To End Chronic Homelessness in California We Need to Distinguish Permanent Supportive Housing from Affordable Housing

When someone says we need more affordable housing to end homelessness, it is often an unintended half-truth.

National, state, and local policymakers and advocates regularly define affordable housing as a household not paying more than 30% of its total income for housing costs that include rent or mortgage, utilities, insurance, and taxes. Policymakers and advocates define permanent supportive housing as affordable, meaning a household does not pay more than 30% of its total income for housing costs.

Although on the surface these two types of housing sound the same, one of the major differences between the two is that permanent supportive housing has to be occupied by persons who were homeless and have a disability or families with an adult or child member with a disability, as required by the U.S. Department of Housing and Urban Development (HUD). A disability includes a diagnosable substance use disorder, serious mental illness, developmental disability, post-traumatic stress disorder, cognitive impairments resulting from a brain injury, or chronic physical illness or disability.

Another major difference involves supportive services, which are automatically offered to residents in permanent supportive housing and not always with affordable housing. Wrap-around supportive services help households maintain their housing. Such services include employment counseling and placement, health care, mental health care, and substance use counseling and treatment.

It Is Time to Publicize the Difference to all Stakeholders

It is time to publicize the difference to all stakeholders because we will never end chronic homelessness without enough permanent supportive housing units.

Chronically homeless persons are those who have been homeless for one year or more or in and out of homeless for at least a few years. To meet the definition of chronically homeless they must also have one, and often have more than one, disabling condition such as those noted above.

Many stakeholders know that permanent supportive housing is an evidence-based permanent housing intervention that research has also proved to be cost-effective, particularly for chronically homeless persons. Additionally they know that cost studies have shown that this intervention also lowers public costs by reducing the use of crisis services such as shelters, paramedic responses, emergency rooms, psychiatric centers, and jails.

Too many stakeholders, however, do not know the benefits of permanent supportive housing. They do not know that hard-to-house chronically homeless individuals and families will not be permanently housed without permanent supportive housing.

Too many stakeholders are not fully aware that prolonged exposure to homelessness has a significant negative effect on individuals that can result in death. They do not know that homelessness is much more than the absence of physical housing—it is a tension-filled, trauma-filled, and treacherous condition that often results in injuries and fatalities. People who were homeless have been brought to county morgues where Coroner Office staff determined that they died by electrocution, thermal injuries, hypothermia, environmental exposure, and blunt force injuries including traffic accidents and being crushed to death by large objects such as garbage bins.

What Next?

Each jurisdiction that has persons who are chronically homeless living on its streets needs to include permanent supportive housing in a plan that

• Explains the difference between affordable housing and permanent supportive housing to the public;
• Educates the public about the health and safety issues that surround chronic homelessness;
• Informs the public about the number of persons who are experiencing serious injury and death while living on the streets;
• Describes the high cost of managing chronic homelessness to the public in terms of emergency assistance;
• Determines the number of persons within the jurisdiction in need of permanent supportive housing by using local data sources;
• Designs and develops permanent supportive housing that works best for residents and community stakeholders.

We will be publishing more reports in the near future that will provide more information about permanent supportive housing, which can also be used for inclusion in strategic plans for solving chronic homelessness.