There is hardly a population of people who face more barriers to securing affordable housing than those who live with severe mental illnesses, such as schizophrenia, bipolar disorder, clinical depression and psychosis.
So in 2015, when the Oregon Legislature created the first fund solely dedicated to building affordable housing for people who live with severe and persistent mental illnesses, both the housing and mental health community knew this could be a gamechanger.
“This is completely unprecedented,” said Chris Bouneff, executive director of Oregon’s chapter of the National Alliance for Mental Illness. “There have been dribbles here and there from the general fund. It sends a strong statement that this (housing) is important.”
But it hasn’t been easy.
The $20 million allocated this past year to Oregon Housing and Community Services was expected to create hundreds of new housing units designed to help people transition from commitment at Oregon State Hospital, recover from psychotic episodes, receive appropriate care and treatment and gain skills to live as independently as possible.
It is also the first time that OHCS and the Oregon Health Authority have partnered to create an application to fund housing development.
But OHCS, the state agency tasked with developing and preserving housing in the state, has allocated just a fraction of the money – $3.76 million of the $20 million available – due to funding requirements potential applicants found difficult to meet.
The process has been a learning experience on what exactly constitutes the best housing for people living with a mental illness.
A new application round is expected to open in January, and with the funding requirements changed, more mental health and housing providers will apply for the remaining $16.28 million. The money must be awarded by the end of June, the conclusion of the state budget biennium.
The $20 million will fund several types of housing. Supported housing applies to those with serious mental illnesses or substance use disorders, and staff are typically onsite at all hours. Residents are not required to participate in services that may be available through this housing. Supportive housing comes with various services, such as mental health counseling or skills training, that the resident is required to participate in. Crisis respite housing provides housing and psychiatric care to people experiencing a psychotic episode or acute mental illness for up to 30 days.
When the Legislature set aside the $20 million, one impetus was an agreement between the state of Oregon and the U.S. Department of Justice, reached in 2012 after a lengthy federal investigation into the conditions of the Oregon State Hospital. The state agreed to create and fund more community-based, rather than institutional, mental health treatment programs.
“There is a recognition that there is an obligation,” Bouneff said.
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“This is a very small percentage of the population – part of the 1 percent who have the most serious mental illnesses in our population,” said Bob Beckett, executive director of Columbia Care Services Inc., a mental health services provider in the Portland metro area, Medford and Southern Oregon.
“Most of them are just a step down from (living at) the Oregon State Hospital,” Beckett said. “I think you’d have to say that if they’re in the State Hospital, they’re not able manage their own illnesses.”
People with mental illness often have irregular and poor rental histories, criminal records and other issues that show up on a background check, making them poor candidates for rental housing in the eyes of many landlords.
“There is a short supply of affordable housing, then you layer these types of complications on top of that, and what you have available … is inaccessible to people with serious mental illnesses,” Bouneff said.
The first round of applications were reviewed in the fall, and five out of seven applicants received $6.2 million in funding in early November.
Shangri-La, a mental health services provider in Eugene, received $43,125 to fund two units of supported housing in an apartment complex. Luke-Dorf Inc. received $417,531, which makes up about a quarter of the budget needed to build a 15-unit apartment building in Portland’s Lents neighborhood, which will include four units of supported housing.
That there is such a small fraction of units reserved for people with mental illnesses is actually a requirement. Supported housing can make up no more than 25 percent of the units in a housing project.
“The Department of Justice had an issue with housing (that) clustered everyone who has a disability in one area,” Luke-Dorf Executive Director John Trinh said. “They want more scatter sites in the community.”
For rural communities, the housing and the investment is a breakthrough for people with mental health issues.
Columbia Care Services received $800,000 to fund two projects in Jackson County.
The Jackson Crisis Resolution Center will have 12 beds available for people who suffer an acute or psychotic episode. They may stay at the Resolution Center for up to 30 days. Beckett said it will be the only respite center of its kind in Jackson County and will divert people away from local hospitals or the Oregon State Hospital “to a facility that only does psychiatric care so that it can do it less expensively, but with the same quality.”
The second project, Swing Lane Supportive Housing, will be an eight-unit apartment building expected to open by the end of 2017. One unit will be reserved for staff, and the other seven will be reserved for people with mental illnesses who have been discharged from the Oregon State Hospital. There will be staff onsite all times of the day.
Swing Lane will be the first supportive housing building of its kind in Jackson County and, like the four units of housing Luke Dorf will operate, will offer a certain level of independence. Residents will live in their own apartments and will have a lease agreement with Columbia Care or Luke-Dorf. But they will receive daily support, mental health care, skills training and other supportive services as needed.
“We work with them to build their skills in terms of managing money, cooking, cleaning (and) shopping so they can move out on their own,” Trinh said.
The largest chunk of funding, $2.5 million, was given to Central City Concern, the Portland social service agency that provides health care, drug treatment and housing to help fund its Eastside Campus. The campus will be a six-story building, at Southeast 122nd Avenue and Burnside Street, which will include two floors of clinic space, modeled after the agency’s Old Town Clinic, as well as 175 units of housing for those in recuperative care or in recovery from an addiction. The campus is expected to open in 2018.
The Oregon Housing and Community Services agency had expected to receive more applications and award all of the $20 million. The small number of applications and the requirement by the Legislature that the $20 million be spent in this biennium had the agency scrambling in late fall to figure out what impeded providers from applying.
“The original (application) was too complex for applicants,” said Ariel Nelson, an Oregon Housing and Community Services spokesperson. “A lot of applicants were not familiar with OHCS’s application process.”
The agency is not where one might expect to turn for funding to build housing for mentally ill people, Bouneff said.
On the flip side, affordable housing developers were unfamiliar with requirements that mental health providers who build housing are used to in their funding applications, such as including a letter of support from the local mental health authority.
Oregon’s housing market also played a role in reducing applications. Increased property values have made it difficult for providers to buy vacant lots or buildings.
“It was not economically feasible,” Beckett said.
Columbia Care, Luke-Dorf and Central City Concern already owned their vacant lots and buildings when they applied for funding.
New application requirements were approved in mid-December, and OHCS expects to accept a second round of applications for the remaining $16.7 million in January.
In addition to simplifying the application, OHCS is also changing how much money an applicant can receive. In the first round of applications, the amount of funding a developer could receive was limited to 25 percent of the total project cost. That, Nelson said, was the biggest deterrent to applications; they could not necessarily prove that they had, or would receive, other funds to fully pay for the project.
Now, applicants can ask for a subsidy of up to $50,000 per unit of affordable housing. That, Bouneff said, is a method of funding that mental health providers are used to applying for.
OHCS will also host a training session and offer more technical assistance for potential applicants, essentially walking applicants through how to craft a persuasive application for funding.
Beckett described the application process for Swing Lane Supportive Housing and the Jackson Crisis Resolution Center as “difficult,” and he said he hoped the new application would be less restrictive.
Bouneff said the units that are already funded will “not make such a huge dent” in addressing the need to build affordable housing reserved for people with serious mental illnesses. The key, he said, will be continued funding for more construction.
“It’s clear if we put money behind it, it will have an impact,” he said.