DOCSLIB.ORG

Housing First

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Housing First Additional Housing Programs: Housing First By Kim Johnson, Policy Analyst, NLIHC Evidence Supporting Housing First wo decades of research and evaluation Research shows that Housing First rapidly ends support the efficacy of Housing First as a homelessness, is cost-effective, and improves means of ending homelessness, including quality of life and community functioning. This Tfor chronically homeless individuals (people with model was first developed for people with serious severe disabilities, including mental illness or psychiatric or substance use disorders who had substance use disorders, who have been homeless been homeless for long periods of time and for a long time). Housing First prioritizes access to was later extended to all homeless populations. safe, stable, accessible housing with services when Housing First has been credited with helping needed to ensure long-term housing stability reduce chronic homelessness by 20% since 2007 and effective treatment for underlying health and veteran homelessness by 50% since 2009. conditions, including substance use and mental Key to the success of Housing First is its health disorders. emphasis on low-barrier access to permanent, stable housing with supportive services when PROGRAM SUMMARY needed. Access to Housing First programs Housing First is a whole-systems model for is not contingent upon minimum income addressing homelessness that prioritizes access requirements, sobriety, criminal history, to permanent, stable housing with services when successful completion of a treatment program, needed. Housing First recognizes that stable or participation in supportive services; rather, housing is a prerequisite for effective psychiatric Housing First recognizes that stable, supportive, and substance abuse treatment, for stable accessible housing is fundamental to being able employment, and for improving quality of life. to effectively utilize wrap-around services. The Once stably housed, individuals are better able model eschews a “one-size-fits-all” approach to take advantage of wrap-around services that to addressing homelessness and instead pairs help support stability, employment, and recovery people and families with the level of financial – goals that are difficult to attain without stable assistance and supportive services necessary to housing. achieve long-term housing stability. Rapid re-housing (RRH) and permanent A random assignment study found that supportive housing (PSH) can both utilize the homelessness programs utilizing low-barrier Housing First model. In RRH, individuals and access to housing and services were more families experiencing homelessness receive successful in reducing homelessness than assistance identifying, leasing, and moving programs where housing and services were into new housing quickly and are connected contingent upon sobriety. When individuals were to supportive services if needed. Similarly, provided access to stable, affordable housing and PSH provides longer-term housing assistance given autonomy in deciding whether and when and voluntary supportive services, including to use services, 79% remained stably housed health care, employment, and treatment at the end of six months, compared to 27% of services, to ensure people experiencing chronic individuals in the control group. homelessness can attain long-term housing In addition to greater housing retention, stability. Housing First has shown success in reducing drug use among chronically homeless people with a history of substance use, more effectively 7–56 2021 ADVOCATES’ GUIDE increasing outpatient service utilization, and USICH Director Robert Marbut, appointed under increasing outreach to and engagement of the Trump Administration, frequently used clients not appropriately served by the public misleading and inaccurate data to falsely claim mental health system. Housing First has also that homelessness has increased as a result of been shown to decrease costs among chronically the widespread adoption of Housing First. Marbut homeless individuals utilizing emergency inflated the number of people experiencing medical services. Housing First provides a vital homelessness by including individuals in RRH option to the many people who are not able to and PSH programs in his homelessness count maintain perfect treatment immediately after – individuals living in their own apartments or exiting homelessness and ensures they will not houses and who are, by definition, not homeless. be relegated to long-term homelessness. He also falsely claimed that Housing First does not provide supportive services when needed and Attempts to Undermine Housing First drawn false conclusions about the underlying Despite its proven success and bipartisan causes of homelessness to support his misguided support in Congress, during its tenure the Trump policies. Administration sought to replace Housing Rather than Housing First, Marbut advocated for First models with programs that would deny an approach that would make it more difficult people and families experiencing homelessness for homeless families and chronically homeless stable housing if they were unable to maintain individuals to obtain safe, stable housing. While treatment or attain perfect sobriety. This shift in Marbut touted his approach as “treatment first,” policy not only ignored the decades of research in reality, high-barrier programs that mandate attesting to the validity of Housing First, but failed perfect sobriety or treatment as a prerequisite to to address the underlying, systemic causes of housing are not nearly as successful at ensuring homelessness and housing instability. long-term housing stability. A metanalysis Under past Republican and Democratic of existing research found that 65-85% of Administrations, HUD and