You need housing to achieve stability, not the other way around.
February 19, 2015 10:59 AM   Subscribe

We could, as a country, look at the root causes of homelessness and try to fix them. One of the main causes is that a lot of people can't afford a place to live. They don't have enough money to pay rent, even for the cheapest dives available. Prices are rising, inventory is extremely tight, and the upshot is, as a new report by the Urban Institute finds, that there's only 29 affordable units available for every 100 extremely low-income households. So we could create more jobs, redistribute the wealth, improve education, socialize health carebasically redesign our political and economic systems to make sure everybody can afford a roof over their heads.

Instead of this, we do one of two things: We stick our heads in the sand or try to find bandages for the symptoms. This story is about how Utah has found a third way.
Scott Carrier reports for Mother Jones on Utah's simple, cost-effective approach to ending homelessness: "finding and building apartments where homeless people can live, permanently, with no strings attached. It's a program, or more accurately a philosophy, called Housing First."

+ Hasan Minhaj investigates Housing First in Salt Lake City for The Daily Show: The Homeless Homed [video only]

+ Christopher Smart for The Salt Lake Tribune: Will Utah end chronic homelessness in 2015?

+ A four-part series published by NationSwell earlier this year:
• part 1: Utah Set the Ambitious Goal to End Homelessness in 2015. It's Closer Than Ever
• part 2: 13 Images of Resilient Utah Residents Who Survived Being Homeless
• part 3: The Compassionate Utah Official Who Believes in Housing First, Asking Questions Later
• part 4: Far From Finished: Utah's 5-Step Plan to Continue Helping the Homeless
+ Although it doesn't focus on Utah specifically, this special reporting project was published by NPR in 2002 (!):
Housing First is a yearlong special reporting project by a team of NPR News radio and Web journalists. Through extensive coverage on-air and online, Housing First will explore why it's so difficult for Americans with special needs to find good housing -- and how the lack of housing often stymies their efforts to join, and flourish in, the mainstream of society.

Tales of New Beginnings
• part 1: "This isn't a bad place, but still..."
• part 2: Beatriz and Jennifer move out
• Part 3: The promised land of a new home
• part 4: No beds, no gas -- but Beatriz is home
• part 5: In the quest to succeed, 'no margin for error'
• part 6: Coming out the other side of homelessness

who needs housing?
people fleeing abusive living situations, people recovering from substance abuse, ex-offenders, youth leaving foster care, chronically homeless people, people with mental illness, people with mental disabilities, people with physical disabilities
//

To find a shelter in your area, visit the U.S. Department of Housing and Urban Development's State-by-State Homeless Shelter Listing, Homeless Shelter Directory[.org], the National Coalition for the Homeless, or the HUD Exchange's Resources for Homeless Persons.

★ If you are a young person at risk of becoming homeless, visit 1800runaway.org or call 1-800-786-2929 (1-800-RUNAWAY).
★ If you are a veteran in the same situation, visit the VA's Housing Assistance for Homeless Veterans site or call 1-877-424-3838 (1-877-4AID VET).
★ If you are in danger of experiencing domestic violence or simply hoping to help someone who is, call 1-800-799-7233 (1-800-799-SAFE) or 1-800-787-3224 (TTY) or visit thehotline.org.

For 24/7 access to confidential, personalized referrals to a variety of community resources -- crisis housing, long-term shelter, and beyond -- just call 2-1-1 (toll-free) or visit 211.org.
posted by divined by radio (114 comments total) 122 users marked this as a favorite
 
Every time there is a story on the local news about homelessness and they do the handwringing BUT WHAT CAN WE DO portion of it I end up screaming GIVE THEM PLACES TO LIVE at the television. I really need to stop watching TV news.
posted by rtha at 11:03 AM on February 19, 2015 [32 favorites]


Also, this is a fantastic post. Thank you!
posted by rtha at 11:03 AM on February 19, 2015 [3 favorites]


Our local LGBT shelter for children, the Ali Forney Center, has over 200 kids on the waiting list. They opened a 24 hour drop in center last month, for meals, showers, clothing, HIV support, mental health services, and case management at any time. The mayor in NYC has committed to adding 100 beds for LGBT homeless youth, but there are still many kids on the streets each night.
posted by roomthreeseventeen at 11:09 AM on February 19, 2015 [3 favorites]


Housing First is actually not as uncomplicated or uncontroversial a program as you might think. I work in homeless services, and sometimes, when you house people who aren't ready for housing, they wind up burning their bridges even more than they had already been burned. This article says "In their apartments they could drink, take drugs, and suffer mental breakdowns, as long as they didn't hurt anyone or bother their neighbors" but gives the impression that that's an uncommon situation. In fact, with the chronically homeless, that's a very common situation. They have difficulty complying with apartment complex rules, difficulty not bothering their neighbors or getting in fights. Some have difficulty with hoarding and so it becomes a health hazard. The article also notes the problem of chronically homeless wanting to invite their friends to live with them - but fails to mention that the only real "solution" that many of these places have for repeated violations is eviction.

Housing is not always a cure for homelessness - it's simplistic, and sounds nice, but it really doesn't go far enough for sustainability.
posted by corb at 11:16 AM on February 19, 2015 [35 favorites]


This is an awesome post and filled with resources that I can throw at my classes the next time they're all "Why don't those bums just get jobs?" (I respond with "Well, what do you need to get a job?" "What do you mean?" "Are you going to hire someone who hasn't had a chance to shower in a week?" "Um, well, no..." "What about an address for tax forms? A phone to call if there's an extra shift?" "Um, er, well...")

So thank you.
posted by joycehealy at 11:16 AM on February 19, 2015 [14 favorites]


In San Francisco, the Homeless Youth Alliance got evicted from its space because their landlord skyrocketed their rent, and has been homeless for more than a year. I wish I were making this up.
posted by rtha at 11:19 AM on February 19, 2015 [9 favorites]


This is excellent reporting and a fantastic post. Thank you.
posted by harrietthespy at 11:20 AM on February 19, 2015


corb I don't think they elided that as much as you think. I read the Mother Jones article yesterday and one of the things they were very clear about was that part of the solution is providing mental health and addiction services and therapy to help solve the socialization skills problems as well.
posted by lonefrontranger at 11:22 AM on February 19, 2015 [4 favorites]


Housing is exactly a cure for homelessness. If we can't design, fund, and staff programs that fully address people's mental health and physical health issues, family configurations, histories of trauma, and economic realities, that is on us, not on the people who are being failed yet again.
posted by gingerbeer at 11:23 AM on February 19, 2015 [25 favorites]


one of the things they were very clear about was that part of the solution is providing mental health and addiction services and therapy to help solve the socialization skills problems as well.

The problem is that many of the people who have gotten to the stage of chronically homeless have absolutely zero interest in that kind of resocialization/therapy/services - and in fact, will often turn down housing or attempt to leave it when it does include those services. So what, genuinely, do you do? What do you do with, for example, Client X who thinks that his rights are being infringed upon if he can't hang out outside his apartment and aggressively catcall every woman who walks by? What do you do with Client Y who gets in fights whenever he feels he's 'disrespected' which could include simply someone trying to look past him? What do you do with Client Z who goes knocking on other people's doors and trying to force his way in and 'borrow' various items?
posted by corb at 11:27 AM on February 19, 2015 [11 favorites]


Every time there is a story on the local news about homelessness and they do the handwringing BUT WHAT CAN WE DO portion of it I end up screaming GIVE THEM PLACES TO LIVE at the television.

Where I live they've stopped even pretending to wring their hands. The homeless only make an appearance once or twice a year in the winter when it's so cold that the few shelters get TV remote trucks in front of them for a couple of days with shoots about "helping the homeless stay out of the bitter cold." Otherwise, it's invisibility 24/7.
posted by blucevalo at 11:33 AM on February 19, 2015 [1 favorite]


What I do is house the many other people who don't have those problems and then work on ways to help the rest. There should be nothing controversial about taking care of some of the low-hanging fruit even when solutions to some of the harder cases to crack aren't within our grasp yet.
posted by tonycpsu at 11:33 AM on February 19, 2015 [31 favorites]


Dangerous people will be harassing and assaulting people whether they have a home or not. Assaulting people is illegal and we can still use the criminal justice system to require dangerous people be supervised or rehabilitated.

Removing people's homes doesn't make them less dangerous.
posted by xarnop at 11:34 AM on February 19, 2015 [15 favorites]


And assuming people you don't know are dangerous and therefore PREEMPTIVELY refusing to give them homes just in case is needlessly cruel and inhumane. If they break the law they can be reported. We should also be designing a rehabilitative criminal justice system, and have a section of "prisons" that are essentially mental health care centers that help people who have committed crimes due to mental health/addiction issues become safe or live in supervised housing where they can get the care they need instead of people punished for an illness or trauma issues.
posted by xarnop at 11:37 AM on February 19, 2015 [10 favorites]


There should be nothing controversial about taking care of some of the low-hanging fruit even when solutions to some of the harder cases to crack aren't within our grasp yet.

I completely agree, but a lot of the times, people try to get funding or political will by promising a solution to the situations we don't have solutions for. Really we should actually be focusing on that 85% who are temporarily homeless in the interests of preventing them from becoming chronically homeless, rather than starting with the chronically homeless which are a far more difficult proposition. However, the way these programs go is usually the opposite way - for the most visible cases, rather than the easiest to aid ones.
posted by corb at 11:39 AM on February 19, 2015 [15 favorites]


Come to think of it, I had a place to live before I got an education and a job.
posted by thelonius at 11:39 AM on February 19, 2015 [3 favorites]


So what, genuinely, do you do

I think maybe that you don't imply that no help is possible for anyone if some people can't or won't be helped in particular ways that would benefit a lot of people.
posted by rtha at 11:39 AM on February 19, 2015 [13 favorites]


Housing First is actually not as uncomplicated or uncontroversial a program as you might think.

