Last month, L.A. County issued a report on Project 50, an incredibly unique effort to support people experiencing homelessness and mental illness on Skid Row.
Unique because it offered help without hoops.
Project 50 identified the 50 most vulnerable persons on Skid Row, those most likely to die the soonest without intervention, and offered them a chance to participate in this pilot program. If they agreed, they would have immediate, (nearly) unqualified access to permanent housing and a variety of services, including medical assistance, mental health counseling, and substance abuse treatment.
Perhaps most importantly, participants were allowed to accept that housing without being required to use any of those services.
I say nearly unqualified because they did pay rent for their homes–30% of their income.
In contrast to this set up, the existing systems on Skid Row are usually first come first serve, temporary, and/or require people to meet certain criteria before they can receive help. Housing is last on the list of things a person receives. “Housing readiness“, it’s called, when “the homeless received a room after demonstrating that they were staying sober and seeking psychiatric counseling.”
Unique because it worked.
As the program continued, it housed 68 people total, 84% of whom were still housed two years later.
84% is a hugely successful number, especially when so much research shows how stable housing is often the root of all other forms of recovery.
Unique because it was expensive.
Investing in these 50-odd individuals cost $3.045 million.
But in the end, it saved money compared to not implementing the program.
The program yielded cost savings of $3.284 million over the two-year observation period, a surplus of $238,700.
More help for less money. Dropping the hoops and offering minimally contingent housing saves taxpayers $4,774 per housed person.
How do the numbers work? Here are just a few key points from the two year implementation and observation:
- Incarceration rates for the Project 50 group reduced significantly compared to a similar sample population.
- Medical costs over this period declined by 68% for Project 50 participants, versus a decline of only 37% for the comparison group.
- While mental health costs were far higher than the comparison group, these people were also in greater need for those services. Substance abuse treatment costs also rose for Project 50, but only about 60% compared to nearly doubling for the comparison group.
What was spent on mental health and substance abuse was more than made up for by lower jail and medical costs.
Solving homelessness is not only difficult and complex, it is also controversial. Wouldn’t we prefer to see a person on a path of help and healing instead of imprisoned?
Of course, of course, we say.
But at church last month, when asked to identify ‘the least of these’, a child answered me, someone who is a bum and homeless because they’re too lazy to work.
Who taught them to see it like that?
Sometimes it feels like our compassion is contingent.
In the midst of the complexity of homelessness, the data from Project 50 and similar programs suggest one particular piece of the solution that I believe we must take the time to consider:
Housing first, not housing readiness.
Resources, not rules.
Maybe that’s grace?
Read about Project 50 from a series of LA Times articles.
Read the cost analysis report.