Saturday, February 8, 2020

Is the White House Targeting Housing First?

By Sarah Owens and Michael Livingston

 

From "The State of Homelessness in America"
The White House Council of Economic Advisors (CEA) has issued a report on "The State of Homelessness in America" that promises to do for Housing First  what Andrew Wakefield's "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" did for immunotherapy for childhood diseases.

Using a "supply and demand" lens, the report argues that the "root cause" of homelessness is inadequate housing supply, which results from zoning and other local housing regulations.  So, if you want to reduce homelessness, get rid of local housing regulations.  It also argues that shelters cause homelessness (by decreasing the demand for housing), so you don't want too many or to make them too nice.  A third cause of homelessness is "tolerability of sleeping in the streets", which the report says is tied to climate and policing.  The report questions whether there really was a 15% decline in homelessness between 2007 and 2018, but if there was, the report says, it wasn't due to Housing First or other federal efforts (see pp 24-29). 

Housing First is a recovery-oriented, harm-reduction strategy that moves people experiencing homelessness into permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements.  You could say that Housing First was a bit of a last resort after decades of trying everything else, including wars on alcohol, drugs and poverty, and insisting that the chronically homeless be "housing ready" before they could be housed.  And, the studies all show Housing First outperforms housing ready, if what you want is to get the chronically homeless stably housed.  However, the tendency to exaggerate its successes has made it vulnerable to criticism.  See, Trilling, D. "Chronic homelessness and the Housing First program: research review of how programs have worked."  (26 August 2016, Journalist's Resource.)     

One such critic is said to be Robert G. Marbut, an apparently self-taught expert in "homeless transformation", who was appointed December 4, 2019, to head the United States Interagency Council on Homelessness following the abrupt, but not unexpected, ouster of the highly respected director, Matthew Doherty, considered a champion of Housing First.

Robert G. Marbut, USICH Director (courtesy Newsedge.com)
As far as we can tell, Marbut's interest in homelessness did not come from any kind of "lived experience."  Wikipedia says Marbut received a B.A. and M.A. from a small private college in California, married, had kids, ran the 1985 and 1987 mayoral campaigns of Henry Cisneros, through whom he acquired a White House fellowship under Bush I, following which he pursued various forms of sports administration (e.g., directing the 1993 Olympic Festival and the San Antonio Spurs "sports and entertainment division").  In the late 1990s he was elected to two terms on the San Antonio City Council, divorced and remarried, and began teaching government at the local community college.  In 2003, he picked up another M.A. in government, followed by a Ph.D. in 2005, the same year that San Antonio passed ordinances targeting aggressive panhandling and public urination.

In 2006, San Antonio's Mayor formed an equivalent to Salem's Downtown Homeless Solutions Task Force.  The task force "tapped Marbut...who had been helping the city coordinate its response to large numbers of New Orleans evacuees in the wake of Hurricane Katrina."  Delaney, A. "How A Traveling Consultant Helps America Hide The Homeless." (9 March 2015, HuffPost.).  In that role, Marbut advised the City to support the 23-acre Haven for Hope homeless complex which opened in 2010 with Marbut in charge.

"Texas-sized" Haven for Hope, cost $101M to build
With Haven for Hope, San Antonio "embraced a traditional model of extended shelter, while encouraging a personal transformation."  
Smith, D. "Here's how a Texas oilman's vision spawned a homeless shelter extraordinaire."  (26 August 2017, Los Angeles Times.) 

HuffPost in 2015 reported that Haven for Hope was "politically popular, despite some concerns about increased nuisance crimes in its vicinity."  At that time, "the facility had a $15 million [annual] operating budget and provided shelter for up to 1,500 people — about 500 of whom were sleeping outside in a courtyard."  IdSmith's LA Times piece provides a more detailed look at the numbers.  Although Haven for Hope seems to have made Marbut the expert in reducing street homelessness, no other city's tried to replicate it to scale.

Marbut's association with Haven for Hope and similar "housing ready" programs seems to be what gave housing and homeless services providers cause for alarm when the White House put him in charge of USICH.  See, e.g., Ockerman, E. "Trump Pick to Lead Homelessness Council Thinks Free Food Is 'Enabling'."  (4 December 2019, Vice News.)  But, Director Marbut's in a very different role now. 

