Study finds housing-first model improves overall well-being

Community Rebuilders report shows permanent supportive housing worked for 47 households studied.
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Neighborhoods of Focus include 17 low-income census tracts on the west and southeast sides of Grand Rapids. Courtesy Community Rebuilders

A nonprofit that provides permanent supportive housing for low-income, physically or mentally disabled, and long-term homeless families in Kent County published a study that shows its programs are improving consumer well-being over time.

Grand Rapids-based Community Rebuilders engaged Public Sector Consultants to conduct a Permanent Supportive Housing (PSH) Evaluation Report, prepared this spring, that evaluated a sample size of 47 households in Kent County that have been served by Community Rebuilders’ PSH programs.

As funding for the full evaluation was provided by a grant through Spectrum Health Healthier Communities, most of the households included in the sample size — 35 — were located in Spectrum Health Healthier Communities’ Neighborhoods of Focus (see graphic), which are 17 low-income census tracts on the west and southeast sides of Grand Rapids.

The heads of household in the 47 families included in the evaluation were disproportionately Black or African American, majority female and generally middle-aged. The households studied are all current Community Rebuilders customers and have remained housed since they entered the program — anywhere from 21 days to nearly 21 years, with an average length of time of more than three years.

The study showed that since accessing services, the households served have not only obtained stable, safe, affordable housing, but also experienced increased income (35%); improved health (53% increased their physical health and 28% increased their mental health) and increased access to health care (51%); increased access to food (51%) and transportation (50%); and greater overall well-being and customer satisfaction.

Anna Diaz, vice president of Community Rebuilders, said the PSH programs her organization offers — which include Housing Solutions, Heroes, LOFT and Shelter Plus Care and offer long-term rental assistance and other supportive services — are designed with the goal of making homelessness rare, brief and nonrecurring.

Community Rebuilders takes a “housing-first” approach, in which participants do not need to address other problems or complete treatment prior to being housed. This compares to a “housing readiness” model used by some nonprofits that require people to gain certain skills or meet certain baselines before they move into housing. The housing-first approach prioritizes providing permanent housing to people experiencing homelessness, to give them a stable platform from which they can pursue personal goals and improve their quality of life.

Diaz said Community Rebuilders’ approach of securing housing for clients first, then working with them through case management to address their other issues, just makes sense, as the nonprofit is working with the county’s most vulnerable populations who can’t access things such as insulin for their diabetes unless they have a refrigerator to store it in or Social Security Income/Social Security Disability Income if they don’t have an address to which the government can mail checks and other communications.

Community Rebuilders’ PSH programs are funded by the U.S. Department of Housing and Urban Development (HUD), which has established criteria for safe, decent and sanitary housing, as well as a housing affordability standard that stipulates consumers pay no more than 30% of their income on housing so that they can also pay their other bills. Community Rebuilders then pays the difference using HUD funds.

Gross monthly rent for the housing units leased by families in the evaluation population for the study ranged from $623 to $1,462 with a median of $817. With rental subsidies, the tenant portion of the rent ranged from $0 to $448 per month with a median of $88 per month. In comparison, the average median monthly rent in the 17 Census tracts included in the NOF area is $920. In Grand Rapids, median monthly rent is $925, and in Kent County, median rent is $899 per month.

Anna Diaz. Courtesy Community Rebuilders

Diaz said there’s a pervasive misconception that people who are homeless don’t want housing or aren’t ready for housing, when in fact, it’s often just the opposite. Community Rebuilders offers consumers housing choice, helping them secure housing where they want to live — maybe it’s somewhere close to their existing social support networks or somewhere away from neighborhoods that are problematic for them — and clients are eager to accept it.

“What we’ve learned through our work is that when you’re offering housing choice and you are helping consumers understand that they’re the experts in their lives, and we’re here to walk alongside them, for many consumers, this is the first time that they’ve ever had this opportunity and are very excited to be able to start finding housing on their own,” she said. “We offer case management supports to help them with navigating the housing market, with discussing what are your needs and preferences with housing? Where do you want to live? Is there a certain place you want to stay away from? (Helping them with) understanding that we have federal program funds so units must be under fair market rents, and what does that affordability look like for them? And that’s just the beginning piece of that case management service.”

She said the PSH model takes a strengths-based approach that honors consumers and gives them agency, and she believes this report proves it also is successful. If the head of household continues to meet the income and disability thresholds that prevent them from maintaining housing on their own, they can continue in the PSH program indefinitely.

Community Rebuilders has shared the report with Spectrum Health Healthier Communities, as well as with its email subscribers, and Diaz said she hopes the study brings the PSH model to the forefront of people’s minds so that they see there are solutions that have the potential to end homelessness permanently in Kent County.

In the most recently published Point in Time count (2020), Kent County reported 185 chronically homeless people, of which 44 were unsheltered and 141 were sheltered. Thirty of those were chronically homeless sheltered people in households with a minor child, 111 were chronically homeless sheltered people in a household without children and 43 were chronically homeless unsheltered people without children.

“We believe that this can be done, and we believe that having programs designed such as what you see here in this report can help end homelessness in Kent County altogether,” Diaz said.

“We think that this is a recipe for success, but we can’t do it alone. Being able to share data and share the information with the whole community only brings more attention to this critical need of homelessness. Any way that we can have this as a conversation starter or help with additional funding to the cause is critical.”

More information about Community Rebuilders is at communityrebuilders.org. The full report can be accessed at bit.ly/PSHreport, and a summary is available at bit.ly/PSHreportsummary.

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