1. Fairbanks Symposium on Homelessness: Supportive Services Session
Permanent Supportive Housing and Rapid Re-housing Services
Kevin Martone, Executive Director
December 6, 2017

2. Housing is part of the overall healthcare system change strategy
Housing is part of the overall healthcare system change strategy. It is a primary intervention and should be incorporated into health planning.

3. Housing First Foundation
A homeless assistance approach that prioritizes providing permanent housing to people experiencing homelessness, thus ending their homelessness
Housing serves as a platform from which people can pursue personal goals and improve their quality of life
Issues that may have contributed to housing instability can best be addressed once people are permanently housed

4. Check Assumptions at the Door
Screen in!
Don’t screen people out for:
Not enough or zero income at entry
Low “employability”
Lacking a “desire” to change
Lacking a “good” attitude
Being “uncooperative”
Not engaging in treatment
Having been unsuccessful at rapid re-housing or PSH before

5. HUD and USICH: Core Principles of Housing First and Rapid Re-Housing Webinar, July 2014

6. Permanent Supportive Housing
Permanent Supportive Housing is integrated, affordable, community based, lease-based housing that provides tenants with the rights and responsibilities of tenancy and links them to voluntary and flexible supports and services.

7. Who is Permanent Supportive Housing for?
Permanent Supportive Housing has evolved from being just for “high functioning” individuals to serving individuals with high needs, including those with behavioral health disorders and other disabilities who are living in:
state hospitals
nursing homes
jails/prisons
groups homes, assisted living, residential care homes or other board and care models
chronic homelessness

8. Core Components of Rapid Re-Housing
Rapid re-housing is an intervention designed to help individuals and families quickly exit homelessness and return to permanent housing. Rapid re-housing assistance is offered without preconditions — like employment, income, absence of criminal record, or sobriety — and the resources and services provided are tailored to the unique needs of the household.
Housing Identification
Rent and Move-In Assistance
Rapid Re-Housing Case Management and Services
Source: USICH

9. Who is Rapid Re-housing for?
Families
Individuals
Youth
Veterans
Survivors of Domestic Violence
People experiencing chronic homelessness in some instances

10. Services Approach Comparison in PSH and RRH
Permanent Supportive Housing
Rapid Re-housing
Housing First philosophy
Longer term intervention
Voluntary and flexible
Strengths-based approach
Case management focused on housing and services
Housing and tenancy supports
Linkage and referral
May have treatment and support focus
Housing Plan
Services Plan
Housing First philosophy
Shorter term intervention
Voluntary and flexible
Strengths-based approach
Case management is housing focused
Housing and tenancy supports focused
Linkage and referral
Non-clinical focus
Housing Plan

11. Services in Permanent Supportive Housing
ACT
Case Management
Peers
Tele-psych / Tele-health
Employment
Integrated health delivery
Crisis
Crisis Intervention Teams (CIT)
Critical Time Intervention (CTI)
Family Psycho-education and Supports
Para- professionals
Informal support networks – Social Inclusion

12. Other Services Outreach and In-Reach Service Assessment
Service Plan Development
Care Coordination
Service Monitoring
Assistance with Daily Living Skills
Caregiver/Family Support
Counseling/Therapies
Discharge Planning
Peer Supports
Support Groups
Skill Development and Acquisition
Equipment, Technology, and Modifications
Financial Support/Entitlement Assistance/Benefits Counseling
Job Skills Training/Education
Transportation
Health Management, Education and Support

13. Services in Rapid Re-housing
Case management is housing focused.
Help households find permanent housing and negotiate lease.
Help resolve issues that impede access to housing.
Provide time-limited services that help people stabilize in housing.
Be available to help resolve crises.
Connect households to resources to help them achieve long and short- term goals.
Services are client-directed and voluntary.

14. Types of Housing-Related Services Specific to Getting and Keeping Housing
Individual Housing Transition Services: services that support an individual’s ability to prepare for and transition to housing
Individual Housing & Tenancy Sustaining Services: services that support the individual in being a successful tenant in his/her housing arrangement and thus able to sustain tenancy
CMS Informational Bulletin on Housing-related Activities and Services (June 2015)

15. Examples of Individual Housing Transition Services
Conducting a tenant screening and housing assessment that identifies the participant’s preferences and barriers related to successful tenancy.
Developing an individualized housing support plan based upon the housing assessment that:
Addresses identified barriers;
Includes short and long-term measurable goals;
Establishes the participant’s approach to meeting the goal; and
Identifies when other providers or services, both reimbursed and not reimbursed by Medicaid, may be required.
Assisting with the housing application and search process.

16. More Examples of Individual Housing Transition Services
Identifying resources to cover moving and start-up expenses.
Ensuring that the living environment is safe and ready for move-in.
Assisting in arranging for and supporting the details of the move.
Developing a housing support crisis plan that includes prevention and early intervention services when housing is jeopardized.

17. Examples of Individual Housing & Tenancy Sustaining Services
Providing early identification and intervention for behaviors that may jeopardize housing.
Education and training on the role, rights and responsibilities of the tenant and landlord.
Coaching on developing and maintaining key relationships with landlords/property managers with a goal of fostering successful tenancy.
Assistance in resolving disputes with landlords and/or neighbors to reduce risk of eviction or other adverse action.

18. More Examples of Individual Housing & Tenancy Sustaining Services
Advocacy and linkage with community resources to prevent eviction when housing is, or may potentially become jeopardized.
Assistance with the housing recertification process.
Coordinating with the tenant to review, update and modify their housing support and crisis plan on a regular basis to reflect current needs and address existing or recurring housing retention barriers.

19. Possible Sources of Funding for Services in PSH and RRH
Type
Federal
HUD (McKinney-Vento)
Veterans Affairs (SSVF)
Medicaid
SAMHSA (CABHI, PATH)
State
State contracts for services
Local
County contracts
City contracts
Private
Foundations/philanthropy
Hospital/Health Systems
Donations

20. Medicaid Opportunities to Pay for Services

21. Discussion What sources of funding currently exist in Fairbanks?
What sources pay for PSH?
What are potential sources for PSH?
What sources pay for RRH?
What are potential sources for RRH?
What strategies can be used to secure sources?
Should these strategies be coordinated or pursued by individual organizations?
Other discussion point?

22. Technical Assistance Collaborative, Inc. – TAC
Contact Us
Technical Assistance Collaborative, Inc. – TAC
@TACIncBoston
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