A Home is a Human right reclaimed supportive housing solutions in - - PowerPoint PPT Presentation

A Home is a Human right

Capstone Presentation

May 4, 2020

Shelby Fredrickson, M.S Candidate

SES 660A Spring 2020 Advisors: Ira Stern & Leonel Ponce

reclaimed supportive housing solutions in baltimore, md

Agenda 1 2 3 4 5 6 8 9

Guiding Reseaarch Questions Introduce Baltimore, MD Typologies of Homelessness Homelessness in Baltimore Intersection of Homelessness & Climate Change Solutions to Homelessness: Housing-First The Impact of COVID-19 A Vision for the Future

7 Reclaimed Supportive Housing in Baltimore, MD

research questions

How can Baltimore, in the face of rising pressure on the homeless population as a result of climate change, utilize its existing vacant housing stock to most efgectively alleviate chronic homelessness?

• How will existing and future factors of climate change impact the chronically

homeless population in Baltimore?

• What is the most efgective long-term housing strategy for chronically homeless

individuals with substance abuse and/or mental health disorders?

• How can afgordable housing developers in Baltimore utilize environmental

psychology to inform design strategies that maximize housing retention and treatment success?

• How is the current COVID-19 pandemic impacting the homeless population in

the U.S. and what are the implications of this crisis for future housing solutions?

client audience

Afgordable real-estate developer in Baltimore focusing on retrofjtting existing buildings for non-profjt space, residences for educators, restaurant incubator space, and more. National non-profjt organization with outreach in many major cities, providing healthcare, support services, and advoacy for individuals experiencing homelessness. Baltimore’s Continuum of Care collaborative body, including

• rganizations that serve homeless persons, homeless and

formerly homeless persons themselves.

baltimore, md

Source: http://cityview.baltimorecity.gov/CityView/, census.gov

• Population: 602,495
• Demographics:

Black: 62.46% White: 30.45% Hispanic 5.5%

• Education: 16.3% attainment, Bachelors
• Median Household Income: $48,840
• Poverty Rate:

Black: 26.07% White: 12.16% Hispanic: 22.51% U.S. MHI 2019: $63,030

Vacant Buildings as of March 2020

baltimore: building stock

Median Household Income

• As of March 2020, there are 16,784 vacant buildings in Baltimore.
• 47.2% of housing units were built prior to 1940, making Baltimore’s

building stock among the oldest in the country.

• Rate of vacancy correlates with relative poverty.

Source: technical.ly, The Baltimore Sun, census.gov/quickfacts/

• Declining population
• Availability of

residential units

• Median rent: $1,051

typologies of homelessness

Transitional

Typically younger individuals; generally enter shelters or “couch-surf” for a brief stay. Sometimes following a traumatic event or life change.

Episodic

Individuals who are currently homeless and have experienced at least 3 periods of homelessness in the previous year, often disabled.

Chronic

Unaccompanied homeless individual with a disabling condition; continuously homeless for a year or more, or has had a minimum of 4 episodes

• f homelessness in the previous 3 years.

Source: https://nationalhomeless.org/about-homelessness/

typologies of homelessness

Transitional

Typically younger individuals; generally enter shelters or “couch-surf” for a brief stay. Sometimes following a traumatic event or life change.

Episodic

Individuals who are currently homeless and have experienced at least 3 periods of homelessness in the previous year, often disabled.

Chronic

Unaccompanied homeless individual with a disabling condition; continuously homeless for a year or more, or has had a minimum of 4 episodes

• f homelessness in the previous 3 years.

