Posted on January 26, 2011
This week’s blog was written by VSH’s Executive Director, Alice Tousignant.
Five years ago, we were all scratching our heads trying to figure out what to do with a certain segment of the homeless population who weren’t getting helped. These were individuals who were chronically homeless with serious mental illness, many of whom also had a co-occurring substance abuse issue. Truthfully, many of us had gotten to the point of saying that this specific population chose to be homeless— that was our excuse. The thing is, no one bothered to ask them what they wanted and if they really did want to be homeless. The bottom line was that the community, including Virginia Supportive Housing, didn’t know how to help them and we had almost given up trying.
But then two things happened: we starting hearing stories from around the nation about how chronically homeless people were costing the community money—in other words, even though chronically homeless people comprise a relatively small percentage (about 15%) of the overall population of people experiencing homelessness, they were using a disproportionately high amount of the resources in the community. We also started hearing about some best practice programs that were successfully housing this population, and these programs were gradually spreading around the nation.
One of these programs was Pathways to Housing, a program that began in New York almost 10 years ago. After hearing about this program, I must admit I was very skeptical. Not only did I not really believe it could work, it also seemed very costly. Then PBS did a special on a gentleman called “Footie” who they followed as he entered the Pathways program. One of the things I vividly remember from the Pathways video was that they talked to individuals who had been living on the streets for years and asked them what they wanted most. And, guess what they said? They wanted housing. They didn’t say they wanted to remain homeless. That video turned my skepticism to amazement and optimism. I remember thinking, “We can do this here in Richmond.”
Working with many partners in the community, including Homeward, the Daily Planet, the Community Services Boards of Richmond, Chesterfield and Henrico and the Virginia Housing Development Authority, A Place to Start (APTS) became our Pathways to Housing in Greater Richmond. The program was launched in late 2007 and began taking individuals off the street shortly thereafter.
APTS places individuals with an extensive history of homelessness and a serious mental illness into permanent housing and wraps intensive services around them. APTS has a dedicated service team of professionals, including a psychiatrist, nurse, social worker, peer counselor, substance abuse counselor and employment specialist who provide services 24/7. APTS also has a housing specialist who works with landlords to broker leases, get clients into permanent housing, and ensure that program participants and landlords are getting what they need.
We knew the program worked because it was evidenced based, but we needed to prove it worked here in Richmond. So, we undertook an evaluation funded through the Greater Richmond Chamber Foundation and conducted by the Central VA Health Planning Agency. The research looked at hospital and incarceration data on 50 clients enrolled in the program and measured costs and incidents 20 months prior to program entry and 20 months after. The research is complete and the report was released today.
While we knew the program would work, we didn’t know how well it would work. APTS has taken 58 people off the streets in three years with a 98% success rate in keeping people stably housed! Only one person has returned to homelessness.
And APTS is saving the community precious resources. The research shows that the program has saved the community over $320,000 in the first 20 months in hospital and incarceration costs alone. This does not even include other costs, such as ambulance costs, judiciary costs, and the costs to the homeless services system.
Has this program made a difference in the community? Yes! In addition to cost savings, it is making a big difference in the community. We’re taking people off the streets. Most of the folks in the program were unsheltered prior to entering the program and were counted as such in the community’s twice yearly count of individuals experiencing homelessness. In July 2008, there were 148 people who were counted as “unsheltered homeless.” In July 2010, that number had gone down to 119, which is a 19% reduction in two years! Some of this reduction is due to APTS.
What about peoples’ lives? Just ask Jerome who has been in the program for over two years. He had been homeless for eight years, living in alleys, dumpsters, and under cars and bushes in Richmond. He suffered frostbite in both feet. “I struggled like a dog.” He said that he would have died if he had lived on the street one more year.
And, there are many more stories like Jerome’s. Despite all that we have accomplished through VSH and APTS, there is still plenty of work that needs to be done. There are still people living on the streets who need to get into housing and get the help they need, and we can’t do that without the community’s support. To support A Place To Start and the work of VSH to provide proven permanent solutions to homelessness, click here. Thank you!
Posted on July 20, 2010
I have asked Katie Van Arnam, VSH’s Director of Housing Access Programs, to write this week’s blog. Thanks, Alice
Is this household able to maintain permanent housing? Are they “ready” to be in their own place? Will they be able to “make it”? In my role at Virginia Supportive Housing, I hear these questions on a regular basis. My answer is always “yes”. I typically provide this response before I know any information about the situation and leave the individual asking me the question with a confused look on their face. In my mind, the issue is not “is this person sustainable in permanent housing” but instead, “does our community have a housing option that meets this person’s needs?”
