Mental Health Systems Response to Homelessness

1. Mental Health Systems Response to Homelessness National Alliance to End Homelessness Annual Conference July 18, 2006

2. NC version of ICH since 1992 Engaged HUD Field Office A few nonprofit housing developers focused on homeless/M.I. populations Limited State staff focused on homelessness (2 F.T. positions – ESG and HOPWA administrators) 20+ Continua of Care across the state, varying degrees of activity and strength In the Beginning…

3. State provided MH/DD/SAS services through roughly 30 Area Programs Before CoC’s, some initial homeless activities were carried out by these area programs (S+C) Some discrepancies in target populations Some discrepancies in services provided across the state Heavy reliance on MH hospitals Very little local acute care ….

4. …. • State has no funds specifically targeting the homeless population or homeless service agencies. • In FY 2004 the NC ICCHP receives its first funding, $250,000, to be used to conduct the work of the Council.

5. Mental Health Transformation • 2001, initiated by the Legislature • Intend to reduce use of State hospitals • 3 hospitals to 2 • Reduce # of beds by half by 2007 • Savings would be used to fund community services • Intend to increase community services • Area Programs become Local Management Entities (LMEs) • LME’s create and contract with community provider network

6. Money? • Mental Health Trust Fund • Intended to help support creation of new community services networks • Originally funded with $50M in 2002 • Within a year, more than ¾ had been redirected • Savings from Hospitals • Admissions increased • By 2006, Governor’s fiscal staff says all savings will be needed to fund the new hospital being built as two others are closed.

7. Leadership • 2002 – Division of MH/DD/SAS Housing Specialist position moved to the Office of the Secretary • 2003 – Homeless Policy Specialist created in the Office of the Secretary

8. Making Pretty Good Lemonade • Low Income Housing Tax Credits • Voluntary (bonus points) in 2002-2003 • Mandatory since 2004 • 10% of all LIHTC units must be made available to people with disabilities who meet SSI income level • Lead Agencies • Key Program – pilot project • 2004 (coming on line spring 2006) • $1M in MHT • $1.7 M in State match $ for HOME • Operating Subsidy

9. Real Choice Grant • Medicaid Services • Staff capacity in communities to • Work with “Lead Agencies” • Ensure units are filled • Esure linkage to services

10. The 400 Initiative • $10,937,500 to HFA - nonrecurring funding for 400 independent and supportive-living apartment initiative • Unofficially includes 250 LIHTC units • $1,205,000 to Div. MH/DD/SAS - recurring operating cost subsidy for persons with disabilities living in 400 Initiative financed supportive living apartment, affordable at SSI level (ongoing and expansion of MH’s portion of Key program)

11. ICCHP Activities • CoC TA • 2004-2005: TA to existing and new CoC’s, increased awards by $8M over the two years • 2006: Balance of State CoC • Research – cost benefit • Trainings • Support local 10 year plans

12. On the Horizon • Housing Support Teams • Caseworkers focused solely on obtaining and maintaining housing • Targeting persons with history of homelessness, cycling through systems (hospitals, jails, prisons, juvenile justice, foster care) • Link to other community services, incentives • Participate in Learning Collaborative

13. Contact Information Martha Are Homeless Policy Specialist NC DHHS 919-733-4534 martha.are@ncmail.net