Sam Tsemberis, PhD
Founder and CEO
Pathways to Housing, Inc.
JUNE 12, 2013
Who is served by Housing First?
 Homeless
 Mental health problems
Addiction and abuse
 Health problems
 Poverty
 Isol...
Frequent users of acute care services
Jail
Shelter
Hospital/
Detox
Streets Institutional Circuit
Housing and Support Services:
Rearranged (Housing first) and
Redesigned (consumer driven)
Levels of Program Fidelity
consumers
Hundreds of choices, change
over time & have tradeoffs r
Management issues include te...
Homeless
Shelter
placement
Transitional
housing
Permanent
housing
Ongoing, flexible support
Harm Reduction
Housing First M...
MHCC At Home / Chez Soi
5 Cities RCT N=2,257
Moncton, Montreal, Toronto, Winnipeg,
Vancouver
Housing
First
(n=1267)
Interv...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
3M 6M 9M 12M
Time Spent in Stable Housing Over Year One
HF TAU
/ 9
Housing First shows cost offsets
Annualized costs: Total sample Annualized costs: High Service Users (defined as
those...
Peer Support:
Recovery Focused Mental Health Services
Hope-instilling
practice
Socially supported
wellness
knowledge an...
Son returns from tour in Afghanistan and stays
with (formerly homeless) dad in his apartment.
Social connections are key a...
Community-based,
Residential Treatment
(on-site clinical staff)
Permanent Single Site
(on-site services)
Permanent
housing...
• People are much
more capable than
we imagined
possible.
Capabilities
For Additional Information
Web sites:
www.pathwaystohousing.org
 Or send an email to
stsemberis@pathwaystohousing.org
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Innovation in Homeless Services: The social, economic and community value of tackling homelessness through Housing First approaches

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Innovation in Homeless Services: The social, economic and community value of tackling homelessness through Housing First approaches

  1. 1. Sam Tsemberis, PhD Founder and CEO Pathways to Housing, Inc. JUNE 12, 2013
  2. 2. Who is served by Housing First?  Homeless  Mental health problems Addiction and abuse  Health problems  Poverty  Isolation  Stigma  PTSD/Trauma
  3. 3. Frequent users of acute care services Jail Shelter Hospital/ Detox Streets Institutional Circuit
  4. 4. Housing and Support Services: Rearranged (Housing first) and Redesigned (consumer driven)
  5. 5. Levels of Program Fidelity consumers Hundreds of choices, change over time & have tradeoffs r Management issues include team- consumer, landlord-tenant, landlord- team, and team-agency interactions Operations Variety of services and housing options Decisions about housing status and consumer engagement Principles Consumer choice Separation of housing and treatment
  6. 6. Homeless Shelter placement Transitional housing Permanent housing Ongoing, flexible support Harm Reduction Housing First Model
  7. 7. MHCC At Home / Chez Soi 5 Cities RCT N=2,257 Moncton, Montreal, Toronto, Winnipeg, Vancouver Housing First (n=1267) Interviews every 3 months: Residential stability, mental health, addiction, quality of life, social integration Treatment as Usual (n=990)
  8. 8. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 3M 6M 9M 12M Time Spent in Stable Housing Over Year One HF TAU
  9. 9. / 9 Housing First shows cost offsets Annualized costs: Total sample Annualized costs: High Service Users (defined as those in top 10% of prior service costs TAU Intervention Difference TAU Intervention Difference Est. annual cost: Non-study services $23,849 $14,599 $ (9,250) $ 56,431 $30,216 $ (26,215) Est. annual intervention cost $17,160 $ 17,160 $16,825 $16,825 Total $ 23,849 $ 31,759 $ 7,910 $ 56,431 $ 47,041 $ (9,390) High Service Users: • There is an overall savings of $9,390 per person per year • Every dollar spent on Housing First for these participants saves $1.56 through reduced use of other shelter, health and justice services Total Sample: • An investment in Housing First requires only an additional investment of $7910 per year • For every dollar spent 54 cents is saved through reduced use of other shelter and health are services after only one year Table 1 – Costs of Housing First versus use of other health, justice and social services after one year
  10. 10. Peer Support: Recovery Focused Mental Health Services Hope-instilling practice Socially supported wellness knowledge and skills to self- manage Emphasis on holistic wellness and positive lifestyle as healing
  11. 11. Son returns from tour in Afghanistan and stays with (formerly homeless) dad in his apartment. Social connections are key and and housing should adjusts accordingly
  12. 12. Community-based, Residential Treatment (on-site clinical staff) Permanent Single Site (on-site services) Permanent housing (scatter-site, off site services) Redesigning the System: System Transformation Longer term Institutional Care Least restrictive to more restrictive setting
  13. 13. • People are much more capable than we imagined possible. Capabilities
  14. 14. For Additional Information Web sites: www.pathwaystohousing.org  Or send an email to stsemberis@pathwaystohousing.org

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