CHICAGO, ILLINOIS. The volume, type, and cost of publicly funded services in Illinois are each favorably impacted by the placement of frequent users who are homeless in permanent supportive housing, according to a new report by the Heartland Alliance Mid-America Institute on Poverty (MAIP), the Supportive Housing Providers Association (SHPA), and the Corporation for Supportive Housing (CSH).

>"Supportive Housing in Illinois: A Wise Investment" tracked 177 individuals in permanent supportive housing in 26 initiatives' in 11 Illinois counties and identified that there were cost savings in inpatient mental health, substance abuse treatment, primary care hospitals, state prison, and county jails. Every system studied showed savings from pre- to post- supportive housing. The total cost of services was reduced 39% from pre- to post-supportive housing with an overall savings of $854,477. This was an average savings of $4,828 per resident for the 2-year time period or $2,414 per resident, per year.

In the 2 years prior to housing placement, the 177 individuals used $2,204,557 in services, which was cut to $1,350,081 post placement. Costs continued to decline with housing stability. Ten individuals had used $50,000 or more in services in the 2 years before housing placement, with individual costs ranging from $54,000 to $194,000.

Residents also changed the type and volume of services they used, moving away from a heavy use of expensive inpatient and acute services before housing placement to less expensive outpatient and preventive care, with overall health improvements. Mental health hospital use decreased 90%, and overnight stays virtually disappeared, with just one person hospitalized for two nights.

The 177 individuals had been in permanent supportive housing for an average of 38 months, with an average age of 42. 52% were male, and 48% were female. Six percent identified themselves as veterans. Study data were drawn from the Illinois Department of Healthcare and Family Services (Medicaid), Illinois Department of Human Services' Division of Mental Health, Illinois Department of Human Services' Division of Alcoholism and Substance Abuse, Illinois Department of Corrections, County Jails, and Uncompensated Hospital Services.

The study was funded by the Chicago Community Trust, Illinois Department of Human Services Division of Mental Health, the Michael Reese Health Trust, Chase Bank, The Community Foundation of Northern Illinois, Pfizer, The Harris Family Foundation, and initially supported by LaSalle Bank.

ST. PAUL, MINNESOTA. Minnesota's Hearth Connection has released a multi-part evaluation of the state's Supportive Housing and Managed Care Pilot, demonstrating the Pilot's effectiveness in targeting permanent supportive housing to individuals and families who had long histories of homelessness and complex personal histories.

The Minnesota Pilot targeted individuals who had not been helped by other programs and had histories of homelessness averaging 5 years. Participants had an average of two serious medical conditions, and two- thirds had more than 3 year histories of substance abuse.

The estimated 343 adults and 175 children in the evaluation used at least $3.25 million per year in publicly funded services. Single adults averaged $13,954 annually. Adults and children in families used $4,582 and $3,691, respectively. Families averaged $11,203 per year.

Single adults, adults in families, and children also used different types of services, according to the study. For family adults and children, the top costs were from income support and medical care. For single adults, the major costs were in the areas of mental health, substance abuse, detox, and prisons and jails.

According to Hearth Connection Executive Director Jennifer Leimaile Ho, "This is one of the most comprehensive studies of supportive housing in the country, encompassing an urban and rural community, as well as both families and single adults. Working successfully with this population required patience, persistence, flexibility and a deep respect for program participants."

As has been shown in numerous other studies, a group of heavy users was also documented. 44% of all costs were attributable to the top 10% of users, and 59% of the total costs were assigned to the top 20% of users.

In 2000, the Minnesota Legislature appropriated funds to serve homeless families in the Minnesota Supportive Housing and Managed Care Pilot, and expanded the initiatives to single adults in 2001.A total of $10 million was invested from 2000 to 2007. The evaluation was conducted by the National Center on Family Homelessness and funded by the Robert Wood Johnson Foundation.

Through contracts with the Minnesota Department of Human Services, resources were distributed to two Minnesota counties: Blue Earth (a rural county including the city of Mankato and its environs) and Ramsey (an urban county including the city of Saint Paul and its suburbs). The counties contracted with Hearth Connection, a nonprofit agency created to lead the Pilot. Hearth Connection then maintained contracts with four organizations to provide direct services in the two counties. The evaluation examines results for single adults and families with children in both urban and rural communities.