the U.S. Interagency individuals participating in Housing First Council on Homelessness (USICH) have endorsed programs remained housed in the two years Housing First as a best practice to ending after entering the program, compared to just homelessness and the model has enjoyed 23-39% of individuals in programs emphasizing bipartisan support from congressional leaders. “treatment first.” Even USICH’s own documents First incorporated into federal recommendations support the efficacy of Housing First programs, under the George W. Bush Administration, finding that pairing Housing First with supportive Housing First was credited with reducing services when needed results in housing homelessness by 30% between 2005 and 2007. retention rates between 75-85% for individuals During the Great Recession, implementation of and 80-90% for families. RRH under the Obama Administration helped Available research on the efficacy of “treatment an estimated 700,000 people at-risk of or first” approaches to ending homelessness did experiencing homelessness find stable housing. not yield promising results. One 2004 study Rather than building on these successes, the concluded “there is no empirical support for the Trump Administration rejected decades of practice of requiring individuals to participate in research, learning, and bipartisan support for psychiatric treatment or attain sobriety before Housing First to focus instead on returning being housed.” Studies have also suggested that to failed “behavioral modification” strategies. requiring “perfect abstinence” as a prerequisite Trump Administration officials made several for housing can actually hinder participants in false claims about Housing First, relying on achieving long-term housing stability, recovery, manipulated data and misrepresented research and employment. to make its case. NATIONAL LOW INCOME HOUSING COALITION 7–57 Housing First, Homelessness, and COVID with developing a strategy to make housing a right for all people. Housing First’s foundational Access to safe, stable, accessible, and affordable tenet of providing people experiencing or on housing is a key determinant of health, and the verge of homelessness low-barrier access to this connection has never been more apparent affordable housing and supportive services when than during the ongoing coronavirus pandemic. needed is central to realizing this goal. Indeed, Policies that would actively deny people President Biden has pledged to ensure the experiencing homelessness or housing instability federal government “commits to a ‘Housing First’ access to housing, including Marbut’s proposed approach to ending homelessness,” including by “treatment first” approach, risk furthering the conducting a comprehensive review of federal spread of coronavirus, prolonging the pandemic, housing policies to ensure they incentivize a and exposing already marginalized people to Housing First approach. irreparable harm. Adequately adopting a Housing First approach The Centers for Disease Control and Prevention to ending homelessness requires a major (CDC) announced a federal moratorium on investment in developing homes affordable to evictions for nonpayment of rent, citing the the lowest-income people, including through “historic threat to public health” posed by programs like the Housing Trust Fund. The the virus and noting “eviction moratoria… private sector cannot, on its own, build or can be an effective public health measure maintain homes at a price extremely low-income utilized to prevent the spread of communicable people can afford, making it necessary for the disease.” The CDC further states that “housing federal government to play a leading role in the stability helps protect public health because construction and maintenance
Load more

Recommended publications
  • Housing First Checklist: Assessing Projects and Systems for a Housing First Orientation
    Updated September 2016 Housing First Checklist: Assessing Projects and Systems for a Housing First Orientation Housing First is a proven approach, applicable across all elements of systems for ending homelessness, in which people experiencing homelessness are connected to permanent housing swiftly and with few to no treatment preconditions, behavioral contingencies, or other barriers. It is based on overwhelming evidence that people experiencing homelessness can achieve stability in permanent housing if provided with the appropriate level of services. Study after study has shown that Housing First yields higher housing retention rates, drives significant reductions in the use of costly crisis services and institutions, and helps people achieve better health and social outcomes.i This checklist was designed to help you make a quick assessment of whether and to what degree housing programs — and entire systems — are employing a Housing First approach. Robust tools and instruments are available elsewhere to quantitatively measure program quality and fidelity to Housing First. This tool is not meant to take the place of those more rigorous assessments, but is intended to help Continuums of Care, individual housing and services providers, funders, and other stakeholders to communicate about, and quickly assess, alignment with key Housing First approaches. Core Elements of Housing First at the Program/Project Level For your homelessness service system to work the most efficiently and Quick Screen: Does Your effectively, individual programs must embrace a Housing First Project Use Housing First approach. This portion of the checklist can help you assess the extent Principles? to which your local programs are implementing Housing First. You can use this tool for trainings or planning sessions, during a site visit or 1) Are applicants allowed to program audit, as a guide when reviewing funding applications, or for enter the program without income? many other uses.
