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

10/19/18 Stepping Up Ohio Summit: Housing Monday, October 22, 2018 1 Presenters: Liz Buck, Deputy Program Director, Behavioral Health, The Council of State Governments Justice Center Sally Luken, President, Luken Solutions 2 1

10/19/18 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 426 counties across 43 states have resolved to reduce the number of people with mental illnesses in jails. 3 Prior Homelessness among People Entering Jails Pr Of the 11 million people admitted to jail annually… About 15% report having been homeless in the year prior to arrest. Rates of homelessness are higher among people with mental illness and co- occurring substance use disorders . 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 . 4 2

10/19/18 Ho Homelessne ness Rates among ng Peopl ple Leaving ng Prison n or Jail 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. 5 Ho Housing Instability & Criminal Justice Involvement: A A cyclical al rel elations nshi hip 4. Lack of stable 1. Law enforcement policies and housing upon exit practices criminalize from jail behaviors contributes to associated with supervision failure, homelessness increases risk of Lack of coordinated strategies or recidivism investment from the homeless and criminal justice 2. Lack of stable systems for 3. Criminal history housing & services housing viewed as serves as a barrier a risk factor and to housing, reduces courts contributing to willingness to housing instability, divert individuals homelessness from jail or prison 3

10/19/18 Fo Four Part Strategy 1. Strengthen LE 4. Improving reentry capacity to respond planning around effectively to housing and piloting homelessness tailored reentry housing assistance/ homeless prevention Strengthening collaboration 2. Helping between criminal communities provide justice and housing 3. Provide guidance on supportive housing as sectors appropriate use of a diversion option for criminal history people with SMI screening in housing admissions 7 Counti Co 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 • This “revolving door” pattern other service ce systems of service utilization suggests that this population has complex needs (co-occurring Jail/Prison mental illness, substance use disorders, medical Homeless Emergency conditions), and are not Services Department being served well by existing services. Psychiatric Detox • Similar to what has been Hospital found in other jurisdictions, Substance Use homelessness appears to be Treatment highly prevalent among this NYC Frequent User Case Study population. Jan-Dec 2001 Jan-Dec 2002 Shelter Jail 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Sources: Unknown 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). 8 4

10/19/18 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. 9 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 INTERVENTION EFFECTS FOR SHELTER USE AND • New York City FUSE INCARCERATION evaluation (2014) found that supportive housing Comparison Group Intervention Group placement was associated 161.9 with a significant decline in the use of homeless services and jails. • A large sample, quasi- 47.6 experimental New York City 25.7 study (2013) found that 15.2 individuals and families provided with supportive S H E LT E R D A Y S O V E R 2 4 JA IL D A Y S O V E R 2 4 housing used fewer days in M O N T H FO LLO W U P M O N T H FO LLO W U P jails than a matched cohort Source: Columbia University Mailman School of Public that did not receive Health (2014) supportive housing. 10 5

10/19/18 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 offset the entire cost of the supportive housing intervention. 11 The Need for a Cross-Sector approach: The responsibility for addressing the housing needs of this population does not squarely rest with either system. Lack of coordination between systems results in the criminal justice system not being connected to evidence-based housing solutions . Traditional transitional Evidence-based housing housing and half-way practices (like supportive houses are by and large not housing) haven’t been achieving desired Stepping focused on recidivism Up goals/recidivism goals. reduction. 12 6

10/19/18 The Need for a Cross-Sector approach: The responsibility for addressing the housing needs of this population does not squarely rest with either system. 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 13 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? 14 7

10/19/18 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. Source: Urban Institute (2012) 15 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 8

10/19/18 Fa Facilitating Re-en entry t to S Stable Ho able Housing using Housing Assistance Tiers Low: Housing navigation Moderate: TIGER Risk Housing navigation + Assessment short-term rental assistance High: NRRC Housing Supportive housing Screener 17 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. 18 9