housing first an evidence based social innovation to tackle homelessness l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Housing First! An Evidence-based Social Innovation to Tackle Homelessness PowerPoint Presentation
Download Presentation
Housing First! An Evidence-based Social Innovation to Tackle Homelessness

Loading in 2 Seconds...

play fullscreen
1 / 16

Housing First! An Evidence-based Social Innovation to Tackle Homelessness - PowerPoint PPT Presentation


  • 107 Views
  • Uploaded on

Housing First! An Evidence-based Social Innovation to Tackle Homelessness. Dennis P. Culhane University of Pennsylvania. Today:. What is “housing first”? Etymology Core principles What it is not Qualifications Emergent federal policy in the US. What is “housing first”?. A slogan

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Housing First! An Evidence-based Social Innovation to Tackle Homelessness' - kimi


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
housing first an evidence based social innovation to tackle homelessness

Housing First! An Evidence-based Social Innovation to Tackle Homelessness

Dennis P. Culhane

University of Pennsylvania

today
Today:
  • What is “housing first”?
  • Etymology
  • Core principles
  • What it is not
  • Qualifications
  • Emergent federal policy in the US
what is housing first
What is “housing first”?
  • A slogan
  • A philosophy
  • A program model
  • A brand
  • A policy
  • All of the above
etymology
Etymology
  • 1993 – “Beyond Shelter” publication (T, Tull)
  • 1998 – Natl. Alliance to End Homelessness
  • Mid 2000s – Applied to Consumer Preference Supported Housing (CPSH) (Tsemberis, Pathways to Housing)
  • 2009 – HEARTH Act/HPRP, US Congress
cpsh program model
CPSH Program Model
  • Established by Pathways to Housing in 1992

Assumption: Housing is a right to be honored, not a privilege to be earned.

Consistent with Americans with Disabilities Act principles: Access and reasonable accommodations

cpsh program model6
CPSH Program Model
  • Core Principles:
    • Consumer choice and empowerment
    • Separation of services and housing
    • Services are voluntary and flexible
    • Community integration
    • Harm reduction and recovery oriented

Are these principles distinct from PSH in general?

cpsh program model7
CPSH Program Model
  • Key Differences:
    • The Target Population:
      • People who are long-term homeless, service “resistant” or “noncompliant,” or who are not effectively treated with existing therapies.
      • People who can’t get into existing PSH or who get evicted from existing PSH.
    • Sobriety or treatment compliance is not required (although, philosophically, PSH is supposed to be similar in this regard).
slide8

Tsemberis slide, 2010

Treatment First Model

Permanent housing

Transitional housing

Level of independence

  • Underlying theory and values:
  • Transitional placements provide
  • for stabilization and learning.
  • Individual change is required
  • through treatment.
  • Consumers must ‘earn’
  • permanent housing

Shelter placement

Homeless

Treatment compliance + psychiatric stability + abstinence

slide9

Tsemberis slide, 2010

Housing First Model

Permanent housing

Transitional housing

Shelter placement

Ongoing, flexible supports

Homeless

cpsh program model10
CPSH Program Model
  • Limits on Consumer Choice:

Legal compliance

Tenant rental contribution (30% of income)

Mandatory weekly home visits

evaluating housing first

Tsemberisslide, 2010

Evaluating Housing First
  • Highly effective program for the ‘hard to house’
  • 85% housing retention rates across many cities and programs
  • Access problems eliminated, retention increased
  • Reduction in acute care services and significant cost savings (pre=post)
  • Improves quality of life
  • SAMHSA’s “National Registry of Evidence-based Practices”

Tsemberis effectiveness (2004);

HUD Pearson 6 cities (2007);

VA Rosenheck 11 cities (2007);

Larimer, cost (2009).

some qualifications
Some Qualifications
  • Tsemberis study compared CPSH to “usual care” not to other PSH programs
  • Not clear that there are differences from PSH more generally – lacking published fidelity measure.
  • When does “first” clock start? (Goal 60 days to housing)
  • Some transitional housing often needed or used (Pathways to Housing sometimes places people in safe havens or in temporary housing prior to apartment)
  • Local political sensitivities sometimes requires some “readiness” or engagement before placement.
has housing first become a brand
Has “Housing First” Become a Brand?
  • Pathways CPSH model was promoted by Bush administration USICH (Mangano); led to visibility and association with “housing first” slogan
  • Now “franchised” to four countries and many cities
  • But is it different than PSH more generally? What constitutes fidelity?
other concerns
Other concerns
  • Not for everyone?: Some PSH residents prefer clean and sober housing, and neighbors
  • Not everyone consistently fails in treatment
  • US context: Screening tool (“Vulnerability Index”)
      • Unknown psychometric properties
      • Case mix problems in practice and policy: Should policy promote “silting” (inverse of “creaming”)?
housing first as policy
Housing First! as Policy
  • HEARTH Act: promotes “housing first” principles: rapid rehousing, followed by community-based services (“homeless” aren’t different from housed)
  • Shift away from shelter-based supportive services and transitional housing
  • Applied to families and transitionally homeless adults
  • A prevention-centered approach is emergent: Housing First! as official policy