Cluster Distributions: Persons and Shelter Days Consumed

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					The Dynamics of Homelessness



        Dennis P. Culhane
     University of Pennsylvania
Point and Period Prevalence of Public Shelter
  Utilization: New York and Philadelphia
3.5

 3
2.5

 2                                   1 Day
                                     1 Year ('92)
1.5                                  3 Years ('90-'92)
 1                                   5 Years ('90-'95)

0.5

 0
      New York City   Philadelphia
  Proportion of NYC Population That Experienced a Shelter
                   Stay in 1995, by Age
% of NYC Population Experiencing a




                                     5%
                                                                                       1995 Proportion by Age
                                                                                       General 1995 Proportion
                                     4%
          Shelter Stay




                                     3%


                                     2%


                                     1%


                                     0%
                                          0   5   10   15   20   25   30     35   40   45    50    55    60      65

                                                                           Age
      Proportional Age Distribution of NYC Single Adult
                        Shelter Users
                   in Four Different Years
14%


                                                                                                                               1987
12%
                                                                                                                               1991
                                                                                                                               1995
10%                                                                                                                            1999


8%



6%


4%



2%


0%
       18

               21

                       24

                               27

                                       30

                                               33

                                                       36

                                                               39

                                                                       42

                                                                               45

                                                                                       48

                                                                                               51

                                                                                                       54

                                                                                                               57

                                                                                                                       60

                                                                                                                               63

                                                                                                                                       66

                                                                                                                                               69

                                                                                                                                                       71
        -2

                -2

                        -2

                                -2

                                        -3

                                                -3

                                                        -3

                                                                -4

                                                                        -4

                                                                                -4

                                                                                        -5

                                                                                                -5

                                                                                                        -5

                                                                                                                -5

                                                                                                                        -6

                                                                                                                                -6

                                                                                                                                        -6

                                                                                                                                                -7

                                                                                                                                                        -7
           0

                   3

                           6

                                   9

                                           2

                                                   5

                                                           8

                                                                   1

                                                                           4

                                                                                   7

                                                                                           1

                                                                                                   3

                                                                                                           6

                                                                                                                   9

                                                                                                                           2

                                                                                                                                   5

                                                                                                                                           8

                                                                                                                                                   1

                                                                                                                                                           3
                                               Numbers of Men

            18




                                 2000
                                        4000
                                                                 6000
                                                                                         8000
                                                                                                10000
                                                                                                        12000




                             0
                  to
                       21
            22
                  to
                       24
            25
                  to
                       27
            28
                  to
                       30
            31
                  to
                       33
            34
                  to
                       36
            37
                  to
                       39
            40
                  to
                       42
            43
                  to
                       45
            46
                  to
                       48




Age
            49
                  to
                       51
            52
                  to
                       54
            55
                  to
           58          57
                an
                   d
           60          59
                an
                   d
                       61
            62
                  to
                       64
            65
      75          to
           an          74
              d
                  ol
                    de
                         r
                                                                                                                US Men in Emergency and Transitional Shelters, US Census Bureau




                                                   2000 Census Data
                                                                      1990 Census Data
Cluster Distributions: Persons and Shelter Days Consumed
                       (Single Adults in Philadelphia)

  90%                                                       Transitionals:
  80%                                                           1.19 stays
  70%                                                           20.4 days
  60%                                                       Episodics:
  50%                                                           3.84 stays
                                                                72.8 days
  40%
                                                            Chronics:
  30%
                                                                1.53 stays
  20%
                                                                252.4 days
  10%
   0%
        Transitional       Episodic       Chronic
                 % of Persons    % Days Used
 Disability Condition & Veteran Status By Cluster
               (Single Adults in Philadelphia)

90%
80%
70%
60%
50%
40%
30%
20%
10%
 0%
      Mental Illness       Medical       Substance         Any One
                                           Abuse

                       Transitional   Episodic   Chronic
                   Implications
 TransitionallyHomeless: Prevention and
  Relocation Assistance
 Episodically Homeless: Low Demand Residences
  (Safe Havens), Harm Reduction, Transitional
  Housing, Residential Treatment
 Chronically Homeless: Permanent Supportive
  Housing
The New York-New York Evaluation
               Culhane, Metraux and Hadley, 2002



         Funded capital, operating and service costs for 3,600
               supportive housing units in NY City

   • Placement recipients must be SMI and have record of
         homelessness
   •   Data available on 4,679 NY/NY placement records between
        1989-97
                      Data Sources

