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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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2014 Gaps and Needs Analysis 2
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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2014 Gaps and Needs Analysis 4
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
Emergency Shelter PIT
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2014 Gaps and Needs Analysis 5
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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2014 Gaps and Needs Analysis 6
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
Permanent Housing PIT
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2014 Gaps and Needs Analysis 7
Snapshot #1
423
373
435
350
400
450
500
550
600
41244 41275 41306
Emergency Shelter PIT
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
Permanent Housing PIT
Permanent Housing PIT
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2014 Gaps and Needs Analysis 8
Snapshot #2
454
511
587
350
400
450
500
550
600
41487 41518 41548
Emergency Shelter PIT
Emergency Shelter PIT
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
Permanent Housing PIT
Permanent Housing PIT
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2014 Gaps and Needs Analysis 9
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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2014 Gaps and Needs Analysis 10
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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2014 Gaps and Needs Analysis 11
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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2014 Gaps and Needs Analysis 12
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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2014 Gaps and Needs Analysis 13
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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2014 Gaps and Needs Analysis 16
14%
86%
0%0%
Gender (Adults in Families)
Male Female Transgender Other
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45%55%
0%0%
Gender (Unaccompanied Children)
Male Female Transgender Other
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51%49%
0%0%
Gender (Children in Families)
Male Female Transgender Other
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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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2014 Gaps and Needs Analysis 24
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
Non-Hispanic/Non-Latino Hispanic/Latino
Don't Know/Refused Information Missing
96%
4%
Onondaga County
Non-Hispanic/Non-Latino Hispanic/Latino
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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.
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