Various sets of public and private, homeless and mainstream system actors need to make commitments and play their parts for systems to change. A community is more poised for successful system change if all of the stakeholders share the goal of ending homelessness, are committed to bringing the goal to fruition, and are open to changing their own systems to make it happen. However, even if only a few agencies are on board, the agencies may act as champions of the process to engage other stakeholders. Ideally the founding partners will be agencies that are pivotal to change, but the specific agencies involved will vary from community to community depending on the population being targeted and the structure of the community. For instance, if a community is targeting family homelessness, critical agencies may be the child welfare, TANF, and workforce development agencies; the public housing authority; and key homeless system leadership. If chronic street homelessness is the issue, law enforcement; the courts; and mental health, substance abuse, corrections, and public benefits agencies will likely be involved in addition to homeless assistance agencies and, sometimes, the business community.
It is likely that several of the key stakeholders will not be at the table at the beginning of the process, and they will need to be convinced to participate. All stakeholders do not have to be involved from the beginning, nor do all stakeholders need to be involved in all aspects of system change. Different communities have had success using different models. Some work on system change within the homeless system, slowly engaging one mainstream agency at a time; some work with several mainstream agencies to develop one component of a community system such as PSH; and some start with mainstream agencies and work on changing the homeless system in later stages. The local context and motivation for change will determine which strategy is likely to work best.
Local communities seldom control key resources or are in a position to make policy decisions essential to ending homelessness. A city will be dependent on cooperation from county agencies that control key resources such as public benefits and health and mental health services. Cities and counties will be dependent on state agencies and their policies, especially policies affecting resources essential to addressing homelessness, including housing, health care, mental health care, and substance abuse treatment. As homelessness is, at base, lack of housing and the ability to afford housing, a local effort to end homelessness will have a much better chance for success if the agencies that can offer housing or that control housing policy are at the table. These include public housing authorities, state housing finance agencies, and community and economic development agencies. Many of the critical housing agencies have an autonomous or semi-autonomous status, being neither city, county, nor state agencies in the usual sense, adding another layer of who controls what to the mix of agencies needed for success.
For the past three years, the first author has been involved in evaluating the multisite Taking Health Care Home (THCH) initiative of the Corporation for Supportive Housing (CSH). This project is designed to move systems in a direction that will promote the development of permanent supportive housing, using a grant as its primary lever for moving systems. All THCH sites invested a portion of grant resources in a coordinator. A recent report (Burt & Anderson, 2006) examined the changes in the study communities at the two-year mark.
Three THCH communities (Portland/Multnomah County, Seattle/King County, and Maine) were the most ready for change, in that at least one public agency had already realized the importance of PSH and had taken its own steps to move more of its resources toward PSH development. The most involved agency in each community took the lead in applying for THCH funds, usually on behalf of a large collaborative body that was already in existence or with the explicit commitment of at least one other agency to work toward system change. The early buy-in of these agencies laid the foundation for relatively rapid and successful system change once the THCH funding was received and a coordinator was assigned to manage the change process.
These three communities differed substantially in the degree to which state agencies were involved in their system change efforts. Portland/Multnomah County proceeded largely without state-level involvement, as the climate for such involvement was unfavorable to investment in homeless issues and no other communities in the state could be counted on to apply pressure to turn that resistance around. Seattle/King County might have found itself in the same situation, were it not for the THCH investment strategy that put resources into both ends of the state in Seattle/King County and in Spokane. From the beginning, an element of the Washington strategy was to develop new state-level funding streams; generating pressure from areas of the state other than the largest population center of Seattle/King County would be critical for success. Another part of the strategy was to include state agency representatives in the Seattle/King County funders group. These representatives became very familiar with the arguments for ending chronic homelessness through permanent supportive housing, and were later instrumental in helping to design a strategy for new state legislation and getting that legislation passed. By the end of two years of organizing, the Washington legislature had approved new legislation that is now providing resources to combat homelessness in every county based on real estate transactions, plus resources to combat family homelessness, and new resources for substance abuse treatment. In Maine, the THCH project was located in a state agency, the housing finance agency, and the primary work of the project involved organizing agencies at the state level. Action at the state level to provide capital resources, facilitate operating resources, and match clients to supportive services through Medicaid and other mechanisms has supported the work of regional councils that do the bulk of local planning, and the work of local providers that develop and run the programs that deliver services to actual clients.