    [Show full text]
  • Can Housing First Work for Youth? Stephen Gaetz
    Part C _ Think Pieces 159 Can Housing First Work for Youth? Stephen Gaetz Faculty of Education, York University, Toronto, Canada Canadian Observatory on Homelessness >> Abstract_ Housing First has emerged as an effective and humane approach to addressing homelessness. In spite of the strength of the evidence, questions remain regarding the applicability of Housing First to sub-populations, including youth. The proposed framework for Housing First for Youth outlined here is intended to provide a starting point for communities, policy-makers and practitioners interested in applying the model to adolescents and young adults, recognising that different national and local contexts present both unique challenges but also opportunities. Housing First does not promise or pretend to be the only approach to addressing youth homelessness. However, it can and should become an important intervention that supports, and in turn is supported by, other preventive and early intervention strategies, short term emergency supports, and so on. >> Keywords_ Housing First, youth, key principles Introduction Housing First has emerged as an effective and humane approach to addressing homelessness. Internationally, there has been debate over its potential for adapta- tion and application in different national contexts based on the recognition that social and housing policy varies widely between countries and on concerns about how the concept has been interpreted and implemented. The case for Housing First has been bolstered, however, by a large volume of research that attests to its efficacy, including the highly successful At Home/Chez Soi project from Canada. The breadth and rigour of this research makes Housing First one of the few home- lessness interventions that can be truly deemed a ‘best practice’.
    [Show full text]
  • Study: Supportive Housing Programs for Chronically Homeless Lower Health Care Costs
    FOR IMMEDIATE RELEASE Contact: Greg Turner, Ball Consulting Group, LLC Phone: 508-380-1217; Email: [email protected] Study: Supportive Housing Programs for Chronically Homeless Lower Health Care Costs BOSTON (Dec. 22, 2020) – The Blue Cross Blue Shield of Massachusetts Foundation released a research report today demonstrating the effectiveness of supportive housing programs in reducing total health care costs for medical services provided by MassHealth (the Massachusetts Medicaid program) to chronically homeless individuals. The study examined Housing First models administered by the Massachusetts Housing & Shelter Alliance (MHSA). Researchers integrated claims data for a group of individuals, comparing expenditures before and after the provision of supportive housing services and with a control group of similar individuals who did not receive Housing First services. Most of the Housing First participants in this study were enrolled in the Community Support Program for People Experiencing Chronic Homelessness (CSPECH), a Medicaid-funded program that provides community-based support services for chronically homeless individuals in Massachusetts. Key findings of the study include: • Individuals enrolled in permanent supportive housing programs had significantly lower per-person, per-year health care costs on average, compared with the cohort that didn’t receive such services. • Individuals in the programs received significantly more mental health services but the cost was more than offset by lower utilization of inpatient and emergency department
    [Show full text]
  • Building Partnerships to Support Stable Housing for Child Welfare-Involved Families and Youth
    BULLETIN FOR PROFESSIONALS November 2018 Building Partnerships to WHAT’S INSIDE Support Stable Housing Child welfare and for Child Welfare-Involved housing instability Families and Youth Barriers to stable housing As a child welfare caseworker, you have most likely seen the impact of housing instability and Benefits of collaboration with housing and homelessness on families attempting to reunify homelessness services with their children or prevent placement in out-of- systems home care. They may be living in shelters, in their car, or in housing that is unsafe or overcrowded, Housing resources to or they may need financial or other assistance explore to access and maintain safe and stable housing. Collaboration tips If you work with youth who are preparing to transition from foster care, you know that many Conclusion of these young adults may soon face similar challenges if they do not receive timely and References thoughtful transition planning and support. Children’s Bureau/ACYF/ACF/HHS 800.394.3366 | Email: [email protected] | https://www.childwelfare.gov Building Partnerships to Support Stable Housing for Child Welfare-Involved Families and Youth https://www.childwelfare.gov Every community is unique. Some offer a full continuum Child Welfare and Housing Instability of housing crisis response options—including emergency The significant crossover between families and youth shelter, short-term housing, and permanent housing— involved (or formerly involved) in child welfare and those and supportive services—including short-term help with requiring assistance to maintain safe, affordable housing housing search and security deposits, intensive case is well-documented. According to the Administration management, and ongoing wraparound services once for Children and Families (ACF), roughly 10 percent of housing has been secured.
