[Hpn] Re: Not just shelter, but home, for the homeless; Boston Globe; 3/23/2008

Morgan W. Brown morganbrown@gmail.com
Sun, 23 Mar 2008 05:43:18 -0400

Read the study report:

11/07: FBP Housing First Final Report:
Note: PDF version; requires Adobe Acrobat Reader
38 pages
via Center for Social Policy
McCormack Graduate School
University of Massachusetts Boston

~related information, as well as another article on the general subject, fyi:

-------Forwarded fyi-------


Father Bill's & MainSpring: http://www.fatherbillsmainspring.org

Housing First

Housing First is based on the belief that when an individual moves
into a home of their own, they can begin to address the issue that
initially led to the loss of housing. Once in a home, formerly
homeless men and women receive supportive services such as case
management and counseling to help them stabilize and remain in

Special Report on Housing First

"This Place Gives Me Peace, Happiness, and Hope: The First Two Years
of Housing First in Quincy, Massachusetts"

Tatjana Meschede, Ph.D., The Center for Social Policy McCormack
Graduate School at UMass Boston, conducted an independent study over
the course of two years on Father Bills & MainSpring's Housing First
initiative*. Tatjana stook an in-depth look at Housing First through
interviews and focus groups with Housing First residents and their
case managers, and collected data on each resident.

The major findings of the study include:

• Providing housing for those who were chronically homeless reduced
chronic homelessness in the Quincy/Weymouth community by 19 percent
between January 2006 and January 2007.

• Of all Housing First residents who moved during the first year of
this program, 86% (56 out of 64) remained housed a year or more after
their move.

• Overall quality of life improved dramatically for all Housing First
residents after leaving the shelter, including increased sense of
independence, control of their lives, and satisfaction with their

• Hospital stays were dramatically reduced, when comparing the year
before housing to the year after. Inpatient hospitalization decreased
by 77 percent, and hospital emergency room visits by 83 percent.

• Their new homes helped Housing First residents to reunite with
family members and build stronger relationships with each other.
However, residents ranked the support they received from staff higher
than any other.

*Please note: the report refers to Father Bill's Place, as the report
was undertaken before Father Bill's Place and MainSpring Coalition for
the Homeless merged.

Click here to download the complete report


February 25, 2008
Street News Service (SNS)

"Housing first" policy aims to reduce costs, improve quality of life
for chronically homeless
(Spare Change, USA)
Sandra Larson
February 25, 2008

Housing the homeless is cheaper than paying for emergency services
such as ambulance rides, emergency room visits and hospital stays,
according to a recent Maine study that echoes the findings of other
studies around the United States.

The study, released by the Maine State Housing Authority in October,
shows that costs were reduced by about 50 percent for 99 formerly
homeless, mentally ill people in the Portland, Me. area who now live
in permanent supportive housing and receive regular care to manage
ongoing physical and mental health problems.

The two-year study was modeled after studies done in larger
metropolitan areas such as New York and Denver, tracking services used
by a group of individuals before and after entering permanent
supportive housing.

Melany Mondello, a coordinator of the Maine study, said that not all
studies around the country showed cost savings overall. Instead, "cost
neutrality" is often the result, she said, and taxpayers need to be
aware that dollars spent are not necessarily reduced, but used more

"It's important for people to know that a small segment of the
homeless population costs a lot," Mondello said.

"The message we are trying to give is that housing programs help shift
the burden away from expensive emergency care to preventive care and
supportive services."

Some agencies and towns in Massachusetts have likewise been shifting
action on homelessness to a "housing first" model, a philosophy that
it is more effective to house a person first and deal with other
problems such as addictions, mental illness or disabilities afterward.
This is a fairly dramatic shift from the traditional model of
requiring homeless people to become sober or to complete
detoxification programs and go through a "continuum of care" before
being eligible for the ultimate goal of permanent housing.

"I think there's great momentum behind it," said Erin Donohue,
spokesperson for Massachusetts Housing and Shelter Alliance (MHSA).

MHSA is "at the forefront" of the housing first movement, according to
Donohue. The idea, she explained, was pioneered in the 1990s by Sam
Tsemberis, a former psychologist who started Pathways to Housing in
New York City when he saw how difficult it was for people with severe
disabilities to navigate the traditional system with its series of
required treatment centers and temporary living arrangements.

MHSA received $600,000 to start a statewide housing first pilot
program, in which homeless provider subcontractors began placing
individuals in housing in Sept. 2006. The state funding has been
doubled, to $1.2 million, for fiscal year 2008.
The United States Interagency Council on Homelessness recognized the
city of Quincy as "a national model" for its success in implementing a
housing first program.

Since 2005, more than 60 people have been moved from emergency
shelters to permanent housing in the Quincy area. And inpatient
hospital days and emergency room visits decreased by about 80 percent
for those placed in housing, according to a report by Tatjana
Meschede, Ph.D., of UMass Boston's Center for Social Policy.

