Supportive Services for Veteran Families (SSVF) Webinar Series Developing a Reasonable Plan for SSVF Veteran Families January 19, 2012

Supportive Services for Veteran Families (SSVF)Webinar Series

Developing a Reasonable Plan for SSVF Veteran Families

January 19, 2012

Presenters

Robert Thompson, VA SSVF Regional Coordinator

Melany Mondello, Technical Assistance Collaborative

Marge Wherley, Abt Associates

Stephanie Nagy, Abt Associates

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Webinar Format

• Webinar will last approximately 2 hours

• Participants’ phone connections are automatically “muted” due to the high number of callers

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Submitting Questions During the Webinar

• Questions can be submitted via email at [email protected]

• Questions will be answered either individually or through an update to the SSVF Frequently Asked Question resource.

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SSVF Hot Topics

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Objectives

During this webinar we will review the following:– Requirements for SSVF Veteran Family Plans– Elements of a Reasonable Plan– SSVF Case Examples– Examples of Reasonable Plans

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What’s Required?

1. Case managers must adequately address participant’s needs.

62.31 Case management services: “…Developing and monitoring case plans in coordination with a formal assessment of supportive services needed, including necessary follow-up activities, to ensure that the participant’s needs are adequately addressed.”

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What’s Required?

2. The plan must address the participants’ future ability to pay bills SSVF has paid:

62.33-34 “…as a condition of providing payments for child care services (or rental assistance, or utilities), the grantee must help the participant develop a reasonable plan to address the participant’s future ability to pay for child care services (or rent or utility payments).”

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What’s Required?

3. The plan should address future housing stability if SSVF has assisted the participant to be re-housed or re-located.

62.34 “As a condition of providing a security deposit payment or a utility deposit payment (or moving costs assistance), the grantee must help the participant develop a reasonable plan to address the participant’s future housing stability.”

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What does “Address” Mean?

Synonyms: – Tackle – Focus on– Concentrate on– Deal with– Attend to

Antonym:– Ignore

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A “Reasonable Plan”…

….“Tackles” and “ deals with” the issues contributing to the participant’s homelessness or risk of homelessness

…. “ Concentrates” and “Focuses” on the participant’s poverty and personal issues

….Does not “ignore” housing barriers

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A “Reasonable Plan”…

…Does not guarantee that every plan will be successful

…Does not assure/ensure that participants will no longer be poor or rent-burdened

…Does not promise an end to future (longer-term) housing risks, housing crises or homelessness

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What does the Reasonable Plan Address?

• Housing Barriers that are economic/financial and which are currently threatening housing stability

• Housing Barriers that are due to a lack of information, a lack of skills, and/or self-defeating patterns of behavior (whether or not those behaviors are associated with a disability) if they are affecting housing stability

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PART ONE: Addressing Financial/Economic Housing Barriers

Start by addressing our common assumptions:

1.People below 30% of Area Median Income cannot afford housing and2.People should not pay more than 30% of their income on rent

…Therefore, we should not accept participants with incomes below 30% of AMI unless we can assure them a deep, permanent housing subsidy.

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Challenging the Assumption

Among households who rely primarily on public benefits for income, approximately 10% become homeless in a year.

But that also means that 90% do not become homeless—even though only a small percentage have a deep rental subsidy.

What? You don’t believe it? Let’s look at an example.

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Hennepin County, Minnesota

1570 families who entered a homeless shelter between 1/1/08-10/31/09:

•66% had incomes of $0-$499/month•28% had incomes of $500-$999/month

•Only 2% spent 35% or less of their income on housing (i.e. they had a deep rental subsidy)•93% spent 66-80% of their income on rent

•Head of household under age 22: 29%

•Head of household age 22-29: 39%

•Children age 0-6 years in family: 93%

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These households were at or below 15% of AMI…and yet:

•Rapid Re-Housing Assistance was provided•With help, they found permanent housing within about 30 days

AND•95% did not return to homelessness within 12 months of leaving shelter

EVEN THOUGH•Income increases for participants were minimal during 6 months of Rapid Re-Housing services

AND EVEN THOUGH•The great majority received neither an initial nor an ongoing rental subsidy

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Therefore….

It is reasonable to plan that a household can obtain and maintain housing

…even if they are extremely low income

…even if they cannot and do not secure a deep rental subsidy

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What is possible for some to achieve may not be reasonable to expect for many

Data from the first year of HPRP showed that only 6.2% (of over 200,000 households) increased their income during the program. The vast majority, 70.3%, showed no change in income.