             NY/NY Housing Placements: 1989-97

           Singles Shelter Users and Stays: 1987-99

             State Hospital Users & Stays: 1990-96

           Municipal Hospital Users & Stays: 1989-96

Medicaid-Reimbursed (non-HHC) Inpatient Hospital Stays: 1993-97

        Medicaid-Reimbursed Outpatient Visits: 1993-97

               Veterans Hospital Stays: 1992-99

    State Criminal Justice Prison Use & Convictions: 1987-97

                     City Jail Use: 1987-99
        The Cost of Homelessness
                         Mean Days         Per
                        Used (2-year      Diem     Annualized
  Service Provider      pre-NY/NY)        Cost       Cost
NYC DHS – Shelter                 137        $68        $4,658
NYS OMH – Hospital                57.3     $437        $12,520
NYC HHC – Hospital                16.5     $755         $6,229
Medicaid – Hospital               35.3     $657        $11,596
Medicaid – Outpatient     62.2 (visits)     $84         $2,612
VA – Hospital                      7.8     $467         $1,821
NYS DCJS – Prison                  9.3      $79          $367
NYC DOC – Jail                      10     $129          $645
Total                                                  $40,449
     NY/NY Savings:
Per Housing Unit Per Year
        Service            Annualized Savings
                             per NY/NY Unit
DHS Shelter                     $3,779
OMH Hospital                    $8,260
HHC Hospital                    $1,771
Medicaid – Inpatient            $3,787
Medicaid - Outpatient           ($2,657)
VA Hospital                      $595
NYS Prison                       $418
NYC Jail                         $328
                   Total        $16,282
NY/NY Housing - Costs and Savings
 $18,000
 $16,000
 $14,000
 $12,000
 $10,000
  $8,000
  $6,000
  $4,000
  $2,000
      $0
           Savings Per Unit from        Annual Per Unit Cost of
                Reduction                      Housing
      Savings Per Unit from Reduction     Annual Per Unit Cost of Housing
                 Key Findings
 95%  of supportive housing costs offset by service
  reductions
 Study underestimated savings associated with
  program-funded services (McKinney) and crime
 Study did not quantify benefits to consumers
 NY/NY was a sound public investment
              What is Needed?
 Depending   on estimates, there are between 1.6
  million (5% of poor) and 2.5 million (app. 1% of
  population) people who become homeless annually
 Single adults account for between 1 million and
  1.65 million
 If 10-15% are chronically homeless, need
  anywhere from 150,000 to 250,000 units of
  housing to “End Chronic Homelessness” today
                       What is Needed?
 Operating Subsidies (Section 8, other rental
      assistance)
 Services (HHS? States? VA? The “Savers”)
    Where necessary:
   Capital (bond financing, tax credits, lenders)

Congress authorized $100m and $200m increases in last two
  years for the “chronic homeless initiative” (25% increase)
Twenty four cities have reported declines in chronic
  homelessness in last two years.
A Typology of Family Homelessness:
       Preliminary Findings


                 Dennis Culhane
            University of Pennsylvania

                 Stephen Metraux
     University of the Sciences in Philadelphia

                    Jung Min Park
     University of Illinois at Urbana-Champaign
                Background
   Singles typology experience
   But families are different:
        - much lower MH/SA rates
        - not different from poor housed families
        - relatively homogeneous
   Potential confounders – policy/program factors
        - use of shelter system as queue for subsidies
        - transitional shelter as a reform movement
         Methodology
 Four  jurisdictions – Philadelphia, NYC,
  Columbus OH, and Massachusetts
 HMIS data – new admissions followed for two
  or three year periods
 30 day exit criterion applied
 Cluster analysis, specifying three cluster
  solution
 Database merges to identify service histories
  Health and Social Service
     Databases Merged
 Inone city: Medicaid, Mental Health,
  Substance Abuse, Child Welfare

 Inone state: Medicaid, Mental Health,
  Substance Abuse, Child Welfare

 In   one city: Child Welfare
      Results: Cluster Solution
          (Massachusetts, family shelter users)

80%
70%
                                                        Transitionals:
60%
                                                            1.0 stays
50%                                                         105 days
40%
                                                        Episodics:
30%                                                         2.0 stays
20%                                                         195 days
10%                                                     Long-Stayers:
0%                                                          1.0 stays
       Transitional     Episodic      Long-stayers          444 days
                % of Persons   % Days Used
Intensive Service Histories of Families
    60%
    50%
    40%
    30%
    20%
    10%
    0%
          Child Welfare    Inpt MH         Inpt SA          Any one
           Placement

                      Transitional   Episodic   Long-Term
  Income Sources

50%

40%

30%

20%

10%

0%
      Earned Income                            SSI
         Transitional   Episodic   Long-Term (n=99)
                       The Average Cost of
                       Shelter Stays by Type
                                        (Massachusetts)



 Transitional                                                $11,550
 Episodic                                                    $21,450
 Long-term                                                   $48,440


Does not include McKinney-Vento funding or non-DTA public service contracts.
    Preliminary Conclusions
 Cluster patterns are robust across sites
 Most families (75%) leave quickly and don’t return
 A small number (5-8%) return repeatedly
 20-25% of families have long stays, using 55-70% of
  resources
 BUT – unlike singles – long stays do not indicate
  personal barriers to housing stability
Preliminary Conclusions (continued)
  Policies and programs driving long stays
  Characteristics of “graduates” may reflect
   selection effects of policies and programs
  Most needy families get fewest system
   resources, and least needy families get most
   system resources
  Need for reform: A new conceptual
   framework required
         Model Cost by Volume Service System
         for Addressing Housing Emergencies
                         Shelter Admission

                                   Diversion,
                                   Relocation and
       V                           Transitional Rental
       o                           Assistance
       l
       u
 Prevention                             Supportive
       m
                                        Housing
       e

                 Cost per Case
Community-
Based programs
                                   Mainstream systems

				
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