Archive for July 25th, 2011
Thank you so much for coming. We know that it takes a lot to get to the conference, and we really appreciate it. We especially appreciate it because we know how much you do and how hard everyone works, and that you are all here because you want to figure out how to do a better job of ending homelessness. That means a lot to us at the Alliance, so we have spent a lot of time really trying to get you the cutting-edge information about how to do that.
When you come to our conference, our philosophy is that we are going to look around the country for what is working best to end homelessness. And I want to take a moment here to thank the National Network for Youth, the Corporation for Supportive Housing, 100,000 Homes Campaign, and our many other national partners who have helped us identify these best practices.
For our conference, we try to look at the national trends and find communities, programs, or people that have the best responses in policy and practice. Where are they making changes and improvements? What innovations are working? Where are they forging creative new partnership to do something that changes the equation? And where are they taking proven interventions to scale; because after all, sometimes we already have the answer, we just need to do more of it.
But make no mistake; we at the Alliance are about change. Because in our view, things are not OK the way they are.
It is not OK that nearly 700,000 people are homeless every night.
It is not OK that youth, who should be being nurtured and educated and only then nudged out the door to independence, are instead being tossed onto the street with no one to love them or show them the way forward.
It is not OK that veterans – young men and women who have gone to war out of patriotism, or been willing to go to war – those who have perhaps the greatest claim to home, have none.
It is not OK that people with mental illness beg for food or that children cry themselves to sleep out of insecurity and desperation.
It is not OK that increasingly, elderly people live out the ends of their lives in shelter.
It is not OK for anyone to be homeless, especially when it is so much within our power to stop it.
To make things OK – to end homelessness – we are going, therefore, to have to make changes; the status quo is not getting it done.
There are lots of factors, of course, in the proliferation of homelessness in our nation. Some we can do something about and others are harder. But I will say this. It is not our job to only sit back and cope with what we are handed. It is not our job just to help people survive homelessness. It is our job to do something to end homelessness, using whatever tools we have in the most effective ways possible; and if we do not have the tools at hand, creating them.
That is what this conference is about, and that is what I want to talk to you about a little bit today. To frame the next three days so that you can leave here with some concrete ideas about how – in this very difficult time – you can do something to help make progress on ending homelessness. Because we at the National Alliance to End Homelessness are not giving up on that goal.
Nevertheless, I think it’s going to get really difficult.
You all know the grim story.
While the economy is re-bounding for some, it is not for poor and low-income people.
The Alliance issued a report this year – State of Homelessness – that looked at the connection between larger economic factors and homelessness. What did we find?
First, unemployment is terribly high among those least able to withstand it: the poor. And of course we learned last week that it has gone up overall. While unemployment among whites was at a still-high 8 percent in May, it was twice that – 16.2 percent – for African Americans. And in poor census tracts across the nation it was in the 20 to 40 percent range. State of Homelessness pointed out that the number of unemployed people in the US increased by 60 percent from 2008 to 2009. And among those who were working, the poor were still disadvantaged. Poor workers wages decreased twice as much as all US workers.
Employment is not the only problem; there is also housing. We all know that the price of housing during the housing boom in the early 2000s was totally out of reach, and so it was a relief that during the recession the rental housing market did soften somewhat. But that little silver lining period is over. Rents are going back up.
A tremendous number of poor people have housing challenges. We know from HUD that nearly three quarters of poor households pay more than half of their income for rent (remember that statistic; it is an important one for those who mistakenly believe that people cannot stay stable in housing if they pay more than 30 percent of their income for rent). We also know that worst-case housing needs are up and that there was a 12 percent increase in the number of households doubled up. So housing remains a problem.
Homeless people are poor people, we know that. And obviously poor people are having a hard time in the current economy.
These trends have been underway for several years, and yet the number of homeless people has not been going up that much nationally since the recession began. Why?
First let me stipulate that the number of homeless people staying flat is not a good thing, because of course we want the homeless numbers to go down. And they were going down prior to 2008 for the first time since homelessness began. But now the trajectory has changed, and it is inching its way up. Families are the hardest hit. But while not acceptable, it could have been worse.
