Housing Homeless Coalition Onondaga County Gaps and Needs Assessment 2013

Nathan Rauscher, LMSW, CASAC Syracuse Behavioral Healthcare

2014 Gaps and Needs Analysis 1

Table of Contents
Content
HMIS 2013 Utilization HMIS Yearly Comparisons (2011, 2012, 2013) HMIS 2013 Demographics HMIS 2013 Onondaga County Community Health Assessment Comparison

2012 Gaps and Needs Client Survey Conclusion and Recommendations

Page 3-8 9-13 14-30 31-36 37 38-41

2014 Gaps and Needs Analysis 2

Year-To-Date Utilization Count

(November 2012 November 2013)

Emergency Shelters Transitional Housing Permanent Housing

2014 Gaps and Needs Analysis 3

Emergency Shelter PIT

Emergency Shelter PIT 600

587
573 550

511 500

450 435 423 413 400 392 373 350 422

454 443 439

391

Between November 1, 2012 and November 1, 2013, there has been an increase of 181 homeless individuals receiving Emergency Shelter services in Onondaga County (46.2%) The lowest sheltered homeless population occurred on January 1, 2013, and the largest population on October 1, 2013 (a difference of +214 homeless individuals)

2014 Gaps and Needs Analysis 4

Transitional Housing PIT

Transitional Housing PIT 330

325

326 323

320

320

319 316 317 317

319

315

313
310 310 311 309 309

305

300

Between November 1, 2012 and November 1, 2013, there has been an increase of 9 homeless individuals receiving Transitional Housing Services in Onondaga County (2.9%) The lowest homeless population count receiving Transitional Housing Services occurred on April 1, 2013, and the largest population on February 1, 2013 (a difference of +17 homeless individuals)

2014 Gaps and Needs Analysis 5

Permanent Housing PIT

Permanent Housing PIT 1070

1050 1043 1038 1030 1023 1010 1037 1036

1054 1049 1049 1043

1007

990

989

970

971

968

950

Between November 1, 2012 and November 1, 2013, there has been an increase of 72 homeless individuals receiving Permanent Housing Services in Onondaga County (7.4%) The lowest homeless population count receiving Permanent Housing Services occurred on December 1, 2012, and the largest population on September 1, 2013 (a difference of +86 homeless individuals)

2014 Gaps and Needs Analysis 6

Snapshot #1
Emergency Shelter PIT
Emergency Shelter PIT 600

Permanent Housing PIT Between February 1, 2013 and August 1, 2013, the Sheltered Homeless population began to stabilize. (beginning at 435 individuals and ending at 454 a change in 19 homeless individuals over a six month period).
Permanent Housing PIT 1010 1007

550

1000

990

989

500

450 435 423 400

373 350 41244 41275 41306

However, one month later, even with the continued increase in Permanent Housing units, the Sheltered Homeless population jumped higher than it had been before the increase in units (increase in 62 homeless)

980

970 968

960

950

41244

41275

41306

2014 Gaps and Needs Analysis 7

Snapshot #2
Emergency Shelter PIT
Emergency Shelter PIT 600 587

550

511 500

When the initial increase of Single Occupancy Permanent Housing units available in Onondaga increased between December 1, 2012 and January 1, 2013, there was an initial reduction in the Sheltered Homeless Population (decrease in 50 homeless). During much of this time, the number of Permanent Housing units increased and stabilized as well. However, between August 1, 2013 and October 1, 2013, while the permanent housing utilization stabilized (+/-5), the sheltered homeless population again spiked, with the population jumping 29% over the two month period (increase of 133 homeless individuals)

Permanent Housing PIT

Permanent Housing PIT 1070

1054
1050

1049

1049

1030

1010

450

454

990

400

970

350 41487 41518 41548

950

41487

41518

41548

2014 Gaps and Needs Analysis 8

Year-To-Year Comparison
HMIS APR Reports

November 1, 2010 November 1, 2011 November 1, 2011 November 1, 2012 November 1, 2012 November 1, 2013

