Is Permanent Supportive Housing the Answer to Homelessness?

In the District of Columbia, my adoptive hometown, Mayor Adrian Fenty has made permanent supportive housing a keynote of his administration. The District's 2009 homeless count report touts it as "the solution to homelessness."

Permanent supportive housing, or PSH, is widely acclaimed as a better alternative than emergency shelters. After all, shelters are notoriously crowded, unclean, unsafe places. And people who are "chronically homeless" need more than a roof over their heads. These are the people who've not only been homeless for quite awhile or recurrently, but who also have a disabling condition, frequently a serious mental illness and/or substance abuse problem.

The Bush administration placed enormous emphasis on getting this 10 percent or so of the homeless population into PSH. Federal grants to local homeless assistance programs gave preference to those that made this a high priority. Communities responded by shifting funds from services for other homeless populations. The HEARTH Act (short for Homeless Emergency Assistance and Rapid Transition to Housing), which reauthorized the U.S. Department of Housing and Urban Development's homeless programs, set the emphasis in stone, with a required 30 percent set-aside for PSH.

But not everyone who's homeless needs a battery of supportive services. Some people just need an affordable place to live.

So in the best scenario, we'd have enough PSH units for those who need intensive health care, counseling and other services, housing vouchers for those who simply need ongoing help with the rent and short-term financial assistance for those who are at risk of homelessness because they can't come up with some ready cash -- to move, for example, or pay the electricity bill.

We're obviously not there yet. Studies have found that PSH costs no more -- sometimes less -- than letting homeless people fend for themselves. Fewer trips to the emergency room, fewer hospital stays, fewer people in jails or prisons and, of course, fewer nights in shelters.

But opening PSH units isn't cheap. According to a recent Urban Institute report, development costs per unit in D.C. averaged $127,000 each. Finding the capital funding to house all chronically homeless people won't be easy, especially in these economic times. With low-cost rental units in short supply, finding landlords who'll agree to PSH contracts won't be easy either.

And then there are the supportive services costs. A 2008 study for the District estimated these at somewhat over $9,600 per unit per year -- more than $24 million for all the units in the District's plan. Costs per unit might actually be higher, since the District plans to house some individuals and families without disabling conditions.

President Obama's Fiscal Year 2011 budget proposes $2.1 billion for homeless assistance grants. Funds from these grants would be used for assistance to prevent homelessness and to expand PSH. But the proposed funding for housing vouchers would just about cover the number now in use. And voucher funding has been insufficient for a long time.

So what concerns me is that local governments will shift their attention -- and their funds -- from emergency shelters while shelter space is still a critical need. We see this in the District, with families packed into the winter-only shelter, some on cots lined up in the cafeteria, other sleeping in hallways. Shelters for individuals are so nasty that some people choose to sleep on the streets. Not a problem unique to D.C., as this posting from Orange County, California shows.

I wonder whether we won't still need emergency shelters in the years ahead -- or something like them but better. After all, homeless people can't get into a PSH unit just by showing up at the front door. Housing vouchers aren't handed out on demand -- and wouldn't be even if enough were available. And once a household get a voucher, it has to find a place to rent.

So perhaps it would make sense to accept that something like emergency shelters will be needed until that wished-for day when homelessness is history. If we did, we could set about ensuring they were safe, decent places to stay.

In Los Angeles, the Beyond Shelter Institute is piloting the use of master leases in apartment buildings to provide temporary housing until families can be moved to more permanent housing. It recommends this model for other communities as cost-effective and more family-friendly.

The cost-effectiveness, however, is in the rapid re-housing, not the master leases. And for many families, re-housing hinges on the availability of vouchers. HUD itself acknowledges that its voucher program "has historically been oversubscribed and waiting lists can run into the years."

So let's not forget one important element in the solution: housing that's affordable for low-income people. While the District of Columbia is forging ahead with PSH, it has allowed its low-cost rental stock to shrink by more than a third.

This too is not a unique situation. Last year, the National Low Income Housing Coalition reported that a decade of condo conversions, housing speculation and gentrification had reduced the nationwide stock of affordable rental units by 17 percent, leaving a 5.5 million shortage before the foreclosure crisis pushed more families into the rental market.

So, yes, we need an alternative to conventional emergency shelters. And we need more PSH for people who need the services it offers. But we also need a renewed federal commitment to affordable housing, backed up with bucks as well as words. And at the local level, we need housing and community development policies that, at the very least, don't promote the destruction of more low-cost housing than they create.

In 2006, Washington Post reporter Michael Grunwald suggested that a real estate crash would solve the affordable housing crisis. Well, we've had the crash. But I've yet to see a solution big enough and smart enough to ensure that everyone in this wealthiest country in the world has a safe, suitable place to live.

Photo credit: fumigene