The reason it did not go up more is two-fold. The first reason was what you have accomplished and HPRP. I have to congratulate people in this room for doing incredible work to ensure that the recession has not yet resulted in a huge increase in homelessness. A big part of that was the Homelessness Prevention and Rapid Re-Housing program, of course. HPRP was $1.5 billion to prevent homelessness and re-house those who did become homeless. That is a pretty huge new program, and although not perfect, it must be said that you all geared up and began putting out this money in a very quickly and efficiently effective way. So you are to be congratulated for your sense of urgency and your skill. And it has obviously made a big difference, as we can tell by looking at those numbers.
The second factor was that homelessness is a lagging indicator. People do not become homeless the day they get foreclosed on, the day they lose their job, the day they get discharged from the military or emancipated from foster care. You know this because you know the stories. It takes awhile for them to use up their resources. And frankly, we probably should not have expected to really see the results of the terrible economy of 2008 and 2009 until right about now.
And that is really bad news, because things are not looking good for our ability to withstand any increase in homelessness.
For the fourth year in a row, states are cutting their budgets. The difference now is that the federal government is not filling the gap with stimulus funding. A recent report from the Center on Budget and Policy Priorities said the following.
- 42 states will have budgets shortfalls in 2012 totaling $103 billion. This means they will likely cut their budgets by that amount, because only a minority of these states is looking at raising revenues.
- The reason for the shortfalls is lack of revenue from taxes. The revenue losses from this recession were higher than those from the previous recent recessions, and they are not going back up as rapidly. That means the answer is not waiting in the wings: state budget shortfalls are expected to continue into 2013.
- At least 46 states plus the District of Columbia have cut public services, despite rising need, especially in the areas of health care, help for elderly and disabled people, and education.
- And speaking of need, just taking one indicator, Medicaid demand has gone up 7 percent to 8 percent each of the past two years. So there is more demand, but fewer resources to address it.
And of course as I said, the federal government is not back-filling here. Stimulus funds to states will go from $60 billion this year to $6 billion in 2012. And you all read the news and know that the federal budget discussion underway is not about how to meet the needs of the most vulnerable, but rather about who can cut more.
So, looking forward, all that can be said is that we will have to do more with less.
The question for us is, how should we approach that? HPRP is ending. Do we just stop doing rapid re-housing and prevention and revert to our array of shelter, transitional housing, and permanent supportive housing programs; wait until there is more money to start HPRP-type activities back up again? If the demand goes up, do we need to increase shelter capacity to meet it? As mainstream programs like TANF and Medicaid are cut, should we just abandon efforts to access their resources and focus on what we know we can deliver through our homeless funding? Given the massiveness of the budget problems at every level of government, does it really make sense to invest a lot of time in advocacy when the tide is going so strongly in the other direction and our voices feel so small? What should be our next steps?
I want to propose three things that we could be doing next. And I will tell you that what I am proposing is not that we re-trench, not that we revert to our core activities, and not that we hunker down. What I am proposing is that we change.
The three things I want to propose are as follows.
First, based upon the success of re-housing, and our increased capacity to do it through HPRP, I suggest we shift more resources into rapid re-housing. If we get more money, fine. But if we do not we should look at our existing resources.
Second, I suggest that we work hard to get access to certain mainstream programs, in part by strategically increasing their targeting to the most vulnerable.
And third I suggest that we join with others in mounting a vigorous campaign to ensure that, no matter how deep our budget woes are as a nation, a key priority for any public spending must be to protect the most vulnerable.
Starting with more rapid re-housing, in a time of diminished resources, the moral thing to do is to be diligent about how we use what we have. We have to take a new look. Some homelessness interventions are considerably more expensive than others. That may well be justified if the needs of the consumer are greater, and/or if the outcomes are better.
But what we must be vigilant in examining is whether we are spending more for people with lesser needs, or whether we are spending more for the same or lesser outcomes. If we are not, then this is not an area that is fruitful for change. But evidence suggests that we are.