2014 Gaps and Needs Analysis 9

Total Serviced Clients

3100

3050

3000

2950

2900

2850

2800

2750 11/1/2010-11/1/2011 11/1/2011-11/1/2012 Total Serviced Clients 11/1/2012-11/1/2013

2014 Gaps and Needs Analysis 10

Total Serviced Clients (Adult and Child Breakdown)

3200

3000

2800

2600

2400

2200

2000 11/1/2010-11/1/2011 11/1/2011-11/1/2012 Adults Children 11/1/2012-11/1/2013

Over the past three years, the number of homeless adults receiving services (according to HMIS) has been stable, increasing by only one: o 2010/2011 2207 o 2011/2012 2272 o 2012/2013 2208 In contrast, the number of homeless children served during the same time period has been gradually increasing: o 2010/2011 676 o 2011/2012 738 o 2012/2013 870 o Since 2010, the homeless child population shows an increase of 28.7% (194 children)

2014 Gaps and Needs Analysis 11

Three Year Comparison Singles vs.

Single Adults
1850 530
510 1800 490 470 1750 450 430 410 1700 390 370 1650 11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013 350 11/1/2010-11/1/2011

Adults

Adults in Families

11/1/2011-11/1/2012

11/1/2012-11/1/2013

Single Adults

Adults in Families

Unaccompanied Children
68 66 64 62 60 58 56 54 52 11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013 600 700 650 800 750 850

Children in Families

11/1/2010-11/1/2011

11/1/2011-11/1/2012

11/1/2012-11/1/2013

Unaccompanied Children

Children in Families

2014 Gaps and Needs Analysis 12

Over the past three years, the total number of homeless served in Onondaga County has risen from 2885 to 3080 (an increase of 195 individuals). Looking deeper into the numbers shows a more startling trend. While the total individuals served shows an increase, the number of single adults has actually declined over the past three years (from 1808 in 2010/2011 to 1696 in 2012/2013, a decrease of 6.2%). In regard to unaccompanied children, while the total number of children decreased, and then increased again, there has only been an increase of two individuals since 2010. On the contrary, there has been a progressive rise in homeless families over the same time period. Since the end of 2010, the number of homeless adults in families has risen from 399 to 511 (increased by 110 adults, or 27.6%). In regard to homeless children in families, there has been a great increase of homelessness, with the population rising from 611 to 803 over the same time frame (increased by 192 children, or 31.4%).
2014 Gaps and Needs Analysis 13

Year-To-Date Demographics
(November 2012 November 2013)

Gender Age Race/Ethnicity Domestic Violence History Veteran Status Disabling Conditions Cash-Income Resources
2014 Gaps and Needs Analysis 14

Gender (Single Adults)

0% 38% 62%

Male

Female

Transgender

Other
2014 Gaps and Needs Analysis 15

Gender (Adults in Families)

0% 14%

86%

Male

Female

Transgender

Other
2014 Gaps and Needs Analysis 16

Gender (Unaccompanied Children)

0%
45% 55%

Male

Female

Transgender

Other
2014 Gaps and Needs Analysis 17

Gender (Children in Families)

0%

49%

51%

Male

Female

Transgender

Other
2014 Gaps and Needs Analysis 18

Age
700 600

500

400

300

200

100

0 Under 5 5-12 13-17 18-24 25-34 Age 35-44 45-54 55-61 62+

2014 Gaps and Needs Analysis 19

Ethnicity
10% 0%

90%

Non-Hispanic/Non-Latino Don't Know/Refused

Hispanic/Latino Information Missing

2014 Gaps and Needs Analysis 20

1% 0%

0%

Race
8%

0%

43% 48%

White Black/African American Asian American Indian/Alaska Native Native Hawaiian/Pacific Islander Multiple Races Don't Know/Refused Information missing
2014 Gaps and Needs Analysis 21

