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Homeless Study Looks at ‘Housing First’ Shifting Policies to Get Chronically Ill in Homes May Save Lives, Money By JOE BARRETT March 6, 2008; Page A10
A four-year study of homeless people with chronic medical problems in Chicago offers fresh evidence that efforts to move the homeless into permanent housing quickly can improve their lives and save taxpayer money.
The study was put together by a coalition of hospitals and housing groups seeking hard evidence supporting this approach to dealing with homelessness. Results of the study, which was financed by housing grants from the federal Housing and Urban Development Department and private charities, will be presented today at the NHousing and HIV/AIDS Research Summit in Baltimore.
The study, called the Chicago Housing for Health Partnership, or CHHP, is among the first to use a scientific approach in a housing study of homeless people with problems other than mental illness, according to Dennis Culhane, a professor at the University of Pennsylvania and leading researcher in the field who has followed the study’s progress. One group of homeless people that received housing and intensive follow-up by a case manager consumed fewer public resources than a separate group that received “usual care” — the piecemeal system of emergency shelters, family and recovery programs — according to a preliminary review of data by the researchers.
Members of the study group, such as Claude Ousley, a 60-year-old with congestive heart failure who had been homeless about five years, spent half as many days in hospitals and nursing homes and went to emergency rooms half as often as the usual-care group over 18 months. The savings more than made up for the $12,000-per-person annual cost of providing housing and a case manager, according to the preliminary findings.
Some homeless advocates remain skeptical of “housing first,” the rapid placement of the long-term homeless in apartments where they can work on the underlying causes of their homelessness. “Taking somebody quickly off the street and moving them to housing without building the right steps” can be a recipe for failure, said the Rev. John Samaan, who runs the 176-bed Boston Rescue Mission. He said homeless people, particularly those struggling with substance abuse, need the community of support and the structure that a residential treatment facility can provide.
Arturo Bendixen, director of the study and a vice president at the AIDS Foundation of Chicago, said housing first works only with the kind of intensive follow-up the study group was given.
The study is likely to add a push to an increasing national shift in homeless policy. Spurred in part by a Bush administration drive to end chronic homelessness over 10 years, many cities are moving to a housing-first policy.
The Chicago study “takes us another deeper step into what we know in the field,” said Philip Mangano, executive director of the U.S. Interagency Council on Homelessness, who has pushed the housing-first model since President Bush appointed him in March 2002. “The old status quo responses of ad hoc crisis intervention are more expensive.”