Permanent Supportive Housing in the District of Columbia: Taking Stock and Looking Forward

Martha R. Burt, Sam Hall

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Abstract

With the generous support of the William S. Abell Foundation, the Urban Institute (UI) surveyed District permanent supportive housing (PSH) agencies and specific PSH projects, asking their staff to detail current projects and future ambitions. This research brief is an analysis of the stock of PSH in the District as of early fall 2008, demographic information on PSH tenants at that time, and a look at how the District might move forward toward fulfilling its commitment to create 2,500 new units of PSH and ultimately eliminating chronic homelessness.

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Highlights

It is increasingly clear that a critical aspect of ending homelessness in America is giving precedence to ending chronic homelessness. Permanent supportive housing (PSH) has proven to be an effective approach to reaching this goal. This report describes the PSH currently available in the District of Columbia and what will be needed to develop enough PSH to help all long-term homeless people leave homelessness for good.

Numbers

• The District had a total 2,741 permanent supportive housing (PSH) beds, or around 2,320 PSH units, during June-September 2008 (the time covered by our survey), virtually all of which are occupied by formerly homeless people.
• Increases since that time:
• As of August 7, 2009, through its Housing First Initiative, The Department of Human Services (DHS) had housed and is providing supportive services for an additional 475 chronically homeless, highly vulnerable single adults and 62 families, and is housing more every day.
• In summer 2008, District homeless assistance providers reported having over 1,600 more units of PSH in some stage of development.

Costs

• The 2,320 existing PSH units cost on average about $8,500 each to operate every year. These costs are paid for mostly by U.S. Department of Housing and Urban Development (HUD)/housing authority subsidies (55 percent), D.C. Department of Mental Health (DMH) contracts (30 percent), and tenant contributions to rent (8 percent).
• We estimate that each resident of a PSH unit is supported by about $7,200 in annual costs for supportive services; Medicaid payments for services cover most of these costs.
• One-time development costs for complete units (with kitchen and bath) averaged about $127,000 per unit; Single Room Occupancy (SRO) units were considerably cheaper to create, but tenants much prefer complete units, and stay longer in them. DMH also used $14 million in District Capital Improvement funds to renovate some of the 985 scattered site beds in its HomeFirst program.

Housing Characteristics

• Housing type—74 percent of the beds were scattered site, 90 percent of tenants hold their own lease
• Tenant households—77 percent were single adults, 23 percent were families
• Requirements for entering the PSH currently operated by District providers—78 percent of beds require being a DC resident, 73 percent require a serious mental illness, 48 percent require sobriety, 35 percent require one to be chronically homeless, 50 percent require a willingness to participate in services
• Reasons for eviction—destroying property and not paying rent are the most common reasons; 25 percent will evict for refusing to participate in services
• Subsidies for PSH beds—35 percent Shelter Plus Care, 28 percent HUD/SHP, 27 percent DMH HomeFirst, 6 percent Local Rent Supplement Program (LRSP), 5 percent Housing Opportunities for Persons with AIDS (HOPWA)

Tenant Characteristics

• 51 percent were chronically homeless; 40 percent were homeless but their length of homelessness was not known
• Disabilities—79 percent had a serious mental illness, 41 percent had addiction problems, 29 percent had both, and 28 percent had a physical disability
• Income sources—45 percent received SSI, 17 percent had earned income, and 6 percent had no income source
• Time in PSH is long—79 percent were in PSH at least one year, and 62 percent were in PSH at least two years
• Post-PSH destinations—28 percent went to their own unit for which they had a rent subsidy, 7 percent went to their own unit without any subsidy, 8 percent went to a residential treatment facility, 7 percent died in PSH, and the destination of 18 percent who left was unknown to PSH staff

The Future

• Provider involvement—70 percent are very likely to be involved in providing PSH in the future; 19 of 23 homeless assistance agencies have long histories of doing PSH and expect to continue
• Biggest inducements to continue—money, especially confidence that the funding for operations (rents) and supportive services will continue from year to year
• Needed for maximum effectiveness in ending homelessness—careful targeting to the most vulnerable, multiply disabled, longest-term homeless single adults and parents in homeless families
• Needed for adequate PSH production—more resources and an effective strategy for streamlining PSH funding of new projects that assures providers that all the pieces will come together and stay together over time.

Introduction

It is increasingly clear that a critical aspect of ending homelessness in America is giving precedence to ending chronic homelessness. Permanent supportive housing (PSH) is being promoted by many cities, housing specialists, and advocates as the "silver bullet" for ending chronic homelessness. A unit of permanent housing whose tenant is supported by a comprehensive set of services, it is argued, is the long-awaited answer to one of the more difficult and persistent policy problems a city or country can face—how can we stabilize a community's most unstable citizens?

Evidence from an increasing number of cities supports this argument for PSH development. Cities such as Denver, San Francisco, New York, and Portland, Oregon, have shown dramatic reductions in chronic homelessness after launching extensive PSH development strategies.

The data are in: housing supported with permanent subsidies combined with such services as physical and mental health care, substance abuse treatment, and general housing stabilization and case management can indeed stabilize chronically homeless individuals and families. Many are able to reach the point where they break free from the revolving door of shelters, emergency rooms, detoxification centers, incarceration, and other emergency services that can be so costly for municipalities and continuums of care.

What is also clear, however, is that for many cities, effectiveness depends on supply and focus—the issue is, where do we get these units and whom do we house?

For the District of Columbia, the process of establishing and targeting PSH has already started. As part of Homeless No More, an ambitious 10-year plan to end chronic homelessness promulgated in late 2005, Mayor Adrian Fenty and DC DHS Director Clarence Carter are working to fulfill a commitment to create 2,500 new units of PSH by 2014. In addition, the District has used a survey of close to 3,000 homeless people to ascertain which are the most vulnerable; has identified almost 4,000 homeless people as highly vulnerable, based on their survey responses; and is targeting new units to house this most vulnerable segment of the homeless population. To ensure the success of this plan, though, the District needs to know more about its current stock of PSH, the current PSH tenant base, and the willingness of District PSH providers and other housing developers to step up to the task of developing new projects and supporting their tenants with appropriate services.

To that end, with the generous support of the William S. Abell Foundation, the Urban Institute (UI) surveyed District PSH agencies and specific PSH projects, asking their staff to detail current projects and future ambitions. What follows is an analysis of the stock of PSH in the District as of early fall 2008, demographic information on PSH tenants at that time, and a look at how the District might move forward toward fulfilling its commitment to create 2,500 new units of PSH and ultimately eliminating chronic homelessness.

(End of excerpt. The entire brief is available in PDF format.)

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