Homelessness in

Texas
Baylor Scott & White
Cultural and Social
Influences on Health
Lecture Series

Strategies For Change

thn.org

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 What is THN?
THN is a statewide agency that…

Leads communities in Texas so that

homelessness is rare, brief, and non-
recurring

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What THN does
two primary focus areas

Texas Balance of State CoC Statewide Initiatives

Establish a CoC
Administer and State level hub on AmeriCorps VISTA
and a CoC
Operate HMIS data & resources project
Board

TX BoS Statewide
CoC Initatives

Conduct CoC Facilitate

Planning and Application for SOAR Advocacy
Operations Funds

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 Homelessness in Texas

The communities that

THN works with/for:

And THN is the lead

agency for TX
Balance of State
Continuum of Care

A CoC or Homeless Crisis Response system:

-A community-based planning network for homelessness assistance.
-The geographic area covered by the community-based planning network.
-A program operated by the Dept. of Housing & Urban Dev. (HUD)

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 Agenda

Homelessness in Questions we What should we

Texas should be asking be doing

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 Extent of Homelessness in
Texas

Annual vs point in time

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• Each homeless crisis response system across the country conducts a Point-in-time or
one day count of people experiencing homeless during one 24 hr period within the last
10 days of January. And, most combine the count with a short survey to measure
characteristics. This is done at the behest of HUD b/c it’s tied to funding and because
many yrs ago when this practice started it was assumed that conducting a census in the
dead of winter would prove to be easier b/c people would more likely be in shelter than
outdoors (not always the case in TX). It’s an imperfect method of measuring the universe
of those that we’re working to help but it is what we have so we use these numbers as
our baseline measurements from year to year.
• This infographic is meant to show a one-day snapshot of homelessness in TX for those of
us, which is most of us, that only have a second or less to take in data as we scroll down
our social media sites, through our google searches, or in the case of our elected
officials, if time is limited because of overwhelming constituent interaction.
• I’m not going into detail on these statistics now b/c I’m covering most in the following
slides. That is with the exception of the Hurricane Harvey statistic here. This data was
gathered in Jan 2018 but I’ve kept it here because I believe we are still feeling the effects
of Harvey in our communities and will for some time still.

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 Number of People Experiencing
Homelessness in Texas
75%
Households
w/o Children

25,848 24%
Households
with Children

Households
1%
only Children
Results of 2019 PIT Counts

• HJere’s what everyone what’s to know, “How Many” ..so this is it

• There are two ways to look at this, 1. “whoa 25K people, that’s huge, what can ever be
done about it?!” 2. “only 25K people, I thought the number was much higher”
• In either case there really isn’t a reason we shouldn’t prioritize ending homelessness.
Either you think the number is too large and you want to do something about it before it
reaches epidemic proportions as it has in CA which has 24% of U.S. Homelessness (2018
AHAR) or you think the number is isn’t insurmountable and it’s one we can take care of
if we put a concentered and collaborative effort into doing that.

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 Homelessness in Texas over the years

Nearly 30% decrease in the past 10 years but since 2016 there has been a 12% increase

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 Chronically
Homeless
People who are chronically
homeless have
experienced homelessness
for at least a year – or
repeatedly over a 3 yr
period– while struggling
with a disabling condition
such as a serious mental
illness, substance use
disorder, or physical
disability.

• The CH make up 14% (3,610) of the overall TX pop. can have an average life expectancy
that is 30 or more years less than the averaged housed person.
• These are the people most often associated with homelessness b/c they are the most
visible and these are the people experiencing homelessness that you, if you are working
in ERs, will see most often because of untreated chronic disease and illnesses and the
fact that being out-of-doors exacerbates health problems.
• Texas have worked hard to reduce the size of this population by 16% since 2015

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 Homeless Veterans
• Homeless Veterans make
up only 7% (1,933) of
homelessness in Texas.
• Communities have worked
hard to reduce the size of
this population by 19%
since 2015 and four cities
have effectively ended
Veteran homelessness
(Abilene, Austin, Houston,
and San Antonio)

• communities have worked hard to reduce the size of this population by 16% since 2015
and four cities have effectively ended Veteran homelessness (Abilene, Austin, Houston,
and San Antonio)

