ARTICLE
10 Best Practices for Successful Permanent Supportive Housing
Imagine trying to stay dry while you are floating in the ocean, with no lifeboat. That is the situation encountered by many people experiencing homelessness. Frequently, programs attempting to address homelessness rely on having people solve their serious personal, mental, and physical health issues before securing housing or a job or other life anchors. The results are often unsuccessful. Permanent supportive housing (PSH) is an alternative strategy that flips those conditions.
Housing First Approach
PSH is a “housing first” philosophy. As numerous studies have shown, getting people into some form of permanent housing first, before resolving all their complex personal and health issues, is more successful in driving homelessness down. Requiring people to eliminate those complicated and sometimes chronic issues before finding housing is often an insurmountable barrier and can contribute to a downward spiral.
A well-managed, permanent supportive housing program combines safe, clean, and affordable housing with onsite supportive services such as counseling, treatment services, and case management. PSH differs from shelters which are temporary, short-term housing with limited basic services. Shelters are meant to address a daily need in the moment, whereas PSH units are imbedded in the housing market.
PSH models could include dedicated houses or buildings, buildings with a mix of supportive and affordable housing, or rental apartments with mixed tenants. Support services could be on-site or provided by mobile teams. Staying in PSH units is not time-bound and includes some form of wrap-around support and may include long-term leasing or rental assistance. Residents of PSH units can and do move on to other forms of housing but it isn’t required.
In addition to lowering homelessness, having stable and affordable housing also contributes to:
- Reduced overall social services costs coming from efficiencies in service delivery.
- Improved medical outcomes from more quickly addressing issues that otherwise would not be treated when needed.
- Declines in crime rates by adding structure and a more positive living environment.
- Increased wages by encouraging new work opportunities that stability affords.
King County, Washington is projected to need at least 13,000 new housing units added every year to keep up with expected growth. That includes 8,000 units per year affordable for low-income people. Meeting those housing needs requires innovative solutions at all levels of the market and permanent supportive housing fits within that greater housing landscape. King County government has put a high priority on using PSH as part of a comprehensive homeless plan.
Keys for a Successful Program
Experience has shown that a PSH program will only be successful if there is a strong infrastructure and high level of involvement for key stakeholders. Understanding the needs of those stakeholders and putting best practices in place is critical to building a strong program and mitigating community issues.
A PSH program must meet the long-term physical and supportive needs of the residents and to be accepted by the community, it must also address the concerns of neighbors. That includes families who live in the area and quite reasonably want to understand the realistic impact on their neighborhood. And local businesses want to maintain a welcoming environment to attract customers.
The following community-based recommendations are steps that address key areas of concern for any PSH initiative.
Siting the Facility:
Take an inclusive approach should be taken to ensure acceptance and reduce opposition. Homeless advocates, local businesses, neighbors, developers, and public officials should all have a voice.
Support & Training
Provide PSH staff with extensive support and professional training to address the uniquely complex social and health related needs of the residents.
Maintaining Appearance
Enact procedures to maintain a clean and appropriate environment such as preventing or removing litter, graffiti, grocery carts, and other inappropriate items.
Parking & Traffic
Make sure a comprehensive analysis of the parking needs, neighborhood parking capacity, and traffic flow is conducted.
Local Residency
Establish a goal of 70% of residents coming from the local area. A resident’s connection to the area leads to better personal and community outcomes.
Management Police
Ensure communication and implementation of binding safety, security, eviction, visitor, and clean-up policies and actions.
Communication & Outreach
Establish communication protocols to cover when the PSH provider will reach out to neighbors about issues, the level of safety issues communicated, and how often service calls are shared.
Code of Conduct
Institute and reinforce a resident code of conduct, defining who is responsible for enforcement, and how often enforcement is monitored.
Police & Fire
Ensure police and fire departments have funding, staffing, and protocols to address issues related to the program. Launch proactive neighborhood patrols—not just incidence response measures—and establish neighborhood monitoring.
Metrics
Establish and share clear and transparent metrics that show that people are moving forward in their journey to stability and out of chronic homelessness.
A Community-based Solution
Permanent supportive housing can be a critical part of the strategy to address homelessness and other social challenges. The key is for the community to work together to remove the barriers to success and institute best practices and policies that are sustainable. The Bellevue Foundation and partner organizations are taking action to further the development of permanent supportive housing programs.
In addition, Washington State has passed legislation focused on expanding and improving permanent supportive housing initiatives. You can find more information at https://www.commerce.wa.gov/permanent-supportive-housing/
References:
(1) https://pmc.ncbi.nlm.nih.gov/articles/PMC8513528/
(2) https://www.thirddoorcoalition.org/research-and-sources
(3) https://www.housingconsortium.org/king-county-affordable-housing-need-dashboard/
(5) https://housingmatters.urban.org/feature/housing-first-still-best-approach-ending-homelessness