CURRENT HOMELESS SERVICES POLICY

Bureaucracies naturally focus on their funding streams. Since a large part of the funding stream for homeless services comes from Metro’s housing taxes, the Homeless Service Department’s policies focus on housing.

In theory, the homeless are supposed to move into shelters and then move to supportive housing…an apartment or room with regular visits from social workers and other professionals who help them transition from the street into a regular living situation.

However good this might sound in theory, in practice, the current policies are only appropriate for many of the short-term homeless and the “at-risk” population. Most of the supportive housing does not offer the intensive support needed by the chronically homeless drug addicts and recovering addicts, nor for the seriously mentally ill. And housing providers, their insurance companies, and their residents do not want active drug addicts or people with severe mental health problems in their buildings, so they stay on the street.

The performance metrics used by the Supportive Housing bureaucracy reinforce this. “Success” is measured by the number of people housed and how long they stay in the housing, which sounds reasonable. But the fall-out rate among addicts is high, if they can be placed at all. Therefore, and in line with the incentives built into the performance metrics, most of the supportive housing effort goes into housing the “at-risk” population, who typically have fewer chronic problems and are therefore easier to “support” and place. Only 11% of supported housing placements are to people from shelters…those who are truly homeless. While this is justified as helping people who might become homeless, no data is offered indicating that this is the best way to spend the money.

It is worth noting that the county calls its program “Housing First”. But it seems to be only a shadow of the real, nationally recognized Housing First program, which matches individuals with the level of support and care that they need as they progress away from homelessness.

GAPS IN THE SYSTEM

What do the chronically homeless addicts need to begin their path to recovery? (and what is falling through the cracks in the system?)

From interviews with addiction-recovery service providers, people recovering from addiction need to go through several stages before they are ready for the kind of supportive housing the county provides. These start with the sobering and withdrawal process, followed by treatment and recovery. While the exact facilities needed and length of time depend on the individual, the early stages often require 24/7 inpatient care. Treatment and recovery often require intensive outpatient care, or “transitional housing”. While sobriety and recovery take 2-6 days, the later stages can take weeks or months, even over a year. Only then can they successfully transition to the county’s “supportive housing”.

The problem is that transitional housing requires specialized facilities and staff, while the staff for county-funded supportive housing is usually comprised of regular social workers working regular hours with limited training in handling the medical and psychiatric issues of withdrawal management.