“Housing is health care”: Supportive living programs for homeless increasing in metro Denver
Published in News & Features
DENVER — Being homeless in Evergreen after an injury put John Alex out of work wasn’t easy, he said.
The only shelter, run by a local Christian group, operated from October to April, and outside those times, the easiest place to sleep undisturbed was the woods. Even that wasn’t always peaceful, though, with bears roaming in search of food and water.
Alex, 50, talked about his time without a home from a more comfortable space on an unusually hot day in late July: his apartment in Lakewood, in a building that opened less than two months earlier. The unit came with furniture and a basket of the basics like linens and cleaning supplies.
Most importantly, he said, it offered a safe place where he could look for a new job and keep recovering from his injury.
“I don’t have so much stress during the day,” he said. “I can actually rest, relax.”
Alex’s home, a 40-unit apartment building called Solid Ground, is one of at least two new supportive housing options that have opened so far this year in the Denver area. Another broke ground in Arvada this spring, with a goal of opening in 2025.
Exact services vary depending on the community each project targets, but supportive housing generally includes on-site case managers, often with some health care or job training classes available in the building. Some programs work with people who will likely move into independent housing after medical treatment and job training, while others are more or less a permanent home for people with severe disabilities.
Colorado used some of its stimulus funding from the American Rescue Plan Act to pay for the services that differentiate supportive housing from just an affordable place to stay. That funding will run out in September, though the legislature appropriated $589,000 to continue paying for services such as case management, said Marc Williams, spokesman for the Colorado Department of Health Care and Financing.
The department is also looking to cover more services for some people who are homeless, though that will require approval from the federal Centers for Medicare and Medicaid Services, he said.
Despite the growth, metro Denver still has fewer supportive housing units than people who could use them. From a window in the stairwell at Solid Ground, residents can see a small tent encampment just across the street. The Jefferson Center for Mental Health, which developed the building and offers treatment onsite, received more than 120 referrals for the available apartments, said Taylor Clepper, director of navigation and housing services at the community mental health center.
“There is much greater need,” she said.
The nonprofit group CSH estimated that Colorado needs more than 14,000 supportive housing units of all types, including for older people and those with developmental disabilities, on top of the roughly 6,600 existing units. For the population experiencing chronic homelessness, the organization estimated the state would need about 1,900 more units.
Solid Ground focuses on people who have been unhoused for a prolonged period and have a disability, whether caused by a physical problem, a mental illness or an addiction, Clepper said. They designed the building to be a healing space by bringing in as much natural light as possible and adding in outdoor elements, such as plants, wooden features and a green and blue color palette in the common spaces, she said.
The facility also offers therapy and the ability to have telehealth appointments onsite, along with a team that can help residents find resources, Clepper said.
“Housing is health care, and I think we really need to start treating it as such,” she said.
A complicated housing model
Not many organizations provide supportive housing, said Cathy Alderman, chief communications and public policy officer at the Colorado Coalition for the Homeless. Housing vouchers for low-income people can cover the cost of rent, but not supportive services such as case management, mental health care, or help finding a job, she said.
“Most people who have been in the cycle of homelessness are going to need supportive services for some time,” she said.
The model isn’t cheap, but it can still be less expensive than letting people bounce between jail, shelters and emergency rooms, Alderman said. An analysis of Denver’s social impact bond, which offered investors a chance to profit if they reduced the city’s incarceration costs, showed each unit provided by the Colorado Coalition for the Homeless cost about $22,000 per year, counting the value of the apartment itself and the supportive services provided.
“Providing someone with supportive services is far less expensive than letting them cycle through homelessness and emergency systems,” she said.
To build Solid Ground, the Jefferson Center for Mental Health relied on low-income housing tax credits, with some assistance from Lakewood and the Colorado Division of Housing, Clepper said.
Residents will pay about 30% of their income toward rent, with state and local housing vouchers making up the difference in the cost to maintain the building and provide support services. Overseeing the construction of a building wasn’t a natural fit for people mostly trained as therapists and social workers, but they can’t address the community’s needs without adding housing, Alderman said.
“I think nonprofits are moving more and more into that development space,” she said.
