1. MHSA AND HOUSING: Understanding the Relationship – Recognizing the Opportunities MHSA Regional Training II Corporation for Supportive Housing www.csh.org www.csh.org

2. 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. HOUSING AND SERVICES

3. 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.

4. 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.

5. 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

6. MHSA Fund Allocation – Year 1 Education/Training = 45% Capital Facilities/ Technology = 45% State Imp/Adm= 5% Local Plan= 5% Prevention= 0% CSS= 0%

7. 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)

8. 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

9. 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!

10. “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

11. 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

12. Preliminary Findings from the AB2034 Housing Strategies Evaluation

13. 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.

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

15. Consumer Preferences  Most consumers want their own apartment without roommates  Majority of consumers don’t 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 Major Findings

16. 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 Major Findings

17. 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. Major Findings

18. 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 Major Findings

19. Housing Strategies, cont’d 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 Major Findings

20. Housing Strategies, cont’d 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 Major Findings

21. Housing Strategies, cont’d 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 Major Findings

22. Housing Strategies, cont’d 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 Major Findings

23. Housing Strategies, cont’d A small, but growing number, of counties/programs are getting involved in developing or operating permanent supportive housing. Major Findings

24. 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 Major Findings

25. 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

26. The Financial Structure of Supportive Housing

27. 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

28. 1.Housing Choice 2.Housing and Services Roles are Distinct 3.Housing Affordability 4.Integration 5.Tenancy Rights / Permanent Housing 6.Services are Recovery-Oriented and Adapted to the Needs of Individuals What is Supportive Housing? 6 Dimensions of Best Practice

29. 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

30. 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)

31. The Three Fundamental Elements of Capital Facilities Create Housing & other Facilities Manage the Asset Support Tenants / Clients STAYS WORKS EFFECTIVE

32. The Three “Flavors” of Money CapitalOperating Services

33. Targeting Investments to Change the Equation CapitalOperating Services ADDING HERE Reduces Costs Here $$ Here can be a magnet for capital and operating funds. ADDING HERE Can ‘leverage’ debt

34.  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 Capital Facilities Costs May Include (Proposed)

35. 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 Guiding Principles The Same Goal = Transformation

36. County’s 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 Guiding Principles The Same Goal = Transformation

37. 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 Capital Facilities Priorities

38. 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 Capital Facilities Priorities

39. Other Capital Facilities Priorities H ousing 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

40. 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

41. 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 State’s share of Prop 63 MHSA funds for rent subsidies Governor’s Initiative to End Chronic Homelessness

42. 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

43. A Few of the Building Blocks Where to begin … Collaborative Planning Investment and Leveraging Resources Coordination, Streamlining, and Integration of Funding Building Provider Capacity

44. 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.

45. Who Creates Supportive Housing

46. 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 organization’s 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 Who Creates Supportive Housing

47. 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 Who Creates Supportive Housing

48. 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

49. 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

50. Developing Supportive Housing Additional CSH Resources: Publications: Not a Solo Act Between the Lines: Legal Issues in Supportive Housing Laying A New the Foundation Family Matters WEB resources: On-line financing summaries (via Resource Library link) MetLife Toolkit to End Long-term Homelessness

51. Making the Pieces Fit  Organization  Services  Place  Money  People

52. 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

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