25.7% entered HPRP with no income and 22.6% exited with no income.

Is it reasonable to set expectations/goals and develop case plans that focus on a significant increase in income during SSVF?

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A Reasonable Plan for Addressing Income Barriers

The goal is any increase in income that is available to pay rent. Many approaches (especially in combination) can accomplish this:

•Secure Additional Benefits: Income supports (e.g. VA Benefits, Disability Lump Sum and Monthly Payments), Energy Assistance, Food Supports, Unemployment Compensation, Workers Compensation (e.g. Payment of medical bills or payouts for permanent partial disability), Earned Income Tax Credit•Increase Earned Income: Temporary Work, Day Labor, Additional Hours, Increased Pay Rate, Overtime/Holiday Work, Advertise to do Odd Jobs•Reduce Expenses: Rent Subsidies, In-Kind Commodities, Budgeting Strategies, Decrease Utility Usage, Subsidized or Relative Childcare; Relocating to a Less Expensive Housing Unit, Home-Sharing.

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PART TWO: Addressing “personal” housing barriers

Start by addressing some common assumptions:

1.People with personal problems and/or disabilities cannot achieve or maintain stable housing

UNLESS

2.Programs take a holistic approach that addresses and includes all needs in all life areas.

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Challenging the assumptions: Hennepin County’s Rapid Re-Housing Data 1/07-2/08

• Level 2 Families: Moderate BarriersChemical Use has resulted in housing loss: 3%Mental Health has resulted in housing loss: 2.9%Domestic Violence has resulted in housing loss: 61.8%Felony: 1.6%

• Level 3 Families: Moderately Severe BarriersChemical Use has resulted in housing loss: 10.0%Mental Health has resulted in housing loss: 36.7%Domestic Violence has resulted in housing loss: 26.3%Felony: 13.3%

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Hennepin County’s Rapid Re-Housing Data 1/07-2/08

• Level 4 Families: Chronically Homeless

Chemical Use has resulted in housing loss: 16.0%

Mental Health has resulted in housing loss: 53.5%

Domestic Violence has resulted in housing loss: 38.2%

Felony: 11.6%

• Level 5 Families: Very Severe Housing Barriers

Chemical Use has resulted in housing loss: 19.0%

Mental Health has resulted in housing loss: 50.00%

Domestic Violence has resulted in housing loss: 33.3%

Felony: 32.5%

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#1: The Decision to Assist

AUDIENCE POLL

How many of you would accept Level 4 Veteran Families (Chronically Homeless) for assistance in your SSVF program?

__YES __NO __NOT SURE

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AUDIENCE POLL

How many of you would accept Level 5 Veteran Families (Very Severe Housing Barriers) for assistance in your SSVF program?

__YES __NO __NOT SURE

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Rapid Re-Housing Program Components

• Initial barrier level assessment, within 3-5 days of shelter admission

• Housing search, landlord/lease negotiations, move-in

• Housing start-up costs: application fees, security deposit, first month’s rent, moving costs

• Landlord and tenant supports for 6 months

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Rapid Re-Housing: What was NOT provided

No rental subsidies were attached to the program. Any subsidies participants were able to secure were obtained via referrals to community programs.

No treatment for CD, MH or DV was provided. While treatment was sometimes encouraged, it was not required. Any treatment participants chose was offered via referrals to community programs.

The case plan was not focused on resolution or improvement in life areas that were unrelated to getting and keeping housing. A participant could, if they wished, add such goals, but the case plan was not structured around life domains.

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Rapid Re-Housing Successful Outcomes (No return to homelessness within 12 months of leaving shelter)

BARRIER LEVEL Agency A Agency B

Level 2 (Moderate)

97% 99%

Level 3 (Moderately Severe)

97% 97%

Level 4 (Chronically Homeless)

92% 88%

Level 5 (Very Severe)

88% 93%

Total: All Families (N= 1635)

95% 95%

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A Reasonable Plan for Addressing Personal Barriers

Goals/Strategy:

•Change the environment to reduce demands to a level the participant can manage

AND/OR

•Teach new skills that allow the participant to manage demands more successfully

AND/OR

•Reduce behaviors that threaten the participant’s ability to get and keep housing

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Let’s Talk About Personal Change

• Many of our problems can be thought of as “bad habits.” Habits are behaviors, thoughts and emotional reactions that do not require any conscious attention.

