Housing First: Expanding the toolbox to combat homelessness in Eastern Iowa

Disturbing headlines last year brought the issue of homelessness, too often forgotten, to the forefront of our attention.

The murders of two homeless people in Cedar Rapids. A homeless man fatally burned while using a candle to keep warm. Another large fire in a Cedar River bank encampment led to a police sweep of the area, scattering those who sheltered there to parts unknown.

'It feels extraordinary, and it should feel extraordinary because it is wrong. It's wrong that we have people living in these conditions,” said Chrissy Canganeli, executive director of Iowa City's Shelter House.

It's a position few would argue with, but what can be done?

In fact, despite advocates' best efforts in Iowa, including here in the Corridor, the number of people accessing emergency homeless shelters has been steadily increasing - 1,400 people in our seven-county region in January 2015, compared with fewer than 1,000 just four years earlier.

Reversing that trend, and banishing homelessness from the Corridor, will require a variety of services, sufficient resources, continued commitment and a critical shift in the way we think about homelessness and housing instability.

HOUSING FIRST

Rarely do people choose to be homeless. Most often, they lose housing as part of a much larger instability in their lives. People lose jobs. They are bankrupted. They struggle with mental illness or substance abuse. They are victims of domestic violence. Other crises contribute to their inability to find and secure safe, affordable shelter.

In years past, it was common to treat housing as a kind of reward for straightening out those other issues: Homeless people were expected to meet certain standards before being helped to find housing. Those with substance abuse issues were expected to end addictions. Individuals with mental health issues needed to be on medication or engaged in therapy. Though well intentioned, advocates now realize it was somewhat of a backward approach.

'At first we saw people getting services and sustaining, but it didn't hold,” Canganeli said. 'For those that are chronically homeless and caught up this cycle of crisis services, we had to admit that what we were doing wasn't working. It wasn't working for them - and it doesn't work for our communities.”

Housing instability contributes to instability in all areas of life, making it more difficult to find and keep a job, to raise children, to eat well and take care of medical issues. That all comes at a real cost not only to the homeless individual, but to entire communities.

A five-year case study by the Johnson County Local Homeless Coordinating Board, completed in 2014, followed four chronically homeless people.

On average, each of the four accumulated about $139,662 per person, per year in unreimbursed taxpayer costs for services such as law enforcement response, ambulance rides, emergency room visits and hospital stays. Over the five year study period, the four accrued more than $2.1 million in unreimbursed costs, nearly 90 percent in medical costs.

Advocates in Linn County expect they'd find similar costs if they completed a similar survey of chronically homeless people here.

Stable housing provides a home base from which other life issues can be addressed in a much more cost-effective and systematic way.

'If we can get them into housing, we've found that they are going to have a much better chance of becoming stable and finding and receiving the other supports and resources that they need,” said Phoebe Trepp, executive director of Willis Dady Emergency Shelter in Cedar Rapids and coordinator for the overflow cold weather shelter.

'I know firsthand that when I get someone housed, even if they have a bunch of other outstanding issues, stability will follow,” said Chris Meyers, a homeless outreach worker with Abbe Center for Mental Health. 'Sometimes housing is the biggest piece of the puzzle.”

A federal initiative known as 'Opening Doors,” marked the first time the nation launched a comprehensive 'housing first” strategy. The first target of the initiative was military veterans, and best practices from those experiences are now being used to help other chronically homeless populations.

'I think we'll get the veterans taken care of and that will pave the way for similar services for the chronically homeless and, hopefully, that will open doors for more consideration of the general homeless population,” said Dusty Noble, supervisor of the Veterans' program through HACAP.

Trepp agreed, but is also concerned about follow through.

'Legislation is one thing,” she said. 'Are we going to have the funding and resources available to meet the goals?”

Rapid Rehousing - placing homeless people and families in homes within 30 days - has been an effective tool. But the housing is temporary, usually available for three months. Another federal program transitioned veterans to permanent homes. For the chronically homeless, no next-step program exists.

AFFORDABILITY

A key to solving homelessness is making sure there is safe, decent housing at a price that aligns with wages.

'These are individuals that may be at or below 30 percent of the area median income,” says Carrie Slagle, director of homeless and housing services at Waypoint in Cedar Rapids. 'For housing to be affordable for them, they can only pay 30 percent of their gross income.”

