Author: Housing First ATX

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People

Impact of Housing First

The beauty of the Housing First model is that, along with housing, residents receive the supports they need to begin a path towards health and well-being. In the graph below, you can see the comparison of utilization of health and justice services for individuals who live at Terrace – 6 months prior to moving in compared with 6 months after moving into a home. We know from experience that this is just the beginning of the journey for Terrace residents and that they will continue to reduce utilization of emergency health services and engagement with law enforcement the longer they are in housing.

Homelessness is expensive for the community. The table below shows the cost of homelessness prior to housing and post housing. An average unit cost was used to estimate reduced cost by category.

We also compared the individuals living in Terrace with the next 50 individuals who are waiting for permanent supportive housing. In the graph below, the individuals waiting for housing are purple and the people living in Terrace are green.

We are truly grateful for your support of this endeavor, and we thank you for following our journey, from groundbreaking through construction to our ribbon cutting to supporting our residents. The opening of Terrace at Oak Springs is the culmination of years of tireless work and advocacy – from Integral Care staff, elected officials, community foundations, business leaders, and neighbors.

We know that Terrace is just the first apartment community of its kind in Central Texas and will be a catalyst in our efforts to create and improve access to affordable housing.

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People

Podcast

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People

Interview with a resident

Take a listen to Integral Care’s most recent podcast. Many donors across the community came together to make Terrace at Oak Springs a reality. The podcast details the tremendous effort to open the community (made possible in part by Foundation funding), as well as one resident’s emotional journey of going from homeless to housed.

#strongertogether #HousingFirst #endinghomelessness

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People

Ribbon Cutting

On Monday, September 23, 2019, we celebrated Terrace at Oak Springs with a Ribbon Cutting Ceremony and a Community Celebration. 
At the Ribbon Cutting, we had the honor of unveiling our new permanent supportive housing community to 250 guests, a true testament to our community’s support of Housing First.

Our distinguished guests included Mayor Steve Adler; Council Member Natasha Harper-Madison; Trina Ita, Associate Commissioner of Behavioral Health Services at HHSC; Kurt Bruckbauer, Chief of Social Work Service at Central Texas Veterans Health Care System; and William Buster, Executive Vice President of Investments at St. David’s Foundation. 

Later that evening, more than 90 neighbors, community members, and exhibitors joined at our Community Celebration.

We are truly grateful for your support of this endeavor, and we thank you for following our journey, from groundbreaking through construction to our ribbon cutting. The opening of Terrace at Oak Springs is the culmination of years of tireless work and advocacy – from Integral Care staff, elected officials, community foundations, business leaders, and neighbors. 

We know that Terrace is just the first apartment community of its kind in Central Texas and will be a catalyst in our efforts to create and improve access to affordable housing.

Photos of Ribbon cutting

Photos of Community Event

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Partners

Leadership in Housing

Leadership in Housing

Despite the capital city’s continued economic growth, many Austin residents are feeling the pinch of an increasingly unaffordable housing market. From 2010 to 2017, metro Austin’s population grew by an average of 55,500 people per year, pushing the housing market occupancy rate to 98 percent. Austin’s lack of affordable housing has a direct impact on housing instability and homelessness—which has risen 5% each of the last three years—and disproportionately affects people of color and other marginalized communities. The Austin Strategic Housing Blueprint states that between 2018 and 2027, the city needs approximately 60,000 new or preserved residential units for households earning 80% or less of median family income and an additional 75,000 units for households earning above that threshold.

Council Member Ann Kitchen

Faced with these challenges, elected officials, government agencies, and community organizations are working together to ensure that everyone in Austin can afford a home that meets their needs. “Austin is a great city.  No person should have to live under a bridge, in a creek bed, or in a car,” said City Council Member Ann Kitchen, who serves as the Vice Chair of the Housing & Community Development Committee. Kitchen, an attorney and health care consultant by profession, recognizes the significance of housing as a health intervention and has worked tirelessly to end homelessness in our community since her election to Council. “We know we must provide people the services and caring support necessary to help them stabilize their lives and create a path to permanent housing.  Not only is it the financially wise thing to do, but more importantly it is the right thing to do, what we must do,” said Kitchen.  

Adrienne Sturrup, Assistant Director of Health Equity and Community Engagement at Austin Public Health

Austin Public Health, which funds contracts with nonprofits to provide prevention, outreach, rapid rehousing, and permanent supportive housing, also has been encouraged by recent developments in the housing space. “City leadership recognizes the importance of this issue,” said Adrienne Sturrup, Assistant Director of Health Equity and Community Engagement at Austin Public Health. “This is a good opportunity to figure out what’s next for housing. The equity piece is at the forefront, and our response will be thoughtful and intentional. We’re approaching this in the right way,” said Sturrup. With years of experience in direct service provision, Sturrup has a keen understanding of the challenges community organizations face in delivering services. For Sturrup, empathy is key to forming strong partnerships between the city and providers—especially as they work together to serve individuals who need additional supports to remain successfully housed.

