00:01 - Welcome, ladies and gentlemen, to the Latino Health Summit.

00:04 - This is a breakout room.

00:05 - And today we're going to have a good session.

00:08 - So for that, we're going to invite to this stage.

00:11 - I mean, they do a lot.

00:12 - She's the director of the regulatory communication for Aetna.

00:15 - Round of applause please.

00:21 - Thank you everyone.

00:22 - and welcome to the session panel for Health and Housing.

00:26 - I would like to introduce the moderator for this panel discussion,

00:30 - doctor Amber Brawley with the Latino Connection Foundation.

00:37 - Thank you.

00:38 - Good morning and welcome.

00:41 - What a great morning already.

00:43 - I'm doctor Amber Borelli,

00:44 - and I'm going to be your guide through this health and housing panel.

00:48 - So just make sure your phones are silent and you're ready to engage.

00:52 - We've got some amazing speakers today.

00:55 - So, you know, Pennsylvania saw nearly 50% increase

00:59 - in Hispanic owned businesses between 2012 and 2019, according to U.S.

01:05 - census data.

01:06 - Noni Hispanic businesses only increased by 9.3%,

01:10 - which means Latinos

01:12 - are creating business at a higher rate than their non-Hispanic peers.

01:16 - However, although we're growing business

01:19 - at a faster rate than those non-Hispanics in the state,

01:23 - we're still facing significant housing disparities.

01:28 - Latino and Hispanics are 20 to 25% less likely to be homeowners

01:33 - when compared to whites, and 54% of Latino households were estimated

01:37 - to be rent burdened, paying more than 30% of their income towards rent.

01:42 - So what do we do about that?

01:43 - Well, that's why we have these amazing folks here to tell us

01:47 - some of the ways to address affordable housing.

01:50 - So for the next hour,

01:51 - we're going to hear from these amazing experts in the housing space.

01:55 - We're going to start with our friend and colleague

01:57 - Anna Smith from Community Action of Lebanon Valley.

02:00 - And she's going to set the stage for us

02:02 - for what housing looks like right here in Bethlehem.

02:05 - Then we're going to show be followed by co-presenter dynamic duo

02:10 - Amy C, Chris from Pennsylvania Housing Finance Agency and Brian McShane,

02:15 - representing the Corporation for Supportive Housing.

02:18 - Amy and Brian are going to provide us an example

02:21 - of how health care and housing industries can come together

02:24 - to create real, impactful solutions to the affordable housing crisis.

02:30 - And last but never, ever least, is our friend Wyatt Schroeder from Hemlock

02:35 - and Forge to talk to us about how we can be a solution in our community.

02:40 - For the unhoused.

02:41 - And then at the end, we will end with some questions.

02:44 - So, Anna, take it away.

02:48 - So we went on

02:50 - that, although she told us that you'd be in videos of Bethlehem.

02:53 - Thank you so much for joining us here in Bethlehem today in my hometown.

02:57 - my name is Anna Smith.

02:59 - I work at Community Action Lehigh Valley.

03:01 - I'm the director of a neighborhood based community development,

03:04 - subsidiary called Community Action Development Bethlehem.

03:08 - and we work heavily in the areas of neighborhood development, housing,

03:13 - preserving and protecting our public and green spaces in our neighborhood

03:17 - and doing community building right here, primarily in the south side of Bethlehem.

03:22 - And so I'm here today to talk a little bit about our community of Bethlehem.

03:26 - for folks who know our area, you may know that we have had,

03:31 - humongous changes in our housing market, particularly over the last five years,

03:36 - that, have taken us from a moment where we had, you know,

03:40 - a little bit of challenges with regard to affordable housing,

03:43 - with some subsets of our community to a full blown crisis.

03:47 - And so I want to talk a little bit

03:49 - about what that looks like right here in Bethlehem on the ground.

03:53 - And what are some of the initiatives that a really remarkable

03:56 - coalition of partners here in Bethlehem have put together?

04:00 - to deal with this housing crisis and try to do something

04:03 - at the local level, to address the impact.

04:07 - And I will couch it before, say, before I get into that by saying, really,

04:11 - we're not going to solve the housing crisis here on the local level.

04:14 - That requires legislation at the state and federal level

04:18 - to really make the changes we need.

04:20 - but nonetheless, we're not going to sit around and wait for that.

04:23 - We're working as hard as we can here in Bethlehem to do what we can

04:26 - with the tools we have, to try to make a difference.

04:29 - So, you know, the city of Bethlehem.

04:31 - Just for those who don't know us,

04:33 - we're the second largest city in the Lehigh Valley.

04:35 - About 76,000 people.

04:37 - we have a, 30% Latino population, which continues to grow.

04:43 - been around in the Lehigh Valley for decades.

04:46 - and as far as our housing here,

04:48 - we have very old housing for the most part.

04:52 - Most of our homes were built before the 1980s, and the median year

04:55 - they were built in this neighborhood is 1940.

04:58 - and about 45% of our households rent their homes.

05:03 - That's a number that continues to increase in the city of Bethlehem.

05:06 - So getting close to 50% of our homes.

05:10 - And so what's happened in the last four years?

05:14 - Well, thanks to a

05:16 - combination of factors and especially the impact of the of the Covid

05:21 - pandemic, we have seen our rents skyrocket here in Bethlehem.

05:26 - just the figures up on the screen here, our median rent in 2019, about $1,300,

05:32 - and then 2023 all the way up to $1,900.

05:36 - this was an astounding increase in a very short time period.

05:40 - And as I always say, you know, whose wages increased,

05:43 - by that much over that time period.

05:46 - And it wasn't just, you know, our rental prices,

05:48 - of course, our, housing market as far as sales were concerned.

05:52 - So, I pretty similar jump our median sales price in 2019,

05:58 - $182,000 was accessible to a lot of folks in our community.

06:03 - you know, that corresponded with interest rates

06:07 - so that at the time to about $850 a month in a mortgage payment.

06:11 - that wasn't too bad.

06:13 - Now we've jumped to $302,000 as our median sales price.

06:18 - When you take interest rates into account on a 30 year mortgage.

06:21 - You're talking about over $2,000 a month in mortgage payments,

06:25 - putting housing out of reach for the majority

06:28 - of our families, our households here in the city of Bethlehem.

06:32 - And when we talk about, you know, when we look at what

06:35 - that means for so many of our residents, it means that particularly

06:40 - our renters here dealing with these astounding increases in rent.

06:45 - almost half of them in our city are cost burden.

06:48 - And when I say cost burden, that means using the definition that the

06:52 - federal government and all of our agencies use to say what is actually affordable.

06:56 - if your cost burden, it means your housing is not affordable,

06:59 - you're paying more than 30% of your income toward your housing costs.

07:03 - Almost half of our renters in the city, are paying that much money.

07:07 - and that high percentage of their income toward rent

07:10 - and a substantial number of our homeowners as well.

07:14 - not quite as many, but about 18%.

07:18 - And why do I bring up the difference here between renters and homeowners?

07:21 - Because this isn't just an issue of economic justice.

07:24 - It's not just an issue of finances.

07:26 - This is an issue of racial and ethnic justice.

07:29 - If you look here in the city of Bethlehem, if you are white,

07:34 - there's a 63% chance that you own your home in the city of Bethlehem.

07:38 - But if you are Latino, there is a 30% chance you own the home.

07:42 - The devastating impact of these rental increases is predominantly

07:46 - borne by our black and Latino communities here in the city of Bethlehem.

07:50 - So I think that's a really important thing,

07:52 - for us to acknowledge and think about as we're talking about,

07:55 - you know, solutions or strategies to address this crisis is that the impact

07:58 - is not borne evenly, among the different members of our community.

