Solving HomelessnessSolving Homelessness

Common Ground

Rosanne HaggertyKnoxville, TN – March 2005

Core IdeasCore Ideas

Information: Counting and differentiating the individuals and the

costs

Targeting: Focus on the most vulnerable (chronic/primary homeless)

Housing First

Prevention

Governance: integration,coordination and accountability for results

Communication: homelessness is solvable, one person at a time

Leadership: political will expressed from the top

Homelessness in New York CityHomelessness in New York City

17501438

2359

38,586

HRA HPD HASA/AIDS DHS

TOTAL: 44,133

1. HRA – 2,3591832 adults + 155 families (x3.4)

2. HPD – 1438500 adults + 276 families (x 3.4)

3. HASA/AIDS – 1750

4. DHS - 38,5868501 adults + 30,085 family members

03/04

Discharge Planning - Foster CareDischarge Planning - Foster Care

Discharge Planning – Jail Discharge Planning – Jail PopulationPopulation

DHS Long Term StayersDHS Long Term Stayers

• Long term shelter stayers - 730 nights out of past 4 years were spent in a shelter.

• Cost of shelter is approx $54/night.

• 17% of homeless use 50% or more of the resources.

• More than 40% have a mental illness.

• Calendar year adult shelter pop. in NYC was 8,612. Estimate Long term stayers at 17%, which is 1464.

HIGH COST MEDICAID PATIENTSAn Analysis of New York City Medicaid

High Cost Patients - March 2004

3.0%

31.7%

7.0%

28.5%

10.0%

17.1%

80.0%

22.7%

0%

20%

40%

60%

80%

100%

Disabled[Non-HIV/Alc/Drug/Schiz/SNF/ICF]

DISTRIBUTION OF PATIENTS AND EXPENDITURES ADULTS - AGE 18-64 - DISABLED

77.3%

San DiegoSan Diego

A study of 15 chronically homeless men over 18 months revealed $1,476,113 million total expenditures for medical services alone.

All 15 were still homeless at end of the study period.

Source: Dunford, J.V., Castillo, E.M., Lindsay, S.P. (1998) UCSD Medical Center

BostonBoston

Health Care for the Homeless Study

Utilization of Medical Services by the Cohort

1999-2003 (N = 119)

Emergency Room Visits 18,384 Medical Hospitalizations 871 Respite Admissions 836

New YorkNew York

Daily Census – New York (For March 4, 2005)

8,645 Families

8,540 Single Adults

35,854 Total Individuals

An overwhelming percentage of homeless families come from certain poor neighborhoods

S2hi – Street to Home InitiativeS2hi – Street to Home Initiative

Documenting Chronic Homelesness: Street Count Results

0

100

200

300

400

500

600

Street/Subway 479 425 300 313

Goal 200 139

2001(w) 2002(w) 2003(w) 2004(w) 2005(w) 2006(w)

S2hi – Street to Home InitiativeS2hi – Street to Home Initiative

76% diagnosed with SPMI

90% current or history of substance abuse

56% MI and Substance abuse

98% MI or Substance abuse

33% Major physical health concern

50% Receive SSI at intake

25% Receive PA at intake

Mean time on streets = 7.7 years

Median time on streets = 6 years

Profile – Street Homelessness in West Midtown

S2hi – Street to Home InitiativeS2hi – Street to Home Initiative

43

27

76

183

0 50 100 150 200

Housed

Pending Placement

Actively Engaged

Intake

Results

Housing FirstHousing First

Pathways to Housing (NYC) - placed over 400 chronically homeless mentally ill individuals directly from the street or hospital into permanent housing since 1992 with 88% retention rate over a five year period.

Direct Access to Housing (San Francisco) - Placed 800 chronically homeless, heavy users of health, mental health system directly into hotels or other facilities leased from private owners and operated through contracts with not for profits or directly by City’s health department. Support services provided by health and housing departments.

Project Connect (San Francisco) - Placed 76 chronic street homeless directly into pre-leased units. Support services provided by health and housing departments.

