From today’s Philanthropy News Digest alert:
Initiated in January 2003 by a broad coalition of public and private partners, Chicago’s plan transformed the city’s homeless system from one that manages homelessness to one that works to end homelessness by moving people quickly into permanent housing. Since the plan’s inception, its main strategies — preventing individuals and families from becoming homeless in the first place; placing individuals and families in permanent housing as quickly as possible when they do become homeless; and providing wraparound services when appropriate to promote housing stability and self-sufficiency — have attracted more than $76 million in funding.
Funded by Chicago Community Trust, the Michael Reese Health Trust, the Polk Bros. and McCormick foundations, and the City of Chicago, the evaluation will be led by homeless policy experts at the University of Chicago and Loyola University Chicago, in conjunction with the Chicago Alliance. Researchers will follow six hundred people as they navigate the city’s homeless system and study what happens to them over the course of a year, while interviewing clients and conducting focus groups to document, from the client perspective, how well the current homeless system meets their needs. In addition, they will create a service inventory to track how homeless services have changed since the plan’s implementation and conduct a comprehensive survey of homeless service agencies to identify successes in implementing best practice models and services gaps.
“The plan to end homelessness holds the promise of a major breakthrough in the way we work together to ensure that everyone has permanent housing,” said Chicago Community Trust president and CEO Terry Mazany. “In these trying economic times when resources are scarce, it is especially important to evaluate and strengthen Chicago’s plan to help more people move from homelessness into stable and productive lives.”
“New Study to Evaluate Chicago’s Plan to End Homelessness.” Chicago Community Trust Press Release 7/08/09.
By Stephen L. Day and Ann O’Hara, Technical Assistance Collaborative
On June 22, 2009, the 10th anniversary of the U.S. Supreme Court’s Olmstead decision, President Barack Obama announced a new Section 8 Housing Choice Voucher initiative as part of “The Year of Community Living” – a new and ground-breaking effort to assist people with the most significant and long-term disabilities to live independent and fulfilling lives in the community.
The Technical Assistance Collaborative applauds this new federal policy direction which inaugurates a promising partnership between the U.S. Departments of Housing and Urban Development and Health and Human Services – along with a new role for the nation’s Public Housing Agencies (PHAs). HUD is proposing to provide 4,000 or more new vouchers through PHAs for very low income people with disabilities including special targeting policies aligned with people moving from nursing homes and other restrictive settings through HHS’s Money Follows the Person initiative.
In 1999, the Olmstead decision affirmed the community integration mandate within the Americans with Disabilities Act by holding that the unjustified institutionalization of people with disabilities is a form of unlawful discrimination – and a violation of an individual’s civil rights. Most people with disabilities affected by the Olmstead decision are receiving government assistance related to their disability and have extremely low incomes.
TAC has worked for many years to illuminate the housing crisis faced by people with the most significant and long term disabilities who rely on federal Supplemental Security Income (SSI) benefits that are 20 percent below the federal poverty line. Our recent study – Priced Out in 2008 – found that in the majority of the nation’s metropolitan areas, rents for modestly priced apartments are higher than the entire monthly income of an individual receiving SSI.
Without housing assistance, people with disabilities at this income level are too often forced to choose between a nursing home bed, a shared bedroom in a substandard and segregated Board and Care facility, or homelessness – all of which cost the government more money than simply providing a housing subsidy and appropriate community based services.
This “hidden housing crisis” is essentially what the Olmstead decision was intended to address. People with disabilities cannot benefit from high quality health care and other social services in the community if they don’t have places to live. That’s why they often face a “Hobson’s choice” by being forced to choose between placement in a nursing home or a Board and Care facility – where they give up their independence and virtually all of their monthly income – and homelessness.
Resources from the nation’s affordable housing system are the solution to this housing crisis. The permanent supportive housing approach – which links decent, safe, affordable and accessible housing with community-based supports and services – has proven to be a successful and cost effective alternative to homelessness and to the unnecessary and illegal isolation of people with disabilities in restrictive and segregated facilities
Disability housing advocates around the country have been struggling for years to get the attention of housing policy makers, including some who view this crisis as one that government human services agencies – rather than affordable housing agencies – should solve. That viewpoint – that somehow because you have a disability your housing needs are not relevant to the federal government’s affordable housing policies – is ironically consistent with the segregated government policies that the Olmstead decision finally overturned ten year ago.