Someone receiving $700 per month in disability assistance would need to find housing at 30 percent of that gross amount, or $210 per month. Even a person working full-time at minimum wage can find they are priced out of the housing market in Linn and Johnson counties.

'The cost in Linn County for a two-bedroom unit cannot be absorbed by a person working full-time and making minimum wage,” Slagle said. 'That person would need to be working about 73 hours a week, 52 weeks out of the year to afford fair market rent on a two-bedroom unit. That's just not realistic.”

Advocates say that affordability gap is growing.

'We are seeing people who are working very hard. I don't think the public understands that even people who doing that, working hard, really aren't making it,” Slagle said.

DIVERSE POPULATION & RESOURCES

While research has shown that providing housing first often provides the stability necessary to begin to work on other challenges, it shouldn't be mistaken for a silver bullet. It's more cost effective and, in many ways, more successful, but it can't be our only tool to combat homelessness.

In addition to short-term and emergency shelters, which continue to be critical, advocates throughout the Corridor are offering individualized services targeting specific subsets of the homeless population.

'As an organization, what we are saying is that we need to have diversity in our community's portfolio. The more diversity we have in our housing approaches, the better catchment we'll have overall,” Canganeli said.

Homeless individuals with severe mental illnesses such as schizophrenia can complete a four-to-six-month process for a spot in one of Iowa City's three Fairweather Lodges. Each house is a permanent home for six people, who live and work semi-independently. Housemates learn to live cooperatively while providing each other supports that would not be as readily available if they lived alone.

Cedar Rapids families who are homeless and have an open child welfare case may be eligible for a five-year, federal demonstration project that provides housing alongside individualized support across multiple agencies.

Participants have been able to develop plans to address their specific challenges, and work with the Department of Human Services to keep their families intact or reclaim children placed in foster care. The program, PUSH-CR, is one of only five nationally, and stakeholders are already discussing how to keep it running after the pilot ends in September 2017.

And, because traditional non-profit funding sources can be scarce and erratic, local groups are looking to diversify income and add stability to their budgets.

Shelter House, for instance, is eyeing an endowment and has launched two small businesses to help their clients learn valuable job skills. When their facility was built in 2010, an industrial kitchen was installed.

Through the Culinary Starts program, shelter residents learn skills they'll need to work in commercial kitchens while making meals for shelter residents and external clients.

The second business, Fresh Starts, is a janitorial service that contracts with local businesses that offers permanent jobs for Shelter House clients, including residents at the Fairweather Lodges. Supervisors have specific training to work with individuals with severe mental illness.

Both are revenue-generating opportunities, Canganeli says, that allow the community to see the shelter and its clients in a different way - as people who want to work and contribute to their own successes.

TAKE ACTION

Ending homelessness, which remains a federal priority, is both a simple and complex issue. On one hand, it's a matter of affordable housing. On the other, widespread and accessible follow-up care needs to be present to achieve long-term success.

'My perspective on homelessness is that it is actually very achievable to end it. We know what we need to do. We need to allocate resources for housing and believe that everybody needs to be in a safe, sanitary housing unit. It's pretty straightforward, and that's what is so frustrating about it. But as a community we really have to believe that, and then follow it with resources,” Trepp said.

Homelessness, Slagle added, is a community issue that 'requires a community solution.”

What local advocates need are resources that can help them achieve the same goals for the chronically homeless population that has been available for veterans.

The federal government cannot expect the same outcomes if it refuses the same level of support.

As a community, lack of affordable housing must be addressed first, but built alongside the programs that overcome the additional barriers that can hamper success.

State leaders should consider a more equitable distribution of resources to the homeless population. Federal priorities for the chronically homeless make no distinction between gender, race or other factors. The state shouldn't either.

Our communities have been consistently generous and committed when called to help those displaced and struggling following disasters. Floods in our own backyards as well as hurricanes on the Gulf Coast had Iowans digging deep to help others. Overcoming such traumas was considered a priority, and no one was considered lazy or weak for accepting a helping hand.

That same spirit should guide our efforts to end the homelessness that often is caused by more personal disasters. Disasters which are equally traumatic, equally damaging and create crises for our neighbors which are equally within our power to solve.

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