Permanent Supportive Housing

Definition and Overview

• Supportive Housing is a non-time limited housing model that provides decent, safe, affordable, and community-based housing that provides tenants with all the rights and responsibilities of tenancy, tenancy support services, and links to other intensive supportive services using best practices, particularly the Housing First model, as well as Harm Reduction and trauma-informed approaches.
• When effectively implemented, Supportive Housing projects see improved well-being of tenants and a significant reduction in recidivism to homelessness, emergency room visits, days in hospitals, psychiatric admissions, Medicaid costs, and justice involvement.
• Supportive Housing projects can be Single Site, also known as Project-Based, or Scattered Site, also known as Tenant-Based. Regardless of the voucher type, in order for a voucher to be utilized at a property, units must meet essential criteria established by a Public Housing Authority (PHA) including payment standards and Housing Quality Standards (HWS).
  • Project-Based Vouchers are rental subsidies which are tied to the unit, not the participant. Project-Based Vouchers are typically governed by a 20-year Housing Assistance Payment (HAP) contract between the PHA and the owner. The HAP contract governs payment made to the owner from the PHA on the tenant’s behalf and includes exhibits relating to tenant selection. Since project-based assistance is tied to the unit, the participant cannot move the assistance to another unit.
  • Tenant-Based Vouchers are rental subsidies which are tied to the participant, not the unit. Participants are responsible for finding and securing units in the community that meet essential criteria and are willing to enter into a lease agreement with the participant. Since tenant-based assistance is tied to the voucher holder, the assistance is transferable, meaning it may be moved to another unit.
• Staffing best practices include a target staff-to-participant ratio of no less than one case manager to every 15 households (i.e., a 1:15 case management ratio). Additionally, projects are encouraged to operate a robust peer program that complements case management and housing staff. As with all programs, staffing structure and model should center lived experiences of homelessness and related systems. Supportive Housing programs may consider hiring nurses, clinicians, and other clinical or specialty professionals, but only if the program cannot secure the staffing through existing medical programs or partnerships as these positions can often be funded through Medicaid or other insurance or services funding.

Program Parameters

Supportive Services

• Housing search and placement: Services or activities necessary to assist program participants in locating, obtaining, and retaining suitable permanent housing, including (i) assessment of housing barriers, needs, and preferences; (ii) development of an action plan for locating or maintaining housing; (iii) housing search; (iv) outreach to and negotiation with owners; (v) assistance with submitting rental applications and and other lease-up assistance, such as understanding leases; (vi) assessment of housing for compliance with unit requirements, such as habitability; (vii) assistance with obtaining utilities and moving arrangements and assistance; and (viii) tenant counseling.
• Housing navigation and landlord mediation: Assists program participants in obtaining housing by helping them navigate housing applications, screening criteria, and relationships with landlords that aim to increase exits to permanent housing with ongoing support. This staff capacity may provide services to landlords to de-escalate any challenges that arise with program participants, with the goal of avoiding evictions or exits to homelessness. This can also include providing services and life skills for program participants to equip them with understanding tenant responsibilities and any other skills that may be needed to achieve long-term housing stability.
• Housing stability case management and tenancy support services: Efforts to assess, arrange, coordinate, and monitor the delivery of individualized services to facilitate housing stability for a participant who resides in permanent housing or to assist a participant in overcoming or mitigating immediate barriers to obtaining housing, including tenant screening barriers. This may include (i) using the centralized or coordinated assessment system to evaluate individuals and families applying for or receiving homelessness prevention or rapid re-housing assistance; (ii) conducting the initial evaluation, including verifying and documenting eligibility, as well as conducting the ongoing re-assessments for ensuring program participants’ continued eligibility and adjusting assistance; (iii) counseling; (iv) developing, securing, and coordinating services to enroll eligible individuals and families into economic security programs and other eligible public benefits; (v) monitoring and evaluating program participant progress; (vi) providing information and referrals to other providers; (vii) developing an individualized housing and service plan, including planning a path to permanent housing stability; (viii) linkages to education, job skills training, and employment support; and (ix) conducting re-evaluations.
  • After move-in, case management best practice is home-based as much as possible and is focused on stabilizing the participant in housing by identifying supports, employment or other income, housing retention barriers, and conflict resolution that may lead to tenancy problems.
  • Case management best practice is participant-driven, voluntary, progressive, strengths-based and focused on housing attainment and retention.
  • Activities may also include in-reach, outreach, engagement, and other on-going tenancy support services, including (i) acquiring necessary furnishings and household goods; (ii) tenancy rights and responsibilities education and support; (iii) eviction prevention supports; (iv) transportation assistance related to housing stability; (v) independent living skills coaching; (vi) de-escalation support; (vii) support groups; (viii) end-of-life planning; and (ix) re-engagement and relocation support.
• Mediation: Mediation between the participant and the owner or person(s) with whom the participant is living, provided that the mediation is necessary to prevent the program participant from losing permanent housing in which the program participant currently resides.
• Legal services: Legal services necessary to resolve a legal problem that prohibits the participant from obtaining permanent housing or will likely result in the participant losing the permanent housing in which the program participant currently resides.
• Credit repair: Credit counseling and other services necessary to assist program participants with critical skills related to household budgeting, managing money, accessing a free personal credit report, and resolving personal credit problems.
• Services for behavioral health, mental health, substance use disorders, and medical care: Includes a continuum of behavioral health services and treatment, as well as coordination of access to healthcare-related services including primary care, substance use treatment, mental health care, vision and dental care, and emergency, crisis, and inpatient services.
• Other supportive services: Includes but is not limited to other supportive services such as:
  • Childcare:  Efforts to establish and operate childcare or provide childcare vouchers for children from families experiencing homelessness, and provide meals, snacks, and comprehensive and coordinated developmental activities.
  • Education services: Efforts to improve knowledge and basic educational skills. Services  include instruction or training in consumer education, health education, substance use prevention, literacy, English as a Second Language, General Educational Development (GED), and others, such as the provision of books, supplies, and instructional material.
  • Food: Efforts to provide meals or groceries to program participants.
    Educational, vocational, and work-based learning opportunities. Efforts to connect program participants to educational, vocational, and work-based learning opportunities that resolve the household’s homelessness as quickly as possible and/or stabilize permanent housing.
  • Recovery care and related residential programs: Efforts to connect program participants to community resources that offer recovery care and related residential programs.

Operations

• Operations: Efforts to provide building maintenance (including minor or routine repairs) specific to the development serving the target population, security, fuel, equipment, insurance, furnishings, and supplies necessary for the operation of Supportive housing programming.
• Grant Activities: Efforts focused on administering a specific grant or funding source may improve effective operations, as well as effective program implementation. Such efforts include planning and executing program activities, such as (i) general program or grant management, oversight, coordination, monitoring, and evaluation; (ii) salaries, wages, and related costs related to preparing program budgets; developing systems for ensuring compliance with grant requirements; developing interagency agreements; and preparing reports and other required documents or activities; (iii) accounting or other services; and (iv) other reasonable and necessary goods and services required to implement the grant program, such as evaluating program results against stated objectives, occupancy costs, and training on program requirements.