Stepping Up Ohio Summit: Housing Monday, October 22, 2018 1 - - PDF document

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Stepping Up Ohio Summit: Housing

Monday, October 22, 2018

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Presenters: Liz Buck, Deputy Program Director, Behavioral Health, The Council of State Governments Justice Center Sally Luken, President, Luken Solutions

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Cr Criminal Justice Leaders are seeing g the lack of housing g as as a a key y bar arrier er to ad addres ess thei eir Step epping Up goal als

• Across the country, criminal justice

and law enforcement leaders are pursuing efforts to reduce the number of people with mental illnesses in jails

• Homelessness and the lack of

housing identified as among top 3 challenges

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426 counties across 43 states have resolved to reduce the number of people with mental illnesses in jails.

Pr Prior Homelessness among People Entering Jails

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Of the 11 million people admitted to jail annually… About 15% report having been homeless in the year prior to arrest.

Source: Greg A. Greenberg and Robert A. Rosenheck, “Jail Incarceration, Homelessness, and Mental Health: A National Study” (Psychiatry Services, 2008), available at ps.psychiatryonline.org/doi/full/10.1176/ps.2008.59.2.170.

Rates of homelessness are higher among people with mental illness and co-

• ccurring substance use disorders.

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Ho Homelessne ness Rates among ng Peopl ple Leaving ng Prison n or Jail

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Nearly 50,000 people enter homeless shelters directly from prison or jail each year. This number does not include people who wind up in unsheltered (street) homelessness, or who become homeless at some later time.

Ho Housing Instability & Criminal Justice Involvement: A A cyclical al rel elations nshi hip

• 2. Lack of stable

housing viewed as a risk factor and reduces courts willingness to divert individuals from jail or prison

• 4. Lack of stable

housing upon exit from jail contributes to supervision failure, increases risk of recidivism

• 3. Criminal history

serves as a barrier to housing, contributing to housing instability, homelessness

• 1. Law enforcement

policies and practices criminalize behaviors associated with homelessness

Lack of coordinated strategies or investment from the homeless and criminal justice systems for housing & services

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Fo Four Part Strategy

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Strengthening collaboration between criminal justice and housing sectors

• 2. Helping

communities provide supportive housing as a diversion option for people with SMI

• 4. Improving reentry

planning around housing and piloting tailored reentry housing assistance/ homeless prevention

• 3. Provide guidance on

appropriate use of criminal history screening in housing admissions

• 1. Strengthen LE

capacity to respond effectively to homelessness

Co Counti ties es have e iden enti tified ed a set t of individuals who are e re repeatedly booked into jails and who also fre requent

• ther service

ce systems

• This “revolving door” pattern
• f service utilization suggests

that this population has complex needs (co-occurring mental illness, substance use disorders, medical conditions), and are not being served well by existing services.

• Similar to what has been

found in other jurisdictions, homelessness appears to be highly prevalent among this population.

8 Jail/Prison Emergency Department Detox Substance Use Treatment Psychiatric Hospital Homeless Services Shelter Jail Unknown Jan-Dec 2002 Jan-Dec 2001

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NYC Frequent User Case Study

Sources: Angela A. Aidala and William Mcllister, “Frequent Users Service Enhancement ‘FUSE’ Initiative,” New York City FUSE II (2014). Corporation for Supportive Housing, “Supportive Housing for Frequent Users of the Homeless, Criminal Justice, and Health Care Systems,” presentation at NCHV Annual Conference, (May 31, 2013).

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A A promising intervention for this population is su supportive housi sing

Supportive housing is an intervention that pairs affordable or subsidized rental housing with intensive wrap-around case management supportive services.

• It can be offered in different configurations including:
• Purpose-built (single-site) apartment buildings
• Apartments leased from private landlords
• Designated or set-aside units within existing affordable

housing developments

With the right supports, supportive housing can serve as a “one stop shop” for addressing housing needs, treating behavioral health conditions, and mitigating criminogenic risks.

