House the homeless: the right combination of housing and personalized support services can be cost-effective and reduce the region's homeless population

South Florida CEO, August, 2004 by Maria Pellerin Barcus

You don't hear much about home-lessness these days. Still, anyone who navigates the streets of South Florida is painfully aware that there are many people living on our streets. The Miami-Dade Homeless Trust estimates there are 4,500 people homeless on any given night, and that half of them suffer from long-term illness and disability and are chronically homeless.

During the past 10 years, Miami-Dade has made strides in its effort to combat homelessness. Our system works pretty well for those who experience homelessness as a result of a crisis such as the loss of a job or because of sudden illness. They are able to get the help they need and return to a normal life in the community. But for the larger percentage of people who are stuck in a vicious cycle of homelessness and are unable to bounce back, "supportive housing" is the only answer.

Supportive housing emerged during the mid-1980s, when providers working with the homeless realized that without affordable, stable housing, other services were ineffective. That realization is one of the most significant advances of the past 20 years. Supportive housing is permanent housing that is affordable to extremely low-income people. A single adult, typically, pays $100 to $150 a month for housing under the program. It is coupled with services that comprehensively address the needs of a person or family, and it is customized to their individual situation. Supportive housing works in the most difficult cases when nothing else will.

For example, take the story of John, a Vietnam veteran who came home from the war suffering from post-traumatic stress disorder. For many years, he raised a family and had a good job. But John suffered through substance abuse. Later, the effects of exposure to the deadly chemical Agent Orange began to surface. His skin and face were disfigured. Eventually, his liver gave out and he slipped into heavy drug use. John's life fell apart, and he lost his job, his family and his home. During the eight years he was homeless, John went through residential substance abuse treatment at the VA hospital four times. Each time he came out, without a home, a job or a family to go back to, he ended up back on the street.

The last time he came out of treatment, John took residence in a supportive housing facility. After three years of stability and sobriety, he reconciled with his family and used his VA benefits to buy his own condominium. John's case is not that unusual--20 percent of the single adults who are homeless are veterans.

The chronically homeless are costly to the public systems they cycle through: the emergency rooms that treat illness and injury, the police that often intervene, the jails that house many of the worst cases. Yet all of these systems fail to produce any lasting improvement in a homeless person's condition. They remain homeless. Supportive housing, on the other hand, successfully stabilizes 85 percent of those served, so that they do not become homeless again. If we can stabilize and house the chronically homeless population, we will reduce the street population by half and free up resources to help the rest.

Stable, supportive housing is the key to improved health, the ability to work and family reunification, and it will inevitably be the key to ending homelessness.

Supportive housing also enables families to stay together, keeping the kids out of the foster care system and breaking the cycle of poverty and homelessness. Long-term studies are now being done to document the savings in foster care, education, juvenile justice, and the benefit of improved future earnings.

Supportive housing is proven to be the most cost-effective means of ending home-lessness. Studies by University of Pennsylvania researcher Dennis Culhane, and others, demonstrate that the savings from other systems of care and intervention will more than pay for supportive housing. In South Florida, the subsidy required to house a single adult in supportive housing for a year is approximately $6,000, compared to $17,575 for a prison stay, or $25,550 for a boarding home (operating costs only).

Developing supportive housing unfortunately entails a difficult process of cobbling together funding from many different sources. The state of Florida and Miami-Dade County are each participating, with funding set aside for supportive housing. Federal Homeless Assistance Grants administered by the Homeless Trust provide the bulk of the operating funding, as well as some of the capital funding. Increasingly, the Florida Department of Children and Families and Medicaid will be funding supportive services.

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Nonetheless, it is essential to secure private, unrestricted funds to fill gaps and guard against changes and fluctuations in various funding streams. A dollar of unrestricted, private funding can leverage $100 in matching government funding, so it behooves the community at large to do its part in helping to generate funds.

Carrfour Supportive Housing, created by the Greater Miami Chamber of Commerce in 1993, is part of the network of organizations coordinated by the Homeless Trust. Our organization houses and serves nearly 700 people (of whom 250 are children) in 400 units. Another 262 units will be completed during the next two years. Based on this experience, Carrfour formulated a realistic plan to develop 1,000 supportive housing units during the next 10 years--a permanent community asset to prevent and end homelessness.