The Supportive Housing and Managed Care Pilot included an independent, in-depth evaluation conducted by the National Center on Family Homelessness. The evaluation was comprised of four studies an annually repeating qualitative study; a quantitative outcome study of adults; a quantitative child study; and an extensive cost study.

Hearth Connection is a Minnesota non-profit that acts as an intermediary, working with government and community social service agencies to help people with very long histories of homelessness secure and succeed in supportive housing. Hearth Connection was created in 1999 as a result of a community planning and design process that asked people in the health care, human services and housing sectors, working in partnership with advocates and people experiencing homelessness, to envision a system that would get better results for people with long histories of homelessness, mental illness, chemical dependency and other chronic health conditions.

SAN DIEGO, CALIFORNIA. Any discussion of cost benefit analysis regarding homelessness and frequent users of public systems inevitably includes the well-known story of 15 chronic inebriates from the streets of San Diego who were tracked for 18 months in their services use to reveal a cost of $3 million to the taxpayers of San Diego City and County.

This San Diego data will now be amplified by a study published last week in Psychiatric Services, the journal of the American Psychiatric Association, which examined mental health service utilization and costs associated with California's AB 2034 Housing First program in San Diego County. Called Reaching Out and Engaging to Achieve Consumer Health (REACH), the program tracked 177 REACH clients and a control group for the study, looking at a 2-year period before and after housing placement.

Overall, when comparing the REACH clients and a control group, case management costs increased by $6,403, and inpatient and emergency costs declined by $6,103. Criminal justice system costs declined by $570. The study found no significant differences in outpatient or total costs for the groups. The net cost of services after considering the cost offsets was just $417 over two years, substantially lower than the $20,241 total cost of services.

Included in the data were mental health services costs for case management, outpatient services, inpatient and emergency services, criminal justice system services, for 2 years before and after housing placement. Data showed that participation in REACH was associated with substantial increases in the use of outpatient services as well as decreases in inpatient and emergency services and criminal justice system services. The new study, funded by the National Institute of Mental Health, finds that "the increased costs of case management and outpatient services were essentially entirely offset by reduced expenditures on inpatient and emergency services and mental health services provided in criminal justice system settings."

While the study did not consider county or federal costs of housing, income, and supplemental support, or other costs such as incarceration costs beyond mental health services provided in jail, the researchers propose that the more limited scope of their focus on analysis of mental health services costs provides a very detailed analysis of the majority of program resources. REACH participants are recruited from shelters and through a homeless outreach team, and community-based mental health programs. The program relies on 100 Section 8 vouchers.

REACH was established in 2000 in response to concerns that homeless people with serious mental illness were being displaced by a new sports stadium in downtown San Diego. The California legislature in 1999 provided $10 million for pilot programs offering integrated housing, mental heath, and supportive services. On the basis of early success in these counties, the legislature passed AB2034 in 1999, which provided the resources to expand the program statewide. In November 2004, voters approved Proposition 63, the Mental Health Services Act (MHSA) which applied a 1% tax on incomes over $1 million to fund public mental health services. 28% of MHSA funding was allocated to full-service partnerships, Housing First programs that do "whatever it takes" to sustain housing and improve mental health.

ALBANY, NEW YORK. New York State completed action on a new budget last week and proponents of supportive housing and services secured key resources for initiatives that serve the most vulnerable and disabled.

Network Executive Director Ted Houghton concluded, "All of us who dedicate our lives to helping homeless people and building strong communities appreciate the leadership shown by Governor Paterson, Speaker Silver, and Senate Majority Leader Smith. In the most challenging budget year in living memory, they reaffirmed their commitment to supportive housing and programs that prevent homelessness before it happens. By protecting permanent, housing-based solutions like these in the face of enormous fiscal pressures, they showed courage and vision."

SRO Support Services funding will sustain all existing supportive housing units, as well as new units opening in the next two years. The budget restored $4.4 million of this critical funding for a total of $20.48 million, enough to preserve full funding to all 18,484 existing units and as many as 1,500 units opening this year.