It's Housing FIRST, not Housing Only
posted by showbiz_liz at 11:41 AM on February 19, 2015 [18 favorites]


If they break the law they can be reported.

You mean, put them in the general population first and just hope that their previously evident problematic behavior will just magically disappear? That so doesn't work.

a lot of the times, people try to get funding or political will by promising a solution to the situations we don't have solutions for.

THIS. People want things like schizophrenia or major heroin addiction to be magically cured with the snap of a finger or a few hundred dollars. That would be so nice.

Great post!!
posted by Melismata at 11:47 AM on February 19, 2015 [4 favorites]


I can understand corb's frustration, though. Much like with education, one great idea gets promoted, that works great for some but doesn't work all the time, and so needs adjustment or additions. But there's not much support for that last part, where you confront the ways your great idea doesn't work, and what to do next.

Homelessness is a tough problem, because it's deeply tied into mental illness and the failures of our capitalist system and racism, and other very tough problems. No one thing is going to fix it.

But, I'm glad they're doing this program, and I hope they can work out strategies to deal with those who are still struggling even with this program. If it helps even a few folks to get to a better place, it's worth it.
posted by emjaybee at 11:50 AM on February 19, 2015 [8 favorites]


I completely agree, but a lot of the times,

How about we focus on this time, not "a lot of the times"? How about we celebrate the fact that a lot of people are off the street and also costing the taxpayers less? Pareto-improving public policy interventions don't grow on trees. The funds saved with this program could go toward the temporarily homeless if you like, but the existence of the temporarily homeless doesn't change the fact that this is an unambiguously good thing that we should try to replicate elsewhere even if we don't have any ready solution for other segments of the homeless population.
posted by tonycpsu at 11:51 AM on February 19, 2015 [10 favorites]


Yeah, homelessness is really a failure of political will. Charlies Hales of Portland or Ed Lee of SF could easily be the mayor that solves homelessness, or at least reduces it. But the developers and the landlords matter most.

I've reached the point where I've developed some very cynical conclusions about my nations policies. It may not be official, but our government wants an unending war on drugs, to supply cheap slave labor to replace the former latino cheap slave labor of the bracero era;
Our government wants strong police state and a thriving security industry, and so mass shootings are tolerated. Everybody in America gets to play the death lottery. Sandy Hook isn't a bug, it's a feature of our social design. A certain continuous baseline of random violence is the point.
And homelessness is a program. It's a policy to weaken labor negotiations and to drive up worker productivity. Because we're all living in fear of living out on the streets. Homelessness keeps wages down, strikes infrequent, and overtime without payment high. It breeds sycophancy and obedience in the greater demographic.

The great illusion of American propaganda is the notion that our social vices are unintentional. They are deliberate, orchestrated to keep the masses on the razor margin of too anxious to argue. The first step to any accommodation with American society is to recognize that your government and your media are inimical to your personal achievement of any lasting peace or satisfaction.
posted by LeRoienJaune at 11:54 AM on February 19, 2015 [32 favorites]


I wholeheartedly support this. Until we start building huge low income apartment complexes with no oversight or support in marginal areas of town. That's been done in multiple countries and societies and it pretty much always ended poorly.
posted by fshgrl at 11:56 AM on February 19, 2015 [3 favorites]




I've actually known a couple of homeless people - now housed, though both precariously - pretty well. I also shared housing with a guy who had been in and out of homelessness and who was dropped into homelessness again after we could no longer handle living with him and the alternative housing he found did not work out. (That was a decision that I regret, actually - I was a lot younger and I think I should have worked stuff out instead of bailing.) I'd say that I have known a reasonable sample of homeless people on a casual basis over a long period.

Actually, I also have a pretty good friend who I realize now that I don't think of as "homeless" because I think of her as too artistic and bohemian to be homeless and because she has mostly been able to stay literally off the street, but a lot of her "housing" has been of the "clandestinely sleeping in [place I have daytime access to]" variety and she hasn't had a stable place to call home as long as I've known her.

Things that occur to me:

1. Almost all those people could have handled a small room of their own. My closer friends were mostly suffering from a mixture of racism, depression, bad luck, gender stuff and poverty, and would have had no trouble dealing with their own small space. Even the guy who I lived with who couldn't handle an apartment on his own - that was really because he was either sick (off his meds) or exhausted and foggy (on them) and it was the administrative/paperwork angle that got him.

2. One person I knew quite well always seemed to me to be fairly unstable - until she got housing. We'd talk (she stayed with us sometimes, but often preferred to be on her own even if that meant sleeping rough) and she'd ramble and get a little weird, and I figured that she was homeless because she was ill. And then she lucked into housing - not even that great housing, just a place where she would always be able to stay - and after a couple of months, no more rambling! She'd been scattered and weird because she was exhausted, hypervigilant and stressed, ie homeless. Obviously this isn't the case for every unhoused person, but I think a lot of people who are ill/angry/paranoid/confused would probably see an amelioration in their symptoms if they had stable, adequate housing.

3. I think there is an issue with housing mentally ill/angry/paranoid people, not least how to keep the housing situation stable and comfortable for people who are themselves more functional. It's no good living in close quarters with someone who is yelling and paranoid or creepy and stalkery. Maybe some people have to get kicked out and can't be housed, or can't be housed in a particular place. Maybe design can ameliorate some of this - better sound insulation, designing so that there aren't small hallways where people can be cornered, etc. And I think there's a legit tension - you don't want to make people live in a panopticon just because they're in state-provided housing. How do you balance that with the need to make sure that people aren't hoarding food garbage, for instance?

But seriously, I think this is the very paradigm of "don't let the perfect be the enemy of the good.
posted by Frowner at 12:01 PM on February 19, 2015 [60 favorites]


Re the bad apples spoiling the barrel: seems as though there needs to be something between a prison and an apartment complex to house the bad apples and hopefully rehab them, but at least get them off the street without putting them through the sausage grinder. That doesn't sound especially like rocket surgery, just a big pain the butt for whoever runs it.
posted by tspae at 12:05 PM on February 19, 2015 [2 favorites]


How about we focus on this time, not "a lot of the time"

exactly. The Utah program was focused primarily on what sounded like the worst of the worst cases of chronic homelessness and the takeaway from the MJ article is that 85% of these hardest cases were still off the streets and doing well after several years in the program.

THAT is the takeaway, not concern trolling about outlier cases who can't be "fixed".
posted by lonefrontranger at 12:05 PM on February 19, 2015 [11 favorites]


But- is people living on the streets healthier or more human for them than living in housing that they can't maintain properly? Is it safer or healthier on the street when it's freezing outside or in an apartment with roaches/mice but that still has a heater?

Where would you rather stay? How is it more humane to say "these homes are trashy so therefore people are better off sleeping in the cold! Behind a dumpster! WHERE THERE ARE RATS AND ROACHES?"

I guess it's more humane, if by making homeless people more invisible by keeping them out of housing projects and I guess the assumption is they will go live in homeless camps outside of town and disappear or something? Or if you destroy the housing projects they will just, magically get better?

We have all these rules about not letting squaters stay in empty buildings (that are out of repair and are going to be torn down anyways) often there are "safety concerns" which is such a joke. Like sleeping on the street on a bunch of ice isn't a safety concern.
posted by xarnop at 12:05 PM on February 19, 2015 [2 favorites]


I can understand corb's frustration, though. Much like with education, one great idea gets promoted, that works great for some but doesn't work all the time, and so needs adjustment or additions. But there's not much support for that last part, where you confront the ways your great idea doesn't work, and what to do next.

I disagree. I mean sure, partisan polarization in Congress has meant there's very little ability to get anything done, but throughout the 20th century all the way through the Clinton administration, there was a long history of programs at the federal level being set into motion with a very narrow mandate, demonstrating some success, but then being tweaked when problems were discovered.

Of course there's a "bug or feature" aspect -- Clinton saw the problem that people were getting welfare benefits for too long as a bug, whereas other people saw those interventions that got people off the welfare rolls as making the program worse -- but I disagree that we never or rarely try to fix programs in motion, especially if you count things that can be done outside of the legislative process by political appointees and civil servants within existing law.
posted by tonycpsu at 12:06 PM on February 19, 2015


Did I miss a link to today's NYT "debate" about this? I was laughing at the dickhead thinktank guy

Oh my god that guy. If we provide housing, everyone will want some! We will incentivize people who want housing! THE HORROR. Rather than supportive housing, we should supply, uh, shelter. With supportive services. Like institutions, back in the day! Jesus, what an asshole.
posted by rtha at 12:10 PM on February 19, 2015 [1 favorite]


Also to be clear- housing first as a model IS innately much more involved than housing projects and more effective. My point is that kicking everyone out of those buildings, even if they suck, I'm still not sure what that solves.

