Access to safe, affordable housing and stable living-wage employment are fundamental to long-term health, wellness, and recovery for individuals, families and communities. New York State efforts, such as the highly successful New York/New York III program, have been a cutting-edge example to the nation, as we have successfully demonstrated the connection between housing and employment services and positive health and behavioral health outcomes. New York/New York III is a New York State/New York City partnership that has provided supportive housing for individuals and families with a range of special needs since 2006. This effort represents the first-time government, services providers, advocates, and consumers joined together, resulting in a pledge to create 9,000 units of permanent supportive housing. Over 7,000 units are now in operation, bringing significant hope to thousands of individuals, their families, and the communities which have benefitted from the new-found stability, recovery, and self-sufficiency of the program’s participants.
The success of New York/New York III has spawned new housing and employment initiatives serving a broader target population across New York State. New York’s Medicaid Re-design Team, for example, has initiated an affordable housing initiative that includes suburban counties on Long Island and in the Lower Hudson Valley as well as the Upstate “Thruway Cities” from Albany to Syracuse, Rochester, and Buffalo. In addition, ten rural counties have been awarded supported housing grants. In 2014-15, New York’s Medicaid re-design efforts will include a second round of funding for supportive housing. This new funding will be available for the development of at least fifteen pilot programs involving partnerships between behavioral health services providers, housing services providers, and health homes that serve persons who have both chronic medical conditions and behavioral health challenges.
The New York Association of Alcoholism and Substance Abuse Providers, (ASAP) has over fifty member agencies that operate supportive housing programs. These agencies have significant experience in “bundling” housing, daily living skills, care coordination, job development, post-employment support, and other recovery support services and activities, because they have been able to successfully secure funding targeted toward each of these activities. Approximately 90% of all admissions originating from substance use disorders services providers remain in permanent supportive housing programs for at least one year; with less than a 10% incidence of addiction-related hospitalizations during that time period. More than one-third of participants originating from substance use disorders services providers become employed within that first year, with another 15% enrolling as full-time college students. Over 90% of all families in permanent supportive housing programs remain intact; one-half of families in housing provided by substance use disorders services providers who had children placed in the child welfare system were re-united with their children by the end of their first year.
Permanent supportive housing programs associated with substance use disorders services providers emphasize the realization of their residents’ potential and economic self-sufficiency. An employment specialist, using a specially tailored job plan, is frequently used to work closely with residents. Residents might receive job coaching or help enrolling in a college-based skills training certificate program. After a resident secures employment, a range of post-employment support services are offered. Substance use disorders housing and employment programs have a culture that values self-sufficiency and independence through stable employment. As residents “Move On” to full independent living, they “Make Room” for the next person to enter their supportive housing unit. This is achieved when employed residents are able to contribute an amount toward their rent that exceeds the Public Assistance Shelter Allowance of @ $200 per month. When a significant number of residents are able to make such a contribution, the voluntary agency is able to rent several additional units without the need for additional government support.
The current housing portfolio for substance use disorders services providers is approximately 2,000 units statewide, with approximately one-third of the housing for families. Permanent supportive housing provided by substance use disorders treatment programs includes approximately 1,000 units of HUD Shelter Plus Care programs for single adults and families (400 of these units are in Upstate communities); 600 units of New York/New York III Housing (400 for Single Adults and 200 units for Families); 75 units of permanent supportive housing in seven upstate counties; and 300 units of Medicaid redesign supportive housing for single adults (100 units in NYC; 55 units on Long Island and in the lower Hudson Valley; and 145 units in upstate New York).
Substance use disorders programs have extensive experience with outreach, motivational counseling, and successful referral to health and social services, especially with homeless people and individuals with histories of criminal justice involvement. These agencies are uniquely situated to provide transitional housing and supports to persons recently discharged from inpatient surgical or medical services. Many of our intensive residential programs have on-site Article 28 primary care clinics and many of our upstate community residential services providers have strong partnerships with hospital and community health center primary care and specialty service clinics.
Peers in recovery are increasingly used in work with persons in treatment or early recovery in community-based health care settings. Peer advocates, Recovery Coaches, and Health Navigators can make a significant contribution to supportive housing residents as they get jobs and become fully integrated into the community.
ASAP strongly supports the inclusion of Supportive Housing programs as an integral component to Medicaid Re-design and Health care transformation. ASAP is convinced that “Supportive Housing Builds Recovery” for individuals, for families, and for communities that have been battered by substance use, homelessness, and lack of economic opportunities.