Housing First model works for homeless

Elizabeth Buck, program manager for policy at the Camden Coalition, and the group's founder, Dr. Jeffrey Brenner, wrote this for "The Field Clinic" on Philly.com.

What remains outside our offices in Camden, N.J., are patches of wet dirt. Three weeks ago, New Jersey state and county officials cleared out the tents that housed homeless individuals there and throughout Camden, displacing nearly 100 vulnerable people.

New Jersey spent more than $300,000 to evict these people, nearly half the money it would take to provide permanent housing and supportive services for 30 individuals over a year. While some have ended up in short-term shelter beds, many others have been displaced, sleeping in abandoned buildings, moving under different highways, and seeking costly care in hospitals.

The destruction of the tent city without any real planning or provision of resources is unconscionable. There are alternatives. Cities and states across the country are investing in evidence-based solutions to homelessness to eliminate this human tragedy. Salt Lake City and Phoenix have ended chronic homelessness among veterans through a Housing First approach, proving that ending homelessness is possible.

In randomized trials, over 84 percent of individuals remained stably housed through a Housing First model. In contrast, under the older housing model of "graduating out of shelters," only 30 percent stayed stably housed.

In Housing First, a homeless person is immediately put into permanent housing and given the support services needed to stay. They are accepted into housing regardless of sobriety, active substance use, criminal background, or credit history. Housing First works for the most hard-core homeless individuals, who generate the most costs at hospitals, shelters, psychiatric facilities, and jails.

It's estimated that the public saves $10,000 for each tenant in permanent supportive housing. Had all of these people been placed into permanent supportive housing using the Housing First model, the net savings would have totaled nearly $1 million.

Philadelphia is leading the way in reducing homelessness through Housing First. Mayor Nutter recently signed on in the national campaign to eliminate veteran homelessness.

Why does Housing First work? First, housing gives an individual the space to address issues of early childhood trauma, mental illness, substance use, or other factors. Housing First saves money because it targets the hardest and most expensive cases - those with chronic disease, complex social issues, mental illness, and substance use - and it cuts their reliance on expensive emergency care.

In Camden, we found that 1 percent of patients account for 30 percent of all health costs.

In Trenton, a homeless woman visited the hospital 450 times in one year, costing over $1 million. After placement into a Housing First program, her yearly visits fell to 12, saving hundreds of thousands. Camden has no Housing First program for the most expensive users of care. So city hospitals have lost tens of millions a year in free care.

Political leaders need to consider the cost of not paying for Housing First. Without it, we will find ourselves with a truly unsustainable health budget and the needless suffering of our fellow citizens.