I have friends who work in a housing first community initiative in my city and it's been going really well here for years (over ten years) and yes they have difficult things come up they have social workers and trained staff who handle those situations and ..it works. Seriously. In this case the placements and standards for different housing communities have different requirements and people who have chronic homelessness/criminal issues might be placed in a different location than women with children or people who do not have conduct problems. (And I think we should not make the focus mentally ill vs not which given that homelessness IS trauma would rule out everyone-- but rather conduct/dangerous behavior or not.)
posted by xarnop at 12:12 PM on February 19, 2015 [7 favorites]


Folks keep responding to a non-issue:

Housing First means housing people who are homeless, instead of waiting until all their issues are solved before housing htem. It turns out, having housing helps with all the other shit, including intensive drug use, mental illness, physical illness, etc.

All Housing First programs acknowledge the need for (and generally include) some level of supportive housing/case management where appropriate.

Housing First does not mean handing over house keys to schizophrenic chronic drug users. Believe me, it is not that easy. If only it were. I’m a nurse case manager for homeless people and believe me, we would all be much better off it was that easy, but even in this model it is not.
posted by latkes at 12:14 PM on February 19, 2015 [36 favorites]


I live in an expensive gentrifying neighborhood and the city recently rebuilt a condo complex as low income housing. It's dense but it's nice: mix of family and smaller units, handicap accessible, garages, well built buildings with modern insulation and fixtures, on the bike trail, next to a park and in an awesome school district. A LOT of people were like "I would pay so much to live there!!" But that's not the point, the point is that we are all better off having this kind of housing scattered throughout the city.
posted by fshgrl at 12:14 PM on February 19, 2015 [7 favorites]


This is great and I hope this concept is put to use everywhere it is applicable. I think one would quite clearly be missing the point if one were to overlook the fact that it does seem to work most of the time, even for what would be considered the most difficult cases, as is clearly stated in the articles.

To me it is interesting that the economics are the way around the "moral" objection. ("Why should I reward these people for their homelessness by providing them an apartment?" "Because it will cost you less than the status quo.")
posted by snofoam at 12:18 PM on February 19, 2015 [4 favorites]


schizophrenic [violent] chronic drug users...

based on the constant back-and-forth I see in our own city council discussions of this issue here in Boulder, plus the constant hand-wringy articles in the Daily Camera / Denver Post and similar, I'm pretty well convinced this trope is the "welfare queens!!!1111" of homelessness that are being used to drive public opinion tbh. I mean it's not that they don't exist? it's that the rare truly dangerous / violent mentally ill homeless out there are being used as a bludgeon to invalidate anyone's opinion on the matter.
posted by lonefrontranger at 12:20 PM on February 19, 2015 [1 favorite]


Also, I have a family member who lives in what I personally find (and I believe any fire inspector would agree) is a place that he has made unfit for human habitation, filled with piles of hoarded objects and garbage, coated in dust and grime, occassionally without heat when he can't get it together to pay for heating oil, etc. I still would much, much rather he live there than live outside in the place where my outside-sleeping homless patients sleep.

Shelter is a basic human need, on par with food, and should be provided for all in any society that is just. What is the point in having government or social organization if we cannot meet the most basic level of need for the people who live in our society?
posted by latkes at 12:34 PM on February 19, 2015 [14 favorites]


Here in Toronto there is an established cycle: we handwring in the new year with a few articles about homlessness after a bunch of people freeze to death. Then one of the Brothers Ford says something about how they should all be turned into pet food or something and we all make angry noises and agree that it's awful, except the Sun, which finds a way to defend them with a 30-character headline with a sub-Zaltzman pun in it.

Then our more enlightened municipal/provincial/federal leadership engages in another rounds of social services cuts. Lather; rinse; repeat.
posted by [expletive deleted] at 12:34 PM on February 19, 2015 [3 favorites]


> This article says "In their apartments they could drink, take drugs, and suffer mental breakdowns, as long as they didn't hurt anyone or bother their neighbors" but gives the impression that that's an uncommon situation. In fact, with the chronically homeless, that's a very common situation. They have difficulty complying with apartment complex rules, difficulty not bothering their neighbors or getting in fights.

Frankly...so what? It's a very common problem in the never-been-homeless population as well.
posted by desuetude at 12:36 PM on February 19, 2015 [10 favorites]


Did I miss a link to today's NYT "debate" about this?

I saw it and purposely left it out of the FPP because blood started pouring out of my eyes as soon as my gaze alighted upon the "but then EVERYONE will want houses" douche dickhead think-tank guy. I'm straight-up repulsed by NYT's policy of oh-so-conveniently leaving out the tilt of their commentators' allegiances when it comes to "debates" of this nature.

Like how they describe this dude simply as "a research fellow in economic policy studies at the American Enterprise Institute," which sounds like a perfectly respectable position on its face unless or until you're moved to Google that shit, an act that immediately unveils AEI as a Republican think tank whose fellows and scholars include such humanitarian luminaries as Lynne and Dick Cheney, John Bolton, Newt Gingrich, Antonin Scalia, John Yoo, and Paul Wolfowitz. (Same with this dude and his employer, the similarly right-wing Manhattan Institute.)

Now there's an institutional mouthpiece I trust to give me the real scoop on the right way to eliminate homelessness!*


*Not.
posted by divined by radio at 12:37 PM on February 19, 2015 [7 favorites]


I know of someone who was helped immensely by this program but still had addiction problems. They are now in treatment and in another state, but I am really glad they had a warm place to live while in this program.
posted by soelo at 1:30 PM on February 19, 2015 [1 favorite]


Because of my volunteer work with Atlantans experiencing homelessness, and just chatting with the folks I see every day, I'm pretty obsessed with Housing First. I was going to tell a couple of stories here, but they're really not mine to tell, except to say that I know at least two people who would be doing so much better if they just had a place where they felt safe and comfortable and could leave their possessions. It's not mental illness to be hypervigilant or even paranoid if you sleep on a sidewalk every night, and I would love to see what these folks could be like if we could just get them to feel safe inside a room of their own somewhere.

Another issue of homelessness I've become aware of is the need for identification. Especially in states like Georgia that are obsessed with citizenship, not having id is a huge issue and getting it is very difficult even for many individuals who have a phone and a computer and an address, let alone for people who lack all of those things. One of the groups I'm involved with is the Central Outreach and Advocacy Center. They do a lot of things, but the biggest one is to help people get copies of their birth certificate and social security card so that they can then obtain a state id card. An awful lot of those id cards say that the holder lives at 201 Washington St SW (the OAC's address). But having that card at all is an important step to having an address of their own.
posted by hydropsyche at 1:32 PM on February 19, 2015 [9 favorites]


Homelessness is a complex problem. There isn't any one answer, though I would very, very much like to see some serious changes in housing policy across the nation such that it is easier for people to find and afford housing that meets their needs. Historically, we used to have a lot more SRO's and boarding houses and other alternatives. Now, in many cities, a single young person making not much money basically needs to arrange to rent a two or three bedroom apartment and share it with roommates if they can't afford a one bedroom on their own. Given my medical handicap and other issues, that's a no-go for me.

You need housing to achieve stability, not the other way around.

I have been trying to work out my own problems with the opposite theory: That I need personal stability before housing makes sense for me. And I am getting there. My health is improving and so is in my income. I am hoping to get off the street before the year is up.

Granted, I have six years of college and other personal assets that many people on the street do not have. WRT to some of the comments above about people thinking a person is better off in slum housing than no housing, well, maybe for people who would choose to sleep behind a dumpster, but that has not been my personal experience. Sleeping in a tent amidst oxygen-giving plants has been far better for my respiratory problems than the crappy mold-infested apartment I was evicted from (it was mold infested largely because the landlord was terrible about dealing with certain problems -- I never want to rent again).

I think I do have some answers that have the potential to help in some of the hard core cases of the sort corb describes. Long before I became homeless, I had a class on Homelessness and Public Policy through SFSU and I interned in a homeless shelter in Vacaville as part of that class. Most people who wind up homeless have one or more intractable personal problems that interfere with their ability to function and that tend to be expensive. Most of them have some sort of either mental health or medical diagnosis. Given how significantly my medical issues sometimes impact my mental health, I strongly suspect that most mental health issues are at least partly rooted in physical ailments. Getting people physically healthier can help them be more functional (productive) and more mentally stable.

I'm not trying to shoot this down and I hope this program does many people a lot of good. I don't think talking about cases where just sticking someone in housing isn't sufficient or even particularly helpful means that there are no cases where it is helpful. But I wish some of the housing policy changes that I would like to see were simply seen as things that are best practices for human beings and not some means to help people that more materially well-off folks often look down upon as being simply incompetent and pathetic and in need of charity. I would far prefer to see the nation pursuing a vision that includes a baseline assumption of "affordable, decent housing is good for the nation" not that it is charity for some small subset of losers and addicts and fuck-ups.

In recent months, I have had a few too many conversations with people that made it clear to me that many people see me as entirely or largely defined by my current lack of housing and serious financial problems. These have been disturbing conversations, some of them quite threatening, some with people who have known me many years and knew me well before I became homeless. I don't think the degree to which classicism is so much more acceptable than racism or sexism is particularly helpful to people on the street. Treating them as a problem to be solved instead of like whole human beings is one of the obstacles we have to deal with in life. I find the views of a lot of more well-off people about who I am and what I need to be one of the biggest challenges I face on the street.

Thank you for posting this.
posted by Michele in California at 1:44 PM on February 19, 2015 [25 favorites]


Michele, I always appreciate seeing your comments in threads discussing homelessness, as few others in this community have any direct knowledge as you do.

I like what you're saying about homelessness in the larger context of class and race too.

I think something for everyone to understand about Housing First is that, it's just a philosophy that we should not create artificial road blocks to housing for people. So where in the past, professional "helpers" said, "No, you can't have housing until you enter drug treatment" for example, that is now becoming a less acceptable policy, because the science says that is unnecessary, and that people will for example be more successful in drug treatment, in general, if they have the option of housing.

