2 ABOUT CSH CSH transforms how communities use housing solutions to improve the lives of the most vulnerable people. We offer capital, expertise, information and innovation that allow our partners to use supportive housing to achieve stability, strength and success for the people in most need. CSH blends over 20 years of experience and dedication with a practical and entrepreneurial spirit, making us the source for housing solutions. CSH is an industry leader with national influence and deep connections in a growing number of local communities. We are headquartered in New York City with staff csh.org stationed in more than 20 locations around the country. Visit [email protected] or email to learn how CSH has and can make a difference where you live. ACKNOWLEDGEMENTS CSH would like to thank MetLife Foundation for its generous support of the development of the CSH Dimensions of Quality Supportive Housing. INQUIRIES For additional resources and materials related to the CSH Dimensions of Quality Supportive Housing please visit csh.org/quality . PERMISSIONS REQUESTS We encourage nonprofit organizations and government agencies to freely reproduce and share the information from CSH publications. The organizations must cite CSH as the source and include a statement that the full document is posted on our website, csh.org. Permissions requests from other types of organizations will be considered on a case-by-case basis; please forward these requests to [email protected] Made possible with the generous support of Copyright ©2013 CSH. All rights reserved.
3 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 1 of 24 BACKGROUND OF THE CSH DIMENSIONS OF QUALITY SUPPORTIVE HOUSING, SECOND EDITION Over its 20-year history, CSH has worked to promote the development of supportive housing throughout the country at the highest levels of quality. Based on its knowledge, and following more than two years of focused conversations with supportive housing tenants, providers, funders and stakeholders, CSH in 2009 created a comprehensive set of resources describing quality in supportive housing — the Dimensions of Quality Supportive Housing (DOQ). Since that time, CSH has provided training and technical assistance to numerous organizations using the DOQ as a framework. Many organizations have accessed and used the DOQ to plan or strengthen their projects. Based on these experiences, CSH identified aspects of the DOQ that have been most valuable to communities, as well as opportunities to strengthen them. This second edition of the Dimensions of Quality Supportive Housing reflects our work with communities to identify the aspects of high-quality supportive housing projects, and it includes updates to align with best practices in the field. In creating and sharing the CSH Dimensions of Quality Supportive Housing, CSH strives to: • Build the capacity of the supportive and affordable housing industries to create and operate high- quality, effective, and sustainable supportive housing units • Encourage the investment of adequate resources, especially from public systems, to support that capacity • Ensure that existing resources for supportive housing are being used efficiently and effectively, and support the allocation of new resources • Create better outcomes for supportive housing tenants, especially those with multiple barriers to housing stability DEFINING SUPPORTIVE HOUSING Supportive housing is a combination of affordable housing and supportive services designed to help vulnerable individuals and families use stable housing as a platform for health, recovery and personal growth. It focuses on balancing three distinct components of the model — housing, supportive services, and property and housing management. These three components can be viewed as a “three- legged stool,” in which each part must bear equal weight to have a balanced project. Supportive housing, however, should not be isolated from the larger community. A project’s relationship to the community adds a vital fourth leg, turning the stool into a community table at which supportive housing providers must have a seat. Quality supportive housing projects are as diverse as the communities in which they are located. Despite these differences, all supportive housing: • Targets households whose heads of household are experiencing homelessness, at risk of homelessness, or are inappropriately staying in an institution. They may be facing multiple barriers to employment and housing stability, including mental illness, substance use, and/or other disabling or chronic health conditions
4 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 2 of 24 Is affordable, meaning the tenant household ideally pays no more than 30% of its income toward rent • Provides tenant households with a lease or sublease identical to non-supportive housing — with • no limits on length of tenancy, as long as lease terms and conditions are met • Proactively engages members of the tenant household in a flexible and comprehensive array of supportive services, without requiring participation in services as a condition of ongoing tenancy • Effectively coordinates with key partners to address issues resulting from substance use, mental health and other crises, with a focus on fostering housing stability • Supports tenants in connecting with community-based resources and activities, interacting with diverse individuals including those without disabilities, and building strong social support networks. CORE OUTCOMES FOR TENANTS IN SUPPORTIVE HOUSING Supportive housing positively impacts a variety of stakeholders, but at its core, focuses on improving the lives of its tenants. Although it is important to understand and measure the quality of individual aspects of supportive housing, such measures are meaningless if they do not produce positive results for tenants. There are many outcomes that an organization may wish to track, but the five outlined here are the core outcomes that all successful supportive housing should observe. The CSH Dimensions of Quality Supportive Housing help organizations understand how to create and operate supportive housing that will best achieve these outcomes. CSH encourages organizations to know their baseline performance with regard to these outcomes and use them to set aggressive targets for improvement.
