Federal policy aims to get homeless people into housing first. Does it work in SLO County?
Nipomo native Henrique Rico had been living on the streets for a decade when he found a home via Transitions-Mental Health Association in San Luis Obispo.
“I was ready to give up, actually,” Rico, 50 said. “This was like a godsend to me.”
Rico is among the community members who have benefited from Housing First, a federal policy that is the U.S. Department of Housing and Urban Development’s preferred method for dealing with chronic homelessness.
As the name implies, the policy prioritizes placing homeless individuals in housing as a first step to resolving their homelessness.
Historically, SLO County has faced serious challenges in solving its homelessness problem over the past two decades.
The county is in the process of rolling out a new five-year plan to reduce homelessness by 50%.
So does the Housing First approach work in SLO County? Local housing and homelessness experts differ in their opinions.
Does Housing First approach save money?
Benjamin Henwood, a professor of social work at USC and director of USC’s Center for Homelessness, Housing and Health Equity Research, said the policy became HUD’s guiding principle under then-President George W. Bush, gaining broader implementation over the past decade and a half.
Henwood called the policy a rare “win-win” economically and socially, saying that it can yield “remarkable” results.
He estimated more than 80% of people enrolled in Housing First programs stay stably housed in the year or two after they gain housing.
When properly implemented, Housing First saves taxpayers more money than most types of homeless responses, he said, while also addressing the social problem of homelessness.
That doesn’t mean the policy is without flaws, though.
Initially conceived as a means of taking care of the highest-need homeless cases — such as those living with severe mental and physical disabilities, financial instability and other “high-service utilizers” — Housing First has been adopted by most U.S. homeless service providers, making it HUD’s generalized approach to homeless care.
Noting that homeless people who are high-service utilizers often end up in hospitals or jail, Henwood said, “Housing First does save money, because you get them apartments and they’re not using all these public benefits.”
When the Housing First approach is applied to families and people who don’t have high medical and psychiatric needs, he added providers don’t necessarily see the same cost savings.
“You’re providing a public good to them that costs money,” Henwood said.
The best outcomes have been achieved when support services such as medical, psychiatric and case management services come bundled with the policy, Henwood said, and service providers have more time to give to individual cases.
Is policy a good fit for SLO County?
Kenneth Triguiero, CEO and president of People’s Self-Help Housing in San Luis Obispo County, acknowledged that Housing First has proven successful in some communities.
Taken alone, though, that approach may not be the best way to deal with SLO County’s homelessness issue, he said.
Triguiero said there are three main components to a successful Housing First program: available housing units, support services to run alongside housing aid, and rental assistance to ensure the housing is feasible for the residents long-term.
If any one of those components isn’t working well, then Housing First is just “treating a symptom of the issue,” Triguiero said.
The most prominent obstacle to its implementation in SLO County, he said, is the same issue that makes getting into housing so difficult in the first place: availability.
“Housing First doesn’t really have the opportunity to play out if there is no housing to go into,” Triguiero said.
People’s Self-Help Housing operates around 1,000 units in the county, virtually all of which are fully occupied, with another 6,000 people in varying stages of housing need on the wait list, he said.
“It’s a problem for people experiencing homelessness because it it puts that person outside on the street for a longer period of time,” Triguiero said. “It means that hole, if you will, that people have found themselves in, just gets deeper. And the deeper you’re stuck in a hole, the harder it is to get out of that hole.”
Elaine Archer, director of housing management for the Housing Authority of San Luis Obispo (HASLO), agreed that the lack of available housing units is a “systemic issue” within the Housing First framework.
“It’s not enough to just give (unhoused people) housing,” Archer said. “Part of the challenge with the behavioral health system is that it says people should be housed in the least institutional setting possible, but when we deinstitutionalized people, the money did not follow them to the local community.”
Without support services, Archer said, that can mean people lapsing back into the same behaviors or situations that resulted in homelessness in the first place.
As it stands, Archer doesn’t think the county’s support services are robust enough to make Housing First policy feasible long-term.
Besides, she added, not every client wants to engage in those services, even if they could lead to future stability.
“One of the things we’re learning is it just takes time to build the trust for the clients to want the services,” Archer said, “Because Housing First says, ‘You don’t have to take the services. You can move in, close your door and say, D”on’t bother me.” ’ ”
According to Jack Lahey, director of homeless services at the Community Action Partnership of San Luis Obispo (CAPSLO), said Housing First is feasible even in areas with few available units.
“It’s not necessarily (that) you have a robust housing supply and then you can do Housing First. No, Housing First happens in really tight housing markets all the time,” Lahey said. “It’s how many barriers are we putting in the way of somebody getting into housing, and have we eliminated them?”
SLO County may also be dealing with an issue of scale, he said.