Sleeping in a tent amidst oxygen-giving plants has been far better for my respiratory problems than the crappy mold-infested apartment I was evicted from (it was mold infested largely because the landlord was terrible about dealing with certain problems -- I never want to rent again)

This is a great point and seems to work well for you. But I wouldn't want to take away the option of housing for someone to live independently because caregivers/social workers/etc disapprove of how the person keeps their home.

Landlords who refuse to do maintenance should be prosecuted, but individuals who are crappy housekeepers should not be penalized in the form of being forced to sleep on the street.
posted by latkes at 1:57 PM on February 19, 2015 [5 favorites]


But I wouldn't want to take away the option of housing for someone to live independently because caregivers/social workers/etc disapprove of how the person keeps their home.

I wouldn't either. And I find it frustrating that there never seem to be enough qualifiers, no matter how hard I try, that make it clear that I would never suggest such a thing and would be appalled if anything I said or did was used to justify or excuse such a crappy policy.

I'm aware that I always "want the moon." But, in my personal experience, the moon seems to be frequently attainable. So I remain unable to see my positions as simply unreasonable.
posted by Michele in California at 2:08 PM on February 19, 2015


I think something for everyone to understand about Housing First is that, it's just a philosophy that we should not create artificial road blocks to housing for people.

Yes, exactly. That's where I come down on this. If you're homeless, the first and most important thing is to put a roof over your head. Give you a door you can close behind yourself. Somewhere to sleep where you're not in danger of being attacked (by someone else who's homeless or by random assbags), or freezing, or being rained on, or getting arrested. An address you can use for job applications, for social support paperwork, for getting your birth certificate or social security card or drivers' licence. An address you can use so you can vote, for fuck's sake.

Of course that housing ideally comes with mental health/addictions support. But when 85% of the target population is helped, it's utter stupid bullshit to even suggest that putting a bloody roof over everyone's head is a bad place to start.

It's really simple: homeless? Here is a home. Hungry? here is food. You cannot deal with other problems when you are having to worry every moment about where you will sleep and whether you will get to eat today.
posted by feckless fecal fear mongering at 2:17 PM on February 19, 2015 [7 favorites]


I can assure you that people working in housing first for dozens of years know extensively about the problems Michele and corb are discussing and provide quality resources to address those specific problems. They EXPECT people to have exactly those problems which is why they provide extensive on site services and a variety of different styles of housing to meet different needs.

Maybe it would help for me to talk about my experience at a housing first program. They had one program designed for people with chronic homelessness/mental health issues that was a series of dorm rooms. The building has multiple staff members onsite, if I remember right 24/7. They can help residents maintain their rooms, access mental health care onsite, provide work training.... they understand that residents will be finding and losing jobs regularly.

This is why HOUSING FIRST means the housing is permanent. They have staff on site to reduce harmful behavior from residents to each other.

Housing first is not build a building and stick a bunch of people in it and stick them there-- it's very very well researched and has been functional and effective in many cities already.

This is not guess work.

This is not being done by people who don't know what they are doing.

This is literally the most demonstratably affective way to provide services.

In my experience, social workers in my city working with housing first are aware of issues that deter homeless from wanting to use services and view that as a problem with the services not with the needs of the people being served. Housing first means ADDRESSING those needs and assuming housing is part of it.

In general when someone became dangerous simply holding up a phone and talking about calling the cops was usually enough to resolve the situation; mental health police were called if someone was having a dangerous episode. If an actual assault occurred police would be called and was fairly rare.

That is how that should work.

Again, for those who haven't seen housing first in action- it specifically addresses the things you're concerned about and that is a central aspect of what makes it very different than previous designs around homeless services. They are very trauma-focused, upgrading in research and have been effectively running housing first models for dozens of years in multiple cities.

Utah is not the first place this is happening, this is simply the first state-wide implementation of an effective method of providing a necessary human service- housing.
posted by xarnop at 2:21 PM on February 19, 2015 [18 favorites]


that there's only 29 affordable units available for every 100 extremely low-income households.

Has anyone ever done a study of incentives here? My observation is that developers to strongly tend to build out units that have higher square footage, have a luxury gloss, and rent or sell above average regional costs, so my assumption is that this is a better way to cover building costs and make a profit, but I don't know, and would love to find a place where I can read more about this.
posted by weston at 3:17 PM on February 19, 2015


What is the incidence of the cost savings? IOW, if private hospitals save money or cops work a little less overtime, why should I care? If this is going to be about savings, it's gotta get to the bottom line for me as a taxpayer. Because I don't frankly care if hospitals save some money or funding to prisons is redirected elsewhere.
posted by jpe at 3:32 PM on February 19, 2015


why should I care?

Because in the wealthiest nation on earth, people shouldn't be sleeping in ditches and under bridges.
posted by feckless fecal fear mongering at 3:36 PM on February 19, 2015 [8 favorites]


Having read What's the Matter with Kansas, I vote for my self-interest.

At any rate, these studies are expressly framing it in terms of my self-interest. I don't feel like it's too much to ask that they do so transparently and clearly.
posted by jpe at 3:38 PM on February 19, 2015


I vote for my self-interest

Which is exactly why people are sleeping in ditches and under bridges. Exactly why people are going without necessary medical care. Exactly why people are suffering and dying every day.

Like it or not, you're part of the human race. And the only reason you're educated and wealthy enough to be typing on this website is because a whole lot of people looked past their narcissistic self-interest--wait, let's not mince words: their colossal selfishness--to make sure you got fed and taught and had the resources to buy a computer.

"Fuck you, I've got mine" is the political position of a three-year-old.
posted by feckless fecal fear mongering at 3:41 PM on February 19, 2015 [18 favorites]


weston, i can't give you studies per se, but before life got in the way, I was planning to be an city planner and I am something of a history buff.

In the 1950's, the average new home was being built for a family of 4 or 5 -- mom, dad and two or three kids -- but typically was 1200 sq ft or less and had two bedrooms, one bath. The country was throwing up suburbs right, left and center because people who had been really poor during the The Great Depression had about two years worth of income saved thanks to WWII causing a high percentage of the country to have two incomes and no kids (and no ability to have kids, since he was off on another continent at war while she was in a factory producing munitions or whatever to support the war effort). The boys came home from war and were given help with buying a house (plus access to affordable to college) and there was huge demand for single family detached housing, like never before seen. The entire country developed the construction and financing infrastructure from scratch to meet this crazy level of demand. Suddenly, you had a large middle class and a high percentage of homeowners.

In the decades since, our housing industry remains a captive of the mental models that birthed it. Financing mechanisms are geared towards single family detached homes and we have tax incentives and other financing infrastructure that actively encourages the growth of McMansions. In the intervening decades, our population has diversified and birth rates are down. We have higher percentages of unmarried people, retired couples, and other non-nuclear family situations and even in the case of nuclear families, the average number of children is down to around one.

So in 2000, the average new home housed about 3 people but was over 2000 square feet.

Anecdotally, my sister lives in Atlanta and has for some years. In a neighborhood where she rented for a time, a builder asked permission to split some land he owned into smaller lots so he could build housing more in character with the rest of the neighborhood. His request was denied. So in order to make the same amount of profit on three homes instead of the five he desired to build, my understanding is he ended up building McMansions instead of building homes more in line with the kind of housing around it that had been built decades earlier, before this neighborhood became de facto part of the city because the city grew out to meet it. (The street my sister lived on still had septic tanks on half the street -- this had been a rural neighborhood at one time, with large yards and modest homes.)

There are many, many, many ways in which our current housing policies actively encourage builders, buyers and everyone else to skew heavily towards building large houses. The guy who dreamed up the Tumbleweed House Company wanted to make a tiny house for himself and learned that was outright illegal under local ordinances requiring a minimum house size. Such ordinances often are passed with seeming good intentions and the stated goal is to prevent slum housing from being created. He got around the ordinance by putting wheels on his first house, but that does not change the fact that there are a great many things that are outright illegal these days -- things that are known to work better than our sprawling suburbs full of McMansions.

New Urbanist developers often have to run their plans past the city planners and then rename streets as 'delivery alleys' or rename things as "parking" or whatever in order to get it approved.

So this is a large part of why I said above, not to put down the Housing First program but because it appalls me that such intervention has been made necessary, that I would love to see the nation as a whole change it's housing policy. The rules we have are a huge, huge part of the problem and actively create a growing divide between people who can afford houses and very often live in McMansions and people who can't afford housing at all. It has nothing to do with suggesting this program is a bad program. It is totally about saying that, having studied housing policy as part of my college degree with intent to become an urban planner, the policies and tax incentives and "rules" of the system created this mess and if we attacked it from that angle, there would be much, much less need for programs of any sort to "help the homeless."

jpe:
And nine years into the 10-year plan to end chronic homelessness, Pendleton estimates that Utah's Housing First program cost between $10,000 and $12,000 per person, about half of the $20,000 it cost to treat and care for homeless people on the street.
posted by Michele in California at 3:43 PM on February 19, 2015 [15 favorites]


I'm glad someone thinks "What's the Matter with Kansas" evinces the moral sophistication of a 3 year old.
posted by jpe at 3:44 PM on February 19, 2015 [1 favorite]


And nine years into the 10-year plan to end chronic homelessness, Pendleton estimates that Utah's Housing First program cost between $10,000 and $12,000 per person, about half of the $20,000 it cost to treat and care for homeless people on the street.

