Hope

Most people find the homeless issue overwhelming. Many people have very little information on the scope, nature and cost of homelessness. Conversations reflect that people think of homelessness as an ongoing problem with no real solutions. Often a persons view of the problem has been gleaned from behind a car window and they are unsure of the accuracy of their perception. I know this was certainly true for me.
The Washington State Housing Finance Committee and the Committee to End Homelessness- King County provide some enlightening statistics.The number of individuals who are homeless on any given night in King County is 8,000. The Emergency Shelter Assistance program in Washington State provides a place to sleep for more than 45,000 individuals a year. In other contexts those numbers would be dubbed a national disaster. People die without a roof over their head in our county. In 2003 , an average year, 42 people died out-of doors and homeless. That is an average of one person dying almost every week.
Housing first program models purpose that an effective way to address homelessness is to first provide housing to the homeless. While this may seem simplistic, naive and cost prohibitive this approach is proving proving to be surprisingly viable and cost effective. The price of homelessness in the use of high cost services overshadows the cost of providing housing. High cost services include emergency room visits, 911 services ,mental health hospitalization, detoxification, inpatient programs, child protective services and incarceration.
Homeless individuals are disproportionately represented in use of these services.
A report on children in homeless shelters , published in Pediatrics Vol. 102 No 3,revealed that a sample of 158 children living in shelters had a 2-3 times higher rate of emergency room visits. It was found that homelessness was an independent predictor of poor health in these children. The UCLA Dept. of Family Medicine sampling of homeless adults found 37 percent had visual impairment, 36 percent had skin/leg/foot conditions, and 31 percent had a positive TB test.
Outcomes of housing first models are promising. The Sound Family Initiative ,funded by Bill and Melinda Gates provides transitional housing, case management and referral services for 1,487 families, 85 percent of whom were single parent families. The vast majority of these families were able to procure permanent housing. The children had an increase in educational stability. The Plymouth Housing group's The Begin at Home Project housed 20 hardest- to reach, chronically homeless.The outcomes after 1 year showed a 75 percent reduction in medical costs, which translate to a savings of 1.2 million dollars. Correction facilities now look at housing as an important component of re-entry programs as they know that housing is a correlate of recidivism. Programs for foster children who "age out" of foster care consider housing crucial in preventing further costs in dollars and quality of life.
Last year I had the good fortune to work an outreach program which increased my exposure to housing and homeless issues. I got to see first hand some of the things that works and don't work. It was my experience that housing was a huge predictor of the success of other services.The work and positive outcomes of The Committee to End Homelessness, The Sound Family Initiative, The Plymouth Housing Group and other Housing First models brings hope. They have turned the conversation from one of managing homelessness to one of ending homelessness. I believe that the ability and resources to accomplish this exist. I am starting to believe that not only is it possible but quite feasible that homelessness can be resolved in our lifetime. The benefits will be far reaching.

Sources:

A Roof Over Every Bed in King County, Our Communities Ten Year Plan to End Homelessness, by the Committee to End Homelessness-King County, 2005

The Evaluation of The Sound Families Initiative, prepared for The Bill and Melinda Gates Foundation by The NW Institute for Children and Families , University of Washington School of Social Work, 2007

The Behavioral Model for Vunerable Populations , UCLA Dept. of Family Mediine , Los Angeles-(Google Scholar)

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1089079

The Commitment Continues: Washington States Efforts to End Homelessness, My View from Kim Herman Executive Director ,Washington State Housing Finance Commission, Feb 2008

Children In Sheltered Homeless Families-Reported Health Status of Use and Health Services,Pediatrics Vol.81 No5- May 1980, Robert Wood Faculty DevelopmentFellowship Oregram, Dept. of Family Medicine & Dept. of Public Health Services,Univesity of Washington, Seattle (google scholar)

http://pediatrics.aappublications.org/cgi/content/abstract/81/5/668