5 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 3 of 24 Tenants Stay Housed Supportive housing is designed to break a cycle of housing instability for tenants and ensure they remain in permanent housing. • Tenants stay in permanent housing. This is inclusive of tenants who exit supportive housing to other permanent housing. Tenants Improve Their Physical and Mental Health Supportive housing and associated services help tenants to access needed physical and mental health care and improve their health status. Tenants promptly receive any needed medical care, including preventive care. • Tenants promptly receive any needed mental health care. • • Tenants with mental health challenges report progress toward recovery since entering supportive housing. • Tenants strongly agree: “Staff helped me obtain information I needed so that I could take charge of managing my illness.” Tenants Increase Their Income and Employment Tenants increase their income in supportive housing by obtaining benefits and/or employment. In cases in which tenants are already employed or receiving all benefits for which they are eligible, they maintain their income. Tenants who have been in supportive housing for one year or more have increased their income. • • Tenants who enter supportive housing with income and/or employment have maintained it. • Tenants who express a desire to work are supported and ultimately, successfully employed. Tenants Are Satisfied With the Services and Housing Tenant satisfaction is an important outcome that ultimately affects the quality of life for tenants and the ability of supportive housing projects to help tenants achieve housing stability. • Tenants are satisfied with their housing. • Tenants are satisfied with the services available to them. Tenants Have Social and Community Connections Supportive housing helps tenants to develop connections to their community and build social support networks. • Tenants are active community members who choose to participate in organizations such as faith communities and peer associations, and/or in activities such as volunteering, voting, community gardens or block parties. • Tenants report a strong social support network.
6 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 4 of 24 USING THE CSH DIMENSIONS OF QUALITY SUPPORTIVE HOUSING CSH designed the Dimensions of Quality Supportive Housing for a wide variety of stakeholders including developers, landlords, service providers, funders, tenant leaders, housing managers, property managers, government officials and health care organizations. The DOQ apply to all models of supportive housing projects in locations ranging from rural to suburban to urban. This document organizes information in two primary ways: Component —The four primary elements of a supportive housing project: • Project Design and Administration —The process of planning and leading the supportive ° housing project, including key decisions about physical structure, team members and funding —The ongoing operation of supportive housing and Property and Housing Management ° connection to private market landlords Supportive Services —The package of support services available to help tenants use stable ° housing as a platform for individual health, recovery and personal growth Community —The relationship to and role of housing in the larger context in which it operates ° • Dimension of Quality —All successful supportive housing projects are: Tenant-Centered —Every aspect of housing focuses on meeting tenants’ needs ° Accessible —Tenants of all backgrounds and abilities enter housing quickly and easily ° Coordinated —All supportive housing partners work to achieve shared goals ° —Housing provides tenants with choices and community connections Integrated ° Sustainable —Housing operates successfully for the long term ° The matrix on the following page summarizes the relationship of the components of a successful supportive housing project to the CSH Dimensions of Quality Supportive Housing. This matrix also serves as a high-level overview of quality supportive housing. The subsequent pages provide a detailed description of each Dimension of Quality as well as core outcomes for tenants that organizations operating high-quality supportive housing have observed. To access resources created to support organizations that are planning and operating quality supportive housing, please visit csh.org/quality .
7 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 5 of 24 CSH DIMENSIONS OF QUALITY SUPPORTIVE HOUSING SUMMARY MATRIX CSH DIMENSIONS OF QUALITY SUPPORTIVE HOUSING SUMMARY MATRIX This matrix summarizes each component and dimension of a quality supportive housing project. Please continue to the This matrix summarizes each component and dimension of a quality supportive housing project. Please continue to the subsequent pages for additional details. Visit csh.org/quality for available resources on planning for or operating quality subsequent pages for additional details. Visit csh.org/quality for available resources on planning for or operating quality supportive housing. supportive housing. PROJECT COMPONENTS PROJECT COMPONENTS Project Property Supportive Project Property Community Design and and Housing Supportive Services Community and Housing Design and Management Administration Services Management Administration Tenants have Tenants play an Staff educates Services are Tenants play an Staff educates Tenants have Services are meaningful active role in tenants on their voluntary, active role in tenants on their meaningful voluntary, opportunities for planning the rights and customized and planning the rights and opportunities for customized and supportive housing leadership through responsibilities as comprehensive, supportive housing responsibilities as leadership through comprehensive, avenues such as project, and all leaseholders, Tenant-Centered reflecting the needs project, and all leaseholders, avenues such as Tenant-Centered reflecting the needs partners share a tenant associations actively soliciting of all household partners share a actively soliciting tenant associations of all household and board common commitment tenant feedback. members. common commitment tenant feedback. and board members. positions. to helping tenants to helping tenants positions. thrive. thrive. Tenants move into Staff actively The housing The housing is The housing is Tenants move into