Solving Chronic Homelessness with Permanent Homes

By Jessica Reid



On any given night in the United States, there are roughly 578,000 people who experience homelessness. Of this 578,000, 15% of these people are classified as chronically homeless (Snapshot of Homelessness, 2015). This 15%, which amounts to about 86,700 people, are defined by the United States Department of Housing and Urban Development (HUD) as individuals who have been homeless for over a year or have had four episodes of homelessness over the last three years. In addition, they must also have a disability (HUD, 2007). Most of these individuals suffer from mental illness, substance abuse, or other physical disabilities. Though the chronically homeless account for a small percentage of the homeless, they cost the public the most in resources and are the most vulnerable and at risk subset of the homeless population. Surprisingly, the solution to ending chronic homelessness is relatively simple. Providing permanent, no-strings-attached housing for the chronically homeless is not only the most humane solution but also the most cost-effective for ending chronic homelessness. This idea is called Housing First.

The quickest way to gain support for the Housing First movement is to talk numbers. The cost to the public for the chronically homeless average from $30,000 to $50,000 per person, per year (United States Interagency Council on Homelessness, 2015). Taking the lower number of $30,000, that means that nationally we are looking at a minimum annual cost to the public of $2.6 billion dollars. Where do the costs come from? From the repeated use of emergency rooms, hospitals, jails, psychiatric centers, detox and other crisis services. What’s worse is that this reactionary approach does little to improve the long-term health or well-being of the chronically homeless, nor does it approach a morally sound solution in providing for the basic needs of our citizens. $2.6 billion dollars later you still have our most at-risk homeless population living and sleeping on the streets, in shelters, hospitals, or jails.

Additionally, this ineffective approach reduces access to services and funding to the 85% of those individuals experiencing short-term homelessness. It unnecessarily overburdens our hospitals, police force, and prison systems. In Utah, for example, the chronically homeless constitute only 5% of the homeless population but consume 50% of the resources for homeless services (Comprehensive Report On Homelessness, 2014).

There are many reasons to focus on chronic homelessness. The first is to end homelessness for those who have become the most vulnerable and improve their safety and quality of life. The second is the cost savings to the community from use of emergency services such as emergency rooms and jails. A third objective is to increase the capacity in emergency shelters. Although this population comprises less than 5 percent of the total homeless population, they consume about 50 percent of the resources for homeless services.

(Comprehensive Report on Homelessness, 2014)


Housing First approaches the problem of chronic homelessness differently from prior systems. Prior systems operate under the do first, then receive model. Housing is earned. Though good in its intention, the system is patronizing and often fails. The homeless are required to meet certain standards of stability before they can receive assistance. They must prove they are sober, attend required meetings, maintain a job, etc. Once they can show stability, they are eligible for housing assistance.

The problem with the approach of earning assistance is two-fold. One, some people are incapable of earning housing according to current social standards. They are either unable to overcome their addiction or maintain employment due to their mental illness or disability. Two, it is incredibly difficult (sometimes, impossible) to obtain and sustain stability in sobriety, mental health, or employment without a permanent home. To obtain a job, a candidate must be clean and have clean clothing. Without access to toilets, showers, and laundry facilities, this poses a true challenge. There are relatively few places that allow public access to toilets, showers and laundry services without payment. Obtaining food and a safe and warm place to sleep are also daily challenges that create incredible stress. The stress, in addition to a feeling of hopelessness and helplessness, can often exacerbate any tendencies towards addictive behavior. Also, consider that in today’s world, in order to apply for jobs you must have access to a computer and the Internet, access to a phone and an email account, and the technological skills to use them. Unlike the majority of the homeless, the chronically homeless often lack the capabilities that are necessary to meet these requirements, which are considered necessary to earn assistance with housing. Thus, they remain homeless. After seeing the failure in this system, the idea of Housing First emerged.

The Housing First concept was pioneered by Dr. Sam Tsemberis of the New York University of Medicine in 1992 under the Pathways to Housing program for homeless adults with psychiatric disabilities and addiction disorders. The concept is quite simple:

Provide housing first, and then combine that housing with supportive treatment services in the areas of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This ‘scattered site’ model fosters a sense of home and self-determination, and it helps speed the reintegration of Pathways clients into the community.

