Aubrey Byron is a guest writer for Strong Towns sharing today's article as part of our ongoing conversation about housing issues.
In 2015, Utah made major headlines for a seemingly miraculous accomplishment. Publications from The Washington Post to comedy news shows like The Daily Show lauded Utah for having “solved homelessness.” But three years later, did a Housing First initiative actually solve the nuanced issue of homelessness in Utah?
Original reports claimed Utah reduced its chronic homelessness by 91 percent. Some outlets refute these numbers and attribute a significant drop to a change in counting. But the stark success gave attention to, at the time, a relatively little known model with a surprising approach.
Housing First seems like a simple solution to a complex problem. Before trying to tackle key issues that often cause or at least exacerbate homelessness like addiction and mental illness, homeless individuals are first given a permanent home. It is an inversion of the age-old philosophy of "Housing Ready," wherein participants must be clean, sober and often working before receiving housing. It also skips transitional housing programs.
Sam Tsemberis co-authored the book Housing First and founded the nonprofit Pathways to Housing in New York City back in 1992. He explained to me, “A lot of people have addictions and mental illness, a lot more than are homeless… It’s Elizabethan to assume people need to be sober to be homed.”
Housing First is also proven to be more successful than traditional models. The Housing Ready model has a 40% success rate, while according to Tsemberis, Housing First is 80%. It has now been replicated around the globe, but it remains on the fringe in much of homeless policy in the U.S., except in Utah.
A Pragmatic Approach
Advocate LLoyd Pendleton, largely responsible for implementing Housing First in Utah, made a fiscal case for using Housing First.
There are different types of homelessness and Utah’s Housing First program wasn’t meant for all of them. The homeless are often defined as temporary, episodic, or chronic. According to Pendleton’s TED Talk, the chronically homeless are individuals who have been homeless for more than one year and make up just 15% of homeless populations, but consume 50-60% of resources. They frequently use emergency services which can cost $20-45,000 a person.
After evaluating these numbers, Utah estimated that homing people in the chronic category was actually less expensive than paying for reactive care.
The potential cost-saving of the model is what helped to get policy-makers on board. But it wasn’t just having a strong advocate like Pendleton that allowed Utah to take such a dramatic approach. The Church of Latter Day Saints, commonly referred to as the Mormon church or LDS, were willing to kick in funding to pilot the program to the tune of several million dollars.
The influence of the church may have played a role, along with their funding. The cooperation of several agencies and organizations related back to shared values, Tsemberis thinks.
Unfortunately, the surge of success in Utah’s model did not last. The program saw a drastic reduction in chronic homelessness, but episodic and temporary homelessness continued to rise. To have a sustainable reduction in homelessness, prevention has to be considered.
“There wasn’t a prevention component to the model, as far as I know,” said Sam Tsemberis.
Utah launched a new program targeted at the “persistently homeless” in 2017 to help fill those gaps in conjunction with The Road Home, the largest shelter in Salt Lake City. Persistently homeless is defined as having been homeless for more than 90 days, but less than 365. Little data is available thus far about the scale or success of the new program.
A Measurable Scale
So far in the United States, the Housing First model has largely been utilized in different cities as autonomous pocket operations. There is at least one domestic example of what a large scale implementation looks like — the U.S. Department of Housing and Urban Development (HUD) expanded VASH, or Veterans Affairs Supportive Housing, under the Obama administration.
A HUD “point in time” count found more than 74,000 homeless veterans in 2010. In turn, bipartisan support led to a large scale Housing First approach with a focus on veterans. For several years, between 7-10,000 vouchers a year were given to homeless vets across the country. In conjunction, the existence of the VA (Veterans’ Affairs) hospitals allowed participants to be provided with the supportive measures they needed to remain homed.
In talks, Sam Tsemberis has often emphasized that it is “housing first, not housing only.” He is adamant that the model will not work without supportive, individualized care. “It’s probably the biggest misconception about Housing First,” he told me. With the right support, HUD-VASH was able to reduce homelessness among vets by 54%.
The HUD-VASH, probably more than Utah’s program, is an example of how successful the model can be on a large scale. But cities like New York City now have, in most recent counts, more than 60,000 homeless living in shelters — the highest point since the Great Depression.
New York is not alone, according to The Economist. Los Angeles has at least 44,000 homeless; Seattle, 10,700; and San Diego and Washington, DC each over 8,000. With such an extreme level of need, individual cities and organizations cannot begin to reduce the growing numbers while serving a few hundred individuals at best. Funding, large scale implementation, and federal policy support are all missing from the equation.
Meanwhile, other countries are running with the model. Canada initiated a plan to spend $119 million per year over five years on Housing First policies. Finland also implemented a national housing first strategy. They converted shelters into permanent housing and then went further with prevention policies. Since nearly eliminating their homeless population, Finland put in place a prevention program that targets at risk individuals for rental assistance.
Finland is a country of just 5.3 million people, however. The United States, by comparison, has 325.7 million and more than 550,000 homeless by conservative counts. It is also historically adverse to large scale social policies. This political and logistical headwind make bringing the model to scale unlikely, but programs like VASH show that it can be done.
Housing First does not always mean creating new homes and units to help home homeless individuals. When development is out of reach, it often operates on a voucher system. This leaves the homeless in cities like Los Angeles to compete in an already exacerbated housing market for a small pool of low income housing. According to Curbed, rent has risen as much as 32% over eight years in L.A., while income levels have actually dropped. Many cities with large homeless populations are experiencing similar affordable housing shortages.
The opioid crisis is also worsening the homelessness epidemic. Tsemberis says the solution remains the same. “But we need to do more and do it more urgently,” he said. Homelessness largely stems from these environmental factors. “It is the visible part of the iceberg of a much larger issue,” Tsemberis says.
Utah may not have solved homelessness, but they showed the measurable effect a strong will to do so can have. Many cities are following suit slowly with grassroots approaches. But they often lack the unique circumstances that helped give Utah its marginal success.
(Top photo source: Matthew Woitunski)
ABOUT THE AUTHOR
Aubrey Byron is a writer based in St. Louis, Missouri. She began engaging with public space as a cyclist and spends much of her free time trying to inspire more women and non-binary people to be comfortable on bikes through the advocacy of a local nonprofit, The Monthly Cycle. Aubrey works in development at St. Louis Public Radio. She is also passionate about outdoor adventure and reading.