Logo of a house enveloped by a wrench, with the words, "Your Way Home Montgomery County" underneath.

Renovating the Housing System

The following article, co-authored by Russell Johnson and Tamela Luce, was distributed at the annual meeting of Grantmakers in Health in San Francisco (March 13 - 15, 2013). Below is an excerpt from the article. Access the full article here.

How does a relatively small foundation ($35 million in assets) foster significant change?

We have been struck by accounts of people served in our housing system whose situations are perpetuated or exacerbated by a lack of access to basic health and human services. The story we share is one we have been working on for six years. It has no ending yet, but our vision encourages those involved to make informed, deliberate decisions focused on achieving desired outcomes.

WHY FUND HOUSING?

Our interest was triggered by a 2006 Temple University study that noted challenges in the county’s system serving the homeless. Programs and services were difficult to access and navigate; not well-coordinated, and expensive.

Service providers affirmed the findings. Providers, our foundation, other funders, and local government decided to act. The result is “Your Way Home Montgomery County,” a blueprint to redesign the housing system.

MONTGOMERY COUNTY - A SNAPSHOT

Montgomery County is one of the most expensive Pennsylvania counties to live in. According to the 2010-2011 Self-Sufficiency Standard, an adult with one preschool-aged child must make an annual salary of $50,064 to meet basic needs, 344% above the federal poverty level. Fair market rent for a two-bedroom apartment in the region is $1,075 a month, requiring about $13,000 a year just for housing.

From October 2011 – September 2012, the county reported a total of 2,476 homeless or near-homeless individuals receiving services.

RENOVATING HOUSING

We knew we were not reaching everyone we needed to. And there were other problems. There was no comprehensive data collection system. And limited public transportation prevented many from accessing services.

The system was essentially broken.

Providers responded by forming a planning group and developed a vision: “All residents of Montgomery County live in safe and affordable housing and have access to consumer-driven, coordinated, and exceptional quality services that promote housing stability, address and eliminate existing homelessness, and prevent future homelessness.”

To address access problems, the foundation and other funders created a virtual Homelessness Prevention Center (HPC) in 2008. The HPC provides a toll-free number for individuals and families to access services. Data from all calls are entered in the data system. HPC staff has access to 2-1-1 to assist clients with additional needs.

The HPC transformed intake and referral, but the system still cost too much and help too few people. The group conducted a nationwide search for evidence-based, best practice tools and found “Housing First.”

THE HOUSING FIRST MODEL

Pioneered in the early 1990s in New York by Sam Tsemberis, founder and CEO of Pathways to Housing, the Housing First approach is simple: help the individual or family find housing first, then provide only the supportive services necessary for the client(s) to remain stably housed.

Without lengthy stays in properties maintained by providers, and without mandating a client to complete a long list of programs, the Housing First approach can serve more clients at much lower cost.

HOUSING FIRST PILOT

The foundation funded a six-month Housing First pilot project in late 2011. The foundation selected Public Health Management Corporation, which had managed a Housing First program in Philadelphia.

Fifteen clients participated. A housing stabilization specialist, working with an employment specialist, provided housing, supportive, and employment services to clients.

At the end of six months, only one client had opted out. Seven clients were no longer at risk of losing their housing within two months of initial contact, and the remaining seven clients all secured permanent housing before the pilot closed.

Services provided to maintain housing were minimal. Under a conventional rapid rehousing model, the average cost to stably house a client was around $5,500. The average spent per client in the pilot, however, was just under $3,100 - a 44% percent reduction!

YOUR WAY HOME MONTGOMERY COUNTY

Assimilating lessons learned, the foundation supported the planning group’s efforts to craft a plan to prevent and end homelessness in the county within 10 years. Additional stakeholders joined, including the domestic violence community, as well as leadership from the six county agencies that fund the housing system.

The plan - Your Way Home Montgomery County” - embraces Housing First, customized to the county, with four overarching goals, related strategies and key performance indicators:

Goals

  • Improve the county’s housing crisis response system
  • Embrace Housing First principles and service delivery models
  • Increase the supply of permanent housing
  • Build infrastructure that will drive sustainable changes in the county’s housing system

CONCLUSION

Systems change is difficult work. In our new strategic plan, we acknowledged this work is dynamic, non-linear, and frequently incremental. Yet we are excited by the potential to dramatically improve how people access and receive services. This is a bold leap, but the health and well-being of Montgomery County it too important not to take that first step.