VIA US Inter-Agency Council on Homelessness

 Aligning Hearts, Heads, & Budgets to End Chronic Homelessness in 2017

By Richard Cho

• Ending chronic homelessness will help bend the health care cost curve – There is broad agreement that health care spending is something that we need to get a handle on, and that one of the ways to do this is to prevent hospitalizations and emergency department visits among the small subset of people with complex care needs and chronic health conditions—sometimes known at ‘super-utilizers’—who are responsible for a big portion of public health care costs. It has also been documented that individuals experiencing chronic homelessness are well-represented among health care super-utilizers. 

1. For example, one analysis in Connecticut identified about 400 individuals experiencing chronic homelessness that cost roughly $28 million a year in Medicaid costs. At the same time, the evidence is overwhelming that permanent supportive housing can dramatically reduce those costs, cutting them by as much as one-quarter or a third.
2.  It is this evidence that’s led the National Governors Association to include a focus on supportive housing as part of their Complex Care Programs Policy Academy, focused on improving care and reducing costs among Medicaid super-utilizers.  .  .  .
   

• Ending chronic homelessness is part of the solution to mass incarceration – Another area where there is incredible bipartisan support is on criminal justice reform. 

1. There is growing consensus that mass incarceration has not made our cities and streets safer and has come at grave costs both to communities as well as to budgets. Corrections spending is among the highest budget items for states second only to Medicaid. 
   
2. There is a significant overlap between people experiencing chronic homelessness and people involved in the criminal justice system. 
3. Roughly 48,000 people who enter shelters every year report prison or jail as their prior residence and about 15 percent of people in jails (about 340,000 people every year) report having experienced homelessness. 
4. Jails have become the warehouses for persons with serious mental illness and people with substance use disorders.
5. Many of these individuals—particularly those experiencing chronic homelessness—are caught in a revolving door of homelessness and incarceration. 
6. Here again, permanent supportive housing has been shown to be an effective solution for people caught in this cycle. 
7. Studies have found that supportive housing reduces the rate of arrests, the number of jail bookings, and the number of days spent in jail. 
8. This has led some states like Connecticut to include permanent supportive housing as part of their comprehensive criminal justice reform initiatives.
   

Link to Richard Cho's US Inter-Agency Council on Homelessness Blog:
http://usich.gov/blog/aligning-hearts-heads-and-budgets-to-end-chronic-homelessness-in-2017