This is an excellent overview of the city and to some extent county homeless services system, some challenges and how they are approaching the housing needs at this moment, after Rethke and Tree Lane. And why.This is from the Common Council Executive Committee meeting yesterday.
You can follow along with the meeting here if you are interested. It doesn’t start til at least 40 minutes in.
Update: Permanent Supportive Housing- Capacity Building, Services & New Ideas Meeting – Linette Rhodes, Community Development Division
Linette Rhodes and Jim O’Keefe from Community Development Division are there to present. O’Keefe says in the past two years the city has done two Supportive Housing Development projects, one at Rethke (single adults) and one at Tree Lane (serving families). A third development had been proposed, it was delayed in the aftermath of some highly visible struggles at the two developments and ultimately cancelled. They have been evaluating what has and hasn’t worked since that time. Linette has slides with background and Sarah Lim (Housing Services Specialist) and Torrie Kopp Mueller (Homeless Services Consortium Coordinator) are also there and they can answer any questions they have.
Linette Rhodes says that they thought they should provide some background. The house the CoC’s Coordinator at the City of Madison so the City has been a very strong partner with our continuum of care that we locally call our Homeless Services Consortium.
She personally believe that the city’s vision of having a inclusive, innovative and thriving city really goes in with the homeless services consortium preventing and ending homelessness. We want to make sure that homelessness is prevented, rare, brief, non-recurring experience.
They have been talking since 2014/2015 about what we need as a community to prevent and end homelessness and we always come up with three things: comprehensive system of services, coordinated entry system and housing first approach. Some of the ideas came from national best practices, some also came as directives from HUD that gives us $3.4M of Continuum of Care (CoC) dollars to support the work we do. As they shifted what they wanted us to do through their regulations we supported the homeless services consortium to shift with those ideas so we can continue to get that money in our community.
Since 2015 they feel they have created a much more robust system to address homeless services (prevention and ending) and to make sure we are exiting people out of homelessness in a quick and effective way. This is an overview of what our services look like now. Today they are focusing on permanent housing. The city puts about $1.6M of general funds in the operating budget each year to support this. We do a funding analysis every year where they look at what is coming in from HUD, the county and United Way. Overall it is about a $10M system that we are working in, that does not count capital expenses, but for operating our portion is about $1.6M.
One of the key things is the Coordinated Entry system that is to make sure people have fair and equal access to services, that they are identified and referred and connected to housing based on their strengths and needs. She says they were steering the titanic to get coordinated entry into the community. Each provider had their own waitlist, their own criteria, their own ways to approach services, so if you were a person in need of housing, you had to make sure you knew everyone’s rules, that you contacted everyone, that you were on all the different lists. This was a real game-changer but it really was the city and HUD pushing some of the providers to go to the coordinated entry approach where we created the housing priority list.
The third thing we talked a lot about in the community that we had to get everyone to was the Housing First approach or philosophy. Again, this is a nation best practice, a lot of us attended national trainings trying to bring the housing first approach to Madison and to understand it. It’s about housing first instead of being housing-ready. We want to quickly get people into housing with low barriers. Sometimes we talk about if there are no or low barriers. In the city led developments we can’t say there are no barriers, so we are still working on how we can get people quickly into this housing but its a philosophy that we want to make sure all our housing providers are trained on. We want to make sure we are reducing the barriers and they approach it as a part of harm reduction. That they are providing appropriate housing and services for people and that we have housing focus at all levels of care. So from anyone who needs mental health services to high levels of care, we want to make sure that as soon as we access someone that needs housing that they are able to get into that stable housing. As you know, as soon as someone gets in that housing, all of those other issues in their lives will be easier to work on and connect with case management as long as they have stable housing.
This is the narrative of how this has impacted our community so much. CDD is not graphic designers, so Jim was making fun of our little men, but we are just trying to make a point. We have all these individuals and they have approached us that they are experiencing homelessness in our community.
Through coordinated entry all of them are going to be assessed through a common tool. The acronmyn for our tool is the VI-SPDAT which will determine the acuity. We put them on a housing priority list after they get the common assessment.
