*** DRAFT***
New Hampshire Governor’s
Interagency Council on Homelessness
ich.nhceh.org
Minutes
Legislative Office Building, Concord, New Hampshire
March 17, 2016
Council Members Present:
Cathy Kuhn (NH Coalition to End Homelessness) / Deborah Schachter (NH Charitable Foundation)Dominique A. Rust (NH Catholic Charities) / Elissa Margolin (Housing Action NH)
Helen Taft (Families First) / Joe Harding (Bureau of Drug and Alcohol Services)
Susan Fulton (Endowment for Health) / Maureen Beauregard (Families in Transition)
Melissa Hatfield (Bureau of Homeless & Housing Services) / Robert Mack (NH Local Welfare Administrators Association)
Terry R. Smith (Division of Family Assistance) / Lynda Thistle-Elliot (Department of Education)
Steve Duprey (Foxfire Property Management, Inc.) / Chris Ellms (for Harold Parker, Governor’s Office)
Sylvia Gale (At-Large Member)
Guests Present:
Nick Toumpas (Seacoast/ Strafford Integrated Delivery Network) / Julie Lane (Bureau of Homeless and Housing)Courtney Fontone (Family Promise of Greater Concord) / Erin Kelly (Child and Family Services)
Stephanie Savard (Families in Transition)
Absent:
Amanda Grady (NH Coalition Against Domestic and Sexual Violence) / Clare Chapman (NH Council of Churches)Dean J. Christon (NH Housing and Finance Authority) / Emily Reisine (VA Medical Center of Manchester)
Maureen Ryan (Department of Health and Human Services) / John Pelletier (Consumer Representative)
Michael McAlister (NH Department of Corrections) / Michele Harlan (Bureau of Behavioral Health Service)
Rep Steven Smith (NH House of Representatives)
I. Welcome and Introductions
· Meeting began at 9:05AM
II. Approval of Minutes from March Meeting:
VOTE:
· Steve Duprey motioned to approve the September NHICH meeting minutes.
· Maureen Beauregard seconded the motion.
· All approved; no opposition or abstentions.
III. Presentation: The Role of Medicaid in Providing Tenancy Supports for People Experiencing Homelessness- Stephanie Savard- FIT, Elissa Margolin- HANH
1. Stephanie Savard and Elissa Margolin gave a presentation on the role of Medicaid in providing tenancy supports for people experiencing homelessness.
2. Stephanie gave a background about Supportive Housing and its demonstrated success in in helping those coming out of homelessness to sustain housing and wellness.
a. Supportive Housing is an evidence based intervention that provides pre-tenancy support (tenant screening, housing search, and help with applications) and tenancy support (identifying early behaviors that might put housing at risk and creating a crisis support plan).
3. 1115 Waiver
a. Focuses on integration between behavioral health and healthcare
i. Studies dating back to the late 80’s in Texas have found that those who are not able to sustain housing suffer from health issues, which can increase the cost of healthcare.
ii. The solution is to help fund the cost of supportive housing programs as a preventative health care measure in order to save money in the long term.
iii. Stabilizing housing will create about $287,000 net savings at the state and federal levels.
4. New Hampshire Efforts
a. Early meetings were held with a number of supportive housing agencies to learn more about Medicaid, and where the opportunities and challenges were.
b. FIT and HANH partnered with the Corporation for Supportive Housing (CSH) to produce a Medicaid Crosswalk to help identify what exists in the NH state plan that would fit in to supportive housing. The Crosswalk found that there were small billable codes, but they need to be expanded.
c. CSH then produced a Business Case which matched HMIS and MMIS data to determine healthcare costs associated with the provision of services to individuals with co-occurring disorders and homelessness.
5. Next steps: Focus on partnering with the regional Integrated Delivery Networks (IDNs) to ideinfy how supportive housing fits in to each proposed project. It is possible to create pilots and evaluate the effectiveness of including supportive housing services into projects being pursued in each IDN.
6. Discussion opened up to the group for questions:
a. Maureen commented that because there is no identified source of funding to provide services, a number of resources to provide housing are being lost. With the Medicaid benefit, supportive housing providers would be able to leverage the resource to increase available housing stock for those with the greatest needs.
b. Melissa Hatfield added that if homeless providers could bill Medicaid for the support services, BHHS could then dedicate more money for rental assistance.
c. Helen Taft references an NPR report that showed for every dollar invested in supportive housing it would save $2 in medical costs.
d. Cathy reminded the group that one of the roles of the ICH is to bring forth and support specific policy recommendations that would enhance services to those who are homeless in NH.
IV. Presentation: Integrated Delivery Networks in New Hampshire- Nick Toumpas, Seacoast/Strafford Integrated Delivery Network
1. Nick opened up the presentation by asking if there were any key points that the group would like addressed by the briefing. Elissa wanted to hear how supportive housing fit into the projects that were happening in Nick’s region.
a. All the IDN’s meet twice monthly, and after reviewing the entire process across the state, discovered that although housing is an essential component none of the IDN’s had chosen supportive housing as a project.
2. Goals of the IDN:
a. Develop and deliver integrated care around the full needs of the individual.
b. Expand provider capacity
c. Reduce the gaps in care during key transitions
d. Move 50% of all Medicaid reimbursements to an alternative payment model by the end of the current waiver period (December 31, 2020)
3. Dominique Rust inquired about the distribution of funds for projects. Nick clarified that funds are earned by achieving certain process and performance metrics, with 80% being achieved through Workforce Development and Health Information Technology and 20% from other projects. However there is a difference in how the funds are earned and how they may be spent. Funds do not need to be spent based on the same percentages in which they are earned.
