In 1998, when the U.S. Departments of Health and Human Services (HHS) and Housing and Urban Development (HUD) sponsored the first National Symposium on Homelessness Research, the focus was primarily on describing the array of approaches to helping homeless people that had been developed during the previous decade, and how they worked. Few in the field had begun to address how a community might end homelessness.
Much has changed since that time. New programmatic approaches have evolved (e.g., Safe Havens), but more important, federal policy has stimulated the development of homeless assistance networks and systems. In 1995, after seven years of distributing McKinney Act Supportive Housing Program (SHP) funds through annual national competitions, HUD implemented the competitive continuum-of-care (CoC) approach for deciding who receives SHP support for transitional and permanent supportive housing. A CoC is a local or regional system for helping people who are homeless or at imminent risk of homelessness by providing housing and services appropriate to the whole range of homeless needs in the community from homelessness prevention to emergency shelter to permanent housing. Each year, HUD develops and publishes preliminary estimates of how much SHP funding each eligible community in the country would receive if it wrote a qualifying CoC grant application. To qualify, communities have to show that they have assessed needs and existing resources and identified gaps, and that the resources they are requesting from HUD will help fill the gaps that the community has identified as top priority. The entire process stimulated a new kind of communication among relevant programs and agencies, often leading to increased cooperation and program innovations and moving many communities closer to having a real system rather than a set of independently operating programs (Burt et al., 2002).
The processes of community organizing developed through the CoC process received a substantial boost beginning in 2000, when the National Alliance to End Homelessness (NAEH) developed and disseminated a plan to end homelessness for the whole nation in 10 years (NAEH, 2000). This plan incorporated a major shift in orientation and emphasis, from managing homelessness to ending it. This shift has been significant enough to be dubbed a paradigm shift in the nations approach to homelessness (Burt et al., 2004), because it entails important new ways of thinking about homelessness and concomitant changes in who should be served, what approaches should be used, and how resources should be allocated.
This shift, and the expectation that it could succeed, was made on the basis of research evidence. Three pieces of information from research helped advocates make a convincing case that shifting the goal from managing homelessness to ending it was both the right thing to do and something that was possible to achieve:
- A finite group of homeless people on which to focus was identified. Research by Kuhn and Culhane (1998) documented subgroups among homeless people characterized by transitional, episodic, and chronic patterns of homelessness. These researchers also documented the fact that the 10 to 15 percent of people with a chronic pattern of homelessness consumed half or more of system resources in this case, shelter bed-nights making them a very expensive group to continue serving in emergency shelter while not resolving their homelessness. A reliable estimate of homelessness nationwide based on the 1996 National Survey of Homeless Assistance Providers and Clients (Burt, Aron, & Lee, 2001) then made it possible to estimate the number of chronically homeless people 150,000 to 250,000 a number that proved to be small enough for policymakers to believe that a solution was possible.
- An effective service approach was identified. Evidence accumulated that permanent supportive housing (PSH) worked to keep many formerly homeless people housed (Shern et al., 1997; Tsemberis & Eisenberg, 2000) especially those who were chronically homeless and had appeared to be most resistant to leaving homelessness.
- The solution was economically worthwhile. Research showed that PSH is cost-effective that it compares favorably in cost to outlays for public crisis and emergency services used by long-term homeless people, but with a better outcome: ending their homelessness (Culhane, Metraux, & Hadley, 2002; Rosenheck, Kasprow et al., 2003).
By 2001, ending chronic homelessness in 10 years had become a goal of the present federal administration. The federal Interagency Council on Homelessness was revitalized in 2001, and federal agencies mobilized to do their share. Federal agencies worked together to organize Policy Academies to help states begin planning to end homelessness. Nine Policy Academies and one National Learning Meeting were held between November 2001 and November 2005, attracting teams of representatives from the mainstream state agencies whose resources and energies would have to be committed if the goal of ending homelessness were to be achieved. Every state and two territories sent teams of state agency representatives to at least one of the five Policy Academies focused on ending chronic homelessness for individuals or the four Policy Academies focused on ending family homelessness. Almost every state created its own interagency council or task force on homelessness, and as of fall 2006, 13 states had adopted 10-year plans to end homelessness or chronic homelessness (Cunningham et al., 2006). Eight of these states were among the 17 that attended two Policy Academies, another indication of their commitment to do something serious about ending homelessness. Some attended two Policy Academies on ending chronic homelessness, while others attended one on ending chronic homelessness and another on ending family homelessness. The Policy Academies themselves, plus follow-up and technical assistance activities, laid the groundwork for mainstream state agencies, with their extensive resources, to become involved in state and local efforts to end homelessness.
HUD embraced the federal goal to end chronic homelessness by establishing a Government Performance and Results Act objective on homelessness, against which the Department is rated annually. Objective C.3. reads: End chronic homelessness and move homeless families and individuals to permanent housing. To support departmental progress on this objective, HUD used tools such as the competitive CoC grant process to support local change. By 2001, the vast majority of cities, counties, and states were organized into one of the more than 450 continuums of care that HUD stimulated through the annual CoC funding process (Burt et al., 2002). HUD began prompting communities throughout the country to adopt the federal goal as their own by requiring a section on plans for ending chronic homelessness and another on addressing other homelessness as part of annual applications. An increasing number of state and local governments have joined the federal government in formally committing themselves to ending chronic homelessness in 10 years. The majority have gone further, taking on the broader task of ending all homelessness. In the National Alliances analysis of the 90 10-year plans that are complete and have been accepted as state or local policy, 66 percent have the goal of ending all homelessness, with the remaining 34 percent focusing only on ending chronic homelessness (Cunningham et al., 2006).
We recount this history because it is directly pertinent to our task in this paper. A community can offer homeless assistance services for decades without needing, or getting, system change. System change can begin within the homeless assistance system, but the goal of ending either chronic or all homelessness will most likely also require commitment from mainstream public agencies. These agencies, be they city, county, state, or private, include mental health, substance abuse, welfare, health, child welfare, workforce development, criminal justice, and above all, subsidized housing and community development. Moreover, mainstream agency involvement must be active, as these systems themselves need to change if the goal of ending homelessness is to be reached. No community is likely to end either chronic or all homelessness without mapping out a multi-year strategy and moving toward it systematically. The resources and actions of mainstream service agencies are essential to the success of any such strategy. So system change how to do it, how to know youve done it, and how to show that the changed system is succeeding in ending homelessness has moved to the forefront of attention.
This paper looks at the process of system change and presents some lessons learned from pioneers in the effort to end homelessness that can be applied more broadly. The paper will also note early successes of system change related to the goal of ending homelessness. The paper does not discuss what an effective system to end homelessness should look like, for two primary reasons. First, system change efforts are still in early stages and we have much to learn before we can draw such conclusions. Second, a good argument can be made that the configuration of a changed system to end homelessness must be defined by local decision makers. Other papers in this Symposium may tell us what works for specific populations, and local decision makers may pick and choose among the best. But the balance of system elements will still depend on local factors.