• Stopping old, bad habits takes more than just willpower; those habits are created, reinforced and sustained by neurotransmitters. Dopamine circuits constantly calculate reward opportunities and drive us toward short-term rewards.

• This makes sense from a survival perspective, but doesn’t help much when you’re trying to avoid busting your budget or blowing up at your landlord!

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More Reasons Why it’s Tough to Change

• Stress, whether physical or emotional, activates another neurotransmitter (serotonin) that causes production of more dopamine. Stress thus makes you more likely to go on autopilot—and continue or revert to old habits.

• There is a genetic component to this—a deficiency in a particular dopamine receptor—that makes some people more likely to become addicted, obese or suffer from PTSD — i.e. to develop patterns of behavior, thoughts and emotional responses that can be maladaptive but hard to change.

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And if that’s not enough….

• Lack of exposure to opportunities for rewards in your life generally diminishes drive and motivation (dopamine). Reduced dopamine reduces the excitability of other neurons that are supposed to put the “brake” on drives toward short-term rewards. In other words, if you’ve lacked chances to make your life better, you are more likely to impulsively (and unconsciously) seek immediate gratification.

• Short-term “rewards” may be enough to escape a blizzard or eat a meal. But they aren’t enough to assure longer-term housing stability!

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What does it take to get rid of old, maladaptive habits and form new and better ones?

Change beliefs, values and expectations about short vs. long-term rewards

Connect the habit to long-term <negative> consequences

Pre-plan for high-risk situations where the habit may re-emerge or be reinforced

Avoid high-risk situations when possible and have alternative solutions ready if/when the trigger occurs

Interact with people who value what we want to value

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What does it take to get rid of old, maladaptive habits and form new and better ones?

Remove secondary gains/reinforcement for maladaptive habits

Enrich your lives—creating a reward-rich environment

Train competing “good” habits and practice, practice, practice

Develop a sense of control

Take care of stress: eat and sleep right, pace yourself, develop cognitive flexibility and problem-solving ability

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And, even then….

• Self-regulation in one domain reduces self-regulation in other domain(s)

• In other words, while successfully managing one new habit, you are less able to perform any other new habit.

• BTW: providing glucose (sugar) reduces brain fatigue caused by self-regulation of Habit #1 and may help you deal with Habit #2! (But only on a short-term basis.)

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Why am I telling you all this?

• When we, human service people, assess a problem, we want to DO SOMETHING RIGHT NOW!

• People cannot change all their maladaptive behavior patterns and bad habits simultaneously (and possibly not even sequentially) in the short-term. It’s a neurological no-brainer!

• SSVF is not designed to achieve long-term behavior change—nor are we clinically competent to do so!

• So what is a “reasonable plan” to address personal barriers to housing stability?

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So, What Should You Do?

Use reasonable planning principles to address behavior, thoughts and emotional responses that threaten immediate (and, often, long-term) housing stability:

1.Prioritize — your perspective: Not every problem or need is directly and immediately related to housing stability (e.g. increasing parenting skills—unless the participant has been evicted for the behavior of her/his children).

What is most urgent and most relevant from your point of view?

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So, What Should You Do? (cont.)

2. Prioritize — based upon the participant’s perspective; Hopefully s/he agrees with you about the most urgent changes needed to stabilize housing, and/or has additional insights about the causes and solutions for the housing crisis.

3. Select a limited number of priorities (after all, that’s the point of prioritizing!)

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4. Gauge the level of expertise needed to achieve priority goals. You are most likely to be effective at providing information about leases and the “soft” expectations of tenancy, teaching basic skills (budgeting, threshold levels of home maintenance, household budgeting, income- enhancing or expense-reducing resources), offering strategies for dealing with conflict between the participant and landlord/tenants, etc.

5. Develop action steps for the goals you will directly support. What will you do? What will the participant do? When will it happen? How will you both monitor progress?

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6. Everything else can and should be:

POSTPONED

and/or

REFERRED TO A COMMUNITY RESOURCE

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Know your VA and Community Resources!

• Know exactly what is offered, by whom– Who has the resources and the expertise?