The Obama Administration’s announcement sends a strong signal to the affordable housing community – including the nation’s Public Housing Agencies – that the housing needs of people with disabilities are a high priority. To reinforce that message, HUD Secretary Shaun Donovan – who has extensive expertise and experience in the permanent supportive housing approach – sent a letter to all PHAs urging them to adopt a high priority for people with disabilities who desire to transition from an institutional setting to housing in the community. On the same day, HHS Secretary Kathleen Sebelius announced several related HHS initiatives that are “only the beginning of the collaboration between HHS and HUD”.
State and local housing agencies are also important partners in the work that must be done to expand the supply of permanent supportive housing opportunities across the country. Legislation to revitalize HUD’s Section 811 Supportive Housing for Persons with Disabilities program is now moving through Congress (H.R. 1675 – the Frank Melville Supportive Housing Investment Act of 2009) and has received strong bi-partisan support. Along with the new voucher initiative, these federal actions will help inaugurate a new and more inclusive era in federal housing policy for people with disabilities by ensuring that permanent supportive housing units can be fully integrated within any affordable housing property – just as people with disabilities can become fully integrated within each and every community.
Both H.R. 1675 and the new disability voucher initiative are the outcome of TAC’s federal housing policy work in partnership with the Consortium for Citizens with Disabilities Housing Task Force. We are gratified that the Obama Administration has adopted our recommendation to link Housing Choice Vouchers to people with the most significant and long term disabilities – a proposal developed through the sustained support of the Melville Charitable Trust.
Philanthropy can also make an important contribution to this work by supporting technical assistance to structure new collaborations and partnerships between housing and services agencies in government and in the community. An outstanding example of the critical role of the philanthropic sector is the successful post-Katrina work being done by TAC and other stakeholders to create a 3,000 unit permanent supportive housing system in Louisiana. This effort could not have been undertaken without the sustained support of the Melville Charitable Trust and other core partners in the Funders Together network.
Almost 20 years after the enactment of the Americans with Disabilities Act – and ten years after Olmstead – the goal of achieving true community integration for all people with disabilities remains an elusive one. However, the actions taken by President Obama, HUD, and HHS on June 22 offer a new vision and a more collaborative framework at the federal for achieving this goal. It is up to all of us to transfer that framework to every state and every community across the country. If we can make that happen, perhaps 10 years from now, on July 4, 2019, we can truly celebrate the full inclusion of all people in the life of this great nation.
About the Authors
Stephen L. Day and Ann O’Hara are Executive Director and Associate Director, respectively, of the Technical Assistance Collaborative, a national non-profit organization that works to achieve positive outcomes on behalf of people with disabilities, people who are homeless, and people with other special needs. Steve and Ann have provided consultation and technical assistance to 35 states, over 100 local jurisdictions, and numerous national policy and advocacy organizations.
(This post originally appeared at The Huffington Post.)
As President Barack Obama tours the country making a compelling case for real healthcare reform, his message is clear: We must do a better job of containing costs by providing more effective and appropriate health care for all Americans. This is especially true for people with complex healthcare needs who are homeless or at risk of homelessness.
The Corporation for Supportive Housing (CSH) believes community-based health services linked to permanent housing for homeless people facing serious medical and behavioral challenges should be an integral part of comprehensive reform. Supportive housing helps connect our nation’s most vulnerable people to the most appropriate and cost-effective healthcare services. Without this connection, many homeless persons go without access to health services, other than expensive emergency interventions that may address a crisis, but cannot effectively address their long-term needs.
CSH has demonstrated how supportive housing can end the cycle of long-term homelessness. Along the way, CSH and our partners have also proven that supportive housing is fiscally responsible, resulting in reduced healthcare costs as well as the use of other costly systems of care. It is clear that tenants of supportive housing achieve better health outcomes than their counterparts still living on the streets. Consider the transformation of just one supportive housing tenant in California.
Every month Bob sought treatment at Highland Hospital’s (Oakland, California) emergency department for cellulitis (a bacterial skin infection). Bob was homeless, so he was unable to shower or perform necessary hygiene. Years before, Bob experienced a difficult divorce and his life fell apart. He began abusing drugs and was arrested for shoplifting and drug possession more times than he can remember.
On one emergency room visit, staff notified Maria Culcasi, a case manager for Project RESPECT that Bob was a “frequent user” of emergency services. Culcasi connected Bob to a community clinic for medical, mental health, and dental care. She helped him find permanent supportive housing and apply for SSI and Medi-Cal (California’s Medicaid program).
