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May 16, 2013
Alaska’s Safe, Affordable
Housing Initiative:
Housing First
Alaska Mental Health Trust Authority
2
Alaska Mental Health Trust A perpetual trust and state corporation
providing for a comprehensive integrated service system for the beneficiaries:
• People with mental illness • People with developmental disabilities • People with chronic alcoholism and other
substance related disorders • People with Alzheimer’s disease and
related dementia • People with traumatic brain injury
Alaska Statistics
• Largest of all states: 571,951 sq mi • State population: 772,718 (US Census) • Employment – moderate growth has been the
norm, especially in health care services • Diversity of residents –
– Alaska Native culture and tribes are strong – Anchorage School District statistic: 94
# languages spoken by students in the district
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4
Alaska’s Native Languages
5
A Different Kind of Place
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A Different Kind of Place
7
Conducting the homeless survey September 2011 in Anchorage
Fairbanks winter
Vacancy Rates and Rent
11.5% ($847)8.2% ($864)8.2% ($712)8.2% ($913)
4.9% ($767)
4.4% ($815)3.2% ($980)3.1% $686)2.3%($862)2.0% ($871)1.2% ($724)
0.0% 5.0% 10.0% 15.0%
Ketchikan GatewayFairbanks, North Star
Kenai PeninsulaSitka
Matanuska-‐SusitnaSTATE AVERAGE
JuneauWrangell /Petersburg
AnchorageKodiak Island
Valdez-‐Cordova
Vacancy Rates and 1 Bdrm Fair Market Rent*
8 Sources: Alaska Department of Labor and Workforce Development, Research and Analysis Section; and Alaska Housing Finance Corporation, 2011 Rental Market Study
Cost of Living
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Alaska’s prices for most living expenses are higher than other states*
• Alaska’s housing costs rose 7.6% over the past 4 years as compared to 1.3% nationally
• Anchorage Consumer Price Index shows energy costs rose 10.8% in 2011
• Bethel’s heating oil and propane were the most expensive, at $5.02 and $7.95 per gallon respectively.
• Food for a week for a family of 4 with 2 children between ages 6-11 ranged from $129-$272 (Bethel).
*Source: Economic Trends May 2011, July 2012
Housing and Homelessness • Problem
– number of chronically homeless increased approximately 19% over prior year
– high cost of housing versus beneficiaries’ income potential
1,642 1,646 1,992 1,863
2,128 1,913
278 439 323 164 226 279
0
500
1,000
1,500
2,000
2,500
2007 2008 2009 2010 2011 2012
Alaska Homeless Point-in-Time Surveys 2007- 2012 *
Total Homeless Chronic Homeless
$12,720 $16,120
$28,246
$0
$5,000
$10,000
$15,000
$20,000
$25,000
$30,000
SSI and state supplement
Alaska minimum wage
Cost of living including studio
apartment
2012 Annual Income and Cost of Living for Trust Beneficiaries **
* Source: HUD Homeless Point-in-Time annual surveys ** Sources: US Soc. Sec. Admin, Alaska DOL, National Low Income Housing Coalition
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Clarifying the Need
• “Vulnerable” designation = three conditions **
‒ major health condition ‒ psychiatric diagnosis ‒ substance addiction
• These conditions = 3-4 times higher risk of death on the streets
* Sources: Juneau Homeless Coalition and Anchorage Coalition on Homelessness ** Source: research by Dr. Jim O’Connell http://www.bhchp.org/
51 56 81
55 41
22 22
21
17 21
0
20
40
60
80
100
120
Self-reported ER visit 3X or more past 3 months
Self-reported hospitalization 3X or
more in last year
Previously in Foster Care
Suspected brain injury
Veterans
Juneau
Anchorage
Juneau surveyed = 55 # “vulnerable” = 40 (73%) Anchorage surveyed = 355 # “vulnerable = 161 (45%)
Vulnerability Assessment of Homeless Individuals Identified as Likely to Die on the Streets *
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Formula for Success
• Identify a problem or community need • Collaborate with governmental agencies,
advisory groups, non profits, service providers, philanthropic organizations and private sector
• Develop strategic, sharply focused solutions • Make lasting system improvements for Trust
beneficiaries
Committed partners + Strategic thinking = Results for Trust beneficiaries
Alaska’s Housing Initiative Timeline: Statewide campaign to address the needs of
Alaskans “left out in the cold” 2005-2006 Preparation phase – gathering data and implementing
framework for increased resources
– Alaska Housing Finance Corporation initiates request for state interagency council
– Alaska Council on the Homeless implemented and report on homelessness is released.
– Anchorage begins 10 year plan on homelessness – Alaska Council on the Homeless drafts a framework to
address shortcomings in the funding mechanisms
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Alaska’s Housing Initiative 2006- 2007 Legislative advocacy to change funding mechanisms at
Alaska Housing Finance Corp (AHFC)
– Housing Trust Coalition composed of 80+ organizations: homeless coalitions, social service providers, business leaders, faith communities, municipal and local officials
– Legislation passed – approving new funding mechanisms for Alaska Housing Finance Corporation to support affordable housing
– 8 million annual appropriation approved (15 mil sought)
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Alaska’s Housing Trust
Essential components
– Capital funding resources – Operations support (utilities, management, rental
subsidies) – Adequate state service structures for support – Augmented social support services = Sustainable supported housing
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Alaska’s Housing Initiative adopts Housing First
2009 – 2011 Project planning phase: Anchorage feels the pressure of the downturn in Alaska’s economy and the shortage of affordable housing.
