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Moving the homeless out of shelters, into homes

A new approach is being heralded not only as more successful in fighting chronic homelessness, but more cost effective.

from the August 20, 2007 edition

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Initially, shelters focused on helping people with psychiatric needs and drug addictions first, and worried about getting them homes afterward. With families, too, social service workers focused on job training and other help before placing them in homes.

Management vs. prevention

Homeless experts began to question that approach when they realized they were managing the homeless problem, not solving it. That's when they pioneered the Housing First concept, targeting the toughest homeless cases, the mentally ill and drug addicts who cycled through homeless shelters, emergency rooms, detox centers, and psychiatric hospitals. Professor Culhane's studies in the 1990s found this population accounted for about 10 percent of the people in shelters – but used more than 50 percent of the resources Moving these people into apartments with rent subsidies and support services was not only more humane, but more cost effective.

"It was a less expensive response than having these people being out on the street or in long-term shelter," says Philip Mangano, executive director of the Unites States Interagency Council on Homelessness. "That's because this is a population that randomly ricochets into very expensive primary and behavioral health systems costing between $30,000 and $150,000 per person per year."

Providing supportive housing, on the other hand, costs between $13,000 and $25,000 a year, says Mr. Mangano.

A study of one supportive-housing initiative in Boston released earlier this month by the Urban Institute found that the average client ended up in the hospital 102 times in the two years before getting into supportive housing. That dropped to seven days in the two years after getting into a home, saving the state $20,000 just in hospital costs. "Solving this problem turns out to be less expensive than managing it," says Mangano.

Almost 300 communities across the the country have now committed to 10-year plans to end homelessness. The federal government, under Mangano's leadership, is also asking for a record a $4.4 billion dollars in 2008 to spur the development of more supportive-housing complexes.

That success in dealing with the chronically homeless has prompted New York and other cities to experiment with similar philosophies for family homelessness. The city is taking a three-pronged approach: prevention, trying to help people with crises before they lose their homes, with an array of services from cash to pay-back rent to counseling and legal services to intervene with landlords; a short-term subsidy program to help families stabilize financially; and a diversion program that's designed to prevent families like the Cedanos from ending up in the homeless system in the first place.

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