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<br />Profile of Homelessness in Boulder County
<br />What is Chronic Homelessness?
<br />Homelessness is an issue experienced by individuals and fam-
<br />ilies across the nation. The causes of homelessness are many,
<br />including loss of work and low wages, increased housing costs,
<br />unexpected medical costs, mental health issues, and substance
<br />abuse issues. A survey of Boulder County residents found that
<br />almost half of Boulder County residents (46%) have a friend
<br />or family member who has experienced homelessnessl. Many
<br />persons and families experience homelessness once and are able
<br />to get back on their feet. Others cycle through homelessness
<br />periodically due to instable income or housing and low incomes.
<br />According to HUD, a "chronically homeless" individual is
<br />defined to mean a homeless individual with a disability who
<br />lives either in a place not meant for human habitation, a safe
<br />haven, or in an emergency shelter, or in an institutional care
<br />facility if the individual has been living in the facility for fewer
<br />than 90 days and had been living in a place not meant for human
<br />habitation, a safe haven, or in an emergency shelter immedi-
<br />ately before entering the institutional care facility. In order to
<br />meet the "chronically homeless" definition, the individual also
<br />must have been living as described above continuously for at
<br />least 12 months, or on at least four separate occasions in the
<br />last 3 years, where the combined occasions total a length of
<br />time of at least 12 months. Each period separating the occasions
<br />must include at least 7 nights of living in a situation other than
<br />a place not meant for human habitation, in an emergency shelter,
<br />or in a safe haven.
<br />Chronically homeless families are families with adult heads
<br />of household who meet the definition of a chronically homeless
<br />individual. If there is no adult in the family, the family would
<br />still be considered chronically homeless if a minor head of
<br />household meets all the criteria of a chronically homeless in-
<br />dividual. A chronically homeless family includes those whose
<br />composition has fluctuated while the head of household has
<br />been homeless? This definition is used by HUD and many
<br />homeless providers using HUD and other similar funding re-
<br />sources. While chronically homeless individuals are not the
<br />largest homeless population in Boulder County or in most areas
<br />of the country, they use a high proportion of services available
<br />to homeless persons as well as public health services, and re-
<br />sources within the criminal justice system. Freeing up these
<br />service dollars to help those who need short term assistance to
<br />get back on their feet would allow Boulder County homeless
<br />providers to serve more people each year, and save local com-
<br />munities money spent on emergency room visits, jail and court
<br />expenses.
<br />1 Perspectives on Homelessness in the Denver Metro Area: Key
<br />Findings from Opinion Research to Guide Public Will -Building,
<br />January 14 — 22 2015 Resident Survey.
<br />2 HUD 24 CFR 91.5, 24 CFR 578.3, Final Rule December 2015.
<br />What is Permanent Supportive Housing?
<br />Permanent Supportive Housing uses the Housing First approach
<br />to serving persons experiencing homelessness that centers on
<br />providing homeless people with housing quickly and then
<br />providing services as needed. According to the National Alli-
<br />ance to End Homelessness "what differentiates a Housing First
<br />approach from other strategies is that there is an immediate
<br />and primary focus on helping individuals and families quickly
<br />access and sustain permanent housing. A Housing First approach
<br />rests on the belief that helping people access and sustain per-
<br />manent, affordable housing should be the "central goal" of those
<br />working with persons experiencing homelessness.' Housing
<br />First is used for both individuals and families. Agencies in
<br />Boulder County use a Housing First approach to serve many
<br />homeless households. According to the Boulder County 10
<br />Year Plan to End Homelessness members, the program has
<br />been very successful. After two years in the program, 70% of
<br />Housing First clients retained their housing and 90% of Housing
<br />First clients increased skill, income, and self-determination.
<br />Permanent Supportive Housing is a type of housing designed
<br />to meet the long term housing and service needs of chronical-
<br />ly homeless individuals and families, and proven to be effective.