We know that the average rapid re-housing intervention is considerably less expensive than a transitional housing intervention, and often less expensive than a shelter intervention. Rapid re-housing is the cheapest. According to a report issued by HUD last year, Costs Associated with First Time Homelessness for Families and Individuals, transitional housing costs considerably more than either permanent housing or permanent supportive housing. Admittedly, this is without services, but the services are not the expensive part of transitional housing; the facilities and the operational expenses are. The report concludes that communities should avoid extensive use of high-cost programs like transitional housing for people who primarily need permanent housing and whose service needs can be met in the community. We know that that describes the vast majority of people who become homeless.
As our Capacity Building team has gone around the country helping communities prepare for HEARTH implementation by analyzing their data, we have seen a similar story (admittedly, not from a representative sample). With regard to housing outcomes for those exiting, we generally see that people leaving shelter are the least likely to exit to housing, followed by those leaving transitional housing. Those leaving rapid re-housing are the most likely to exit to housing.
If we look at costs combined with outcomes, we see that the lowest cost overall is for rapid re-housing, and the lowest rate of return to homelessness is for rapid re-housing. So, rapid re-housing is the cheapest and has the best outcome. In a time of increasingly scarce resources, we certainly have to consider whether we should be devoting more of our continuum money to rapid re-housing and less to other approaches at least for those people who are not chronically disabled and therefore in need of permanent supportive housing.
I think that the danger moving forward is that as HPRP ends communities will just stop doing rapid re-housing and prevention because the targeted funds are gone, and revert to the core shelter and transitional housing programs. I think this would be a huge mistake because it means we will leave a lot of people completely un-served. Already around 40 percent of homeless people are unsheltered.
Rapid re-housing lets us house more people faster and link them to services. Despite the fact that many providers feel that people getting rapid re-housing will not be able to make it without a Section 8-type housing subsidy, it seems that they do. Remember, people leaving shelter and transitional housing now typically leave with zero subsidy and not appreciably higher incomes. People with rapid re-housing have more rent subsidy than they would have if they left transitional housing or shelter.
How do we implement this?
First, we need to think about how to shift not just resources, but existing organizational capacity to these new strategies, because we certainly do not want to lose the committed and trained staff and boards of established organizations. This is not about abandoning organizations; it is about re-thinking how we do the work of ending homelessness.
Second, we certainly do not want to overly reduce shelter capacity; we need to right-size it, but certainly not eliminate it. We must have a place for people in crisis to go, and we must have a front door into the homelessness system. But if we strategically use more resources for rapid re-housing, and give shelter providers more tools to help people exit successfully, we could potentially increase the turnover rate of shelter beds, thus making more beds available: increasing capacity without having to increase supply.
Third, where there are dedicated buildings involved or where organizational missions remain focused on transitional experiences, we can target these better. For example, we could screen in rather than screen out the people with the highest needs for whom a transitional intervention is essential and proven. Residential recovery with children, reentry housing, and interim housing for families are examples. Another very important one is transitional housing for youth. I mentioned our partnership with the National Network for Youth. One thing we both feel strongly about is that transitional housing is the proper approach for that minority of youth who need a longer-term housing intervention.
In some communities there has been a big move to transform transitional programs into permanent housing programs and permanent supportive housing programs. This is a decision that has to be made locally, but it must be made strategically and based on data. Remember that we are trying to serve more people by shifting resources into a more cost efficient and effective strategy. Serving the same people with an intervention that is still too expensive and in which people stay even longer is obviously not the goal. We must increase the supply of permanent supportive housing but we must target it really well to the highest need people. It will be important that where these shifts are made, providers receive technical assistance, financing, and tools to help them make the appropriate changes. We call upon HUD to be flexible and supportive as communities consider how best to use their resources.