Domestic Violence History

1% 0%

If "yes", when Domestive Violence last occured

25%
74%

3%

13%

31% 7% 8%

38%

Less Than 3 Months Ago 3-6 Months Ago 6-12 Months Ago 12+ Months Ago Don't Know/Refused Yes No Don't Know Refused Information Missing
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Veteran Status
1% 0%

9%

90%

Veteran

Not a Veteran

Don't Know

Refused
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Disabilities Among Total Homeless Population (3080 Total Clients)

40

In Percent (%)
35

30

25

20

15

10

0 Mental Illness Alcohol Abuse Drug Abuse Chronic Health Condition HIV/AIDS Developmental Disability Physical Disability

Disabilities Among Total Homeless Population (3080 Total Clients)

2014 Gaps and Needs Analysis 24

Number of Disorders

25% 17% 34% Co-Occurring Disorders 17%

41%

None

1 Condition

2 Conditions

3+ Conditions
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Monthly Cash Income

600

500

516

400

417

300

245
200

258
239

122
100

80 50
0

90 44

94 50 3

Monthly Cash Income

2014 Gaps and Needs Analysis 26

Percent of Individuals Living Below NYS Poverty Standards (More Than $11,170 Yearly) - At Follow-Up/Discharge
0% 1%

33%

66%

Below Poverty Level

Above Poverty Level

Don't Know/Refused

Missing/No Follow-Up

In terms of this graphic, individuals making less than $1,000 a month are listed below poverty standards. Standards have been taken from: http://www.health.ny.gov/health_care/medicaid/publications/docs/gis/12ma009att.pdf
2014 Gaps and Needs Analysis 27

Cash Income Sources (At Follow-Up/Discharge)

700

600

500

400 685 300 436 200 417

382 319

100 90 0 59 28 26 21 11 46

SSI Child Support Worker's Comp

General Assistance (PA) Unemployment Insurance Pension

SSDI Veteran's Disability Private Disability

Earned Income Veteran's Pension Alimony

TANF/Equivalent Retirement (SS) Other Sources

Employment Rate (Adults Only) = 16.6% (Total with Earned Income / Total Adults at Follow-Up/Discharge)
2014 Gaps and Needs Analysis 28

Non-Cash Income Sources (At Follow-Up/Discharge)

1800 1600 1400 1200 1000 800 600 400 200 1608 1387 1025

146 0

117

108

65

38

SNAP VA Medical Temporary Rental Assistance

MEDICAID WIC TANF Child Care

MEDICARE Section 8, Public Housing, Rental Assistance Other TANF

State Children's Health Insurance

None

TANF Transportation

Other Sources

2014 Gaps and Needs Analysis 29

Length of Stay
1000 900 124

800

700

600

500 808 251 300 174 228 200 75 223 100 166 482

400

117
0 Less Than 30 Days 31-60 Days 61-180 Days 181-365 Days

111

94 13

70

104

17
3-4 Years

11
4-5 Years

12 5+ Years

1-2 Years

2-3 Years

Leavers

Stayers
2014 Gaps and Needs Analysis 30

HMIS / County Report Comparison

(As taken from Onondaga County Community Health Assessment)

Race/Ethnicity Domestic Violence History Veteran Status Disabling Conditions Cash-Income Resources

2014 Gaps and Needs Analysis 31

According to the Onondaga County Community Health Assessment, the following percentages represent the
differences in race characteristics between Onondaga County as a whole and the homeless population (through HMIS): HMIS Onondaga County Community Health Assessment

0% 1% 0% 48%

0% 8%

1% 3%

1%

2%

43%

11% 82%

White Black/African American Asian American Indian/Alaska Native Native Hawaiian/Pacific Islander Multiple Races Don't Know/Refused

White Black/African American Asian American Indian/Alaska Native Other Race Multiple Races

2014 Gaps and Needs Analysis 32

According to the Onondaga County Community Health Assessment, the following percentages represent the
differences in ethnicity characteristics between Onondaga County as a whole and the homeless population (through HMIS):