“We’re very lucky in our community to have multiple organizations that do permanent supportive housing and provide wraparound services that help people lead healthy lives,” said Vella Karman, Social Services Policy Unit Manager at Austin Public Health. Karman explained that permanent supportive housing has long been a city priority, with City Council pushing forward several resolutions over the last few years. “Permanent supportive housing is an important intervention for many members of our community and offers ongoing support for people with multiple chronic conditions who wouldn’t be able to maintain housing otherwise,” said Karman. One of Austin Community 10-Year Affordable Housing Goals includes building or preserving 20,000 housing units specifically for individuals at 30% MFI or below, including permanent supportive housing.

Vella Karman, Social Services Policy Unit Manager at Austin Public Health

Fortunately, there is ample community buy-in to support affordable housing initiatives, including permanent supportive housing, and it’s showing at the polls. According to Karman, the community is starting to understand some of the barriers—such as chronic health conditions or criminal justice involvement—that people have to overcome to secure housing. This past November, Austinites overwhelmingly voted in favor of a $250 million affordable housing bond, with 73% of voters saying yes to Proposition A. “The bond approved by the voters is exciting,” said Karman. With the backing of Austin residents and committed city leadership, Austin is poised to address affordable housing in a way that takes into account the unique challenges facing our community. 

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Partners

Collaborators in Care at Community First! Village

At the Topfer Family Health Center, Integral Care and CommUnityCare Clinic work together to provide behavioral and primary health care for more than 200 residents of Community First! Village, a permanent supportive housing community. Check out our blog to learn more about our collaboration and the future of integrated care at Community First! Village.

As Mobile Loaves & Fishes expanded from delivering food to individuals experiencing homelessness to creating a permanent supportive housing community at Community First! Village, the organization was guided by one foundational principle: housing will never solve homelessness, but community will. Community First! Village is home to more than 200 individuals who formerly experienced chronic homelessness. In addition to housing, these residents have access to gardens, an art studio, an outdoor movie theater, an onsite medical facility, and various other resources to build their health and well-being. This innovative residential program is supported by a wide variety of nonprofits, businesses, volunteers, and community members, all of whom are helping to build community onsite.  

“The organizations providing services here are brought together by shared love for our neighbors,” said Amber Fogarty, President and Chief Goodness Officer of Mobile Loaves & Fishes. For Fogarty, developing strong partnerships was key to providing residents with the services and resources they need. “We know our neighbors well, but we aren’t experts in everything that they need. We have amazing organizations in our community that already do those things.” When they were living on the streets, these individuals often could not access one crucial resource: health care. 

Amber Fogarty, President & Chief Goodness Officer, Mobile Loaves and Fishes

According to Fogarty, offering onsite health care was a priority from the community’s inception, as many individuals experiencing homelessness also have significant medical and mental health needs. “We want to provide the best care possible for our neighbors,” she said, which includes ensuring access to behavioral health and primary health care in one convenient, easily accessible location.  To meet this need, Community First! Village partnered with Integral Care and CommUnityCare to deliver behavioral and primary health care at the Topfer Family Health Resource Center, an onsite medical facility.  Integral Care has an onsite team of mental health professionals available five days a week.  CommUnityCare’s mobile team is available onsite twice a week to work hand in hand with the Integral Care team in addressing medical and mental health care issues. The same staff members are available each week to ensure continuity of care for residents.

Jaeson Fournier, Chief Executive Officer of CommUnityCare, stressed the importance of this collaborative work. While the two organizations currently co-locate and work in coordination, he believes that there is an opportunity to advance integrated care at Community First! Village. “We have been working to develop a model of care with a much greater level of integration,” Fournier said. “We are distinct entities, but that should mostly be behind the scenes. To a patient, we should really be serving as one team.” For a population with high-intensity needs, such as the residents of Community First! Village, fully integrated care is critical. Over the next few years, Mobile Loaves & Fishes will expand Community First! Village to provide additional housing and resources for individuals transitioning out of homelessness. During Phase II of development, the organization will also open a new onsite clinic that will increase its current healthcare offerings. At this new, 10,000 square foot facility, Integral Care and CommUnityCare will partner to deliver fully integrated care not only to residents, but they will also provide services to the surrounding neighborhood.

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Meet the Team

Meet Audrey Kuang, MD, Internal Medicine Physician & Clinical Lead at ARCH/Mobile/Street

We recently met with Audrey Kuang, a physician and the clinical lead for CommUnity Care’s ARCH/Mobile/Street clinic. The clinic provides full-service primary care to patients at the Austin Resource Center for the Homeless (ARCH). They have a mobile team that provides on-site medical care at several community locations and a street medicine team that provides care to those staying at encampments, bridge underpasses, and anywhere that care is needed.

