Chronic unemployment or sudden job loss can lead to homelessness. For individuals able to work, regaining a steady job can make it easier to exit homelessness and can support long term housing stability and financial security. However, homeless people often face many obstacles when searching for and maintaining employment. Many have limited skills, education, and experience, and opportunities for jobs that pay a living wage can be limited. The lack of a car or access to public transportation is an additional barrier. However, research has shown that the homeless, both those who are chronically and acutely homeless, are willing and able to work if given the opportunity. Gary Shaheen and John Rio present a thoughtful argument for the role of employment in preventing and ending homelessness.
EMPLOYMENT SERVICE MODELS
Multiple models have been developed to provide employment services to people experiencing homelessness. Several of these models stress the importance of job training in the employment process. For example, the Coalition for the Homeless in New York City has a First Step Job Training Program that provides homeless and low-income women with training, social support, education, and work experience to overcome obstacles to employment. This program offers classes that teach employment skills and an understanding of the labor market and workplace.
Supported Employment is an evidence-based practice that stresses the importance of obtaining employment through a rapid job search as soon as the participant feels ready. Unlike many traditional models, supported employment does not provide lengthy pre-employment assessment, training, and counseling. Rather, evidence suggests that rapid access to jobs is more effective than providing extensive job-readiness training. The most common model of supported employment, the Individualized Placement Support (IPS) model, helps individuals gain rapid entry into the job market, with a job at or above minimum wage, while providing supportive services. These services typically include one-on-one job coaching, on-the-job training and credentialing, mental health treatment, and ongoing reassessment to identify and address emerging barriers. The National Coalition of Homeless Veterans successfully uses an IPS supported employment model for the veterans they serve.
WorkFirst is an employment model that draws on IPS principles and is designed to operate parallel to housing first efforts. It prioritizes employment as a strategy for promoting self-sufficiency and long-term housing stability. The WorkFirst model, like supported employment, stresses the importance of rapid access to a job. This model’s philosophy is that “any job is a good job” and that the best way to prepare an individual for work is to have them work, and as quickly as possible. Clients develop work skills and competencies on the job rather than in job-readiness trainings. If one is not able to find employment right away, WorkFirst provides additional services to address factors that impede employment, such as education or training, but these are brief in nature to allow the job search to quickly recommence. A WorkFirst Demonstration Project at the Pine Street Inn in Boston is a great example of how effective this method can be.
In addition to these formal models, communities across the country are developing innovative ways to increase employment opportunities for people experiencing homelessness. For example, the Interfaith Partnership for the Homeless in Albany, NY started the Ambassador program, a year-long training program that connects homeless individuals to work in the community while also helping them pursue life goals and gain important skills. The program partners with local theaters and parks to provide homeless people with a job, often their first job, which helps them get a second job in the future and builds their resumes. The There’s A Better Way program in Albuquerque similarly provides access to jobs beautifying the city, such as landscaping and cleaning up litter.
These are just a few examples of employment services and supports for people experiencing homelessness. To learn more about these and other models, click here for a quick overview or here for a closer look at how employment can prevent homelessness and promote health.
Blog Post Author: Kelsey Whittington, graduate assistant for the National Center for Excellence in Homeless Services.
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Check out this one written by Dr. Emmy Tiderington from Rutgers University.
Permanent Supportive Housing (PSH) is an evidence-based intervention that combines affordable housing with wrap-around support services in order to end homelessness for individuals who experience barriers to housing stability, such as serious mental illness, substance use problems, and chronic health conditions. Since the model’s inception, the number of PSH beds in the U.S. has increased substantially, up 52% just over the past ten years. Currently, the U.S. Department of Housing and Urban Development estimates that close to 320,000 PSH beds exist within the federal housing inventory. However, demand for PSH still outstrips supply, and one of the overarching questions for policymakers is how to “right-size” homeless services to individual need and maximize the use of limited resources.
While some service recipients will require the intensity of support services and housing assistance that PSH offers for a lifetime, others may not need this level of support after some time and want to transition from the PSH program into mainstream housing completely separate from supportive services. In fact, a previous study of PSH programs estimated that 5 to 25 percent of PSH residents would be able to successfully move on from these programs and live independent from services.
In recognition of this gap in the homeless service system, several recent pilot programs (commonly called Moving On initiatives) are assisting willing and able PSH residents with the transition from program-based apartments into mainstream independent units using a combination of transitional supports and affordable housing subsidies. Moving On initiatives address the PSH “supply bottleneck” by allowing homeless individuals and families with greater needs to access intensive services, while providing opportunities for those who can move on with the opportunity to achieve fully integrated, independent living in the community in the least restrictive setting possible. However, best practices for the Moving On model have yet to be developed and little is known about the outcomes of those leaving PSH through these initiatives over time.
Dr. Emmy Tiderington (Assistant Professor of Social Work at Rutgers, the State University of New Jersey), in collaboration with Dr. Dan Herman (Professor of Social Work at Hunter College), is conducting a three-year study funded by the Oak Foundation of the implementation and outcomes of New York City’s Moving On Initiative (MOI). The New York City MOI is one of the largest in the country, assisting 125 PSH recipients across five supportive housing agencies and a range of subpopulations (e.g. adults, families, and youth who have aged out of foster care) as they move from PSH into independent apartments using Housing Choice Vouchers and various transitional supports.
