The Ten Year Plan to End Homelessness
Social Work Today
Vol. 4 No. 1 p. 14
By David Surface

It was seven years ago at a conference for social workers in Berkeley, Calif., that Nan Roman had what she calls an “epiphany.” “I was speaking at this conference,” says Roman. “A retired social worker came up to me. We were talking and she said, ‘You know, I used to see families all the time who’d lost their housing and we’d find them another place to live. Now when they come in, we say, Oh, you’re homeless, and we send them to the homeless shelter.’”

What the retired social worker said resonated with Roman’s own experience. “I’d been working for a community action agency here in DC,” says Roman. “We were seeing some homeless people, and mostly we were dealing with that by finding them places to live. We were just beginning to refer people to shelters. That was the period when there was a shift at the community level—where we used to provide people with services and get them back into housing as quickly as possible. Instead, we started referring people to the homeless system.”

That was when Roman realized that “it’s what we do that defines homelessness as much as the experience that people have.” At the National Alliance to End Homelessness (NAEH), Roman, its president, works not only to redefine homelessness, but also our nation’s entire approach to solving the problem.

Changing Perspectives
The problem of homelessness in America started to emerge in the 1980s. “At that time, we thought it was an anomaly, an emergency situation,” says Roman. “The thinking was that people needed to be taken care of in the short term, and that when the economy improved, the problem would go away. But that’s not what happened.”

Another person who realized that the problem of homelessness was more complex and deeply rooted than originally thought was Elizabeth Boyle, MSW, secretary of the NAEH. “We realized in the mid- to late ’80s that this wasn’t a temporary problem but more of a structural problem,” says Boyle. “We began to look into the root causes. There were many—lack of affordable housing, mainly. Also, the loosening of the family structure, the loosening of the safety net of social services. So many elements were playing into all of this.”

Boyle and Roman first worked together for The Committee for Food and Shelter, a nonprofit organization incorporated in 1983. The purpose of the committee was to access federal services for homeless people and cut bureaucratic red tape.
Roman, who became involved with The Committee for Food and Shelter in the mid-’80s, traces its evolution. “They did an exceptional job of accessing surpluses for food and shelter. They’d worked with Second Harvest and food networks. They’d brokered agreements with the Department of Defense and Human Services to make commodities, cots, blankets, buildings available for shelter, and food.”

But, then it became clear that just meeting survival needs was not enough. As Roman puts it, “There were bigger forces at work. In 1987, we started focusing on housing issues and changed our name to the National Alliance to End Homelessness.”

Reevaluating Needs
To say that housing, or the lack of it, is at the root of homelessness seems like a no-brainer; yet, it was an idea that was not readily accepted when Roman first put it forth.
In the ’70s and ’80s when Roman worked at the National Association of Neighborhoods, she and her colleagues focused on residential displacement. “We realized that if we kept tearing down affordable housing buildings and converting them to condos and co-ops, there would be a shortage of affordable housing in cities. We were scoffed at by liberals and conservatives alike. They said that homelessness will never be a problem in the United States because people will not tolerate it.”

Time, of course, proved the critics wrong. By the mid-1980s, homelessness had become a national problem. What was not as obvious to the public at large was that the homeless assistance system that had sprung up to deal with the problem was not having the desired effect.

“We were all doing what we were supposed to be doing,” says Roman, “Yet, people keep coming into our system from all these other systems—mental health, veterans, foster care. We can’t control it. For every person who goes out of the back door, two more come in the front door.”

Using New Data
Roman cites two main forces that were behind the development of the alliance’s plan.

“First,” says Roman, “there was a new body of research from the University of Pennsylvania. All we had previously were these point-in-time counts that cities would do. These new data were more illuminating. [The information] described the dynamics of the problem better. It showed that people were different in how they used the system. Secondly, we also saw that the homeless system was getting bigger and bigger, but the problem was getting worse. Nationally, there were 40,000 programs to help homeless people. Everyone was doing exactly what we thought they should be doing, providing services, yet there weren’t fewer homeless people—there were more.”

Boyle agrees that the new data on homelessness from the University of Pennsylvania had a galvanizing effect. “We had data coming in that clarified who the homeless people were, why they were homeless, and what could best be done to end their homelessness,” says Boyle. “Because we had this information, we’ve been able to clarify how to solve the problem rather than Band-Aid it. We couldn’t have gotten to this step without that data.”

The Plan
The alliance’s plan to end homelessness is comprised of four steps:
1. Plan for outcomes: Collect better data at the local level, and create an outcome-driven planning process that involves all mainstream agencies whose clients are homeless.
2. Close the front door: Reduce incentives for other assistance systems to shift the cost of serving the homeless to the homeless assistance system.
3. Open the back door: Get people out of the homeless system and into permanent, supportive housing as soon as possible.
4. Create the infrastructure: Increase the supply of affordable housing and make the incomes of poor people adequate to pay for necessities such as food, shelter, clothing, and healthcare.