Audrey is also the Associate Director of Community Engagement and Health Equity at CommUnityCare and Assistant Professor in Department of Population Health and Internal Medicine at Dell Medical School.

 

What are your thoughts on the Housing First model? Why do you believe in it?

Without housing, you can’t do health. Housing is absolutely fundamental to a person’s wellbeing.

As a medical provider, so many medical problems we see are directly related to the absence of housing.

  • We see back problems that result from carrying a 50-pound backpack all day, which is exacerbated by sleeping on concrete.
  • We see foot ulcers from being on their feet all day that progress to leg amputations because these cannot heal on the streets.
  • We see poorly controlled diabetics who then develop kidney failure and blindness because of the difficulty in taking medications while living on the streets. As a doctor, we spend so much of our training learning about physiology, pathology of disease and the appropriate treatments and drugs needed. At the end of the day, housing is what my patients need most.

 

Tell us what guides your work providing primary health care to the homeless.

The healthcare system has many assumptions- that patients have a phone, transportation, access to food, a home and that they can advocate for themselves. For individuals suffering from homeless, every aspect of medical care is a challenge. Therefore my goal is to offer medical care that is easy to access with as few barriers as possible.

  • Our shelter clinic is a one stop shop where many needs can be addressed. Not only do we provide medical (acute, chronic and preventative) care, but also offer mental health services, assistance with things like transportation, medications, food stamps, vision vouchers and insurance.
  • We engage our patients where they are staying, rather than waiting for them to come to us through our mobile and street teams.
  • We strive to create a safe and welcoming environment where our patients feel respected, heard, and their priorities and preferences are incorporated into the treatment plan.
  • We believe in community collaboration and are fortunate to partner with Integral Care and Austin Travis County EMS Community Health Paramedics who bring healthcare for the homeless to a whole new level.

 

What’s your background that made you want to work with this population?

One of my first jobs was working as a hospitalist. I quickly started to see the revolving door of the hospital for my homeless patients who would come back to the hospital days to weeks later because they couldn’t take care of their wounds, they couldn’t afford the medications, and they were unable to make it to their follow up appointment. It was then that I helped start the Santa Clara County Medical Respite Program which gave homeless individuals a safe and clean place to heal after an acute hospitalization, while addressing mental health needs, substance abuse issues, and working on benefits and housing. Working alongside our social worker,  nurse, psychiatrist, community health worker and addiction specialists, affirmed my belief in the importance of integrated, team-based, holistic care. I am hoping to start a program like this in Austin someday.

I believe all lives are of equal worth, yet not everyone gets equal treatment. To me, this truth is unacceptable. As the wealth gap grows, so does the health gap. I make it my mission to change that.

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Meet the Team

Meet the Staff: Darilynn Cardona-Beiler

We recently met with Darilynn Cardona-Beiler, Director of Adult Behavioral Health Systems at Integral Care, to learn about her experience with and passion for Housing First.

 

Why are you passionate about Housing First?

It’s very simple – I’ve seen it work. Housing is at the core of health and well-being. Housing First is the solution to homelessness and it serves as a platform from which an individual can pursue personal goals and improve their quality of life. When you don’t have a home, there are very few opportunities to achieve a state of well-being. One of the things that makes me very passionate about Housing First is the philosophy of treating people with unconditional positive regard in contrast to traditional homeless programs that insist on preconditions such as sobriety or psychiatric care and moving through steps to have a home. Individuals don’t have to earn their housing. Once someone is housed and achieves stability, it creates a positive ripple effect that impacts their lives and the lives of those around them.

 

Can you tell us about your involvement with Housing First in Ohio?

I’ve been involved in the provision of homeless services since 1997 and have been involved with the development of Housing First since 2000. I was part of a team in Cleveland who was charged with the implementation of Housing First in Cleveland. While I was there, we built the first Housing First program that created the energy to bring stakeholders together to create more housing opportunities for people with disabilities. The Housing First Initiative has been successful. As it stands now, Housing First has implemented 518 apartments for singles and over 100 apartments for young adults and families with histories of long-term homelessness and disabilities.  While I was there, I was part of the development of 6 of those properties and the creation of 378 units of permanent supported housing.

 

What excites you most about bringing Housing First to Austin?

I am passionate about Housing First because this model is effective in changing people’s lives. Housing first is not housing only. It is housing with supports. There’s nothing I want to do more than ending homelessness in our community.  It’s unfortunate to see how many people in Austin don’t have a safe place to call home.  Integral Care’s Housing First Oak Springs project will stand as an example in our community to develop more housing opportunities for people with mental illness. In the same way that the first project in Cleveland created momentum, I’m excited to see how Housing First Oak Springs will stand as that building that will energize the community behind this initiative.