08:02 - This disproportionately affects our communities of color here

08:06 - in, in Bethlehem.

08:08 - And these are, you know, you will find similar statistics

08:11 - throughout pretty much every community, in the Lehigh Valley, at the very least,

08:16 - probably state wide and and nationally as well.

08:20 - And so what does that also mean about who can afford to live here?

08:24 - when our rental and sales prices jumped so much, they made,

08:28 - 16 of the 20 most common occupations here in Bethlehem,

08:33 - unable to afford a one bedroom apartment in our city.

08:38 - and we're talking about the folks

08:41 - who are essential to making a community a community, right?

08:45 - Our our home health care workers, our retail workers, our food services workers.

08:50 - all of them would need to earn $40,000 more on top of what they're already

08:55 - earning to afford a one bedroom apartment in the city of Bethlehem right now.

09:00 - but it isn't just those workers we're talking about.

09:03 - We're talking about an elementary school teacher is one.

09:06 - You know, your first year elementary school teacher

09:08 - cannot afford a one bedroom apartment in Bethlehem.

09:10 - a brand new nurse at one of our local hospital networks is not able

09:14 - to afford a one bedroom apartment in the city of Bethlehem.

09:18 - So, you know, this impacts for years was something

09:22 - that folks like us at an anti-poverty organization.

09:25 - You know, we're talking about.

09:26 - But right now, we're seeing as the impact has spread onto

09:30 - folks of every economic level in the city of Bethlehem.

09:34 - you know, we need more engagement, particularly of our major employers,

09:37 - in recognizing, you know, this is not a small subset of our population.

09:42 - This is folks at every level throughout all of our, you know, major industries

09:46 - that are really struggling with housing, in our community.

09:51 - And so now that, you know, we talked about how bad it is,

09:54 - I do want to talk a little bit before I hand the mic over about

09:58 - what are some of the things that we're actually trying to do about that.

10:01 - You're gonna leave you with that, this dark picture of housing and affordability.

10:06 - but, you know,

10:07 - we are trying to make efforts locally, so I'll just highlight a few of those,

10:10 - the things that we're working on here through a coalition of partners.

10:15 - right here in the city.

10:17 - you know, during the Covid pandemic, the initial groundwork was laid

10:21 - for continuum of eviction prevention services.

10:25 - right now, we're in the process of developing,

10:28 - a free eviction filing, landlord tenant mediation program,

10:32 - hopefully to get tenants keep tenants in their homes.

10:35 - if they have any sort of challenge early on with rental payment

10:39 - or any sort of dispute with their landlord.

10:41 - we have a very successful pilot here, right in South Bethlehem, of a program

10:46 - that provides legal representation to folks facing eviction.

10:50 - who income qualify? It's completely free.

10:53 - And that has made a huge difference in keeping folks in their homes.

10:57 - and rental assistance being an essential component of this

11:01 - when there is funding to help families

11:03 - through a short term crisis, to be able to stay in our homes.

11:07 - you know, it makes it easier for landlords to prevent turnover in their apartment,

11:11 - and their homes. And it keeps families

11:14 - in their neighborhoods, keeps kids in their schools.

11:17 - and so these programs are offered through a variety of different partners

11:21 - that are part of our coalition we're working together on.

11:24 - our city is also initiating strategic zoning reform through, really cool

11:30 - partnerships, one with Lehigh University and Community Action,

11:33 - where, we've received to date over $1 million in funding to launch a pilot

11:38 - accessory dwelling unit program right here in West Bethlehem.

11:42 - we'll be building a what we're calling an alley house at the back of the home.

11:48 - that's owner occupied.

11:50 - And then that will be rented out, to a low to moderate income family

11:55 - through a partnership with New Bethany here,

11:57 - one of our homelessness services providers.

11:59 - And simultaneously, we've gotten some funding to work

12:02 - with Lehigh University to study, the concept of accessory dwelling units

12:07 - and make, strategic, updates to our zoning ordinance

12:11 - to allow for these in areas citywide where it makes sense, where they'll be

12:15 - neighborhood compatible and, can provide additional housing options,

12:19 - particularly, for folks who are looking to age in place or,

12:23 - you know, as we often hear,

12:25 - a recent college graduate maybe moving back home looking for a place to live.

12:29 - there's a lot of demand for this variety of housing types.

12:33 - And then finally, a particularly through our city government, in partnership

12:36 - with our local housing authority and some of our nonprofits, we're

12:39 - looking to incentivize the construction of more affordable units.

12:43 - There's no way to build affordable housing without subsidy.

12:46 - And so we're looking at every single angle to help affordable housing developers.

12:51 - build more houses in Bethlehem.

12:54 - We just recently announced almost right across the street from here

12:58 - in partnership with Penrose.

12:59 - we'll be building 120 units of, mixed income housing,

13:04 - the majority of which will be affordable to super exciting.

13:10 - And I have to give a

13:11 - huge shout out to Lehigh Valley Industrial Parks, who's built

13:15 - all of our industrial parks around here and warehouses and things like that.

13:19 - They made this project possible

13:20 - by deciding they were going to buy the land

13:23 - to put it on, and they were going to donate it to the project.

13:25 - Over $4 million of a donation to this incredible project.

13:30 - and then, you know, simultaneously, our city and housing authority

13:34 - are working on a Choice Neighborhoods

13:36 - planning grant in the Pembroke village, right across the river from here.

13:40 - It's, public housing that was built in the 1940s.

13:43 - They're planning to demolish all of it, replace all 196 units of subsidized

13:48 - housing, and add 2 to 300 additional units

13:51 - of mixed income housing to create a ladder of economic opportunity.

13:55 - So, as folks, you know, move out of public housing, there's a place to go.

13:59 - You can take that promotion and you don't get kicked out of your home.

14:03 - by doing so.

14:04 - So, those projects are all in the works.

14:06 - And in the coming years, we're going to see those come to fruition.

14:09 - And just a last slide before I'll pass it over.

14:12 - I'm probably past my ten minutes.

14:13 - how are we actually doing this in thoughtful,

14:17 - community action is what?

14:18 - What? One small piece.

14:19 - I'm just the messenger here from a broad coalition that engaged first in a year

14:24 - long data collection and planning process to make the case for these initiatives.

14:29 - We collected data, working together with consultants,

14:33 - and we put together a plan that made the most sense

14:36 - for our Bethlehem community based on the specific needs here.

14:40 - we built coalitions across the, you know, city government

14:43 - really led the way here in Bethlehem, but brought together a housing authority,

14:46 - our nonprofit, and many of our private sector partners to be a part.

14:50 - And, the last one here is the one nearest and dearest to my heart

14:53 - is the extensive community engagement right.

14:55 - How do we know what's right for our community?

14:58 - Well, because we have to be in constant contact and talking

15:02 - with the neighbors that are most affected by, you know, the housing crisis,

15:06 - to really understand what the needs are and ensure that our neighbors understand

15:11 - what these new initiatives mean, how they're going to affect their lives,

15:15 - and see why we all have a stake in making some of this stuff happen.

15:20 - to combat that kind of not in my backyard idea,

15:24 - we are holding, neighborhood meetings throughout the city

15:27 - where the city government is providing regular public updates

15:30 - four times a year on the progress for the affordable housing plan.

15:33 - And we're working to train and community ambassadors to, get the word out

15:37 - and be that voice in their neighborhoods to, answer questions and filter

15:42 - feedback back to the organizations that are leading this, initiative.

15:46 - So a little bit about what we're doing.

15:48 - And just my last slide here is showing, you know, these are just,

15:51 - some of the partners, the biggest ones that are making a concrete investment

15:55 - right now in advancing all the programing that I talked about.