In a smaller county such as SLO County, individual failures in the system stand out more than in larger counties, even if the overall success rates is the same, Lahey said.
“We have our own local stuff to deal with and ... you adapt (the policy) to what’s going on in your locality,” Lahey said. “But to think it doesn’t work because we’re different enough from everywhere else in the country, I don’t think that actually holds true.”
Homeless resource center has seen success in Housing First approach
Transitions-Mental Health Association, one of the largest housing and homeless resource centers in SLO County, has worked under a Housing First approach since 2014.
TMHA homeless services director Mark Lamore said the approach — currently in use by the organization’s Housing NOW program — has helped protect some of SLO County’s more vulnerable homeless individuals.
Using SLO County’s Coordinated Entry System (CES), Lamore said TMHA has been able to take advantage of a “dynamic list” of unhoused people based on their individual needs and other factors that contribute to homelessness, and house those vulnerable individuals.
Lamore said clients enrolled in TMHA’s Housing NOW program are selected based on need.
Such clients have spent an average of eight to 10 years in a state of chronic homelessness and often experienced multiple simultaneous conditions such as mental health issues, physical problems, addiction and financial instability.
“We take that person where they are,” Lamore explained.
“With the Housing First model, it’s a low barrier (to entry),” Lamore said, with “basically no requirements or caveats, other than just following some basic housing rules that we all follow when we’re renting an apartment or living in a house.”
All the program asks is that 30% of their income goes toward rent, he said.
According to Lamore, most people enrolled in the Housing First program either have no income or are on general assistance, which means they receive about $315 a month, or are on Social Security, which provides around $1,000 a month.
“The key to the Housing First (approach) is the case management services that are provided once a person is housed,” Lamore said.
Those can include financial aid, substance abuse help and assistance with applying for jobs, Lamore said, adding that all that help comes at a lower price than other means of dealing the core problem.
When TMHA tracked the costs of clients the year before and after enrolling in a Housing First program, the overall cost of treating an individual’s homelessness — including trips to the emergency room, police contact, jail days, hospital stays and contact with emergency services — was reduced between 75% and 85%.
To keep costs down, Lamore said TMHA often finds congregate housing for its program participants, which can present some complications.
“Under the Housing First model, there’s no restriction (on entry),” he explained. “So if you have a person that’s coming in off the street who may still be having some issues with substance abuse and the three other individuals in the house have been working in a recovery program, it can cause some tension and can cause some challenges for us.”
SInce its inception in 2014, Lamore said the Housing NOW program has housed more than 200 people in permanent supportive housing.
Lamore said 80% to 90% of the graduates of the organization’s Housing First program go on to find permanent supportive or standard housing.
Participants praise Housing First programs
After what he described as a “difficult upbringing” that involved attention problems and an early introduction to drinking and drug addiction, Rico said, he dropped out of school to pursue a career in auto maintenance.
He now lives in a home on Branch Street in San Luis Obispo operated by TMHA’s supportive housing program.
For the past two and a half years, Rico said he has been getting his life on track thanks to the stability of having a place to call home.
Engaging with support services, Rico said, allowed him to seek help and diagnoses for the problems that had ailed him since his youth, allowing him to “read my own meters” and maintain a sense of stability.
Rico has enrolled in Cuesta College’s automotive program, where he hopes to restart his career.
“I’m 50 years old now and I feel like, spiritually, mentally, I’m at the best in my life ,” Rico said. “I’ve never felt so good.”
Another TMHA client, who The Tribune is identifying only as Lisa because of she is a survivor of abuse, experienced a similar improvement once she was given her current housing. She’s lived at another Branch Street home operated by TMHA for the past three years.
Lisa, 52, said she has lived with mental health problems all her life.
She fled an abusive relationship in 2014, and became homeless when the local women’s shelter was unable to give her a place to stay.
“I just sat there in Meadow Park and cried for two weeks straight,” Lisa said. “Then (other) homeless people just took care of me, and then I just was living on the street,” Lisa said.
A support group at 40 Prado Homeless Services Center in San Luis Obispo connected Lisa to TMHA’s supportive housing programs, which she said was all she ever wanted during her four years on the street.
Living in supportive housing has allowed Lisa to “learn to swim,” she said, getting her back on her medication and in touch with therapists and allowing her to treat her alcoholism.
“Honestly, I didn’t really know what I wanted other than housing,” Lisa said. “I didn’t want to be homeless anymore, so I just sat there and did everything they asked me to do — I did it with gracious gratitude and said ‘Thank you.’ ”
“I think everybody deserves an opportunity to get off the streets and start working towards an independent lifestyle,” Lamore said.
This story was originally published October 12, 2022 at 1:14 PM.
