1. Supportive Housing Providers Association: What is Supportive Housing?

2. Our State Big City: Chicago Mid-sized Cities
Very Rural and Impoverished Areas
Great Geographical Distances

3. Supportive Housing Providers Association
100+ member organizations across the state
More than 9,500 units of supportive housing
12,000 men, women, and children
Advocacy, education, training, technical assistance, networking, resident services
Specializing in active, engaged members - including staff, residents, and boards

4. Supportive Housing
Is affordable housing combined with support services.
Helps individuals become stabilized in housing.
Positively impacts health—physical and mental health.
Helps individuals avoid returning to jail or prison.
Makes possible productive lives, including employment.

5. What Is Permanent Supportive Housing?
HOUSING that is:
Permanent: Not time- limited, not transitional;
Affordable: For people coming out of homelessness; and
Independent: Tenant holds lease with normal rights and responsibilities.
With Services that are:
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.

6. Supportive Housing Serves
Individuals and families
People who have special needs such as:
- Mental illness
- Chronic, debilitating physical illness, such as HIV/AIDS
- Substance abuse disorders
- Chronically homeless

7. Individuals with Serious Mental Illnesses or Other Disabilities
The Cycle:
Jail
Street
Hospital Emergency Room
State Operated Mental Hospital
Nursing Home, IMD, State Institution
OR Supportive Housing

8. Who Needs Supportive Housing?
A portion of the homeless population that needs supportive housing to stay housed.
A portion of the prison and jail population that will need supportive housing to stay housed.
Individuals with disabilities living in
- Institutions for Mental Disease,
- Nursing Homes, or other State Institutions
who could live better in the less restrictive setting of supportive housing.

9. Supportive Housing in Illinois: A Wise Investment!
In April of 2009, SHPA released the first comprehensive study of supportive housing in Illinois, entitled:
Supportive Housing in Illinois: A Wise Investment.
The study was a collaboration by Supportive Housing Providers Association, CSH, and The Social IMPACT Research Center

10. Supportive Housing in Illinois: A Wise Investment!
The study looked at the cost-effectiveness of supportive housing.
177 supportive housing residents around Illinois were enrolled in the study.
Their use of 6 systems was studied two years before entering housing comparing it to the two years after entering housing

11. Supportive Housing in Illinois: A Wise Investment!
The 6 systems studied were:
Medicaid-reimbursed services
Uncompensated hospital services (not covered by Medicaid or private insurance)
State Mental Health hospitals
Substance Abuse Treatment
State Prison
Illinois County Jails

12. Supportive Housing in Illinois: A Wise Investment!
There was a cost decrease in all 6 systems studied from “before housing” to “after entering housing”.
There was a spending shift:
from use of expensive inpatient services before housing (nursing homes, inpatient care, state mental health hospitals)
to less expensive outpatient services after entry into housing (outpatient medical and psychiatric care, case management).

13. Supportive Housing in Illinois: A Wise Investment!
Prison stays dropped to zero; stays in county jails decreased 86%.
Nursing Home use decreased 97%.
Emergency Room total use decreased over 40% and the use of inpatient medical care went down 83%.

14. Supportive Housing in Illinois: A Wise Investment!
There was an average cost savings of $2,400 per person per year.
These cost savings greatly under represent costs due to data that was unable to be collected such as substance abuse costs, police contacts, soup kitchens, shelter stays, and many others.

15. Supportive Housing in Illinois: A Wise Investment!
The study shows that Supportive Housing is cost effective:
It leverages federal funding:
- Medicaid reimbursement
- Renewable HUD rental subsidy
- Capital funding, mostly from HUD
cost savings in public funding accrued from pre- to post- supportive housing, a 39% reduction overall.

16. Supportive Housing in Illinois: A Wise Investment!
Supportive housing cost far less than other places where people with disabilities end up.
The cost of serving a person in supportive housing is:
one half the cost of a shelter,
one quarter the cost of being in prison and
one tenth the cost of a state psychiatric hospital bed.

17. Additional Research Shows the Value of Supportive Housing !
Housing for Health Partnership in Chicago studied homeless people with inpatient hospitalization for chronic medical conditions, including: - (HIV/AIDS, - renal disease, - liver disease, - cancer, - COPD, - stroke, diabetes

18. Additional Research Shows the Value of Supportive Housing !
Those who received “usual” care continued to use high amounts of costly emergency care
The intervention group who received recuperative care and access to permanent supportive housing used
- 45% fewer days in nursing homes;
- 42% fewer days in the hospital; and
- 46% fewer ER visits

19. Housing IS Health Care! It is no surprise –
study after study has found that supportive housing programs work for people with disabilities, even those who are hardest to house, such as chronically homeless individuals with mental illnesses.
Housing is a key social determinant of health.
Housing is, in fact, an important health care service!