15:58 - And we couldn't do it without the leadership of our city

16:00 - government up there at the top, the city of Bethlehem,

16:03 - in this current administration and city council

16:05 - have been fabulous in prioritizing this issue.

16:07 - So, that's Bethlehem,

16:10 - I'll hand it over to operations.

16:15 - Let's finish up a note, folks.

16:17 - Hear me? Okay.

16:18 - Yeah. Just, time to move to Bethlehem.

16:21 - Okay, okay.

16:23 - We need you adding more housing. That's true.

16:24 - I'm sorry. I'm sorry.

16:26 - Yeah, right. Yeah, right. Time to development.

16:28 - So, tough to follow, of course.

16:30 - and just really impressive.

16:32 - Everything that, we we might be missing a few.

16:36 - That's okay. So, No worries.

16:39 - So, real quick, folks, Brian McShane.

16:42 - you see him? Pronouns.

16:43 - from the Corporation for Supportive Housing.

16:44 - We're a national nonprofit.

16:46 - We are dedicated to the idea that we want to see more supportive housing,

16:50 - in communities across the country.

16:52 - and we want to help folks

16:54 - that are already trying to create and sustain supportive housing.

16:58 - we are a national organization.

16:59 - my team focuses, regionally on our work in New York, new Jersey and Pennsylvania.

17:05 - I am the PA lead, based out of Philly.

17:07 - so, the reason I'm here and the reason I'm, grateful to be part of this

17:12 - and this amazing day, is that we've been working with the Pennsylvania

17:16 - Housing Finance Agency on, some health and housing programing.

17:20 - So a couple of, content that I'll just, share with you verbally before we get to

17:26 - the challenges is I don't think I need to do too much

17:29 - because I did a really good job of kind of spelling it out.

17:31 - When you get to a statewide focus, which is what we've had over

17:34 - the last year and a half, the numbers look very similar, right?

17:38 - You've got, six, 13.5 thousand

17:42 - at least that we know of people experiencing homelessness in the state.

17:46 - You've got 27% of the state are what we consider to be extremely low income.

17:50 - So when we look at this as

17:52 - these are like housing terms that get tossed around a lot.

17:54 - Affordable housing can be anything from 80.

17:57 - Your income is 80% of the area

18:00 - median income, all the way down to 30%.

18:04 - and that's where we consider somebody extremely low income,

18:07 - the folks who need supportive housing, these are folks who have experienced

18:10 - homelessness, have had some kind of trauma, or interaction

18:14 - with, systems like child welfare, incarceration,

18:18 - the behavioral health system, they need both that extremely affordable

18:22 - housing and supportive services to be able to be successful.

18:26 - And they may not need it forever.

18:28 - But at least when we meet them, that's what we need.

18:30 - So when we talk about supportive housing,

18:31 - we're really looking at that intersection.

18:33 - It started about 30 years ago trying to end street homelessness.

18:36 - We realized you're not going to be able to do, to end homelessness

18:40 - by just looking at the folks who are currently experiencing it.

18:43 - You have to swim upstream.

18:44 - You have to look at where people are getting tossed in the water.

18:47 - And so that intersection between health and housing is a really natural

18:50 - fit for us.

18:52 - We see things like, you know, including folks

18:55 - that are currently housed in aging housing stock affected by, you know, lead

19:00 - paint, mold and things that, that are rough on the respiratory system.

19:05 - So we need both solutions for those folks currently experiencing, homelessness.

19:11 - But we also need the kind of help that you all are targeting towards

19:14 - the folks that need eviction prevention, repairs to their homes and stuff.

19:18 - So, again, we'll just leave there and talk about all the challenges and just, pass

19:22 - on the questions, or what we can talk about as a really exciting time.

19:26 - We have in Pennsylvania, where some solutions are being proposed.

19:29 - So bottom line, when we look at like the sheer volume

19:33 - of the affordable housing need we have, it's daunting, right?

19:36 - And then when we think about how we're

19:37 - going to address that, knowing that like high construction costs,

19:42 - which have increase over the course of the pandemic,

19:44 - high rates of low income and extremely low income households,

19:48 - which have also increased over the course of the pandemic.

19:51 - And as Anna did, a really good job, we see that Bipoc households

19:55 - bear that, the brunt of that

19:58 - disproportionately, disproportionately, we see the aging housing stock.

20:02 - Most homes in PA were built before 1978.

20:05 - we see limited operating subsidy.

20:08 - and I was kind of referring to the need for that and to be able

20:11 - to spur development and affordability at the local level.

20:14 - And we really see a need to identify new sources of subsidy and investment

20:18 - to meet this kind of growing costs in the

20:22 - we talk about financing affordable housing,

20:25 - which is a, you know, we're going to build more,

20:26 - we're going to figure out how to pay for it. Right.

20:28 - And so we talk about this using the image of a three legged stool.

20:32 - You've got three separate unique budgets you've got to pull together

20:36 - especially when you're talking about supportive housing.

20:38 - We have the capital the operating and the support of services.

20:41 - We're not going to get in too deep

20:43 - of detail about this today, but the capital is buying land,

20:47 - building something, renovating property, the operating is how do you keep it open

20:52 - and affordable and safe and high quality over the course of it staying open.

20:57 - And the services again, are about for those folks

20:59 - that really need some kind of support, to be able to sustain their housing,

21:03 - at least for, you know, the initial, phase that they're in it,

21:07 - how are you going to fund those services?

21:10 - I'm not going to read all this.

21:11 - These are the typical funding sources, you see,

21:14 - kind of put into play the folks who do housing development in the room

21:18 - or that, you know, us, are masters at pulling this puzzle together.

21:21 - Right?

21:22 - They find the different ways that these different sources can be leveraged.

21:25 - You've got a bunch of different capital resources, a bunch of different

21:28 - operating resources and services resources.

21:30 - Every community does this a little bit differently,

21:33 - but they all tend to pull on one of these bullet points.

21:38 - So what can the government actually do to help pull this together

21:41 - and help communities who are trying to address this affordable housing need?

21:45 - There's only so much role that they can play, but they can play an important role.

21:48 - And for our purposes, I think, you know, Anna just did a really good job of talking

21:52 - about what a local government can do.

21:54 - I'm going to kind of zoom back out to a state level.

21:56 - We can we can have programs to incentivize investments

22:00 - in social determinants of health, like housing.

22:03 - We can create mechanisms to structure those investments.

22:06 - the government can act as a convener when the government when a,

22:09 - when a state agency or a local agency holds something, a lot of people show up.

22:12 - And they can also kind of bridge some of those divides.

22:14 - What we have found in our work, with the HFA is that

22:19 - and some of our other health and housing work, health care folks are doing

22:22 - this really good job over here trying to meet the needs of their folks.

22:25 - They have their own language, their own set of challenges, their own processes,

22:29 - housing folks doing as much as they can to meet the needs of their folks.

22:32 - They have their own language, their own process.

22:34 - And so they need somebody to help kind of convene

22:37 - and be that bridge and translator sometimes.

22:40 - and then we need to leverage our federal resources like, low income

22:44 - housing tax credit is probably the primary source of affordable

22:48 - housing financing in the country, and definitely in PA.

22:52 - but then there's also resources like Medicaid that can be leveraged.

22:54 - We heard Secretary Arkush mention that this morning.

22:58 - and really just kind of more coordinated health and housing.

23:01 - Right? So health care has been doing a lot.

23:04 - Housing has been doing a lot.

23:05 - We're really getting to the point where we need

23:07 - to see better coordination between the two.

23:09 - The good news is this is a really exciting time for this kind of coordination.

23:14 - And some of these resources in Pennsylvania.

23:17 - you have on the capital side that construction, the building and everything.