Full service funding was secured for all NY/NY III supportive housing units for youth aging out of foster care, including 100 scattered-site units, and 105 units in one existing, and three new, residences, a restoration of approximately $1 million. Full funding is also in place for all NY/NY III units for chronically homeless people with HIV/AIDS, including 400 scattered-site units and 121 units in six residences that have recently opened or will soon open, a restoration of $1.3 million, to a total of $5.8 million.

Key homelessness prevention funds were also restored, including $3.685 million for the Homelessness Intervention Program (HIP) and $5.719 million for Homelessness Prevention Programs. As a result, providers will continue to operate and in some cases expand their efforts to keep thousands of families in their homes.

DENVER, COLORADO. The doors are now open at a new first-ever green housing development where 50% of the new residents will be formerly homeless neighbors in Denver, Colorado. The Colorado Coalition for the Homeless this week opened the Renaissance Riverfront Lofts, a four-story development in downtown Denver. The Lofts include 100 one- and two-bedroom apartments and were designed and built to incorporate sustainability features such as water conservation, energy efficiency and environmentally friendly building materials.

Renaissance Riverfront Lofts is located on a 1.46- acre former asphalt production site on the South Platte River, near the Railyards Marketplace retail center. In addition to the units set aside for formerly homeless people being served by the Coalition, the remainder of the apartments will be leased to low- income households. Groundbreaking for the project was in January 2008.

"This development will help meet a critical housing need in Denver for both homeless individuals and persons working downtown who cannot afford to live in the nearby luxury loft developments," Coalition President John Parvensky said.

According to the Coalition, private equity from Enterprise Community Investments and JP Morgan Chase was provided through the Federal Low Income Housing Tax Credit program administered by the Colorado Housing Finance Authority. The City and County of Denver provided a HOME grant and the property is the first City-supported housing site to follow the Green Communities criteria. The Colorado Division of Housing, FHLB Affordable Housing Program, The Gates Family Foundation and HUD's Supportive Housing Program also provided funding to keep rents low. Acquisition financing was provided by Mile High Community Loan Fund. Construction and permanent financing were provided by JPMorgan Chase.

The opening comes as Denver Mayor John Hickenlooper has launched Greener Denver. Denver is one of eight cities selected last fall by the Rockefeller Brothers Fund to participate in its Climate Prosperity Project. Using a strategy developed by Global Urban Development, an international nonprofit policy consultant, each of the participating cities created an initiative to transform their economy, achieve climate goals and ensure social equity in a sustainable future.

Denver is also preparing for its Project Homeless Connect #7 on April 24 at the University of Denver. In addition to Denver's Road Home, the city's 10 Year Plan and United Way Denver, partners are joined by sponsors Regis University, Sodexo, Xerox, Qdoba, Suncor Energy, and Kaladi Bros. Coffee.

WASHINGTON, DC. In preparation for issuing a one-time extra $250 monthly benefit to individuals who receive Social Security, SSI, and other benefits, the Social Security Administration is distributing printed copies of its publication on the extra payment, which has been an online-only publication until this point. Copies will be printed and distributed for public use. Every SSA office in the nation will receive a supply for the public, and Walmarts across the country will display the publication in their stores. In addition, members of Congress will also be supplied with the publication. Under the American Recovery and Reinvestment Act (ARRA), one-time extra monthly payments will be made by the end of May 2009.

According to SSA Commissioner Michael Astrue, the payments will inject more than $13 billion into the economy. The law provides for a one-time payment for certain individuals who receive Social Security, Supplemental Security Income (SSI), Railroad Retirement and Veterans benefits. If individuals were eligible for one of these benefits at any time during the months of November 2008, December 2008 or January 2009, they may be eligible for the one-time payment. The one-time payment to Veterans Affairs (VA) and Railroad Retirement Board (RRB) beneficiaries will be handled by the VA and RRB.

Recipients should receive the one-time payment by the end of May 2009. No action needs to be taken to receive this payment. Social Security does not need to contact beneficiaries to request information, and beneficiaries do not need to contact SSA unless they do not receive the extra payment by June 4, 2009. The Department of the Treasury will be sending payments throughout the month of May.

SSA has posted a detailed Q and A on their recovery web site.