    [Show full text]
  • A Survey of Homelessness Laws
    The Forum September 2020 Is a House Always a Home?: A Survey of Homelessness Laws Marlei English J.D. Candidate, SMU Dedman School of Law, 2021; Staff Editor for the International Law Review Association Find this and additional student articles at: https://smulawjournals.org/ilra/forum/ Recommended Citation Marlei English, Is a House Always a Home?: A Survey of Homelessness Laws (2020) https://smulawjournals.org/ilra/forum/. This article is brought to you for free and open access by The Forum which is published by student editors on The International Law Review Association in conjunction with the SMU Dedman School of Law. For more information, please visit: https://smulawjournals.org/ilra/. Is a House Always a Home?: A Survey of Homelessness Laws By: Marlei English1 March 6, 2020 Homelessness is a plague that spares no country, yet not a single country has cured it. The type of legislation regarding homelessness in a country seems to correlate with the severity of its homelessness problem. The highly-variative approaches taken by each country when passing their legislation can be roughly divided into two categories: aid-based laws and criminalization laws. Analyzing how these homelessness laws affect the homeless community in each country can be an important step in understanding what can truly lead to finding the “cure” for homelessness rather than just applying temporary fixes. I. Introduction to the Homelessness Problem Homelessness is not a new issue, but it is a current, and pressing issue.2 In fact, it is estimated that at least 150 million individuals are homeless.3 That is about two percent of the population on Earth.4 Furthermore, an even larger 1.6 billion individuals may be living without adequate housing.5 While these statistics are startling, the actual number of individuals living without a home could be even larger because these are just the reported and observable numbers.
    [Show full text]
  • THE PREVENTIVE EFFECT of HOUSING FIRST on HEALTH CARE UTILIZATION and COSTS AMONG CHRONICALLY HOMELESS INDIVIDUALS: New Evidence Using Propensity Score Analysis
    THE PREVENTIVE EFFECT OF HOUSING FIRST ON HEALTH CARE UTILIZATION AND COSTS AMONG CHRONICALLY HOMELESS INDIVIDUALS: New Evidence Using Propensity Score Analysis DECEMBER 2020 ABOUT THE AUTHORS Kevin Brennan was a Manager at Analysis Group, Inc. from 2007 through August 2018. Mr. Brennan led the development of technology solutions to enable rapid and efficient analyses of very large databases to investigate legal issues. He provided expert technical advice and analytical services to consultants and clients of Analysis Group's Health Economics practice, and has prepared reports and testified as an expert witness in litigation matters on enterprise information systems and the software industry. Since August 2018, Mr. Brennan has served as Visiting Professor of Practice in the Daverio School of Accountancy at the University of Akron’s College of Business Administration. Kathryn Buggs was a Senior Analyst at Analysis Group, Inc. until July 2020. Since Fall 2020, she has been enrolled at the University of Michigan Law School. Pete Zuckerman was a Senior Analyst at Analysis Group, Inc. until July 2020. Since Fall 2020, he has been enrolled in the Doctoral Program in the Department of Statistics at the University of Washington. Singumbe Muyeba, PhD, is Assistant Professor at the University of Denver’s Josef Korbel School of International Studies. His research and teaching are in the areas of international development, homelessness and housing poverty in the United States, urbanization, property rights to low-income property among the poor, and the crisis of slums in Sub-Saharan Africa. He has a book and peer-reviewed publications in national and international journals in these research areas.