“What’s fundable” may not be what homeless youth need
Some organizations had to get even more creative than Solid Ground to bring their projects together.
In late July, Urban Peak opened its $40 million remodeled youth shelter on the south side of Denver. The project, called the Mothership, now includes additional space for people up to 24. The two floors above the short-term shelter will offer six “neighborhoods” where 84 residents will live in two-person rooms while they work to leave homelessness, while the fourth floor has rooms for classes, therapy and group activities.
Initially, Urban Peak looked into building independent housing for youth, funded by tax credits, but the group felt that just offering a place to live wouldn’t be enough to change their clients’ trajectories. People leaving homelessness, and especially those in their teens and early 20s, need time to develop the skills that build a stable life, said Christina Carlson, CEO of Urban Peak.
What they wanted to do wouldn’t fit the criteria for the tax credits, so they brought together a mix of city, state, federal and private funding, she said.
“We felt like we were doing what was fundable” instead of what was best for youth, she said. “I think there’s a level of needing the time to grow up.”
The neighborhoods will cater to pregnant and parenting youth; young people with intellectual and developmental disabilities; young adults leaving foster care; youth in recovery from addiction; young immigrants; and those who are holding down jobs or attending school full-time, Carlson said. Each neighborhood will house between 12 and 20 people, she said.
The Mothership also used trauma-informed design. Sometimes that comes down to small choices, such as not labeling a closet-like space as the bedbug-killing room, because youth find the implication that their things aren’t clean to be embarrassing, Carlson said. Other choices were larger, such as laying out the hallways to avoid blind corners and making rooms slightly different, so they don’t feel like a hospital, she said.
“What we really thought about with the Mothership is how can we wrap full, comprehensive services around youth,” she said.
Growth hasn’t met demand
Despite the challenges, new projects continue to break ground. In April, work started on an 85-unit development known as Marshall Street Landing, which is scheduled to open in Arvada in 2025.
The projects are welcome, but don’t fully meet the need for housing geared toward people experiencing homelessness, said Lori Rosendahl, CEO of Foothills Regional Housing, the housing authority for Jefferson County. The most recent point-in-time data, from January 2023, found 854 unhoused people in Jefferson County. That was a 153% increase from the previous year and a sharper rise than in other parts of the metro area, she said.
People who are chronically homeless and have a disability will be eligible to stay at Marshall Street Landing, said Cassie Ratliff, chief impact officer at Family Tree, a nonprofit focused on homeless families and survivors of domestic violence.
The Jefferson Center for Mental Health will station a clinician on-site to offer mental health and addiction treatment, and Family Tree will have case managers to help with goals such as getting a job, she said. A grant from the U.S. Department of Housing and Urban Development will pay for some of the supportive services, but Family Tree also is seeking funding from Medicaid and other sources.
“We really try to connect people to whatever services they need,” she said. “We need a whole spectrum” of housing and support options.
To build Marshall Street Landing, the developers had to cobble together funding from the city of Arvada, Jefferson County, Colorado Gives, private funders and the federal housing department, Ratliff said. This will be their first designated supportive community, though they offer services to people receiving housing vouchers to rent housing on the open market. About 85% of people who received support and subsequently left the voucher program went into stable housing, she said.
Pharmacy chain CVS also provided about $19 million in funding for Marshall Street Landing through a program that lets anyone with a tax liability invest in projects receiving tax credits to provide housing to low-income people, said Keli Savage, head of impact investment strategy. The investments earn a small return, but not comparable to putting money into real estate that would sell or rent at the market rate, she said.
“CVS recognizes that having equitable access to safe, affordable housing is one of the most important determinants of health,” she said. “We know that housing is health care.”
Marshall Street Landing also will use principles of trauma-informed design, such as putting windows in almost every room, because clients reported traumatic experiences in dark, confined spaces, Ratliff said. They also chose door handles and other fixtures that don’t look like those in an institution, she said. (Places that treat people in mental health crises typically have lightweight fixtures that make it harder for someone to anchor a noose.)
If people don’t feel safe in a space, they can’t focus on goals like reducing substance use or getting job training, Ratliff said.
“If (the need for) safety’s not met, it’s hard to meet those other pieces,” she said.
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