<br />According to the Corporation for Supportive Housing, it "com-
<br />bines affordable housing with services that help people who
<br />face the most complex challenges to live with stability, auton-
<br />omy and dignity. Supportive housing improves housing stabil-
<br />ity, employment, mental and physical health, and school atten-
<br />dance, and reduces active substance abuse. " People living in
<br />supportive housing would not be able to stay housed without
<br />a wide range of supportive services. Most "have a long history
<br />of homelessness and often face persistent obstacles to main-
<br />taining housing, such as serious mental illness, a substance abuse
<br />disorder, or a chronic medical problem. While services are
<br />necessary to help tenants maintain stability, being housed is an
<br />essential first step in addressing these conditions that often have
<br />gone untreated for many years."4 Permanent Supportive Housing
<br />does have basic lease compliance guidelines and expectations
<br />for residency that clients must meet, but tenants are supported
<br />with case management and other services to help them achieve
<br />successful residency and live within the guidelines of their
<br />community or program.
<br />Permanent Supportive Housing also is a cost effective way to
<br />serve the chronically homeless residents of a community, and
<br />those in danger of becoming chronically homeless. Chronical-
<br />ly homeless individuals and families utilize many costly local
<br />services, including shelter services, hospital emergency room
<br />and public safety resources, social service and crisis management
<br />resources. By providing a safe, decent, place to live with access
<br />3 What is Housing First? Solutions Brief, November 2006. National
<br />Alliance to End Homelessness.
<br />4 Supportive Housing Research FAQs: Who Lives in Supportive
<br />Housing? Corporation for Supportive Housing.
<br />for residents to the services they need to live off the streets,
<br />Permanent Supportive Housing saves money otherwise spent
<br />on high cost crisis care and emergency housing, and allows these
<br />resources to be used on other individuals and families.
<br />The recently published Housing Stability
<br />report by Boulder County Housing and
<br />Human Services notes that the Denver
<br />Housing First Collaborative estimates
<br />cost savings of $31,000 per person over
<br />a two year period as a result of
<br />comprehensive housing and supportive
<br />services.
<br />The Supporting Housing Network of New York reviewed more
<br />than 16 national studies that analyzed the cost of permanent
<br />supportive housing vs. the cost to public services for chronically
<br />homeless residents. The Network summarized the overall savings
<br />in usual care vs. supportive housing care for three cities:
<br />• In Chicago, when supportive housing was offered to 200
<br />people with chronic illnesses, their use of hospitals
<br />decreased by 45%. The program saved a total of
<br />$900,000 in 18 months.
<br />• Seattle, Washington offered supportive housing to
<br />chronically homeless alcoholics, and public costs were
<br />reduced by more than 75%.
<br />• In New York, NY 4,000 homeless, mentally ill residents
<br />were offered permanent supportive housing and their
<br />annual inpatient Medicaid costs decreased by 35%.
<br />The study also notes that in eight different cities, the use of
<br />emergency room care was reduced up to 74% after qualified
<br />tenants moved into supportive housing. The use of hospitals
<br />in eight areas fell as much as 75%.5 Many other studies and
<br />reports of PSH programs across the nation conclude that there
<br />are cost savings in multiple public systems from placing chron-
<br />ically homeless individuals in PSH.
<br />Homeless providers in Boulder County
<br />have estimated the cost of serving
<br />homeless persons living on the streets
<br />in Boulder County. Agencies estimate
<br />this cost at $43,300 per year, due to
<br />expensive emergency shelter, the cost
<br />of emergency room care, police and jail
<br />time, and court time among other
<br />factors. By comparison, the cost of
<br />providing a Permanent Supportive
<br />Housing unit in Boulder County is only
<br />$11,700 per year, providing a savings:
<br />$31,600 per year.
<br />Of the 658 homeless people in Boulder
<br />County in 2015, 57% had been homeless
<br />for more than 1 year, or about 375
<br />persons. At $43,300 per year, these 375
<br />people cost the community over $16
<br />Million per year. If they were housed
<br />with a Permanent Supportive Housing
<br />solution, it would save the community
<br />over $11 Million per year.
<br />5 Supportive Housing Reduced Spending on Services, The
<br />Network, The Supportive Housing Network of New York, 2010.
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