23:23 - And Amy's going to

23:23 - talk more about creating, a program

23:27 - to incentivize health care partnership in, in that creation of, of housing.

23:31 - and then you have the really exciting,

23:35 - services piece that, Secretary Kush talked about this morning.

23:42 - these, I think are slides that everybody will get.

23:43 - This will send you to their landing page for this Medicaid waiver,

23:48 - which is, the primary, I would say the primary,

23:54 - innovation we've seen in supportive services funding in states

23:57 - across the country.

23:58 - We're really excited that Pennsylvania has done this.

24:01 - We think it's going to be a tremendous complement

24:02 - to what the other state agencies are looking to do to create housing solutions,

24:06 - not just for those folks who are in our workforce,

24:09 - but also for the most marginalized in our communities.

24:13 - So given that,

24:16 - there's some resources there, my contact, if you need it.

24:19 - But just if you want to see more about what

24:20 - this intersection looks like, and I am going to hand over to individual.

24:24 - Oh, yes.

24:24 - Which you can.

24:25 - Yes. Yeah.

24:28 - Yeah, yeah, that's a nonprofit I'm used to.

24:31 - Yeah.

24:31 - We're housed

24:33 - right. Yes.

24:35 - Oh yeah I get it. Seven.

24:37 - Yeah okay.

24:39 - Good morning everyone. My name is Amy Siegrist.

24:41 - I'm a senior policy officer at the Pennsylvania Housing Finance Agency.

24:45 - for those of you who aren't familiar with us, we've been around since 1972.

24:49 - We're a state affiliated agency, which means we're kind of a state agency.

24:52 - But we raise our own funds through our own investments.

24:55 - we do a lot in terms of homeownership counseling and consumer education.

25:00 - And we're also involved

25:01 - in the development of affordable housing across the Commonwealth.

25:04 - as Brian was talking about, we are the folks who allocate the low

25:08 - income housing tax credit,

25:10 - which is the mechanism by which pretty much all affordable housing across

25:13 - the country is developed and financed nowadays.

25:17 - and so I'm here to talk about our health for housing

25:19 - investment program, which we began about two years ago.

25:23 - But first, I just wanted to pull up this continuum.

25:26 - I think it speaks to what we've already been talking about today.

25:29 - So when we started in this work, we really saw and, a lot of partnership

25:34 - that was already happening kind of around the services side,

25:37 - maybe more on that local level thinking kind of clinics

25:40 - and the first floor of an affordable housing building or,

25:43 - you know, doctors coming to, a certain like service

25:48 - provider, homeless and service provider and providing, flu shots.

25:52 - But we we saw kind of a lack or at least an opportunity

25:55 - on the development side in terms of bringing together partnerships

25:59 - further up the pipeline and bringing health care in to act,

26:03 - as we've been talking about, as an additional thunder for these projects.

26:07 - and so that inspiration is also

26:11 - what brought us to, the National Council of State Housing Agencies.

26:15 - They had a grant opportunity, which we were fortunate enough to win,

26:19 - along with six other states, I believe, to work on looking at

26:23 - and taking a year and a half to really take our time in terms of engaging

26:27 - with both the health care sector and the housing sector, and thinking about

26:31 - how can these different sectors

26:32 - come together to fund more affordable housing development.

26:36 - We know that there's a lack of, I think, about 267,000, maybe more.

26:41 - affordable units across the Commonwealth.

26:44 - So there's a big need.

26:45 - and we're trying to figure out

26:47 - as the financing people how to get more money in that pipeline

26:50 - so we can continue to scale and increase housing development that so badly needed.

26:54 - And so we took a year and a half, and we did a lot of engagement.

26:59 - Some of you might have been involved in that.

27:01 - and if you were, thank you very much.

27:04 - we did stakeholder listening sessions.

27:06 - We convened statewide advocacy leaders.

27:09 - we completed a needs assessment, which I'll talk about in a second.

27:13 - we coordinated interagency meetings with other state agencies.

27:17 - and we just generally were doing kind of research, collecting best practices

27:21 - and trying to hear from the folks that were out there doing this work

27:25 - about how we can kind of get more involved

27:28 - and create more incentives to have this work continue to grow.

27:32 - so the Health and Housing dashboard, this came out of our needs assessment work.

27:36 - It's publicly available.

27:38 - and it's really exciting.

27:39 - It brings together health care data with housing trends data.

27:44 - So in terms of affordability, things like that, we have really viewed it

27:48 - as a tool for starting some of these conversations.

27:51 - Say you're a housing, you work at a housing organization

27:55 - and you're trying to figure out how do I start to engage with my hospital

27:58 - and my community.

27:58 - We know we've got an overlap in some of the communities that we prioritize

28:02 - and who we want to serve.

28:03 - But how do I start talking about that in language that they'll understand?

28:07 - And so this dashboard brings together, some of the reporting data

28:11 - that hospitals are required to provide to the state in order to

28:15 - if you want to look in at your community and see, like from my specific

28:19 - hospital, where are their patients coming from in the surrounding area?

28:23 - Are they coming from the local area

28:24 - right around the hospital, or are they coming from further away?

28:27 - And are those areas places

28:28 - that have an affordability need, or are they places a jump?

28:31 - so it starts to just give an opportunity to kind of look at this issue,

28:36 - in a way that brings together data that is very like individual,

28:40 - patient centered

28:41 - and starting to bring it to some of these more trends and community

28:44 - based level data that the housing sector really tends to deal with.

28:49 - so that is publicly available.

28:50 - We can share the link with these slides as well.

28:52 - And I hope you take a look at it.

28:54 - and we hope to continue

28:55 - to kind of keep that up to date and use it as the program continues.

28:59 - So out of all of that engagement, we came to these five strategies

29:03 - of how we're going to be moving forward with the program.

29:05 - most of them are around coordination efforts,

29:08 - as Brian mentioned, as a statewide agency, a lot of our role

29:12 - we see as being a convener and really trying to bring together

29:16 - disparate efforts to start making sure they work together.

29:18 - So some of the Medicaid work that's going on,

29:21 - how do we make sure that that's aligned with what we're doing?

29:24 - So that at least is

29:25 - working towards the same goals, and it's not kind of at cross-purposes?

29:29 - and then I think the one that we're most excited about,

29:32 - and that I'll continue to share about in the next few slides, is the incentives

29:36 - that we've created through our help for housing investment programs.

29:39 - each of it, as a funder and a financer is really lucky

29:42 - because when we can pull

29:43 - certain levers and create incentives that have a pretty immediate impact

29:48 - in terms of what folks bring to us by way of projects and applications.

29:52 - And so we were able to, with the support of our board and our executive director,

29:56 - placed incentives into our most recent low income housing tax credit rounds.

30:01 - so for those of you who aren't familiar with the low income housing

30:03 - tax credit, it's again, the main mechanism by which,

30:06 - affordable housing gets financed throughout the Commonwealth.

30:10 - there are federal tax credits to get allocated by us,

30:14 - and we have a qualified allocation plan, which kind of stipulates and outlines

30:18 - what we're looking for in terms of those projects

30:20 - so they can be scored and eventually allocated.

30:23 - And so we were fortunate, fortunate enough,

30:25 - to have a tax credit set aside specifically for a project

30:31 - that meets the criteria that we set up for health and housing investment,

30:34 - which is they have a capital investment from a health care partner.

30:38 - so this looks a little bit different than I mean, we left it really broad, right?

30:42 - We could have said, we want to make sure

30:44 - that you have permanent supportive housing units as part of your project

30:47 - and kind of add a little bit more detail, but we really wanted to leave it broad

30:51 - and see what came in and kind of see

30:53 - what the playground was like, what were people bringing to us

30:56 - and see how we we could kind of amend it as we move forward.