HMIS
0% 10% 0%

Onondaga County

4%

90%

96%

Non-Hispanic/Non-Latino Don't Know/Refused

Hispanic/Latino Information Missing Non-Hispanic/Non-Latino Hispanic/Latino

2014 Gaps and Needs Analysis 33

According to the Onondaga County Community Health Assessment, the following percentages represent the
differences in income status between Onondaga County as a whole and the homeless population (through HMIS): Chart Title

80 70 60 50 40 30 20 10 0 Less Than $10,000 a Year $10,000-$24,999 Onondaga County HMIS 25,000+

Please note HMIS measures monthly income ($0-$750, $751-$1000, $1001-$1250, etc.). In regard to this data, individuals making less that $750 a month ($9000 yearly) were included in the first column. $751 to $2000 a month ($9012-$24000 yearly) were included in the second column. Any individual making more than $24000 a year was included in the final column.

2014 Gaps and Needs Analysis 34

The following was included in the Onondaga County Community Health Assessment:

Among all residents, 14.7% had income in the last 12 months that was below the federal poverty level. Especially striking is the poverty rate among children in Syracuse, where 49.0% of those under age 18 live in poverty, compared to 21.0% of children in Onondaga County. Poverty rates for families can be seen in Figure 12. Poverty rates are consistently higher in Syracuse than in Onondaga County, peaking at 56.0% among femaleheaded households with related children under 18 years of age.
In comparison, 66% of all individuals receiving Homeless Services were below the poverty level, compared to 14% of the population of Onondaga County.

2014 Gaps and Needs Analysis 35

Mental Health and Substance Abuse

According to the Onondaga County Community Health Assessment, 17.4% of all adults of Onondaga County stated that they had 14 or more days of poor mental health in the past month. This is compared to more than 37% of all individuals receiving homeless services in Onondaga County. In addition, alcohol shows the closest correlation between the general population of Onondaga County and individuals receiving homeless services. 21.9% of adults in Onondaga County reported binge drinking in the last month, compared to 17.4% of individuals received homeless services stating they have an alcohol related disorder. There was very limited substance abuse information in the Onondaga County Community Health Assessment discussing only drug dependent babies and mothers testing positive for drugs upon delivery. This information will not be included in this assessment.

2014 Gaps and Needs Analysis 36

Gaps and Needs Client Survey (2012)

(Comparison with 2013 Information)
The following data was taken from the 2012 Gaps and Needs Client Survey: The top four most prevalent disabling conditions remained the same between 2012 and 2013 HMIS data (Mental Health, Drug Abuse, Alcohol Abuse, and Physical Disability) Employment status has dropped 21% reporting employment in 2012 compared to 16% employed (according to HMIS) in 2013 Focus Group Responses (2012) o Recurring responses to What is the major reason you became homeless or are having a housing crisis?: Addiction Mental Health Legal Issues Lack of Quality Affordable Housing Employment o Recurring responses to What services/entitlements are you receiving right now?: Financial (SSI, SSD) Non-Cash (SNAP, Transportation) Support Services (Case Management, Substance Abuse/Mental Health Treatment) o Recurring responses to What do you still need?: Affordable Housing Treatment (Mental Health, Substance Abuse, Physical Health) Employment Case Management o Recurring responses to What is keeping you from getting what you need?: Lack of Affordable Housing Support Mental Health / Substance Abuse
2014 Gaps and Needs Analysis 37

Conclusion
The following graphic was included in the 2013 Onondaga County Community Health Assessment and defines what is needed to promote better health related services in Onondaga County:

Improved health means to not only provide the medical and mental health care, but to also follow that with additional support and services needed to maintain the improved health. This same concept can be used to determine what can assist the homeless population of Onondaga County. In order to improve an individual or familys housing status, finding safe and affordable housing is only the beginning. Maintaining housing is where the bulk of the services need to come. For example, if an individual lost his job and thus his housing due to mental health concerns or substance use, placing the individual in low-income housing and not addressing the other concerns will only lead to continued recidivism.
2014 Gaps and Needs Analysis 38