• criteria: the community has identified all veterans experiencing homelessness; the
community provides shelter immediately to any veteran experiencing unsheltered
homelessness who wants it ; the community has capacity to assist veterans to swiftly
move into permanent housing: the community has resources, plans, and system capacity
in place should any veteran become homeless or be at risk of homelessness in the
future

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 Unaccompanied
Youth
• Unaccompanied youth
make up 5% (1,351) of
homelessness in Texas.
• There’s more to learn
about this sub-population
• Communities are
beginning to address
Youth Homelessness
more strategically – Austin
is an example

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 Other Sub-populations

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What questions we should
be asking about
Homelessness

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 Rely on data - not myths & misconceptions

be vigilant about focusing on objective data

For example, focusing on the data is helping us end homelessness for Veterans in four TX
cities

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ES9

Myths & Misconceptions

• People are not getting rich off panhandling, research shows that asking for money on
the street all day nets an average of $25/day
• "Some people just want to live on the street“
• People come to Texas to be homeless because of the weather
• People just need to work, homeless people are lazy (% of all and % of those that can
work)
• Why aren’t they spending the money they have wisely? Why do they have cell phones,
nice clothes, and for those that have automobiles WHY do they HAVE nice trucks?

Questions like these are tantamount to saying, “they deserve this”, or “they aren’t
deserving” ; both are making assumptions that do nothing to work toward a solution.

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Slide 16

ES9 Los Angeles County's Project 50. Begun in late 2007, it sought to house the most vulnerable and chronically
homeless adults living on skid row. Four years later, only 20 participants had left the project and 94 people
were still living in stable housing.
Eric Samuels, 7/1/2019
 Myths & Misconceptions

• "Most homeless people are mentally ill or abuse substances”

• Homelessness doesn’t affect me. That’s short-sighted, not only could it affect you
directly but it currently affects you even if you are housed.
• "Homelessness is too expensive and complex to solve"
• Homelessness isn't too expensive to solve; it's too expensive not to solve.

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 We should be asking about what
Homelessness costs us
Costs at Individual/Household
level
• Individual and household
health is compromised
• Potential exposure to
trauma is in increased
• Children are more likely to
experience homelessness
as adults
Costs at the system level
• Cost – homelessness costs
taxpayers through
disproportionate use of
public health systems
• Quality of city life and
accessibility to public space
may be compromised
• Homelessness can create a
public health issue

Public health systems are commonly defined as “all public, private, and voluntary entities
that contribute to the delivery of essential public health services within a jurisdiction.”

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 We should be asking about what
Homelessness costs us
Costs at Individual/Household
level
• Children without stable
housing are also more likely to
use E.R.s rather than a regular
health care provider
• People ages 25 - 44
experiencing homelessness
face an all-cause mortality risk
that is 8.9 times higher than
the general population
Costs at the system level
• A 2 yr UT survey of homeless
individuals found that each
person costs taxpayers
$14,480/yr, primarily for
overnight jail. ($20K State/Fed
prison.)
• According to studies chronic
homelessness costs taxpayers
an average of $35,578/yr. ER
visits make up a substantial
share of this cost.

The health and well-being of a child is inextricably linked to the health

and well-being of his/her parent (Guarino & Bassuk, 2010

2) According to studies the chronically homeless costs the taxpayers an average of $35,578
per year. The costs associated with emergency room visits make up a substantial share of
this cost. When compared to average Medicaid recipients how much does ER treatment
cost for people experiencing homelessness?
Expenditure rates are nearly four times as high of Medicaid recipients

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 Finally..

We should be asking how we can make

homelessness rare, brief, and a one-
time event

• Homelessness affects everyone

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What do we do about
Homelessness

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What should we be
doing?
1. Collaborate on the
issue as a community
2. Create more
affordable housing
3. Invest in prevention
and diversion
4. Integrate data systems

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 Community-wide
dedication to
ending
homelessness
1. Abilene 100 Day Challenge –
goal was to house 50
people in 100 days – 64
ended up being housed
2. Mayor Anthony Williams, the
West TX Homeless Network,
land lords, businesses made
it a priority
3. Ending Veteran Homeless
campaigns work,
communities that rally on
this issue have success

• communities have worked hard to reduce the size of this population by 16% since 2015
and four cities have effectively ended Veteran homelessness (Abilene, Austin, Houston,
and San Antonio)

• criteria: the community has identified all veterans experiencing homelessness; the
community provides shelter immediately to any veteran experiencing unsheltered
homelessness who wants it ; the community has capacity to assist veterans to swiftly
move into permanent housing: the community has resources, plans, and system capacity
in place should any veteran become homeless or be at risk of homelessness in the
future

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 Create more
affordable Housing
•According to a Zillow study The areas
that are most vulnerable to rising rents,
unaffordability and poverty hold 15
percent of the U.S. population – and 47
percent of people experiencing
homelessness.