That's aggregate cost, and that's exactly why I was asking about incidence.

At feckless: see? The argument is expressly about my self-interest. If you think I'm a meanie for taking that argument seriously, so be it.
posted by jpe at 3:46 PM on February 19, 2015


Is there any other way to describe ME ME ME ME ME ME when it comes to politics?

Do enlighten us.

It's telling that you didn't actually bother to respond substantively. Perhaps on some level you actually know how selfish your policies are.
posted by feckless fecal fear mongering at 3:47 PM on February 19, 2015


I would've responded substantively to a substantive question.
posted by jpe at 3:51 PM on February 19, 2015


Do you not understand that a whole lot of people thinking beyond their self-interest is exactly why you have the wealth and education to use the computer you're typing on?
posted by feckless fecal fear mongering at 3:54 PM on February 19, 2015 [1 favorite]


> Because I don't frankly care if hospitals save some money or funding to prisons is redirected elsewhere.

If you are too uncurious to look this stuff up for whatever municipality/state you live in, I don't see why everyone here should do your homework for you. A ton of this data is out there. It's not that hard to find. You said you read the Kansas book, so you're not unfamiliar with the terminology or vocabulary. Use those bootstraps you have.
posted by rtha at 3:56 PM on February 19, 2015 [4 favorites]


I asked you a substantive question, and instead you respond with snark. Like I said, it's telling.
posted by feckless fecal fear mongering at 3:57 PM on February 19, 2015


I have a recurring dream about converting abandoned malls and Walmarts into homeless housing and organic greenhouses and staffing them with the people who live there. Excess produce would be sold in farmers markets. No NIMBY bullshit because the buildings and their thousand acre parking lots are already there. Solar panels on the rainwater collecting roofs would cover most of the input needs.

Too simple, right?
posted by halfbuckaroo at 3:59 PM on February 19, 2015 [7 favorites]


A ton of this data is out there.

It's certainly not foregrounded in any of the linked pieces. The writing goes: housing > magic > cost savings for taxpayers.

If the goal is to be persuasive, rather than just make the echo chamber louder, it fails.
posted by jpe at 3:59 PM on February 19, 2015


housing > magic > cost savings for taxpayers.

What about 'actually giving a damn about fellow human beings'?

Also, I believe that Michele in California showed the cost savings, in any case.

What you really mean, of course, is that taxpayers shouldn't be paying for anything that helps people who need help.
posted by feckless fecal fear mongering at 4:03 PM on February 19, 2015 [3 favorites]


The answer I'm getting from this is that's it's *not* in my self-interest to support this.

Thanks for the circuitous answer!
posted by jpe at 4:07 PM on February 19, 2015


It's in the interests of people to support this, and you know it. I'm done with you, you're no longer even pretending to engage in good faith.
posted by feckless fecal fear mongering at 4:10 PM on February 19, 2015 [1 favorite]


The argument is expressly about my self-interest

Beyond the fact that it is quantifiably cheaper to solve the problem than to not solve it, I will suggest that crime will go down and other quality of life indicators will also improve.

jpe, I raised a narcissist and managed to convince him that fucking over everyone around you is not actually in your best interest. It tends to come back to bite you in the arse. It's called enlightened self-interest. It sometimes can't be readily quantified in the way you are asking for it to be and the process of pointing it out to someone who thinks like you apparently think tends to be a long and complicated one. If you earnestly want to know if the data exists that makes it make sense in a way that works for you, I will suggest that taking a fighty position in a public forum is extremely unlikely to get you that kind of data.
posted by Michele in California at 4:16 PM on February 19, 2015 [10 favorites]


That's a really big 'if'; facts and data lay bare the moral vacuum at the centre of their ideology, and are thus rejected.
posted by feckless fecal fear mongering at 4:22 PM on February 19, 2015


jpe: "The answer I'm getting from this is that's it's *not* in my self-interest to support this. "

Ever play a team sport? Perhaps baseball? You may have heard of something called a "sacrifice fly."

You're on an enormous team. You simply choose to pretend you aren't.
posted by InsertNiftyNameHere at 4:25 PM on February 19, 2015 [8 favorites]




HOUSING FIRST means the housing is permanent. They have staff on site to reduce harmful behavior from residents to each other.

The thing is, it's really impossible to say that anything is "permanent", and the definition of "permanent housing" for homeless services does not mean what most people might think it meant if they heard the words out loud. "Permanent housing" doesn't actually mean "This person has the apartment, guaranteed, no matter what." It is a word that is used in opposition to transitional housing (usually a program for under 2 years that requires you to leave after that mandated time). So the difference between "permanent housing" and "temporary housing" is that "permanent housing" means there is no pre-mandated limit to the amount of time that you can maintain the housing. It doesn't mean you have it forever.

A vast majority of the homeless individuals I deal with have an extremely difficult time with re-housing in part because they have more than one eviction. Having one eviction I would say lessens the ability to attain affordable housing by about 50%, and the odds decrease for each additional eviction. Thus, the very real problem I have seen with Housing First programs - the thing that makes them actively more destructive than not - is that often, it sets up someone who is not ready for housing to get into an apartment and then get bounced out of it.

In addition, while supportive housing sounds great, it is important to remember that it is the most actively hated type of housing for actual homeless individuals. Most homeless individuals that I have encountered deeply dislike it - they feel that it treats them like children, they feel that it is too much of a panopticon. They hate having to sign in visitors and having to not smoke in their rooms and hilariously enough, half the time they hate being around other formerly chronically homeless people and do not want to be in a development containing them. I would say at least 10% of the calls I get are from people who are currently in supportive housing and want to get the hell out of it into an independent apartment complex. But independent apartment complex come with independent apartment complex rules - and in reality, every time an independent landlord takes a chance on a formerly chronically homeless individual and they flame out, that is usually one less landlord who wants to house the chronically homeless.

Housing First straight up doesn't work. Neither does Housing Readiness - waiting until someone is perfect before getting them into housing. What's really needed is something in between - providing support until someone is not going to actively cause problems to other people, and then housing them. And what's really, really needed, though almost no programs want to do it because it's not sexy, is support for street living. Providing street homeless with warm, protective clothing and with solid tents and sleeping bags that protect them from the elements. Providing hygiene facilities open to the street homeless, where they're not tracked in any way (homeless people also tend to hate the HMIS system) but are able to get fully clean and wash their clothes in washers provided. Places where street homeless people can get free haircuts and medical care, more often than the "stand downs" once a year or so that offer it. And don't require them to verify their homelessness - anyone who is desperate enough to go to such a location needs it.
posted by corb at 7:32 PM on February 19, 2015 [7 favorites]


Related: Million-Dollar Murray
posted by monkeymike at 7:46 PM on February 19, 2015 [1 favorite]


Housing First straight up doesn't work.

Can I ask what definitions you're using for "housing first" and " doesn't [or does] work"?
posted by rtha at 7:48 PM on February 19, 2015 [3 favorites]


The transition isn't usually a jump from rental property to homeless and vice versa. Motels land in the middle.
posted by Brocktoon at 8:18 PM on February 19, 2015


> hilariously enough, half the time they hate being around other formerly chronically homeless people and do not want to be in a development containing them

"Hilariously enough" why? Formerly chronically homeless people should be higher moral beings who are beatifically free of the sort of judgements and suspicions that..most people typically have about the neighborliness of formerly chronically homeless people?

Landlords "take a chance" on people who turn out to be bothersome, rule-breaking, perhaps unpleasant neighbors all the time. If they get the lease on their own and pay their rent, they get benefit of the doubt that a known formerly-homeless person getting housing assistance does not receive.
posted by desuetude at 8:29 PM on February 19, 2015 [3 favorites]


corb: "Housing First straight up doesn't work. "

Hahahahahaha!!!!! So the article was an outright lie? A delusion? Did the authors lie about all the people they claimed it helped?
posted by InsertNiftyNameHere at 8:54 PM on February 19, 2015 [5 favorites]


A lot of people work with homeless people and a lot of people are or have been homeless and each of us has our own experiences and opinions. I don't share corb's perspectives and I, apparently like corb, am also part of the homeless industrial complex. Personally, I think my salary would be better spent on rent for a few of my homeless clients who would fare fine in conventional housing. I do have clients who have cognitive damage and persistent, intense and debilitating drug use patterns, all of whom have unfathomable histories of intergenerational trauma reinforced by explicitly racist social structures, and all of whom, in a just world, would have the option of a safe shelter and ready access to nursing and social services.

I guess my point is, there is room for all of us to have our perspective, but research and science support Housing First.
posted by latkes at 8:58 PM on February 19, 2015 [11 favorites]


Can I ask what definitions you're using for "housing first" and " doesn't [or does] work"?

Sure, that's actually a really good question. For "Housing First" I mean, "Housing First as currently practiced by homeless service providers", which is admittedly a very, very imperfect system. It tends to mean, at least how I've seen it in practice, that people are looking for the "most needy", ie the most chronically homeless who have had the biggest difficulty getting into housing. Then they take those people and try to get them into either stand-alone "market rate" apartments with vouchers, usually that require them to pay 30% of whatever income they get as rent, or into supportive housing complexes with a lot of incredibly minute and somewhat paternalistic rules that the chronically homeless in particular have less tolerance for, in particular because if they're chronically homeless, they've already figured out that they can in fact survive on the street, and it starts to look better than being treated like a kid.

When I say "doesn't work", I mean, "It's not the most efficient use of resources, and it doesn't promote the kind of stability that advocates of it tend to promise."