Staff actively The housing housing quickly, works to ensure application and affordable, in a affordable, in a housing quickly, works to ensure application and and the process that tenants are screening process is location that meets location that meets and the process that tenants are screening process is accommodates aware of available part of a larger tenants’ needs and tenants’ needs and accommodates aware of available part of a larger their varying services, which are community accommodates Accessible accommodates their varying services, which are community Accessible backgrounds and at convenient hours strategy to persons with persons with backgrounds and at convenient hours strategy to cultural needs. and locations. coordinate access to special needs. special needs. cultural needs. and locations. coordinate access to housing. housing. Roles, responsibilities Staff works closely The primary service Tenants who have Roles, responsibilities Staff works closely The primary service Tenants who have and communication with service provider has high service needs and communication with service provider has high service needs strategies are clearly providers and established or who are high strategies are clearly providers and established or who are high established among landlords to ensure connections to utilizers of existing established among landlords to ensure connections to utilizers of existing Coordinated the supportive tenants sustain mainstream and systems are given Coordinated the supportive tenants sustain mainstream and systems are given housing partners, stable housing. community-based priority for available housing partners, stable housing. community-based priority for available codified in written resources. units. codified in written resources. units. agreements and agreements and revisited regularly. revisited regularly. There is an overall Staff supports All tenants are The supportive DIMENSIONS OF QUALITY There is an overall Staff supports All tenants are The supportive strategy promoting tenants in offered a choice of housing project DIMENSIONS OF QUALITY strategy promoting tenants in offered a choice of housing project the ability of developing and housing unit and meets or exceeds the ability of developing and housing unit and meets or exceeds tenants to choose strengthening have a lease community tenants to choose strengthening have a lease community from a variety of connections to their identical to tenants standards, and the Integrated from a variety of connections to their identical to tenants standards, and the Integrated housing models and community. not in supportive partners actively housing models and community. not in supportive partners actively neighborhoods. housing. engage in neighborhoods. housing. engage in community dialogue. community dialogue. Goals outlined in The supportive While respecting The supportive Goals outlined in The supportive While respecting The supportive community planning housing project has tenant rights and housing project has community planning housing project has tenant rights and housing project has efforts, such as funding that is privacy, staff funding that is efforts, such as funding that is privacy, staff funding that is 10-year plans to end sufficient to provide regularly checks to adequate for its 10-year plans to end sufficient to provide regularly checks to adequate for its homelessness and services to tenants ensure that the unit ongoing operations Sustainable homelessness and services to tenants ensure that the unit ongoing operations Sustainable consolidated plans, on an ongoing basis remains in good and allows it to consolidated plans, on an ongoing basis remains in good and allows it to are furthered as a and flexible enough condition and target its intended are furthered as a and flexible enough condition and target its intended result of this to address changing receives any needed tenants. result of this to address changing receives any needed tenants. supportive housing. tenant needs. maintenance. supportive housing. tenant needs. maintenance.
8 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 6 of 24 PROJECT DESIGN AND ADMINISTRATION The Project Design and Administration component refers to the process of planning and leading the supportive housing project, including key decisions about physical structure, team members and funding. Tenant-Centered Tenants play an active role in planning the supportive housing project, and all partners share a common commitment to helping tenants thrive. Tenant-Driven Planning Tenants are part of the team creating the supportive housing project, providing meaningful and ongoing input during the project’s planning phase. At least one individual who represents the target tenant population meets regularly with the • supportive housing project team. • There is at least one focus group comprised of members of the targeted tenancy. • There are multiple, documented instances of how tenant feedback has been incorporated into the supportive housing. Commitment to Supportive Housing Goals The lead organization has clearly established and committed to goals for the supportive housing. Additional partners, such as landlords, housing and property managers, and service providers, are selected for their ability to help achieve tenant and overall supportive housing goals. • Leadership and key staff members at the lead organization articulate the goals of the supportive housing and targeted tenant outcomes. • These goals and target outcomes have been shared with all supportive housing partner organizations. • These goals and outcomes are used as criteria when selecting additional partners such as landlords. Privacy and Living Space Housing unit and building features meet needs that tenants identify, including privacy, household activities and community interaction. • Sharing of bedrooms by non-related, single, adult tenants is not required. • The housing unit provides adequate living space for essential daily activities, such as cooking, eating, sleeping and studying. • Based on the household composition, there are an adequate number of bedrooms. • Each unit has a private bathroom and kitchen. • The building includes common space, such as community rooms that can accommodate a variety of activities and where tenants can choose to interact with one another. Alternatively, common space is provided off-site for tenant use.
