Cities Try New Approach to Solving Homelessness

In the fight to eradicate homelessness, several American cities are using a concept called Housing First. The idea is to get people into permanent housing before dealing with other problems, such as substance abuse and mental illness. Monica Brady-Myerov of member station WBUR reports.

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DEBBIE ELLIOTT, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Debbie Elliott. The number of homeless Americans is growing, but homeless advocates say they are on the verge of reversing that trend. The approach is called Housing First and it allows chronically homeless people to move more rapidly from emergency shelters to permanent homes with support services. From WBUR in Boston, Monica Brady-Myerov reports.

MONICA BRADY-MYEROV reporting:

Kevin Maloney is a 55-year old Vietnam veteran whose been homeless on and off for 15 years. Maloney is dancing to music on the clock radio in his private room.

Dancing in your own room.

Mr. KEVIN MALONEY (Vietnam Veteran): That's right, hey, you know, that's the thing. I could have a guest in here and we can dance. You know, wine and dine without the wine.

BRADY-MYEROV: Maloney is a recovering alcoholic. He flashes a smile with a few teeth missing.

Mr. MALONEY: The first time I was in this room I went on a real natural high because I had been homeless for a long time. It's pretty damn huge.

BRADY-MYEROV: Maloney has been living in this rooming house for homeless men in Quincy, a city close to Boston, for two months. It's run by a local shelter where John Yazwinski is the executive director.

Mr. JOHN YAZWINSKI: This is housing for what we would view as the toughest customer, people that have been in and out of expensive systems of care, emergency rooms, corrections, police, ambulances, street. You know, in downtown communities for eight, nine, ten years, ricocheting in emergency shelter systems.

BRADY-MYEROV: Housing First takes chronically homeless people and gives them subsidized housing first, then uses case workers to address their other problems such as substance abuse or mental illness.

Mr. PHILIP MANGANO (U.S. Interagency Council on Homelessness): And literally what Housing First does is it changes the equation of homelessness.

BRADY-MYEROV: Philip Mangano heads the U.S. Interagency Council on Homelessness, which provides federal leadership for homeless initiatives.

Mr. MANGANO: It's not you provide services, services, services while people are still in a very unstable situation. To the contrary, you provide what the antidote to what homelessness is to begin with. The antidote of course is housing.

BRADY-MYEROV: The Council on Homelessness has helped more than 100 cities around the country adopt this strategy. The model is credited with reducing the homeless population by 28% in San Francisco and 13% in New York City. Some homeless advocates fear the emphasis on permanent housing will mean less money for emergency shelter beds. Before Housing First, homeless people had to go through multiple steps before applying for permanent subsidized housing, including sleeping in rows of cots, staying sober and moving into transitional housing. The Housing First model only requires residents to act like any other tenant. They need not be sober or employed.

DR. JIM O'CONNELL (Boston Healthcare for the Homeless): Hey Billy, this is Dr. O'Connell, how are you?

BRADY-MYEROV: For 20 years Dr. Jim O'Connell with Boston Healthcare for the Homeless used an outreach van to bring medical services to homeless people. Now many of his patients have phones, one of the benefits of having a permanent place to live.

Dr. O'CONNELL: I've often dreamed, I remember back in 1985 thinking that it would be really cool if on one of my Mass General scripts I could write in addition to penicillin for a pneumonia or an infection I could also write one studio apartment, use as directed, 30 days refillable for six months or something like that. It would make as much sense I think as the other treatment.

BRADY-MYEROV: Studies by cities with Housing First programs have found significant savings, especially in healthcare. Boston Healthcare for the Homeless found that people who choose to sleep outside have an average healthcare cost of $28,000.00 a person a year. Once those same people have permanent housing, their healthcare costs dropped to $6,000 a year. But O'Connell says he doesn't expect this model to eradicate homelessness.

Dr. O'CONNELL: That's a dream. I think we will reduce the population of people living on the streets a lot. But I suspect we're going to have to keep vigilant and make sure as soon as somebody comes onto the street again we still have those services and can get to them and then get them into housing.

BRADY-MYEROV: And O'CONNELL admits even the best Housing First programs have seen tenants leave and return to the streets, either by choice or because of disruptive behavior. For NPR News, I'm Monica Brady-Myerov in Boston.

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