issue 2, p213-225. 13p. 1 Chart. http://www.csh.org/supportive-housing-facts/evidence/

Studies & Cost Savings Osceola County Florida: 37 homeless individuals were incarcerated for 61,896 nights. Costing $6,417,905 over 10 years. Jail is not an affordable housing plan (2014, AHAR to Congress) PSH saved over $15,000 per housed homeless person (2006, Denver Road Home) PSH reduces annual cost of homelessness from $40,000.00 to $14,000.00 per year. (HUD, 2014) One 85 unit “Moore Place” PSH in Charlotte, NC saves the community 1.8 million annually due to 447 fewer ER visits and 372 fewer nights spent in the hospital. (UNC, 2009) In Santa Clara, CA $43,706 is estimated to be saved annually by housing the most chronically homeless individuals. These are the people with the most pressing health needs. (EconomicRoundtable.org, 2015) http://economicrt.org/wp-content/uploads/2015/05/Home_Not_Found_2015.pdf http://www.occ.gov/publications/publications-by-type/other-publications-reports/cdi-newsletter/feb-2012/homeless-ezine-article-2-kravitz.html http://www.motherjones.com/politics/2015/02/housing-first-solution-to-homelessness-utah

Cost of Serving the Homeless Declines in Permanent Supportive Housing (2005-2008) http://www.occ.gov/publications/publications-by-type/other-publications-reports/cdi-newsletter/feb-2012/homeless-ezine-article-2-kravitz.html http://usich.gov/PDF/OpeningDoors_2010_FSPPreventEndHomeless.pdf USICH.GOV, Opening Doors, 2010

Per-Person Annualized Cost of Public Services Before and After Entering PSH Chart created from estimates located at: http://www.csh.org/wp-content/uploads/2011/11/Cost-Effectiveness-FAQ.pdf

Cost of Doing Nothing is not Nothing… Nightly Cost Estimates – High/ Medium/Low *Based on analysis across 9 cities Just an illustrated cost comparison of supportive housing and crisis management programs often ‘housing’ those who are homeless

Permanent Supportive Housing ER visits reduced 57% Emergency detox services down 85% Incarceration rates down 50% 50% Increase in earned income of residents 40% Rise in rate of employment among tenants when employment services are provided More than 80% of residents stay housed for at least one year Zoe Summary of key finding from studies across the country

…and it saves money 32% Reduction in service costs by providing Permanent Supportive Housing to people with disabilities who are experiencing homelessness in rural areas 57% Reduction on expenditures for Mental Health Services, illustrating a shift away from expensive inpatient care to less expensive community-based services Permanent Supportive Housing placements reduced service costs: Shelters by 99%, Emergency Rooms by 14%, Incarceration by 95%, & Ambulance Transportation by 32% Zoe Rural Maine study in 2009 Many of the studies are much more dramatic, big cities, frequent users

Housing First: New model designed to end chronic homelessness. People do not need to be “housing ready” in order to move and live successfully in housing. Housing is a right. No one should be denied housing for any period of time because they did not meet pre-determined clinical goals or did not choose to participate in services. Homelessness is a terrible treatment plan, whatever alcohol and drugs make bad – homelessness makes worse. People who are homeless, who use drugs/alcohol and or who may have a mental illness can successfully keep and maintain housing. Housing should never be used to coerce people into services they would otherwise not choose. Housing and services are two separate areas with separate criteria for operation and evaluation. Stress permanent, independent, affordable housing for people with disabilities who are homeless or at risk of homelessness; services are provided as part of the normal operation of the housing as a way of helping residents maintain the maximum possible level of independence, stability and participation in the general community. Like other forms of housing – it typically looks and functions exactly the same way as any kind of permanent housing except that tenants have access to supportive services as one of the benefits of living there. Enables families and individuals to live independently, with improved health, and greater participation in work and community Saves public money by shifting resources from costly emergency services toward cost-effective, long-term solutions

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