Archive for October, 2009
Without question, the news of the day is the reported 38 percent drop in Los Angeles, CA.
In a year when everything seemed to present endless challenges for the homeless and homeless advocacy community – rising unemployment, stifled state budgets, increasing homeless counts, reduction of public services, and the rest – it seemed incredible that the city with the largest homeless population in the country saw such a pronounced decrease in their numbers. The Los Angeles Continuum of Care (CoC) is a solid ten percent of the entire homeless population in the country – so any significant movement in their number would represent a notable change in the nation’s homeless population.
All to say – we definitely noticed.
And the inevitable question that rises from such a report is this: how?
Alliance staff has ruminated about the data for the last couple days. Together, we discussed the drop in the sheltered count (down by 19 percent), rental unit vacancy rates for the last five years (up by 3 percent), the unemployment rate (up by 5 percent), the Consumer Price Index (down by 4 percent), and – of course – methodology. We compared Los Angeles to New York and the nation, comparing numbers and rates and population, noting the general difficulties in counting homelessness people – especially the unsheltered (67 percent of the homeless population in LA is unsheltered.)
Of course, all these variables could play a role in determining how and why the count went down as significantly as it did. The rate of rental unit vacancies, the rate of turnover in a homeless shelter, the way the CoC decided to define and count the homeless population all affect the number.
As I’m considering this reality, I’m also reminded that this number – although telling and significant and interesting – is only one piece of information. It’s one number derived from one count on one night in one continuum of care and, by itself, certainly not enough to paint a picture of the depth and breadth of the homeless problem, even just in Los Angeles.
Because homelessness is a complex issue, one that must be contextualized with all those other elements in order to full understand and – hopefully – solve.
That being said, our heartiest congratulations and thanks to Los Angeles for their report and their leadership in this field. Many new programs in the area are being funded by the City and County of Los Angeles, and the County launched a $100 million Homeless Prevention Initiative. The CoC hosts a Permanent Supportive Housing Program, expanded Section 8 voucher programs, and has long worked to ensuring that homeless families and individuals are not only housed but also equipped with the skills and tools to pursue permanent independence. Contextualized or not, we know that ending homelessness in Los Angeles is no easy task, and commend the CoC and their partner organizations hard at work developing innovative solutions and new ideas.
Yesterday, the Alliance hosted a convening of the Research Council – a handful of leaders in the homelessness research field – to discuss the direction of homelessness research. After a few moments sharing new and innovative projects that each member was working on, the group went forth to discuss three major points:
- What has been achieved from the last agenda?
- What is the future of homelessness research?
- What are the policy implications of our research?
In the last Research Agenda, the council attempted to answer some of the bigger questions facing the field:
- What programs and policies are effective in preventing chronic homelessness?
- What mix of housing assistance and services prevents and ends homelessness?
- What characteristics distinguish those poor, at-risk families who become homeless from those who don’t?
As the voices of these research heavyweights whirled around the room, I furiously took notes on the questions that seemed to resonate loudest. It became clearer and clearer that as much as we have learned about homelessness, there is even more that we don’t know. Now that the foundation has been laid on the issue of homelessness, the charge – it seems – is to dig deeper and deeper until homelessness is no longer the social problem we know today.
But in this economic climate and at this particular point in time, there are a few questions that rose as the obvious questions we need to answer soonest:
1. What is the impact of the recession on homelessness? How do the housing markets and unemployment factor in?
2. Will President Obama’s Homelessness Prevention and Rapid Re-Housing program manage to make a difference? Who will this program help? How much of a difference will be made?
3. What do we know about homeless youth?
4. What do families need? Are there more homeless families now, and how can we help them?
They’re certainly questions that have been coming across my desk – from colleagues and reporter and the like; undoubtedly, I am not the only one struggling to find answers to these questions.
The Council conducts important research to help bring us closer to an answer and to demystify this population that – as we are learning now – are not so different than us.
Case studies of seven communities that have implemented homelessness prevention and rapid re-housing programs similar to those that can be funded through HPRP:
- The HomeBase prevention program in New York City
- The Ohio Family Homelessness Prevention Pilot
- Chicago’s Housing Locator program
- The Family Housing Collaborative and rapid re-housing program in Columbus, OH
- Hennepin County’s rapid re-housing program, Rapid Exit
- Shelter to Independent Living, a prevention program in Lancaster, PA
- The Rural Homeless Initiative of Southeast and Central Ohio
- A guide to designing and delivering financial assistance, including rental assistance
- A description of the role of case management in preventing homelessness and in rapidly returning homeless individuals and families to housing stability, including specific information about case management within HPRP and useful information for system planners
- Strategies for connecting HPRP with mainstream workforce programs
- A presentation of HUD’s vision for HPRP
- Several resources to assist with documentation and certification, including a Habitability Standards Checklist and description of HPRP unit inspection requirements, and tools to assist with income and housing status determination
- A sample sub-recipient agreement
These resources and others can be found in the HPRP Resource Library on HUD’s Homelessness Resource Exchange.