Reexamining Incentives
“One of the foundations of our 10-year plan,” says Roman, “is that if you have an infrastructure into which people can be shifted, they will be shifted into it. If all these other programs can shift cost into somewhere else, it will happen—not because anyone is evil, but because everyone is pressed for resources.”

“The system does present incentives to hospitals and prisons to dump people rather than give them the proper case management—because it doesn’t cost as much,” says Boyle. “It’s more expensive to have caseworkers on staff, to retrain, reacclimatize people. It’s not easy to do that. It’s expensive. We want to reallocate the money that goes into the shelter system. We need to require that our system help mental health, prisons, and foster care agencies all do the proper termination case management.”

Boyle recognizes the good work done by the current homeless assistance system. “What we’ve done—the shelters, the services for homeless people in the past 20 years—has been great. Now, we have information that helps us move on. It’s a reallocation of funds and a rethinking. Thinking smarter. Using our money smarter.”

Focus on Outcomes
Roman explains where the time frame for the plan comes from. “The idea with the Ten Year Plan is that this isn’t something you turn around in a day—it takes time. It came from the notion that there are around 200,000 chronically homeless people, and that if we apply the current resources for housing from HUD [U.S. Department of Housing and Urban Development], that would do about 15,000 units per year. Over 10 years, that’s 150,000 units.”

This practical focus on specific, measurable outcomes distinguishes the NAEH from other, larger agencies. “I think that’s the role of organizations like ours more than government agencies,” says Roman. “They strive to improve things and coordinate better, but they don’t seem to pick an outcome and direct resources toward it. Coordination is a factor in improved outcomes, but coordination alone doesn’t result in the outcome of ending homelessness. We could have an extremely well-coordinated system that keeps people homeless for years and years.”

The Plan In Action
According to Boyle, by summer 2004, 100 U.S. cities will have signed off on the alliance’s plan. “The U.S. Conference of Mayors has taken it on as a project,” says Boyle, “as has the administration about two years ago. It’s practically common knowledge now in the political and social services arena.”

Roman cites San Francisco as one American city that’s successfully implemented aspects of the alliance’s plan. “There’s a program in San Francisco called Direct Access to Housing,” says Roman. “It’s run by the public health department. They noticed in their emergency rooms that they had a relatively small group of patients who were extremely expensive because they were constant users of acute care health systems. They decided to look more carefully at those folks and found that a good percentage were homeless. They decided to start providing housing because they found that it would actually be less expensive to provide housing.”

Another city that’s done well with the plan is Columbus, Ohio. “They saw that they had folks who were living in the homeless system and had spent years there,” says Roman. “At first, they were considering relocating shelters; then they thought, ‘Why would we build another shelter? Why don’t we build housing instead?’”

In praising the Columbus project, Boyle once again stresses the importance of data. “Columbus is one of the best and earliest programs,” says Boyle. “The main thing was that they got the data properly. They did the proper research, got a really good exhaustive count, and then they took the information they gathered and used it extremely well.”

Is there a specific sequence of steps that a city must take to “sign off” on the NAEH plan?

“No,” says Roman. “If they tell us they’ve got a plan, that’s fine. We just have a general framework suggesting that they need a data system, that they look at prevention and back door stuff. I’d say Columbus is doing better with the plan than any other city, and they’re just implementing the strategies—they don’t have a plan. What you need is an outcome orientation. Some places have spent a lot of money and time on developing a plan, and they’re still no closer to solving the problem. What we’re trying to say is that if you have an outcome orientation, you’re going to have a real effect on the problem.”

Why, then, has no one tried this approach before?

“We didn’t know any better because we didn’t have the data,” says Boyle. “When a problem arises, it takes people a little while to figure out what to do about it. There wasn’t the money to come up with the data. When you’re working with a nonprofit, you often don’t have the money to come up with the best solutions.”

And how will the alliance know when its plan is working? “Through data systems,” Roman answers. “Congress has required HUD to work with communities to establish homeless information management systems, so we’ll know some things from that. We have to have fewer homeless people. On a community level, the data makes it possible to know what ‘fewer’ means.”

Roman acknowledges the widespread belief that homelessness is an insoluble problem that may always be with us, but insists that this belief is based on a misperception.

“Homelessness in the scope of things is a pretty small problem,” says Roman. “We ought to be able to solve it. It’s not poverty, it’s not housing—it’s related to those problems, but it’s much smaller than any one of them. We ought to be able to solve it.”

— David Surface is a freelance writer and editor based in Brooklyn, NY.