1. The Dynamics of Homelessness Dennis P. Culhane University of Pennsylvania

2. Proportion of NYC Population That Experienced a Shelter Stay in 1995, by Age

5. Cluster Distributions: Persons and Shelter Days Consumed (Single Adults in Philadelphia)  Transitionals:  1.19 stays  20.4 days  Episodics:  3.84 stays  72.8 days  Chronics:  1.53 stays  252.4 days

6. Disability Condition & Veteran Status By Cluster (Single Adults in Philadelphia)

7. Implications  Transitionally Homeless: Prevention and Relocation Assistance  Episodically Homeless: Low Demand Residences (Safe Havens), Harm Reduction, Transitional Housing, Residential Treatment  Chronically Homeless: Permanent Supportive Housing

8. The New York-New York Evaluation Culhane, Metraux and Hadley, 2002 Funded capital, operating and service costs for 3,600 supportive housing units in NY City Placement recipients must be SMI and have record of homelessness Data available on 4,679 NY/NY placement records between 1989-97

9. Data Sources NY/NY Housing Placements: 1989-97 Singles Shelter Users and Stays: 1987-99 State Hospital Users & Stays: 1990-96 Municipal Hospital Users & Stays: 1989-96 Medicaid-Reimbursed (non-HHC) Inpatient Hospital Stays: 1993-97 Medicaid-Reimbursed Outpatient Visits: 1993-97 Veterans Hospital Stays: 1992-99 State Criminal Justice Prison Use & Convictions: 1987-97 City Jail Use: 1987-99

10. The Cost of Homelessness Service Provider Mean Days Used (2-year pre-NY/NY) Per Diem Cost Annualized Cost NYC DHS – Shelter137$68$4,658 NYS OMH – Hospital57.3$437$12,520 NYC HHC – Hospital16.5$755$6,229 Medicaid – Hospital35.3$657$11,596 Medicaid – Outpatient62.2 (visits)$84$2,612 VA – Hospital7.8$467$1,821 NYS DCJS – Prison9.3$79$367 NYC DOC – Jail10$129$645 Total$40,449

11. NY/NY Savings: Per Housing Unit Per Year ServiceAnnualized Savings per NY/NY Unit DHS Shelter$3,779 OMH Hospital$8,260 HHC Hospital$1,771 Medicaid – Inpatient$3,787 Medicaid - Outpatient($2,657) VA Hospital$595 NYS Prison$418 NYC Jail$328 Total$16,282

12. NY/NY Housing - Costs and Savings

13. Key Findings  95% of supportive housing costs offset by service reductions  Study underestimated savings associated with program-funded services (McKinney) and crime  Study did not quantify benefits to consumers  NY/NY was a sound public investment

14. What is Needed?  150,000 units of housing to “End Chronic Homelessness” today  Rental subsidies ($4k-6k each)  Service supports ($6-13k each)  Capital costs in some cities

15. What has been done?  Congress and President have increased funding $400 million since 2004; 35% increase  60,000 units created  HUD reported a 20% decline in CH from 05 to 07

16. City and County 10-Year Plan Update (October 2007) # 200 www.usich.gov #300 UNITED STATES INTERAGENCY COUNCIL ON HOMELESSNESS 300+ and counting

17. UNITED STATES INTERAGENCY COUNCIL ON HOMELESSNESS RESULTS IN REDUCING STREET AND CHRONIC HOMELESSNESS San Francisco: 38% decrease Philadelphia: 50% decrease Miami: 50% decrease Portland: 70% decrease Nashua, NH: 64% decrease Raleigh/ Wake County, NC: 11% decrease New York City: 15% decrease Denver: 36% decrease Dallas: 43% decrease Quincy, MA: 55% decrease Duluth: 15% decrease Shreveport: 15% decrease Madison: 30% decrease Asheville, NC: 23% decrease Nashville, TN:* 21% decrease Atlanta: 8% decrease www.usich.gov Montgomery: 14% decrease Seattle/King County: 20% decrease Contra Costa: 35% decrease Norfolk 17% decrease Tacoma: 65% decrease St. Louis: 34% decrease Danbury, CT: 10% decrease Mobile: * 26% decrease * For the year 2006 – 2007. Fort Worth: 42% decrease Gainesville: 18% decrease DC: 6.5% decrease Monterey, CA: 11% decrease Chicago: 9% decrease Augusta: 16%decrease Portland, ME: 49% decrease Yakima: 15% decrease

18. Testing a Typology of Family Homelessness Dennis Culhane University of Pennsylvania Stephen Metraux University of the Sciences in Philadelphia Jung Min Park University of Illinois at Urbana-Champaign

19. Background  Singles typology experience  But families are different: - much lower MH/SA rates - not different from poor housed families - relatively homogeneous  Potential confounders – policy/program factors - use of shelter system as queue for subsidies - transitional shelter as a reform movement