Source: https://nationalhomeless.org/about-homelessness/

homelessness: the “system”

Education Addiction Health Status LGBTQIA+ Foster Care Incarceration Criminal History Domestic Violence Veteran Status Loss of Family Credit History Disability Job Loss Mental Illness Poverty Disinvestment Discrimination Unemployment Deinstitutionalization Low Wages Cost of Healthcare Racialized Policing Underfunded Public Housing Redlining Stigmatization

RISK FACTORS

INDIVIDUAL SOCIETAL

Diagram modifjed & adapted from The Ecology of Homelessness: David A. Patterson

homelessness: the “system”

Isolation Mental Illness Criminal Activity Victim of Crime Exposure Death Substance Abuse Job Loss Sexual Abuse Communicable Disease Violence Chronic Stress Personal Neglect

Diagram modifjed & adapted from The Ecology of Homelessness: David A. Patterson

Crime Truancy Street Violence Panhandling Strain on Public Institutions Increased Police Activity Vacant Homes Municipal Costs ER Backlogs Public Health Crisis Availability of Drugs Public Encampments

INDIVIDUAL SOCIETAL

OUTCOMES

Lack of Afgordable Housing Economic Recession

Lack of Access to Health Services

1. 2. 3. 4. 5. 6.

Can’t Afgord Housing Working & in Poverty Unemployed Cannot Afgord Healthcare Chronically Ill and/or Disabled

Structural Stigma, Racism, & Oppression

Criminal History Preventing Employment

7.

Displacement as a Product of Redlining

8.

Stigma of Housing Status

Employed

Able to work, but unemployed or not paid a living wage. Unable to work,

• r unable to

work without support. Unemployed, Uninsured, Unhoused,

• r Vulnerable to

Chronic Homelessness.

Diagram modifjed & adapted from Understanding Homelessness

designing solutions

Sustainable solutions to chronic homelessness must be designed to:

Be available not only to individuals experiencing chronic homelessness, but the broader universe of those at risk of or experiencing housing instability. Provide employment opportunities with a viable living wage. Provide healthcare that is not contingent on maintaining employment. Expand on a foundation of environmental justice and harm reduction as guiding frameworks.

1 2 3 4

homelessness in baltimore

2017 Point in Time Count: 2,669 Individuals Experiencing Homelessness

Gender Mental Illness Race Household Type Housing Status

Black White Multi-Racial Other

83% 11% 4% 2%

Other Men Women

0.1% 72% 28% 93% 7%

Unhoused Emergency Shelter Transitional Housing

20% 43% 37%

Substance Abuse Disorder Severe Mental Disorder Trauma/Domestic Violence

13% 29% 44%

Source: Baltimore Mayor’s Offjce of Homeless Services

homelessness in baltimore: stakeholders

Social Health Civil

Individuals Families Youth chronic homelessness

• Police Departments
• HUD
• Prison System
• Mayor’s Offjce of Homeless

Services

• Foster Care System
• Community members
• Emergency Rooms
• Rehabilitation Services
• Health clinics
• Harm Reduction services
• Emergency Shelters
• Women’s Homes
• Transitional Housing
• Permanent Supportive

Housing

• Rapid Re-Housing Programs
• Homeless Support NGOs

homelessness & climate change

RISING TEMPERATURES RAPID URBANIZATION INCREASED STORM EVENTS FLOODING FROM SEA LEVEL RISE RESPIRATORY ILLNESSES MENTAL ILLNESSES CHRONIC ILLNESSES DISEASE TRANSMISSION HEAT INDUCED ILLNESSES FATAL EVENT INCREASED PRESSURE ON EXISTING SERVICES

PRESSURES OF CLIMATE CHANGE OUTCOMES FOR HOMELESS POPULATION DESCREASED AIR QUALITY INCREASED MORTALITY PROLIFIC VECTOR TERRITORIES FEWER CAPITAL FUNDS PATHWAYS OF IMPACT

impact pathway: heat

RISING TEMPERATURES INCREASED FREQUENCY OF HEAT WAVES URBAN HEAT ISLAND EFFECT

HEAT STROKE

DECREASE IN AIR QUALITY

EXASPERATES EXISTING CHRONIC ILLNESSES

AGGRAVATED CARDIO- VASCULAR ILLNESSES

AGGRAVATED CAR- DIOVASCULAR ILLNESSES

AGGRAVATED CARDIO- VASCULAR ILLNESSES

PREMATURE MORTALITY FROM COMMON ILLNESSES

AGGRAVATED CARDIO- VASCULAR ILLNESSES INCREASED MORTALITY FROM PSYCHIATRIC ILLNESSES

AGGRAVATED CARDIO- VASCULAR ILLNESSES

INCREASE IN GROUND LEVEL OZONE (O3)