•Housing first works, communities looking

at “frequent use” data have found housing
the homeless cost efficient and effective.

•Utilizing Rapid Re-housing pairs well with

ending family homelessness, communities
that open units for this use have success.

No universal template
Policy solutions to housing unaffordability require solutions as diverse as the markets
themselves. The most effective solutions will involve a suite of policies and programs that
tackle the multifaceted nature of this problem across a diverse range of housing markets.
Places with the worst affordability already know that their current interventions and tools
have been dulled by continually hammering against rising rental costs. Now they can see
similar areas where that may not be the case.
Some policies will necessarily create more housing in general, while some will need to be
more pointedly focused on creating affordable housing in particular. Other policies will
need to increase accessibility to the affordable housing that already exists, by taking a hard
look at how vouchers are working and what can be done to improve tenant-based
assistance. Still other solutions will have little to do with housing at all, and will involve
hard work on improving transit from where we live to where we work and other factors.
The point is there is no one-size-fits-all approach, because there is no universal template
for how homelessness evolves and responds in a given community.

Almost everyone will agree to come inside if they are approached respectfully and offered
actual housing, not just temporary shelter. Perhaps the clearest repudiation of the housing-
resistance myth is Los Angeles County's Project 50. Begun in late 2007, it sought to house
the most vulnerable and chronically homeless adults living on skid row. Four years later,

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only 20 participants had left the project and 94 people were still living in stable housing.

https://www.latimes.com/local/la-xpm-2012-jun-08-la-me-0608-homeless-savings-
20120608-story.html

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 Prevention
and Diversion
Homelessness Prevention is the
provision of rental/utility
assistance and supportive
services directly related to
the prevention of homelessness
to households who are in danger
of eviction, foreclosure or
homelessness .
Diversion is a process that uses
safe housing options based on a
household’s available resources
and, if necessary, connecting
them with services and financial
assistance to help them return to
permanent housing.

While each of the communities' approaches had its own nuances, three common themes
emerged, which I like to think of as the “Three C’s of Diversion.”
1. Commitment – Communities need to commit to the diversion approach. Even when
there is capacity in the shelter system, diversion prevents households from the stress
associated with shelter stays. The communities that are seeing significant results from
diversion strategies are communities that recognize a majority of households presenting for
shelter are not literally homeless, but in many cases staying with family or friends. These
communities recognize that such households can be better served by not entering the
shelter system.
2. Conversation – Successful diversion uses the first conversation with a household as an
opportunity to explore their current housing crisis, not to ask a list of “diversion questions.”
A good problem solving conversation includes exploring any potential resources a
household may have to stay where they are currently residing or move to another housing
opportunity. In many cases, just having staff engage in a conversation to get to know the
household allows for a successful resolution without any financial assistance.
3. Creativity – There is not a single strategy that makes diversion a success. Staff who
engage in diversion conversations with households are creative in their solutions, and
explore every option to divert households from shelter. This can range from helping
someone locate a family member or friend that can help to acting as a mediator in the
current housing situation to develop a resolution that can allow the household to stay.

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Implementing effective diversion starts at the point of entry when someone is asking for
shelter. It embraces the approach that households can be best served by having a creative
conversation to assist them in finding another direction that prevents them from entering
the shelter system.

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 Integrate Data
Systems
People experiencing homelessness
often interact with multiple agencies –
housing, healthcare, law enforcement,
and nonprofits providing support
services.
Those organizations rarely share
information with each other – a
challenge that, if addressed, can be a
game changer in the national efforts
to prevent and combat homelessness.

Utilizing data to target resources

where the needs are is cost efficient,
data removes guesswork

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