Gaps and Needs Analysis Final 12-17-2013

8/13/2019 Gaps and Needs Analysis Final 12-17-2013

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2014 Gaps and Needs Analysis 1

Housing Homeless Coalition Onondaga CountyGaps and Needs Assessment 2013

Nathan Rauscher, LMSW, CASACSyracuse Behavioral Healthcare


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Table of ContentsContent PageHMIS 2013 Utilization 3-8HMIS Yearly Comparisons (2011, 2012, 2013) 9-13HMIS 2013 Demographics 14-30HMIS 2013 Onondaga County Community Health Assessment Comparison 31-362012 Gaps and Needs Client Survey 37Conclusion and Recommendations 38-41


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Year-To-Date Utilization Count(November 2012 November 2013)

Emergency Shelters

Transitional HousingPermanent Housing


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Between November 1, 2012 and November 1, 2013, there has been an increase of 181 homeless individuals receiving Emergency Shelterservices 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)

392

423

373

435

413 422

443

391

439

454

511

587

573

350

400

450

500

550

600

Emergency Shelter PIT



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Between November 1, 2012 and November 1, 2013, there has been an increase of 9 homeless individuals receiving Transitional HousingServices in Onondaga County (2.9%)

The lowest homeless population count receiving Transitional Housing Services occurred on April 1, 2013, and the largest population onFebruary 1, 2013 (a difference of +17 homeless individuals)

310

320

311

326

313

309 309

319

316317

323

317

319

300

305

310

315

320

325

330

Transitional Housing PIT

Transitional Housing PIT


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Between November 1, 2012 and November 1, 2013, there has been an increase of 72 homeless individuals receiving Permanent HousingServices in Onondaga County (7.4%)

The lowest homeless population count receiving Permanent Housing Services occurred on December 1, 2012, and the largest populationon September 1, 2013 (a difference of +86 homeless individuals)

971968

989

1007

1023

1038 1037

1043

1036

1049

1054

1049

1043

950

970

990

1010

1030

1050

1070

Permanent Housing PIT



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Snapshot #1

423

373

435

350

400

450

500

550

600

41244 41275 41306


Emergency Shelter PIT Between February 1, 2013

and August 1, 2013, the

Sheltered Homeless

population began to stabilize.

(beginning at 435 individuals

and ending at 454a change

in 19 homeless individualsover a six month period).

However, one month later,

even with the continued

increase in Permanent

Housing units, the Sheltered

Homeless population jumpedhigher than it had been before

the increase in units (increase

in 62 homeless)

968

989

1007

950

960

970

980

990

1000

1010

41244 41275 41306




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Snapshot #2

454

511

587

350

400

450

500

550

600

41487 41518 41548



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 muchof 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 populationagain spiked, with the

population jumping 29% over

the two month period (increase

of 133 homeless individuals)

1049

1054

1049

950

970

990

1010

1030

1050

1070

41487 41518 41548




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Year-To-Year ComparisonHMIS APR Reports

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


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2750

2800

2850

2900

2950

3000

3050

3100

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Total Serviced Clients

Total Serviced Clients


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Total Serviced Clients (Adult and Child Breakdown)

Over the past three years, the number of homeless adults receiving services (according to HMIS) has been stable, increasing by only one:o 2010/20112207o 2011/20122272o 2012/20132208

In contrast, the number of homeless children served during the same time period has been gradually increasing:o 2010/2011676o 2011/2012738o 2012/2013870o Since 2010, the homeless child population shows an increase of 28.7% (194 children)

2000

2200

2400

2600

2800

3000

3200

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Adults Children


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Three Year Comparison

Singles vs. Adults

1650

1700

1750

1800

1850

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Single Adults

Single Adults

350

370

390

410

430

450

470

490

510

530

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Adults in Families

Adults in Families

52

54

56

58

60

62

64

66

68

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Unaccompanied Children

Unaccompanied Children

600

650

700

750

800

850

11/1/2010-11/1/2011 11/1/2011-11/1/2012 11/1/2012-11/1/2013

Children in Families

Children in Families


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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 twoindividuals 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 110adults, 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%).