DEHYDRATION PNEUMONIA ASTHMA

PULMONARY DISEASES

AGGRAVATED CARDIO- VASCULAR ILLNESSES

AGGRAVATED RESPIRATORY ILLNESSES Source: https://statesatrisk.org/maryland/extreme-heat

Heat Wave Days are

projected to increase from 10 to 50 days a year by 2050 in Maryland.

traditional continuum of care

Emergency Shelter Individuals experiencing chronic homelessness Transitional Housing Permanent Housing Medical Sobriety Behavioral

Required Treatment Pathways:

Employment Income Tenant Responsibilities

Deinstitutionalization

• 1. Initial Triage
• 2. Diversion
• 3. Intake Assessment

Fail Point

Fail Point

Fail Point

Where chronically homeless individuals typically are at risk of falling out

• f the system.

Diagrams modifjed & adapted from Perry Service Learning Source: https://homeless.baltimorecity.gov/about-1

• 27 emergency & transitional shelters
• 11 Outreach 7 Day Service Houses
• 8 hospitals
• Homeless Services Program budget:

$48 million to distribute annually.

Baltimore:

The existing system of temporary housing and crowded emergency shelters does not have the capacity to accomodate an increasingly displaced and exposed population, or meet the needs of individuals experiencing homelessness that have extensive medical needs or chronic disabilities.

The housing first approach

Individuals experiencing chronic homelessness

• 1. Eligibiliy & Preparedness

Assessment

• 2. Comprehensive

Assessment

• 3. Coordinated Entry

Rapid-ReHousing

• 1. Initial Triage
• 2. Diversion
• 3. Intake Assessment

Permanent Supportive Housing

• 1. Voluntary Medical, Mental,

& Behavioral treatment based

• n Harm Reduction
• 2. Employment Support
• 3. Subsidized Housing

Personal Autonomy Allied with a Support Team Access to Healthcare Connection to Employment Integrated into Community Life Skills Training

STABILITY = ABILITY

Diagrams modifjed & adapted from Perry Service Learning

The housing first approach

Why Housing-First is the most sustainable option:

1 2 4

Higher rates of housing retention. Opportunity to retrofjt existing vacant housing units.

3 Lowers cities’ reliance on emergency shelters and hospitals.

Increases cities’ capacity to address chronic homelessness and housing instability.

5 Participants have better longer-term health and employment

• utcomes.

reclaimed supportive housing

Baltimore Journey to Home Action Plan Key Strategies:

1 2 4 5

Increase the Supply of Afgordable Housing Create a More Efgective Homeless Response System

3 Transform the Shelter System

Improve Access to Employment & Economic Oppoturnities Establish a Race Equity Agenda

Source: https://journeyhomebaltimore.org/

reclaimed supportive housing: Framework

Legislation to Pardon Expunge- able Non-violent Misdemeanors with no Conviction for Participants within Pilot

Group-Based Learning & Listening Recovery Toolkit for Service Provider Network Service-Oriented Planning & Design Criteria Voluntary, Holistic Treatment for Substance Abuse Built into RSH Package

Invest in Deep Retrofjts of Existing Infrastructure to Create Subsidized Supportive Housing

Independent Housing Units within Semi- Scattered Site Plans

Employment Pilot Program with the Civic Works Center for Sustainable Careers Passive Home Design Implementation to Maintain Low-Cost Cooling & Heating and Air Quality Standards Urban Farming CSA/ Work Exchange & Education Program with Local Baltiimore Farms and Markets

SUSTAINABILITY RECOVERY STABILITY POLICY DESIGN PROGRAMMING

Source: https://pmhealthnp.com/pmhnp-topics/maslows-hierarchy-of-needs/

Legislation to Pardon Expunge- able Non-violent Misdemeanors with no Conviction for Participants within Pilot

Group-Based Learning & Listening Recovery Toolkit for Service Provider Network Service-Oriented Planning & Design Criteria Voluntary, Holistic Treatment for Substance Abuse Built into RSH Package

Invest in Deep Retrofits of Existing Infrastructure to Create Subsidized Supportive Housing

Independent Housing Units within Semi- Scattered Site Plans

Employment Pilot Program with the Civic Works Center for Sustainable Careers Passive Home Design Implementation to Maintain Low-Cost Cooling & Heating and Air Quality Standards Urban Farming CSA/ Work Exchange & Education Program with Local Baltiimore Farms and Markets

SUSTAINABILITY RECOVERY STABILITY POLICY DESIGN PROGRAMMING

12 Member sites of the Farm

Alliance of Baltimore are potential employer partners.