(Housing First Model, 2015)

The system works. Not only does the system have an extremely high retention rate but it is cost-effective. Providing permanent housing to the chronically homeless costs less than the $2.6 billion that we are already spending. Housing First programs have begun springing up all over the United States and the cost savings are immediate. In Seattle, a Housing First program was created for homeless men and women facing chronic alcohol addiction. During the first year of operation, the program saved taxpayers 4 million dollars. In Denver, there was a decrease from $43,239 in emergency costs per person to $11,694 after being placed in a Housing First program. A cost savings of 79% over a 24 month period. If the Housing First program was extended to all 513 chronically homeless individuals in Denver the savings, after investments, are estimated at 2.4 million dollars per year (Denver Housing First Collaborative, 2015).

Although enormously successful, these programs have been small in focus and conducted as trial programs in individual cities. Much of the resistance is due to requiring a change in conventional wisdom and assumptions that previous models for dealing with the homeless have encompassed. In 2005, Utah implemented a statewide Housing First program to end chronic homelessness in 10 years.

How Utah accomplished this didn’t require complex theorems or statistical models. But it did require the suspension of what had been conventional wisdom. For years, the thought of simply giving the homeless homes seemed absurd, constituting the height of government waste. Many chronically homeless, after all, are victims of severe trauma and significant mental health and addiction issues. Many more have spent thousands of nights on the streets and are no longer familiar with home-living. Who, in their right mind, would willingly give such folk brand new houses without any proof of marked improvement? But that’s exactly what Utah did. “If you want to end homelessness, you put people in housing,” Walker said in an interview. “This is relatively simple.”

(McCoy, 2015)


As of April 2015, the number of chronically homeless individuals in Utah has dropped from 1,932 to 178, a reduction of 91% (Semerad, 2015). Officials are working with the remaining 178. “We know these individuals by name, know their situation, and we can help them move out of chronic homelessness, if they choose,” said Gordon Walker, director of the state Housing and Community Development Division (Glionna, 2015). The costs for providing housing and services in Utah through Housing First is $11,000 per person versus the $17,000 average in costs for those on the street (Glionna, 2015). Walker says that the annual savings are $8,000 per person (McCoy, 2015). Multiplying the savings of $8,000 per person to the 1,754 chronically homeless in Utah that have received housing creates an annual taxpayer savings of 14 million dollars.

Housing First is also able to boast high retention rates, consistently between 85-90%, even for individuals who have not succeeded in other programs (Housing First Model, 2015). There are other benefits as well. Colorado found that 50% of participants experienced improvement in their health, 43% had improved mental health, 15% had reduced their substance use, and 64% improved their overall quality of life. In fact, the programs are so successful that in 2014, Canada adopted the Housing First model as its national policy to end homelessness (Housing First Model, 2015).

Another group that has adopted the Housing First policy is the United States Department of Veterans Affairs. This program is being initiated for all homeless Veterans, chronically homeless or not. Before making Housing First the official policy for addressing homelessness in the Veteran population, the VA ran a pilot program with 177 Veterans. The program sought to contrast the results of the Housing First model with the standard policy of requiring “housing readiness”. In the Housing First group, Veterans were moved into housing within 35 days versus 235 days if they had to show housing readiness. Housing retention rates were significantly higher and emergency room use declined significantly. In October of 2012, the VA adopted a three-year evaluation pilot program using the Housing First model at 14 program sites (Housing First, 2015). In the first two years of implementing this program, almost 100,000 individuals received assistance. After being housed, only 15% returned to homelessness two years after exiting the program (Fact Sheet: Veteran Homelessness, 2015). There was a 14% decline in Veteran Homelessness from 2013 to 2014 and a 33% decline in 2014 compared
to 2009 (Veterans, 2015).

