Chronic homelessness: emergence of a public policy.

• Author: Burt, Martha R.

INTRODUCTION

The past two years have witnessed a major shift in public commitment to end chronic homelessness within the next decade. This Article examines the phenomenon of chronic homelessness and its emergence as the focus of a significant policy transformation. It first sets the scene with a brief review of why homelessness remains a significant social problem after twenty years of public and private investment in homeless assistance networks. It then looks at definitions of homelessness in general, and chronic homelessness in particular. With respect to policy, it traces a story that starts with research. Initial research showed that even the most chronic, disabled, street-dwelling homeless people will accept and remain in housing, given the right configuration and the right supportive services. Research on program effectiveness was followed by analyses showing near break-even public costs for providing the housing. The story continues with evidence that the numbers of chronically homeless people who would need housing are within a manageable range. The Article concludes by examining what advocates have done and are still doing with the research evidence, and an overview of public commitments and the effort it will take to assure that they are fulfilled.

1. CAUSES OF HOMELESSNESS

   Two types of factors are generally acknowledged as causing homelessness in the sense that they create the conditions under which people are more or less likely to find themselves homeless. (1) Factors of the first type are structural--they are larger societal trends and changes that affect broad segments of a population. (2) These include changes in housing markets and land use, employment opportunities, the quality and relevance of public education, institutional supports for people with disabilities, and discriminatory policies of several varieties. (3) If housing prices go up, all other things being equal, fewer people can afford housing. (4) If unemployment rises, or if pay levels of the most available jobs remain too low relative to the price of housing, fewer people can afford housing. (5) If public education and other institutions do not prepare most people to obtain jobs that pay a living wage, more people will be at risk of homelessness. (6) And so on. Structural factors determine why levels of homelessness rise or fall in this place, at this time, rather than in some other place or at some other time. (7)

   Factors of the second type are individual--they are the conditions and circumstances that make particular people particularly vulnerable to homelessness. (8) These include various disabilities (for example, mental illness, developmental disabilities, and physical disabilities), illnesses, illiteracy, and addictions. (9) They may also include personal circumstances such as domestic violence, too many to support on one income, having no family to rely on (for example, because one has been in foster care, or because of familial abuse), apartment condemnation, or fire, flood, hurricane, or war. (10)

   A third factor, public policies, may mitigate structural and individual factors that determine the ultimate level of "literal" homelessness in a particular time and place. (11) Emergency relief often can provide this for victims of natural disasters or war. A guarantee of housing may afford this for citizens of several European countries. Income and other support for people with disabilities severe enough to prevent their working might prevent their becoming homeless. (12) There will always be some people without roofs, communities, or families. The sheer number of people experiencing literal homelessness in the United States during the past two decades, however, indicates a very unfortunate convergence of structural and individual factors that, to date, have not been countered with public policies adequate to reduce their ability to generate homelessness. The campaign to end chronic homelessness during the coming decades will arise from recognizing that public policy changes could make a substantial difference.

2. DEFINING HOMELESSNESS AND CHRONIC HOMELESSNESS

   Homelessness has been defined in various ways in different eras, countries, and circumstances. Historically, ideas of homelessness have usually incorporated one or more of the concepts of being without place (not being "from here"), without family, or without housing. (13) In the United States during the last two decades, federal policy has been governed by the definition articulated in the principal federal legislation related to homelessness--the McKinney-Vento Homeless Assistance Act, subsequently renamed the Stewart B. McKinney Homeless Assistance Act ("McKinney Act") (14) and subsequent reauthorizations and expansions. (15) The Act defines a person as homeless if the "individual lacks a fixed, regular, and adequate nighttime residence." (16) People sleeping in "a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings," as well as those staying in shelters for homeless people, are part of the definition. (17)

   To operationalize the public policy of the Act's definition, at a practical level it is often translated into the narrowest of working definitions--having been without housing last night, or expecting to be without housing tonight. Thus, people in precarious circumstances who still manage to stay in conventional dwellings by moving every few days or weeks from one relative's house to another would not be considered homeless until they reached the situation of having nowhere to go but the streets or a shelter.

   Similarly, someone whose pension or disability check provides enough money to afford a cheap hotel room for three weeks out of every month, but who resorts to the streets until the next check arrives would only be considered homeless at the end of the month, even if this pattern has lasted for years. The consequence of this policy-driven working definition has been the development of an extensive network of homeless assistance programs that help to ameliorate the realities of homelessness for those already without housing. (18) But most existing homeless-specific programs can do little to prevent homelessness or change the forces that continue to generate homelessness.

3. CHARACTERISTICS OF CHRONICALLY HOMELESS PEOPLE

   Regardless of how "chronic" is defined, the population is largely male (seventy-seven to eighty-six percent), about sixty percent are middle-aged (between thirty-five and fifty-four years old), and most are very disabled. (19) Between eighty-three and eighty-seven percent, again depending on definitions of chronic, have mental health, alcohol, and/or drug problems. (20) Thus, ending chronic homelessness means assisting people who have one or more severe disabilities, and often...