The Wall Street Journal recently reported that Director Marbut "opposes offering support services only after a home has been provided and wants to tie services to housing vouchers or placement", and quoted him as saying, “We need services and housing together.”

Now, there is nothing controversial about offering services before or with housingBut, if by "tie services to housing" Director Marbut means he wants to make engagement in services a precondition to housing, or necessary to retain housing, then he's essentially saying he wants federal policy to revert to a "housing ready" standard.  But, that's not what he he told the WSJ.  What he told the WSJ was "he doesn’t want to argue over definitions of Housing First because its meaning has changed over time."  Kesling, B. "New Homelessness Czar Takes Aim at Longstanding Policy."  (1 February 2020, Wall Street Journal)

There's irony here.  The fact is, many homeless housing providers would secretly agree with Marbut about the need for preconditions (e.g., be assessed, get your i.d., clear a UA, pass a criminal background check, take a Rent Well class, go to an orientation, talk to WorkSource Oregon, leave your pet, leave your stuff, leave your partner, leave your adolescent male child, leave your gender identity, recover from surgery, recover from addiction, take your meds, apply for benefits, designate a third-party payee, etc.).  Such preconditions, in effect, require most people to engage in services.  Providers claim their programs are Housing First, because that's what gets them funded, but, as a practical matter, they're merely Housing Firstish.  That's why Marbut's right when he says the meaning has changed over time.

The CEA report referred to above states that HUD's Continuum of Care Program "maintains a commitment to providing housing with no preconditions to program participants."  But the report also points out that, in 2020, programs would be allowed to impose "service participation requirements for participants after they have been stabilized in housing", and that, in future, HUD would be putting greater emphasis on "self-sufficiency."  Is this a change?  Or is policy merely reflecting what providers are already doing,? 

Bear in mind that Consultant Marbut was not professionally trained, and the lens through which he saw homelessness was comparatively narrow.  When professionals think of homelessness, they tend to think about either the particular population they serve (e.g., students, disabled, DV victims, elderly, chronic), or the entire panoply.  Consultant Marbut, a former City Councilor, was hired to meet the needs of city officials, business owners, police and sheriff departments.

Consultant Marbut's job was to find short-term "solutions" for cities -- like Salem, only bigger and richer -- who were "grappling" with their visible "street homeless", whom he tended to see as able-bodied individuals, more or less capable of "self-sufficiency" with the right tools and incentives.  He believed that "Having a home is not the problem for the homeless. It’s maintaining a financial stability that allows you to maintain your homestead."   See Stephens, A. "Cities Are Hiring This Controversial Homelessness Consultant."  (31 March 2015, Next City.)  Mid-Willamette Community Action Agency Director Jimmy Jones estimates that maybe one quarter of Salem's 1,000 unsheltered homeless fit Consultant Marbut's description, and none of them are in the group outside Rite-Aid.    

In 2014, Consultant Marbut told NPR,

[C]ities first go from doing nothing. And that doesn't work, and it hurts the economy and the individuals that are homeless are having problems. Then they overreact. They pendulize to the extreme other side and start arresting everybody and criminalizing. Then they find out that doesn't work. And that's about the point in time I get the call. 

Consultant Marbut began his study of homelessness by pretending he was living on the streets.  The experience led him to conclude that cities should discourage "street feeding" because "if you give food on the street, you end up in a very convoluted way, but still an important way, you end up preventing people [street homeless] from going into 24/7 programming", which he considered necessary to their recovery.  Few professionals would argue with that view, assuming the availability of 24/7 programming for street homeless, which not every community has.  Right now, Salem just has the Union Gospel Mission. 

Over the course of "visiting 237 homeless service providers in 12 states and the District of Columbia", Consultant Marbut developed "Seven Guiding Principles of Homeless Transformation."  (They are set out at the end of the post.)  He offered them to cities as a "measuring stick" for reviewing the work of homeless service providers and "moving [them] from enablement to engagement."  Professionals concerned about Director Marbut's intentions find Consultant Marbut's principles shocking.

In December 2019, Diane Yentel, president of the National Low-Income Housing Coalition, described Consultant Marbut's seven principles as "paternalistic, patronizing, [and] filled with poverty blaming/shaming."  A number of Yentel's followers agreed with that assessment, particularly as applied to principles 4 and 5, which advocate rewarding positive behavior, and ensuring consequences for negative behavior.