20. Methodology  Four jurisdictions – Philadelphia, NYC, Columbus OH, and Massachusetts  HMIS data – new admissions followed for two or three year periods  30 day exit criterion applied  Cluster analysis, specifying three cluster solution  Database merges to identify service histories

21. Health and Social Service Databases Merged  In one city: Medicaid, Mental Health, Substance Abuse, Child Welfare  In one state: Medicaid, Mental Health, Substance Abuse, Child Welfare  In one city: Child Welfare

22. Results: Cluster Solution (Massachusetts, family shelter users)  Transitionals:  1.0 stays  105 days  Episodics:  2.0 stays  195 days  Long-Stayers:  1.0 stays  444 days

23. Intensive Service Histories of Families

24. Income Sources

25. The Average Cost of Shelter Stays by Type (Massachusetts)  Transitional $11,550  Episodic$21,450  Long-term$48,440 Does not include McKinney-Vento funding or non-DTA public service contracts.

26. Summary  Cluster patterns are robust across sites  Most families (75%) leave quickly and don’t return  A small number (5%) return repeatedly  20% of families have long stays, using 50% of resources  BUT – unlike singles – long stays do not indicate personal barriers to housing stability

27. Conclusions  Policies and programs driving long stays  Characteristics of “graduates” may reflect selection effects of policies and programs  Most costly service users are not differentially service-needy  Need for reform

28. VolumeVolume Cost per Case Model Cost by Volume Service System for Addressing Housing Emergencies Prevention Supportive Housing Shelter Admission Diversion, Relocation and Transitional Rental Assistance Mainstream systems Community- Based programs

29. Shelter Day Care Employment Housing Placement Family Services MH/SA Services Prevailing ModelEmerging Model Housing Stabilization Day Care Employment Shelter Family Services MH/SA Services

30. NYC Advantage (5/07) Work Advantage (for employed) 1 yr rental ass. (renewable for 1 yr) Daycare access Savings match Fixed Income Advantage (for disabled or open CW cases) 1 yr rental ass. (renewable for 1 yr.) In queue for Section 8 Next Step Shelter (for unemployed) Intensive engagement (services and employment) Transition to Work Advantage Undocumented Lump-sum rent payment (equals 6 mos. rent) “Exit Doors”

31. Massachusetts: “Tiered” Intervention (Mass. Special Commission Report, 1/08) Tier 1: Emergency Assistance for Families w/ Temporary Economic Struggles – Stabilization/Diversion/Relocation Tier 2: Economic Development Rental Assistance I - for Families w/ Moderate Economic Challenges – Relocation and Temporary Rental Assistance Tier 3: Economic Development Rental Assistance II – for Families with Complex Economic Challenges – Relocation, Temporary Rental Assistance, Employment Supports Tier 4: Permanent Housing with Service Engagement – for families with economic and social challenges

32. Shelter admission Community- based Prevention (Diversion and Stabilization) $1-2k per case Rapid Exit: Relocation $2-4k per case Up to 2-4 weeks shelter Housing Stabilization Service I Relocation, Critical Time Intervention CM, Temp Rental Ass. 1 year shallow rental subsidy Housing Stabilization Service II More intensive services, 1 more year of Temp Rent Ass. Shelter exit Transition to mainstream systems Long-Term Subsidy and Service Engagement “Progressive Engagement”

33. The Masschusetts Commission: Highlighted Principles  “The Right Resources, to the Right People, at the Right time”  Effective coordination and delivery of prevention services to reduce shelter admissions  Establish “regional networks” for housing relocation and stabilization for sheltered families  Leverage mainstream services and permanent housing resources to support reform strategy

34. Other Strategies “On the Drawing Board”  Creating a defined “Emergency Assistance” benefit within TANF  Families have an “account” for managing housing emergencies, eg. to spend on prevention, shelter and temporary rental assistance  Licensed “housing stabilization” providers access and administer the account

35. Issues for Further Consideration:  Should clients be matched to housing and service packages a priori? Or should “benefit” be uniform, with progressively intensive interventions based on continuing need?  What is reasonable expectation of time for housing placement?  When should different interventions be triggered?  How long should stabilization services be provided to families?  How much and for how long should temporary rental assistance be provided?  Can the long-term subsidies be leveraged to “reinsure” against the risk of families with on-going needs?

36. Future Research  Develop assessment tools for classifying families  Develop housing assistance models to relocate families and test efficacy by type of family  Use HMIS for assessment and tracking outcomes, possibly routinely check for service histories of families  Study selection behaviors of facilities, role of policies

37. Suggested web resources  National Alliance to End Homelessness www.endinghomelessness.org  United States Interagency Council on Homelessness www.usich.gov