Housing First Doesn't Manage Homelessness -- It Ends It

According to a Metro Denver Homeless Initiative survey conducted last January, 3,737 individuals in Denver County were without a home. And that number's on the rise as skyrocketing housing costs push folks out of their homes.

"A lot of our chronically homeless are housed in jail or the emergency room; that costs taxpayers a lot of money -- a little more than $40,000 per person per year," says Ken Seeley, valuation specialist for the Denver Office of Strategic Partnerships. Criminalization of homelessness via ordinances prohibiting camping in public spaces compounds that number.

Permanent supportive housing, by contrast, sets taxpayers back about $17,000 per person annually, Seeley says. So, why are we taking the expensive route?

"Because," Seeley explains, "we don't have enough of the right housing built yet."

Seeley continues, "A lot of shelter space has been built for the homeless in Denver, and shelter space is just a Band-Aid for this chronically homeless population." The Mental Health Center of Denver (MHCD) has witnessed that firsthand while providing temporary, transitional housing lasting 30 days to two years.

"Housing," explains MHCD Marketing and Communications Director Karen Prestia, "is an important aspect for recovery. We realized we needed to look at permanent supportive housing because we know it helps people regain their lives when they have a permanent, safe place."  

Another issue with short-term housing: It's typically tied to treatment, and usually carries strict sobriety requirements. "That is totally unrealistic for this population," Seeley says.

Permanent supportive housing -- sometimes called Housing First for the philosophy on which it's based  -- offers an alternative to the shelter routine. Disabled, chronically homeless individuals are provided long-term, independent and affordable housing that's augmented with services in integrated health, mental health, substance abuse and general support. The setup mirrors a typical landlord-tenant situation, where the lease isn't conditioned on sobriety. When executed right, permanent supportive housing is extremely effective.

An evidence-backed program CCH current owns and manages about 1,600 housing units in over a dozen buildings; some are permanent, others are transitional or shelter.

Gearing up to increase its own permanent supportive housing efforts, Denver organizations look to other cities with robust programs -- particularly Seattle's Downtown Emergency Service Center (DESC).

Seattle's leading provider of award-winning housing and support services for chronically homeless adults, DESC entered the permanent supportive housing arena in 1994 with the opening of a 52-unit historic building called The Union.

DESC's program is built on the Housing First philosophy -- essentially the notion that vulnerable clients are more easily engaged in robust clinical services and experience greater success once the chaos of living on the streets is eliminated. In opening The Union, DESC moved from merely managing the homeless to ending homelessness.

During the program's first six months, even after considering administration costs for the 95 residents served, a study showed an average savings of 53 percent; or, nearly $2,500 per month per person in health and social services, as compared to the costs of a wait-listed control group of 39 homeless people.

Two studies published in the Journal of the American Medical Association in 2009 corroborated this, finding that DESC's Housing First program was successful in reducing costs to taxpayers, reducing substance use by participants, and reducing hospitalizations and emergency department visits.

Utah had similar findings when evaluating permanent supportive housing programs in Salt Lake City; giving people supportive housing cost the system about half as much as leaving the homeless to live on the street.

Housing First in Denver

Permanent supportive housing isn't totally new to Denver. The Colorado Coalition for the Homeless (CCH) is our major provider, according to Seeley. But, he adds, their units are scattered, and they don't currently have the infrastructure to accommodate enough people.

In 2003, Denver was one of eleven cities funded nationally through HUD and the Ending Chronic Homeless Initiative program. With extra cash, CCH created the Denver Housing First Collaborative in partnership with the Denver Department of Human Services, Denver Health and Hospitals Association, Arapahoe Housing Substance Treatment, the Denver VA Medical Center and MHCD.

The program, explains CCH President John Parvensky, "was a different twist on the housing development we'd being doing for the past 25 years." But even that wasn't CCH's foray into permanent supportive housing.

CCH was ahead of its time when in 1996 it opened Forum Apartments, 100 permanent and supportive studio units at the site of Denver University's former law school. The complex had ground level retail, marking CCH's first retail partnership, too.