However, if you believe your target population to be "able-bodied individuals, more or less capable of 'self-sufficiency' with the right tools and incentives", a policy of rewarding positive behavior and ensuring consequences for negative behavior is hardly outside the professional mainstream.  

None of this is to suggest Consultant Marbut hasn't given cause for concern.  As the five-minute clip below explains, he apparently claimed, without evidence, to have cut street homelessness by 80-90% in St. Petersburg and Clearwater, Florida, he doesn't know enough about the federally mandated Homeless Management Information System to realize it's a complete shambles, and his Pinellas Safe Harbor "jail diversion" program was described in a 2014 report to the United Nations Committee Against Torture as a “cruel, inhuman, and degrading.”   

courtesy ytCropper


At the end of the day, the current administration isn't any more or less interested in ending homelessness (homelessness was not mentioned in the 2020 State of the Union address, for instance) than prior ones have been.  Homeless policy, like immigration policy, remains an unsettled area, full of contentious issues that carry significant blame-shifting, divisive and destructive potential.  If what one's interested in is a law-and-order, deregulation agenda, homeless policy's the perfect vehicle.  See, e.g., Levin, S.  "'They've turned their back on us' California's homeless crisis grows in numbers and violence."  (27 December 2019, The Guardian.)  Cities and states who don't like that ride can and should set their own policies.  See, e.g., Evans, W. N., D.C. Phillips, and K. Ruffini, K."Reducing and Preventing Homelessness: A Review of the Evidence and Charting a Research Agenda."  (July 2019, Abdul Latif Jameel Poverty Action Lab.) 




Consultant Marbut's 

Seven Guiding Principles of Homeless Transformation



1. Move to a Culture of Transformation (versus the Old Culture of Warehousing):

Homeless individuals must be engaged and no longer enabled.  Everybody within the services delivery system (e.g. general public, media, elected politicians, appointed officials, monitors, boards, staffs and volunteers of service agencies and most importantly the homeless themselves) must embrace a culture of transformation.  A culture, that through the help of others, homeless individuals can transform and integrate themselves back into society.  For moral and fiscal reasons, homelessness must become and unacceptable condition that is not tolerated in the U.S.A.

2. Co-location and Virtual E-integration of as Many Services as Possible:

In order to increase success, all services within a service area must be e-integrated.  Virtual e-integration improves coordination of services, enhances performance, reduces "gaming" of the system, engages individuals on the margin of society and increases cost-effeciencies within and between agencies.  Further more, whenever financially possible, services should be co-located.  Co-location goes beyond virtual e-integration by increasing the numbe rof "service hits" into a shorter period of time through the reduction of wasted time in transit and minimization of mishandled referrals.  Co-location also increases the supportive "human touch."

3.  Must have a Master Case Management System that is Customized:

Because there are so many different service agencies helping homeless individuals (e.g., government at multi-levels, non-profits and faith-based), it is critical that ONE person coordinates the services an individual receives and to do so in a customized fashion.  The types of service provided is critical, but what is more important is the sequencing and frequency of customized services.

4. Reward Positive Behavior:

Positive behavior of individuals should be rewarded with increased responsibilities and additional privileges.  Privileges such as higher quality sleeping arrangements, more privacy and elective learning opportunities should be used as rewards.  It is important that these rewards be used as "tools" to approximate the "real world" in order to increase sustainable reintegration into society.

5.  Consequences for Negative Behavior:

Too often there are no consequences for negative behavior of individuals.  Unfortunately, this sends a message that bad behavior is acceptable.  Within the transformational process, it is critical to have swift and proportionate consequences.

6.  External Activities Must be Redirected or Stopped:

External activities such as "street feeding" must be redirected to support the transformation process.  In most cases, these activities are well-intentioned efforts by good folks; however, these activities are very enabling and often do little to engage homeless individuals.

7. Panhandling Enables the Homeless and Must Be Stopped:

Unearned cash is very enabling and does not engage homeless individuals in job and skills training which is needed to end homelessness.  Additionally, more often than not, cash is not used for food and housing but is instead used to buy drugs and alcohol which further perpetuates the homeless cycle.  Homeless individuals who are panhandling should be engaged into the transformational process.  Furthermore, most panhandlers are not truly homeless but are preying on the good nature of citizens to get tax-free dollars.