Please note that these resources are posted to HUD’s Homelessness Resource Exchange, and they come with the following disclaimer:
All peer-to-peer resources shared on www.HUDHRE.info have been provided by the community that developed them. The documents have not been reviewed by HUD or its contractors for applicability, legality, or compliance with Federal statutory and regulatory guidelines. The posting of these documents on www.HUDHRE.info is not intended as an endorsement of the documents by HUD or any of its contractors. Please bear in mind that these documents were created by communities based on their specific needs and objectives, and they reflect the local laws and policies of that community. Each community should go through its own process to develop policies and corresponding procedures that are appropriate locally and that are compliant with Federal, state, and local law.
Recently, the Washington Post launched a series about HIV/AIDS funding in the District of Columbia. The series shed light on waste, mismanagement, and neglect – hallmarks, it seems from the story, of a program intended to serve those desperately in need of services. DC, as the story confirms, has the highest rate of HIV/AIDS in the country; higher than some West African countries.
As I was reading this well-researched expose, I was struck at the intersection of HIV/AIDS and housing.
I was particular taken with the profiles of two people: a homeless man afflicted with HIV named Alexander Harrington and a [housed] single mother of two named J’Mia Edwards.
Harrington was an ex-offender who, upon his release, sought out assistance from an AIDS service center that promised counseling, a lead on permanent housing, and job training. Shortly after his stay there, he was pushed out with nothing to show for his time.
J’Mia Edwards is an outreach worker, attempting to ensure that her friends and neighbors are educated about HIV/AIDS, all the while caring for her two young children.
Resonant throughout the stories of these two was their deep desire for stable housing.
J’Mia Edwards go so far as to remark,”…if I don’t have adequate housing, I’m not gonna worry about taking my medication…a part of my prevention is my housing.”
And these deliberations by people who are presently experiencing this need only solidifies the notion that housing is as critical a component to recovery – and to reducing chronic homelessness – as an medical or therapeutic intervention, maybe even more so.
Permanent supportive housing has proven to be an effective end to chronic homelessness – much of the decrease in homelessness from 2005 – 2007 can be attributed to a greater availability or permanent supportive housing units and community efforts to transition to a housing first approach.
Happy Monday, everyone!
In case you didn’t catch it, we’re posting Nan Roman’s Huffington Post blog on here, entitled “the Healthcare-Homelessness Connection,” – a look into how the current health care debate is affected by homelessness, and vice versa.
While health care reform is being hotly debated across the nation, one of the groups most likely to be affected by reform has been characteristically silent: people who are homeless.
It’s a common misconception that everybody living in poverty is eligible for Medicaid — in truth, there are many poor people who are not currently eligible for Medicaid. Non-disabled, childless adults — even those with health problems — are often not eligible. The same applies to mothers with health conditions whose children have been placed in foster care, and young adults aging out of the foster care system.
In fact, a 1996 nationwide study of homelessness found that only 25 percent of homeless single adults were enrolled in Medicaid.
It’s not always easy to see, but homelessness and health care have a clear — and cyclical — relationship: poor health can lead to homelessness, and homelessness can aggravate poor health. And both can be a burden on our health care system.
Many people become homeless due to a lack of health care. Untreated illnesses can lead to disability and job loss — and unemployment remains one of the leading causes of homelessness. It’s worth noting here that the leading cause of bankruptcy in the United States is medical expenses, insured or not. So people’s incomes are clearly tied up with their ability to get or pay for health care; and the lower incomes lead to higher risk of homelessness.
The other side of the coin is that homelessness aggravates poor health. The lack of access to water, food, and clean, safe and stable housing only puts further pressures on a person’s body.
With few resources and little access to any alternatives, homeless people will wait until the last possible moment to seek treatment, and then likely resort to costly emergency room (ER). Once they’re in the hospital, then tend to stay longer. After discharge, pushed back into homelessness, their symptoms often return and worsen, until they’re right back in the ER.
The cost of this inefficient, ineffective cycle is something we all pay for — through higher medical costs, insurances rates, and local and state taxes. In fact, many cost studies of this social problem suggest that it may be more financially prudent to ensure that homeless people receive preventive and primary care before minor conditions become chronic ones.
In Seattle, the Downtown Emergency Service Center has a supportive housing project called 1811 Eastlake for chronic alcoholics who have lived for years on the streets. In evaluating the costs for 75 of the residents they found that within a year they had collectively cut days spent in jail by half. Medicaid costs dropped by over 40 percent and hospital visits had decreased by a third — ultimately saving Seattle and the federal government millions. These findings were published in the Journal of the American Medical Association in April 2009.
A similar story comes from Chicago, called the Chicago Housing and Health Partnership. Over four years, the Partnership followed 405 chronically homeless people. Half of the 405 received immediate housing and intensive case management (similar to those services offered to the 1811 Eastlake group); the other half of the 405 were offered typical homeless services. Those receiving housing decreased the incidence of hospital admission and days spent in the hospital by a third, and decreased their emergency room visits by 25 percent. Again, cost savings are significant.
These studies suggest that addressing the health care needs of homeless people would not only benefit them, but us as well.
With worries about the cost of health care reform, the spiraling national debt, and the future of our country, it’s reassuring to know that sometimes doing the right thing is actually the right thing to do.