9 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 7 of 24 Accessible The housing is affordable, in a location that meets tenants’ needs and accommodates persons with special needs. Affordability Housing units are affordable to tenants on an ongoing basis. • The tenant household ideally pays no more than 30% of its household income toward rent and utilities, and never pays more than 50% of income toward such housing expenses. Location Housing units are located within neighborhoods that meet the needs of tenants, including safety and security, and are located near opportunities for employment, schools, services, shopping, recreation and socialization. • Tenants report satisfaction with the location of their housing unit. • Tenants report that they feel safe in their home. • Housing units are located near a wide array of amenities. In locations where this is not feasible, a plan exists to assist tenants in accessing needed resources. Transportation The location of the housing unit provides easy access to public transportation with reasonable frequency, or alternate transportation options are provided to tenants. • The housing is located near public transportation or transportation services are provided. Transportation options include night and weekend availability Physical Accessibility The housing unit, building and any associated common areas accommodate persons with special needs. • There is a system to ensure that any needed accommodations are requested and completed prior to tenant move-in. • Tenants can fully access any common rooms and public spaces, including lobbies, sitting areas, meeting rooms, mailrooms, laundry rooms and trash collection areas. • The housing meets or exceeds the minimum number of accessible units as indicated by applicable federal, state and local laws. There are additional units that are adaptable or incorporate universal design standards.* *Items may be most relevant for supportive housing projects that include the development of new units of housing (whether new construction or rehabilitation), rather than those leasing existing units in the community.
10 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 8 of 24 Coordinated Roles, responsibilities and communication strategies are clearly established among the supportive housing partners, codified in written agreements and revisited regularly. Roles and Responsibilities Roles and responsibilities for each of the supportive housing partners are clearly defined in writing and are revisited and revised regularly to support the overall success of the supportive housing. There are written descriptions of each supportive housing partner’s role, including, at minimum, • the project sponsor, housing and/or property manager and supportive services provider. • These descriptions detail the responsibilities of each partner. • These written descriptions are reviewed and revised annually at a minimum. Communication Staff regularly communicates regarding their roles and the coordination of their efforts. There are regularly scheduled forums for staff within all involved organizations to discuss their • roles and the coordination of their efforts, tenant health and safety issues, and gaps in management and operations. • There are effective methods and opportunities for communication among the project partners between scheduled meetings. Continuous Quality Improvement The supportive housing partners involved in ongoing operations schedule regular times to communicate and engage in a continuous quality improvement process to ensure project goals are being met. • There are regularly scheduled forums for leaders within the supportive housing partner organizations to review performance against goals, identify any needed strategies for improvement and develop clear action steps.
11 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 9 of 24 Integrated The supportive housing project meets or exceeds community standards, and the partners actively engage in community dialogue. Appearance The supportive housing is attractive in appearance, and the unit and/or building maintains or exceeds community standards. Tenants maintain the exterior of their units in a manner consistent with their lease and • local community. • The scale, appearance, design, maintenance and quality of the building are consistent with the neighborhood and reflect or exceed local community standards. Community Dialogue The supportive housing project partners are active in ongoing community dialogue and activities. • The supportive housing partners participate in community improvement activities such as neighborhood association meetings and community policing discussions. • The supportive housing partners are responsive to neighbors’ or community members’ concerns regarding the supportive housing. • The supportive housing partners seek input from neighbors regarding the design, development and operating plans for the housing.* • The supportive housing partners incorporate this input into the supportive housing structure and meet community needs (such as incorporating a gym or meeting space), if possible.* • Regular updates on the supportive housing development process and ongoing operations are provided to neighbors.* *Items may be most relevant for supportive housing projects that include the development of new units of housing (whether new construction or rehabilitation), rather than those leasing existing units in the community.
12 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 10 of 24 Sustainable The supportive housing project has funding that is adequate for its ongoing operations and allows it to target its intended tenants. Capital Funding The financing of the supportive housing is structured to preserve its long-term affordability for tenants. • There is a commitment, either through funding restrictions or through the presence of a mission- focused owner, to keep the property affordable for a significant period of time, typically at least 30 years.* If the supportive housing is near the end of its maximum affordability period, an ongoing ownership • structure is identified to preserve its affordability.* Rent Subsidies/Operating Funding Long-term rental subsidies are in place to ensure affordable tenant rents and adequate income to cover operating expenses. • The rent and/or operating subsidies for the supportive housing have been allocated to the sponsor organization for a multi-year period, ideally at least five years. Following this initial period, it is highly likely, based on history and current funding sources, that subsidies will be renewed. The project has sufficient cash flow and/or reserves to meet its ongoing obligations (such as debt • service), operational costs and repair/replace major systems while maintaining affordable tenant rents. For a project that is not yet operational, the project budget indicates that these conditions will be met. Efficiency The design and operation of the housing incorporates features designed to increase efficiency and reduce ongoing expenses. • Tenants are provided with information to assist them in environmentally friendly practices such as energy and water conservation, recycling and use of non-toxic household products. • The housing incorporates appropriate and feasible green design practices, such as the use of energy-efficient and water-conserving fixtures and products.* • The housing utilizes durable materials chosen to reduce future maintenance costs.* *Items may be most relevant for supportive housing projects that include the development of new units of housing (whether new construction or rehabilitation), rather than those leasing existing units in the community.
