ARE THEY REALLY WORKING? A Critique of ‘10 Year Plans to End Homelessness’

Felicity ReynoldsChief Executive OfficerMercy Foundation

Abstract - summary

My interest – Churchill Fellowship 2007 Past 5 years in USA – 10 year plans. Why? Cost studies Who and how? Key components of plans Progress results Lessons for Australia

Acknowledgement: Thank you to Philip Mangano, Executive Director of USICH for generously sharing some of his data and slides on the development and outcomes of 10 year plans.

Background – 10 Year Plans

Since 2002 – now 340 10 year plans, across all states.

Supported federally through the United States Interagency Council on Homelessness (USICH).

Why? A range of reasons, which include: Existing models were not solving homelessness for

some people. Chronic Homelessness ‘seemed’ to be getting worse –

but no good data on problem. Costs (eg. NY study $41,000 per year).

Cost studies I presented paper at previous National

Homelessness Conference (Sydney, 2006) – estimate, based on HPIC data and Outreach case studies indicated it could be as much as $34,000 per year to remain chronically homeless in Sydney.

Studies from the USA include Culhane (NYC - $41,000 per year).

Counter intuitive – looks cheap to be homeless.

Now numerous studies in the USA (next slide)

Seattle

Asheville, NC

Boston

Reno

Key West

California

Santa Barbara

New York

Waco

Atlanta

Broward County

Dayton

Richmond

Gainesville

Portland

Minneapolis

Jacksonville

Chicago

Denver Indianapolis

Los Angeles

Louisville

Minnesota

QuincySalt Lake City

San Diego

Completed Studies

Studies in Progress

San Francisco

Maricopa County

SOURCE - USICH (P. MANGANO)

COST STUDIES (65 to date)

SE CT

www.usich.gov

Lee County

Maine

San Antonio

North Carolina

South Carolina

A few local cost studies from the USA

10-Year Planners analysed the service use of 37 homeless men and women over a period of 3 years and found that these individuals cost the city and county more than $800,000 each year (police and jail costs; hospitalisation costs etc). (Source: Looking Homeward: The Ten Year Plan to End Homelessness, Asheville and Buncombe County 2005, courtesy P.Mangano).

The Boston Health Care for the Homeless Program tracked 119 persons experiencing chronic homelessness for 5 years and discovered that they had more than 18,000 emergency room visits at an average cost of $1000 per visit. (Source: Boston Health Care for the Homeless Program, courtesy P. Mangano).

Example: successful initiative in Seattle

A ‘Housing First’, supportive housing initiative in Seattle for 75 chronic inebriates – showed $2.5 million in saving after 12 months. Saving included reduced emergency mediacl visits, jail, sobering up and detox.

Annual operating costs: $1 million. Significantly cheaper to provide housing and support –

multiple studies have shown this. In most places an average 85% successfully sustain

housing over the longer term (this includes statistics from Housing First intitiave in Toronto, Canada).

10 Year Plans – Who?

340 cities and other communities now have 10 year plans. These include:

Chicago Miami Philadelphia Portland Seattle Dallas Washington DC

10 year plans – How?

Key components of successful plans: Political will and leadership. Plans based on business principles and results

measured and reported. Multi-agency and politically bi-partisan, with

business community involvement. Use of Federal, State, City funds plus private

investment. Use of initiatives that have been proved to be

effective (evidence based) eg. more affordable housing; assertive treatment teams and support; street outreach linked to ‘Housing First’.

11 key elements of success HUD notes 11 key elements to successfully reduce

chronic homelessness. The first five of these are considered essential elements for success. They are: Paradigm shift Clear goal set Community wide approach Organisational structure and leadership specifically for reducing chronic

street homelessness Mainstream agency involvement Trigger event Private sector involvement Local elected official commitment Progress tracking mechanism New approaches to services Strategy to combat NIMBY (Not in my back yard)

NAEH – successful strategies include Plan (envision and plan to end chronic

homelessness) Data (measure outcomes; be accountable for your

services and actions) Emergency prevention (close the front door) Systems prevention (close the front door) Outreach (open the back door) Shorten homelessness (open the back door) Rapid re-housing (open the back door) Services (sustain) Permanent housing (sustain) Income (sustain)

Results oriented activities

Use of enumeration methodologies (counts) in order to measure success.

Increased research and use of evidence based interventions (eg. Evidence that the same outcomes are achieved for families who go straight to permanent housing, as opposed to transitional housing first).

Consumer focus – what do people want? (not, what is it we can we provide?)

Focus on most vulnerable and complex (chronically homeless).

But also ensure all other parts of system working (eg. Prevention; help for families etc).

Progress results

HUD announced 12% reduction in chronic homelessness in November 2007.

This was based on one year (2005 -2006) and represents a little over 20,000 people nationwide.

Based on agreed count methodologies. Some cities announced even larger % decreases.

Depends on the progress of plan, increases in affordable housing and support services.

Not all components of all plans successful – stop doing those things if that happens.

UNITED STATES INTERAGENCY COUNCIL ON HOMELESSNESS

RESULTS IN REDUCING STREET AND CHRONIC HOMELESSNESS:DECREASES FROM LOCALLY REPORTED DATA

San Francisco: 38%

Philadelphia: 50%

Miami: 50%

Portland/ Multnomah

County: 70%

Nashua: 64%

Raleigh/Wake

County, NC: 11%

NYC: 25%

Denver: 36%

Dallas: 43%

Quincy, MA: 55%

Duluth/St. Louis County: 15%

Shreveport: 15%

Madison, WI: 38%

Asheville/Buncombe

County : 23%

Nashville:* 21%

Atlanta: 8%

www.usich.gov

Montgomery: 14%

Seattle/King County: 20%

Contra Costa County: 35%

Norfolk, VA: 40%

Tacoma: 65%

St. Louis: 34%

Danbury, CT:10%

Mobile/Baldwin

County: *26%

* For the year 2006 – 2007.

Fort Worth/Tarrant County:

42%

Gainesville/Alachua

County: 18%

DC: 6.5%

Monterey, CA: 11%

Chicago: 9%

Augusta, GA: 16%

Portland: 49%Springfield,

MA: 39%

Tucson: 6%

Lessons for Australia

Planning to end chronic homelessness works. Ending chronic homelessness is cost effective (as well

morally responsible). Not just the USA, lessons from the UK rough sleepers

initiative also showed it was possible to reduce chronic homelessness. Canada also now doing 10 year plans and getting results (eg. Toronto).

Must have buy-in from all stakeholders at the local level: Federal; State; Local; NGOs; Business; People who are homeless, as well as other residents in the community.

A local champion really helps.

Conclusion

Lest I be accused of believing that all bright shiny new objects invented in America are always the answer to Australia’s problems, let me say that I don’t. I know that not all parts of all 10 year plans have been successful. But the concept is a solid one and the objective a worthy one. We can make the necessary adaptations to Australian conditions and for the particular composition of our chronic and non-chronic homeless populations. It is also very clear that there is much that we already do that is very good and we must not throw those things away.

Contact details

For further information and/or a copy of my Churchill Fellowship report:

Felicity Reynolds

CEO, Mercy Foundation

PO Box 3221 Redfern NSW 2016

Phone: 02 9699 8726

Mobile: 0438 771 518

Email: executive@mercyfoundation.com.au