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Su Supportive e housi sing g has s been een dem emonstrated ed to be e an effect ctive intervention for individuals with complex needs who are e homel meless ess

• New York City FUSE

evaluation (2014) found that supportive housing placement was associated with a significant decline in the use of homeless services and jails.

• A large sample, quasi-

experimental New York City study (2013) found that individuals and families provided with supportive housing used fewer days in jails than a matched cohort that did not receive supportive housing.

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161.9 47.6 15.2 25.7 S H E LT E R D A Y S O V E R 2 4 M O N T H FO LLO W U P JA IL D A Y S O V E R 2 4 M O N T H FO LLO W U P

INTERVENTION EFFECTS FOR SHELTER USE AND INCARCERATION

Comparison Group Intervention Group Source: Columbia University Mailman School of Public Health (2014)

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Su Supportive e housi sing g can pay for itsel self as s it resu esults s in av avoided costs from lower use of jails, hospitals, homeless service ces

• New York City study found

supportive housing for individuals with serious mental illness resulted in the following cost avoidance:

• Jail: - $1,776
• State psychiatric centers: -

$1,424

• Medicaid - $2,956
• Shelters – $9,916
• These cost avoidances virtually
• ffset the entire cost of the

supportive housing intervention.

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Lack of coordination between systems results in the criminal justice system not being connected to evidence-based housing solutions.

The Need for a Cross-Sector approach:

The responsibility for addressing the housing needs of this population does not squarely rest with either system.

Traditional transitional housing and half-way houses are by and large not achieving desired Stepping Up goals/recidivism goals. Evidence-based housing practices (like supportive housing) haven’t been focused on recidivism reduction.

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Continuum of Care/Housing perspective:

• Supportive housing is insufficiently funded and communities

struggle with meeting the need.

• Not uniform recognition that this population is experiencing

homelessness and is in need of supportive housing

The Need for a Cross-Sector approach:

The responsibility for addressing the housing needs of this population does not squarely rest with either system.

Opportunities

• New opportunities for federal and state cross-sector

alignment and investment

• County/statewide momentum with Stepping Up
• Criminal justice agencies have achieved/show promise in

achieving low recidivism rates for this population in supportive housing; how do we scale?

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The Need for a Cross-Sector approach:

The responsibility for addressing the housing needs of this population does not squarely rest with either system.

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Inno Innovativ tive e Model: del: Cross Sec ector Par artner tnership hips and and Funding Funding

Returning Home Ohio:

• PSH for re-entry population at risk of homelessness & disabling condition
• Ohio DRC funds services and operating subsidies

Findings:

• RHO participants were 61 percent less likely to be re-incarcerated than the

comparison group subjects.

• RHO participants were 40 percent less likely to be rearrested than the

comparison group subjects.

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Source: Urban Institute (2012)

Inno Innovativ tive e Model: del: Cross Sec ector Alig lignm nmen ent t and and In Inves estm tmen ent

Colorado Second Chance Housing and Reentry Program: cross sector coordination and funding streams, now embedded system approach for reentry population in Homeless Services.

• Permanent supportive housing and rapid rehousing for reentry populations
• Utilizes Second Chance Act funding (CJ funding)
• Partnership between DOC and Mental Health Centers

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Fa Facilitating Re-en entry t to S Stable Ho able Housing using

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Low: Housing navigation Moderate: Housing navigation + short-term rental assistance High: Supportive housing

Housing Assistance Tiers TIGER Risk Assessment

NRRC Housing Screener

Ea Early lessons from innovative/emerging mod models

• Aligning statewide DOC and Housing funding streams.
• Helps support efforts to meet mutual agency goals and build sustainability of

program

• Where possible, aligning local, statewide, and federal resources can

fill needed gaps for this population.

• Utilizing statewide funding to support County needs.
• Importance of understanding philosophical differences and the need

for interagency buy-in and coordination.

