Transcript of Felicity Reynolds The Evidence And Opportunities 2 April 2009
1. THE EVIDENCE AND THE OPPORTUNITIES IN AUSTRALIA NOW APRIL
2009 Felicity Reynolds CEO, Mercy Foundation
2. Presentation overview
Breaking the cycle focus
Research agenda
A very quick trip through the evidence for high cost of crisis
responses, effectiveness of Housing First, Assertive Outreach,
Permanent supportive housing, Low threshold services.
Federal and State money now!
3. The White Paper Federal Policy
Prevention Turning off the tap
Doing things better Improving and expanding
Ending homelessness Breaking the cycle
4. Research Agenda
The White Paper also calls for further research to better
evaluate current programs as well as build evidence for prevention
and effective interventions.
This will be an essential part of building on the current
evidence, especially where there is limited Australian research in
some areas.
Think about this as we run through some of the evidence.
5.
What works
(and what doesnt)
A very brief review of some of the evidence
6. High costs of not solving chronic homelessness
We have already heard some of this today but here are
references to some specific studies .
It costs essentially the same amount to house people as it does
to leave them homeless . ( Culhane, 2004)
Providing stable housing for homeless people generated cost
savings in a range of support areas. In some cases the savings paid
for most, in not all, the housing expenditure. (Berry, 2003)
7. Housing First
Again, we have heard about Housing First today there is now a
body of research that shows:
People can sustain housing straight from the streets but must
have the right support (Tsemberis and others).
People are more likely to become stable with mental health and
other conditions once in stable housing (not the other way
around).
We need more Australian based research.
8.
An example of the results of a study :
Homeless participants were randomly assigned to programs that
emphasized consumer choice or to the usual continuum of care, in
which housing and services are contingent on sobriety and progress
in treatment.
A drop-in centre approach. after 24 months only 38% of
participants had moved to community housing.
A subsequent apartment program, in which individuals in the
experimental condition moved to subsidized apartments directly from
the street, with services under their control, had 79% in stable
housing (compared to 27% in the control group) at the end of 6
months. (Tsemberis, Moran, Shinn, Asmussen, Shern, 2003)
9. Assertive outreach
There is evidence that assertive outreach is effective in
engaging and linking homeless persons with substance use disorders
to substance abuse treatment services. ( Fisk, Rakfeldt, McCormack,
2006).
10. Another outreach study
This evaluation showed that the impact of an integrated (mental
health/substance abuse) assertive community treatment program on
homeless persons with serious mental and substance use disorders.
High rates of retention in treatment, housing stability, and
community tenure were attained, and all but the most severe
substance users appeared to gain these benefits.( Meisler,
Blankertz, Santos, McKay, 2004).
11. Permanent low cost supportive housing
HASI works (SPRC evaluation, 2007)
Housing plus ongoing support (numerous international studies
eg. Tsemberis, Culhane etc)
After entering permanent supportive housing, those individuals
each used less than $26,000, and that included the cost of housing.
While making progress toward ending chronic homelessness, Portland
Oregon is saving the public over $16,000 per chronically homeless
person. (Moore. 2004).
12. Low threshold services
A managed alcohol program for homeless people with chronic
alcoholism can stabilize alcohol intake and significantly decrease
ED visits and police encounters. (Podymow, 2006)
Seaton House Annex Toronto (Report by Comeau, 2005).
However, limited longitudinal analysis or evaluation of other
managed residential alcohol programs, although they are also
implemented in the UK and Ireland.
13.
Safe Havens limited formal evaluation but local reports
indicate they work well for a particular sub-group of people who
experience chronic homelessness. But more evidence needed.
A priority to test this model in Australia and measure outcomes
over time.
14. More low cost and affordable housing
When people are forced to accept inappropriate accommodation
their situations usually get worse (Johnson, Gronda, Coutts
2008).
While refuge or transitional housing represents an effort to
maximise limited resources, it frequently leads to the initiation
of newly homeless people into the homeless subculture (Johnson et
al 2008).
15.
What are the opportunities now?
16. National initiatives
In 2008, the Australian Government introduced new funding
arrangements.
The overarching framework for this new approach is set out in
the Intergovernmental Agreement (IGA) on Federal Financial
Relations. The National Affordable Housing Agreement (NAHA) is one
of a number of new National Agreements agreed under the IGA.
From 1January 2009, the NAHA incorporated and replaced the
Commonwealth State Housing Agreement (CSHA) and the Supported
Accommodation Assistance Program (SAAP).
17.
The total funding provided by the Australian Government for
housing and homelessness to all states and territories over the
next five years under all the schemes add to:
$6.20 billion for social housing and homelessness under the
National Affordable Housing Agreement (NAHA)
$0.40 billion under the Social Housing NP
$0.40 billion for homelessness support services under the
Homelessness NP
$0.15 billion for capital construction under the Homelessness
NP (A Place To Call Home initiative)
$1.94 billion under the Remote Indigenous Housing NP
$6.40 billion for social housing under the National Building
and Jobs Plan NP
18. Matching funds from the States
In addition, under the Homelessness NP, States and Territories
will contribute matching funding of $0.40 billion for support
services and $0.15 billion for A Place To Call Home. This brings
the combined total of Australian, State and Territory Government
funding for social housing and homelessness to $16.04 billion.
The Nation Building and Jobs NP provides funding for capital
construction and refurbishment of housing stock, with the dual aims
of significantly increasing social housing stock, and rapidly
delivering economic stimulus measures to support employment and
growth.
19. Outputs and outcomes
The Homelessness NP contains a number of agreed outputs aimed
at reducing homelessness across Australia.
States and Territories have responsibility for the allocation
of funding for homelessness services within their jurisdiction, but
must achieve agreed outputs.
Mainstream services will be expected to improve their responses
to clients to prevent or respond to homelessness and targeted
homelessness services will be expected to build stronger links with
mainstream services to ensure seamless service delivery.
20. A place to call home
The A Place To Call Home program commenced in July 2008 and has
now been incorporated as one of four core outputs of the
Homelessness NP.
A Place To Call Home differs from other capital construction
funding arrangements because support for tenants is built into the
funding model.
Under the initiative, people who are at immediate risk of
homelessness move directly into permanent housing. They receive
tenancy and support services for up to 12 months
21. A place to call home a bit more
People housed under the program will not have to leave their
home at the end of the support period. The houses will be
transferred to the public housing pool and their tenancy extended
in accordance with normal arrangements for public housing. A Place
To Call Home dwellings returning to social housing stock will be
replaced by another property, ensuring a constant supply of
dwellings over the life of the program. States and Territories must
demonstrate that at least 600 additional dwellings have been added
to social housing stock by 30 June 2013.
22.
Australian Government funding is provided for the capital
component of the A Place To Call Home program. States and
Territories are matching Australian Government funding to provide
land, construction or refurbishment of dwellings, and support
services.
Some States are implementing innovative supported housing
models, including Foyer models and Common Ground models to provide
long term housing and support for people who have been chronically
homeless.
These more complex housing models require a longer planning and
lead time for delivery than is acceptable under the National
Building and Jobs NP, although all are expected to be operational
by 30 June 2011.
23.
An important final point:
What gets measured gets done (NAEH)
(Setting clear targets and making clear agreements was a great
move!)