5 comments:

  1. At least he's making the hard choices compared to our do nothing Salem politicians who keep feeding the problem allowing the homeless to take over our streets, running customers and businesses out of town destroying our economy while spending hard working Oregonian taxpayers money on endless programs that do nothing to solve the problem. Enough babying the problem, A tough love approach is what's needed. If you don't like what's offered take some self accountability and do something about it. I say to all of you that think it's okay to feed the problem sponsor a homeless person in your house. Feed them, clothe them, pay their bills, drive them around to where they need to go, etc... Ive helped several and for my efforts each has stolen from me. This city needs more undercover policing to attack the drug trade in Salem with harsh penalties to the dealers. Clean out the drugs and you'll take a big dent out of the homeless problem. Enough is enough.

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    1. Dear Tax paying citizen: If by "he" you're referring to the President, you can't have read the blog post. The post makes no mention of the President, much less any "hard choices."

      It must be very frustrating to be convinced you know better than more experienced people what should be done to solve a very complex problem, but history has proved that "more undercover policing to attack the drug trade" will not "take a big dent out of the homeless problem." It will only house people at maximum expense to your "hardworking Oregon taxpayers." That, obviously, would be pretty stupid.

      Salem has for years been using a "tough love" approach to homelessness, which the main reason Salem has so many street homeless. Providers have cherry-picked people they believed would be easier to get into housing, and left the others outside where they have become sicker and more and more socially isolated. If you had been following this issue you would know that there is no facility or program in Salem that can shelter these individuals. That's why the city and state are working to fund a low-barrier shelter, which providers have long warned was needed. Maybe you could put your energy toward that effort.

      Yes, the City Council has taken too long to realize that homelessness is, in fact, the City's problem. White House appointee Robert Marbut, our new Homeless Czar (the main subject of the post), describes the typical process this way. "[C]ities first go from doing nothing. And that doesn't work, and it hurts the economy and the individuals that are homeless are having problems. Then they overreact. They pendulize to the extreme other side and start arresting everybody and criminalizing. Then they find out that doesn't work."

      It's a sign of intelligence to be able to learn from the mistakes of others. It remains to be seen whether Salem will do that, or whether it will continue to cave to pressure from people like yourself, and make things worse for everyone.

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    2. Author/journo Nicholas Kristoff talking about a new book, "We think the big problem in the U.S. has been the tendency to point fingers at those who fall off the tightrope and to obsess with the personal responsibility narrative." https://www.opb.org/radio/programs/thinkoutloud/segment/tightrope-nicholas-kristof-sheryl-wudunn-yamhill-county-oregon/

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  2. Sarah Owen's I've been homeless so I speak from experience. When you become homeless your job becomes finding all the giveaway programs you can and that becomes your way of life (or job). It spreads like wildfire amongst the homeless until resources become tapped. When your addicted to a substance, which is why a majority of the people are homeless, bottoming out is usually the only way to get to a point of do or die for your mind to seriously start dealing with your situation. By providing unlimited service you do the disservice of not allowing someone to get to the point of bottoming out. Constantly propping them just above the bottom. People are resiliant and will do the right thing when it's the only option. I've been there. The way the mayor and councilors are handling it is devastating our state capital which should be the example for the rest of the state. If you want to see Salem in shambles keep up the way it is or make some tough choices for people so they can make serious self accountability choices for themselves.

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    1. Dear Tax paying citizen, I appreciate your sharing that you have lived experience, however, reasoning from personal experience is not a reliable basis for making policy. For instance, while it might be true that you needed to hit the bottom, there's no evidence that most addicts needs to do so before "doing the right thing", (https://www.ok.gov/odmhsas/documents/Addiction%20myths%20and%20facts.pdf), or that a "bottoming out" policy would result in fewer street homeless here in Salem. It might well result in more. But, this is the second time you've mentioned the need for tough or hard choices. Please describe what it is you would advise the City Council to do or not do to "change the way things look downtown"? If there are costs or other obstacles, please describe how they should deal with those, and please explain how you think your strategy would have the desired effect and for how long.

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