Communities should have an array of options for those experiencing a housing crisis including outreach, prevention, emergency and transitional shelter, and affordable rental housing, and permanent, supportive housing. These options should be available to anyone who needs them, including those with physical disabilities and language barriers. Most importantly, the services and programs should match the needs of the household. Instead of blaming the person experiencing the crisis and saying “they will never make it in permanent housing” or “what did they do to get themselves here”, we should be looking at the services available in our community and asking why we do not have the capacity to meet this person’s needs.
VSH’s A Place to Start (APTS) program is a perfect example of this theory. This program serves single individuals with an extensive history of homelessness as well as a serious mental health disorder. By most standards, participants would not be able to “make it on their own” in permanent housing. However, the APTS program has proven otherwise. By matching the appropriate level of support services (in this case, intense service) to the needs of program participants, people are able to remain stable and avoid returning to homelessness. After operating for two and a half years, this program has shown a 98% success rate. This is for a group that most felt would not be “suitable” in permanent housing.
This housing first approach to ending homelessness is not unique to Richmond. According to HUD, more than 70,000 units of permanent housing as described above have been funded since 2001. Nationwide, the number of chronically homeless individuals has decreased by a third since 2005 (dropping to 112,000). Nationally, it is recognized that people may not “look ready for permanent housing” but they can, and will, make it in permanent housing if given the appropriate opportunity.
In addition to being the socially just thing to do, this matching of needs with services makes fiscal sense. The cost of homeless prevention, emergency shelters, transitional shelters, permanent supportive housing, and support services varies greatly. It is our responsibility to ensure that the most expensive programs are utilized for those who truly need them, and to then demand outcomes that justify the expense. In a recent article printed in the Washington Post, Dennis Culhane discusses five myths about America’s homeless. He discusses the role of emergency shelters since the 1980’s, and stresses that shelters have become “institutionalized way stations for lots of poor people with temporary housing crises.” He goes on to state, “To be in a shelter is to be homelessness, and the more shelters we build the more resources we divert from the only real solution to homelessness: permanent housing.”
I have urged my staff, and I am urging you to change your frame of thinking and begin to believe that anyone and everyone is able to “make it” in permanent housing. It is not our job to make that call. It is, however, our job to ensure that a wide variety of options are available.
Posted on June 9, 2010
I have asked Alison Jones-Nassar, VSH’s volunteer program coordinator, to write this week’s blog. Thanks, Alice
This morning, as I waited for my mom to come out of surgery, I scanned the NY Times for items relating to homelessness, thinking I would surely find at least one brief mention of the issue. And sure enough, as soon as I turned to the Op-Ed page, my eyes fell upon the heading, “Still No Shelter.” But as I continued reading, I realized it did not refer to homelessness after all, or at least not as it concerns NYC or even the US. Instead this column bemoaned the lack of progress in Haiti, where it claimed, “More than a million people are displaced [from the earthquake]…and Haiti’s government has no clear strategy to get them…into more secure shelter any time soon.”
Needless to say, this is an urgent situation and there is no question that it needs to be a high priority for the entire region. Human suffering on this scale, regardless of where it is, should not be acceptable and cannot be ignored.
But meanwhile, homelessness has been on the agenda in this country for more than three decades. Since 1980 billions of dollars have been spent nationwide on the problem. And yet the number of individuals experiencing or at serious risk of experiencing homelessness only continues to climb. On any given night, almost 700,000 people in the US lack a safe place to sleep at night and have no secure access to food, clothing, or sanitation – never mind employment, transportation, or health care.
What is our government’s “clear strategy” for getting these suffering human beings “into secure shelter”? The good news is that, after three decades of merely managing the issue of homelessness, our nation is finally beginning to shift resources toward strategies that solve the problem. Permanent supportive housing is an evidence-based cost-effective model that works. With even the hardest-to-serve populations, the rate of success is around 90% and the expense to taxpayers is a fraction of what we have been spending.
If we are really serious about responding to human suffering at home and abroad, then we need to get serious about ending homelessness now. By implementing permanent supportive housing on a large scale to meet the large need confronting our society, we could achieve that goal within our lifetime. Only then will we be in a position to judge the response strategies of other countries. And only then will we be in a position to respond ourselves.