20. Supportive Housing Works
Supportive Housing enables residents to:
Become stabilized in housing,
Have freedom and necessary support,
Get consistent proper medical care,
Avoid returning to jail or prison,
Manage their substance use,
Reconnect with family & community,
Take positive steps in their lives, including employment for those who are able.

21. Supportive Housing takes many forms across Illinois
It is tailored to the community where it is located and the population it serves.

22. Types of Supportive Housing
Scattered site rental units in buildings owned & managed by another entity.
All in one building owned and managed by provider or partner.
4 units to over 100 units
single homes
Many different styles, for Families and individuals

23. Heritage Behavioral Health, Decatur
Three supportive apartment buildings
form a small community.

24. Southern Illinois Coalition for the Homeless.
Eight two-and three-bedroom single family homes serve as supportive housing for families in a 24-county area

25. Grand Apartments. Located n downtown Rockford
Zion Development Corporation, Rockford
Grand Apartments. Located n downtown Rockford

26. Stenger Apartments, located in Cairo - near the downtown area
Delta Center, Cairo
Stenger Apartments, located in Cairo - near the downtown area

27. Brand New Beginnings, Chicago
Family Supportive Housing, an apartment building for families.

28. Financing for Supportive Housing: the “Three –Legged Stool”
Capital Funding
Rental Subsidy or Operating Reserve
Funding for
Services

29. Capital Funding Acquisition, Rehab, New Construction

30. Financing Acronyms NSP=Neighborhood Stabilization Program
HOPWA= Housing Opportunities for Persons with AIDS
IDCEO=IL Dept. of Commerce & Economic Opportunity
IHDA=IL Housing Development Authority
HUD=US Dept. of Housing & Urban Development
SHP= HUD Supportive Housing Program

31. Financial Acronyms FHLB=Federal Home Loan Bank
IDHS=IL Dept. of Human Services
DMH=Division of Mental Health
CDBG=Community Development Block Grant

32. Sources of Capital Funding
State/Federal/ Other
IHDA Trust Fund
State
HUD SHP
Federal
HOME
NSP
IHDA Trust Funds grants to non-profits serving the very low income
HUD SHP = Acquisition, Rehab, New Construction, Leasing, and Operating Costs
Under Hearth Act, are individuals leaving prison or jail eligible for SHP housing?
NSP - NSP - Under NSP2, HUD allocated $1.93 billion on a competitive basis to states, local governments, and non profit organizations. The program objectives and eligible uses did not change under the Recovery Act, but the allocation process and some regulations on the funds have changed. The deadline to apply for NSP2 funding is July 17, See NSP2 NOFA for details.

33. Sources of Capital Funding
State/Federal/ Other
HUD 811
Federal
HOPWA
IDCEO Energy Grants
State
LIHTC
HUD Capital and rental assistance for low income individuals with physical disability or chronic mental illness.
HOPWA – Capital, rental assistance, and service funding for low income people living with HIV/AIDS.

34. Sources of Capital Funding
State/Federal/ Other
State Tax Credits
State
County Mental Health Boards
County
IL Clean Energy Foundation
Private
Chicago Dept of Environment
City
IL Clean Energy Foundation – independent foundation funded with an endowment from Commonwealth Edison.

35. Sources of Capital Funding
State/Federal/ Other
FHLB Grant
Federal
Agency Funds or Property
Agency
Cook County
DuPage County
County
Northfield Township
Township

36. Sources of Rental Support
Rental Subsidy or Operating Reserve

37. Sources of Rental Support
State/Federal/ Other
HOPWA
Federal
HUD SHP
HUD Sec. 8 Housing Choice Vouchers
HUD Shelter Plus Care
HOPWA - Capital, rental assistance, and service funding for low income people living with HIV/AIDS.Housing Choice Vouchers - HUD contracts with housing authorities to provide Section 8 voucher assistance to very low-income households, households already assisted under the Housing Act of 1937 and households with incomes up to 80 percent of area median that qualify to receive a voucher in connection with other HUD programs. HUD determines median income levels for each area annually.
HUD Shelter Plus Care -
The Shelter Plus Care Program provides rental assistance for hard-to-serve homeless persons with disabilities in connection with supportive services funded from sources outside the program. Shelter Plus Care (S+C) is a program designed to provide housing and supportive services on a long-term basis for homeless persons with disabilities, (primarily those with serious mental illness, chronic problems with alcohol and/or drugs, and acquired immunodeficiency syndrome (AIDS) or related diseases) and their families who are living in places not intended for human habitation (e.g., streets) or in emergency shelters

