www'desc'org

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Ending Chronic HomelessnessThrough Low Threshold
Housingpresented byBill Hobson,
DESCSeattle WA Bureau of Substance Abuse
ServicesMass Dept of Public HealthSpringfield,
MA September 17, 2008
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• Overview of DESC
• supportive housing
• licensed mental health services
• licensed chemical dependency
• services
• emergency shelter
• high level of integration across programs

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Core convictions

• housing is a basic human right
• housing is not a reward for clinical
• success or compliance

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Old approach - Risky Business

• Housing readiness
• criminal background
• housing history
• treatment compliance

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Truth The science of prediction is primitive
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Continuous two-year housing retention
p0.22, (Fishers Exact test, 1-sided)?
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Housing First Principles
1Targeted to the most vulnerable
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Housing First Principles
2People are moved into housing directly from
the street without preconditions of treatment
acceptance or compliance
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Housing First Principles
3Provider is obligated to bring robust services
into the housing.

• Services are predicated on assertive engagement,
  not coercion.

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Housing First Principles
4Continued housing is not dependent on
participation in services
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Housing First Principles
5Harm reduction approach rather than mandating
abstinence
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Housing First Principles
6Residents have leases and tenant protection
under the law
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Integrated services and property management
Typical staffing for 75 unit project

• 1 project manager
• 14 residential counselors
• 24/7 staffing
• 3 clinical support specialists
• residential service plan

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1811 Eastlake

• borne out of community dialogue
• development slowed by opposition
• strong political support
• opened in December 2005 75 units

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Impact on community dialogue

• Dispute about the effects on adjacent property
  values.
• Quickly became a public discussion about
• Housing First
• Supportive housing
• Harm reduction
• affordable alternatives to homelessness

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Impact on community dialogue

• Focused attention on the local Ten-Year Plan as
  few other issues could have.
• Policymakers took a risk and now tout (and own)
  the successes of the building.

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DESC Housing Who lives there?
Mental illness
Other DESC Housing
1811 Eastlake
No 7
Yes 48
No 52
Yes 93
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DESC Housing Who lives there?
Substance abuse
Other DESC Housing
1811 Eastlake
Yes 57
Yes 100
No 43
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1811 Eastlake Who lives there?
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1811 Eastlake Who lives there?
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Improvements in the lives of tenants

• Housing First application resulted in improved
  housing stability.
• Adjusting for deaths (6), 74 of tenants
  remained housed for at least one year.
• Marked improvements in basic health.
• Chronic conditions now better managed.
• Days residents consume alcohol to intoxication
  reduced by nearly 50.
• Six of 75 (8) became sober.

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Improvements to the community

• 2.5M of crisis system costs of residents have
  been eliminated after 12 months of operation
• Medical expenses down 41
• County jail bookings down 45
• Sobering center usage down 87
• Shelter usage down 92
• 48 reduction in alcohol-related incidents
  observed by Downtown Ambassadors.

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