Let’s be realistic and recognize that providing housing for the chronically homeless is not going to be a magical solution. There is no assurance (nor requirement) that the individual will recover from their substance abuse, nor that there will be a significant improvement in their mental illness, if they have one. Housing First does, however, provide a humane and cost-effective way of getting the homeless that are mentally ill, disabled, or battling addictions, off the streets and away from businesses and tourists. It is also more effective at integrating the chronically homeless back into their communities, rather than as social outcasts. Housing First stops the cycle of dehumanizing the chronically homeless. It relieves community systems, resources, and finances to focus on the larger homeless population, those who have fallen on temporary hard times and are capable of stabilizing their lives with minor assistance. By caring for and reducing costs in providing care and support for the chronically homeless we will better improve our abilities to support the 85% of the homeless population that there are far too little resources for.



Comprehensive Report on Homelessness. (2014).

Defining Chronic Homelessness: A Technical Guide for HUD Programs. (2007, September 1).
Retrieved from

Click to access DefiningChronicHomeless.pdf

Denver Housing First Collaborative: Executive Summary. (n.d.). Retrieved November 17, 2015, from

Click to access Executive_Summary_DHFC_study.pdf

Fact Sheet: Veteran Homelessness. (2015, April 22). Retrieved from

Glionna, J. (2015, May 24). Utah is winning the war on chronic homelessness with ‘Housing First’
program. Retrieved from

Housing First. (n.d.). Retrieved November 18, 2015, from

Housing First Model. (n.d.). Retrieved November 20, 2015, from

McCoy, T. (2015, April 17). The surprisingly simple way Utah solved chronic homelessness and saved
millions. Retrieved from

Semerad, T. (2015, April 28). Utah’s chronic homeless numbers drop from 1,932 to 178 in 10 years.
Retrieved from

Snapshot of Homelessness. (n.d.). Retrieved November 17, 2015, from

United States Interagency Council on Homelessness. (n.d.). Retrieved November 16, 2015, from

Veterans. (n.d.). Retrieved November 18, 2015, from

Rise: The Story of the Refugee

Life is still whirling away at a crazy, fast pace. I thought I would take a minute and share a recent project of mine.

I created this video regarding the refugee crisis as an art project for my Humanities class. It is one of the most emotional things I have ever done. As we all sit down to celebrate with our families and give thanks, I hope that you will pause and consider that according to the United Nations Refugee Agency there are currently 59.5 million people on the move as refugees in the world. Humanity has never seen a displacement like this before. Ever.

I know that we fall all over the spectrum, politically, in how to respond to this global crisis but despite these differences I hope that we can remember that the fear, the terror, the desperation, and the pain are the brutal truth for too many.

This is the story of the refugee told through art. A combination of photography, poetry, and music.


I believe I can fly…

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That song, “I believe I can fly,” has been stuck in my head for weeks. Seems a lot more fitting for today. Had everything all packed and ready to go last night. I had a small Reece Witherspoon moment like in Wild, trying to put that pack on for the first time. It’s like carrying a large child on your back.

My mom drove me to the Vancouver airport this morning and we made it to the airport a few minutes before 7. I was all checked in, through baggage and security, and in my terminal by 7:30 am! Talk about fast! My flight departs in about 45 minutes and we’ll be boarding soon. Since I haven’t flown for 9 years it was a bit stressful not knowing what to expect flying out of Canada and not having ever used a passport before, but it was super simple. I did get my bag searched by security because my travel size contact solution was a bit larger than they allow, but they let me through with it anyway.

From here in Vancouver I will fly to Toronto, then to Lima, and then to Cusco by about 6:30 am. So, in a little less than 24 hours I will be there.

If you can see it from the picture, I come equipped with Cards Against Humanity and Bananagrams. Should come in handy during the long layover in Lima tonight with all the other volunteers that will be waiting to make the connecting flight to Cusco. We’re all planning on meeting up and playing games. Should be a fun (but sleepless) night!

48 Hours to Launch

In 48 hours, I will be leaving the United States for my first ever trip to another country, unless you include Canada (which I don’t). Sorry Canada. I will be flying out of the Vancouver airport with a layover in Toronto, and then another in Lima, before settling in Cusco. 20 hours to fly in and 22 hours to fly out. All in all, I will be gone for 17 days. The main part of my stay in Cusco will be as a medical volunteer through IVHQ with free time on the weekends to explore. At the end of my volunteer stay, I will be heading out on a 4 day jungle trek to Machu Picchu.