It will also be important to re-look at our overall local systems so that we target interventions properly and right-size the supply of each. This means using data to assess what works; creating coordinated intake; and doing assessment and triage of everyone who enters the system
The first action step, then, is to look at how to shift existing resources into more cost efficient and more effective strategies like rapid re-housing so that we can meet the increasing needs and still make progress on our goal of ending homelessness. We should build this new approach within the existing system, because that is where the commitment, the skill, the knowledge, and the resources are. This is a complicated change and there will be a lot of information about it in the conference workshops.
The next thing we should do is work on mainstream resources. It is definitely the case that mainstream resources are also going to be stretched thin. TANF is being affected, and workforce and employment programs will be as well. Medicaid and mainstream housing programs are being cut.
Mainstream resources will become increasingly scarce, and this is why it will be important to advance the principle that those resources that are available should go to those with the highest needs. The importance of mainstream resources for prevention and for serving homeless people was a key element of Opening Doors: The Federal Strategic Plan. Barbara Poppe and her colleagues at the US Interagency Council on Homelessness are working hard on this and they are great allies and resources. They are here at the conference. We need to seize the opportunities the commitment of the plan provides.
I do have a few suggestions as to where there might be opportunities to expand mainstream involvement in ending homelessness.
The Affordable Care Act as it moves forward should enroll all homeless people in Medicaid. This has several implications. First, it will be important to work with health care advocacy groups and state health policy people to ensure that the covered services are adequate to meet the needs of the people you care about. Second, it will be important to work with the same partners to ensure that a delivery mechanism is available to the people you care about. Finally, if you provide permanent supportive housing you are going to want to build partnerships or capacity so that Medicaid can fund the services you deliver.
Another opportunity is TANF and child welfare. Through these programs, particularly TANF, there are numerous initiatives that can assist homeless families. One key is to work with your TANF and child welfare agencies to ensure that all eligible homeless families are receiving TANF – at present far too few are. It is also important to work with your TANF agency to ensure that they ask families specific questions about their housing status and that they have a policy to respond, because they have resources to prevent families from losing their housing. Finally, TANF has tremendous service programs like Home Visiting that can prevent homelessness or support rehoused families with services. You can make sure that these are being targeted to your families.
There are also opportunities around veterans. VA is increasingly partnering with nonprofit organizations to deliver assistance to homeless veterans. It can contract with nonprofits for services in HUD-VASH and can use its own teams to provide ACT-type services, although often these things do not happen. If you are providing permanent supportive housing for veterans, work with VA in your community to ensure that services are covered. You can also make sure that you know whether or not your consumers have served in the military. An astounding number of clients are never asked if they served. Consequently they do not receive benefits to which they are entitled.
We will have to leverage mainstream services if we are to avoid massive numbers of unserved homeless people in the future.
The third action step is advocacy. There is an epic debate going on about the nature and responsibility of government and what the priorities of government should be. Good people with differing philosophies can agree and disagree on elements of this debate. However, now is not the time that good people can sit back and passively accept whatever outcome prevails.
You are the people who care about homeless people. There are many organizations out there that are fighting the battles over the budget and the need to protect vulnerable people: the usual politically-oriented organizations, but also others like faith based, membership, civil rights, and disability organizations. It is critical that you engage in the overall discussions that are now setting the priorities for our nation, our states and our localities into the future. It is also crucial that your board members speak out, and that your consumers have the means to engage in this debate. It may be that your organization cannot get involved, but you certainly can do so as an individual. Because all of us who care about social justice really must stand up and be heard now – the stakes are huge.
So moving forward, times will likely be tough – very tough. We cannot do our jobs by making changes around the margins. We have to look at our programs and really figure out whether we are using our resources in the most efficient ways possible. These are three things we can do.
- First, use existing resources to do more rapid re-housing and retool the local system to target better.
- Second, go after mainstream resources.
- Third, get involved politically in the big picture work to define the future values of the country.
You are an incredible group of people. I do not know of another human services sector that is so committed to help the most vulnerable and so oriented to constant improvement and to outcomes. And lucky for us, this not only means that we are always doing better by homeless people, but it also means that we can show our outcomes and build political and public will to get resources. And that is not always true with respect to human needs, and that is due to you.
Thank you so much for all you do. Please let us know how we can help you.