Objectives

To determine whether controls over the Empire State Supportive Housing Initiative (ESSHI) are sufficient to ensure the needs of high-risk target populations are being met, and whether providers deliver the services that are required in their contracts with State agencies. The audit covered the period from July 2017 through March 2023.

About the Program

Established in 2016, ESSHI is part of the Executive’s comprehensive plan for affordable and supportive housing to ensure all New Yorkers have access to safe and secure housing. As part of this plan, ESSHI’s goal is to develop 20,000 units of supportive housing over a 15-year period ending in 2031. The Office of Mental Health (Office) serves as the lead procurement agency for ESSHI, which provides up to $25,000 annually per individual toward supportive housing for vulnerable populations experiencing homelessness. As such, the Office issues Requests for Proposals (RFPs) annually, with the goal of developing 1,400 units of supportive housing each year.

Proposals should address the needs of the various populations to be served by both the Office and the other State agencies under ESSHI. Each of the Office’s ESSHI contracts contains a work plan detailing the provider’s objectives as well as the housing-related support services to be provided. The Office’s Supportive Housing Guidelines (Guidelines) provide a framework for operating supportive housing programs, such as ESSHI, and require the Office to engage in monitoring of supportive housing programs once per 5-year contract cycle.

Additionally, case managers are required to have monthly face-to-face visits with residents, make quarterly in-home visits, develop an initial support plan within 30 days, and verify their income annually. The face-to-face visits allow case managers to ensure the resident remains stable and to monitor their needs for changes, and aid in ensuring the support plan is relevant. Further, in-home visits allow the opportunity for the provider to see the resident’s living environment.

From the program’s inception in 2016 through April 26, 2023, there have been 286 ESSHI projects and 8,122 units permanently awarded across all State agencies under ESSHI. The Office has contracts for 87 of these projects, comprising 3,021 units. Of the 87 projects, only 66 (relating to 2,087 units) are currently active and providing supportive housing. The remaining 21 projects are in the process of becoming active and are in various stages of construction.

Key Findings

We found significant deficiencies in the Office’s oversight of the ESSHI program, including insufficient monitoring of Guidelines and contract requirements, provider performance, and conditions at some housing units.

• Of a sample of 61 residents’ progress notes, we determined:
  • 11% of the face-to-face meetings were not held
  • 12% of the in-home visits were not conducted
  • 38% of the initial support plans were not developed within 30 days
  • 38% of the annual income verifications were not performed
• During our audit, we found that two residents had been missing for extended periods of time. The provider did locate one of the residents; however, the other resident’s location remained unknown. This resident’s alleged relative was living in the unit and had changed the locks on the door. In June 2023, the provider located the resident in a nursing/rehabilitation facility following an inpatient hospital stay.
• Four of the six providers’ ESSHI projects we inspected had critical issues at the housing units, such as water leaks, water stains, and mold, while two of the six had lesser issues, such as evidence of vermin (i.e., mouse hole), damage to walls, and peeling paint. Water leaks within a building may result in immediate and long-term damage if moisture is not removed appropriately.
• The work plans for each contract did not always include attainable, measurable objectives that would enable each provider to track the progress of their stated objective. In addition, the Office does not monitor the progress of these objectives or evaluate the provider against its work plan despite the inclusion of them in each contract.

Key Recommendations

• Increase the frequency of the Office’s provider monitoring visits to ensure ESSHI units are adequately maintained, provider performance is acceptable, and Guidelines are met.
• Develop and implement a process that ensures provider contracts have objectives and performance measures that are attainable, measurable, and reportable prior to awarding contracts.
• Develop and issue policies and procedures to field offices related to monitoring and reviewing work plans to ensure providers comply with contract requirements.