90% graduate

employment rate since 2003.

Client Focus: Pursuing Economic Opportunity

A criminal record is the #1 cited barrier to employment for individuals experiencing homelessness in Baltimore. 43% of

individuals have at least 1 expungeable criminal record.

81% of all

charges are misdemanors with an 11% conviction rate.

Source: https://journeyhomebaltimore.org/

Client Focus: Healthcare, Harm Reduction, & Recovery

Legislation to Pardon Expunge- able Non-violent Misdemeanors with no Conviction for Participants within Pilot

Group-Based Learning & Listening Recovery Toolkit for Service Provider Network Service-Oriented Planning & Design Criteria Voluntary, Holistic Treatment for Substance Abuse Built into RSH Package

Invest in Deep Retrofits of Existing Infrastructure to Create Subsidized Supportive Housing

Independent Housing Units within Semi- Scattered Site Plans

Employment Pilot Program with the Civic Works Center for Sustainable Careers Passive Home Design Implementation to Maintain Low-Cost Cooling & Heating and Air Quality Standards Urban Farming CSA/ Work Exchange & Education Program with Local Baltiimore Farms and Markets

SUSTAINABILITY RECOVERY STABILITY POLICY DESIGN PROGRAMMING Sobriety ≠ Recovery Combining therapeutic and evidence-based treatment resources into a replicable toolkit for other Baltimore provders. Ensuring that services and healthcare is accessible to particpants in supportive housing.

Focus in harm reduction that recognizes that poverty, class, racism, social isolation, past trauma, and other social inequalities afgect both people’s vulnerability to and capacity for efgectively dealing with drug- related harm.

Source: https://harmreduction.org/about-us/principles-of-harm-reduction/

Client Focus: Reclaiming Baltimore for Our Neighbors

Legislation to Pardon Expunge- able Non-violent Misdemeanors with no Conviction for Participants within Pilot

Group-Based Learning & Listening Recovery Toolkit for Service Provider Network Service-Oriented Planning & Design Criteria Voluntary, Holistic Treatment for Substance Abuse Built into RSH Package

Invest in Deep Retrofjts of Existing Infrastructure to Create Subsidized Supportive Housing

Independent Housing Units within Semi- Scattered Site Plans

Employment Pilot Program with the Civic Works Center for Sustainable Careers Passive Home Design Implementation to Maintain Low-Cost Cooling & Heating and Air Quality Standards Urban Farming CSA/ Work Exchange & Education Program with Local Baltiimore Farms and Markets

SUSTAINABILITY RECOVERY STABILITY POLICY DESIGN PROGRAMMING Ensuring afgordable housing stays “afgordable” by reducing maintenance costs and increasing unit resilience. Utilizing the resource of existing building stock to not

• nly create supportive housing,

but invest in neighborhoods that have been plagued by disinvestment & vacancy. Building on previous pilots that have found success with scattered units while ensuring on- site support within RSH “cluster” model.

Covid-19 & homelessness

CDC Guidelines: COVID-19

• Stay home as much as possible.
• Keep at least 6 ft of distance

between yourself and others.

• Everyone should wear a cloth

face cover when they have to go

• ut in public.
• Wash your hands often for 20

seconds with soap and water, especially after you have been in a public place.

• Clean and disinfect frequently

touched surfaces daily.

Source: https://www.cdc.gov/coronavirus/2019-ncov/index.html

The Reality of Temporary Housing or Unsheltered Homelessness in a Pandemic:

6 ft.

Addiction, exposure to air pollution, and existing chronic health problems are

immunocompromising conditions.

Shelters do not have the space to enforce social distancing. Unhoused Individuals

• ften do not have access

to PPE, running water, or even soap.