10492337_10207236346649279_2897338813979905637_nEver since I was a child I wanted to ‘do something’ with my life that would ‘make a difference’. I was never able to quantify what that was. These are my initial steps in aligning myself towards that vision to make a difference in whatever small ways I can. Now, I recognize that a couple week trip to another country isn’t going to ‘make a difference’ in any tangible, earth shattering way, but it will likely make a difference to me. To my outlook. To my limited, narrow, unexperienced view of the world.

My life has been dramatically shifting for the last several years. It’s been a whirlwind process of redefining everthing I thought I knew about myself and what I wanted in life.

These pictures are from a recent hike to Mount Baker, last Sunday. This was our first official LEAP hike. LEAP is a group that I organized and created at the end of April and that I’ve been envisioning for almost a year, waiting for enough free time to get it up and running off the ground.


It’s a free social group designed to build community and get more people active and involved in trying and experiencing new things. The group has been in existance for less than 2 months and so far is nearing 90 members. I am excited to see where it will go in the next year.

These great pictures were taken by my friend Pavlina, who joined us, along with KJ Dammel, in the Baker Hike. This is specifically from the Park Butte Trail lookout. I was actually introduced to the Park Butte Trail, two weeks earlier, by Michael Campa. It was incredible what an amazing difference there was in trail conditions in the two week timeframe.

10407320_10207236350009363_8130730868612451348_n I honestly can’t say that I ever saw myself becoming a hiker. Or a runner. Or someone who would fly helicopters, planes, or jump out of them for that matter. It’s all part of a discovery process that has been incredibly powerful and healing. I was the person who had intangible dreams, lots of ‘maybe someday’ items collecting dust in a bucket that was never going anywhere. I watched life happen, I didn’t live it. The realization that you can redefine and shift your purpose and direction, at any point in life, is probably the most empowering thing I’ve ever learned. This drive to challenge myself in letting go of this thought that I’ll never be ‘this’ or ‘that’ has grown right up alongside my desire to see the world, and become a global volunteer. It will still be awhile until I am an RN and capable of making any real significant volunteer impact but I’m not going to let that stop me in making whatever difference I can make at this stage in life.


Sometimes I get caught up in thinking about what I’ve lost in life. The marriage. The friends. The faith. I see the struggles the kids go through, and the struggles that I face, and the ‘damage’ that has occurred, and inevitably you have to ask yourself, again, and again, whether it was ‘worth it’. It isn’t a pleasant or easy process. At this stage, I can easily say I am better off. I am happier than I have ever been in life and more aligned to who I’ve always wanted to be. I don’t long for some far off distant time when such and such will be possible. It’s harder to answer about the kids. Obviously, what I’d like to believe is that they are also better off. However, they are too young to even understand most of what has happened over the last three years, or to see where things would have been if a course had not been changed. Only they, as adults, will be able to reflect back on everything and make their own personal decisions on what has happened and on how it has impacted them. I hope only to be able to communicate and show them, through my actions, a few things that have become important to me in life.



1. You can walk away from toxic relationships. Family is important. Friendships are important. Working hard to solve problems is important. Not giving up too soon is important. But sometimes, walking away, is more important.

2. You are in control of who you are and where you are going. You always have more choices than you think you have.

3. People are worth knowing, worth helping, and worth being vulnerable for. Human connection supersedes anything else in life. Human connection is life.

11217575_10207236300768132_2144568646868708883_n4. Sometimes your vulnerability is going to get you hurt. Really, really, hurt. It’s still worth the pain. Walk away. Learn the lesson. Be vulnerable again.


5. No matter how long you have believed something, advocated for it, lived and breathed it… it’s okay to change your mind. Embrace when you’ve been wrong. It makes you a more empathetic and understanding person.



6.  Life is incredibly short. There are a lot of things to chase in life. You get to decide what you will chase, but I hope you won’t chase money.

