Opened in 2006, The Center’s Housing project provides permanent supportive housing for 23 formerly homeless, high risk LGBT young adults 18-24 who, as a result of their experiences, also have physical or emotional challenges. That opening was preceded by four long years of community planning and expert review of the most effective program models for housing special high risk populations. Part of our commitment to the project is a continual effort to educate all of our community and stakeholders about this program model.

The model, since also adopted by San Diego’s Regional Task Force on the Homeless as well as a variety of other cities/counties, is a “supportive housing” model. Supportive housing is designed to address some of the problems and challenges noted in some other models of programming that had led to an undesirably high number of program drop-outs, program incompletions, and a return to homelessness by high risk participants.

Preventing a return to homelessness was a particular concern for us, so as to ensure that people remain housed and that the costs of homelessness (both the human costs and actual costs to the taxpayer and donor) are reduced. Chronic homelessness does indescribable human damage and costs taxpayers and the public health system billions each year.

Financial costs of return to homelessness include those readily apparent and those that are sometimes called “the hidden costs” of homelessness: costs associated with the inappropriate emergency use of hospitals and social service programs, costs to businesses that are located in high traffic areas, law enforcement costs, the costs of continued drug addiction and the behaviors that accompany that challenge.

Supportive housing combines an atmosphere designed to teach independent living skills and expectations with on-site, easily accessed program services. It is the model with the best long term outcomes for high risk populations.

In terms of independent living skills, residents are provided with leases for small studio units. Those leases include all of the basic rental provisions and expectations for any rental properties: no illegal drugs or any other illegal activity is allowed on the premises; and no disruption of others or of the peace or enjoyment of the living environment is permissible. Units need to be kept in a clean and responsible fashion. Rents must be paid on time. In return, residents who qualify can continue their residency by following all of the rules and expectations and paying their rent on time. Rents are subsidized, with residents paying no more than 30 percent of their income. This subsidy allows formerly homeless youth who often have few job skills or experiences, an opportunity to acquire those skills and work their way toward full employment, employment that can someday sustain them in unsubsidized housing. Learning to live in the real world, with real leases and rules and rent payments is an important life skill that helps provide a sense of stability and security for residents and reduces the “real world shock” many report upon leaving differently structured programs.

For many high risk young adults, supportive services are the ultimate key to repairing badly damaged lives. These services include primary health care services (many for the first time), mental health services, employment, education and skills services, and a variety of other reparative programs. These supportive services are provided on-site for residents to attempt to reduce the barriers many report when trying to access services. Participation in services is voluntary; however this voluntary model paradoxically produces higher rates of program engagement and higher rates of productive participation than the mandatory models of program participation. Each resident has an assigned case manager and most meet with them weekly.

An additional part of the vital services for this population is substance abuse/addiction treatment, and the model for intervention is a “harm reduction” model. Harm reduction models attempt to engage an individual in substance abuse treatment from the beginning rather than waiting for them to be ready or willing to engage in total abstinence. Based upon the development of a truthful relationship with a case manager and beginning with small steps toward risk reduction (use a condom more frequently even if you aren’t ready to commit to always using one, drink less often and never when you drive even if you aren’t ready to stop drinking, consider out-patient treatment even if you aren’t ready to commit to in-patient residential treatment) harm reduction introduces the beginning steps toward recovery early. The evidence is clear that this approach holds the greatest hope for long term recovery for many.

For more information, visit: www.signonsandiego.com/uniontrib/20070815/news_lz1e15kaplan.html and here www.csh.org.