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

GenderAge

Race/EthnicityDomestic Violence History

Veteran StatusDisabling Conditions

Cash-Income Resources


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62%

38%

0%0%

Gender (Single Adults)

Male Female Transgender Other


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14%

86%

0%0%

Gender (Adults in Families)



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45%55%

0%0%

Gender (Unaccompanied Children)



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51%49%

0%0%

Gender (Children in Families)



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0

100

200

300

400

500

600

700

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

Age

Age


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90%

10% 0%0%

Ethnicity

Non-Hispanic/Non-Latino Hispanic/Latino

Don't Know/Refused Information Missing


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43%

48%

0%

1%0%

8%

0%Race

WhiteBlack/African American

AsianAmerican Indian/Alaska NativeNative Hawaiian/Pacific IslanderMultiple RacesDon't Know/RefusedInformation missing


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31%

7%

8%

38%

3% 13%

If "yes", when

Domestive Violence

last occured

Less Than 3 Months Ago

3-6 Months Ago6-12 Months Ago

12+ Months Ago

Don't Know/Refused

Information Missing

25%

74%

0%

1%

Domestic

Violence History

Yes No Don't Know Refused


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9%

90%

0%

1%Veteran Status

Veteran Not a Veteran Don't Know Refused


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0

5

10

15

20

25

30

35

40

Mental Illness Alcohol Abuse Drug Abuse Chronic Health

Condition

HIV/AIDS Developmental

Disability

Physical Disability

Disabilities Among Total Homeless Population (3080 Total Clients)

Disabilities Among Total Homeless Population (3080 Total Clients)

In Percent (%)


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41%

25%

17%

17%

34%

Number of Disorders

None 1 Condition 2 Conditions 3+ Conditions

Co-OccurringDisorders


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516

80

50

245 258

417

239

122

90

44

94

3

50

0

100

200

300

400

500

600

Monthly Cash Income

Monthly Cash Income


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Employment Rate (Adults Only) = 16.6(Total with Earned Income / Total Adults at Follow-Up/Discharge)

0

100

200

300

400

500

600

700

685

436 417382

319

9059

28 26 21 11 7 2 246

Cash Income Sources (At Follow-Up/Discharge)

SSI General Assistance (PA) SSDI Earned Income TANF/Equivalent

Child Support Unemployment Insurance Veteran's Disability Veteran's Pension Retirement (SS)

Worker's Comp Pension Private Disability Alimony Other Sources


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0

200

400

600

800

1000

1200

1400

1600

1800

1608

1387

146 117 108 65 6 5 4 2 1 38

1025

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

SNAP MEDICAID MEDICARE

VA Medical WIC Section 8, Public Housing, Rental Assistance

Temporary Rental Assistance TANF Child Care Other TANF

State Children's Health Insurance TANF Transportation Other Sources

None


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0

100

200

300

400

500

600

700

800

900

1000

Less Than 30

Days

31-60 Days 61-180 Days 181-365 Days 1-2 Years 2-3 Years 3-4 Years 4-5 Years 5+ Years

808

117

223

166111

13 17 11 12

124

75

251

174

228

94 70104

482

Length of Stay

Leavers Stayers


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HMIS / County Report Comparison(As taken from Onondaga County Community Health Assessment)

Race/Ethnicity

Domestic Violence HistoryVeteran Status

Disabling ConditionsCash-Income Resources


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

HMIS):

43%

48%

0%1%0%

8%0%

White

Black/African American

Asian

American Indian/Alaska Native

Native Hawaiian/Pacific Islander

Multiple Races

Don't Know/Refused

82%

11%

3%1%

1%

2%

White

Black/African American

Asian

American Indian/Alaska Native

Other Race

Multiple Races

Onondaga County Community Health AssessmentHMIS


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

HMIS):

90%

10% 0%

0%

HMIS


Don't Know/Refused Information Missing

96%

4%

Onondaga County



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

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.

0

10

20

30

40

50

60

70

80

Less Than $10,000 a Year $10,000-$24,999 25,000+

Chart Title

Onondaga County HMIS


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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.


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Mental Health and Substance AbuseAccording 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.


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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


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ConclusionThe 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

notaddressing the other concerns will only lead to continued recidivism.


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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. Inorder 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 onlybe the start. This individual will need assistance finding and maintaining mental healthand substance abuse treatment. Once this has been stabilized, other avenues (such as employment) can be

addressed. Just placing the individual in housing and expectinga 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%)


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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


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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 isturn-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, non-

supportive, 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 thehomeless population how to maintain their housing whilegiving them housing, the upward trend of homelessness inOnondaga County will change.

Gaps and Needs Analysis Final 12-17-2013

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