• Know the target population and admission criteria for every relevant service

• Know the application process• Know the gatekeepers who can influence the

success of a referral• Know the average wait list/time to obtain an

appointment

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Case Scenarios

We’re going to consider two actual case scenarios* recently submitted to the Regional Coordinators by SSVF grantees:

Case A. Homeless Veteran (Category 2)

Case B. Veteran Being Evicted (Category 1)

*Where information was not available, it was added (for clarity) and names were changed. The Veteran’s housing situation, barriers, plans and outcomes are real. The “case consultation discussion” is entirely fictitious but represents the kind of team decision-making that any SSVF program can utilize.

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Case A: Henry

In the past year, Henry, age 62, has spent 344 nights in the local homeless shelter. He has zero income.

He was referred to SSVF by a Veteran representative at the shelter. During eligibility screening, SSVF verified his status as “Under Honorable Conditions.” His income is below 50% AMI and he is literally homeless (Category 2). He is eligible for SSVF.

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AUDIENCE POLL

How many of you would accept Henry for assistance in your SSVF program?

__YES __NO

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If You Voted NO

AUDIENCE POLL

Why? Pick the answer that was most important to your vote - choose only 1 answer

We don’t work with people who have zero income (screening policy)

We don’t work with people who are experiencing chronic homelessness (screening policy)

I don’t think we can help him within the time limits of SSVF Temporary Financial Assistance

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#2: How to Assist (What is a Reasonable Plan?)

Housing: Is it reasonable to find housing for someone who has zero income? What kind of housing is reasonable?

Income: Is it reasonable for Henry to secure income from employment? What public benefits could he reasonably obtain?

Can this be accomplished within the limits of SSVF rental assistance? If not, will Henry be homeless again?

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Goals for the Plan

• Housing Goals: Find housing, using SSVF for deposit and “bridge” rental assistance.

• Income Goals: 1. Obtain Section 8 (non-VASH) rental subsidy (Henry is

on a waiting list for Section 8)2. Obtain VA benefits (Henry has had a VA

Compensation and Pension case pending for nearly a year but his case has not advanced)

If both goals are met, Henry will have affordable housing and discretionary income. Research continues to show that a permanent housing subsidy is the most effective method of achieving long-term housing stability.

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Action Steps to Achieve Henry’s Goals

• Case manager will contact Housing Authority to identify any means of improving access to Section 8. Henry did not identify himself as a Veteran—this could gain him priority.

• Case manager will contact VA to identify status of Comp and Pension case. Case manager will obtain any additional documentation needed.

• Case manager will assist Henry to obtain low-cost housing while housing subsidy and VA benefits are pending.

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Outcomes

• Henry received a Section 8 voucher. The voucher was for another city that is still within the SSVF’s catchment area. The case manager assisted in a new housing search, the Housing Authority conducted the housing inspection and the SSVF program provided the security deposit. Henry obtained his housing.

• Henry was awarded a Non-Service Related VA Pension of $1,021, beginning December 1.

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What Additional Supportive Services Could be Offered to Henry to Maintain Housing?

With Henry’s consent:

•Offer some level of mediation/intervention to landlord, for xxx period of time, in case of conflict, lease violation or non-payment.

•Offer tenancy and budgeting supports to Henry, including home visits to look for red flags.

•Offer assistance in securing mental health services for Henry -- if needed and wanted.

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Case B: Robert

Housing Crisis: •Robert’s common law wife passed away in August, 2010, but she left her estate (her home) to a friend/neighbor.•After months of conflict between Robert and the Beneficiary’s family, Robert was given an eviction notice. He must move out but has no resources, plan or support network.

Robert meets the SSVF eligibility criteria: a Veteran, very low-income, living in permanent housing but imminently homeless (Category 1).

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Robert’s Barriers

1.Robert is extremely low income—below 30% AMI. His monthly income is $709 ($619 from Social Security and $90 from VA).

2.Robert has no rental history or experience being responsible for rent, utility bills and living expenses.

3.Robert is a registered sex offender.

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Should SSVF assist Robert to find new housing?

This is a team decision.

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What is the initial plan for housing search?

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Team Review: New Plan Needed

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Team review: Another Plan

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Outcome

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Follow-up Services

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Summary: Goals in a “Reasonable Plan”

1.The goal for all SSVF participants is immediate permanent housing….and, when necessary, increase the participant’s income available to sustain housing.

2.The Plan may include intermediate objectives. An intermediate objective brings the household to the final goal, but can be changed when necessary—e.g. the initial intermediate objective for Robert was low-cost rental housing. When that was not possible, the new objective was “shared housing.”