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Em Emergi ging ng Mode del: Santa Clara, , CA

• Santa Clara County, CA providing supportive housing using a Housing

First approach to 250 individuals diverted from jails identified as having a serious mental illness

• Partnerships efforts for diversion involve aligning strategies and

funding among key agencies including behavioral health, criminal justice, and homeless services/supportive housing.

• CSGJC is finalizing a case study to demonstrate areas of opportunity in

diversion/homelessness efforts

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Em Emergi ging ng Mode del: Ohi Ohio Housi using ng Coun unties

Through Melville Charitable Trust and Peg’s Foundation, The Council of State Governments and Sally Luken are providing technical assistance is supporting Ohio Counties to assess the prevalence of people with serious mental illness who cycle between jails and homelessness and develop a housing plan/strategy to address the problem.

• 1. Building cross sector partnerships
• 2. Understanding the problem: Who is experiencing homelessness
• 3. Developing a Housing Plan to address the need

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Oh Ohio Housi sing g TA - 6 Cou 6 County T Teams ms

Athens Cuyahoga Delaware Lorain Mahoning Stark Com Common

• n N

Needs & I & Issues E Emergi ging g

• Building the cross-sector team: understanding each other’s system and prioritization processes
• How to conduct a data match to identify the frequent users (and leverage State’s interest in this

work)

• TA on data matching, CSG and CSH Data Match guide, and engagement with the state
• Assessing housing needs and developing a housing plan for the population identified
• How to make the Business case for support
• Reentry planning when a person is in jail a short time
• Connection to the local homeless system of coordinated entry, assessment & prioritization of

resources

• Funding strategies to address how to incentivize housing this population

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As Asses essing Hou g Housing N g Need eed a and D Devel elop

• ping a

g a Hou Housing P g Plan

Determining who is experiencing homelessness

• Several Counties have implemented homeless screening processes in the jail

and several more are actively working on this

• Counties are engaged in a data match process to understand the global

picture of someone with SMI, who cycles between jail and homelessness Developing a plan to address homelessness

• We are working with Counties on housing plans and identification of funding

streams and opportunities to develop supportive housing for this population

Making the Business Case

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Funding Funding Str trategies egies

Workgroup for a Landlord Incentive/Risk Mitigation Fund

Purpose: Assist the Stepping Up Ohio project research best practices in existing Landlord Incentive/Risk Mitigation Funds and develop the program framework for these Funds in Ohio Workgroup Members:

• Carli Boos, Program & Policy Manager, OHFA
• Kelan Craig, Director, OHFA
• Holly Cundiff, Forensic & Special Projects

Coordinator, Lorain Co Board of Mental Health

• Holly Holtzen, CEO, OHFA
• Melissa Knopp, attorney and Project Coordinator for

Ohio Stepping Up

• Sally Luken, President Luken Solutions and

consultant to Ohio Stepping Up

• Jen Griffin, Director of Housing Programs, EDEN of

Cuyahoga County

• Barb Lewis, Delaware County Commissioner
• Jim Lewis, President of the Board for People in Need,

Inc of Delaware County and attorney at law Thanks to OHFA for supporting this workgroup:

• Franklin County Commissioners & staff in Office of Justice Policy &

Programs

• CSH Ohio staff & their PSH initiatives
• CSH National office & their FUSE initiative
• 6 County Teams & their experiences
• NEOMED & their work on Intercept Mapping
• Ohio’s Human Services Data warehouse & the OHFA research staff
• Stepping Up subcommittees including Dept. of Medicaid & TAC

Si Significant P Part rtners Con Contri ributing t to Le

• Learn

rnings

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Stepping Up Housing TA to 6 Ohio Counties

For more information or questions: Liz Buck ebuck@csg.org (646) 383-5760 Sally Luken sally.luken@lukensolutions.com (614) 946-0313

Thanks to Melville Charitable Trust and Peg’s Foundation for it’s commitment to this work.