38. Sources of Rental Support
State/Federal/ Other
Rental Housing Support Program
State
HUD 811
Federal
Operating Reserve Sources
IDHS-DMH Bridge Subsidy
Rental Housing Support Program - The Long Term Operating Support Program ("LTOS") is part of the Rental Housing Support ("RHS") Program intended for affordable housing developments. The goal of the LTOS program is to increase the supply of affordable housing to households earning at or less than 30% of Median Income by providing a long term, unit based, rent subsidy. LTOS Grants will be awarded in response to a competitive Request for Applications ("RFA") published 2 or 3 times per year. Please note, if your project is located within the City of Chicago, please contact the City's Department of Housing for details on the LTOS and RHS Program for Chicago.
FY 2009 Special Request for Applications
IHDA is pleased to release the FY 2009 Special Request for Applications ("RFA") for the first round of LTOS Grant funding. The RFA intends to fund projects that are currently operational or that will become operational within 3-6 months of application. The RFA also intends to give preference to applicants who commit to provide outreach to special needs populations.
HUD Capital and rental assistance for low income individuals with physical disability or chronic mental illness.

39. IDHS/DMH Bridge Subsidy
DMH Housing Policy: The Department of Human Services, Division of Mental Health (DMH) is supportive of the development and expansion of Permanent Support Housing (PSH) for individuals who meet defined criteria of eligibility and who are diagnosed with a serious mental illness.
DMH plans to devote its attention and future resources toward expansion of the Permanent Supportive Housing model – an acknowledged best practice.1
1 Illinois Division of Mental Health (2008). Illinois Division of Mental Health permanent supportive housing policy. Available at

40. DMH Priority Populations
Resident of a Long Term Care Facility (nursing facility), or
At risk of placement in a nursing facility, or
Extended long term patient (at least 6 months) in a State Hospital, or
An aging-out adolescent or young adult from an Individual Care Grants (ICG) program, or
A DCFS ward aging-out of guardianship, or
A resident of a DMH funded supported or supervised (including MH-CILA) residential setting, or
Experiencing chronic homelessness as defined by DMH.

41. Bridge Subsidy Initiative
Began with “test phase” in August 2008 and 1st Round in October 2008
Tenant-based subsidy designed to help consumers “bridge” the gap between the time a consumer could leave the nursing home or other institution and the time they can access a Housing Choice Voucher (HCV) in the community
Consumers must be connected to their local DMH contracted mental health center in order to apply
No pre-determined length of “bridge”
Each consumer can access up to $2,000 in transition funds

42. Funding for Services
Funding for
Services

43. Sources of Service Funding
State/Federal/ Other
HUD-HOPWA
Federal
HUD SHP
Supportive Mental Illness Housing
State

44. State Funding for Supportive Housing
FY 1999, $3.6 million
FY 2004, $1.75 million
FY 2005, $2.7 million
FY 2006, $1.7 million
For FY 2007, $4.2 million  
For FY 2008, $3.9 million
For FY 2009, $4 million
For FY 2010, $1.4 million
For FY 2011, $1.4 million
For FY 2012, less than 1% cut.
For a total of $23.9 million, providing services in over 8,500 supportive housing units to 10,106 men, women, and children.

45. State Funding for Supportive Housing
SH - Funding Increases
State Fiscal Year
New Funding
Cumulative Funding
% Increase
2003
$6,464,838
Base Year
2004
$2,104,450
$8,569,288
33%
2005
$1,822,174
$10,391,462
21%
2006
$1,113,079
$11,504,541
11%
2007
$1,882,368
$13,386,909
16%
2008
$1,419,468
$14,806,377
2009
$1,196,935
$16,003,312 8%
2010
$355,284
$16,358,596 2%
2011
$2,708,121
$19,066,717
17%
2012
$2,003,155
$21,069,872
2013
$2,591,216
$23,661,088
12%
2014
$1,112,500
$24,773,588 5%
2015
$2,600,000
$27,069,229 9%
For a total of $30.4 million, providing services in over 9,500 supportive housing units to 12,000+ men, women, and children.

46. Supportive Housing Funding from Department of Human Services

47. Sources of Service Funding
State/Federal/ Other
IDHS-DMH Bridge Subsidy
State/Federal Medicaid
CDBG
Federal
Foundations/ Corporations
Private/Corporate

48. HUD Homeless Funding, Continuums of Care, & Supportive Housing
Challenges: A person cannot enter HUD Continuum of Care funded permanent housing directly from jail, prison, nursing home, IMD, state run institution because a person must be homeless to be eligible.
Many people exiting these systems become homeless immediately if not sooner, they are then eligible to participate in HUD McKinney-Vento Programs.
It’s all in the definition!

49. Partnerships IDHS & SHPA/Providers & Federal Funding, etc.
IDHS/DMH & CSH
Providers combining Federal, State, County, Township, and City Funding.
Providers partnering with developers, government entities, housing authorities
Others…