3.Intermediate objectives are based upon the family’s situation, preferences and information initially available—e.g. Robert did not want permanent supportive housing, so that was out.

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Summary: Action Steps in a “Reasonable Plan”

4. Action steps are discrete activities that the family and/or the case manager can perform now to move the household toward the intermediate objective and ultimate goal.

5. Action steps must resolve immediate housing barriers. E.G. if a landlord refuses to rent to a participant with serious housing barriers, the action step might involve the case manager negotiating with the landlord to see if a larger deposit or follow-up response for participant lease violations might overcome the landlord’s resistance.

6. Action steps are subject to <sometimes frequent> change as they are accomplished, added or discarded… or as new information or situations emerges

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A Simple Housing Plan Example: Robert’s Initial Plan

Goal: Permanent Housing*

Intermediate objective #1: Secure an efficiency or one-bedroom apartment with rent that Robert can pay with his current income.

Intermediate objective #2: Explore options for increasing SS or VA income

Intermediate objective #3: Review household expenses and create a budget so Robert has as much discretionary income as possible for rent.

*All SSVF participants should have this goal

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Robert’s Initial Plan (cont.)

Action Steps*: 1.Robert and case manager will meet at Housing Inc. office on Tuesday, November 1 at 1:00 to create a housing search plan.

2.Robert will bring to the meeting a first draft of a monthly budget for his essential expenses to discuss how much rent he can pay.

3.Case manager will have newspaper and electronic ads for vacant units at the meeting and Robert will select three or more apartments that appear suitable.

*These will be updated frequently—probably at every meeting with the participant.

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Robert’s Initial Plan (cont.)

4. With Robert’s consent, case manager will immediately call landlord/caretaker(s) for the listings Robert selects -- to discuss apartment availability and their tenant screening process.

5. If the landlord/caretaker is willing to consider Robert, the case manager and Robert will set (an) appointment(s) to see the unit(s) as soon as possible.

6. By Friday, November 4, the case manager will also contact landlords who have provided housing to other SSVF participants with high barriers, to see if they have a vacant unit and would be willing to consider Robert as a tenant.

7. Robert and case manager will meet again at Housing, Inc. on Wednesday, November 9 at 2:30 to review appointments and landlord reactions, a revised household budget, and next steps.

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Robert’s Second Plan

Goal: Permanent Housing

Intermediate objective #1: Shared housing, with Robert contributing toward host’s expenses.*



*revised

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Robert’s Second Plan (cont.)

Action Steps*:1.Robert will visit his sister (by Monday, November 14) and talk to her about the possibility of moving into her home. He would offer to continue to provide care for her (as he does now) and would also share household chores and expenses.

2.If his sister is willing to allow him to share housing, Robert will contact his parole officer (by November 14) to get approval for relocating to his sister’s home.

3.Robert will continue to write down everything he spends, every day, so he knows where his money is going. This would include money spent on gas for his car, cigarettes and beer, etc.

*all are new—reflecting progress toward some objectives and changes in others

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Robert’s Second Plan (cont.)

4.Before leaving the office, Robert will sign Medical Release/Consent Forms so Housing Inc. can refer him to VA for review of his benefits.

5.Robert and the case manager will meet Tuesday, November 15 at 2:30 to talk about what he learned from his sister and the parole officer.

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Robert’s Third Plan

Goal: Permanent Housing

Intermediate objective #1: Shared property, with Robert contributing toward host’s expenses.*



*Objective hasn’t really changed, but Robert is now looking at a different host and a different living arrangement!

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Robert’s Third Plan (cont.)

Action Steps*:1.Robert and case manager will meet with Robert’s brother (William) to discuss ground rules for sharing the property, including utility costs, yard work, use of laundry, etc.2.Robert and case manager will search for a mobile home that is within Robert’s budget and is suitable for William’s property.3.William will assist with transporting the mobile home, tie downs and utility hookups. *all are new—reflecting progress toward some objectives and changes in others

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THANKS FOR PARTICIPATING IN THIS WEBINAR!

This PowerPoint will be posted on VA’s SSVF Website:

www.va.gov/homeless/ssvf.asp

Next month’s national call:

February 16, 2012

2:00pm – 4:00pm

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Documents

Supportive Services for Veteran Families (SSVF) Webinar Series Developing a Reasonable Plan for SSVF Veteran Families January 19, 2012