 

What else would you like readers to know?

I feel honored to be part of an amazing team that has embraced and supported the Housing First philosophy. Most importantly, I am really inspired by the strength of the people we serve. We currently have over 450 individuals in housing, but last year, Integral Care served 3,000 individuals experiencing homelessness, which means we have work to do!

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Meet the Team

Meet the Staff: Stephanie Dziuk

We recently met with Stephanie Dziuk, who works on the Assertive Community Treatment (ACT) team. This program provides treatment, rehabilitation and mental health support services to adults living with mental illness and substance use disorder who have experienced multiple hospitalizations. Some of these clients are formerly homeless individuals. Services include: 24-hour crisis support, counseling, medication management and fills, housing support, nursing services, help managing symptoms, social skills building, and community living and job skills training. Services can be provided in the community or at the client’s home.

Tell us about your role at Integral Care.

I work on the ACT team. I am pursuing my LPCI (Licensed Professional Counselor Internship) and have to collect 3,000 hours before I can become fully licensed. On Mondays, I hold individual counseling with four different people, which is mostly trauma counseling. I also facilitate the Social Skills Group with another one of my teammates. Every Wednesday, we alternate between serving clients in the community and practicing our skills as a group in the office. Clients come to me for individual counseling or I meet them in their homes.

What do you like most about your job?

The population of people served by ACT team are typically marginalized.  A genuine human connection can mean the world to them. I enjoy that I am able to help clients feel like they are important and that they matter.

What made you want to work with this population?

I felt drawn to this population early in life.  I was taking speech class through a community college and we had to do a group presentation.  I chose the topic of mental illness and fell in love with the idea of working with the types of individuals we serve.

Describe about an impactful experience you have had here.

A year ago, one of the individuals that I work with weekly was in distress. She required repeat hospitalization. She didn’t go in very often, but when she did, it was really challenging for her. We’ve been working together for about 7 months. She is going to be graduating from the ACT team to a less intensive level of care soon. She communicates with family members and other people whereas before, she would isolate in her apartment. But now she socializes. She wants to use her lived experience with depression to reach out and help others who are struggling. Seeing true success in this field is amazing.

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Meet the Team

Meet the Staff: Kristi Kaiser

We recently met with Kristi Kaiser, Program Manager II with the Healthy Community Collaborative.

Tell us about your role at Integral Care.

I am a Program Manager with the Healthy Community Collaborative team.  Our program works to expand services to individuals experiencing mental illness and homelessness.  I manage a team of nine at Community First! Village—a supportive housing community in East Austin with unique dwellings for the individuals who were chronically homeless.  I am responsible for overseeing operations at Integral Care’s on-site clinic, The Topfer Family Health Resource Center.  On a day to day basis, I coordinate the interested resident prioritization list, interface with community partners, and work with our mental health experts in our clinic. I also maintain a relationship with Mobile Loaves and Fishes, the ministry that developed the community and serves as Resident Care and Property Management.

What are some opportunities you see in your position?

I am fortunate enough to be part of a larger team that values and honors flexibility and thinking outside of the box in order to best meet the needs of our clients.  As the census grows at Community First! Village, my team has been able to expand and includes mental health case management, Peer Support services, as well as medical and administrative staff.  In the future, I can imagine growing our capacity for outreach as well as potentially bringing DBT, WRAP or skill building groups. We have been working to increase primary and specialty medical care, as well as develop a Health Risk Assessment that would allow us to track health outcomes for those transitioning from the streets into housing.

What do you enjoy most about your work?

I feel that one of my most fundamental functions is to build a team that likes each other and likes their job.  Because this was a new project, I was able to hire my team from the ground up, allowing me to be selective about bringing on staff who are dedicated to providing quality care to an otherwise underserved and often misunderstood population.  As a team, we have been able to play a part in transitioning 134 individuals into permanent housing from chronic homelessness.  It doesn’t get better than that!

Describe about an impactful experience you have had here.

Just recently, we were able to rehouse an individual at Community First! Village who had been evicted and incarcerated.  It was pretty rewarding to see how things came full circle for him, and how low-barrier entry allowed him to return to the community that he’s chosen as his permanent home.  He has since accessed residential substance use treatment, and is eager to continue taking advantage of the array of wrap around supports available to him at the Village.

Is there anything else you’d like people to know?

The Housing First model works! An individual is only able to start building stability once they have a safe place to call home.  People need this basic necessity before attending to things like getting a job, or managing their substance use.  This approach is universally appropriate for individuals or households experiencing any degree of service need—not to mention how cost effective this intervention is! Providing access to housing without pre-condition saves the community money, as housed people are less likely to utilize emergency services including hospitals and jails. Housing First is a win-win for all!