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'Housing is health care': Utah advocates say more permanent supportive housing is needed

Magnolia, a new permanent supportive housing building owned by Shelter the Homeless and operated by the Road Home, has 65 units for people who have experienced homelessness.

Magnolia, a new permanent supportive housing building owned by Shelter the Homeless and operated by the Road Home, has 65 units for people who have experienced homelessness. (Spenser Heaps, Deseret News)

Estimated read time: 5-6 minutes

SALT LAKE CITY — Utah housing and disability advocates pushed back Wednesday on a recent audit that criticized the low turnover of permanent supportive housing and called for the state legislature to allocate $200 million of federal funding to affordable and permanent supportive housing.

Permanent supportive housing is provided to individuals who are considered chronically homeless and provides additional social services. Chronic homelessness is defined by the state as a person with a disability who has either been continuously homeless for at least a year or has experienced homelessness four times in three years.

As the number of people in Utah experiencing homelessness in the past five years has continued to rise so has the discussion of the state's attempts to solve it. State legislators also announced in the 2021 session that $50 million set aside in the state budget for affordable housing and homelessness initiatives would be multiplied to $730 million through community donations and investments.

The rising number of those experiencing homelessness has led to contention between elected officials. Most recently, Salt Lake City Mayor Erin Mendenhall expressed her frustration that the city is hosting "far more than its fair share of homeless services" in a statewide crisis.

Despite the money funneled into addressing homelessness, the state has continued to struggle with the need and the recent state legislative audit questioned "whether large increases in funding will produce the desired results."

State auditors additionally asked whether success would be determined by helping individuals achieve self-sufficiency or housing. The housing-focused strategy, the audit noted, costs a considerate amount of money but doesn't necessarily provide housing for all that need it. The audit pointed to supportive housing's low turnover and noted some residents "choose not to address the mental illness or substance abuse issues that led them to homelessness and are therefore unable to achieve self-sufficiency."

But some advocates for Utah's homeless say the critique of permanent supportive housing and its costs are shortsighted.

"Over the years supportive housing is shown to not only improve outcome but reduce health care costs when provided to those individuals who have some complex needs. When someone stays long term in housing that is the desired outcome. It shows the model is working," panelist Sherri Wittwer said in a webinar hosted Wednesday by Crossroads Urban Center, the Disability Law Center and the Utah Housing Coalition.

The sentiment was echoed by another panelist.

"The word permanent should say something," said Tara Rollins of the Utah Housing Coalition.

Both Whittwer and Rollins said the cost savings of permanent supportive housing were overlooked by the audit. Providing permanent supportive housing to those experiencing homelessness — especially those with mental health or substance abuse issues — would reduce costs of encampment clean-ups, overuse of ambulances and emergency rooms.

"While we've made some great progress in the development of crisis response systems, we have much work to do on preventing crisis from happening in the first place," Whittwer said.

Whittwer argued that the solution isn't to build more psychiatric facilities or beds but to couple permanent supportive housing with evidence-based mental health services such as peer support, community-based care, effective case management and assertive community treatment.

"If we want sound policy solutions that will reduce the burden on our homeless services system, law enforcement and first responders, courts, corrections and emergency rooms, we must first look to housing," Whittwer said. "When we provide a variety of housing options with services and support based on individual needs we will break the cycle and be able to provide quality cost-effective solutions that focus on the individual's long-term stability, independence, development and dignity."

The auditors failed to recognize that long-term housing paired with community-based services leads to self-sufficiency, panelists argued. Andrew Riggle of the Disability Law Center added that the audit's point on drug addiction and mental illness shifted the blame to a perceived failure of an individual instead of the failure of a system to provide adequate resources and support.

"It's easier and less costly to ignore a person than it is to fix a problem. Ethically, it's simple — Utah must take responsibility for closing the revolving door of hospitalization or incarceration by investing in alternatives beyond suicide prevention and crisis stabilization," Riggle said.

The low turnover rate also goes beyond those who need additional support due to drug addiction or mental illness, the panel added. The advocates pointed to those with disabilities who struggle outside of permanent supportive housing.

Disabled Rights Action Committee member Tecuani Oliver said being autistic impacted her while experiencing homelessness. Individuals with different disabilities need to be considered and met with a variety of options instead of a "monolith," Oliver added.

"There are portions of the vulnerable population that are going to need this supportive housing for the rest of their lives but there are a large number of people who can transition it, with the right support and mentoring and coaching and access to the right services," said Utah state Rep. Clare Collard, D-Magna.

While calling on state legislators to allocate $200 million of federal funding to affordable and permanent supportive housing, advocates pointed to one last need legislators should address.

"It's critical that we have access to these services within the communities where people live. We can't expect people to all come to Salt Lake County or a larger metropolitan area. We really need to have the services within the community where they reside and where they possibly have already some community support," Collard added.

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