There are other examples of states that have developed state-level strategies and resources for combating or ending homelessness that facilitate local planning and implementation and make it easier for providers in local communities to meet the needs of individual clients.
- In 2004, Minnesota promulgated a state 10-year plan for ending long-term homelessness (Minnesota Departments of Human Services and Corrections, and Housing Finance Agency, 2004). The plan calls for the development of 4,000 new units of permanent supportive housing within seven years at an estimated cost of $540 million. State sources were projected to supply two-thirds of this amount, including capital resources ($90 million in general obligation bonds, $90 million in housing finance agency resources, and $60 million in tax credit financing) and supportive service resources ($120 million through the Department of Human Services, including state appropriations and various public benefits). The working group that developed the plan issues regular progress reports. As of fall 2006:
- 1,091 of the 4,000 promised new units had received funding commitments and were underway.
- The legislature appropriated and the Department of Human Services awarded the first $10 million in state funding for supportive services to seven multi-county consortia.
- California has recently passed several important pieces of legislation or voter initiatives that make new resources available for addressing homelessness and the disabilities that often keep people homeless for long periods of time. These include:
- 2006 a new state housing bond issue for $2.85 billion to create affordable housing throughout the state, with a component aimed directly at developing permanent supportive housing for chronically homeless people.
- 2005 Proposition 63, which became the Mental Health Services Act in 2006, provides close to $200 million a year statewide. Allocations are up to each county, but it is expected that a significant portion will be used to provide the supportive services that help keep people with severe and persistent mental illness in housing.
- In November 2005, New York announced a new wave of the New York/New York Initiative, known as New York/New York III, to create 9,000 new units of permanent supportive housing by the end of 2015. As did earlier waves, the first of which was signed in 1990, this third wave of combined state and city funding will focus on ending or preventing homelessness among single adults with severe and persistent mental illness. It will have a broader focus as well, serving single adults with substance abuse disorders or HIV/AIDS, families with a disabled head of household, and youth aging out of foster care.
- Investments in Connecticut and Massachusetts are described in more detail later in this paper.
These examples illustrate the importance of and potential results associated with involving agencies with resources and decision-making authority, particularly at the state level. Without their intimate involvement, it will be significantly harder to effect changes in power or money. With their involvement and support, these agencies may identify problems within their own systems and suggest solutions to address them. It is also important to note that some of these state-level changes focus on assisting the larger categories of extremely poor people or people with a certain disability rather than just people who have already become homeless. By implication, they also involve stakeholders who may not be directly involved in ending homelessness but who can be significant allies in securing policies that should reduce homelessness by reducing the likelihood that people in these categories will become homeless in the first place. Increasing the availability of affordable housing, whether through rent subsidies to low-income households or public investment to reduce capital costs, is probably the single biggest public policy that could affect levels of homelessness (Quigley, Raphael, & Smolensky, 2001; Dasinger & Spieglman, 2006). Assuring housing with supportive services to populations whose disabilities, coupled with extremely low incomes, are known to increase their vulnerability to becoming homeless is another non-homeless-specific strategy that could have a substantial impact in reducing the flow into homelessness.
In the discussion above, we have talked mostly about the roles of the usual suspects homeless assistance providers and government agencies whose missions connect to homelessness through funding, direct service, or both. Communities that have succeeded in involving a wider variety of stakeholders have found their presence to be useful in many ways. The participation of state and local elected officials can be critical to securing the funding needed to carry out the new plans, and also to helping interpret and champion the new plans to the general public. Business associations and business improvement districts have participated in developing and implementing plans to end homelessness, and have also contributed significant resources and developed service structures of their own in Philadelphia; Denver; Washington, D.C.; Columbus, Ohio; and many other communities. Community leaders were the main participants in Reaching Home, Connecticuts public education campaign that sought to win public support for state investments needed to end chronic homelessness. Foundations, such as the Melville Charitable Trust in Connecticut, have played major leadership and funding roles in some communities. The Conrad F. Hilton Foundation is another example the foundation recently invested $8 million in efforts in Los Angeles to reduce chronic homelessness among people with serious mental illness, and pursues a number of initiatives to stimulate the city and county to develop and implement approaches to ending homelessness that have a known track record of success.