13 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 11 of 24 PROPERTY AND HOUSING MANAGEMENT Property management refers to the set of functions involved with receiving and processing tenant rental applications, receiving rent payments, and ensuring the ongoing physical upkeep of the housing. In projects that include ongoing ownership of units or a long-term master lease arrangement, property management staff is typically part of the supportive housing team. Housing management refers to the set of services concerned with connecting tenants to housing in the private rental market, making rental payments for units that the organization may lease directly from a landlord, and in some cases, receiving tenant rent payments. Such staff often serves as an ongoing landlord liaison and has a distinct role from a service provider. Housing management staff is typically found in organizations in which the tenants or the organization directly lease the units associated with the project from the existing rental market. Tenant-Centered Staff educates tenants on their rights and responsibilities as leaseholders, actively soliciting tenant feedback. Tenant Education Staff provides tenants with information on being good neighbors, their rights and responsibilities as leaseholders, building positive relationships with property management/landlords and other topics of interest to tenants. • Shortly after move-in, staff provides tenants with an orientation to help maximize their experience with the housing and as tenants. This orientation introduces them to the housing unit, neighborhood, and their rights and responsibilities as leaseholders. • Staff provides tenants with written materials to support the content covered in the orientation. Written materials use plain language, and staff assists tenants in understanding their content, when necessary. • Multilingual staff, translated materials, and/or interpretation and translation services are available to tenants, as needed. Tenant Feedback Staff actively solicits tenant feedback in order to ensure the living environment helps tenants to achieve their goals. • Staff actively solicits tenant feedback on their housing units/building. • Tenants can provide feedback in multiple ways (e.g. written, oral, online). • There is a tenant council or another tenant-led group that meets regularly with the supportive housing project partners. • A significant percentage of tenants report being satisfied with their housing. Tenant Communication Staff provides tenants with clear information on making property management requests and addressing emergencies. • Staff clearly communicates to tenants the process to make property management requests and the timeline for receiving a response. • A plan for 24-hour crisis coverage exists to address urgent issues. • There is a clearly communicated plan for tenants to reach staff quickly.
14 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 12 of 24 Accessible Tenants move into housing quickly, and the process accommodates their varying backgrounds and cultural needs. Housing First The supportive housing entrance process supports moving persons quickly into housing from settings such as the streets or shelters, without preconditions of treatment acceptance or compliance. • The application process is short, and tenants are housed quickly in a unit of their choosing. • The eligibility criteria for the supportive housing meet the minimum that the funder(s) or landlord require (without additional criteria imposed). • Sobriety is not an entrance requirement. • Medication compliance is not an entrance requirement. Agreement to participate in services is not an entrance requirement. • • There is no minimum income requirement. Landlord Relations Staff has formed relationships with landlords and assists tenants in advocating for their entry into housing. • Housing management staff has relationships with landlords who are willing to consider tenants who have poor credit, criminal backgrounds or prior evictions.** • With tenant permission, housing management staff assists tenants in advocating for themselves with landlords and explaining potential background issues.** **Items may be most relevant for supportive housing projects that lease existing units in the community rather than those that include the development of new units of housing. Application Process The application process for the supportive housing project is streamlined, clearly stated and separate from any assessment for services. • The housing application and screening processes are fully accessible to persons with disabilities. In addition, appropriate, reasonable accommodations and necessary supports are provided, as needed, during the application and screening processes. The housing application is separate from the service needs assessment and does not request • detailed clinical information. • There is a timely and clearly stated process for the approval or denial of housing applications and appeals. There is an established system for staff to communicate with tenants during this process and to track and retain documentation. • The supportive housing application and intake processes include the minimum number of questions needed to determine tenant eligibility.
15 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 13 of 24 Cultural Competency Every aspect of the application process is designed to ensure that prospective tenants with diverse cultures and backgrounds understand the information being requested. • All materials for tenants are written in plain language, and staff assists tenants in understanding the content of written materials, when necessary. • Any intake/application forms can be completed orally, and written materials are available in multiple languages. • Multilingual staff, translated materials, and/or interpretation and translation services are available to tenants, as needed.