Today the 216-unit Renaissance at Civic Center Apartments is CCH's primary site for its Housing First program. When the program launched, though, it only had capacity for 100 individuals and families, and it had received 622 applications by its sixth month of operation. That demand prompted CCH in 2005 to establish more integrated housing and support services chronically homeless individuals with mental health and substance treatment issues.

CCH current owns and manages about 1,600 housing units in over a dozen buildings; some are permanent, others are transitional or shelter. The organization also contracts with landlords throughout our community, providing 600 vouchers to help homeless individuals with disabilities pay rent.

Tenants pay landlords 30 percent of their adjusted income for rent, and the vouchers like Federal Rental Assistance for Low-Income Families (Section 8) make up the difference. "For the housing we own, it is mostly based on that same calculation," Parvensky says.

CCH's permanent supportive housing program has served upwards of 400 individuals, and there's a retention rate of 96 percent. With nearly 4,000 houseless individuals in the Denver Metro Area, there's plenty of demand for more housing. The Mayor's task force, in fact, estimates a need for 27,000 more units for housing for individuals and families at 30 percent or below the area medium income, Parvensky says.

There's a big disconnect between that growing demand and the real supply, notes Seeley: "The Mayor's current plan projects 3,000 units in the next five years. We've run out of permanent housing available for qualifying low-income people." Sure, there are federal programs like Section 8, he says, but right now there's a long wait list for the housing because "Denver landlords aren't offering up housing for Section 8 anymore."

Expanding the initiative According to a Metro Denver Homeless Initiative survey conducted last January, 3,737 individuals in Denver County were without a home.

CCH's Housing First program shows promise: In 2006 the organization released a report evaluating emergency service records of program participants during the two years prior to entering its Housing First program and the two years after entering the program.

That study showed a 72.95 percent reduction in emergency service costs for chronically homeless individuals with disabilities over 24 months; total emergency cost savings averaged $31,545 per participant, and utilization of emergency room care, inpatient medical and psychiatric care, detox services, incarceration and emergency shelter were significantly reduced.

To augment its current program, CCH is working closely with the Mayor's Office on a social impact bond project that will create an additional 100 units of housing," Parvensky says; MHCD is involved, too.

"We have 103 apartments under construction near Park Hill that will be ready by the end of the year, and we're working on acquiring the financing to build another 100 units downtown," Parvensky elaborates.  

CCH's Renaissance at North Colorado Station in the Clayton neighborhood west of Park Hill, is a mix of studios and one-, two-, and three-bedroom apartment homes, and 26 units will be reserved for homeless veterans. CCH will provide supportive services for at least 50 homeless households.

The building is designed by Studio Completiva utilizing energy-efficient and healthy building materials, and demonstrating that eco-friendly construction can be the standard for affordable housing.

These buildings aren't cheap. The cost, says Parvensky, "averages at about $150,000 per unit; so, that's about $15 million for a 100-unit development."

CCH relies on the Federal Low-Income Housing Tax Credit along with support from public sector partners including the City and County of Denver Office of Economic Development and the Colorado State Division of Housing, and private foundations and individuals.

MHCD is currently scraping together cash for a permanent supportive housing unit, too. "We're building a three-story, 60-unit apartment complex with one-bed, one-bath furnished homes," says Prestia. Her organization's still in the finance and design stages, and doesn't anticipate construction breaking until the spring of 2016, with units opening the following year.  

Remember the first rule of real estate? Location, location, location. That's been one roadblock for MHCD and CCH. "Nobody wants it in their backyard," says Seeley.

MHCD's facility will be in Southwest Denver, says Prestia. The organization is currently working with the prospective community, though, and Prestia wants to make sure neighbors are on board before announcing a site. "We anticipate we'll have some backlash," admits Prestia.

"There's always a NIMBY response, but we work closely with neighborhoods," Parvensky chimes in. "We do quality design; we manage our properties well," he continues, adding that initial concerns are usually dissipated once CCH has had a chance to engage a community. "We opened a project at the edge of downtown, the new Renaissance Stout Street Lofts, and actually received a Good Neighbor Award once we were finished," says Parvensky.

Prestia reminds, "It's a benefit to every citizen in Denver to have these types of buildings so people can reintegrate back into society and lead productive, healthy lives."

http://www.karapearson.comPhotos by Kara Pearson Gwinn.