Clients in Onondaga County become homeless for a variety of reasons whether it was the loss of employment, mental health stability, substance use, or any other reason. Providing the individual with low-income housing and no additional services is not solving the problem it only masks it. By placing an individual into housing without supporting, teaching, and encouraging an improved life style only sets the client up to fail. What if an employee at your agency continues to make the same documentation errors week after week and you, as the supervisor, follow them and edit their mistakes as they make them. You may be solving the problem, but you are masking the true issue that the employee has learned a way of working that is detrimental to their employment. In order to correct the problem is to teach the employee the correct way of documentation. Same can be said for housing stability. If you have a client that lost their housing due to mental health and substance use, finding them and placing them in low-income housing can only be the start. This individual will need assistance finding and maintaining mental health and substance abuse treatment. Once this has been stabilized, other avenues (such as employment) can be addressed. Just placing the individual in housing and expecting a change in behavior and outcomes without providing the additional services is unacceptable. In 2012, the Gaps and Needs survey shed light on how important follow-up services are for our clients: 57% clients stated that they are not ready to live independent from services The following services were needed by at least 10% of the clients served: o GED/Educational Training (12.2%) o Counseling (17.5%) o Budgeting (22.4%) o Cooking/Nutrition (10%) o Employment (25.9%) o Social Skills (12.6%) o Transportation (27.5%) o Section 8 Housing (36.3%) The following services over 30% of clients stated that they would be receiving in the next 12 months: o Counseling (34.4%) o Schooling (30%)
2014 Gaps and Needs Analysis 39

o Employment (35%) o Health/Medical (32.8%) o Mental Health (31%) Its apparent that the number of safe, secure, and healthy low-income housing will not be increasing to the level needed in this county, so in order to provide clients with the opportunity for a better future, the ability to maintain housing and improve their education/employment status needs to be addressed. I propose the following to serve as a blueprint for housing homeless services in Onondaga County:

Permanent Supportive Housing

Life Skills Education

Improved Health Care (Mental, Physical)

Budgeting and Financial Literacy

Sustainable Employment Permanent, Public Housing

2014 Gaps and Needs Analysis 40

The idea is that, in contrast to the term permanent, Permanent Supportive Housing should be viewed as a long term stabilization program. The individual could be in the program for six months, two years, or ten years, but the overall goal is to reach a level of self-sufficiency where the client can maintain their own apartment (whether it is turn-key or public housing). As stated above, 57% of clients stated that they could not live without their current program leaving 43% ready to leave services. For the purposes of this argument, lets say 25% are truly ready and able to exit supportive housing and live independently from services. As of November 1, 2013, there were 1043 individuals housed in permanent housing programs, with an additional 573 individuals in emergency shelters. If 25% of individuals in housing moved out (via turnkey or completion of the program) and entered their own apartments, this would make 260 apartments available, leading to almost half of the emergency shelter population becoming permanently housed. The lack of low-income affordable housing is an issue, however this is not what is being discussed. If the client becomes stabilized, and is able to find and maintain employment, low-income housing would not be an issue. According to the HMIS data, there are 94 individuals with a monthly income of $2000 and currently receiving services (taking into consideration of HUDs 30% rule, their rental amount would be $600 per month). Depending on their stability, these could be 94 individuals who could exit permanent housing programs and enter public, nonsupportive, permanent housing, in return, adding an additional 94 units for individuals in shelters. This potential solution cannot be utilized overnight. Clients will not stabilize tomorrow and obtain suitable, sustainable income sources by next week. However, if the focus shifts from providing an apartment to educating the homeless population how to maintain their housing while giving them housing, the upward trend of homelessness in Onondaga County will change.

2014 Gaps and Needs Analysis 41