16 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 14 of 24 Coordinated Staff works closely with service providers and landlords to ensure tenants sustain stable housing. Building and Maintaining Landlord Relationships Housing management staff quickly makes initial connections with landlords/property managers and promptly addresses any concerns. • Shortly after move-in, housing management staff reaches out to landlords/property managers regarding tenant service needs and available services (with tenant permission).** • Housing management staff promptly responds to any concerns raised by landlords/property management staff regarding supportive housing tenants.** Housing management staff has established and meets regularly with a landlord advisory group.** • **Items may be most relevant for supportive housing projects that lease existing units in the community rather than those that include the development of new units of housing. Coordinating Property/Housing Management and Supportive Services Property/housing management staff and supportive services providers perform distinct roles, but understand one another’s functions and communicate frequently. • Property/housing management and supportive services have separate and distinct roles. Files and office space are not shared. • There is a comprehensive, written eviction prevention policy that details how all supportive housing partners work together to promote housing stability. If eviction occurs, there is evidence of communication between service provider and property manager/landlord, including evidence of prevention efforts. • If a tenant is behind on rent, staff works with tenants to create a rent repayment plan and ensures they have the necessary support to fulfill its terms. • All property/housing management and services staff have received training in order to understand one another’s roles. • Supportive services and property/housing management staff hold regularly scheduled forums to discuss their roles, the coordination of their efforts, any current issues, and to address gaps in services and operations. • Property/housing management staff promptly notifies services staff of any unmet tenant service needs. Supportive services staff promptly notifies property management staff when they observe safety or maintenance concerns. • When notified of any issues, property/housing management and services staff respond promptly.
17 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 15 of 24 Integrated All tenants are offered a choice of housing unit and have a lease identical to tenants not in supportive housing. Housing Unit Choice Tenants are offered a choice between multiple units of housing. If possible, they are also given a choice between housing models and locations. Staff works with tenants to develop an understanding of their needs and wants from a housing unit. • Staff supports tenants in searching for and selecting a housing unit that meets their needs, including • any accessibility needs. This includes communication and advocacy with landlords as needed. • Tenants are given the opportunity to view and choose among multiple housing units. Leases and Tenant Rights Tenants have standard leases or subleases and a clear understanding of their rights and responsibilities as tenants. • All supportive housing tenants are provided with leases or subleases identical to non-supportive housing tenants — without service participation requirements or limits on length of stay (as long as lease terms are met). Ideally, the initial term of a lease or sublease is at least one year. • Tenants cannot be evicted for not participating in services or for failing to follow through on their services and/or treatment plan. • Tenants are not evicted for failing to maintain sobriety. • As part of the lease signing process, property/housing management staff walks tenants through the lease agreement, clearly explaining their rights and responsibilities as leaseholders. Tenants are provided with a signed copy of their lease. • Tenants are notified of the process for any lease violations and grievance/appeal procedures. • Tenants are not removed from housing without legal eviction proceedings.
18 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 16 of 24 Sustainable While respecting tenant rights and privacy, staff regularly checks to ensure that the unit remains in good condition and receives any needed maintenance. Housing Maintenance Housing units are inspected regularly, proactively maintained and any identified issues are quickly addressed. • Staff inspects units prior to move-in and at least annually thereafter. The inspections ensure that units meet or exceed the U.S. Department of Housing and Urban Development’s Housing Quality Standards (HQS). • Tenants are given proper notice of any scheduled inspections. • Staff ensures that inspection results that require follow-up or corrective actions are addressed within reasonable timeframes. • Property management staff has a comprehensive, written plan and schedule for inspections, pest control, routine maintenance and replacement activities designed to sustain the quality of the physical environment. • There are clear procedures for tenants to report maintenance problems, and for work orders to be created and completed. • Staff has funds available to address minor instances of tenant-caused damage to the unit, in the interest of maintaining landlord relationships and housing stability.
