Road To Zero: How Chronic Homelessness Is Ending In A Major Rust Belt Community

by Héctor Colón & Chris Abele

“I was just so…overwhelmed,” said Michael “Squirrel” Macias. “I actually think I cried myself to sleep that first night…joyful tears.”

Squirrel spent the previous two years living in a makeshift shelter along the banks of the Milwaukee River. A former member of what he referred to as the “wife and kids and cubicle life,” Squirrel slowly fell victim to a combination of drugs and undiagnosed mental illness.

When we came into contact with him, Squirrel was one of the hundreds of people in the County of Milwaukee who, as of September 2015, was considered “chronically homeless.” Chronic homelessness is defined by the U.S. Department of Housing and Urban Development as those who are without a home for a collective twelve months over a thirty-six month timespan.

“My first winter out there [in 2013], I had been out there for maybe eight months,” Squirrel said. “I had built an awesome structure. It was winterized. It had a little kitchen area, a little sleeping area, and you could almost stand in it! Three days before Christmas, I stayed at a friend’s house for a night, and I came back, and I guess the Sheriff’s Department found it. They took every single thing I owned.”

Squirrel took months to recover from that setback. Around a year and a half later, in June of 2015, we declared we were going to do something big. We were going to take all of those hundreds of individuals and house them within three years. We knew this would be a major undertaking. In making this declaration, we knew we would be the largest metropolitan area in the nation to end chronic homelessness, and the timeline we set for ourselves would make us the fastest in history to accomplish such a feat.

Only two years later, the end is already in sight.

In our January 2017 “Point in Time” count [a HUD mandated count of all the homeless individuals in our jurisdiction], that number of individuals considered chronically homeless was shaved down to just 56. In May 2017, we announced 75 more housing units scheduled to come online before the end of the summer. We’re almost there.

And we did this by employing the “Housing First” philosophy.

Housing First was first deployed in 1988 in Los Angeles by Tanya Tull’s “Beyond Shelter” program, and first fully fleshed out by Dr. Sam Tsemberis of NYU, when he founded Pathways to Housing in New York City. The basic premise is simple: provide housing to those with chronic needs without precondition. Housing First does not demand participants be sober before entering housing, or to participate in treatment for substance abuse, mental illness, or anything else.

“The voluntary nature of treatment programs is what makes them successful,” Milwaukee County Housing Division Administrator Jim Mathy said. “Treatment for these types of issues is far more successful, we’ve found, when the first step in that treatment is the person saying, by themselves, ‘I’m ready for this.’ And when they say that, we’re there and ready to go.”

In Milwaukee County, we utilized apartment complexes with on-site services, but most options consisted of scattered site housing units throughout the community 

“It felt really surreal, you know, to feel like a human being again,” said Squirrel, sitting in his eclectically-furnished, one-bedroom apartment in Milwaukee’s trendy East Side neighborhood. “There’s a lot of dignity involved. I hadn’t seen a psychiatrist in two years. I had stopped taking my meds. But when I got my first place, it really took me two or three weeks to realize…I had a toilet…and a bathroom. I had a shower that I could go and shower in any time!”

Human dignity is the primary goal of Milwaukee County’s Housing First program. At the same time, fiscal responsibility, as stewards of taxpayer money, is also critical. To that end, the results we have achieved are best described as ‘jaw-dropping.’

The Milwaukee County Housing First program operates on a $2 million annual budget. With that investment, our analysis shows, we have reduced BadgerCare (Medicaid) costs to the State of Wisconsin by $2.1 million. We have reduced unreimbursed costs to our Behavioral Health Division (part of our own department) by more than $714,000. We have reduced the number of municipal violations among our participant group from an annual average of 240 down to 39, and with that, another half million dollars in savings to state, county, and municipal justice expenses.

We have partnered with the Downtown Milwaukee Business Improvement District, the Milwaukee Police Department, and Milwaukee County District Attorney’s Office to refer chronically homeless individuals to us instead of making arrests on nuisance violations. Our local 2-1-1 service provider, Impact, Inc., serves as a coordinated entryway for all homeless needs in the county. The local homeless shelters have partnered with us, and expanded their mission to be full-fledged homeless service providers with case management services.

As for the participants themselves, 100 percent of them are participating in services to help meet their needs, including substance abuse and mental health care. It’s worth reiterating the voluntary nature of this participation.

Additionally, 77 percent of participants have experienced an increase in income since coming into the program. This is important since participants contribute a fixed percentage of their income toward rent. This means, the more income a participant has, the more they can contribute, and the further our taxpayer dollar goes to bringing more chronically homeless individuals into the program.

Twenty-seven percent of our participants have found employment.

Most importantly, in almost two years of the program’s history, we have had zero evictions, and 99 percent of participants remain in the program more than a year after entering. All exits have been voluntary, and remain housed. We have a Resident Advisory Council, where Housing First participants gather monthly to set real housing policy.

As for Squirrel, a member of that Council, he’s working part time, hoping his therapists green-light him to work full time soon. On top of that, he’s developing a magazine concept for Housing First residents and the overall homeless community in Milwaukee County. He hopes to have that in publication before the end of the year.

We were able to help Squirrel, and hundreds of other people because we prioritized our resources.  We broke down silos within the Department of Health and Human Services and with our partners.  We developed robust collaborative efforts with the City of Milwaukee, Milwaukee Housing Authority, shelter providers, coordinated entry, District Attorney, the judiciary, and many more. The community has come together to do the right thing with leadership, partnership, and resources.   

However, our work is still in progress, and the headwinds are picking up.

The most recent budget proposals from the current administration would zero out Community Development Block Grants and HOME funds. These funds currently provide about fifty percent of our annual operating budget for Housing First. If such a thing would come to pass, we could see at least half of our participants put back out on the streets by the end of that month.

That would be the best case scenario, if the federal budget were to pass as proposed.

What we know for sure, though, is that the Housing First model is not only the humane thing to do, the right thing to do, but it’s also the smart thing to do. Housing First values the dignity of the most vulnerable in our community with better outcomes and significant savings. This is one of those programs that truly yields a great return on investment. We see this in our data, and in our people. We just hope we can complete our journey down the Road to Zero before it disappears.

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