Eighteen months later, Bob was a new man and shared his experiences while appearing before the California Senate’s Health Committee.
“Maria Culcasi helped me get treatment for drug use and depression,” he said. “Now I have a place to sleep every night and a place to keep my medicine, so I don’t get sick as much. And, I have a place to keep food and prepare meals. Because of help from Project RESPECT, I don’t need to go to the hospital anymore. It’s good to be out of jails and hospitals.”
Bob is an example among thousands of successful supportive housing stories.
Several recent studies — from California, Minnesota, Illinois, Massachusetts and Washington State – point to the savings that can be achieved when supportive housing and community-based health services replace expensive — and often preventable — emergency room visits and hospital stays.
An evaluation of the Minnesota Supportive Housing and Managed Care Pilot by the National Center on Family Homelessness for Hearth Connection found that supportive housing significantly improved residential stability and decreased both mental health symptoms and alcohol and drug use. The evaluators concluded the Pilot had an impact on the cost of mainstream public services and that there was a desirable shift from expensive inpatient mental health and chemical dependency services, detox, and prison to more routine and less costly preventative health care services.
Another report released by the Heartland Alliance Mid-America Institute on Poverty (MAIP), the Illinois Supportive Housing Providers Association (SHPA), and CSH found that affordable housing that provides on-site services for people who are homeless, people who have mental illnesses, and other vulnerable populations could also dramatically reduce the use and cost of expensive public services such as nursing homes.
In Massachusetts, the State Office of Medicaid tracked the first 97 participants in the “Home and Healthy For Good” pilot program and found that placing chronically homeless people in permanent housing saved money across systems including hospitals, corrections and emergency shelters. Massachusetts found that Medicaid costs dropped 67 percent among program participants.
And lastly, a study of a supportive housing program in Seattle, Washington published in The Journal of the American Medical Association (JAMA) shows that supportive housing is saving local taxpayers more than $4 million a year while helping people with severe alcohol problems reduce their alcohol consumption. Researchers from the University of Washington maintain that placing homeless chronic inebriates in a safe living situation has helped some residents decrease their drinking or quit.
There are numerous other studies providing additional data and details on how supportive housing reduces the costs associated with institutional care and public services, and produces better health outcomes. As President Obama and Congress look for ways to advance healthcare reform and bring billions of dollars in skyrocketing budget costs back down to earth, they would be wise to turn to housing-based solutions as a key component of our national healthcare reform agenda.
Deborah De Santis is President and CEO of the Corporation for Supportive Housing. She previously led CSH’s New Jersey program, tripling the lending portfolio, successfully advocating for creation of New Jersey’s $200 million Special Needs Housing Trust Fund, and helping create a statewide grassroots organization to advocate for development of 100,000 units of affordable housing over 10 years, including 10,000 units of supportive housing. She is available to speak on topics pertaining to supportive housing, CSH, and the national movement to end homelessness.
By Bill Pitkin, from the Poverty and Inquality Blog
The Los Angeles Times is largely a shell of its former self, part of an overall downturn in the quantity and quality of newspapers. However, the paper is developing quite a niche in reporting on homelessness (which I guess makes sense because Los Angeles is home to more homeless persons than any other city in the nation). Thankfully, these columns tend to not focus on the negative, but rather uncover the personal stories of people struggling against the odds to overcome homelessness and poverty.
The most familiar of these stories is the extensive reporting by Steve Lopez on Skid Row and his friendship with Nathaniel Ayers, which resulted in “The Soloist” book and movie. Other recent stories may not be as well-known but are just as compelling.
Esmeralda Bermudez wrote about Khadijah Williams, an 18 year old who has long been homeless but is going to Harvard this year. Sandy Banks has written about Eddie Dotson, a man who created his own home in tight spaces near LA freeways and who was reconnected with his children through the columns. Banks’ most recent column highlights how Dotson “captured a community,” and she makes the important point that overcoming the odds wasn’t just a matter of personal will. Each of these special people received help from someone.
We should be inspired by these personal stories of triumph, while remembering that it is up to us to make sure that all the Nathaniels, Khadijahs, and Eddies out there have the opportunity experience similar victories.
The United States Interagency Council on Homelessness shared highlights of it’s first Full Council meeting of the Obama Administration, including the appointment of U.S. Housing and Urban Development Secretary Shaun Donovan as Chairperson, and statements from President Obama and several of the Council members on their expectations for the work of this important cross-agency partnership.