19 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 17 of 24 SUPPORTIVE SERVICES The supportive services component refers to the comprehensive package of supports that help tenants sustain housing stability and meet life goals. These services may be provided by the project’s designated primary service provider or by collaborating organizations. The primary service provider ensures that tenants can access needed services on an ongoing basis. Tenant-Centered Services are voluntary, customized and comprehensive, reflecting the needs of all members of the household. Service Design All members of tenant households have easy, facilitated access to a flexible and comprehensive array of supportive services. Tenants are actively involved in choosing the services they would like to receive. The specific services and their intensity can vary over time, based on changing tenant needs. • There is a comprehensive, written services plan for the supportive housing project. It describes the available services, identifying whether they are provided directly or through referral linkages, by whom, and in what location and during what days and hours. • All tenants are provided with a menu of services that includes, at minimum, how to access case management services, medical services, mental health services, substance abuse treatment services, peer support, parenting skills, education, vocational and employment services, money management services, life skills training and advocacy. • Service staff actively involves tenants in the design, development and implementation of their individualized service plans. Staff also works with tenants to develop goals that are realistic, achievable, measurable and tailored to the tenants’ preferences. • The service design and staffing plan includes the opportunity for tenants to receive services and support from peers. • Service needs assessments and individualized service plans are updated regularly to reflect tenants’ changing service needs and goals.
20 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 18 of 24 Delivering Voluntary Services Supportive services staff uses a variety of proactive and creative strategies to engage tenants in on-site and/or community-based supportive services, but participation is not a condition of ongoing tenancy. In delivering services to tenants, staff uses the most appropriate techniques or best practices, based on tenants’ unique needs. • Participation in services is voluntary, meaning that tenants can choose whether to participate and select the services they prefer. A significant percentage of tenant households voluntarily utilize at least one supportive service. • Service staff is educated about techniques that engage and support tenants in changing their behavior, such as motivational interviewing and the stages of change model. • Service staff is trained to deliver services effectively, taking into account each tenant’s age, culture, background and/or disability. • Services are not time-limited and are available to tenants throughout their tenancy. Services staff is available to provide more frequent and intensive services at the beginning of a tenant’s residency, in order to facilitate the tenant’s transition into supportive housing. • Service staff assists tenants to anticipate, prevent and manage the negative consequences of substance use or relapse. Supportive services staff works to reduce the harm caused by tenants’ substance abuse, including actively working to prevent evictions. • Service staff is educated about evidence-based best practices that can assist them with tenants, such as trauma-informed care, integrated dual diagnosis therapy, wellness recovery action planning and critical time intervention. • Service staff encourages all tenants to participate in meaningful activities, and assist all tenants who express a desire to work to obtain appropriate vocational services, employment services and employment. • Service staff supports tenants in moving on from supportive housing if they choose to do so and ensures that interested tenants have access to appropriate supportive services after moving out.
21 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 19 of 24 Accessible Staff actively works to ensure that tenants are aware of available services, which are at convenient hours and locations. Housing Outreach The service provider ensures that there are assertive outreach and in-reach efforts to facilitate the ability of persons living on the streets, in shelter or in institutions to access the supportive housing. • The service provider uses, or partners with an organization that uses, assertive outreach and in- reach methods to engage people living on the streets, in emergency shelters, in jails or prisons, or in institutions such as nursing homes. Availability of Services Services staff ensures that tenants are aware of available services and that service hours and locations are convenient. • Service staff meets with new tenants prior to move-in to review available supportive services options. Service staff meets with tenants regularly to review available supportive services. • • Tenants can choose to receive services in their home or can access services in a convenient community location. • Service staff and programs are available during hours that ensure maximum access and utilization by tenants, including tenants who may be working or are engaged in other activities during regular business hours. • Crisis services are available to tenants. • All programs and spaces used for the delivery of services are fully accessible to persons with disabilities, and appropriate reasonable accommodations are provided to tenants with disabilities to facilitate their participation.
22 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 20 of 24 Coordinated The primary service provider has established connections to mainstream and community-based resources. Connections With Mainstream and Community-Based Service Providers The primary service provider facilitates tenants’ connections to resources and supportive services in the community, particularly behavioral healthcare, primary healthcare, substance use treatment and support, and employment. • Soon after housing entry, staff assists all tenants in applying for relevant public benefits. • The primary service provider establishes linkages, codified by MOUs or other written agreements, with providers of core services to tenants, including, at minimum, behavioral healthcare, primary healthcare, substance abuse treatment and support, and employment. • Tenants can see a behavioral health care provider, including a psychiatrist if needed, within a short period of time after making the request. • Tenants can see a primary health care practitioner shortly after making the request. • Tenants have a primary health care provider. • Tenants can access substance use treatment and support shortly after making the request. • Tenants are connected with relevant workforce development and employment resources shortly after expressing interest. Integrated Staff supports tenants in developing and strengthening connections to their community. Community Connections Staff works with tenants to identify community opportunities and relationships of interest and ensure that they have the support needed to pursue them. Staff provides tenants with information about community resources and activities in conjunction • with the move-in process. This also includes an orientation to the neighborhood. • Staff supports tenants in identifying and accessing community activities of interest, such as public gardens, faith communities and peer associations. This may include support with obtaining transportation. • Staff provides tenants with opportunities to connect with peers, including other supportive housing tenants, if desired. • Staff ensures tenants have opportunities to interact with diverse individuals, including persons without disabilities. • Staff supports tenants in establishing or strengthening positive relationships with friends and/or family members.