WASHINGTON, DC. The future of key McKinney- Vento Homeless Assistance Act programs at the U.S. Departments of Housing and Urban Development and Labor are the focus of legislative proposals now in Congress. Congress also passed and sent to the President a major expansion of community volunteer programs.

HUD McKinney-Vento Act. The Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act (S. 808 and H.R. 1877) was introduced in Congress last week by Senators Jack Reed and Christopher Bond and 11 other Senators and Representatives Gwen Moore, Judy Biggert, and 5 other House members. Program consolidation, prevention, housing emphasis, flexibility, and performance are among the key goals for reauthorization. Among the elements of the proposals, the bills would permit up to 20% of federal funds to be used for prevention or rapid re-housing under a new "Emergency Solutions Grants" (replacing Emergency Shelter Grants). The HUD Supportive Housing Program, Shelter Plus Care, and the Moderate Rehabilitation/Single Room Occupancy Program would be consolidated into one program, and there would be increased emphasis on performance measured by reduction in homelessness. The measure would create a Rural Housing Stability Assistance Program to provide rural communities with a flexible model to use funds.

DOL McKinney-Vento Act. The House approved the reauthorization of the McKinney-Vento Homeless Veterans Reintegration Program at the Department of Labor. The bill would reauthorize the HVRP through 2014. The bill authorizes an additional $10 million to provide dedicated services for homeless women veterans and homeless veterans with children. Grants would be made available to provide job training, counseling, placement services, and child care services to expedite the reintegration of veterans into the labor force.

Federal Volunteer Service. Congress passed and sent to the President the Edward M. Kennedy Serve America Act to expand community service programs, including AmeriCorps and VISTA, administered by the Corporation for National and Community Service (CNS), a federal agency created in 1993 and a member of the U.S. Interagency Council on Homelessness. The Corporation engages four million Americans in result-driven service each year, including 75,000 AmeriCorps members. The AmeriCorps program will expand from 75,000 positions annually to 250,000 by 2017. The legislation creates a Social Innovation Fund to expand proven initiatives and provide seed funding for experimental initiatives, leveraging federal dollars to identify and grow ideas that are addressing our most intractable community problems. The CNS 2009 National Conference on Volunteering and Service will convene June 22-24 in San Francisco.

At every Project Homeless Connect, where resources range from "haircuts to housing," it is often haircuts which both attract consumers and offer professional satisfaction to the volunteer stylists on site. At the recent Omaha Project Homeless Connect, Jessica Puente of Xenon International Academy organized volunteer stylists and students to offer their services to more than 400 people. She shared a short reflection she wrote about her experiences from Omaha's two PHC events. Following are excerpts.

"Today was another great year at the Project Homeless Connect Omaha. In 2008, Xenon attended with 7 students, 1 educator, and me as the coordinator. This year my plan was to bring 15 students and have an extra educator. I knew more help would mean more haircuts for the guests. To say the least, we doubled our haircut services! Last year we did 200, this year we topped out at 400, and this year over 450 guests attended. Therefore, we almost gave every guest a haircut.

"The students questioned what the event will be like, meaning, they didn't know what to expect when we say 'haircuts for the homeless.' I gave them my insight from last year's event, and they were on board. At 8:33 am we had our first client, and it was all business from then on. Seeing our students reach out a hand to shake and say "Hi, I'm Janessa, what's your name?", it was truly eye opening because these students are used to having a state of the art facility to do haircuts; including a shampoo bowl, shampoo and conditioner, proper lighting, styling tools, and usually an hour to perform a haircut service.

"These students did 400 haircuts in a men's locker room with hair clippers and cutting shears flying everywhere. They shared all their tools and just did haircut after haircut with no problems. Peels Salon Services also donated their services as well by delivering styling stations and hydraulic chairs, to make it a more 'salon' type experience, and it was just that!

". . . I had to force a student to take a break because she was so in the zone trying to get everyone taken care of, on her break she swept up hair, that's how dedicated these students are. The day started slowing down and coming to an end, however, we did haircuts until there was not a single guest waiting.

"As we packed up and put the tools away, one thing that didn't get packed up was the open hearts of the students. They all extended their hand to make a change to the homeless community of Omaha, Nebraska."

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