“If good intentions, well-meaning programs and humanitarian
gestures could end homelessness, it would have been history
decades ago.”
— Philip Mangano, Executive Director, United
States Interagency Council on Homelessness
Of all the shortcomings of the Bush presidency, perhaps none was
as frustrating to conservatives as its poor communications
strategy. The problem wasn’t just the administration’s habit of
announcing policies without sufficiently explaining them, or its
failure to defend unpopular policies. Most discouraging was its
reluctance to talk about policies that proved wildly successful.
Last week, the president’s office of Faith-Based and Community
Initiatives released a
report called “Innovations in Compassion.” The report
highlights some of the triumphs of the much-maligned agency,
among which is this gem: a nearly one-third decrease in chronic
homelessness between 2005 and 2007.
The man most responsible for the precipitous drop in homelessness
is Philip Mangano, executive director of the U.S. Interagency
Council on Homelessness. In a recent interview, Mangano talked to
me about the secret to his success, which is rooted in his
mission “to change the verb of homelessness. After 20 years of
managing the crisis, our intent was ending the disgrace.”
This small shift in emphasis has produced great results. Besides
the 30 percent decrease in chronic homelessness (defined as
homelessness of at least one year of a person with serious mental
illness and/or drug or alcohol addiction), there was a 12 percent
reduction in overall homelessness nationally (from 763,000 to
672,000). Also, there was an almost 40 percent decrease in the
number of homeless veterans between 2001 and 2007.
In order to move from managing homelessness to ending it, Mangano
recognized the need for his agency to get rid of the old
strategies. Under President Clinton, funding was tripled for
programs to decrease homelessness, but the number of homeless
only increased. “We had been busy servicing homeless people,”
Mangano says, “spending more money without any results.”
So when he was appointed by President Bush to lead the council in
2002, Mangano and his team implemented an approach to
homelessness that was entirely appropriate for the administration
of the first president with an MBA. “For many years,” Mangano
says, “the issue of homelessness was driven by anecdote,
conjecture, guess work and feeling.” But with Mangano at the
helm, the touchy-feelyness was replaced by a results-oriented
business approach rooted in evidence and data.
And, predictably, the evidence showed that moving chronically
homeless people into housing units was the only reliable way to
end chronic homelessness.
The council’s “housing first” strategy was truly an innovation in
compassion. But it also sounded expensive. And the seven
consecutive years of record resources targeted to homeless people
(this year’s budget includes an unprecedented eighth year of
record resources for homelessness) might make fiscal
conservatives wince. But Mangano’s position is: What’s cheaper:
putting homeless people in homes, or letting them cycle through
shelters, hospital emergency rooms, jails and the street?
He says, “We discovered through our research that these are some
of the most expensive people to the public purse, randomly
ricocheting through very expensive primary health, behavioral
health, law enforcement and court systems.” The results of 65
cost studies revealed that the true costs of chronic homelessness
are staggering, between $35,000 and $150,000 a year per person.
Consider these examples.
• Boston Health Care for the Homeless Program tracked 119 persons
who were chronically homeless for 5 years and found that they
made more than 18,000 emergency room visits at an average cost of
$1000 per visit.
• One study found two homeless men in Reno cost the city over
$100,000 each in health and law enforcement in one year.
• The University of California at San Diego followed 15
chronically homeless street people for 18 months and found that
they cost the city $200,000 per person. As one official put it,
“We could have placed them in condos with ocean front views for
less.”
Contrast those numbers with the annual cost of supportive housing
for homeless people, which runs between $13,000 and $25,000 per
year, per person. And, importantly, once homeless people have
homes, the expense is reduced further as they build new lives and
address the costly correlates of homelessness, such as mental
illness, substance abuse and corrections. In Mangano’s words, “A
place to live is most likely to create a trajectory out of
dependence, toward self-sufficiency.”
The net cost savings to taxpayers is significant. In one example
in Portland, Oregon, 35 homeless individuals were placed in
housing. The pre-enrollment health care and incarceration costs
per person, per year were $42,075. The post enrollment cost
averaged $25,776. That translates into an annual cost savings
$16,299 per person.
Mangano’s success in reducing homelessness demonstrates the
transformative power of faith-based initiatives. It also begs the
question: Will Mangano and his innovative approach to
homelessness find a place in the Obama White House? Mangano is
unsure what will happen. Although his work has drawn praise from
across the political spectrum, Mangano says there will always be
“nostalgia for the old approaches.”
At one point during his
Inaugural Address, President Obama, directing his remarks to
“the cynics,” implied that bipartisanship will now be the order
of the day, noting:
“The question we ask today is not whether our government is too
big or too small, but whether it works — whether it helps
families find jobs at a decent wage, care they can afford, a
retirement that is dignified. Where the answer is yes, we intend
to move forward.”
At a time when job losses and record foreclosures threaten to
slow progress in ending homelessness, preserving the Bush
administration’s results-oriented, housing-first strategy to
combat homelessness is a way Obama can prove the cynics wrong.