It's possible that with unlimited resources and better implementation - such as the ability to pay for transportation to a location of the individuals' choice elsewhere in the country or for standalone houses that arent' dependent on external landlords- that kind of modeling could be useful. But as it stands, it just tends, in my view, not to be helpful.
posted by corb at 10:12 PM on February 19, 2015 [3 favorites]


Housing First programs - the thing that makes them actively more destructive than not

Actively destructive? By all means, show us this destruction. Not a story, show us actual documentation that the programs documented here do more harm than good. Because 85% of people still housed after a year seems like the opposite.

Housing First straight up doesn't work.

Really? Wow, that's a lot of journalists colluding in a lie then.
posted by feckless fecal fear mongering at 12:53 AM on February 20, 2015 [2 favorites]


So, uh, this seems like a good place for someone to offer some citations.
posted by atoxyl at 2:16 AM on February 20, 2015 [1 favorite]


Corb- I question how much experience you have with housing first programs as practiced in locations beyond what you've seen. "Thus, the very real problem I have seen with Housing First programs - the thing that makes them actively more destructive than not - is that often, it sets up someone who is not ready for housing to get into an apartment and then get bounced out of it. "

Because this is the opposite of how it works in my city. Given that a large body of research indicates it does in fact work, I wonder if what you have seen in practice is an evidence based version of housing first as practiced currently in a number of cities, or whether these are projections you're making up based on misunderstanding of what housing first actually is based on a model that was roughly based on housing first but not well designed you have experience with or based on your concerns about it even though you haven't actually seen a well functioning housing first program in action.

I'm all in favor of supports for street living populations, I have no problems with that,I think if people refuse the housing offered the reasons are real and they need to be addressed, not that people need to be forced into housing that is not meeting their needs.

If homeless people are a monolith as you say and no one wants these programs then why are there year long or more waiting lists for the housing first programs happening in my city, with people who get in staying so long that it drives the waiting lists up like crazy because it's working for them and there is no time limit once in?

It's clearly working for many people, and to say that it's not is destructive to expanding a highly sought after service. I'm sorry the people you saw doing housing first were doing it wrong, or you have a bad experience with it, but I'm honestly not sure from the things you're saying that you understand how housing first actually works in a functional program. I have to go to work, but I can link some more detailed descriptions of how housing first works in practice to address the concerns you're presenting.
posted by xarnop at 5:53 AM on February 20, 2015 [6 favorites]


> When I say "doesn't work", I mean, "It's not the most efficient use of resources, and it doesn't promote the kind of stability that advocates of it tend to promise."

Housing First is definitely not the silver bullet, but according even to this one study from Seattle*, asserting that it is "not the most efficient use of resources" is just incorrect.
The project demonstrated significant cost savings and reductions in alcohol use for housed individuals over the course of the first year. Cost offsets for HF participants at 6 months, in comparison with wait-list controls and accounting for the cost of housing, averaged $2449 per person per month. At 12 months, the 95 housed individuals had reduced their total costs by more than $4.0 million compared with the year prior to enrollment, or $42 964 per person per year, as compared with a cost of $13 440 per person per year to administer the housing program. Finally, length of time in housing was significantly related to reductions in use and cost of services, with those housed for the longest period of time experiencing the greatest reductions.
We have a lot of evidence that treatment first models don't work for everyone either; we have a lot of evidence that sober-only group shelters also don't work for everyone. But you're not advocating that we abandon those models. I don't understand why you insist that because Housing First doesn't work for everyone, it shouldn't be on the table.

* Full study should be available free via that link, but if it's not, click through to it from this page where it says "view the study abstract."
posted by rtha at 6:21 AM on February 20, 2015 [5 favorites]


I mean, "It's not the most efficient use of resources, and it doesn't promote the kind of stability that advocates of it tend to promise."

Extraordinary claims require extraordinary evidence. Your individual experience is certainly relevant, but the fact that it conflicts with the results presented in the FPP, the experiences of other Mefi-ites, and the Seattle study make it seem much more likely that your experience is atypical, and that you're extrapolating from your individual experiences to make blanket statements about programs that might share the same name but vary widely in how they're implemented.
posted by tonycpsu at 7:28 AM on February 20, 2015 [2 favorites]


and hilariously enough, half the time they hate being around other formerly chronically homeless people and do not want to be in a development containing them.

I am homeless. I spend all kinds of time with my homeless sons. Beyond that, I want to have little or nothing to do with other homeless people. Having a common bond of poverty is not a great starting point for a positive social relationship. Also, most people on the street have health problems. Crowding together a lot of sick people is a bad idea. It just makes all of them sicker. Also, a high percentage of street people are heterosexual men who ain't getting any puntang and see me as in their price range or something. No, no, I am not in your price range or something. I am not some cheap ass whore who will sleep with your alcoholic/drug addicted, socially impaired self just because we appear on the surface to be equally poor. In fact, if I wanted to whore myself out, doing so is a potential path off the street for me. Thanks.

There is nothing funny about it. It's a very serious issue.

And what's really, really needed, though almost no programs want to do it because it's not sexy, is support for street living. Providing street homeless with warm, protective clothing and with solid tents and sleeping bags that protect them from the elements. Providing hygiene facilities open to the street homeless, where they're not tracked in any way (homeless people also tend to hate the HMIS system) but are able to get fully clean and wash their clothes in washers provided. Places where street homeless people can get free haircuts and medical care, more often than the "stand downs" once a year or so that offer it. And don't require them to verify their homelessness - anyone who is desperate enough to go to such a location needs it.

I agree with a lot of what you have said in this paragraph and I promote that approach on my homeless site: The idea that street people should access resources that will keep them fed, keep them clean, and keep them adequately clothed and warm and safe without giving up their agency because many programs do, in fact, treat homeless people like children and want to control their lives like slaves and require you to agree to things that tend to impair your ability to get back to a middle class lifestyle and tend to foster a permanent underclass.

I would like to find more answers than that, better answers than that. But, currently, I don't know what works better than that. I do know that even the expectation that we need to get someone back into housing before we can treat them in a humane fashion puts prerequisites and conditions upon treating them decently. And when people say "First blah before we can treat you decently" the outcome is usually, nope, we are never going to treat you like an equal, a full human being, entitled to hope and dream and decide for yourself. We are always going to come up with some excuse as to why you should accept being some kind of second class citizen, having some kind of lesser life.

Again, I am really not interested in talking trash about this program. I really am not and I absolutely wasn't earlier when people reacted as if I were. But in reading the article, it is clear that their success entails basically warehousing these people in subsidized apartments with a weekly delivery of food from a food closet that they probably have little or no say in what all food they get access to.

If I told you that I have a dream that one day all black people in the U.S. would get subsidized apartments and a weekly delivery of food from a food closet, it would immediately be a shitshow. Untold numbers of people of color would rise up and tell me "Bitch, I have a college education just like you and I want a good paying job, like white folks get, and to buy my own McMansion. You can keep your goddamn insulting dream of making me part of a permanent underclass and then acting like I should be grateful for your so-called generosity."

And rightly so.

Yet, I write these remarks with some trepidation because I have already gotten pushback yesterday, when I absolutely WAS NOT criticizing this program in the slightest, because the expectation that we should actually treat homeless people like people is just a really, really hard sell. Classicism seems to be a lot, lot harder to get people to see than racism or sexism.

I am aware that some folks on the street are very, very ill and have little or no hope of ever working a full time job again and that for some of those people, a subsidized apartment and a box of food every week is far better than what they will ever be able to arrange for themselves. But we currently deal with the issue of homelessness like it is a fire and the answer is buying more fire trucks without trying to address prevention. We spend far too much time talking about getting people off the street and far too little time talking about what the hell went wrong in this country that we have the levels of homelessness that we have and what on earth can we do about these systemic issues -- such as a widespread lack of affordable, decent housing -- that are the root cause of these high numbers of homeless people.

Yes, even after you fix the systemic issues, there will still be SOME homelessness and I hope we continue to have programs that help the homeless. But the excess focus on "helping the homeless" amounts to saying it is their fault and it's not a systemic issue -- it's just a bunch of very incompetent individuals, and not a nation grinding people up, spitting them out and then acting like they should be grateful if anyone does anything for them.

Most homeless people have serious medical conditions. Whether they are on the street or off the street, if you don't help them get healthier, you don't really fix their lives. I wish there was a helluva lot more focus on helping homeless people get their health back.

I know that sounds crazy to most people. But it's not. We have historical evidence that it's not.

Syphilis is known to cause mental health issues and before antibiotics came along, having syphilis would eventually result in the person being placed in a mental institution. After penicillin came along, thousands of people in mental health institutions were cured of syphilis and the schizophrenia it caused and then released.* I don't know what their quality of life was like after they were released. But I imagine it was a damn sight better than having an STD that was making them insane and slowly killing them and being locked up in an institution because of it.

* Cite: Diseases of the Mind
posted by Michele in California at 10:30 AM on February 20, 2015 [10 favorites]


There is nothing funny about it. It's a very serious issue.

Sorry for my phrasing, MiC - when I said 'hilarious' I was thinking more of gallows humor. Like anyone else who works with or experiences this on a daily basis, it is incredibly draining and exhausting and awful and sometimes my bitterness shows.
posted by corb at 11:35 AM on February 20, 2015 [1 favorite]


> Again, I am really not interested in talking trash about this program.