31:00 - We expect that it's going to be something that will be an archetype for, you know,

31:04 - a good number of years.

31:05 - and so we also very excitingly, were able to set aside

31:09 - $10 million from our state housing trust fund as a matching fund.

31:12 - So let's say a hospital put $10 million into a project.

31:15 - Who is committed to matching that million dollars?

31:19 - it has a cap on it.

31:20 - It's up to 2 million for 9% projects, up to 1.5 million for 4% projects.

31:25 - but in general, we're just really excited to actually be able to put some money

31:28 - behind this and see again what kind of partnerships come up

31:32 - from this first round, and then how we want to hone in as we move forward.

31:37 - We also, put an additional funding priority

31:39 - within the program, which a lot of you will might be familiar with.

31:44 - it's one of our more flexible funding pools.

31:46 - I think we're still trying to figure out exactly how to kind of use this

31:49 - incentive best.

31:51 - but it is a priority that we've placed within the fair application.

31:56 - and so how can you get involved?

31:58 - Again, we're at the point in this program where we're just starting

32:01 - really implementing.

32:02 - We're trying to see what comes in by way of applications

32:05 - so we can continue to refine and continue to make sure

32:07 - that we're getting to the end goals that we set out for ourselves.

32:10 - So we want to hear from you all.

32:12 - We want to hear, you know, do you have thoughts on projects?

32:15 - Do you have thoughts on ways

32:16 - that we could better integrate health equity into our application?

32:20 - we're really at the point where we're committed to this work for the long haul,

32:23 - and we want to keep refining it as we move forward.

32:26 - So we've got, you know, sign up for our emails,

32:29 - reach out to us if you have thoughts about projects or partnerships

32:32 - you'd like to kind of use our dashboard to start engaging with.

32:36 - and we'd be happy to provide that assistance.

32:39 - I also am happy to announce that we had six applications

32:42 - into our 9% round under the Health and Housing Investment Program,

32:47 - and so we're really looking forward to being able to,

32:50 - give out one of these tax credits and the, I don't know, next few months.

32:55 - They don't share the timeline with me.

32:57 - so that

32:58 - will be kind of our first kickoff of that project.

33:01 - and then we'll again have these examples we can continue to build on.

33:05 - So we're really excited about this work.

33:07 - We think it's a great option for incentivizing what we want to see.

33:11 - We're trying to build it and just see if they came with projects.

33:14 - And they have so we're excited to keep moving forward.

33:17 - And I think that's all I have.

33:20 - Right.

33:25 - And huge applause.

33:29 - For the work that piece of has done around this.

33:31 - This is not I very recently lived in Idaho.

33:34 - Yes, you heard that correctly.

33:35 - and the the HOA there is not contemplating anything like this.

33:41 - No offense or having me any Idaho representatives here.

33:43 - So having Pennsylvania take this leadership

33:45 - and the combination of health and housing is absolutely huge.

33:49 - Hello, everyone.

33:50 - My name is Wyatt Schrader.

33:52 - I'm the director of a new B Corp that got stood up in last

33:55 - four months called hemlock and forage.

33:57 - And we're working kind of a two levels right now to help end homelessness

34:01 - in Pennsylvania and Delaware.

34:02 - We're helping at the community level to do a lot of partnership management

34:06 - to make sure we can stand up our capacity to actually create housing

34:10 - that ends homelessness,

34:12 - really come alongside all these statewide initiatives to say, hey,

34:14 - it takes a lot of implementation control to really pull off these things.

34:17 - As Hannah set up,

34:18 - it takes a lot of work to pull off 100 units,

34:21 - and it's even harder to pull off permits, supportive housing for people

34:23 - experiencing chronic homelessness.

34:25 - So we're coming alongside, communities right now like Pittsburgh, Erie

34:29 - and the state of Delaware to help build out some supportive housing pipelines.

34:32 - And we're coming along providers as well.

34:35 - I come from the nonprofit Space working and domestic violence shelters,

34:38 - and homeless service providers my entire career until now.

34:42 - And we've always wanted to get more in the housing game,

34:45 - but we didn't really know how we saw these grants flying by.

34:48 - We heard about tax credits, may read an article about it once,

34:51 - but really trying to stand up our internal capacity

34:53 - to leverage other's resources was always that thing we'd get to one day.

34:57 - And so we now help out at the provider level, helping people

35:01 - lean more into as either behavioral health provider or homeless service provider

35:04 - to lean more into that housing space, to figure out

35:07 - what the financial management needs to look like,

35:09 - figure out what that integration behavioral health services looks like

35:12 - and what your investor strategy should be

35:15 - like.

35:15 - We quick get to know you all.

35:16 - So I'm curious who is in this room.

35:18 - So it's that's us.

35:20 - How many can I get some hands up for our government folks.

35:22 - How many folks representing government here? Couple.

35:25 - Thank you. Thank you for being honest.

35:27 - how about how many philanthropy folks you folks funder on the funder side,

35:31 - I see him is scarier of a fund to raise their hands than everyone just flocks.

35:36 - how about, health care space?

35:39 - Great.

35:39 - on our health care space, how many folks are on the payer health side?

35:43 - You know, like some kind of integrated model or directly couple,

35:46 - homeless services.

35:49 - Okay. Hello.

35:50 - Good to see you there, Brian. Nice people. Hello.

35:52 - and how much is generally other social services here?

35:56 - Right. Thank you. Thank you.

35:58 - Okay. Great. Curious. Yeah.

35:59 - Who was up there?

36:00 - as we get closer to questions, so this slide won't be a shock.

36:05 - I think based on everyone who just raised their hand.

36:07 - You've heard all these.

36:08 - But from our thinking through like that implementation, why doesn't it work?

36:13 - Why are we not ending homelessness?

36:15 - We're having more and more people talk about it.

36:17 - You can open up your Google feed, without seeing more

36:20 - and more awareness around, homelessness and housing.

36:24 - So why are we not catching up?

36:26 - from our lens, I think one of the key things is really

36:29 - this idea that our systems are broken.

36:33 - And one of those key things is, I think while we're starting to stand up

36:36 - more on the housing development side, in my opinion,

36:39 - we're starting to see that grows coming out.

36:41 - especially as the recession was behind us and our interest rate climate

36:44 - got a lot better.

36:45 - We got really aggressive

36:46 - on the housing development, but we kind of left services behind.

36:50 - And so one thing that at least

36:53 - is my, interpretation of all this is

36:56 - that we have to integrate services and that word integrate

36:59 - especially for health care folks.

37:01 - You're probably picturing that clinic space

37:02 - where we're integrating like pay for health consultants.

37:05 - We're not really doing that.

37:06 - I think in a great way in housing right now.

37:08 - And one thing I think we get caught on that is kind of my health

37:11 - to die on is that referrals are not partnerships.

37:14 - You hear it again, people.

37:15 - Referrals are not partnerships.

37:17 - So if you're a housing developer, you've probably gotten really comfortable

37:20 - about something, a service plan that's actually just based on referrals.

37:25 - We don't actually know if there's a resource on the other end of that though.

37:28 - So even listening to like, PR navigate come together is really interesting.

37:32 - approach for the Pennsylvania to think about,

37:34 - how can we, like, prescribe housing?

37:36 - You'll hear that a lot. How do we prescribe housing?

37:38 - Well, that prescription to, for food

37:42 - insecurity only works if there's food on the other end, right.

37:45 - The same thing with housing.

37:46 - If we prescribe housing to someone,

37:48 - only works if there is a housing unit available.

37:50 - Well, that referral may lead to nowhere.

37:53 - And unfortunately, then I think we're experiencing a lot with

37:55 - with our work around homelessness is there's a lot of referrals

37:58 - into an already broken system around homelessness.

