Staff Columnist

Iowa City project bets $3 million on new approach to homelessness

'Housing first' programs already proven cost-effective in other cities

Members of the steering committee break ground at a  ceremony for new housing organized by the Shelter House in Iowa City on Thursday, April 5, 2018. The complex will be the first Shelter House initiative that involves a
Members of the steering committee break ground at a ceremony for new housing organized by the Shelter House in Iowa City on Thursday, April 5, 2018. The complex will be the first Shelter House initiative that involves a "housing first" strategy, which prioritizes providing stable housing before working with the homeless on their social services and mental health needs. (Rebecca F. Miller/The Gazette)

Sometimes you have to spend money before you can save money.

That’s the rationale behind so-called housing first programs taking hold across the nation. Last week, an Iowa City social services agency broke ground on one of the state’s most ambitious such projects.

Shelter House is Johnson County’s central anti-homelessness organizations, and leaders say their new 24-bed facility on Iowa City’s south side will serve a distinct purpose from its traditional shelter in the same neighborhood.

The construction now underway on Cross Park Avenue is supported by $2.7 million from the Iowa Finance Authority, in addition to public and private dollars from the local community.

Known as FUSE — for Frequent User System Engagement — the housing first project aims to serve the heaviest users of local services, who often cycle back and forth between the justice system and health care facilities, racking up enormous costs to the public.

The housing first philosophy entails getting clients into permanent housing, without high barriers for participation. That’s a shift from the traditional “housing ready” approach, which gives top priority to clients who are making the most progress on their lifestyle and career goals.

The basic idea is that common problems among individuals experiencing homelessness — including mental illness, substance abuse and other behavioral health issues — are difficult to treat when people also are faced with the stress of living on the streets. When people have stable housing, their chances of recovery may be significantly higher, a hypothesis which is increasingly backed up by data.

“Housing is a necessary precursor to health,” Shelter House Executive Director Crissy Canganelli told about 100 supporters gathered at last week’s groundbreaking ceremony.

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Studies in cities across the United States have shown placing housing-challenged people in what providers call permanent supportive housing, like the new FUSE facility, actually ends up saving money. Organizers here have repeatedly pointed to a small-scale study following a small group of service users in Johnson County.

Analysts found just one chronically homeless person can generate well over $100,000 in unreimbursed costs to local services over the course of a year. In contrast, advocates estimate permanent housing would cost as little as 60 percent of that amount, and it would lead to better outcomes.

As I’ve written before, many of my fellow conservatives are instantly skeptical about low-barrier assistance programs, which they see as rewarding poor choices, like drug use.

I get it. In my own small-government fantasy, the government would not play a major role in funding or organizing social services.

However, we live in a behemoth bureaucratic state, not in a libertarian utopia. Government-sponsored welfare projects will not be dismantled overnight, and as long as society is footing the bill, we ought to demand our dollars are spent in ways proven to be effective.

In other words, there’s nothing fiscally conservative about continuing to pour money into programs which offer little hope for positive and sustainable outcomes.

Utah is one of the most politically conservative states in the nation, siding with the Democrat presidential candidate just once in the past 70 years. Yet the state is also known as one of the most charitable, and policymakers there have embraced the housing first philosophy.

While homelessness persists in the state, advocates say they’ve seen significant progress. Between 2005 and 2015, Utah’s chronically homeless population dropped by 91 percent, by one measure.

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A key tenet to the housing first philosophy both in Iowa and in Utah is empowering clients to make their own life decisions, which advocates say leads to better engagement.

“In order for Housing First to be effective, clients’ choices must be available in housing selection and service participation. When a client is able to exercise that choice, he or she is more likely to be successful in maintaining housing and making life improvements,” Utah administrators wrote in their 2016 state report on homelessness.

Canganelli said Shelter House’s FUSE facility in Iowa City will offer client services like case management and behavioral health counseling, similar to the existing shelter. While participation in those programs will not be required, organizers are hopeful for improved outcomes over the traditional model.

“Those are voluntary and they are not a condition of an individual’s residency, which is also different from past approaches. Communities that have moved forward with housing first have been able to show that the vast majority of people over time build trust and they do engage. … The vast majority of people do indeed stay housed,” Canganelli told me.

• Comments: (319) 339-3156; adam.sullivan@thegazette.com

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