We have assessment hubs throughout the community at street outreach, day resource center and the shelters. They have trained people to do that common assessment. The key thing is that when they get the assessment done, there are three places they can get placed on the list. If someone has a lower acquit that probably means that they need the lightest touch possible in our homeless system. They will potentially be getting out of homelessness on their own. They might need help from housing navigation services, a street outreach worker or case manager to find the housing, but they won’t need the intense case management services going forward
We have people that have moderate acuity, they will time limited financial assistance or case management. We are seeing these individuals go into our rapid re-housing programs. They are getting rent subsidy or getting some assistance for up to two years, but usually they get employment and they stabilize on their own.
The third bucket is people with higher acuity. They are people with high needs, they are highest on the priority list because they have high scores on the Vi-SPDAT. That is where we really need to think about that housing first approach. They probably have lots of barriers to get into traditional housing in our community based on past experiences. They probably have police calls, evictions and other barriers. And they probably, most likely, will need those permanent supportive housing case management to make that housing successful. The key here is that before coordinated entry and housing first and Retake and Tree Lane, we had lots of permanent supportive housing units in our community. We are now asking those permanent supportive housing units to make a switch. Where they had a range of all clients from all perspectives, but we are saying because of the federal regs and the housing first approach we would like you to start taking every body from the high acuity. So the case management services they once provided, the number of people they had to staff didn’t change with how quickly HUD changed and we started the housing first approach.
We saw a lot of changes in our system. We saw people in need of more street outreach services to access housing, because only people with high needs were getting into supportive housing. It impacted all of our system. That’s the back story of how we got here. Now we will talk about where we are not and what we have learned from our work since we opened the city-led developments.
O’Keefe said he would interrupt Linette just once and this is that point, this is important. As we have focused on housing first and insisted that housing providers draw their tenants from the top of the housing list, the profile of the tenants and residents in the properties has changed to a point where it is much more focused on residents with higher needs but there hasn’t been a corresponding adjustment to the resources for the support services, there is a disconnect. As providers are being asked to serve residents with higher needs there hasn’t been adjustments in the support system.
Rhodes says that permanent supportive housing is housing that is paired with support services and they are usually taking a household with someone with a disability, especially if they are receiving HUD funding, it has to be someone with a disability.
This is a snap shot from the last housing inventory count of what the permanent supportive housing portfolio looks like. The city let initiatives, Rethke and Tree Lane brought in about 54 new units of single housing and about 40 new units of family housing that we are taking off the priority list. We have a lot of other site based and scattered site units that are being ran by our local nonprofits. Mostly Housing Initiatives, Porchlight, CAC used to run some of our scattered sites, you know our local nonprofits. As we started talking about the lessons that the city learned through our developments we wanted to start reaching out to our community partners as well and it was very interesting having that expanded conversations because we thought we learned a lot by having our hands in the property management and the services and all that stuff and the development of two of those. But the service providers came back and gave us some more information about their current environment. They are very interested and willing to support more permanent supportive housing in our community, but they kind of said to us “please stop” we have to look at the current capacity challenges that we have in our organizations right now as our units were filled for a long time with people with lower acuity and lower needs are now being filled with people with higher needs and our case management is not as robust to support them. They had a survey with the community partners and two very robust conversations. They had a community meeting and a summit where they invited everybody for about 4 hours to come and give us feedback about the challenges right now in the community, for the to continue focusing on the national best practices of housing first and the coordinated entry system. Some of the agencies can’t work in the boxes HUD has provided and we need additional support before we build more.