The aims of this mixed methods study are to: 1) Capture MOI recipient outcomes regarding quality of life, health and recovery, community integration, service utilization, and housing stability, at one year and two years post-leaving PSH; 2) Describe MOI program implementation processes and experiences within and across the five different Moving On provider agencies; and 3) Identify the individual-, program-, and system-level barriers to and facilitators of MOI recipients’ successful transition from PSH programs to independent living in the community. Findings from this study will be used to inform the development of best practices for MOI implementation and broader scale-ups of MOI across the country.
Blog Post Author: Emmy Tiderington, PhD, LMSW Assistant Professor, School of Social Work and Associate Faculty, Institute for Health, Health Care Policy and Aging Research at Rutgers, The State University of New Jersey
Dr. Tiderington’s research focuses on the implementation and effectiveness of supportive housing and other forms of homeless services as a means for ending homelessness and improving outcomes for service recipients. She is a licensed social worker with extensive direct practice experience working in supportive housing and case management services for adults with serious mental illness. In addition to leading the Moving On study, her research has explored the mechanisms and processes by which homeless adults achieve recovery from substance abuse and serious mental illness. She has also examined the individual, organizational, and macro-systemic barriers to “street-level” policy implementation of person-centered care, harm reduction, and the management of risk and recovery in supportive housing services.
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Check out this one written by Dr. Kimberly Bender from the University of Denver.
When I talk about what I do, I am never sure if I should describe myself as someone who researches homelessness or someone who researches health issues, including HIV/AIDS. In reality, I do both. Before going the research route, I worked as a social worker in Chicago managing supportive housing programs for people who were homeless and HIV positive. The intersection of HIV and homelessness is still a personal passion, as well as the focus of much of my research.
This July I had the opportunity to attend and present at the International AIDS Conference in Durban, South Africa. This conference, held every two years, is a huge gathering of more than 15,000 researchers, health care professionals, activists, policymakers, and government leaders who come together to discuss all aspects of the AIDS epidemic. Presentation topics run the gamut from the development of vaccines and new drugs to the social issues that drive the epidemic, such as the criminalization of sex work, poverty, and social inequalities. It was humbling and exciting to be among this group of people from around the world, with such vast and varied knowledge and experiences.
Initially, I was a little disappointed at what felt like a lack of attention to housing issues in the conference program. My online search of the hundreds of conference presentations yielded only a handful with “homelessness” or “housing” in the title. I soon found, though, that homelessness was in fact addressed in a number of ways. For example, in one session I attended, none of the presenters had made housing and homelessness a focal point of their research—and yet it came up several times. One presenter discussed the HIV risk context of women who were displaced in Haiti after the 2010 earthquake and no longer had permanent housing; another described how young injection drug users in Vancouver were more likely to share needles when they didn’t have a stable home base from which to access syringe exchange and other harm reduction services; and a third presenter discussed homelessness as increasing the risk of sexual assault for HIV positive immigrants in France. Hearing all of these examples solidified my belief that “housing is health”—without stable housing, it is infinitely more difficult to feed one’s self, to seek treatment for various conditions, to take medication, to practice harm reduction with regard to sex or substance use, and to protect one’s body.
One of the highlights of the conference was having the chance to visit the Denis Hurley Centre, a nonprofit agency that works with homeless and low-income people in Durban. Like many of the homeless-serving agencies that I am familiar with in the U.S., the Denis Hurley Centre strives to serve people with dignity, to care for their basic human needs, and to give people opportunities for growth and empowerment. It was interesting to me to learn what this looks like in a South African, and specifically a Durban, context. Durban is a large and diverse city that is home to people of many different racial, ethnic, religious, and national backgrounds. The director of the center, Raymond Perrier, mentioned that he wondered if this was the only social service agency in the world that is named for a Catholic bishop but that maintains a halal kitchen, as the agency has a large Muslim clientele. To me, this is a great example of the social work credo of “meeting where the client is at.”
Disturbingly, I also learned from Mr. Perrier that in advance of the conference, the police had “swept” the central business district and forced many of the homeless people staying there to relocate elsewhere. I have heard of such sweeps occurring before major events in U.S. cities and elsewhere, but to do this before an HIV conference with a theme of “access, equity, rights now” seems particularly cruel and ironic. South Africa has one of the world’s largest HIV epidemics, with approximately one in five adults living with HIV, and even higher rates among poor and marginalized groups. Being homeless is hazardous to one’s health, and it’s particularly detrimental to HIV health. When people don’t have a safe, stable place to stay—and when they are forced by police to move from their places on the street—it is very difficult to adhere to lifesaving HIV medications. I knew this to be the case with the clients I worked with in Chicago, and Mr. Perrier described how it is the same in Durban. The idea that the conference would cause even one HIV-positive homeless person in Durban to disrupt their medication adherence is deeply troubling to me.
I left South Africa with the sense that while it is important to acknowledge our geographic, national, and sociopolitical differences, problems like the criminalization of homelessness and the lack of safe and affordable housing for many HIV-positive and at-risk people are truly global in scope. Visiting the Denis Hurley Centre showed me that the solutions to addressing these problems are both local and global. It is one thing to talk about access, equity, and human rights, but it is a far more difficult thing to live out this mantra in a world that constantly denies the rights and the value of so many lives in so many locations.
And yet, there is always hope and work to be done still.
Blog Post Author: Elizabeth Bowen, PhD
Elizabeth Bowen, PhD, is an Assistant Professor in the School of Social Work at the University at Buffalo (UB)-State University of New York. Her research focuses on the relationship between housing and health. She is the UB faculty contact for the National Homelessness Social Work Initiative and co-leads the New York/New Jersey regional network of social work programs.
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Check out this one that Elizabeth wrote in April 2016.
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