– Nearly 30 deaths on the streets/parks occur in this period – primarily in winter or in wet weather
– Anchorage’s Mayor Sullivan appoints a task force of 40 community members to examine possible solutions
– Housing First is one of the top recommendations – Possible project site identi#ed/ RurAL CAP sponsor
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Housing First Technical Assistance • 2009-2010 Technical Assistance and site visits facilitated
by the Alaska Mental Health Trust – allow community members to see projects in operation and to
hear #rst hand the value and success of the projects in communities
– Key community leaders identi#ed for the visits to Seattle’s Downtown Emergency Services Center
– Technical Assistance sought for projects working primarily with American Indian populations: Corporation for Supported Housing and Minnesota connections
– Planning resources are a must for good TA and site visits…don’t go it alone!
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Project Implementation • 2010 – First large scale project funded by newly retooled
housing grant program at Alaska Housing Finance Corporation
Funders include contingency on zoning approval
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• Neighborhood opposition
• Numerous public forums through the process
• Community is divided over the location (not the model)
Conditional Use Permit
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• Municipality works with project sponsors to create a channel for the project’s approval • Legal challenge to ordinance initiated November 2011
Severe Alcohol Dependence ordinance
The First First 2011 – 46 unit Housing First project opens
Anchorage Project highlights • 46 unit Housing First • 2 meals per day • Community engagement activities • Chore and housekeeping services
twice/month • Services provided: partnership with
community providers
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• Volunteer opportunities • Employment opportunities • Location in downtown corridor close to services
Karluk Manor
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Partnership Among:
TCC Health Department Fountainhead Development
Alaska Mental HealthTrust Authority Alaska Housing Finance Corporation
Rasmuson Foundation
Fairbanks Housing First Program
Tanana Chiefs Conference
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Numerous efforts converged to make the Housing First program become a reality: – $e Ecumenical Mission for Shelter partners to focus
on the lack of sufficient shelter for the population – TCC Executive Board of Directors passed and 42
tribes unanimously approved a resolution to provide housing for the chronically homeless alcoholics in Fairbanks
– Fountainhead Development owner, Tim Cerny, was in discussion with bank to purchase the hotel
– Fairbanks community members toured 1811 Eastlake program in Seattle & Duluth Housing First Program
– Alaska Housing Finance Corporation and Mental Health Trust made funding available and invited TCC to apply
TCC Housing First
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• Located in the larger half of a former hotel
• Commercial kitchen and laundry
• Large dining and community areas
• Numerous office spaces • Fully renovated prior to
closing • All furnishings are new
Housing First Target Population • Most vulnerable chronic homeless
– Greatest users of community crisis services (Emergency Department, Detox, Police)
– Severe substance use with little or no interest in treatment – Long-term homelessness with few options for housing due
to history – Difficulty meeting personal needs (food and shelter) – Chronic medical condition(s) – Vulnerable to predators, exploitation, and victimization – Mental or cognitive impairment – Untreated mental health needs – No sex offenders
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TCC Housing First Outcomes
Anticipated: • Housing First program will house 47 individuals. • Current cost to Fairbanks: $2,293,224 (47 residents x $48,792
crisis services costs). • Costs to the community after Housing First: $540,312 (47
residents x $11,496 crisis services costs). • Potential savings to community: $1,752,912
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TCC Housing First Outcomes Anecdotal report of progress to date: Savings in Emergency Dept. use (estimated using minimal cost for services at $250.00/visit): $7,312.50 27
Tenant A
2011
(total)
By quarter
2011
May-July 2012 (1st quarter) TCC Housing First
Emergency Dept visits
121 30.25 1*
Detox visits 33 8.25 2
CSP pick-ups 108 27.00 5
Police contacts 146 36.5 0
TCC Housing First Outcomes Anecdotal report of progress to date:
28
Tenant B
2011 (total)
By quarter
2011
May-July 2012 (1st quarter) TCC Housing First
Emergency Dept visits
24 6 1
Detox visits 26 6.5 0
CSP pick-ups 46 11.25 6
Police contacts 29 7.25 2
10 Month Outcomes • $e preliminary evaluation of Housing
First assessed the pre/post usage and cost of the #rst ten Housing First residents’ community crisis services including – emergency medical care – detoxi#cation services – Community Service Patrol and – police services
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10 Month Outcomes
• In the year prior to Housing First, the #rst 10 residents cost the community $767,818 in community crisis services– an average of $76,782 each.
• In comparison, Housing First costs $21,651 per resident, which includes apartment rent, three meals a day, and supportive services.