38:01 - And so I'm not saying we shouldn't do this referrals, but we should recognize

38:04 - that we have to kind of flip our thinking.

38:07 - So a lot of the work that we're trying to do is, is what you'll hear

38:10 - me say is move from left to right into right to left a thank you,

38:14 - which is we're investing a lot right now,

38:16 - I think, in our crisis stabilization system, referring people.

38:19 - If anyone's done discharge work from any institution

38:22 - or the E.R., you're used to referring people to shelter,

38:25 - which would be great if our shelter system is actually connected to housing.

38:30 - The ERS

38:31 - is not the ones I've worked in.

38:33 - it's not because our shelter is not doing a good job,

38:35 - but they're part of a system that is only kind of connected to housing.

38:39 - And so we need to be thinking right to left, which is looking at our

38:43 - communities to say, what is the actual gap?

38:45 - You heard this from these three.

38:47 - What's our actual gap in our community

38:48 - and how can work on a true pipeline approach?

38:50 - Amy mentioned the word pipeline, which to me is, yes, we have great

38:53 - developers or programs being stood up to do that one building, and we need that.

38:58 - But the whose job is in our community is to pull together a true system approach

39:02 - that gets those one off, projects into a pipeline approach

39:05 - that works backwards from what our actual big, hairy, audacious goal is

39:09 - how many people are actually experiencing chronic homelessness in our community?

39:12 - How many youth are experiencing homelessness in our community?

39:14 - how many veterans, how many people with intellectual disabilities?

39:18 - How are we working backwards from that number

39:21 - and then taking those one off projects through a strategic approach?

39:24 - Jordana talked about the coalition building it takes to do that.

39:28 - So that's really a

39:29 - lot of kind of the projects that we're seeing as we're struggling.

39:32 - If you've heard of things like Housing First,

39:35 - which is a model of care to help end homelessness,

39:39 - that's an idea that's been around since the 90s,

39:41 - but we're struggling, I think, to take it to scale.

39:44 - And I think it's back to that partnership building

39:45 - that that struggle to implement as we have good ideas.

39:49 - There are smart people in Pennsylvania, the smart people in Delaware.

39:52 - but we're struggling to take off to scale.

39:55 - We're living still at that program level.

39:57 - And so,

40:00 - the nice thing is we know that it works.

40:03 - So if folks heard of Housing First before

40:06 - some not so maybe it's real quick.

40:09 - So, Housing First is a model for how we can end homelessness.

40:13 - It's the idea

40:14 - that if you think about Maslow's hierarchy of needs more rapidly,

40:18 - we can get someone into safe and stable housing.

40:21 - The more effective we will be in addressing things like,

40:24 - there's substance misuse,

40:27 - maybe there's severe and persistent mental health issues.

40:30 - maybe just some of their general social service needs.

40:33 - We're gonna be more effective once you have that stability

40:36 - because of the brain architecture we have in our heads.

40:38 - If we're living in the trauma state, as you all know,

40:41 - you'll love your in health care, if not all.

40:43 - If you're living in that trauma state.

40:45 - Our case managers have a really hard job.

40:48 - Right.

40:49 - But not that not it's very aggressive. Yeah.

40:52 - That's a knowing that you're like even leaning to like make eye contact.

40:55 - I appreciate that.

40:56 - so I don't have to go on.

40:57 - But there's like we have to get that stability first.

41:00 - And in homelessness we've built up a system

41:03 - that has housing at the end of the rainbow.

41:06 - Even as we know that homelessness is a housing problem,

41:09 - still, housing is still this thing out there

41:11 - that eventually we have referral after referral after referral to,

41:13 - to get you to it.

41:14 - So how is it versus how can we rapidly get you in a housing?

41:18 - And then once you're there we see a huge health impacts.

41:20 - we see roughly about if you do a good job,

41:23 - by 85% of folks are stably housing or later.

41:26 - Yes, even those who are dual diagnosis,

41:29 - we see over 90% engagement.

41:32 - We do a good job.

41:33 - Everyone engage as deeply and intensely in services.

41:36 - If you build that relation that trauma informed approach.

41:39 - and a number of studies, about 35 case studies around the country

41:43 - that have happened, we see that one of the most expensive

41:45 - things we do as a community is keep you experience homelessness.

41:49 - If you're using the ER as your primary care,

41:51 - the ambulance as your taxi,

41:53 - it's really expensive for our community and the taxpayer, you know, our hospital

41:57 - systems, right?

41:58 - You're writing off a ton for charity care every single year.

42:02 - Well, if we house people,

42:04 - we see about a cost savings per person per year, around $25,000.

42:08 - Right?

42:08 - So just do that math of you're seeing everything from a police officer

42:12 - who gets now a couple extra hours a week to do something else.

42:15 - You actually do community policing, you know, we see, your E.R.

42:19 - discharge nurse get to be a little bit more,

42:21 - you know, intentional and in some of their approaches

42:24 - versus having to be in those ten minute increments

42:26 - so that that reallocation has some real human benefits.

42:30 - and it's also working at scale, focusing on veterans homelessness

42:33 - so that just homelessness decreased by 11% since 2020

42:38 - during the pandemic,

42:40 - we decreased homelessness for this entire population.

42:43 - That's huge.

42:45 - So again, it's not from lack of ideas, on what it takes to get there.

42:49 - I think it's a really on this idea of our we've built a homeless services system

42:53 - that still has housing at the end of it

42:55 - versus trying to guess to flip that, to think right to left,

42:59 - how much housing do we need and how can we get there?

43:03 - Do we have to have anyone

43:03 - here from Erie that want to make that turnpike journey?

43:07 - Why not ask? You know, anyone over

43:09 - speak of a subcommittee and I use the wrong local reference.

43:12 - now we're doing work up at Erie right now.

43:15 - we actually just had an announcement yesterday.

43:17 - We're here for the first time.

43:18 - We had the county executive and the mayor standing together in a press conference.

43:22 - because politics are tough on a lot of places, right?

43:25 - You know, there's and we announced

43:28 - that we're going to functionally end chronic homelessness in Erie County,

43:32 - by developing 150 units of housing first buildings.

43:37 - And with that, we launched a new initiative called Housing First Erie.

43:40 - Recognizing that our homeless service system

43:43 - is exhausted, they are tired.

43:47 - And so the idea that somehow we're to say, congratulations, you're also

43:49 - now on top of just trying to keep the crisis stabilization together,

43:53 - you're also now going to do a strategic initiative

43:56 - that's to leverage $20 million in public private funds that you have to go find

44:01 - and to increase your services, etc., etc..

44:04 - This I know you all do that.

44:06 - So we pulled together private funders, health care to create

44:09 - a new initiative called Housing First Area to address chronic homelessness

44:12 - in partnership with existing system.

44:15 - And so it all came from this idea that we have this huge gap that

44:18 - I think this chart

44:19 - probably is similar to a lot of places, which is good work is happening.

44:23 - Like in Erie, we're housing 400 people a year.

44:27 - That's awesome.

44:29 - But look at the size of the 400.

44:31 - We're seeing about 1200 come into our system,

44:34 - and this is probably it.

44:35 - And if you see the same thing, Brian, but like seems to be about like 75%

44:40 - of most communities are like first time homeless somewhere around that, right?

44:43 - It's like in most communities,

44:45 - every single year, if you think of a hundred people touch your system,

44:48 - 75 of them, it's their first time coming through.

44:52 - So we need to get more rapid with that group.

44:55 - But then somewhere around that 25%, a quarter of folks are sticking around

44:59 - there.

44:59 - again though, that more likely that more vulnerable population.

45:03 - This is true in Erie, where every single year they got about 450

45:07 - people who experienced homelessness before that were coming back around.

