Despite the perception that the issue of homelessness can never be solved, we actually know what works: permanent supportive housing, or in other words, housing with wrap-around professional support services that include mental health and addiction programs. Now that this has been firmly established here in Hawaii and across the nation, we know there is no shortcut to addressing the unsheltered homeless who are living on our streets and other public spaces. Most of those who remain in places unfit for human habitation are very ill and need both a stable place to sleep and support services to become healthy again and reintegrate into society.
Housing First, one of the most-studied forms of permanent supportive housing, delivers the kind of results our island communities need. A University of Hawaii evaluation of the city’s program determined that after three years, 86% of those housed through Housing First remained in housing. Even more promising, a report of participants in 2018 indicated that 91% of program participants were identified as chronically homeless and over 60% of those came directly from city streets.
Meanwhile, the state’s Housing First program has a 92% retention rate over five years, with almost 75% identified as chronically homeless.
Yet another evaluation of both the city and state Housing First programs found that after clients were housed, estimated per client monthly savings in health care alone totaled $6,200, a reduction of 76%.
Some people may not be aware that over the past two years, Oahu has actually reported its first declines in homelessness since 2009. This year, the total homeless count dropped by 4% (184 persons) to 4,311. While most of the decline was driven by reductions in sheltered homelessness (-19%, or 440 persons to 1,910), the number of unsheltered homeless persons increased significantly (+12%, or 256 persons to 2,401). Although the more detailed Point in Time Count report has yet to be released, we know from past experience that most of those living on our streets are among the most ill — the exact population Housing First is designed to help.
So, why have we seen reductions in sheltered homelessness? In a nutshell, we are moving more people into permanent housing than ever before due to strong implementation of housing programs by our many service providers, in addition to increased affordable housing units such as Kahauiki Village (Kalihi), Kauhale Kamaile (Waianae), and Ena Road (Waikiki).
Ultimately, the only solution to homelessness is a combination of housing and personalized support services, especially those targeting homeless individuals and families.
On April 1, those who serve the homeless on Oahu (Partners in Care) and the neighbor islands (Bridging the Gap) presented state lawmakers a unified solution agenda: sustained annual commitments for truly affordable housing, which includes targeted housing for the chronically homeless; sustained annual commitments for core homeless services such as Housing First; and changes to mental health laws to ensure people incapacitated by mental illness are connected with the help they need. More than 90 organizations, including business and government sector stakeholders, signed the agenda in support.
As stated previously, we know what works to address homelessness, and we know how much funding we need to save taxpayer money in the long run. What we need now is community support and the political will to do the right thing for those who live on our streets and remain vulnerable. It’s time for us to quit looking for the magic wand, and embark full speed ahead on what research, data and detailed evaluation has shown actually works.
Scott Morishige chairs the Hawaii Interagency Council on Homelessness and is the governor’s homelessness coordinator; Marc Alexander is executive director of the Mayor’s Office of Housing.