The 20 Continuums of Care with the largest homeless populations in the U.S., Public Housing Agencies and Programs, and Homeless Admission Preference

See Each Percent of New Homeless Household Admissions in Table Below

There was an annual decrease in the total number of persons counted as homeless in the United States during the seven years between 2011 and 2016. However, there was a slight increase in 2017.

As a promising practice, a homeless admission preference has the potential to reverse the increase and save millions of dollars spent on managing homelessness instead of ending it as noted below. It also has the potential of saving thousands of lives of people sleeping on the streets for too many have experienced tragic and gruesome deaths also noted below.

Background Information

The table below lists the answers that Public Housing Agencies (PHAs) gave to the 20 Continuums of Care (CoCs) with the largest homeless populations in the U.S., who were asked two questions by the U.S. Department of Housing and Urban Development (HUD) that focused on local PHAs and homeless admission preference in section 1C-4 of their 2017 Continuum of Care Program application.

The 20 CoCs were asked to provide the following information for up to five of the largest PHAs in their geographic area:

• identify the percentage of new admissions to the Public Housing or Housing Choice Voucher (HCV) Programs in the PHA’s last fiscal year that were homeless at the time of admission; and
• indicate whether the PHA has a homeless admission preference in its Public Housing and/or HCV program.

The answers in the table below reveal that of the 64 Public Housing Agencies listed,

• 22 or approximately one-third (34.4%) had a percentage of 10% or less of new admissions to the Public Housing or Housing Choice Voucher (HCV) Programs in the PHA’s last fiscal year that were homeless at the time of admission;
• 16 or one-fourth (25%) had a percentage of 50% or higher of new admissions to the Public Housing or Housing Choice Voucher (HCV) Programs in the PHA’s last fiscal year that were homeless at the time of admission;
• 53 or more than three-fourths (82.8%) of PHAs had a general and/or limited homeless preference in their public housing and/or HCV programs.

Cost-effectiveness of Housing Homeless Persons Instead of Leaving Them Languishing on the Streets

There is an increasing number of studies that have shown the cost-effectiveness of housing homeless persons instead of leaving them languishing on the streets. Over the years, the pioneering work of the University of Pennsylvania, national symposiums, and the past advocacy and recent advocacy of the U.S. Interagency Council on Homelessness and other universities, symposiums, and national and local advocacy organizations have driven home this point over and over again.

Recent studies include

• New York State Department of Health Medicaid Redesign Team Supportive Housing Evaluation: Cost Report 1;
• Evaluation of Housing for Health Permanent Supportive Housing Program;
• Homelessness in Orange County (CA): The Costs to Our Community;
• The Costs to Our Community: Home Not Found: The Cost Of Homelessness In Silicon Valley;
• Family Options Study Short-Term Impacts of Housing and Services Interventions for Homeless Families;
• City of Albuquerque Heading Home Initiative Cost Study Report Phase 1;
• The Cost of Long-Term Homelessness in Central Florida; and
• Getting Home: Outcomes from Housing High Cost Homeless Hospital Patients (Los Angeles).

Preventing Tragic and Gruesome Deaths

People who died while 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.

The stories are both tragic and gruesome. The Guardian U.S. News Edition did a “review of news reports from the last decade (and) found at least 50 cases of dumpster-related homeless deaths and serious injuries.” The act of trash collection itself is fatal as noted in the story:

• “A man in Oklahoma City, Oklahoma, was tipped out of a dumpster and then run over by a garbage truck;
• In Fort Worth, Texas, a screaming man had a heart attack after the dumpster he was inside was picked up;
• More common are situations in which homeless people, sleeping in dumpsters or sheltering from the elements, are collected by garbage or recycling trucks and compacted (and crushed) along with the trash.”

Other media stories highlight more tragedies like these.

Here’s one story in which a man was scooped up with a tent and dumped into a garbage truck but was pulled from the truck before being compacted.

Urban Initiatives is in the process of gathering information about the number of persons who died while homeless from the 58 counties that make up California.

Next Steps

In 2013, HUD provided “strategies that PHAs can pursue to expand housing opportunities for individuals and families experiencing homelessness through the Public Housing and HCV programs.”

Also, in 2013, the United States Interagency Council on Homelessness provided “guidance to PHAs on how to collaborate and align resources to best prevent and end homelessness” and “how partnering with a variety of organizations can make a substantial impact on ending homelessness.”

Recommendations in these publications focus on increasing the percentage of homeless persons who obtain public housing and Housing Choice Vouchers whenever possible. They also focus on encouraging Public Housing Agencies to establish written homeless preference policies.