Seeking a Home Remedy

By Brennan Jensen

The one bedroom apartment in an unassuming housing complex outside Columbus, Ohio, is modest, but to its 43-year-old occupant, the space marks his entry into a brave new world. 

"I've never lived on my own before," says Daston, who asked to be identified by his first name only.  "This is all new to me." 

Before moving in a year ago, Daston's address has often been a state prison, where drug charges have sent him several times. Other times he had no address at all.

"I was what you call a front-porch homeless person," says Daston, who has a mental disability that brings on depression and paranoia -- both made worse by drug and alcohol abuse. "I would sleep on my family's front porch, or in a car, coming and going before they'd wake up."

Years of Drifting

Housing advocates and the federal government have another name for Daston's way of life: chronic homelessness. At any given time, 150,000 people nationwide are on the streets after years of drifting from shelters to hospitals and sometimes, like Daston, to prison.

The chronically homeless are a tough group to help, and an expensive group to ignore. Research shows that they use a disproportionate amount of social services, such as beds at shelters and soup-kitchen meals, and heavily burden public health-care systems. Such studies, combined with promising results from some innovative programs, have prompted many advocates for the homeless to zero in on this population.

Last fall, nine foundations -- including the Rockefeller and Robert Wood Johnson Foundations -- contributed $37-million toward ending long-term homelessness by 2014. The Bush administration has also been steering a growing share of housing dollars to help such people and has pledged to end chronic homelessness as well. It created the Collaborative Initiative on Chronic Homelessness in 2003, which has distributed $35-million pooled from three agencies (Housing and Urban Development, Health and Human Services, and the Veterans Administration).

Supporters of the focus on the chronically homeless say that unless such people get help, homelessness will never disappear. They say that while people have always been homeless, it has only been in the last 20 years or so that it has become a burgeoning social problem.

Some housing advocates, however, worry that the move dangerously divides the homeless population, as by design it only focuses on adult singles and ignores the swelling ranks of homeless families and children. Social-service organizations in rural and suburban areas say it also puts too much emphasis on urban problems. The endgame, they say, should be ending homelessness for everyone.

Services on the Side

Most of the efforts to help the chronically homeless center on so-called supportive housing, which gives the homeless not just low-cost apartments, but also health care and social services.

Daston's rent, for example, is paid largely by the Community Shelter Board, a Columbus nonprofit organization that coordinates the city's homelessness programs. The charity received a $3.3-million federal grant last year. In addition to getting a roof over his head, Daston receives medication and weekly therapy. And he is now taking computer classes, reconnecting with his children, and looking for a job.

"I'm rebuilding my life," Daston says. "My five-year plan now is go to school so I can learn to help others."

While recovery from extended homelessness makes for heartwarming stories, housing advocates say that cost savings, not just concern for the welfare of others, is behind the push to end chronic homelessness.

"What is being discovered across the country is that the costs associated with a homeless population randomly ricocheting across systems may be more expensive than providing them with housing and all the support services that they need to end their homelessness," says Philip Mangano, executive director of the Interagency Council on Homelessness, in Washington, which coordinates homelessness efforts of 20 federal agencies. "The cost-benefit analysis is driving political will in our country now."

Pivotal to this conclusion is a 1998 study by a professor at the University of Pennsylvania School of Social Policy and Practice. Dennis Culhane analyzed shelter usage over two years by adults in New York and Philadelphia. The data showed that while the bulk of the shelter residents came and went rather quickly, about 10 percent of them -- which Mr. Culhane called the "chronic homeless" -- made extended use of shelter space, to the point of using 50 percent of the shelter's resources over time.

"Half of the shelter system was inappropriately functioning as permanent housing," Mr. Culhane says.

Mr. Culhane and other researchers next studied the expenses that governments incur when helping 10,000 mentally ill New Yorkers, half of whom where in supportive housing programs that cost, on average, slightly more than $17,000 a year. The other half were homeless and on their own.

After tallying costs for such things as shelters, hospitals, jails, inpatient psychiatric services, and Medicaid assistance, the researchers found that those in supportive housing required an average of $16,282 a year less in other charity and government services than did the homeless group. The savings were all but enough to offset the cost of the supportive housing.

Lobbying Efforts

Armed with such research, housing advocates have been lobbying for increased spending on supportive housing. Mr. Mangano, for example, spends much of his time traveling the country encouraging states, counties, and cities to develop their own 10-year plans to end chronic homelessness. The U.S. Conference of Mayors endorsed the idea in 2003, and nearly 200 local plans have been created.

"The chronic-homeless initiative refocuses us on that original population that we were responding to at the beginning of the contemporary response to homelessness," Mr. Mangano says, noting that some of the first homeless people to emerge in numbers were mentally ill people who had been ejected from psychiatric hospitals in the 1960s and '70s. When homelessness swelled in the 1980s, he says, those "hardest to serve got passed over by the homelessness bureaucracy."

The U.S. Department of Housing and Urban Development defines chronic homelessness as a single adult with a disabling condition who has either been continuously homeless for a year or more or has had at least four episodes of homelessness in the past three years. (A "disabling condition" can be a substance-use disorder, a mental illness, or a physical illness or disability.)

Through its Collaborative Initiative on Chronic Homelessness, the federal government is paying for supportive housing for 544 chronically homeless men and women in 11 cities. Mr. Mangano says this group cumulatively represents some 3,500 years of homelessness.

For the rest of the article, please go to the Chronicle of Philanthropy website at: http://www.philanthropy.com/ and go to Back Issues, August 18, 2005.

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