23 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 21 of 24 Sustainable The supportive housing has funding that is sufficient to provide services to tenants on an ongoing basis and flexible enough to address changing tenant needs. Funding Commitments Funding or a funding strategy is in place to ensure that tenants have access to supportive services for the life of the project. • Service funding for the supportive housing is committed/contracted for a multi-year period. Following this initial period, it is highly likely, based on history and current funding sources, that funding will be renewed. • The service funding source(s) is flexible enough to allow for the specific services to change with client needs, both daily and throughout the life of the supportive housing. Provider Partnerships The primary service provider has established linkages with other service providing organizations to ensure tenants have access to comprehensive services on an ongoing basis. • The primary service provider has written agreements with external providers that services will be made available to tenants.
24 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 22 of 24 COMMUNITY The most successful supportive housing does not operate in isolation, but serves an integral role in the larger community. This component represents the opportunities that an individual supportive housing project has to contribute to the achievement of larger community goals. Tenant-Centered Tenants have meaningful opportunities for leadership through such avenues as tenant associations and board positions. Tenant Leadership Leadership development opportunities for tenants are created and/or supported by all partners. • The supportive housing partners support or promote the development of a community-wide (at the local, regional or state level) association of supportive housing tenants that meets regularly and is tenant-led. • Each of the supportive housing partners has at least one tenant representative on their organization’s board. The organization(s) provides support to tenants who serve on boards by providing board mentors, transportation and/or a stipend. • All external partner organizations have current or former recipients of their housing or services on their boards or in key leadership roles. • Written agreements between the lead supportive housing partners and external partner organizations specify that current or former recipients of services or housing serve on their boards or in key leadership roles. Accessible The housing application and screening process is part of a larger community strategy to coordinate access to housing. Coordinated Access The supportive housing partners participate in or lead community efforts to coordinate access to housing. • The supportive housing partners participate in a designated community process to coordinate access to housing, including the use of coordinated referrals and triage, common applications, common entrance criteria and centralized waitlists. If the community does not have coordinated access to housing, the supportive housing project partners clearly communicate the referral and application process to the entire community. • The supportive housing partners participate in or lead efforts to ensure that community application processes, documentation of eligibility and intake processes are streamlined and efficient, so that applicants are not asked for the same information on multiple occasions.
25 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 23 of 24 Coordinated Tenants who have high service needs or who are high utilizers of existing systems are given priority for available units. Targeting Units The supportive housing partners prioritize persons who are vulnerable or who are high utilizers of existing systems (e.g. hospital, jail, shelter) for all or a portion of available units. • To the extent allowed by funding, the supportive housing prioritizes persons that community data identify as having a high need for services (such as a high vulnerability index score) or frequently utilizing crisis systems (frequent users) for all available units. Discharge Planning The supportive housing partners connect with and support the efforts of community stakeholders working to ensure positive institutional discharges. • The supportive housing partners participate in community discharge planning efforts designed to ensure that persons exiting institutions such as hospitals, nursing homes or prison/jail do not experience homelessness after their release and make units available to support these efforts. Integrated There is an overall strategy promoting the ability of tenants to choose from a variety of housing models and neighborhoods. Tenant Choice The supportive housing partners help develop and implement a community plan designed to ensure that new supportive housing increases tenant choice with regard to housing models and locations. • The community has a plan to ensure that supportive housing exists in a variety of models and locations, or the supportive housing partners promote the development of such a plan. • For new projects, the model and location of the supportive housing contributes to the achievement of this plan by increasing tenant choice.
26 CSH | Dimensions of Quality Supportive Housing | Second Edition Page 24 of 24 Sustainable Goals outlined in community planning efforts, such as 10-year plans to end homelessness and consolidated plans, are furthered as a result of this supportive housing. Community Planning The supportive housing project partners coordinate with larger community efforts, aligning with and furthering the achievement of related community plans. • The development and/or ongoing operation of the supportive housing helps achieve goals outlined in relevant community plans, such as 10-year plans to end homelessness, consolidated plans and/ or Olmstead implementation plans. • The supportive housing project partners participate in the development and ongoing implementation of relevant community planning processes. Data Tracking and Sharing While preserving client confidentiality, the supportive housing partners track and share demographic, performance and other relevant data to improve outcomes for tenants. • The supportive housing uses appropriate information management systems to track relevant data, in order to determine its performance against project goals and community standards. • The supportive housing partners participate in community data-sharing agreements to track data and performance community-wide.
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