1. COMMUNITY SUMMIT TO END AND PREVENT HOMELESSNESS OCTOBER 26, 2015 Tatiana Bailey, Ph.D. UCCS College of Business 1

2. Topics Covered 2  Context – Homelessness Facts  Context – Health Care in the U.S.  Economic Factors  Best Practices

3. The Context – U.S. Facts on Homelessness 3  The U.S. spends less on cash transfers on assistance to the needy than 26 other developed nations. This includes transfers like unemployment assistance and social security. (Source: OECD 2012, “Income inequality and growth: The role of taxes and transfers”, OECD Economics Department Policy Notes, No. 9. January 2012.)  Over 600,000 homeless people in the U.S. are homeless (Source: U.S. Department of Housing and Urban Development, HUD).

4. The Context – U.S. Facts on Homelessness 4  One quarter of homeless people are children (NCLB definition – over one million children living in cars, parks, bus or train stations or awaiting foster care placement).  Almost 10% of homeless are veterans (mental health more of an issue)  More than 90% of homeless women are victims of severe physical or sexual abuse; escaping that abuse is a leading cause of their homelessness.

5. The Context – U.S. Facts on Homelessness 5  Rise in homelessness in America over the past 20-25 years largely due to a growing shortage of affordable rental housing and a simultaneous increase in poverty. (Source: National Coalition for the Homeless).  Increases in health care costs also a major factor

6. The Context – Affordable Housing 6  US needs at least 8 million more affordable apartments for low income; low supply means millions of families spend more than 50% of their monthly income on rent.  Five million homes foreclosed since 2008  Lack of affordable housing: HUD budget slashed by over 50% in recent decades (loss of 10,000 units of subsidized low income housing each year).

7. The Context – Mental and Physical Health 7  Poor health is both a cause and a result of homelessness.  Inability to pay health care bills is #1 reason for bankruptcy in the U.S.  Homeless 3-6 times more likely to become ill.  Cost shifting: Those with insurance end up paying for emergent care of uninsured

8. The Context – Mental and Physical Health 8  6% of general U.S. population suffers from severe mental illness; 20-25% of homeless population; mostly schizophrenia and bipolar disorder; 3 rd largest cause of homelessness  Self medication exacerbates the problem.  On average, the homeless mentally ill use $40,500 a year in public funds for shelter, jail and hospital services. Providing them with supportive housing, health and employment services would cost the same amount. (Source: University of Pennsylvania, 2001; http://www.upenn.edu/pennnews/news/housing-homeless-mentally-ill-pays-itself-according-university-pennsylvania.)http://www.upenn.edu/pennnews/news/housing-homeless-mentally-ill-pays-itself-according-university-pennsylvania

9. The Context – U.S. Facts on Homelessness 9  Homelessness increasingly a crime: 24% beg in public; 33% loitering;18% sleeping in public; 43% sleeping in car; 53% sit or lay down in particular public places.  Camping ban in Colorado Springs although not many tickets actually issued; awareness of available resources happens first (e.g. Aspen Point, Partners in Housing, Springs Rescue Mission)

10. Homelessness in El Paso County 10  Survey by PPUW: 1,219 homeless people on the night of Jan. 26, 2015 ( PPUW Point-in-Time Survey )  269 people without shelter due to shortage of shelter beds; but EPC school districts tallied almost 900.  Most likely undercounted  Chronically homeless are about ¼ of total homeless – long term issue

11. Homelessness in El Paso County 11  The city needs more than 18,400 units to meet its affordable housing shortfall this year, and that figure is expected to grow by 8% in five years. (Source: PPUW Point in Time Survey)  In 2009, before Colorado Springs' budget tumbled, the city allocated nearly $550,000 for housing services, with more than $400,000 of that going to competitive grants for social service programs.  That amount has decreased roughly 50 percent and about 65 percent, respectively.

12. Health Care Expenditures in Perspective 12  We spend more on health care (17.5% of gross domestic product) than we do on education (5.4%) and more than we spend on the military (4.7%) (Source: http://data.worldbank.org)http://data.worldbank.org  This amounted to $3.1 trillion in 2014 (Source: Centers for Medicare and Medicaid Services – https://www.cms.gov)  Opportunity cost of high health care expenditures

13. Health Care Expenditures in Perspective 13  Percent of GDP in 1960: 5.2%  Percent of GDP in 2014: 17.5%

14. Health Care Expenditures in Perspective 14  U.S. spends over 2.5 times the OECD average

15. Health Care Outcomes & Expenditures in Perspective 15 We spend significantly more than other countries, but aren’t necessarily achieving greater outcomes: Source: Mary Meeker, KPCB (Kleiner, Perkins, Caufield & Byers)

16. Health Care Outcomes & Expenditures in Perspective 16 Source: Health Affairs, April 2013 “Flat of the Curve”

17. Confounding Factors 17

18. Confounding Factors 18

19. The Context – Decline in the Middle Class 19 “Middle class” making within 50% of the median income (btw. $25,970 and $77,909 in 2013).

20. The Context – El Paso County Per Capita Personal Income 20 Source: Bureau of Economic Analysis; El Paso County 2014 is estimate by UCCS Southern Colorado Economic Forum Data not available for Teller County in 2014.

21. The Context: Total Average Weekly Wages in Colorado and El Paso County 21 Source: Colorado Department of Labor QCEW

22. Best Practices 22 Albuquerque’s Heading Home Initiative:  Jointly funded through municipal tax revenue, private donations and community organizations – public/private partnerships are key  The Initiative helped save the city about $12,800 per program participant by reducing their need for emergency room visits, shelter and social services (Source: University of New Mexico)  28% reduction in homelessness in three years

23. Best Practices 23 Phoenix Veteran’s H-3 Program:  Regardless of mental state or substance abuse, the program is open to all veterans.  Housing is the first and core intervention because once housing is in place, homeless become much more engaged.  “Navigator” to each homeless person – key  31% reduction in homeless population (2007-2013)

24. Best Practices 24 Salt Lake City (Housing First - state program):  Chronic homeless given housing and a social worker.  Vulnerability index determines who needs help the most (not based on first-come-first-serve).  22% reduction in housing since 2005