7. I’m fallible. You’re fallible. Everyone is fallible. No one really knows what they’re doing. Forgive easily. Keep boundaries where you need to, and walk away if you must, but let go of the anger. It’s not worth holding.

8. Your thoughts and your beliefs belong to you. What I believe, or what anyone else believes, does not matter. Try on as many beliefs and thoughts as you’d like. Build them on a foundation of love and understanding for others. People worth having in your life will love you despite differences in belief and thought.


9. When you become a parent, it will be easier to see what I got wrong and what I got right. Don’t worry, I’m well aware that I’m doing a lot of things wrong, and I don’t expect you to do things like I did. Don’t let anyone else control how you parent. Build and improve on what I’ve done and know, that despite my flaws, I love you like crazy and that it will be hard to comprehend until you’re doing it yourself.

10. Be weird and silly and different. Life is better that way. Life will have hard moments no matter what you do. What makes the greatest difference in life is your attitude and the people you surround yourself with.

I Need You to Know That I Loved You.


I need you to know, more than anything else, that I loved you.

I was so scared. I have never known fear as great as the day I found out that you would be coming to this world. But I loved you. So much. I still love you and I will always miss you.

There were so many things I wondered, worried and agonized over. Almost every waking moment, and many of my sleeping ones, I ran over every possible scenario that I could think of. How much of that did you feel? How much of my stress caused you harm? Could you feel my love too?

Never have two little pink lines been so terrifying. I am so sorry that there were no tears of joy and squeals of laughter. All babies should be welcomed that way. You weren’t any less beautiful, miraculous, or amazing. I was so angry when I realized I was pregnant. Not at you, or because of you, but I was angry at how it could be possible for a responsibility and a privilege so great to be given to someone like me, who had no way of providing, protecting or loving you the way that you deserved. The way every beautiful, precious, miracle of a baby deserves.

Your amazing beating heart flickered there on the screen for me. It was weak and you were small but you were fighting. You lived, if only briefly. I wanted not to worry. I wanted to be joyful but instead there was just gut wrenching fear.

How do I explain who your father is? What he is? Where he is? What he did? How do I conceal that you even exist to protect you? The world is small and eventually he would have found out…how do you trust a broken governmental system to protect the most vulnerable among us? How could I provide for you? How could I walk away from you every day to leave you in daycare? How would I afford daycare? How do I face each day, being the mom you need, stretched too thin, with no financial resources? How do I deserve you? How will it feel for you to watch your siblings leave to go see their father and you won’t have one to go to? What will you say? How will I explain it?  Will my love be stronger than the pain he caused? Am I a good enough mom? How will I afford any of this? How do I face my fears, acknowledge them, and let them go? How do I trust that the world will be here for us when the world has felt so dark?

Darkness. Everywhere things just feel dark. How could all of this happen? What did I do to deserve this? How do you keep faith in humanity when things keep going wrong. Consistently, irreparably wrong? I have always been a positive person. Looking on the bright side. Trusting the good in people. In the world. Little by little, the world is changing me. How do I stop it from changing me? How do I stop from becoming dark myself?

I tried to be brave for you. To think of the beautiful birth you would have. Would you be born wide awake and curious like your sister? Huge and quiet with one eye open like your oldest brother? Or would you sleep through a fast and furious birth like your youngest brother? I imagined wearing you in a wrap and nursing you. I imagined rocking you and holding you and our quiet days together, when your siblings were with their dad.

Were you the little girl we’ve all been hoping and waiting for? The sister that’s been longed for? Were you going to teach me that I am stronger and braver than I give myself credit for? Would you show us with your beautiful smile, your sweet grasping hands, those deep soulful eyes, and that indescribable baby smell that despite the darkness in the world, that each amazing, beautiful life possesses the power to bring meaning and light?

I will never know the answers to those questions. Your little heart stopped beating and you, my brave, sweet baby, with your short powerful life, will leave me forever wondering about you. Missing you. Loving you.

I am thankful that you have been spared the fears and possibilities that I agonized over. I am grateful and relieved and yet pained with guilt, remorse, pain, and loss. But above absolutely anything else… I love you.