| Questions and Answers
About the "Chronic Homelessness Initiative"
In February 2002, NCH released a paper entitled "Poverty Versus
Pathology: What's Chronic About Homelessness?" That paper assessed
the initiative to "end chronic homelessness" and the policies
Since that time, the "chronic homelessness" initiative has
taken more specific forms in federal policy and legislation. Unfortunately,
much confusion still exists about the nature and impact of the policies,
as well as the opposition to them.
NCH has prepared this document to resolve common misunderstandings about
the "chronic homelessness" initiative, to clarify the impact
of proposed policies, and to re-state concerns about what we believe to
be a short-sighted and misguided initiative.
What is the "Chronic Homelessness" Initiative?
The "chronic homelessness" initiative is a campaign to target
federal, state, and local homeless assistance and other resources to people
who meet the definition of "chronic homelessness."
What is the Federal Definition of "Chronic Homelessness?"
A "chronically homeless" person is defined as "an unaccompanied
homeless individual with a disabling condition who has either been continuously
homeless for a year or more, or has had at least four episodes of homelessness
in the past three years." (1)
By definition, the "chronic homelessness" initiative excludes
the following groups of people: children (with disabilities and without
disabilities) who are homeless with their parents; parents (with disabilities
and without disabilities) who are homeless and who have children with
them; youth on their own with disabilities who have not been homeless
long enough to fit the federal definition; youth on their own without
disabilities; unaccompanied individuals with disabilities who have not
been homeless long enough to fit the federal definition; unaccompanied
individuals without disabilities; and unaccompanied individuals who are
unwilling to be declared disabled.
What is the Stated Rationale for the Chronic Homelessness Initiative?
Proponents of the chronic homelessness initiative point to research analyzing
the shelter use patterns of single adults in publicly funded shelters
in New York and Philadelphia. (2) This research found
that 80% of these shelter users experienced a single episode of homelessness
and stayed in shelter for a relatively short period of time; another 10%
had four or five episodes of homelessness and, cumulatively, stayed in
shelter for a longer period of time; and yet another 10% had an average
of two episodes of homelessness, but stayed an even longer cumulative
time in shelter. This last group of people, classified as "chronically
homeless," and often suffering from serious health and mental health
issues, occupied 50% of the total number of shelter days over a three-year
Many policy implications have been drawn from this research. Most significantly,
proponents of the "chronic homelessness" initiative argue that
because the "chronically homeless" group "used up"
half of all the shelter days, a larger portion of homeless assistance
dollars should be targeted to permanent supportive housing for them. The
often-stated purpose of this policy is to "free up" more emergency
shelter beds for the remaining 90% in need.
Why is this Rationale, and the Policy Implications Drawn from it,
Inappropriate and Misleading?
While the above-cited research is informative, the conclusions that have
been drawn from it are misleading and inappropriate as a basis for national
- The claim that "'chronically homeless' people represent 10%
of all homeless people, and use up 50% of all homeless
services" is a misrepresentation of the research findings. The
particular study that lead to the typology of "chronically homeless"
only included data regarding single adults who used publicly funded
shelters in two major metropolitan areas. It did not include families
with children or unaccompanied youth. Nor did it include rural or suburban
areas. Finally, the study did not measure use of any service
other than publicly-funded, centrally-administered emergency shelter
days. Therefore, the claim that "chronically homeless" people
represent 10% of all homeless people, and use up 50% of all
homeless services" is incorrect and should not be used as the basis
of national policy.
- Targeting resources toward permanent supportive housing for the
"chronically homeless," as currently proposed, is unlikely
to "free up" emergency resources for families or other populations.
The argument that targeting resources toward permanent supportive
housing for the "chronically homeless" will "free up"
emergency resources for families and other populations assumes that
there is a fixed, unchanging population of people who are "chronically
homeless," and that "freed up" shelter beds will go to
serve other populations. Neither assumption is true. Without addressing
the causes of homelessness among people with disabilities, new people
will continue to join the ranks of the "chronically homeless"
and be in need emergency shelter beds. Moreover, no plan, discussion,
or proposed restructuring of homeless assistance grants has been offered
to specify precisely how "freed up" emergency shelter
resources will be redirected toward "non-chronic" populations.
In the absence of such a plan, or a significant influx of new resources
for all populations, the targeting of resources toward permanent
supportive housing for the "chronically homeless" merely re-shuffles
the deck, resulting in fewer, not more, services for families
and other populations.
- The "chronic homelessness initiative," as currently envisioned,
is incapable of "ending homelessness" for people with disabilities.
While permanent supportive housing targeted to people who are currently
homeless is an essential service in resolving the homelessness of
many people with disabilities, it cannot prevent currently housed
people with disabilities from losing their housing. Even if enough funding
were allocated for permanent supportive housing for every person who
is currently "chronically homeless," new individuals with
disabilities would continue to become homeless because the underlying
causes of their homelessness are not addressed by the initiative. Similarly,
while "discharge planning" has been part of the "chronic
homelessness" discussion around prevention, it becomes merely an
ad hoc exercise in problem management when no affordable housing exists
to which people can be discharged. Only a sustained effort to address
the long-term causes of homelessness, including lack of adequate health
care, affordable housing, and livable incomes, will prevent and end
homelessness for people with -- and without -- disabilities.
- The argument that "chronically homeless" people are "the
most vulnerable" among people experiencing homelessness, and therefore
deserving of greater attention and resources, is inappropriate.
