Daring to end homelessness
While the recent collapse of the U.S. housing market has prompted a renewed debate about American homeownership and its future, the related topic of homelessness has remained largely ignored. Hundreds of thousands of citizens live lives of addiction and mental illness on the streets of American cities. On any given day, 900,000 people — including 200,000 children — go to sleep homeless in the United States, and the current economic crisis has only increased these numbers. Until very recently, the conventional approach towards combating homelessness did not focus on effectively solving the problem but rather on serving the homeless sporadically in soup kitchens and shelters. Although certainly valuable, this work had not caused any significant reductions in the numbers of the chronically homeless in major U.S. cities.
Yet a new approach by the U.S. Interagency Council on Homelessness, led by “Homelessness Czar” Philip Mangano, has revolutionized urban programs and brought major reductions in the chronically homeless populations of U.S. cities. Taking advantage of what Mangano, in an interview with the HPR, called a new climate of “unprecedented political will and unprecedented resources” to “dare to put the verb ‘end’ with the noun ‘homelessness,’” the Council has helped 350 American cities and counties implement “Ten-Year Plans to End Chronic Homelessness.” These plans prioritize ending homelessness by providing housing and counseling for addiction and illness rather than serving the homeless from the streets. Though the plans have been criticized for focusing too intently on assisting those who are already homeless rather than helping those at risk of homelessness stay in their homes, their success at reducing the chronically homeless population is irrefutable, and they are likely to spread to many more American cities in the near future.
Chronic Homelessness: Understanding the Problem
The chronically homeless, those who live on the streets permanently rather than those who are sporadically in and out of homes, have consistently presented the most difficult problem for cities to solve. As Kevin Fagan, a San Francisco Chronicle reporter who from 2003 to 2006 was the only journalist in the country writing exclusively about homelessness, told the HPR, the chronically homeless make up between 10 and 40 percent of a city’s street population, and virtually all are mentally ill or addicted to drugs or alcohol. They survive relying solely on their ability to scrounge for food, get their next fix, and find a safe stoop to sleep on each night. There is a strong focus on getting this population off the streets; according to Fagan, “if you help the worst-hit segments of the homelessness problem, it frees up resources to help the rest of the homeless population.” If cities can find a viable solution to the hardest problem, other urban issues become easier to tackle.
The economic crisis has certainly had adverse effects on efforts to slow homelessness. Mary Brosnahan, Executive Director for the Coalition of the Homeless, describes the problem as “a revolving door” of Americans moving in and out of homelessness. In the 1990s, at least 2.3 million people, and perhaps as many as 3.5 million people, experienced homelessness at some point, annually. The housing crisis has only exacerbated this problem. Ironically, however, the crisis does not significantly affect the chronically homeless population — without jobs or homes, they are largely unaffected by rising unemployment and foreclosures. Yet the problem remains dire. The Interagency Council’s “Ten-Year Plans” signal a shift from “service to solving,” according to Mangano, and have brought significant success to the cities that implement them.
Representatives of the Interagency Council have traveled the country promoting these “Ten-Year Plans,” influencing cities to put greater political will and resources into fighting homelessness than ever before. According to Mangano, these plans are “field tested and evidence-based,” and locally constructed in each community, “not shaped inside the Beltway.” They are initiated, led, and managed by local mayors and county officials who bring together community stakeholders to craft specific plans.
One source of the plans’ success, Mangano asserts, is their business-like models. “If there’s one thing we’ve learned in the last 25 years, it’s that if well-meaning programs could end homelessness, it would have been over years ago,” he noted. Rather than relying on moral, spiritual, or humanitarian arguments, the plans look at economic cost studies. For example, it has been calculated that, while it costs between $35,000 and $150,000 in police monitoring and medical costs to leave one chronically homeless person on the street for a year, it only costs $13,000 to $25,000 per year to give that same person housing and counseling. In the United States, an emergency room visit costs $1000 on average, an ambulance ride $500. Costs like this add up quickly, and the homeless have no insurance to cover them. As Fagan found in his reporting, one particular woman in San Francisco cost upwards of $100,000 of taxpayer money a year to leave on the street. As Mangano says, “you don’t need to be Warren Buffet or Suze Orman to know which of those investments makes sense.” The U.S. Interagency Council on Homelessness recently published some encouraging financial numbers: efforts by Seattle/King County’s Eastlake Housing First program have saved the city $4 million, and Massachusetts’s Housing First pilot program has shown a 67 percent reduction in annual health care costs per person. These numbers often prove far more persuasive than moral arguments in convincing mayors to implement the plans.
Nonetheless, some experts argue that the “Ten-Year Plans” focus too much on the already homeless and not enough on systems — such as healthcare, education, and social services — which must be reformed in order to truly end homelessness. As Dr. Kedar Karki, author, sociologist, and homelessness activist, told the HPR, “when assistance is restricted to those who are homeless tonight, not much can be done to prevent homelessness tomorrow.” Mangano agrees that reforms are needed in other areas, but holds firm that “affordable housing [for those who are homeless] is the most important public policy evolution that needs to take place.”
Seeing is Believing
Mangano’s approach has certainly had a significant impact. From 2005 to 2007, 350 local “Ten-Year Plans” in cities throughout the country brought a 30 percent decrease in chronic homelessness. This statistic translates into 52,000 people leaving the streets and finding housing. While the economic downturn has produced an increase in overall homelessness, chronic homelessness — the crux of the problem — is decreasing. As long as this trend continues, we will see more and more cities implementing “Ten-Year Plans” and adopting the new philosophy that a solution to homelessness is possible.
Ashia Wilson ’11 contributed reporting for this article.