    [Show full text]
  • Hc3.2. National Strategies for Combating Homelessness
    OECD Affordable Housing Database – http://oe.cd/ahd OECD Directorate of Employment, Labour and Social Affairs - Social Policy Division HC3.2. NATIONAL STRATEGIES FOR COMBATING HOMELESSNESS Definitions and methodology This indicator presents an overview of strategies and major legislation tackling homelessness at the national and regional level, as reported by OECD, key partner and EU countries responding to the 2021 and 2019 OECD Questionnaire on Social and Affordable Housing (QuASH), and other sources. Homelessness strategies are defined as policy documents setting out targets and actions to tackle homelessness, requiring links across policy sectors. Further discussion of homelessness can be found in the OECD Policy Brief, Better data and policies to fight homelessness in the OECD, available online (and in French). Key findings Fewer than half of countries have an active national strategy to combat homelessness, while some have regional and/or local strategies in place According to the OECD Questionnaire on Affordable and Social Housing, 21 of 45 countries report having an active homelessness strategy in place: Canada, Chile, Colombia, the Czech Republic, Denmark, Finland, France, Ireland, Israel, Japan, Luxembourg, the Netherlands, New Zealand, Norway, Poland, Portugal, the Slovak Republic, and the United States (Table HC3.2.1). The United Kingdom has separate homelessness strategies across the constituent countries of England, Northern Ireland, Scotland and Wales. In a number of countries, homelessness strategies ran through 2020; due to COVID-19, the updating of such strategies was likely postponed as policy makers focused on implementing on-the-ground solutions to support the homeless population during the pandemic (see Table HC3.2.2) .
    [Show full text]
  • Using Housing First in Integrated Homelessness
    Using Housing First in Integrated Homelessness Strategies A Review of the Evidence Nicholas Pleace February 2018 Copyright © University of York, 2018 All rights reserved. Reproduction of this report by photocopying or electronic means for non- commercial purposes is permitted. Otherwise, no part of this report may be reproduced, adapted, stored in a retrieval system or transmitted by any means, electronic, mechanical, photocopying, or otherwise without prior written permission of the Centre for Housing Policy, University of York. ISBN: 978-0-9929500-6-4 Further copies of this report or any other Centre for Housing Policy publication can be freely obtained by visiting our website: https://www.york.ac.uk/chp/ Contents Acknowledgements .................................................................................................................... i Disclaimer ................................................................................................................................. ii Summary ................................................................................................................................... iii About this Report ....................................................................................................................... v 1. New Approaches to Homelessness ............................................................................... 1 Introduction ................................................................................................................................ 1 Changes to
    [Show full text]
  • Housing First—The Benefits and Problems by Dionne Miazdyck-Shield
    Housing First—The Benefits and Problems By Dionne Miazdyck-Shield Housing First, what is it exactly? The term is used very loosely as the opposite of traditional services for homeless people (emergency shelters, transitional programs). There are ambitious claims made about ending homelessness and saving tax-payers money through using a Housing First approach. I wanted to understand Housing First, the research, benefits, problems, who it works for and how it could be applied in Saskatoon. Here is what I found out. Housing First (HF) has two different, but connected meanings.1 Housing First is an intensive, clinical intervention program developed specifically for chronically street homeless individuals with a mental illness that originated in New York (Pathways to Housing). This program prioritizes permanent housing as a right and self-determination, and the only expectations are that clients pay some income towards their rent and that they talk to an outreach worker or case manager weekly. Earlier program versions were implemented elsewhere with less intensive supports2. In Toronto, Houselink placed people in housing without requiring treatment first as they left institutions in the 1970s. The term “Housing First” was actually coined in Los Angeles with the program Beyond Shelter that rapidly rehoused families at risk of homelessness. Housing First is a general philosophy of providing homeless/at-risk people with permanent housing, first, without a requirement of sobriety or compliance, respecting their choice about where they want to live and promoting health and wellbeing. Many different types of services or programs could be based on this ‘rapid rehousing’ or ‘housing led’ philosophy for a broader range of people.
