Chronic Homelessness

Chronic homelessness is defined as long-term or repeated homelessness, often coupled with a disability.

Under the Department of Housing and Urban Development's definition, a chronically homeless individual is one who has experienced homelessness for a year or longer, or who has experienced at least four episodes of homelessness in the last three years and has a disability.

Many chronically homeless people have a serious mental illness like schizophrenia and/or an alcohol or drug addiction. Most people who experience chronic homelessness have been in treatment programs in the past and have still found themselves repeatedly homeless.

According to Volume I of the 2012 Annual Homeless Assessment Report, the chronically homeless population, around 100,000 individuals, accounted for just fewer than 16 percent of all homeless people in 2012. The number of individuals experiencing chronic homelessness has declined by 19.3 percent since 2007.

The solution to chronic homelessness is permanent supportive housing along with homelessness prevention policies.

Permanent supportive housing is housing coupled with supportive services. Research and experience have shown that stable housing is often an essential component to being successful at rehabilitation, therapy, and other areas.

What's more, this intervention is cost-effective. Most people who experience chronic homelessness draw services from many federal, state, and local systems, including hospitals, corrections systems, and the like. Permanent supportive housing curbs use of these systems and reduces public costs.

Studies have shown dramatic results from this intervention. A Journal of the American Medical Association study of the 1811 Eastlake program in Seattle, WA, which provides housing to homeless people with the most extensive health problems, saw a savings of nearly $30,000 per tenant per year in publicly-funded services, all while achieving better housing and health outcomes.

Prevention policies are also important to ending chronic homelessness. By identifying people leaving prisons, mental health facilities, and other institutions who are at risk of becoming homeless and connecting them with housing, we can prevent their homelessness before it begins.

Spotlight

Federal Policy Brief | February 19, 2013
This resource provides the Alliance's comments on the Medicaid Proposed Rule of January 22, 2013. The Alliance's comments address several issues that affect vulnerable adults who are chronically homeless, at-risk of becoming chronically homeless, or recovering from chronic homelessness in permanent supportive housing.
Federal Policy Brief | November 9, 2012
This policy brief discusses how Medicaid health homes can help improve the behavioral and physical outcomes for vulnerable people experiencing homelessness and lead to positive housing outcomes.The brief explains the Medicaid health home benefit under the Affordable Care Act, and reviews models that have already been approved by the U.S. Department of Health and Human Services.
Solutions Brief | October 17, 2012
Post-Traumatic Stress Disorder (PTSD) can be caused by the experience of homelessness. This brief includes an overview of PTSD, implications for providers, and principles of trauma-informed care.
Webinar | January 19, 2012
A video recording of the webinar entitled, "Putting the Pieces Together: Primary Care and Behavioral Health Services in Permanent Supportive Housing."
Federal Policy Brief | March 18, 2010
This brief examines chronic homelessness and provides an overview of key strategies used to reduce chronic homelessness, including permanent supportive housing, prevention, and targeting.

Library Resources

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Webinar | November 13, 2012
This webinar provides strategic information and recommendations for improving communities’ capacity to solve chronic homelessness by effectively integrating supportive housing and community-based health care delivery.
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Fact Sheets | January 24, 2010
Although chronic homelessness represents a small share of the overall homeless population, chronically homeless people use up more than 50 percent of the services. The most successful model for housing people who experience chronic homelessness is permanent supportive housing using a Housing First approach.
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Best Practice | April 4, 2008
Streets to Homes is a Housing First program in Toronto that targets unsheltered homeless people and provides them with government subsidized permanent housing with follow-up supports. To date, approximately 1,500 people have moved directly from living on the street into permanent housing units, and 87 percent have remained housed.
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Solutions Brief | January 19, 2007
This two-page brief highlights three cities - New York, NY, Denver, CO, and Portland, OR - that have done studies of the cost effectiveness of providing supportive housing for homeless people with mental illness and/or addictions. The studies demonstrate that the cost of providing supportive housing is about the same or less than the cost of allowing them to remain homeless.