Campaign helps communities house the chronically homeless

January 15, 2012

'100,000 Homes' aims to help house 100,00 people by mid-2013


A national not-for-profit says it can help communities to house chronically homeless individuals by making the communities aware of approaches, programs, funding sources and resources that they may not have known about or tried before. New York City-based Community Solutions has set the goal of working with community coalitions across the U.S. to house 100,000 homeless people by July 2013, through the "100,000 Homes" campaign it launched in July 2010.

Health care providers, including Seton Healthcare Family of Austin, Texas, are among those supporting the campaign because they understand that bettering the lives of the homeless can further their mission of improving the health of the community, said Ann Howard, executive director of Austin's Ending Community Homelessness Coalition, or ECHO, a group taking part in 100,000 Homes.

According to a 2009 homeless assessment report from the U.S. Department of Housing and Urban Development, about 110,917 people are chronically homeless, meaning they have been homeless continually for a year, or four times in the span of three years.

It is common for communities to have organizations — or coalitions of organizations — that provide emergency and/or permanent housing and support to homeless people, using either private donations or government funding. And, many such groups are becoming increasingly sophisticated, in part because top funders including HUD are requiring them to form formal coalitions, conduct counts of the homeless in their community and develop formal plans for combating homelessness.

And yet, many organizations are failing to curb chronic homelessness for a number of reasons, explained Catherine Craig, Community Solutions' director of health integration, and Jake Maguire, director of communications for the campaign. Craig and Maguire said some advocacy organizations have failed to create effective coalitions. Some have not accurately assessed the needs of the chronic homeless. Some have failed to gain the support of community leaders. Some are not using the most effective methods of securing housing and subsidies. Some are so focused on emergency response that they fail to devote sufficient manpower to strategic planning.

"We try to close the gap between what we know works and what communities are doing," said Maguire.

Housing first, then services
Community Solutions draws its experience from Common Ground, a New York City-based, not-for-profit homeless services provider. Over its 20-year history, Common Ground has successfully housed difficult-to-place people by speaking directly to homeless people to understand their needs, working with community partners to house the people first and then to ensure that they have a deep well of supportive services. Common Ground spun off Community Solutions in July to help other communities replicate this approach. Many on Community Solutions' 35-member staff are former Common Ground staffers.

The 100,000 Homes campaign now focuses on communities with 1,000 or more people deemed to be chronically homeless — although any community can join the campaign. Campaign staffers normally call homeless services providers, not-for-profit organizations and faith-based organizations in target communities to determine who is able and willing to take the lead in that area. Sometimes, a leader in a community calls 100,000 Homes proactively, having heard or read about the campaign and wanting to join.

The communities that have joined the campaign form a network that shares their best practices on how to create a strong local coalition, correctly assess the needs of the homeless, line up housing and support services that match the needs and help people stay housed. The communities in the campaign share information through meetings, phone calls, webinars, a website and materials from Community Solutions as well as through consultation with Community Solutions' experts in social services, public policy, real estate, finance and other areas. The campaign also has created a mentor network so that "veteran" groups can help "novices."

Most of the efforts are funded by philanthropic and government grants.

Assessing vulnerability
At the heart of the 100,000 Homes approach is a registry event, a multiple-day sweep of streets, parks, homeless shelters, hospitals and other places where homeless people stay. The local community coalitions use trained volunteers to survey all of the homeless people they find about their housing history, health, where they sleep and what support they need. The volunteers also photograph each person who consents, so that outreach workers can recognize that person when they return to follow up on an individual's identified needs. Maguire explained that this level of needs assessment is much deeper than the homeless counts in most communities.

The survey results help each collaboration to pinpoint which homeless individuals are most vulnerable, or most at risk of dying if they are not housed. Community Solutions has determined based on research analysis that homeless people with eight specific characteristics are more vulnerable to dying on the streets than others. For instance, those with trimorbidities — substance abuse, mental health and medical conditions — are more vulnerable to near-term death than those without trimorbidities.

