Time Magazine had a story last year about a study out of San Francisco which I missed. It was about the declining costs of providing social services to formerly homeless people as they age in Permanent Supportive Housing. So, after the first two years of high costs, the social service support goes down significantly.
I also checked out the City of San Francisco report that this story is based on and the finding seem consistent with what is happening in Cleveland. Nearly all residents benefited from the service, obviously. They were generally older and there are a few individuals in the housing who have very high costs with hospital stays. They have more medical and behavioral health services after being placed in the housing. San Francisco was looking at different models to see which is the most effective. In Cleveland, we basically have only one style of Permanent Supportive Housing owned by EDEN and supportive services provided by Frontline Services.
While they were living on their own in the first years of the study, the costs to the city and other federal and state sources was roughly $19.4 million, which breaks down to an average of about $21,000 per person. (Not all people being tracked have records of accessing services in a given year.) The biggest costs were for urgent care, jail time and behavioral health services.
This all makes sense because they are typically self medicating with drugs or alcohol. They are not taking care of their mental health issues, and may have any number of other health issues. The issue that I do not understand is why these on-going costs are being funded by the homeless programs. If a guy has been in housing for two years, they are no longer homeless. Why do the emergency services have to continue to pay for these costs in our community? Why isn't the Mental Health Board or the Alcohol and Drug community or the Health care community paying for these support services? We could put the homeless dollars back to work to keep people alive who are dying on the streets. We could fund more beds for people waiting for a shelter. We could provide rental assistance to get families back into housing quickly. We could fund homeless legal assistance program to prevent evictions. We could pay for more outreach staff to find people sleeping at the airport or in abandoned buildings. We could pay for a panhandling outreach staff to help with jobs for those who are so desperate that they beg for money.
No one asks the bottom line question: Why are the homeless programs suffering with closings and constantly being starved for funds, when the Permanent Supportive Housing programs are using the homeless dollars to support the social services for these guys for five, six, seven years? It just does not make sense that we are using emergency dollars for the long term support of some of our citizens.
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