"Quincy is definitely leading the way in Massachusetts," said Sean
Glennon of the Quincy planning department.

Glennon said housing first is a fairly new concept in Quincy. Until
about 2005, he said, the city focused on emergency shelter and
transitional housing rather than permanent supportive housing.

Quincy's main partner in the quest to end homelessness is Father Bills
& MainSpring, an organization formed from the recent merger of two
shelters, Father Bill's Place in Quincy and MainSpring Coalition for
the Homeless in Brockton. The new, larger organization will place more
focus on permanent housing.

"In any other business, if you're continuously seeing a problem not
get better, you change," said John Yazwinski, CEO of the merged
organization, who has a business degree and worked in the lumber
industry before joining Father Bill's in 1996. He called the change a
"complete organizational transition" to a focus on permanent solutions
instead of crisis management.

In the city of Boston, it is unclear whether a housing first model is
going to replace the shelter model anytime soon. Glennon said he is
not aware of Boston organizations actively pursuing a housing first
strategy, though like Quincy, Boston and many other communities have
adopted a 10-year-plan to end chronic homelessness, he said.

Boston's Pine Street Inn is known primarily for its emergency shelter,
which offers overnight refuge and a hot meal for about 700 men and
women every night, and its outreach vans that offer transportation to
shelter or medical facilities.

But Pine Street has also been quietly transitioning some clients to
various types of housing, including permanent supportive housing, for
decades, according to spokesperson Alicia Ianiere. She said Pine
Street opened its 26th residential facility in November—a "beautiful
rehab" of an existing building in Roxbury—housing seven formerly
homeless people.

Costs of housing are notoriously high in Boston, and so it may seem
unrealistic that providing more housing could save money—but the
emergency medical services that are overburdened with many people are
homeless are expensive, too.

An ambulance ride in response to a 911 call in Boston costs $850 at
its most basic level, and up to $1700 for a major medical crisis
requiring treatment by paramedics, according to Jim Montgomery,
Director of Administration and Finance at Boston Emergency Medical

And for people without stable shelter, normally minor or manageable
health problems can easily rise to crisis levels, causing greater use
of emergency rooms and hospital beds.

The MHSA report "Home and Healthy for Good" lists a dozen ways in
which homelessness directly affects a person's health, ranging from
stark facts of life on the streets such as being unable to rest and
having medications stolen, to more subtle factors such as increased
stress during homelessness and the likelihood that care won't be
sought until an illness is advanced.

"My diabetic patients who are homeless have a hard time finding a
private place to inject insulin," said Dr. Jessie Gaeta, a physician
advocate at MHSA and internist with Boston Health Care for the
Homeless Program and Boston Medical Center. It's also hard to keep the
medication refrigerated, she added, and homeless diabetics are
sometimes arrested for needle possession, or their needles are stolen.

"So some don't take their insulin and they end up in the hospital," she said.

"Housing is a medical intervention," stated Gaeta, "because it allows
patients to care for their illness."

The city of Quincy's program is saving the Quincy Medical Center
$60,000 per year in emergency costs, based on the hospital stays of
one group of women studied. While homeless, the 12 women spent a total
of 44 inpatient days in the hospital in a one-year period. In the year
following their transition to permanent housing, their total hospital
days dropped to just four.

In the Maine study, the mentally ill homeless people received more
mental health care after being placed in housing, but it still cost
less overall because the services were routine and managed instead of
irregular emergency care, said Mondello.
Cost reduction is what housing first advocates emphasize to convince
legislators and taxpayers. But those involved in ending homelessness
are quick to note that the formerly homeless people also have much
greater quality of life now.

"They are healthier, happier, more productive, and feel more a part of
the community," said Glennon. He said they are also more likely to
find employment or apply for state and federal programs than they
would have been in an emergency shelter.
Mondello also emphasized the increased wellbeing of the newly housed
people in the Portland area. She said she believes the housing first
model is going to keep growing.

"I think it's starting to be clear that this approach is working," she
said, "because it is humane; you can't go wrong with housing; and
people realize that it actually works."

By Sandra Larson

Reprinted from Spare Change News


**In accordance with Title 17 U.S.C. section 107, this material is
distributed without charge or profit to those who have expressed a
prior interest in receiving this type of information for non-profit
research and educational purposes only.**


-------End of forward-------

On Sun, Mar 23, 2008 at 4:51 AM, Morgan W. Brown <morganbrown@gmail.com> wrote:
> Key excerpts:
>  Sunday, March 23, 2008
>  Boston Globe
>  [Boston, Massachusetts]
>  Local News section
>  Not just shelter, but home, for the homeless
>  http://www.boston.com/news/local/articles/2008/03/23/not_just_shelter_but_home_for_the_homeless/