In addition, HUD Secretary Donovan and VA Secretary Shinseki also announced the allocation of $75 million to local public housing authorities across the 50 states, the District of Columbia, Puerto Rico and Guam to provide permanent supportive housing and dedicated VA case managers for an estimated 10,000 homeless Veterans, including families. This innovative joint initiative is called the Veterans Affairs Supportive Housing Program (HUD-VASH).
See below for full text of the of the update.
WASHINGTON, DC. The United States Interagency Council on Homelessness (USICH) yesterday convened for the first Full Council meeting of the Obama Administration, under the leadership of U.S. Department of Veterans Affairs Secretary and Council Chairperson Eric Shinseki. U.S. Housing and Urban Development Secretary Shaun Donovan was elected Chairperson for the upcoming year, and U.S. Labor Secretary Hilda Solis was elected Vice Chairperson. U.S. Health and Human Services Secretary Kathleen Sebelius and Melody Barnes, Assistant to the President and Director of the White House Domestic Policy Council, also attended the meeting.
In a statement released for the meeting, President Obama said: “It is simply unacceptable for individuals, children, families, and our nation’s Veterans to be faced with homelessness in this country. I am confident that the Interagency Council on Homelessness, under Secretary Donovan’s leadership, will have a renewed focus on coordinating efforts across federal agencies and working closely with our state, local, community-based, and faith- based partners to address these serious issues.”
Secretary Shinseki welcomed Council members and noted the importance of continuing efforts to end chronic homelessness, continuing to reduce veterans’ homelessness, and addressing the homelessness of families during the economic downturn. The Secretary indicated that the Council’s record showed the importance of collaboration in making progress in preventing and ending homelessness.
On behalf of the White House, Ms. Barnes greeted Council members and noted that the meeting came a “critical moment” which both recognizes past efforts and renews focus on the problem of homelessness with the promise of Administration leaders to partner both policy and budget in the effort to prevent and end homelessness.
HUD Secretary Donovan reported that progress has been made during the first 150 days of the Administration, pointing to the successful collaboration of HUD and VA through the HUD-VASH housing program (see related story), as well as through the new $1.5 billion Homelessness Prevention and Rapid Rehousing Program under the Administration’s recovery initiative. Secretary Donovan noted the recent reauthorization of the Department’s homeless programs under the HEARTH legislation signed by the President last month, including the creation of a new rural homelessness initiative.
“Ending the continuing tragedy of homelessness demands thoughtful and focused leadership,” said Secretary Donovan. “President Obama and I are committed to working through the USICH, the agencies it represents and our state, local and non-profit partners to build a thoughtful and compassionate response to this crisis. The bottom line is that through our combined efforts every man, woman and child in this nation should have access to a safe, affordable place to lay their head at night.”
U.S. Department of Health and Human Services Secretary Kathleen Sebelius said her agency “stands ready” to be a partner in making services accessible for people experiencing homelessness and in promoting best practices. Secretary Sebelius described increases proposed for the 2010 budget for targeted mental health and treatment services.
U.S. Department of Labor Secretary and new Council Vice Chairperson Hilda Solis reported to the Council on Labor’s initiatives for homeless veterans, youth, and women, including women veterans. She noted the potential for increasing the impact of Job Corps for youth aging out of foster care, and the proposed 2010 budget increase of over 30% for the Homeless Veterans Reintegration Program. Secretary Solis pointed out the proposed $4 million funding level for the Department’s initiative for incarcerated veterans employment services.
Secretary Shinseki asked all Council members to report on agency initiatives ranging from the Department of Commerce’s preparation for the 2010 census to the Department of Energy’s job creation goals using recovery resources, and including results from a multi-year Social Security Administration initiative to enroll homeless persons into SSA benefits. Council partners heard about the Department of Homeland Security’s continuing post-Katrina housing and case management activities, the Department of Agriculture’s accessibility opportunities for food and nutrition programs, the Department of Justice’s reentry and special courts efforts, and the Department of Education’s resources for education of homeless children during the economic downturn. Xavier de Souza Briggs, Office of Management and Budget Associate Director for General Government Programs and Mark Weatherly, Deputy Associate Director, Housing, Treasury and Commerce Division, affirmed recent federal increases in targeted spending on homelessness.
Interagency Council Acting Executive Director Pete Dougherty reported on the Council’s commitment to federal collaboration, and the past success of Council initiatives to encourage creation of State Interagency Councils on Homelessness and jurisdictional Ten Year Plans.