4. Challenges:
a. Organizations that don’t currently have relationships with each other need to create new relationships and learn each other’s languages. (ie. Mental health, substance use, primary care etc.)
b. Confidentiality - Creating comprehensive care plans that can be shared across systems of care.
c. Collection of data- In order to measure and quantify, there must be accurate data collection processes in place.
5. Next steps: Regions are developing detailed project and implementation plans by June 30, 2017.
6. Joe Harding asked about what Nick is doing in his region about developing additional capacity for substance abuse disorder treatment services. Nick explained that they are looking at the challenges and creating different models to explore, including peer and recovery supports.
7. Cathy asked if Nick has thought of specific ways to reach out to homeless and housing providers to make sure they are part of the discussion. Nick suggests having a champion within each area that can get involved. Melissa added that she surveyed Balance of State providers and discovered that there are providers involved at some level but that at the next COC meeting the focus could be on this topic. Nick has offered to sit in on the discussion on the next meeting and get involved with the discussion. Nick mentioned that it is possible for IDNs to provide stipends to agencies who are participating in the process to help them to cover expenses associated with the time commitment of active involvement.
V. Updates on Key Budget Items and Requests- Elissa Margolin, Housing Action New Hampshire
1. Homeless Housing Access fund- At the last General Council meeting, the ICH made a recommendation to increase the fund from $50,000 per year to $200,000. It was successfully brought to the Governor and added to the Governor’s budget. Advocacy to keep this increase in the budget is happening now.
2. Flat funding has been proposed in the Governor’s budget for homeless shelter funding that renews state contracts for those providing shelter services. The feedback from the Speaker was that although the house in the past has cut that fund by 50%, that was not the strategy they would use this year.
3. Affordable Housing Fund- NH is only 1 of 4 states in the nation that does not regularly fund its trust fund. There is an ask for $25 million dollar capital budget appropriation to the fund. The bill was amended to $5 million, coming out of committee 4-0 with positive recommendation, and then passed the senate 19-5. It is now tabled waiting for the capital budget to get to the Senate side.
VI. NH ICH Workgroup Updates:
· Medicaid:
o Would like to bring the discussion to workgroup about bringing Nick Toumpas or other to come in to talk specifically about the subjective of trying to integrate supportive housing in to the selected projects.
o Is planning to have a workgroup meeting ahead of the IDN June planning meeting.
· Unsheltered Homelessness:
o Focus has been on working with public housing authorities on strengthening relationships with homeless service providers. During the Executive Director meeting of the PHA, there was interest in learning about homeless services.
o After surveying continuum providers, it was discovered that most regions have existing informal partnerships. For example Keene has a moving to work/rapid rehousing program, and in Concord the Coalition to End Homelessness has funding to provide support services for individuals who are denied services due to a conviction.
o Discussed changing the focus of the group, brainstormed many ideas but decided to reconvene when the group had higher attendance to make a decision. Cathy added that originally the workgroups were intended to be short term, to accomplish specific objectives. She would like to have a discussion within the next 6 months with the chairs to discuss the mission of the workgroups.
· Employment:
o During the September ICH meeting the group supported the recommendation on moving forward with CLIF effect research and trying to get funding to do a NH supported CLIF Effect project to inform policy makers about the impact that the NH benefits structure can have on working families. The NHCEH submitted a proposal to HNH for funding. UNH Carsey Institute and the NH Fiscal Policy Institute are providing letters of support to use while pursuing additional funding for this project. The plan is to apply through the Endowment for Health, NH Charitable Foundation. There are also discussions to possibly approach the Commissioner about other possible funding sources.
o Education and Training- The group has discovered that although education and training programs exist in NH, the homeless population is often not able to get access to them. The group is working with 2-1-1 to identify how it may be able to enhance access to these services for those who are experiencing homelessness and/or housing instability.
o Transportation had previously been a tabled topic but the workgroup is looking at creating some goals surrounding transportation and employment.
VII. Council Membership
· Lisa Christie has retired and there is an open seat on the council. The administrative committee would like to put forth Martha Stone, the ED of Crossroads House.
o Helen Taft motioned to approve the recommendation for Martha Stone.
o Maureen Beauregard seconded the motion.
o All approved, no opposition or abstentions.
· There is an open seat for a business representative on the council, the council is accepting recommendations. Please contact Cathy Kuhn and she can help with the recruiting and nomination process.
· Cathy Kuhn’s term as ICH Council chair is ending. If there is someone who would either be interested in self-nominating or put someone forth, please do so. If not, Cathy would be willing to remain in the chair position. The vote for board chair will be at the September meeting.
VIII. House Keeping:
· Next meeting tentatively scheduled for September 15, 2017.
· All notes and handouts are posted on the NH ICH website at http://ich.nhceh.org/
IX. New Business/Public Announcements:
· Elissa Margolin introduced Housing Action NH’s new Engagement and Communication Manager Tom Derosa.
Adjourn:
Hearing no additional new business, Cathy asks for a motion to adjourn.
· Maureen Beauregard makes a motion to adjourn the meeting
· Steve Dupree seconds
· All approved, no opposition or abstentions
· Meeting adjourns 10:44