A brief follow up on homelessness policy

A couple weeks ago I wrote about DC's announcement on how it plans to follow through with closing the large DC General homeless shelter, by creating smaller facilities across the city ("Decentralizing homeless shelters in DC").  This is controversial in many quarters, because few people want to live by a homeless shelter, and the plan to create smaller facilities across the city simultaneously creates eight potential centers of opposition from people living nearby.

There is an interesting article, "Stop opening tent cities, homelessness expert tells Seattle leaders," in the Seattle Times about the homeless problem there, which gets a lot of attention because of the creation of legal homeless tent camps, which can be quite dangerous ("Five shot, two dead, at Seattle homeless encampment," ST).

(In my opinion, from observation, the homeless problem in western cities such as Salt Lake, Seattle, San Francisco, and San Diego appears to be much worse than in DC, where a lot of the people on the street appear to be profoundly disturbed.)

Barbara Poppe, the expert Seattle has retained, has criticized the tent camps, saying they divert resources and attention away from dealing with the problem in a focused way.  She contrasted programs in Utah/Salt Lake City and Houston as examples of much better practice. From the article:

The mayor and City Council passed an ordinance last year authorizing three encampments with up to 100 people each, calling them a stopgap measure needed for people living on the street. Two have opened, in Ballard and Interbay, and a third will open soon in Rainier Valley. Some people living in them are children, Poppe noted.

“I find it horrifying you have children living in encampments and that is somehow acceptable to this community,” she said. “It’s just unconscionable to me this is a choice that’s been made here. That said, I understand there’s great pressure to have a short-term solution. But I don’t happen to think these encampments are the best solution.” ...

Mark Putnam, director of All Home, which coordinates homeless services among King County cities, disagrees. East Coast officials may not understand how many people are camping outside in West Coast cities, with or without sanction, he said.

“We’re very much aligned with what Barb is saying — this is the exception,” he said, of the Columbus, Ohio-based expert. “We know (authorized encampments) are safer (than the street). People aren’t getting murdered in (authorized) tent cities.”

Poppe, whom Seattle is paying $80,000 for about nine months of part-time consulting, with three visits, is a proponent of the Housing-First approach, which gives people immediate access to permanent housing, usually with supportive services on-site.

Seattle was one of the first cities in the country to help nonprofit organizations use the approach, Poppe pointed out. Seattle’s Downtown Emergency Service Center, an innovator in the field, now manages nearly 1,000 units of supportive housing, while Plymouth Housing Group manages almost 1,000 units in Seattle and King County.

The article includes a link to Poppe's presentation on the creation of a Homelessness Investment Policy Framework, which provides a lot of insights. They distinguish between the chronic homeless, people who have a disabling condition and have been on the street for a long time, and shorter term homeless, and segment the homeless population into three: youth and young adults; single adults; and families.

From the abstract, "Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults," American Journal of Public Health, 103 (2013):

Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness.

Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

One advantage Seattle has is the ability to work with King County to develop a more integrated program between the two jurisdictions, along with nonprofit providers. In the DC area, cross-jurisdictional programming and integration is virtually impossible--it could be done but would require incredible vision and leadership and would be unprecedented in crossing state borders.

In looking to Seattle's work, I came across an earlier document, the Homeless Investment Analysis which appears to lay out a more detailed approach than DC, at least based on the public pronouncements and media reporting on the issue.

The HIA document outlines an integrated program for homelessness intervention specifying a tripartite approach to prevention, intervention, and provision of permanent housing. For example, intervention element includes eight components:

- Emergency Shelter
- Transitional Housing
- Day/Hygiene Centers
- Case Management & Outreach
- Housing Stability Services
- Homeless Youth Employment
- Domestic Violence Supportive Services
- Meal Programs

Compared to the snap announcement by DC of the sites for homeless shelters and the scheduling of simultaneous meetings across the city a mere three days later, I was surprised to see that the DC's homeless services planning document, Homeward DC, while not at the level of detail of the various Seattle documents, appears to lay out a similar approach.

Somehow DC has inadequately communicated that they are working to implement best practice as it relates to homelessness services, although I would argue that it does not appear that DC is doing so, because it seems that most of the facilities that will be built are for transitional housing, and with one exception don't adequately serve other program elements and population segments.

Although as I said in the thread on the previous entry, the issue comes down to faith and trust in the city's ability to implement successfully such a program, and in general the city doesn't have a good track record when it comes to implementation of innovative human services programming.

Utah.  Utah is a best practice example in dealing with the population of chronic homeless, by focusing on providing permanent housing, paired with services and is unique because it is the result of a state-level initiative ("Utah reduced chronic homelessness by 91%, here's how," NPR; "Mother Jones Magazine; "Utah praised for initiative to end chronic homelessness," Salt Lake Tribune), and that created a scale at which programs could be organized that supersedes the capacity of the average city or county.  For example, as part of their Housing First program addressing chronic homelessness, they built five apartment complexes with more than 1,000 units of housing.

But the state by no means has eliminated homelessness in the other population segments (families, youth, single adults).