Public Housing Agencies and Permanent Supportive Housing for Chronically Homeless People. 9. Conclusions


We found some promising examples of strong leadership, innovation, and collaboration to use PHA resources to expand the availability of supportive housing for people who have had long histories of homelessness and to facilitate their access to the housing. Significant opportunities exist to support, strengthen, expand, and replicate collaborations that involve PHAs working with the public agencies that finance supportive services, as well as with community-based service-providers such as CHCs and providers of Medicaid-reimbursed behavioral health care services.

Additional PHAs and their Health Center partners might be encouraged to use the HRSA PHPC grant program for programs that can meet the needs of assisted families, including PSH housing subsidized through HUD programs such as Shelter Plus Care, HCVs, or public housing. This program might also be used for ongoing support services for “graduates” of PSH who use housing assistance. To date this HRSA grant program has not been widely used to finance services designed to meet the needs of tenants with histories of homelessness.

PHAs both with and without MTW status have implemented promising approaches to creating PSH and facilitating access to housing opportunities for the most vulnerable homeless people. They have used the flexibility they have in managing waiting lists and preferences to establish priorities for homeless people, and in some cases, to create separate waiting lists for PSH. They have “project-based” some vouchers to support site-based PSH. MTW PHAs have also experimented with “sponsor-based” models under which a provider of PSH signs a master-lease for a group of housing units and have converted some housing subsidy funds to funding for supportive services. HUD could examine further which approaches can be used by PHAs without MTW authority and highlight these practices. HUD might also discuss with MTW PHAs that are not collaborating to provide PSH the opportunities they might have to do so.

Community leaders and stakeholders involved in efforts to end chronic homelessness are interested in creating more opportunities to use resources controlled by PHAs to provide opportunities for PSH tenants who want to move on to less service-intensive affordable housing. This can enhance the ability of PSH to reduce the number of vulnerable, chronically homeless people who are living on the streets or in shelter. But it takes a coordinated effort to identify tenants who are ready to move--or ready to use a different type of housing subsidy to pay the rent while remaining in the same apartment. Most importantly, tenants who are “graduating from PSH” need a safety net to ensure that services and supports will be available if and when they need them. PSH providers may need some incentive to identify tenants who are ready to move on, to offer the support these tenants will need before, during and after making the move, and to use vacancies created by these moves to provide housing opportunities for the most vulnerable chronically homeless people.

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