Proponents of the chronic homelessness initiative have sought to garner
support for it by asserting that "chronically homeless" people
are "the most vulnerable" among people experiencing homelessness,
and therefore deserve a greater portion of federal resources. (3)
Such assertions unethically pit needy populations against each other
for service dollars. Moreover, the accuracy of the assertion is undermined
when research on children is considered -- research that is strikingly
absent from discussion at the federal policy level. Rarely mentioned,
for example, is the finding that young children were most at risk of
staying in public shelter in New York and Philadelphia, and the younger
the child, the greater the risk; indeed, infants under the age of one
had the highest rates of shelter use. (4) To assume
that these children are less vulnerable to the ill effects of homelessness
because they move through the public shelter system more quickly is
wrong. Many of the horrific conditions of homelessness directly contribute
to physical, mental and emotional harm. For example, infants and toddlers
who are homeless are at extreme risk of developmental delays and health
complications. (5) Children experiencing homelessness
are diagnosed with learning disabilities at much higher rates than other
children. (6) In addition, there is evidence that experiencing
homelessness as a child is associated with experiencing deep poverty
and homelessness as an adult. (7) Ignoring the plight
of this equally vulnerable population, under the questionable assumption
that it is "less vulnerable" than single adults with disabilities,
all but guarantees the perpetuation of "chronic" homelessness
into the foreseeable future.
What is the Impact of the Federal Mandate to Prioritize Chronic Homelessness
on Local Communities?
- Communities are being forced to overlook the results of their own
needs assessments in order to meet federal mandates to serve "chronically
homeless" people. As a result, federal funding is not addressing
the service gaps determined by communities. In distributing homeless
assistance grants, HUD asks communities to rank local needs and prioritize
the gaps in the resources available to meet those needs. It then awards
grants based on that process, called the "Continuum of Care."
Over the past few years, as a result of the "chronic homelessness"
initiative, HUD has given preference to communities that use funds for
permanent housing to "end homelessness for chronically homeless
people." (8) This preference disregards local
needs, realities, and emerging trends, and is therefore in direct conflict
with the stated goal of the Continuum of Care process: rather than enabling
local communities to determine their own priorities based on local need,
HUD has determined their priorities for them. Many communities have
witnessed significant growth in the scale and severity of homelessness
among families with children, unaccompanied youth, and disabled and
non-disabled populations that do not fit neatly into the "chronic
homeless" paradigm. Yet these communities are being forced to overlook
emerging needs in favor of a narrowly constructed national priority.
As a result, equally vulnerable populations face service gaps that,
if left unaddressed, have the potential to cause irreparable harm and
even lead to "chronic homelessness."
What about Poverty?
Perhaps most troubling about the "chronic homelessness" initiative
is the complete absence of any discussion of poverty and the affordable
housing crisis that underlie homelessness for all populations. To separate
homelessness from poverty and housing is fundamentally to distort its
causes; yet this is precisely what the chronic homelessness initiative
appears to have accomplished. People experiencing homelessness, and those
at-risk of experiencing homelessness, deserve better.
The "chronic homelessness" initiative is beginning to redefine
homelessness. Press releases, plans to end homelessness, and news articles
are using the terms "chronic homelessness" and "homelessness"
interchangeably, as though they were one and the same. No other kind of
homelessness appears to exist -- or at least to be worthy of discussion
or action. In this collapsing of categories, all people experiencing homelessness
are either pathologized or made invisible.
Proponents of the "chronic homelessness" initiative have attempted
to deflect criticism of the lack of attention to "non-chronic"
homelessness, especially the homelessness of families, by calling for
"research and innovation" concerning those populations. Yet
existing research has been ignored, and the involvement of service providers
and public agencies with insight and knowledge about them has been minimized.
Worse, the "chronic homelessness" initiative has diverted attention
and energies from broader solutions to homelessness, most significantly
the National Housing Trust Fund and mainstream housing assistance programs
such as the Section 8 and Section 811 programs. Without greater support
for these measures, as well as the soon-to-be-introduced Bringing America
Home Act, people with and without disabilities will continue to experience
homelessness. NCH urges service providers, advocates, public agencies,
and elected officials to discard slogans, embrace solutions, and work
to prevent and end homelessness for everyone who suffers it.
1. Notice of Funding Availability for
the Collaborative Initiative to Help End Chronic Homelessness/Federal
Register, Vol. 68, No. 17/Monday, January 27, 2003, 4019. This definition
is shared by the U.S. Department of Housing and Urban Development, the
U.S. Department of Health and Human Services, and the U.S. Department
of Veterans Affairs.
2. Culhane, D.P. & Kuhn, R. (1997).
Patterns and determinants of shelter utilization among single homeless
adults in New York City and Philadelphia: A longitudinal analysis of homelessness.
Journal of Policy Analysis and Management, 17 (1) 23-43.
3. News Release, U.S. Department of
Housing and Urban Development, December 17, 2002. "Bush Administration
Awards Record $1.1 Billion to Provide Housing and Services to Homeless
Individuals and Families."
4. Culhane, DP & Metraux, S (1996).
One year rates of public shelter utilization by race, sex, age and poverty
status in New York City (1990-1995) and Philadelphia (1995).
5. Homeless infants and toddlers have
higher rates of low birth weight and need special care right after birth
four times as often as other children. Nearly 70 percent of homeless infants
and toddlers have chronic illnesses. Children experiencing homelessness
are diagnosed with learning disabilities at twice the rate of other children,
and suffer from emotional or behavioral problems that interfere with learning
at almost three times the rate of other children. The Better Homes Fund,
America's New Outcasts: Homeless Children (1999).
7. Interagency Council on the Homeless,
Homelessness: Programs and the People They Serve, 1999.
8. Notification of Funding Availability
for Continuum of Care Homeless Assistance Programs, Office of Community
Planning and Development, U.S. Department of Housing and Urban Development;
Federal Register: April 25, 2003 (Volume 68, Number 80)].