    [Show full text]
  • Housing First in Canada: a New Approach to Homelessness And
    RUNNING HEAD: Housing First in Canada Housing First in Canada: A New Approach to Homelessness and Best Practices for Municipal Implementation MPA Research Report Submitted to The Local Government Program Department of Political Science The University of Western Ontario Michelle (Shelly) Steffler July 2016 RUNNING HEAD: Housing First in Canada 1 Abstract This paper examines the Housing First approach to homelessness, which provides people living on the street with permanent homes before offering them optional supports. This stands in stark contrast to the traditional approach to housing, where people need to meet preconditions, such as sobriety, before being assisted to obtain housing. This paper examines the history, causes, and impact of homelessness, and the rise of Housing First in Canada. It uses case studies from Medicine Hat and Toronto to explore the implementation of Housing First in two Canadian cities. The paper concludes by providing best practices and offering cautions for municipalities considering Housing First. The case studies indicate that data collection, stakeholder engagement, a systems approach, and support from all levels of government are important components for any municipality considering Housing First. RUNNING HEAD: Housing First in Canada 2 Table of Contents Introduction .................................................................................................................................................. 3 Background Information ..............................................................................................................................
    [Show full text]
  • The Multi-Dimensional Lives of Children Who Are Homeless
    ______________________________________________________________________________ The Multi-dimensional Lives of Children who are Homeless _____________________________________________________________________________ Steve Grineski, Minnnesota State University—Moorhead Abstract It is widely reported that children who are homeless are victimized by overwhelming challenges like poverty and ill-advised policy decisions, such as underfunding the McKinney-Vento Home- less Assistance Act. This act is the only federal legislation devoted to this marginalized group. Children who are homeless, however, should not be characterized as single-dimensional and hapless victims solely defined by this unwanted status. This kind of deficiency-thinking leads to presumptions, generalizations, and a narrow ascribing of not just their abilities, but their full humanity as well. Deficit-thinking may cause human service providers to try and ‘fix and man- age’ children who are homeless, instead of building on their interests, gifts, and talents. Viewing children who are homeless as multi-dimensional and unfinished, with “hopes, dreams, and aspi- rations…passions and commitments… [and] skills, abilities, and capacities…”1 should be the reality for the more than one million children who are homeless. This manuscript provides a richer understanding for the multi-dimensional lives of children who are homeless. Interviews conducted with key stakeholders and surveys completed by children staying at an emergency homeless shelter located in a Midwestern mid-size city inform preliminary ethnographic findings presented here. Generated from a two-year community- and shelter-based activity program these findings push back against a narrowing social construction of children who are homeless, as do several studies investigating this idea. A more holistic narrative that illustrates multi- dimensional children who act on varied interests, gifts, and talents are suggested.
    [Show full text]
  • Housing First in Permanent Supportive Housing
    HOUSING FIRST IN PERMANENT SUPPORTIVE HOUSING What is Housing First? Housing First is an approach to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements. Supportive services are offered to maximize housing stability and prevent returns to homelessness as opposed to addressing predetermined treatment goals prior to permanent housing entry. Housing First emerged as an alternative to the linear approach in which people experiencing homelessness were required to first participate in and graduate from short-term residential and treatment programs before obtaining permanent housing. In the linear approach, permanent housing was offered only after a person experiencing homelessness could demonstrate that they were “ready” for housing. By contrast, Housing First is premised on the following principles: Homelessness is first and foremost a housing crisis and can be addressed through the provision of safe and affordable housing. All people experiencing homelessness, regardless of their housing history and duration of homelessness, can achieve housing stability in permanent housing. Some may need very little support for a brief period of time, while others may need more intensive and long-term supports. Everyone is “housing ready.” Sobriety, compliance in treatment, or even criminal histories are not necessary to succeed in housing. Rather, homelessness programs and housing providers must be “consumer ready.” Many people experience improvements in quality of life, in the areas of health, mental health, substance use, and employment, as a result of achieving housing. People experiencing homelessness have the right to self-determination and should be treated with dignity and respect.
    [Show full text]