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Chapter 6: Housing and Shelter • [ndividuals with mental disabilities; • Chronically ill individuals, including those with HIV/AIDS; • Individuals with chronic alcohol and drug problems; - • Multiply diagnosed individuals; and • Frail elderly individuals. There are a variety of models for providing permanent supported housing. Some models are "project-based" with services provided at a specific housing complex or linked to that site via transportation services. Other models are service-provider based and link services to existing - permanent housing programs throughout the community. A mixed population approach offers opportunities to better serve some populations, but is often hard to fund due to the requirements and expectation of funding programs. It is important to encourage a variety of - models and to ensure that supported housing is sited in a variety of neighborhoods throughout the community. The greatest challenges to expanding the supply of permanent supported housing are 1) the lack of long-term, stable funding for the services component of supported housing, 2) the need for stronger links between affordable housing providers and programs and service providers, and 3) insufficient existing housing funding for new housing affordable to households at 35 of area median income or below. Within Alameda County, people with psychiatric disabilities are frequently among those individuals who are homeless or at risk of being homeless. Without a home, people with severe psychiatric disabilities are more likely to be re-hospitalized and/or incarcerated and housed in living situations against the person's own wishes. This results in the cycle of streets to hospitals/jails to board and care and back to the streets. In addition, those severely mentally ill individuals whose communities are in the East and South areas have almost no supported or supervised housing options if family members can no longer provide housing. The lack of permanent supportive housing options has resulted in "tracking" people with severe mental illness into institutional settings. The result has been an over use of primary and acute medical and psychiatric facilities for emergencies and more frequent and longer stays in - long-term care facilities. As with transitional housing, permanent supportive housing can be site-based or long-term rental assistance with accompanying case management and support services. Alameda County-Wide Homeless Continuum of Care Plan: April 1997 88