Bandaids vs Solutions

Many people find the issues surrounding homelessness overwhelming.Often people have little information on the scope, the nature or the true cost of homelessness.Conversations reflect that people believe homelessness is an ongoing problem with no real solutions.It may be that a persons view of the problem is formed from behind a car window and they are unsure of the accuracy of their perception. I know that this was certainly true for me. The card-board-sign bearing panhandler seems to bear witness that in spite of wellmeaning shelter and human services systems, homelessness is still challenge. Current methods that manage homelessness are ineffective and should be rethought.

The Washington State Housing Committee and the Committee to End Homelessness-King County provide some enlightening statistics. The number of persons 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. In 2003, an average year,42 people died out-of doors and homeless in King County . That is an average of one person dying almost every week. These deaths occur in rural as well as urban areas.

Last year I had the good fortune to work an outreach program that increased my exposure to housing and homeless issues. I got to see first hand some of the things that work and some that that don't. The myths I held about homelessness crumbled. Once homeless it is very difficult to co-ordinate services. The shelters have intakes, late arrive times and early release times. They require sobriety and civility. Most waking hours the homeless are on the move. They don't have personal calenders, cell phones or bus passes. If there are resources, scheduling and keeping appointments is problematic. It was my experience that housing was a huge predictor of the success of other services.

Housing First program models purpose that an productive way to address homelessness is to provide housing for the homeless. This may seem simplistic, naive and cost prohibitive. However, this approach is proving to be surprisingly viable and cost effective. Homeless persons are disproportionately represented in the use of high cost services.The UCLA Dept. of Family Medicine's sampling of homeless adults found that 37 percent had visual impairment, 36 percent had skin/leg/foot conditions and 31 percent had Positive TB tests. An report on children in homeless shelters published in Pediatrics Vol. 102 No 3, revealed that children living in shelters had a 2-3 times higher rate of emergency room visits, It was also determined that homelessness was an independent predictor of poor health in these children. High cost services include emergency room visits ,911 services, mental health hospitalizations,detoxification, inpatient programs, child protective services and incarceration. Reduction in use of these services alone
justifies the cost of housing.

The Plymouth Housing Group's Begin at Home project housed 20 hardest -to-reach, chronically homeless individuals. The projects outcomes after 1 year showed a 75 percent reduction in medical costs, which translates to 1.2 million dollars. The Sound Families Initiative , funded by Bill and Melinda Gates provided transitional housing, case management and referral services to 1,487 families, 85 percent of whom were single parent households. Evaluation of the project showed an increase in the children's educational stability. The vast majority of these families were able to procure permanent housing. People involved with other target populations are turning their attention to the issue of housing also.Programs for foster children who "age out" now consider housing crucial in preventing further costs in dollars and quality of life. Correction facilities now look at housing as an important component of re-entry programs as they now know housing is a correlate of recidivism.

The work and positive outcomes of The Plymouth Housing Group, The Committee to End Homelessness-King County, The Sound Family Initiative and other Housing First models bring hope.They have turned the conversation from one of managing homelessness into one of ending homelessness. I believe that the ability and resources to accomplish this exist. I also believe that not only is it possible, but quite feasible that homelessness can be essentially resolved in this lifetime.The benefits would far-reaching.

Sources:

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

The Commitment Continues: Washington State's Efforts to End Homelessness, My View form Kim Herman, Executive Director, Washington State Housing Finance Commission, Feb .2008

Children In Sheltered Homeless Families- Reported Health Status of Use and Health Services ,
Robert Wood Faculty Development Fellowship Program, Dept. of Family Medicine& Dept. of Public Health Services, University of Washington, Seattle, Pediatrics Vol 81 No 5 -May 1090
(google scholar) http://pediatrics.aappublications.org/cgi/content/abstract/81/5/668

The Behavioral Model for Vunerable Populations, UCLA Dept. of Family Medicine ,Los Angeles
(google scholar) http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid+1089079

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