45:10 - So that was the group. We said, if we can get that moving,

45:13 - then we think we'll, make a big difference.

45:17 - And so to do it with this new initiative I mentioned, we're going to build

45:21 - one new building of 50 units, with that Housing First design.

45:27 - So we've pulled in a developer to do that,

45:29 - and it's going to have services directly on site.

45:32 - And then we're going to, have 100 scattered site units throughout,

45:37 - throughout the entire community, all backed with a lead service agency.

45:42 - And so this new model,

45:46 - out in Erie, I think, like, shows that there's

45:49 - there's possibility for us to pull things together, even

45:52 - as some of our statewide folks figure out funding systems.

45:55 - I think too often.

45:55 - I don't know if this rings true for you, but I hear a the ground level

45:59 - a lot of folks are saying, oh, we'll do this when the state does AP

46:02 - and say, we'll do this when HUD and the federal government does.

46:06 - We'll do this when the Biden administration wins reelection.

46:09 - Feel like, well, like we'll just wait

46:10 - versus there's a lot we can do today, isn't it the scale we want? No.

46:13 - But that implementation is really hard.

46:15 - If we're waiting for the state to do these three things

46:17 - and then we start our process, our process is still going take a long time

46:21 - to level up our services, to get funders educated, to build the right round table.

46:25 - All that stuff takes years, so we need to get better.

46:28 - I think about starting today.

46:30 - And so my ask of you all is, is who's your local coalition of the willing?

46:35 - I don't know any organization area group

46:38 - that doesn't start with three people having coffee, lunch or a beer.

46:43 - I hope you're already doing it.

46:44 - Sounds like and it sounds like you're this for for here in Bethlehem.

46:48 - Like who?

46:48 - Locally.

46:49 - Can you just go and buy coffee for

46:51 - and just be like, what's it look like if we just take those

46:53 - those programs we have and have a like a system approach around it

46:55 - and then just start building from there,

46:57 - then eventually it gets to a county commissioner

46:59 - and a mayor, like we need government on the table. Absolutely.

47:02 - But more times than not, I feel like it's one funder.

47:05 - It's health care pulling in.

47:06 - also, I think getting those unlikely partners,

47:10 - especially if those health care folks, your time is now.

47:13 - Your time is now to be pulled into this.

47:15 - you probably have had some kind of social determinants of health.

47:19 - You know, VPI, some community health.

47:21 - VPI for a long time, they've probably done 10 to 12 reports by now.

47:26 - which is awesome.

47:28 - But if if that same VPI just went to the soup kitchen tomorrow and sat

47:32 - and listened,

47:34 - what would you come up with?

47:36 - Right? Where would you start?

47:38 - Who would that BP then take to to coffee the next day?

47:40 - How can we just get going to launch that implementation?

47:45 - and at the end is number six and close up,

47:47 - that coalition and building up these systems of care

47:50 - and build up the right systems approach, you know, it gets pretty wonky.

47:54 - And at the end of the day, I think one thing we also struggle

47:56 - with is, again, as I mentioned, all of our social services

48:00 - are doing a lot and we're stretched and we've got workforce shortages.

48:03 - And so we're doing a time.

48:05 - And so to do these partnerships, we need to be asking like, who's that backbone?

48:09 - Where can we get our funders to agree on creating some that backbone agency

48:13 - approach, which is who is making sure that the work happens between meetings?

48:17 - I think we're all tired of having that awesome coalition meeting.

48:21 - And then we go a month later and we kind of have to remember,

48:23 - like, wait, what do we what we talked about last time,

48:26 - and we start again and we start again. We start.

48:27 - And whose job is it between those?

48:29 - It's like work that Brian does.

48:31 - Like whose job is to make sure work happens in those 30 day period

48:34 - to, to call Amber and say, okay, did you oh, you didn't call that person.

48:37 - I'm gonna sit here with you. So you do.

48:39 - so who's that backbone for you guys?

48:41 - It might be you.

48:43 - I hope it's you.

48:44 - You're here.

48:44 - and so really be thinking about that.

48:47 - So I think there's a lot we can do.

48:48 - I think, yes, there's a huge need, but that need, I think,

48:52 - can really be broken down by population groups.

48:54 - And these few providers, and we can really get going.

48:57 - So one, thank you for all the work that you are already doing.

49:00 - and thank you for allowing us time to speak.

49:01 - We're gonna move into a question and answer.

49:09 - Question.

49:10 - And so do you have can feel free to raise your hand.

49:12 - I'll come around with the mic and our panel can answer questions for you.

49:16 - Who's got questions?

49:19 - Yeah.

49:19 - All right, here we go.

49:21 - And don't forget on Hulu

49:23 - you have the option to put in different questions you have for the panelists.

49:27 - So feel free to. That's,

49:29 - hello. Okay. Hi.

49:31 - My name is Fritzy. I'm a nurse.

49:33 - I was wondering how as a state

49:36 - or whether it be as an organization

49:39 - or citywide, etc., how we're incorporating like those with SMI

49:44 - or severe mental illness and housing and affordability.

49:48 - I recently spent some time in Alaska, and I was very impressed that

49:52 - a lot of the patients who are on a team or a sort of community treatment

49:56 - team are with SMI had like some kind of housing resource in Alaska.

50:02 - I don't know the ins and outs because I'm not from like legislation in Alaska,

50:07 - but it was impressive to see that even though they still have

50:09 - a lot of homelessness population, to see that there is resources.

50:13 - And I feel like as a nurse who works at a community hospital,

50:16 - I don't know those resources in my area and if they even exist.

50:20 - So I'm just wondering.

50:25 - Yeah.

50:27 - Let's start with, real quick.

50:29 - For folks that aren't familiar,

50:30 - SMI stands for either series or Significant Mental Illness.

50:33 - So we're talking about folks that maybe have more than just a depression

50:37 - diagnosis, folks that are dealing with schizophrenia, bipolar disorder,

50:40 - what have you.

50:41 - So this is kind of like why CSA exists, why supportive housing exists,

50:46 - why housing first exists. Right?

50:47 - There are a lot of people like why it said,

50:49 - the folks who are flowing into homelessness

50:51 - that don't need a ton of support or whatever, they need a few things,

50:56 - maybe assistance with employment or whatever it may be to

51:00 - or just that base of operations for a little while

51:02 - to get back on their feet and get get back in the mix. Right.

51:05 - And that's a really important role

51:06 - that our systems that, like white is talking about, have to have to play.

51:10 - For the folks with SMI, you can't paint two broad brush either, right?

51:13 - For those of us who worked with folks with SMI, like,

51:16 - there's folks who, you know, also just need light touch.

51:19 - And then there's the folks who definitely are like,

51:22 - in case you forgot five minutes ago, I still have this, that I'm dealing with,

51:26 - and it really affects me day to day and minute to minute.

51:29 - So I think, like what you're talking about when we talk about, like, an act,

51:32 - you know, sort of community treatment team model or whatever it represents

51:35 - the highest like level of service we can wrap around somebody.

51:40 - But ultimately that's what this comes back down to, is like

51:43 - when and I think we did a really good job on touching on this.

51:46 - Right.

51:47 - We've been operating for years and services are over here.

51:50 - Housing's over here. Right.

51:52 - And that's the same with health care like we talked about earlier.

51:55 - And it really comes from a I think from starting

51:59 - from a point of let's assume everybody has some kind of services need.

52:03 - There's been study that show about 48 hours into experiencing homelessness.

52:08 - The impacts of like traumatic stress and post-traumatic stress disorder

52:11 - start to sink in.

52:12 - That's not a huge window. Right.

52:14 - And what we know is, even for first time folks, that experiencing homelessness

52:18 - is going to be for more than two days.