After the registry events, each local coalition identifies how best to get each of these most vulnerable community members into housing and then connect them with supportive services.

Maguire said most people are housed using federal subsidies and other federal dollars, in existing apartment stock in the community. He added that 100,000 Homes members have keyed each other in to tips on new subsidies becoming available. For instance, more U.S. Department of Veterans Affairs housing subsidies recently have become available for the homeless.

Building urgency
Howard, the executive director of Austin's ECHO, said the 100,000 Homes network is among the best resources the Austin coalition has accessed. That coalition of government housing agencies, homeless services providers and other Austin partners had evolved informally over the last 10 to 15 years and then formally became a nonprofit organization in 2010.

ECHO helps ensure its member organizations' efforts are coordinated and effective, explained Howard, and the 100,000 Homes network has helped ECHO to do this. Howard said that the ECHO coalition has used the 100,000 Homes resources and Community Solutions staff as a library of ideas. She said the vulnerability survey and registry week ideas were particularly helpful since the ECHO coalition had not yet assessed the Austin homeless population's needs in that depth. During ECHO's registry week in November, about 100 volunteers surveyed 289 homeless people.

Howard said being part of 100,000 Homes helped ECHO put a human face on the homelessness issue and demonstrate the urgency of helping the homeless. The survey helped ECHO assess and describe the homeless population and their needs, an achievement that increased ECHO's standing with community leaders who can support the coalition's efforts.

She said that using campaign resources, ECHO also hopes to locate new housing sources. For instance, the group is looking into an untapped market of small apartment complexes for new housing stock.

Interconnected issues
Seton is a member of ECHO and is helping to coordinate the 100,000 Homes push. It also recruited and trained volunteers to conduct the registry.

Alan Isaacson is vice president and chief operating officer of Seton Shoal Creek Hospital in Austin and a member of the ECHO board. He said Seton lent its support because of "the volume of people we serve who are homeless and experiencing mental illness throughout all our ministries. Through careful thought, planning and action, we can positively impact the lives of the people in our community."

Community Solutions' Craig noted homelessness, health status and concerns about health care access are interconnected: Life on the street can be dangerous. Homeless individuals normally do not have a safe place to recuperate following a hospitalization or emergency room visit. They may not be able to access or properly store medications or otherwise comply with instructions from clinicians.

"Home is a foundation for health," Craig explained.

Campaign results to date

Communities getting help from the 100,000 Homes campaign report the number of people they house to the campaign. Since 100,000 Homes launched in July 2010:

  • 110 communities have joined the campaign
  • More than 40 of these communities have conducted registry week events
  • The participating communities have surveyed more than 24,000 people
  • They have housed more than 11,400 people

Homelessness in the U.S.

  • About 1.59 million people used an emergency shelter or transitional housing program between Oct. 1, 2009, and Sept. 30, 2010, according to the U.S. Department of Housing and Urban Development.
  • On a particular night in January 2010, according to a "point in time" study, there were about 649,917 sheltered and unsheltered homeless people in the U.S., according to HUD.
  • Nearly two-thirds of U.S. homeless people are single adults. Two-thirds of this group are men who are generally 30 to 60, according to a fact sheet from Austin's Ending Community Homelessness Coalition.
  • One to two percent of U.S. homeless people are unaccompanied youth, according to ECHO. (That means they are living separately from any family members or guardians.)

Austin's homeless population, at a glance

The November Ending Community Homelessness Coalition registry event in Austin revealed this profile of Austin's homeless population, based on its survey of 289 homeless people:

  • 20 percent are veterans
  • 83 percent have been jailed
  • 42 percent have been imprisoned
  • 35 percent have been attacked physically while homeless
  • 27 percent are frequent hospital users (more than three times per year)
  • 48 percent have mental health conditions
  • 72 percent are substance abusers
  • 25 percent are substance abusers, with a mental illness and serious medical concerns


Copyright © 2012 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2012 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.