01 / 56Overview of Permanent Supportive Housing and Recovery Support
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Overview of Permanent Supportive Housing and Recovery Support
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Learning Objectives • Become familiar with the core elements of SAMHSA's Permanent Supportive Housing Evidence-Based Practices KIT (PSH Toolkit). • Understand how to best align your program with the core elements of the PSH toolkit.
Learning Objectives Be able to identify the issues that need to be addressed, the questions to ask, and the stakeholders who need to be engaged during the planning and development of a permanent supportive housing program.
Dr. Fran Randolph • Director of the Division of Services and Systems Improvement in the Center for Mental Health Services, SAMHSA
What is Permanent Supportive Housing? Decent, safe, and affordable community-basedhousing that provides residents with the rights of tenancy under state/local landlord tenant laws and is linked to Voluntary, flexible support and services designed to meet residents’ needs and preferences.
Supportive Housing Philosophy People with serious mental illnesses and other disabilities have the same rights and opportunities as all citizens to choose, obtain, and live in regular community housing. People have the right to receive, refuse, and direct their own support services.
Access: Housing First Permanent: Rights of Tenancy Safe, decent, affordable Integrated Separates housing from services Provides choice Tailored services Core Elements
Housing First • Access, support, retain housing. • Everything else follows: • Make return to permanent housing immediate. • People move directlyinto affordable rental housing in residential areas from shelters, streets, or institutions. • Home-based services are provided as long as needed.
Permanent: Rights of Tenancy Residents have full legal rights in a tenant-landlord relationship. Tenants are responsible to abide by the normal standards of behavior/conduct outlined in a lease. Distinct from “program” rules. Permanent: length of stay is determined by the agreement between the landlord and tenant.
Tenants/residents pay a reasonable amount of their income towards rent and utilities. HUD affordability guidelines = 30% of adjusted income for housing expenses. Reality: People on SSI often pay 60 - 80% of their income towards housing that is substandard. Housing Affordability
Integration Housing is located in regular residential areas. Housing is scattered site: Large, homogeneous, congregate sites can become mini-institutions; or Mixed populations in the building or neighborhood: avoid the creation of mental health ghettoes. Tenants participate in community activities and receive community services. Natural supports are encouraged.
Scattered – site Individual units dispersed throughout an area Apartments, condos, single family houses Owned or leased Conforms with local zoning Permanent Supportive Housing Models
Single-site mixed-population Large building or complex with multiple units Serves more than one type of tenant: Low income families People with mental health problems Seniors Students Homeless adults Often includes “set-asides” for specific target group(s) Can be owned or “master-leased” by housing agency Permanent Supportive Housing Models
Services It is not “placement.” It is not a cookie-cutter approach.
Services in supportive housing are Individualized Voluntary Recovery-focused Ongoing, shoulder-to-shoulder Flexible: type, location, intensity & frequency of services meet changing needs of resident. Include risk management and crisis planning. Tailored Services
Separation of Housing & Services • Participation in specific support services is NOT required in order to get or keep housing. • Various approaches: • Legal separation between housing management and service delivery. • Functional separation – Distinct housing and service staff roles. • Operational separation – Service providers are based off-site.
SAMHSA ToolKITs SAMHSA’s ToolKITs, including the PSH ToolKIT, offer states, providers, consumers and family members resources to implement and assess clinical practices that work!
Support for Evidence-Based Practices “The emphasis on implementing evidence-based practice (EBP) stems from a consensus that a gap exists between what we know about effective treatments and the services currently offered.” SAMHSA. Permanent Supportive Housing: How to Use the Evidence-Based Practices KITS. HHS Pub. No. SMA-10-4509, Rockville, MD: CMHS, SAMHSA, U.S. Department of Health and Human Services, 2010, page 1.
Support for Evidence-Based Practices Evidence-based practices are linked to predictable, beneficial outcomes for participants. If those outcomes are desired in your system, then implementation of the evidence-based practice is a necessary step! Implementation must be accomplished with attention to “fidelity” to the model.
PSH Fidelity The Permanent Supportive Housing ToolKIT, in “Evaluating Your Program,” offers a fidelity scale. The purpose of the fidelity scale is to offer providers and communities the opportunity to conduct a self-assessment.
Dimensions of PSH Fidelity • Choice • Separation of housing and services • Decent, safe, and affordable housing • Integration • Access to housing • Flexible, voluntary services
Joseph Tardella • Executive Director, Southwest Counseling Solutions, Detroit, Michigan
The Detroit Experience Learning objectives: • Identify the issues to be addressed, the questions to be answered, the tasks to be completed and the stakeholders to be engaged when planning a PSH program • Understand how best to align your program with the PSH Toolkit
The Detroit Experience What HMIS tells us about Detroit: • In 2010, over 20,000 unduplicated individual/families we’re served • 12,600 individuals, 7,400 individuals living in families • 5% increase over 2009 • 4,700 PSH units