52:19 - So I think that, I think it's about this kind of culture shift.

52:25 - I think

52:25 - one of the things

52:25 - that we're up against right now is, although Housing First

52:28 - has these amazing, like, evidence base and everything like that,

52:31 - because the amount of people in flowing into the system is so much

52:36 - higher than the folks that we've been able to to work with and help get out.

52:40 - It looks like it's not working, but it really is about kind of

52:44 - doubling down on that approach that we're going to assume

52:46 - that everybody needs some level of support,

52:48 - and we can tailor that to the individual.

52:50 - And I'm not sure if I'm totally answering your question,

52:53 - but like, that's what leads to a community in Alaska.

52:56 - Being able to integrate

52:57 - and acting with a housing is starting from that, like culture shift

53:00 - to like, oh, and it goes away from like, you know what? Why?

53:04 - It was something that we used to do this thing called a linear residential model.

53:07 - You go to a shelter, if you can prove you can have a little more independence,

53:10 - we'll give you a little bit more of an independent setting if you do.

53:13 - Okay. There. We'll give you a little bit of a bump up.

53:15 - It kind of strips the humanity and the dignity from all of our people.

53:18 - And it also just doesn't work as well when it creates a system

53:22 - where people get stuck.

53:23 - We're figure they have to game the system.

53:26 - So it really goes back

53:27 - to this idea of housing first doesn't just mean giving them housing,

53:30 - it means housing first and then wraparound support

53:33 - and so I think a lot of that to go back to your question

53:35 - of how you do that from your perspective is

53:37 - who are those folks who are out there providing that behavioral health support?

53:41 - All of their folks need housing, right?

53:44 - How do we get them in the same room as the people who have a bunch of,

53:48 - you know, housing programs?

53:50 - And there's a lot of there folks who need support.

53:52 - It's like, we just got to get the peanut butter and jelly together.

53:57 - Awesome.

53:57 - Thank you guys for answering that.

53:58 - Any other question?

54:03 - Good morning.

54:03 - My name is Melvina McLeod.

54:04 - I'm a public health nutritionist with the Pennsylvania Week program,

54:08 - and I'm also a veteran.

54:10 - So I want to say thank you,

54:11 - sir, for the work that was done to house all the veterans.

54:15 - That's really huge.

54:16 - you made that announcement.

54:18 - But my question is lead abatement.

54:20 - when I worked at one of our local, work programs, we had a family.

54:26 - we're always doing, you know, lead poisoning prevention.

54:29 - And we had a family that, unfortunately, she had a slumlord,

54:33 - as her landlord and, her both her children have elevated lead levels.

54:37 - I was just wondering, to your point, sir, with,

54:40 - you know, starting with the house and and building around it, like, how

54:44 - where does lead abatement fall in, to that?

54:48 - a lot of houses here in Pennsylvania, we all know, were built,

54:51 - you know, turn of the century, quite honestly.

54:53 - and not just, you know, not just turn of 2000s, turn of 1900s,

54:58 - and their older brick homes,

55:01 - were right here next to, Bethlehem Steel.

55:05 - I mean, that's kind of pretty representative of the whole state.

55:08 - And I was just wondering where that falls.

55:10 - And, speaking for Pennsylvania,

55:14 - how how does the leather Bateman piece fit into, safe housing?

55:22 - well, I

55:23 - can't speak to this in great detail because it's a program of DCD,

55:27 - but the whole home repair program is is

55:30 - definitely something that kind of speaks to that piece of housing quality.

55:33 - I think we're

55:34 - always thinking about things is really about the development of new housing.

55:38 - But that preservation piece. Right.

55:40 - We know that, like,

55:42 - Pennsylvania has some of the oldest housing stock in the country.

55:44 - And so how do we and that often tends to be what we would call

55:47 - naturally occurring affordable housing, just units that are a little bit less.

55:52 - Well, captain, therefore, our lower rents, but I think that is

55:56 - such a key piece of this and hopefully the whole homes repair

55:59 - program will start to kind of eat away at one little bite at a time.

56:04 - But I don't know if other folks have thoughts.

56:08 - Sure.

56:08 - And so in the Lehigh Valley, I think we have some pretty, impressive

56:13 - models of lead abatement programs both in Allentown and the city of Bethlehem.

56:17 - I think a key component

56:18 - of making those successful has been, partnerships between agencies

56:23 - that, you know, can detect a lead issue, right in our in Bethlehem, for example,

56:28 - Bethlehem Health Bureau gets a report of every single elevated lead level.

56:33 - you know, when kids are doing their testing and,

56:36 - makes contact with those families, but then they have within our,

56:40 - our city government and our nonprofit structure,

56:42 - a significant amount of funding through HUD,

56:45 - led and Healthy homes programs that allows for that,

56:48 - you know, warm handoff essentially to say, okay, you have this issue.

56:53 - Let's sit down with the health

56:55 - bureaus, social workers and figure out how to fill out this application.

56:59 - get your, you know, income information.

57:01 - It's a process.

57:02 - Right.

57:02 - And, and those applications are usually because it's federal funding.

57:06 - They can be pretty complicated.

57:07 - And so that coordination between the programs

57:09 - I think is really essential because often, you know, you're shifting out

57:13 - of the health bureau into a department that's focusing on construction.

57:16 - So it's not the same people.

57:18 - but ensuring that, you know, agencies

57:20 - like the Health Bureau have the social workers

57:21 - that help to walk folks through the application process,

57:24 - get them connected to lead and Healthy homes programs.

57:27 - and then can get that remediation done.

57:30 - And so, you know, within like Lehigh and Northampton counties, for example,

57:34 - there's a lot of money available through those programs.

57:37 - some of those are administered through our cities, like an Allentown in Bethlehem.

57:40 - community action also administers for the boroughs and townships

57:44 - outside of the cities.

57:46 - but I think, yeah, the most successful, programs

57:50 - integrate, services, have collaboration between partners.

57:54 - And then just the one other piece that I will mention is,

57:58 - local legislation.

57:59 - Right.

57:59 - Allentown has some of the most robust, you know, rental

58:03 - inspection ordinances that are proactively looking for lead in homes.

58:07 - Bethlehem were a bit more reactive.

58:09 - but that is a conversation you can have with your local housing inspection.

58:13 - your city council members, your administration to increase, so,

58:17 - you know, proactive efforts to test for lead when rental homes

58:20 - are being inspected and ensure that landlords, are able to remediate

58:25 - and have funds to be supported in remediation because it's costly

58:29 - and you don't want to see those additional expenses

58:31 - passed on to the tenants through increased rent payment.

58:34 - So, you know, a coordinated effort

58:36 - through all of those elements, I think, makes program more successful.

58:39 - And it can I just check on one quick thing?

58:41 - All right.

58:42 - We'll let you one more quick thing before Nico tackles me up here.

58:45 - He's like wrapping up. Right. You're wrapping up.

58:47 - One of the things we found when we were doing our work

58:49 - is that a lot of times, health

58:51 - care partners don't know the circumstances that their patients are living in.

58:55 - So I think the other part of like a lot abatement conversation starts

58:58 - with like asking the patients, where are you living?

59:01 - What are the conditions like?

59:02 - And that is the first crucial step.

59:05 - And if you can get to a point where you can tell that story,

59:07 - what data, it can help sustain these programs.

59:09 - And so I just wanted to, guys, this has been an amazing panel.

59:14 - I have so many notes for follow ups and thought.

59:16 - Don't forget to use your Hulu app and ask questions

59:20 - as we're going through our day, and we'll be available to answer those.

59:23 - But let's give our panel a round of applause.

59:25 - Thank you guys.

59:26 - Amazing, amazing.

59:29 - Thank you. Thank you guys. Have a great day.