Here’s some of the lessons learned from leading development and from the community partners as well. Current challenges supporting the clients not just in the city-led developments, but the community still has strong needs for permanent supportive housing so we need to look at the future. At present there are few agencies equipped to meet the added demands. Every agency told us some reason why they were in need of some type of support system to move forward with this type of housing. The current funding streams for support services are inadequate. Before they opened Rethke they were going to rely a lot on Comprehensive Community Services (CCS) dollars to bill medicaid. With this population we should not rely on that source to leverage the city resources. People have to opt in to those services, and we we have people who are just trying to stabilize their housing, getting housing for the first time sometimes, this is not a match to help us leverage our support services. They also learned that concentrating high need residents in a single location adds a lot of challenges. Through working on the 2 developments they did research with other cities and asked questions about density and what works, what should be the make up of projects as the move forward. They also realized relationships are so important – relationships with the tenants, between city agencies (CDD, CDA, Police), with the developer and property manager. It takes time to build relationships to have quality housing. They learned that quality and consistent property management is essential, not just for permanent supportive housing, but all housing in the city of Madison. Also, the capacity and quality of the property is as important as the location. We try to ensure its near a bus line, but is it an adequate bus line for the people they are trying to serve.
They have engaged with community partners to figure out what conversations they need to have as they move forward, to support the inventory we have now and as we expand. They gave us feedback that they need more training in trauma informed care, housing first, motivational interviewing and overall more trainings to come to Madison and the opportunity to send their individuals to national trainings. We have a very, very, very, very small budget though our CoC grant that we can maybe send one or two people a year to a national conference that are part of our non-profit community. As those conferences get more expensive that might dwindle more. People are begging for more opportunity to get education and support for their case managers. They are talking about enhancing organizational capacity. As we build more units we want a healthy ratio of case managers to residents and what we are missing in some situations are “middle management”, the agencies have Executive Directors and Case Managers but they need to a robust middle management. The case managers really need that support system to go to, to problem solve and some of the supervisors are supervising over 15 or 16 people who have high need cases and it gets pretty daunting. They also suggest a support system led by someone with housing First practices. We all have different roles in the system but there is no housing first specialist that can go to the agencies and help them with their staff structure and to problem solve. They also talked about a housing focused supportive service team to support people who have contacts with other systems. Even if someone gets into supportive housing they are still having interactions with the police, going to the ER a lot and they are having a hard time staying stable in their housing and maybe they are not connecting to the case manager at that site. They have talked about this for a while and have seen some best practices in other cities where there is a holistic team of potentially nurses, case managers, mental health trained persons that are not assigned to a project but are there to problem solve with the community. The last thing that the providers talked a lot about is resources to help when the property is damaged. A landlord mitigation fund. The turn over and expenses to get someone else off the streets and into that housing sometimes takes 6 months with the damages and up to $8,000. Some of that help to get units back on line in a timely manner.
She wants to end with strategies they are working on in the community. She says that a lot of people think that since phase 3 is on hold that we don’t know where we are going with permanent supportive housing, but we talk about it on a daily basis. We want to support not only what we are doing now, but we want to have it in all the affordable housing we are trying to support. Right now we are still strengthening the relationships with the nonprofits and private developers. The new Affordable Housing Fund RFP asks developers to work with the local nonprofits, especially with nonprofits working with people experiencing homelessness. We might not have a site based 30 units of housing, but we could potentially get 8 – 10 units of scattered site permanent supportive housing that is more in a mixed income situation. We have a variety of those coming, the Breese (Stone House and Road Home) that about 9 of the units are families who are coming right off of the permanent supportive housing list. Another 8 units will open soon with Stone House and Road Home. They also have a “moving up” project that is 20 units that will be coming on. They will take people currently in permanent supportive housing that don’t need that permanent supportive case management and move into units with light case management freeing up the permanent supportive housing units. They also have 12 units that will work with individuals in the rapid rehousing range as well. They still have units coming on line, but they are a scattered site, mixed income type of approach. They also have made great strides working with the housing authority. Just recently as of September 5th the Housing Authorities applied for Mainstream Vouchers, the CDA applied for 45 vouchers, that will focus on the moving up philosophy. These would be for people who need the rent subsidy but don’t need the services any more freeing up more units. The state is looking at the medicaid waiver that will bring additional services through CCS. They also continue to network and problem solve with the Homeless Services Consortium. There is a housing first provider committee and case managers that also come together. That is a key place to problem solve, so they are looking at problems now but also how to move forward.
