Permanent Supportive Housing – Building your Program

1 BuildingYour ProgramPermanent Supportive DEPARTMENT OF HEALTH AND HUMAN SERVICESS ubstance Abuse and Mental Health Services AdministrationCenter for Mental Health Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Mental Health ServicesPermanent Supportive HousingAcknowledgmentsThis document was produced for the Substance Abuse and Mental Health Services Administration (SAMHSA) by Abt Associates, Inc., and Advocates for Human Potential, Inc., under contract number 280-04-0095 and Westat under contract number 270-03-6005, with SAMHSA, Department of Health and Human Services (HHS). Pamela Fischer, , served as the Government Project views, opinions, and content of this publication are those of the authors and contributors and do not necessarily reflect the views, opinions, or policies of the Center for Mental Health Services (CMHS), SAMHSA, or Domain NoticeAll material appearing in this document is in the public domain and may be reproduced or copied without permission from SAMHSA.

2 Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization from the Office of Communications, SAMHSA, Access and Copies of PublicationThis publication may be downloaded or ordered at Or, please call SAMHSA s Health Information Network at 1-877-SAMHSA-7 (1-877-726-4727) (English and Espa ol).Recommended CitationSubstance Abuse and Mental Health Services Administration. Permanent Supportive Housing : Building Your Program . HHS Pub. No. SMA-10-4509, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Department of Health and Human Services, Office Center for Mental Health Services Substance Abuse and Mental Health Services Administration 1 Choke Cherry Road Rockville, MD 20857 HHS Publication No.

3 SMA-10-4509 Printed 2010 Building Your Program Building Your Program is intended to help mental health authorities, agency administrators, and Permanent Supportive Housing Program leaders think through and develop the structure of Permanent Supportive Housing programs. Because you will work closely together to build Permanent Supportive Housing programs, we have included a brief overview, Understanding Permanent Supportive Housing . However, for ease, we created two separate sections of tips that target your specific needs:n Tips for Mental Health Authorities; andn Tips for Agency Administrators and Program , we have included more detailed sections on the following topics:n Sources of Funding;n Local and State Housing Plans;n Evaluating a Housing Market.

4 Andn Phases of Housing references, see the booklet, The Supportive HousingThis KIT is part of a series of Evidence-Based Practices KITs created by the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, Department of Health and Human booklet is part of the Permanent Supportive Housing KIT, which includes eight booklets:How to Use the Evidence-Based Practices KITsGetting Started with Evidence-Based Practices Building Your ProgramTraining Frontline StaffEvaluating Your ProgramThe EvidenceTools for TenantsUsing Multimedia to Introduce Your EBPWhat s in Building Your ProgramUnderstanding Permanent Supportive Housing ..1 Tips for Mental Health Authorities..13 Tips for Agency Administrators and Program Leaders.

5 21 Sources of Funding..65 Local and State Housing Plans..73 Evaluating a Housing Market ..89 Phases of Housing Development..97 Appendix A: Case Study Housing Support Teams ..105 Appendix B: Sample Job Description Housing Support Team Housing Specialist..109 Appendix C: Case Study Washington, ..113 Appendix D: Case Study Allegheny County, Pennsylvania ..119 Appendix E: State Housing Agencies ..123 Appendix F: Memorandum of Understanding Between a Public Housing Agency and a Mental Health Authority..129 Permanent Supportive HousingBuilding Your ProgramUnderstanding Permanent Supportive Housing This section of Building Your Program defines Permanent Supportive Housing and describes developing a Housing affordability strategy. These topics are discussed at a planning and policy level geared toward an audience of local, regional, and state mental health authorities and executive directors or Program managers of provider agencies.

6 The two sections that follow, are aimed more specifically toward mental health authorities or Program Is Permanent Supportive Housing ?As its name implies, Permanent Supportive Housing is the following:n Permanent . Tenants may live in their homes as long as they meet the basic obligations of tenancy, such as paying rent;n Supportive . Tenants have access to the support services that they need and want to retain Housing ; andn Housing . Tenants have a private and secure place to make their home, just like other members of the community, with the same rights and Your Program 1 Understanding Permanent Supportive HousingFederal law requires public mental health systems to provide services in integrated community settings, and Permanent Supportive Housing is a proven approach for doing so.

7 It presents an alternative to hospitals, shelters, and other settings that segregate people by disability, such as nursing homes, board and care homes, and other residential care facilities, in which residency is tied to receiving the particular services the facility ElementsPermanent Supportive Housing programs distinguish themselves in a number of critical ways from other efforts that provide living arrangements to people with psychiatric disabilities. Although Permanent Supportive Housing has evolved with variations, growing agreement in the field supports a number of critical elements described below and reflected in the fidelity scale included in this policies supporting integrated housingUnjustified isolation, we hold, is properly regarded as discrimination based on Supreme Court, Olmstead v.

8 (1999)The federal government must assist states and localities to implement swiftly the Olmstead decision, so as to help ensure that all Americans have the opportunity to live close to their families and friends, to live more independently, to engage in productive employment, and to participate in community George W. Bush, Executive Order (June 18, 2001)n Tenants have a lease in their name, and, therefore, they have full rights of tenancy under landlord-tenant law, including control over living space and protection against eviction. For a living arrangement to be considered Permanent Supportive Housing , consumers must have a written lease or sublease or an oral lease where permitted by law. Usually the owner of the unit directly holds this lease.

9 However, many people with psychiatric disabilities have trouble obtaining a lease due to past credit problems, lack of rental history, substance abuse, or criminal convictions. Therefore, in some cases, a service agency may hold a lease, with tenants holding a sublease, and, in other cases, the agency itself might own the property. Regardless of the arrangement, for it to be considered Permanent Supportive Housing , tenants leases or subleases must confer full rights of tenancy including limitations on landlords entry into the property and the right to challenge eviction in landlord-tenant court. The legal rights of tenancy represent a crucial aspect of tenants ability to have a home of their own and to control the services that they Leases do not have any provisions that would not be found in leases held by someone who does not have a psychiatric disability.

10 Permanent Supportive Housing is Housing the same type of Housing lived in by people who do not have psychiatric disabilities. Therefore, tenants must have the same type of lease held by other people who live in Housing in the community, without any special provisions related to their disabilities. Including such limitations in leases might even violate local, state, and federal fair Housing laws. These fair Housing laws permit tenants to request reasonable accommodations to help them apply for and occupy Housing and maintain the obligations of Permanent Supportive Housing 2 Building Your ProgramBuilding Your Program 3 Understanding Permanent Supportive Housingn Participation in services is voluntary and tenants cannot be evicted for rejecting services.