Supportive HousingSupportive Housing

Integrated, mixed income housing to create social networks, break down social stigma, de-concentrate

poverty/special needs

Platform for cost-effective, coordinated, outcome-focused service delivery

Synergistic solution to multiple community needs: affordable housing, historic preservation; re-use of dormant properties; retail development; sustainable

design; job creation; response to homelessness; support for artists and the arts

Supportive HousingSupportive Housing

Qualities of Supportive Housing

  Immediate solution to homelessness

Comprehensive services prevent future homelessness, build tenant capability to participate in mainstream society

Sustainable

Cost effective

Supportive HousingSupportive Housing

Financing Supportive Housing  Dedicated low interest loan fund (New York City) State grant programs (New York, California) Blended agency funds –mental health, housing, social services

(Connecticut) Tax incentives for creating affordable housing and restoring historic

properties (US) Redirected funds from closure of large mental health institutions (New

York State) Redirected funds from reduced usage of hospital services, welfare

benefits (San Francisco) Redirected funds from reduced usage of hospital-based mental health

services (Phoenix)

Supportive HousingSupportive Housing

Financing Supportive Housing

  Tax on hotels, restaurants (Miami) Dedicated percentage of real estate transfer taxes (Denver) Dedicated bond issue (California) Mandatory developer contributions (Boston) Zoning bonuses and private developer incentives (New York City,

elsewhere) Lottery (Great Britain) Redirected public land and buildings (Great Britain)

Supportive HousingSupportive Housing

PreventionPrevention

Foster Care:• Foyers (Europe, North America)• First Place (California)• Resettlement packages (Great Britain)

Prisons:• Maryland Reentry Partnership Initiative (REP)• Illinois Department of Corrections• Department of Correction/Department of Homeless Services

Task Force (NYC)

PreventionPrevention

Brownsville, NY

Population: 85,000Population: 85,000

Percentage of families below poverty Percentage of families below poverty line: 28.6line: 28.6

Percentage of units that are public Percentage of units that are public housing: 75% (highest % of NYCHA housing: 75% (highest % of NYCHA units in the city)units in the city)

Number of homeless families over 4 Number of homeless families over 4 years: 858years: 858

* fifth highest unemployment rate in * fifth highest unemployment rate in NYC at 14.1%NYC at 14.1%

PreventionPrevention

Common Ground’s Homelink

Daycare/after school link

Landlord organizing and outreach

Eviction prevention

Family mediation

Landlord mediation

Housing reclamation and improvement

New Housing Development

Crisis intervention

Home visits

Community organizing

Legal assistance

Flexible cash assistance

Education links

Healthcare link

Employment links

GovernanceGovernance

Philadelphia

6th largest US City

850 street homeless in center city 2001; 40 in 2005 Centralized activities of 17 city agencies through assistant managing director of

city Centralized services intake to assure coordination with all city services and

reduce “creaming” Weekly street counts and on-going data matching between agencies Bi-weekly progress meeting of all stakeholders: city agency staff; downtown

businesses, not for profit providers

CommunicationsCommunications

Problem is Solvable

Issue is personal

Role for each of us

LeadershipLeadership

 

Great Britain: Tony Blair

 

Rough Sleepers Initiative reduced chronic homelessness by 75% in four years

Next StepsNext Steps

  Closing the gap between what is known and what is

practiced

175 mayors, county executives, governors developing ten-year plans to end chronic homelessness

Covenant Initiative of US 46 mayors collaborating to implement best practices

SolutionsSolutions

Information: Counting and differentiating the individuals and the

costs

Targeting: Focus on the most vulnerable (chronic/primary homeless)

Housing First

Prevention

Governance: integration,coordination and accountability for results

Communication: homelessness is solvable, one person at a time

Leadership: political will expressed from the top

Common Ground Common Ground CommunityCommunity

We are solving homelessness through innovative programs

that transform people, buildings, and communities.

Solving HomelessnessSolving Homelessness

Common Ground

Rosanne HaggertyKnoxville, TN – March 2005