And then

> If I told you that I have a dream that one day all black people in the U.S. would get subsidized apartments and a weekly delivery of food from a food closet, it would immediately be a shitshow.
posted by rtha at 12:10 PM on February 20, 2015


We spend far too much time talking about getting people off the street and far too little time talking about what the hell went wrong in this country that we have the levels of homelessness that we have and what on earth can we do about these systemic issues -- such as a widespread lack of affordable, decent housing -- that are the root cause of these high numbers of homeless people.

These are very important points. The good news is that, because these programs are saving money rather than costing money, there's no tension between trying to address these systemic causes and providing help via a voluntary program to people who really do want/need a place to live right now. The minute these are pitched as something to be done in lieu of other efforts to make it easier for people to afford a place to live, get medical care, etc. is the minute I stop supporting them, but as long as they save us money and help people who want the help, I see them as an important part of the puzzle.
posted by tonycpsu at 12:10 PM on February 20, 2015 [2 favorites]


hilariously enough

perhaps better phrased as "counterintuitively." :-)
posted by Michele in California at 12:12 PM on February 20, 2015 [1 favorite]


Housing First has a shockingly lack of analysis and support for women and children's homelessness. Much of the research focuses on harm reduction and mental health experiences of men. There is very little acknowledgement of supporting women fleeing violence (the primary reason women end up homeless) and offering trauma informed services.
Traditionally, women and children do not sleep on the street - as it is simply not safe. If they are on the street, women risk sexual violence and threats of having their children taken by the government. Women and children are often referred to as the "invisible homeless". Because women do not sleep on the street - they are unlikely to qualify for Housing First programs.
In Vancouver, where it is just being implemented by the Federal government, it has come at the cost of closing advocacy services, front line drop-in's, senior support services and an odd shuffling around of mental health beds. There is a tremendous amount of money being waved around - yet, it appears that a very small percentage of the money will ever be seen by the homeless person.
posted by what's her name at 12:57 AM on February 21, 2015 [2 favorites]




" There is a tremendous amount of money being waved around - yet, it appears that a very small percentage of the money will ever be seen by the homeless person."

I agree this is a huge problem, and I do NOT think housing first is the one and only expenditure that should be spent on meeting the housing needs of human beings- as with any multi-faceted issue you need multifaceted solutions. Having housing communities that are low cost but have HIGH standards of behavior/screening, or that place screened individuals in "normal" people housing, will be appealing to many people. This would allow people who are not violent or dangerously mentally ill to live for cheap or free.

Having a screening process is important for serving the needs of, as mentioned, women and children who do not have a history of violent behavior and need a community that screens for and rejects violent or abusive people.

I just had a long conversation with a friend who works in (not housing first modeled) supportive housing and he said that he would like to see a lot more funding for a lot of different types of support services, and that would include housing first but certainly not only housing first or at the expense of other services.

I think there have been a few attempt sat the policy level (my friend mentioned a very poorly put together project by HUD to increase housing first but that required service providers to come up with a proposal within ONE MONTH to make it work right).

I think overall though-- the idea that Utah has decided that we should invest in services to the homeless, and try to house people regardless of ability to pay as an overall benefit to other expenditures will prove to be correct while I think "housing first" will need to be flexible and responsive to concerns of people being served and service providers-- and also that it should be along a spectrum of public services that should be expanded which includes increasing minimum wage to be a living wage, supportive housing that functions to offer DESIRED amenities and services rather than patronizing and excessively controlling housing being considered "supportive" (as the problem to be solved is that the people needing help are bad and have bad poor people behavior that needs to be controlled/stopped rather than that externalizing behavior is the result of a need for ... actual supportive services like trauma therapies, support for healthy living such as exercise and body movement classes, healthy prepared meals, housekeeping services, on site gardens, access to the arts, biographical/creative writing groups, discussion groups etc that actually promote healing, meaningful connection, inner growth, and living a healthy life- and essentially be flexible and open to direction and voice from residents about what services/amenities are most sought.
posted by xarnop at 10:58 AM on February 21, 2015 [3 favorites]


Housing First has a shockingly lack of analysis and support for women and children's homelessness.

Housing First is not a program. It is a philosophy that instead of treating interconnected social and personal issues (i.e.: drugs, mental illness) before helping people find housing, we can fund housing immediately. This philosophy can be implemented in a wide range of ways and does not exclude specific money earmarked for domestic violence.

I totally agree that there are not adequate funds for the myriad of other services our communities need, and that list of needed services is tremendous, and homelessness is but one impact of the systemic inequalities we must address to allow every human a life with meaningful work, a way to connect with the wider community, the freedom to make individual choices about lifestyle, activity and recreation, safe housing, nutritious food, high-quality education, etc etc. We live under an enormously punishing government that pulls needed money from one service to hand to another, instead of pulling money from the rich dicks who have it all. But those economic choices should not be blamed on the Housing First philosophy.

As a footnote, in my county there are programs and money for women who have experienced domestic violence that are not available to women who have not. So I literally have female clients who would be housed right now if they had been fleeing domestic violence, but since they are not, they are still homeless. Ditto for people with HIV - there are specific housing subsidies for HIV+ folks that are unavailable to others. Those very specific funding methodologies create very uncomfortable hierarchies of service which I personally find highly problematic.
posted by latkes at 2:58 PM on February 22, 2015 [3 favorites]


The good news is that, because these programs are saving money rather than costing money, there's no tension between trying to address these systemic causes and providing help via a voluntary program to people who really do want/need a place to live right now.

Tonycpsu, it is really really important when looking at these programs to note that the cost savings are often not actually coming from the anti-homelessness programs - they are savings from police and hospital budgets, not savings from homeless services program budgets, largely. So just because the police have more money to buy MRAPs does not mean that there is more money out there for homelessness prevention.
posted by corb at 9:36 AM on February 23, 2015 [1 favorite]


Your attempt to conflate this issue with the entirely orthogonal issue of police departments spending money on unnecessary toys is risible. As this chart (via) and this one (via the FPP link) clearly show, policing expenses are a very tiny sliver of the overall cost of caring for the homeless.

Setting aside the silly MRAP distraction, the remainder of your argument is that hospitals saving money is somehow a bad thing. If you want to make that case then go right ahead.
posted by tonycpsu at 10:14 AM on February 23, 2015


(And by "hospitals saving money", I mean "less spent in public subsidies to compensate hospitals to provide care for people who can't pay for it themselves.)
posted by tonycpsu at 10:22 AM on February 23, 2015 [1 favorite]


My point is not that saving money for hospitals is a bad thing. My point is more that homeless management funding is a limited and valuable resource, and money saved from another public pot does not necessarily go back to the homeless management pot. So there is actually constantly a tension between homelessness prevention and rapid-rehousing of the homeless in funding, and the fact that one program saves money elsewhere doesn't really affect that tension at all.
posted by corb at 11:59 AM on February 23, 2015 [1 favorite]


It's not "another public pot", though, it's money that these entities -- mostly healthcare services as the charts show -- wouldn't be getting otherwise. The clinics, hospitals, addiction counselors, etc. get paid only because these people can't afford to pay themselves. If the housing first approach saves money, then this is money that never has to get spent, not some mystical pot of money that could be easily redirected to something else. Your argument is completely invalid here.
posted by tonycpsu at 12:08 PM on February 23, 2015


I..think we are arguing the same thing against each other?
posted by corb at 12:14 PM on February 23, 2015


I really don't think so, no. Less money spent on something with better outcomes for the recipients of that spending is a policy win. You're characterizing it as something where the savings will be squandered on other wasteful spending (hence the MRAP diversion) when there's no evidence to support that. Even if only 10% of the savings went to continue to help address homelessness (whether that's via housing subsidies, income support programs, whatever) and 90% went to total shit, that's still better than wasting it on our existing ineffective approaches to the problem.
posted by tonycpsu at 12:33 PM on February 23, 2015 [1 favorite]


Less money spent on something with better outcomes for the recipients of that spending is a policy win.

It would be if that were the case, but the thing is, I'm not sure that it is.

Let's say that there are, for the sake of simplistic argument, 100 individuals or families in the homeless management system, presenting in housing crisis. Of those, 80 of them are imminently at risk of homelessness, and 20 of them are literally homeless at the current time.

Of those 80, let's say 50 of them are in short-term crisis. They legitimately can't pay their rent this month and are in danger of imminent eviction. With wraparound support and one month's rent or less, they could be stabilized in their home and not in danger of homelessness. The remaining 30 will require 2 or 3 months to stabilize. Once stabilized, they may never be in danger of homelessness again. They may not be again for years.

Let us suppose the 20 literally homeless, under a Housing First program, need full support. That's 20x12 months of rent (240 months of rent) - which costs more than stabilizing every one of those 80 families (110-140 months of rent)

Now if you're just looking at financials for the homeless management pot - which provides both prevention and rehousing - and looking at positive outcomes for number of individuals - you would stabilize the 80, and then work on housing the literally homeless. It is cheaper, from that pot, to do so, and you have helped 80 individuals or families avoid homelessness, as opposed to getting 20 people out of homelessness.