Posted on April 13, 2010
The crisis of homelessness in America incurs many quantifiable costs. These costs include the money that it takes to place people experiencing homelessness in shelters, emergency rooms, jails and prisons, etc.
Perhaps the least examined and talked about cost of the crisis of homelessness in America is the loss of future productivity. In basic economic terms, loss of future productivity is an “opportunity cost”: the benefits which would have been received if a different course of action was taken.
The National Alliance to End Homelessness explains the concept of lost future productivity in the article The Cost of Homelessness.
“Decreased health and more time spent in jails or prisons, means that homeless people have more obstacles to contributing to society through their work and creativity. Homeless children also face barriers to education.”
One VSH client, James Trent* of Roanoke Va., found himself unable to work because of his severe health conditions. James had a bad knee and was in serious need of heart bypass surgery. After running out of money, he found himself on the streets.
Through a local shelter organization, James heard about VSH and contacted them about housing. He was finally able to receive bypass surgery, he qualified and received housing through VSH and is looking forward to beginning his new job soon.
“It’s a good feeling,” James said about his housing and ability to work again. New Clay House provides him with “privacy” and makes him “very happy” in his every day life.
By working to end homelessness instead of provide temporary solutions to the crisis, VSH hopes to provide an opportunity for people like James who, by having a place to live, will be able to contribute what they have to offer to society.
*Name was changed to protect participant’s privacy.
Posted on February 16, 2010
I have asked Katie VanArnam, VSH’s Director of Housing Access Programs, to write this week’s blog. Katie is a licensed clinical social worker with more than 10 years of experience providing direct services and administrative functions in a variety of non-profit and Government agencies. She holds an MSW degree from Virginia Commonwealth University with a dual concentration in Clinical Services and Administration. Katie directs the A Place To Start program along with two other housing programs. Thanks, Alice
I recently had the opportunity to see some friends from high school. It had been many years since I had seen these ladies and we have all gone our different ways in life. One is a school teacher, one a lawyer, one is a successful business woman and then there is me, the social worker.
After a few days of reacquainting ourselves, we started talking about our chosen professions and the challenges we face on a daily basis. I gave a brief synopsis of the job I do and those who receive services from the programs I oversee. My three friends listened intently, and then one asked, “What do you do about the people who just choose to be homeless? Why don’t they get help?” The question was asked in a very “innocent” fashion and my friend was simply trying to get a better understanding of those I serve.
In formulating my response, it occurred to me that no one really chooses to be homeless. In some cases, people make choices that contribute to their housing crisis, often resulting in the loss of their housing. However, I do not believe that these people are really choosing to be homeless.
Encarta Dictionary defines “choosing” as deciding among a range of options or making a deliberate decision. In the majority of cases, people who have fallen into homelessness do not have a range of options. While the causes of homelessness are many, the solutions are numbered. A “choice” may include entering the shelter system, finding new affordable housing or living on the streets.
While the shelter system in Richmond has come a long way, this system is not an ideal option for many experiencing homelessness. The rules, expectations, communal living situation and schedules can be very difficult to manage. This can be especially true for those who are suffering from an active addiction, have a physical disability, have male teenage children and/or are experiencing symptoms of a mental illness. Shelter is not a choice for everyone.
Many believe … ” if they would just get a job, they could afford housing”. In Richmond, the fair market rent (a rent that is considered to be “fair” and average for a unit) for a one bedroom unit is $832. This means that a single individual who is working full time and earning minimum wage ($7.25 an hour) would have to pay about 90 percent of their take-home pay just to cover the cost of rent. Rent does not include any other costs or expenses. According to Homeward, the region’s coordinating body for homeless services, 25.8 percent of the homeless population IS currently working; 50 percent of these employed individuals are working full time.
What happens when “just getting a job” is not a choice? The fairly recent economic downturn has left a considerable amount of the American population unemployed, making the job market even more competitive. Many people who are homeless have been forced into “choosing” to live on the streets, “choosing” to live in cars and “choosing” to sleep in abandoned buildings and on park benches. They have simply “chosen” from the only option they were given.
As I explained this to my friend, I could see the realization in her face. The next time you see someone experiencing homelessness, and you will see them if you choose to look, ask yourself, what choice did they have?