The Chronically Homeless in America

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The mark of a civilized society is how well the most helpless are treated –animals, children, the elderly, and those who are homeless. There is always room for improvement. We are plenty generous with people from other countries, but we miss the mark when it comes to helping our own chronic homeless, the veterans, babies in the womb, the elderly, and others who cannot protect themselves.
It is in plain view that we have failed the homeless. We all pass by people who look healthy, able-bodied, and well-fed, asking for help on a street corner, professional panhandlers who have a nice car and a home to go to – they make a living panhandling. But then there are those sleeping in the streets, in the cold, in the rain, too dirty and too exhausted to beg; they’ve become so invisible and ignored, nobody speaks to them anymore.
How did they get this way? Homeless people live in unimaginable places. How can a society as rich as ours allow this to happen? Why do we care about the downtrodden of the world but not our own citizens?
The Department of Housing and Human Development (HUD) told us in 2014 that there were 84,000 chronically homeless, down from 120,000 in 2007 thanks to a 2002 program aimed at ending chronic homelessness in ten years. As any government program, the goal failed and the program was extended through 2017. HUD used the Homeless Assistance Grants, the Veterans Affairs Supported Housing Program and other demonstration programs to achieve this goal.
The government had decided to end chronic homelessness because it cost the taxpayers too much money to care for individuals who “use many expensive services often paid through public sources, including emergency room visits, inpatient hospitalizations, and law enforcement and jail time.” Citing the fact that putting the homeless in shelters is also costly, bureaucrats admit that there are also ethical reasons to help our fellow man and end chronic homelessness.
The previous model did not work so a new strategy was deployed – “allowing chronically homeless individuals to move into permanent supportive housing without preconditions. Permanent supportive housing (PSH) is not time-limited and makes services available to residents.”
One such PSH is Housing First, supported by both HUD and the Department of Veteran Affairs, chosen because the homeless people can select the type and “intensity of services and does not require abstinence or medication compliance.”
PSH increases days spent in housing and reduces days spent homeless. “The outcomes in other areas are not as clear.” In other words, they either don’t know or are not saying if costs are reduced in use and service, if substance use and abuse are diminished, and if mental health improvements are present.
Medicaid funds are used for housing-related services; lobbyists and housing advocates prefer that states use “their own shares of Medicaid funds to finance permanent supportive housing for chronically homeless individuals” since funding through HUD programs is limited for new units. Another source of funding could be Pay for Success Initiatives; private investment in PSH would be paid back if “certain outcomes are attained.”
The term “chronic homelessness” has been used in research since the 1980s, referring to people who have spent more than a year in the streets while suffering from one or two disabling conditions, substance abuse and/or mental illness.
Randall Kuhn and Dennis Culhane categorized homelessness in three groups of people:
– Transitional (short periods of time in shelters who do not return)
– Episodic (more frequent users of shelters, not exceeding a few months)
– Chronic (stay in shelters for long periods of time)*
According to Libby Perl and Erin Bagalman, the federal standards to be deemed chronically homeless are as follows:
– Individuals and families can be chronically homeless even though in the Hearth Act only unaccompanied individuals were included in the definition
– One unaccompanied individual or adult head of household must have a disabling condition such as “substance use disorder, serious mental illness, developmental disability, post-traumatic stress disorder, cognitive impairments resulting from a brain injury, or chronic physical illness or disability, including the co-occurrence or two or more of those conditions”
– Duration requirement (continuously homeless for a year or more or at least four occasions in the past three years)
– Where someone sleeps (a place that is not meant for human habitation such as a park, street, abandoned building, sewer, emergency shelter, or safe haven)**
In 2015 HUD reported the total number of homeless individuals to be 564,708. Mental illness and substance use disorders (drugs and alcohol) seemed to be prevalent among the homeless.
The permanent supportive housing (PSH) is not time-limited and services are available to residents. HUD provides much of the funding and thus requires certain criteria such as basing it in a community, not an institution; time of stay cannot be limited; residents can have a renewable lease; and helping residents with disability to live independently.
PSH may rent units in a condominium or apartment complex; subsidies are provided through housing vouchers; single-site multi-family rental property with affordable housing designation; residents pay 30% of their income towards rent and the rest is subsidized. Such units exist around the D.C. area. Some of the units are reported by the other residents as sources of bed bugs infestation and other pests.
Not all PSH providers require their residents in permanent housing to “abstain from drugs and alcohol” in order to remain eligible for housing. Housing First, developed in New York in 1990s under the name Pathways to Housing, does not require residents to abstain from drugs and alcohol or to take their meds, but services are available 24 hours a day to help them if they ask – nurses, caseworkers, and psychiatrists.
Prince William County in Virginia is considering placing its 409 homeless people in 8X12 tiny prototype homes at a cost of $3,000 per unit. Woodbridge HUGS, a non-profit formed last year to “assist the county’s homeless population” and to provide the homeless with essential goods and housing, said through its representative, “We found what we want as our prototype… we want to put in a composting toilet, a skylight, a generator, a door that locks, [and] windows for cross-ventilation.”
I cannot imagine what these tiny slum units would do to the surrounding landscape and the property values of the adjacent properties. Is this the best way to help the homeless in one of the richest counties in the nation?
Instead of sheltering the homeless in proper and stable housing, why are we moving them essentially into shanty areas? Why must we relegate the homeless, the unemployed, and the poor to ePodments, to tiny homes, to mini-homes, to dwellings made of junkyard scrap and other cheap materials, to dwellings the size of closets?
Are we doing this because the economy is in such dire-straights thanks to this administration’s disastrous economic policies? Or is there another reprehensible Agenda and plan in place to crowd people into stack-and-pack tiny apartments and temporary units the size of a dog house in order to return the suburbia to its original wilderness?
In spite of HUD Homeless Assistance Grants, as a primary tool of the federal government of funding housing for homeless people, HUD-VA Supported Housing program, which was started in 1992, and other social programs, homelessness is far from being addressed properly and will continue to exist.

*Randall Kuhn and Dennis P. Culhane, “Applying Cluster Analysis to Test a Typology of Homelessness by Pattern of Shelter Utilization: Results from the Analysis of Administrative Data,” American Journal of Community Psychology, vol. 26, no. 2 (April 1998), pp. 207-232.
**CRS Report 44302, December 8, 2015, pp. 3-4.

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