But the Housing First model isn't looking at the homeless management pot. It's looking at the citywide pot. It's looking at saving in reimbursements for emergency room visits and hospital visits. It looks at those 20 individuals and judges that they cost more. It takes a bloodyminded pragmatic view that those currently on the streets already have the mental health and physical and legal problems that cost them so much money. And it doesn't give a damn about those 80 families. They're not on the streets yet. Sure, even one episode of homelessness will radically lower all of their chances of success and give most of them trauma. But they won't start costing the city that much money for a long time. It takes time on the streets to start racking up the ER visits and hospital stays. And so it needs to start with the "worst offenders" for it to fiscally work for the city - even though that isn't the majority of the people who desperately need help.
posted by corb at 3:43 PM on February 23, 2015 [1 favorite]


If anyone was advocating that housing first approaches should replace instead of complement existing approaches to helping at-risk families (housing subsidies, rapid re-housing, rental support, etc.) then you'd have a point, but the cost savings of housing first do not come at the expense of those other programs, they come in comparison to the status quo spending on the already-homeless. We're not talking about taking funds away from those programs, we're talking about saving money on the programs that specifically try to help those already without a home. We can keep doing what we're doing with at-risk families with existing revenue streams, and, as I said, redirect some of the savings on the already-homeless to help prevent people from becoming homeless in the first place.
posted by tonycpsu at 4:58 PM on February 23, 2015 [2 favorites]


It would be if that were the case, but the thing is, I'm not sure that it is.


Again, the articles linked here flat out say you're wrong. And you have yet to provide any kinds of actual documented statistics, just the same old wild-eyed edge case hypotheticals you trot out in literally every single thread you ever comment in.

Citations, please.
posted by feckless fecal fear mongering at 6:12 PM on February 23, 2015 [1 favorite]


We're not talking about taking funds away from those programs

The thing is, and I know this is kind of inside baseball, we actually are talking about it. Because of the Housing First model that is new and sexy and sweeping everywhere, people are moving away from prevention models and more towards Housing First re-housing of the literally, chronically homeless. This is happening right now. I am seeing funding radically lower for prevention right now. This is a thing that I am seeing and getting angry at and reacting to. I'll give specifics via memail if you're super interested in how this actually breaks down, but I promise you, this is a real thing that is actually happening.

I mean, I understand all you have to go on is an article, and it's really hard to quantify subjective provider experience, but by the time I post on Metafilter in the morning, I've usually had to deny five needy families that I desperately want to help, but can't, because the programs no longer consider them the new flashy target demographic. And that's upsetting, honestly.
posted by corb at 9:54 AM on February 24, 2015 [2 favorites]


When I say "we're not talking about taking funds away", I'm talking about my preferred public policy, not what politicians are doing when they want to demonstrate so-called fiscal responsibility on the backs of our most vulnerable citizens.

I am certainly willing to accept at face value that you've observed a correlation between the rollout of housing first projects and a reduction in homeless prevention funds, but in order to accept that the former is causing the latter, I'm going to need to see something more substantial that excludes other possible causes of the funds being cut from prevention programs. At a time when state and municipal budgets are stretched thin, it's far more likely that these cuts would be happening anyway, since they largely affect a demographic that doesn't turn out in numbers that would make politicians worried about the backlash.
posted by tonycpsu at 10:29 AM on February 24, 2015


I'll give specifics via memail if you're super interested in how this actually breaks down, but I promise you, this is a real thing that is actually happening.

Nah. You're making the claims publicly; back them up publicly.
posted by feckless fecal fear mongering at 10:57 AM on February 24, 2015


Nah. You're making the claims publicly; back them up publicly.

People who get paid to do something usually have restrictions on what they can say publically about their work, whether in the form of a signed NDA or just good common sense. Asking someone to basically risk getting fired for the sake of argument on the blue seems like dirty pool.
posted by Michele in California at 1:27 PM on February 24, 2015 [2 favorites]


This is true, but at the same time, this is a discussion forum, so if we're debating an issue, "I have secret inside knowledge that I can't share with the audience I'm engaging with" isn't very compelling. Like I said, I am happy to assume arguendo that corb has witnessed a simultaneous increase in housing first funding and decrease in homeless prevention funding, but it's quite a leap of logic from those data points to her insinuations that (a) those data points are representative of a larger nationwide trend, and (b) that the decrease in prevention funding was caused by a redirection of funds to housing first programs. These latter implications are not things anyone should be expected to accept simply as an argument from authority.
posted by tonycpsu at 1:35 PM on February 24, 2015 [2 favorites]


There must be publicly available documentation that backs up corb's claims, if they are accurate. The claims that imply that every single one of these articles is lying.

Also worth noting that I am asking for citations for the statements "Housing First straight up doesn't work," and "the thing that makes them actively more destructive than not" (in the same comment), not the goalpost-shifting later in the thread.

The thing is, every single one of these articles states flat-out that Housing First as a philosophy does work, and that it is not destructive. Surely if corb's statements are so manifestly true, there must be accurate and reliable reporting somewhere that supports them.

So no, it's not dirty pool. It's asking corb to back up what she says with actual data readable by the rest of us. Otherwise it's just the usual edge case handwaving with a total lack of basis in observable reality.
posted by feckless fecal fear mongering at 1:38 PM on February 24, 2015


tonycpsu: Please note that I did not quote your very reasonable position of I am certainly willing to accept at face value that you've observed a correlation between the rollout of housing first projects and a reduction in homeless prevention funds, but in order to accept that the former is causing the latter, I'm going to need to see something more substantial, a position I have zero problem with.

So no, it's not dirty pool. It's asking corb to back up what she says with actual data readable by the rest of us. Otherwise it's just the usual edge case handwaving with a total lack of basis in observable reality

fffm, you are coming across as very dismissive and disrespectful. I realize I spend relatively little time on the blue and I realize there is history here and that you personally may be fed up with how corb argues. But you are basically baiting her in a way that is personal and ugly. I am perfectly fine with the above position that "until I see something more substantial" which is completely reasonable and not attacking. I am not so comfortable with what you are doing here, regardless of how you choose to justify it.
posted by Michele in California at 1:43 PM on February 24, 2015 [1 favorite]


Take it as you will. Someone is making claims that directly contradict every one of the more than a dozen articles linked. As said upthread, extraordinary claims require extraordinary evidence. It's not baiting, but I find that your opinion matters about as much to me as mine, I suspect, does to you. So... there we are I guess.
posted by feckless fecal fear mongering at 1:48 PM on February 24, 2015


[Folks, this needs to wind down just in general. corb, if you're citing data in an argument that you know you can't actually refer anybody to, that's not a great idea and it'd be better to skip it outright; everybody, we need to not go in circles on that if it's just not happening.]
posted by cortex (staff) at 1:48 PM on February 24, 2015 [1 favorite]


I fully support Housing First in opposition to previous policies that withheld housing pending resolution of substance use and mental illness. And, I think there are contexts where Housing First based programs save hospitals money and reduce jail and mental hospital utilization. All good things.

Having said that, saving money does not magically make that money available to those who need it. By keeping super high utilizing homeless patients out of the ER, we are not magically providing adequate funding for medical services for the poor in our communities. For one thing, the scale of cost is vastly different. Even though homeless repeat hospital users are expensive, they are nowhere near as expensive as the cost of providing high quality preventative health care to the number of poor people who need it. So Housing First does not magically make there be enough money.

Second, it is true that funding fashion can be very punishing on existing and still needed programs. If your county suddenly has money for Housing First based programs, it is very realistic that the county may, in proportion, have less money for traditional winter shelters. That is real – that one homeless program is robbed to pay the next. Until we address that problem, ie: meaningfully and sustainably fund medical care and social services for the entire community, then I agree with those who state homelessness will not be solved.

However, again, I think the move toward Housing First models for the chronically homeless is pragmatic, cost effective and much more humane than the previous (current) models and I hope it continues.
posted by latkes at 1:52 PM on February 24, 2015 [3 favorites]


[Sorry, saw your note after I posted, Cortex]
posted by latkes at 1:59 PM on February 24, 2015


Having said that, saving money does not magically make that money available to those who need it.

My argument does not rely on magic, it relies on the very simple fact that something that costs less to do more effectively can't possibly lead to worse outcomes.

Until we address that problem, ie: meaningfully and sustainably fund medical care and social services for the entire community, then I agree with those who state homelessness will not be solved.

I think we're all in agreement on this, so I don't know that the horse needs any more beating. Whether we would agree on how exactly the funding would be provided, I don't think anyone left in the thread would argue that we can end homelessness without more resources for these problems.

If your county suddenly has money for Housing First based programs, it is very realistic that the county may, in proportion, have less money for traditional winter shelters.

Please show your work here -- why would this be the case absent downward pressure on resources that would already be present? What force is causing a program that targets those currently without homes to take away resources from programs that target other segments of the population? Let's say there's a 4:1 ratio between prevention and intervention right now -- how would spending less on the intervention cause the prevention side to lose resources? I just don't see the connection there at all.
posted by tonycpsu at 2:04 PM on February 24, 2015 [2 favorites]


Fair enough. My statement is based on my perception working in the field. I'll need some time to look at actual HUD and local spending patterns to respond acurately.
posted by latkes at 3:18 PM on February 24, 2015 [1 favorite]


I'm extremely late to this thread, so I don't know if anyone's still reading, but if so:

I've been looking at the study from Seattle that rtha linked to. (Thank you, rtha!)

The study compares people in the Housing First program with a control group of people on the waiting list for that program.

In Table 3, they show statistics for the wait-list folks "Six months after intervention."

I've skimmed the study, and I can't find any information on what kind of intervention, if any, was offered to the control group.

It's interesting to see that most of the stats for the control group improved, too, although not nearly as dramatically as those for the Housing First group.

Can anyone tell me what, if anything, changed for the people in the control group, or why their hospital costs (Harborview Medical Center, HMC in Table 3) were so much higher than the Housing First group in the 1 Year Prior to Housing column?
posted by kristi at 2:26 PM on March 7, 2015


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