# Presentation: 087689

## Preventing Homelessness – What Works?

- Francine Williams
- Policy Research Associates, Inc.
- Delmar, New York
- Policy Academy on Homelessness
- April 2004

## Why Address Prevention?

- Until we address the role of mainstream systems in creating and resolving homelessness, we will never be able to end it.

## Why Focus on Mainstream Programs?

- People who experience chronic homelessness are heavy users of expensive mainstream services.
- Levels of disability and poverty make individuals and families likely to be eligible for mainstream programs.
- Approaches that work for some may make mainstream services more accessible for others.

## How Can Homelessness Be Prevented?

- Identify risk and protective factors to help prevent homelessness among individuals and families at risk.
- Use evidence-based practices to prevent homelessness.

## Individual Risk Factors – Chronic Homelessness

- Chronic health conditions, mental illness and/or substance use disorders
- Limited or no social support networks
- Domestic violence and other victimization or trauma-related factors
- Family instability as a child (out-of-home placement, family homelessness, incarceration of a parent)
- Combat experiences for veterans.

## Individual Risk Factors – Family Homelessness

- Young head of household
- Pregnant or recent childbirth
- History of domestic violence
- Household with absent children/involvement with child welfare system
- Non-leaseholder/never having apartment in one’s own name
- Frequent moves (> once per year)
- Crowded living conditions (> 2 persons per bedroom).

## Individual Risk Factors – Youth Homelessness

- Family conflict/abuse
- Disrupted family history
- Residential instability
- Institutional discharge/”aging out” of foster care
- Lack of alternative placements

## System-Based Risk Factors

- Lack of permanent affordable housing
- Very low or no income
- Institutional discharge

## Evidence-Based Prevention Practices

- Few evidence-based interventions
- Several promising practices
- Housing subsidies
- Eviction prevention
- Discharge/transition planning
- Youth prevention

## Housing Subsidies

- Housing subsidies are one of the most effective interventions to prevent housing loss.
- Receipt of subsidized housing is a primary predictor of housing stability among homeless families (Shinn and Weitzman).
- SAMHSA’s study of homelessness prevention among people with mental health and/or substance use disorders found access to housing subsidies or supportive housing to be the strongest predictor of residential stability—regardless of level of disability.

## Housing Subsidies - Examples

**Section 8** (improving access, setting priorities, increasing retention/use of vouchers/certificates)
- Family Unification Program – HUD-funded partnerships between public housing authorities and public child welfare agencies provides housing vouchers and support services to families in the child welfare system
**TANF Block Grant funds** can be used to provide emergency assistance, including a short-term housing subsidy and/or transitional case management services, to eligible families for up to 4 months
**State-funded bridge subsidies** (e.g., Department of Mental Health may provide funding for temporary vouchers for people with serious mental illnesses who are on the Section 8 waiting list.)
**Work with landlords** to increase willingness to rent to people using subsidies
**Work with public housing agencies** to overcome barriers to housing for vulnerable families

## Eviction Prevention

- Promising practices include:
- Representative payees and other financial management interventions
- Short-term cash assistance for emergency rent and utility payments
- Landlord/tenant mediation services
- Legal services to prevent eviction
- Respite for family caregivers

## Eviction Prevention - Examples

*Pathways to Housing* in NYC, a housing first model, uses money management -- one of two key tools (the other being ACT teams) -- to keep people who were chronically homeless in housing of their choice.
- In *Minnesota*, the legislature created a $50,000 fund to pay for rent for up to 90 days while an individual with serious mental illness is in inpatient treatment.
- The *Alaska* Department of Mental Health and Developmental Disabilities provides flexible service funds of up to $2,000 per client for any expense needed to keep the client in community-based housing.

## What mainstream systems can do

- Adopt protocols to assess housing needs/resource of clients
- Adopt program models to help individuals and families in crisis retain their housing through financial assistance, mediation, or case management.

## Discharge/Transition Planning

- Discharge planning, linked to affordable housing and aftercare, is recommended as a strategy to prevent chronic homelessness—particularly for people with health and behavioral health disorders.

## Discharge/transition planning

- Discharging institutions -
- Jails/Prisons
- Hospitals
- Shelters
- Detox and residential substance abuse treatment
- Foster care
- Very few adequately address housing needs upon discharge—often times the result is homelessness.

## Discharge / Transition Planning - Examples

- System-level changes –
* *
*Massachusetts* evaluates contractors on performance measures where homelessness is a negative outcome and housing is a positive outcome. These outcomes are tied to penalties and incentives for each system (corrections, mental health, etc.)
*Philadelphia* is applying this same principle with shelter providers. Shelters are given incentives to place people in housing and provide services to keep them there - shelter beds have decreased by 5% annually as a result.

## Discharge / Transition Planning - Examples

*Critical Time Intervention & Short-term ACT Services - *intensive clinical services for 6-12 months during & following transition from shelters, hospitals or jails to foster linkage to mainstream supports & housing stability.
*Respite Care - *to bridge the period following hospital discharge for people who are homeless.
*Transition Planning in Corrections**  -  *transitional services that begin in jail or prison and emphasize access to housing and clinical case management upon release.
*Youth in Transition  -  *Federal Independent Living Program funds can be used to provide housing and services for youth transitioning from foster care until they reach the age of 21.

## Prevention Strategies for Youth

- Primary prevention
- Family-based preventive interventions
- School-based interventions
- Short-term residential alternatives
- Preventing repeated homelessness
- Early targeting
- Combine crisis intervention with long-term services for youth & their families
- Can be shelter based
- Intensive case management & outreach to families
- Alternative housing options for youth that cannot be reunited

## Conclusions...

- Preventing homelessness is not identical with ending poverty or promoting economic self-sufficiency.

## Conclusion

- Most effective strategies target those at risk & increase protective factors & services

## Strategies to Consider...

- Housing subsidies/affordable housing options that target the worst-case housing needs
- Eviction prevention programs and discharge planning efforts
- Services to support people who have been chronically homeless in housing – particularly during periods of transition -- are critical
- Mainstream systems can assess housing stability of clients – provide emergency/crisis assistance & case management to prevent housing loss
- Interventions targeting youth & their families