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Fairbanks Housing First 10 Month Outcomes
• In the 10 months after being housed, these same 10 residents cost the community $111,256 in community crisis services—
• an overall reduction in cost to the community of $656,652.
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• Community Service Patrols decreased by 211 pick-ups– a 10-month cost savings of $23,632.
• Admissions to the Fairbanks Memorial Hospital
Emergency Department decreased by 330 admissions– a 10-month cost savings of $505,386.
• Fairbanks Police Department encounters decreased by
436 encounters – a 10-month cost savings of $43,600. • Detox Center Admissions decreased by 115 admissions
—a 10-month cost savings of $148,120.
Fairbanks Housing First 10 Month Outcomes
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Learning From Others Seattle leads the way with 1811 Eastlake and Evans House 1. Move people into housing immediately 2. Service provider is obligated to bring robust
services to the person 3. Continued tenancy is not dependent on
participation in services 4. Units are targeted to the most disabled homeless 5. Harm Reduction 6. Everyone holds a lease
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Alaska’s Initiative: Critical Components
• Housing philosophy and extended outreach to develop relationships
• High quality (durable and provide respect) • Simple rules required of tenant-
– Pay rent on time – No violence to self or others – No damage to the unit – Be a good neighbor – No illegal activity 36
Critical Components • Housing as engagement and extended
outreach: • Permanent housing – high quality • Flexible structure of the units –
– “project based” - preferable for populations with more intensive needs
– “scattered site” – used in urban settings and with more skilled populations
– Continuum of programs – having options for the best #t and resident choice. 37
Critical Components • Permanent housing – high quality
– How to plan with community to incorporate units into the social fabric
– What if the housing #rst units are the nicest in the community?
• Flexible structure of the units – – “project based” - preferable for populations
with more intensive needs – “scattered site” – used in urban settings and
with more skilled populations – Continuum or mix of con#gurations –
having options for the best #t. 38
Critical Components: Juneau Demographics High Rate of Homelessness
39
• Population: 32,290+ • State Capital • Isolated: Travel by plane or boat • Average rent (2br): $1200 • Average cost of Single-family home:
$329,974
JEDC Housing Needs Assessment
• 170-230 new rental units and 513+ single-family homes needed to reach 5% vacancy rate.
• 441 public housing rental units/ or vouchers needed.
• Average of 40 new housing permits the last three years.
Juneau Alaska Vulnerability Index Survey • 55 people experiencing homelessness
surveyed (about 80% of known vulnerable pop.)
Extremely Vulnerable and “Myth-Breaking”
• 9.5 years average length of time spent homeless;
• 75% of respondents were born, went to school, worked, or had family in Juneau;
• 38% of those vulnerable have been in foster care;
• 60% of those vulnerable are Native Alaskan
Housing First Partnership
• Tlingit-Haida Regional Housing Authority
• Rural Cap • Juneau Alliance for Mental
Health, Inc. (JAMHI) • Rainforest Recovery
Center
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Critical Components Applied Statewide
Nome Alaska – planning for housing – Population 3,598 (2010 census) – Cold weather shelter serving 24 communities – Average bed nights (Nov 2012-April 2013) =
416 nights in shelter – 10 people use up to 50% of these nights
42
Nome AK Proposed: mixed use housing – housing #rst 10 units, – boarding/shelter program in shared facility – Close coordination of services with Norton
Sound Health Corporation behavioral health services developing alcohol treatment services
– A %exible model that will allow for seasonal in%ux of people needing shelter (#shing, mining)
– Mobility of people between village and the hub 43
References and Recommended Reading • Alaska Mental Health Trust, Housing Focus Area: www.mhtrust.org • 100,000 Homes campaign: http://100khomes.org • Seattle’s Downtown Emergency Services Center: http://desc.org • Gladwell, M. Million Dollar Murray: $e New Yorker, Issue of 2006-02-13 and 20,
Posted 2006-02-06 • Collins and Malone, et al., 2012 Project Based Housing First for Chronically Homeless
Individuals with Alcohol Problems: Within-Subjects Analyses of 2-Year Alcohol Trajectories. American Journal of Public HealthVol.102(3)
• Larimer,M.E., Malone, D.K. et al., 2009 Health Care and Public Services Use and Costs Before and After Provision of Housing for Chronically Homeless Persons with Severe Alcohol Addictions, JAMA 301 (13) 1349-1357.
• New San Marco Housing First video: http://www.youtube.com/watch?v=ETGd2EP4z70
• Tanana Chiefs Conference: http://www.tananachiefs.org/ • Juneau Homeless Coalition: http://www.jedc.org/juneau-homeless-coalition • Alaska Coalition on Housing and Homelessness:
http://www.alaskahousing-homeless.org/ 44
$ank you! Nancy Burke Senior Program Officer Alaska Mental Health Trust Authority (907) 269-7961 [email protected] www.mhtrust.org
Shirley Lee Fairbanks Housing First Program Manager Contact: [email protected] Scott Ciambor Chair, Alaska Coalition on Housing and Homelessness & Planner: Alaska Mental Health Board/Advisory Board on Alcoholism and Drug Addiction (and all around good housing guy) Contact: [email protected]