It’s little wonder that in his address to the National Conference on Ending Homelessness, Secretary Shaun Donovan of the Department of Housing and Urban Development (HUD) remarked: “Simply put, if we want to tackle health care reform — if we want to lower costs — we must tackle homelessness. It’s that simple.”
In this moment, we have a rare opportunity to both satisfy our needs for efficient, effective reform and our ethical sensibilities. In our efforts to reform health care, we must turn to hear those characteristically silent, and remember that we have a chance to provide for homeless people and lighten the load on our beleaguered health care system.
Let’s take it.
Happy Friday, everyone! Apologies for the long absence.
This week, in the Friday News Roundup, we thought we’d share a bit of Alliance news about – what else – the health care debate.
On October 15, Senators Shaheen (D-NH), Brown (D-OH), and Menendez (D-NJ) introduced a coordinated care Medicaid program as part of health reform: the REDUCE Act (Reduce Emergency Department Utilization through Coordination and Empowerment Act). As we’ve explained before in our video, Medicaid is a key priority for the Alliance in ensuring that the interests of those experiencing homelessness are considered in the health care debate.
Now – the Alliance is working to help attain additional Senators to co-sponsor (officially sign-on in support of) co-sponsor the bill.
This legislation would:
- Improve health outcomes for people who are homeless and have multiple disabling conditions;
- Allow participating states to reimburse supportive housing providers for all of the primary health care and behavioral health services that people need to remain safely housed; and
- Improve future Medicaid benefits packages by tracking and evaluating reductions in hospitalizations or institutional admissions and use of emergency health services.
To be attached to health reform, the REDUCE Act will likely be offered as an amendment when the Senate votes on health care reform legislation. Before health care legislation can proceed to the Senate floor, though, the Senate Finance committee’s version must be combined with the version of the legislation passed this summer by the Senate Health, Education, Labor, and Pensions committee.
For more information about the health reform bill and how it relates to homelessness, check out Nan Roman’s piece in the Huffington Post.
Continuing with the theme of research, data, and scholarship this week (did a chance to see our video fact sheet?), I thought I’d highlight a couple of magazines that are near and dear to our hearts at the Homelessness Research Institute. These magazines cover current events, data and statistics, and social innovation – using evidence-based, fact-driven research to influence and inform policy and practice.
We flip through the magazines and click through their website to read the latest in innovations in the field and get inspired for our own projects and tools.
A few we really like:
The name says it all, doesn’t it? This straightforward, scholarly, no-nonsense magazine is a clear and thoughtful arbiter of information about social innovation.
Their goal, as they delineate themselves, is to “share substantive insights and practical experiences that will help those who do the important work of improving society do it even better.. to strike a balance between the pragmatic and the intellectual, to embrace no predefined political ideology, and to champion the interests of no single constituency. Instead, we will broker conversations, ask hard questions, disseminate the fruits of rigorous research, and present real-life case studies.”
Miller McCune looks to “turn research into solutions” – or more specifically, “draws on academic research and other definitive sources to provide reasoned policy options and solutions for today’s pressing issues.” The magazine looks into legal affairs, business and economics, society and culture, science and the environment, among slew of other issues facing the world today.
An fairly recent Alliance mention in the magazine: “The Homemakers.”
The racier rebel of the group, Good magazine is for – truly – “people who give a damn.” And in other terms, “Good is a collaboration of individuals, businesses, and nonprofits pushing the world forward.”
And that’s about as specific as it gets – the magazine, like the two before – covers a range of issues with no specific focus on any particular one. It feature blogs and videos and promotes upcoming events, but my personal favorite part of the magazine is the way they deal with visuals and graphics.
For example the site boasts it’s use of “ Infographics – a series of visual representations of social problems. A couple of more recent ones covered religion, health care, and crime. The artwork is truly creative, if sometimes a bit hard to consume.
So those are some of our online favorites – check them out! And feel free to share yours with us – don’t hesitate to let us know if there’s something we should see!
Apologies for the hiatus over the last week.
But today, we make it up to you by launching our very first video fact sheet.
A lot of times, we get asked this question: How many homeless people are there?
And while that may seem like a simple question to answer, it’s actually more complicated than it seems. It’s not easy to count homeless people, so there are a lot of estimates. It depends on how you define “homelessness”. It depends on the groups you’re interested in – most people think of single adult men when they picture homelessness, but there are also families and children and veterans.
There’s also different methodology – the Department of Housing and Urban Development requires that all communities count homeless persons in their area every other year, but people count in different ways, so the number should account for that.
And we get variations of the question, too. How many people are homeless in a specific community? How many people who are homeless have a serious disorder? How many people are disabled? How many are youth? How many qualify for federal assistance – and of those, who’s accessing federal assistance?
So it’s actually a pretty complicated answer – and sometimes it can be hard to understand.
But luckily for you, the director of the Homelessness Research Institute – M William Sermons – put together this great video fact sheet explaining the numbers in an easy, understandable way.
Check it out. And hey, we want to do more of these in the future so if you’re hankering for an answer to a homelessness-related question, feel free to give us a shout!