Over the past couple weeks, a few of our readers have asked questions or made comments that we felt required a response that should be shared with all our readers. Thank you!
Q: The premise of Housing First makes sense to me, but I wonder about how it integrates care for chronically homeless individuals. For someone who recently became homeless and has fewer barriers (e.g. smaller or no criminal record, shorter history of addictions, etc.), the supportive services would quickly aid them to self-sufficiency. However, for people who have been on the street for many years (and perhaps are taking advantage of public services without accountability like case management or preconditions for services), does putting them in housing first help them initiate the process they have struggled to commit to previously?
A: What a great question! It gets right to the heart of the purpose of and reasoning behind Housing First.
People who are living on the streets do not have the wherewithal – emotionally or physically – to address the issues that may have contributed to their homelessness because 100% of their energy is devoted to survival.
Once people are housed, they are finally able to examine their circumstances in a thoughtful and deliberative way. It can take time, and it certainly takes a great deal of support, but the housing and the supportive services that we provide along with that housing are exactly the things that enable our most challenged participants to make positive changes in their lives.
Q: Today I heard an NPR program talking about using funds from both HUD and HHS to provide services to seniors in Vermont. It's been proven successful because it reduces emergency room visits and overall health care costs. While I know that it works to reduce costs because the population it serves are Medicare recipients, it might be a good model to be used with other populations...you'd know better than me, but it was interesting.
A: Yes — the NPR story was likely about a form of supportive housing similar to what we provide for people who are chronically homeless. Did you know that, on average, it costs our community about $50,000 per year for each chronically homeless person living on the streets? This is due to emergency room visits, hospitalization, police involvement, court activity, etc.—but for the most part, it is due to health-related issues, both physical and mental. Living on the streets is a singularly unhealthy experience; some researchers have found that chronic homelessness can take as much as 20 years off a person’s life.
The supportive housing Connections provides, on the other hand, costs far less, primarily because it eliminates the health problems that are a direct result of living on the street. It does this by 1) removing the participant from the exposure to weather, dirt, and violence and other dangers they encounter while living outside, and 2) engaging the participant in individualized healthcare activities, including enrollment in healthcare benefits and coordination with mainstream medical care providers, either through Medicare or other plans made possible by the Patient Affordable Care Act (Obamacare).
Though we did not talk much about supportive housing in our initial blog postings, we will do so soon, as it has been found to be the most effective way of helping people with barriers to stability retain their housing on a permanent basis.