Finding the Way Home • HFL only uses case management to support people who were Similarly, a mobile support service that offers permanent formerly homeless in ordinary housing. This case management ordinary housing but which requires abstinence or treatment is not an ICM model like that used by PHF services. This compliance is not a form of housing-led service. means that workers have a higher caseload and less contact with people who are homeless using the service (caseloads Table 2.1 (page 13) summarises the similarities and and contact hours vary between services). differences between different broad types of housing-led services. • HFL services do not employ an ACT team and there is no direct provision of health care or personal care. Access to mental health, medical, drug and alcohol and other health and The international evidence on housing-led support services is only secured through case management. services • HFL are relatively low intensity services compared to PHF or CHF models. The main function is to case manage a package The Pathways Housing First Model of services and ensure that sufficient supports are in place to Evidence of success facilitate tenancy sustainment, the team will provide little or no direct support to people who are homeless. PHF has shown a very high success rate in delivering sustained exits from homelessness. In New York, 88% of • HFL can be used to support people who are homeless who formerly long term homeless people with very high support have various levels of need, this can include people who have needs36 who were supported by PHF stayed in settled housing lower levels of need or whose support needs may lessen over over the course of five years, compared to 47% of people with time. Some of these services operate on the assumption that the same characteristics using staircase services37. An they will become ‘dormant’ as independence grows and ongoing study of an Amsterdam-based housing-led service support needs lessen, though they do not set a timetable or based on PHF reported a 77% housing sustainment rate, have an expectation that this point will be reached by the again among people with long term experience of people using the service32. By contrast, PHF and CHF services homelessness with high needs38. are only designed for people who are homeless who have very high needs who are very likely to have an ongoing need for Work in the USA shows comparative costs for PHF at significant levels of support. contemporary prices are 28% less than maintaining a person • HFL services were originally developed without reference to the with high support needs who is homeless in emergency PHF model. These services reflect the wider philosophy of PHF accommodation ($57 a night for PHF compared to $71 a but did not originally derive their ideas from PHF. The housing- night in emergency accommodation)39. There are also claimed led philosophy is sometimes not interpreted as presenting a to be significant cost offsets, centring on reductions in use of ‘new approach’ to tackling homelessness in countries where emergency medical services and mental health services and a HFL services, or something close to an HFL approach, already reduction in arrests and short term imprisonment, producing exists33. By contrast, HFL services have been developed with significant savings for the criminal justice system. There is explicit reference to the PHF model, sometimes in contexts evidence of a broad ‘stabilizing’ effect on users of PHF linked where less resources were available than were necessary to fully operationalize the PHF approach34. HFL models are quite often used in European contexts where at 32 Lomax, D. and Netto, G. (2008) Evaluation of Tenancy Sustainment Teams London: least some social housing is available and may work closely with Department of Communities and Local Government. social landlords. Some HFL services will also work with the private 33 Johnsen, S. and Teixeira, L. (2010) op cit. 34 Pleace, N. (2012) op cit. rented sector, either using negotiation with PRS landlords or 35 Pleace, N. (2012) op cit. offering the kind of full housing management service, including 36 The USA does not have a concept of ‘long-term’ homelessness and services are instead guaranteed rent, which is employed by PHF to secure private targeted on what is termed the ‘chronically homeless’ population (who are characterized rented housing. by long-term homelessness, a risk of long-term homelessness and high support needs). The US department of Housing and Urban Development (HUD) http://portal.hud.gov/hudportal/HUD defines a “chronically homeless person” as someone Services which use mobile teams of workers who resettle people who has been continuously homeless for a year or who has had four episodes of who are homeless in ordinary housing as the final ‘step’ within a homelessness in the last three years, who is unaccompanied (a single homeless person who is alone and is not part of a homeless family and not accompanied by children) with staircase or as part of a supported housing service are not HFL a disabling condition, including a diagnosable substance abuse disorder, a serious models. Like PHF services, HFL services immediately provide mental illness, a ‘developmental disability’ (learning difficulty) or a chronic physical housing with no requirement to be ‘housing ready’. UlSnesesfinirtdoinaobfilhioymienlelsusdiesgstiheclcuod-escsueeepning on tawplarce noe mfeahnetsfeorohnudmtaonns. Theiictotromoofiecrrlconnnc,tsiodli habitation or living in an emergency shelter. Equally, to be regarded as a form of housing-led service, HFL 37 Tsemberis, S. (2010b) op cit. services must also follow the pattern of providing ongoing support. 38 Wewerinke, D.; Wolf; J.; Maas, M. and Al Shamma, S. (2012) ‘Discus Amsterdam’ Housing Services that set a fixed ceiling on the amount or duration of First: A Key Element of European Homelessness Strategies, 23rd March 2012 Unpublished conference proceedings. French Permanent Representation, Brussels. support that is offered are not a form of housing-led service, http://feantsa.horus.be/code/EN/pg.asp?Page=1409 though they may reflect the approach in other respects. 39 http://www.pathwaystohousing.org/content/our_model 12
Finding the Way Home
To see the actual publication please follow the link above