At the Bill & Melinda Gates Foundation, we recently launched a new set of investments to support the goal of ending family homelessness in the Puget Sound region within the next 10 years. Working with demonstration communities in King, Pierce, and Snohomish counties and with the Washington Families Fund (WFF), we are tackling one of the thorniest issues facing our communities these days–especially in light of the current recession.
The foundation, in partnership with WFF, will invest in five strategy components that we believe are essential to building a high-performing system to address the needs of families at risk of losing their housing. These five components are:
- Coordinated entry: Using common point(s) of entry to identify what families in crisis need up-front, as early and as quickly as possible.
- Prevention efforts: Working to keep as many families as possible in their existing housing through services such as eviction prevention and landlord mediation.
- Rapid re-housing: Minimizing lengths of stay in shelter for as many families as possible before they return to permanent housing.
- Tailored services and programs: Getting the right services to the right families at the right time for the right duration.
- Economic opportunity: Helping wage-earners in families access the training, education, and workforce development opportunities that can lead to jobs that pay a family living wage.
Our investment strategy is based in part on successful examples of activities across the country, where significant reductions in family homelessness have been documented over time. As our key partners at the county, state, and organizational levels begin their own planning work related to implementation of the five funding areas identified above, we decided to sponsor a visit to two communities that are doing some particularly innovative work: Chicago, Illinois and Minneapolis/Hennepin County, Minnesota.
During a whirlwind trip from June 9 – 12, 13 representatives from Washington visited programs, engaged with staff, questioned core concepts, and examined measured results. Not to mention that we ate up a storm at some fun restaurants in both cities–always with an agenda for discussion with local hosts!
It is difficult to describe the value of actually seeing the work going on in these communities first-hand. It is one thing (and quite helpful) to read reports about what is happening in a given system. But that up close and personal approach–where a visitor can get the actual flavor of what is happening on the ground–to see and experience the work as it is unfolding in a given setting–is invaluable.
In Chicago, we were struck by the effectiveness of a Homelessness Prevention Call Center that receives screened referrals directly from the city’s 311 system and works to keep families in their housing rather than enter the shelter system. We learned how the Chicago Department of Family and Support Services has decided to invest a significant amount of their federal stimulus funds into a pilot project with the Chicago Public School system to test a new approach to stabilizing the households of children that have been identified as homeless by the McKinney-Vento workers in their schools. We saw a demonstration of a new Corporation for Supportive Housing (CSH) “Housing Options Tool” that can help to match the specific profile of a person or family seeking housing with the programs and services available in a given community.
In Hennepin County, we spoke with the staff performing the central intake function seeking to promote diversion from shelter wherever possible. We saw the enormous value of employing staff for this work that have themselves experienced homelessness and offer both wisdom gained on the streets and powerful role models of successful recovery. We explored Hennepin’s rapid re-housing model that minimizes the length of stay in shelter for each family and learned about the stresses and strains that have been put on their system by the economic downturn and foreclosure crisis that too often forces families renting in foreclosed units onto the streets and into shelters. We engaged in a hearty and at times passionate discussion about the most appropriate outcomes for measuring success–is keeping families out of shelter the right measure or should we be aiming at a different set of outcomes that seek to promote longer-term stability for families over time?
In both cities, we were impressed by the energy, passion, and drive that have been applied by government agencies, non-profit organizations, and representatives from the business and philanthropic sectors. In Chicago, a group of private sector funders have been collaborating closely for more than a decade to ensure that their funding is carefully aligned with the primary goals of the system. In Hennepin County, funders and providers are working together to understand and address the new stresses being placed on the system by the current economic environment.
In short, the trip was an enormous success. The bakers dozen of us who went on the trip all slept on the plane most of the way back to Seattle–and agreed that it would have been difficult to sustain even one more day at the pace we had maintained during the visits. Nevertheless, we came back from these communities re-invigorated about the importance of work that we are doing, the amazing passion and energy that is being applied around the country to the task of ending homelessness, and the impact that dedicated people can have in making real change happen working together with families struggling to stabilize their lives after the brutalities of homelessness.
David Wertheimer is Senior Program Officer with the Bill & Melinda Gates Foundation in Seattle, Washington. David carries lead responsibilities for oversight of the foundation’s programs addressing housing and family homelessness, and also serves on the national Steering Committee for Funders Together.