Sustain Fact Sheet

1. SUSTAIN Permanent Supportive Housing Grant
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DBHDS Grant Project Information Sheet
SUSTAIN – Supported Upward Stability through Advocacy in New Housing
The State of Virginia is committed to its current initiative to advance housing opportunities for individuals with
disabilities and reduce homelessness. As a result, recent grant funding opportunities were provided by the State
Department of Behavioral Health and Developmental Disabilities (DBHDS) so that local Community Services Boards can
develop Permanent Supportive Housing (PSH). PSH is a national Evidence-Based Practice for adults with serious mental
illness. PSH combines affordable rental housing with supportive services to address the treatment, rehabilitative, and
recovery support needs of participants.
In September 2016 the Fairfax Falls-Church Community Services Board (CSB) was awarded a multiyear grant totaling
over $1.4 million to develop permanent supportive housing options for adults with serious mental illness who are
receiving CSB services and who are homeless, at risk of homelessness, or at risk of coming in contact with the criminal
justice system. Also eligible are individuals leaving hospitals or state institutions (such as the Northern Virginia Mental
Health Institute) who have no housing plan.
The local partner in this new housing is New Hope Housing. In addition to housing, the CSB will provide clinical and
supportive services. Working collaboratively with New Hope Housing, the CSB anticipates that the SUSTAIN grant
program will offer hope and supports for stronger individuals and families and a healthier community for all. This project
will support the development of 32 permanent supportive housing units. No new service resources/dollars are
associated with this permanent supported housing. Any case manager that refers someone for this housing will need
to continue their case management and supportive services.
Primary goals
 Promote a housing model that separates housing from clinical services.
 Increase longevity in independent housing (how long people remain in their housing).
 Increase independence and self-sufficiency skills to allow individuals to thrive on their own.
 Improve employment outcomes and promote constructive daytime activities.
 Reduce number of psychiatric hospitalizations per person living in Permanent Supportive Housing.
Who is eligible?
 Currently homeless or currently at risk of homelessness and unstably housed.
 At risk of criminal justice system contact (i.e. Diversion First clients).
 Individuals leaving hospitals or state institutions (such as Northern Virginia Mental Health Institute) with no
immediate housing plan.
Prioritization criteria
Tier 1 (primary prioritization)
o Length of homelessness history as documented by the CSB referring entity
o Frequency of psychiatric hospitalizations (2 or more in a 90 day time period)
o Utilization of Crisis stabilization or Detoxification services ( 2 or more in a 90 day time period)
o Frequency of contact with criminal justice system (2 or more in a 90 day time period)
o Any combination of 2 of the above occurring in the previous 60 days (from date of
application); Frequency can be 1 or more in each area.

2. SUSTAIN Permanent Supportive Housing Grant
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 Tier 2 (secondary prioritization)
o Unstably housed as defined by DBHDS
o Clients stepping down from Supervised Residential Treatment Programs
o Any of the tier 1 events occurring in the last 90 days.
Services provided by housing partner New Hope Housing
 Housing location
 Leasing
 Landlord outreach to develop new relationships and maintain existing relationships
 Collaboration with case management staff to resolve issues impacting housing stability
 Recertification
Services provided by the Community Services Board
 Eligibility review
 Required routine case management and linkage to community resources and services
 Behavioral health outpatient and case management
 Assertive community treatment, Intensive case management
 Jail diversion, Diversion First
 Collaboration with housing partner to resolve issues impacting housing stability
 Reporting, data collection, and survey requirements that are needed to track grant outcomes
Referral process
 Case manager completes CSB Community Housing Screening Form in Credible (dated within 30 days) and
Attaches:
o CSB Authorization to release information
o Treatment Plan
o Adult Assessment dated within 1 year
o Last Service Plan Review
o VISPDAT [PATH]
o Progress Notes [PATH]
o Safety Plan
o Current state issued ID
o Social Security Card AND Current proof of income (i.e. SSI/SSDI letter) or last 3 pay stubs
o Any info Housing partner needs to be aware of that impacts housing stability
 Once the above application items are compiled send and encrypted email to CSBHousinginfo@fairfaxcounty.gov
with “SUSTAIN” in the subject line and the Credible Number or fax entire application to 703-653-6684.
 An acknowledgement of the application will occur within 5 business days. A decision regarding acceptance will
be shared with the Case Manager within 10 business days or less.
Geographical areas served by New Hope Housing : Alexandria, Annandale, Falls Church, Lorton
Reston, Centreville, Burke, Springfield, Fairfax, Chantilly, Herndon and Vienna (Human Service Regions 1-4).