As we move forward in ending homelessness, we have seen an increasing focus on measuring positive outcomes for clients. Programs and systems are evaluated on their ability to produce these outcomes. For some, this has caused a fear that programs will “cream”.
When we talk about “creaming” in the homelessness system, we talk about intentionally selecting families and individuals that we expect will have the best outcomes to participate in our programs. The term is particularly used when we talk about programs that are rich in services and provide longer term financial assistance. While this may seem selfish or calculating, it isn’t always. Sometimes we fear “setting up a client for failure” or providing an intervention and, at the end of it, “being right back where we started”.
The assumption of some people who “cream” in their programs is that community resources could be wasted and as such, these people offer their resources to families or individuals who could take better advantage of limited capital. Unfortunately, this is the wrong assumption on both accounts and, often, the cost to communities is both human and economic.
To start with, we know from research on rapid re-housing that the majority of families are able to exit homelessness to permanent housing with very little help. Unfortunately, the families and individuals who are often the most in need of assistance (and frequently the deepest assistance) are also the families and individuals who look like they will “fail”. They end up being left with little or no assistance, spending long stays in emergency shelters or worse, on the street or in another unsafe environment. The impact these long stays have on individuals, families, and children are sometimes not measurably negative, but they are known to disrupt to family dynamics, increase the incidence of depression, and compromise children’s education.
In addition to the human toll that long stays in homelessness take on families and individuals who are the most in need of assistance and the least likely to exit homelessness independently, these families and individuals tend to cost systems – not just the homelessness system, but mainstream systems as well – a lot of money. By not directly targeting these families and individuals and instead choosing households who may not have been able to exit homelessness with very little assistance or no assistance, programs are actually costing the community additional resources in shelter expenditures, jails and police costs, child protective services interventions, and health care.
While “creaming”—either intentional or unintentional—may help improve a single program’s outcomes, in the long run it diminishes a community’s likelihood of ending homelessness and places additional burden on the families and individuals most in need within a community.