Source: https://www.pbs.org/newshour/health/las-vegas-marking-parking-places-for-home- Source: https://www.wpr.org/homeless-shelters-moving-ice-rinks-recreation-centers-amid-covid- Source: https://www.wired.com/story/coronavirus-covid-19-homeless/ Source: https://www.usnews.com/news/healthiest-communities/articles/2020-04-22/home-

Covid-19 & homelessness homelessness is incompatible with health.

1% of population in SF is homeless. 20% of COVID-19

hospitalizations in SF are homeless patients.

*approx. 8,000 persons

SARS-CoV-2 positive cases SARS-CoV-2 positive cases

April 6, 2020 April 10, 2020 April 13, 2020

2 8 Days in San Francisco Shelter MSC South

First SARS-CoV-2 positive cases

April 15, 2020

All clients are moved out of shelter

70 91

Source: https://www.theguardian.com/us-news/2020/apr/15/san-francisco-home-

Covid-19 & homelessness: baltimore

% Black Population by Zipcode COVID-19 Cases by Zipcode

Source: The Baltimore Sun, https://coronavirus.maryland.gov, https://data.imap.maryland.gov/datasets/

36%

• f cases have been

reported by Black patients. Zipcodes in Prince George’s County and Baltimore City, the most predominantly black counties in Maryland, have the highest rates of COVID-19.

vision

Baltimore City’s 10 year plan to End Homelessness is enacted under mayor Stephanie Rawlings-Blake.

2008 2014

The Journey Home is established as the strategic Continuum of Care Coalition. Continuum Board reconstituted & begins holding listening sessions with the community.

2017

2,669

Point in Time Count, January COVID-19 pandemic spreads rapidly among homeless popuiations around the U.S.

2020

Hundreds are moved from shelters to vacant hotels for isolation.

2022

Community Land Trust Takes posession of vacant properties in 3 elected neighborhoods.

2024

Reclaiming Baltimore Coalition establishes Supportive Housing Pilot for 200 individuals experiencing chronic homelessness. First RSH Pilot Class graduates from Green Job Work Training Collaboration.

2026

Afgordable, Multi-Family render by TwoPoint, Baltimore.

2030

Pilot is expanded to 500 residents, 6 neighbordhoods.

Source: The Baltimore Sun, The Journey Home

Image Source: https://www.tripsavvy.com/nicknames-for-baltimore-308028

THANK YOU

sources

Source: http://cityview.baltimorecity.gov/CityView/ Source: technical.ly Sources: census.gov/quickfacts/ Source: The Baltimore Sun Source: https://nationalhomeless.org/about-homelessness/ Source: The Ecology of Homelessness: David A. Patterson Source: Understanding Homelessness Source: Baltimore Mayor’s Offjce of Homeless Services Source: https://statesatrisk.org/maryland/extreme-heat Source: https://homeless.baltimorecity.gov/about-1 Source: Perry Service Learning Source: https://journeyhomebaltimore.org/ Source: https://harmreduction.org/about-us/principles-of-harm-reduction/ Source: https://www.cdc.gov/coronavirus/2019-ncov/index.html Source: https://www.pbs.org/newshour/health/las-vegas-marking-parking-places-for-homeless-encampment

Source: https://www.wpr.org/ homeless-shelters-moving-ice- rinks-recreation-centers-amid- covid-

Source: https://www.wpr.org/homeless-shelters-moving-ice-rinks-recreation-centers-amid-covid- Source: https://www.wired.com/story/coronavirus-covid-19-homeless/ Source: https://www.usnews.com/news/healthiest-communities/articles/2020-04-22/homement Source: https://www.theguardian.com/us-news/2020/apr/15/san-francisco-home- Source: https://coronavirus.maryland.gov Source: https://data.imap.maryland.gov/datasets/eb706b48117b43d482c63d02017fc3fg_1?selectedAttribute=PNHB Image Source: https://www.tripsavvy.com/nicknames-for-baltimore-308028

Special Thanks to Primary Sources: John Shapiro Thibaeult Manekin John Fredrickson

Source: https://pmhealthnp.com/pmhnp-topics/maslows-hierarchy-of-needs/