What Works for the Homeless Problem

Medicine Hat, Alberta, Canada has had functionally zero homeless for about six years.

Japan, Singapore and Denmark also have been very successful in dealing with homelessness. Singapore is a multi-ethnic society with about 6 million people.

Hamilton, Canada ( a city with a population of 750,000) has also has great success reducing homelessness.

Medicine Hat’s example is cleaner because it removes the power and exceptional capabilities of Lee Kuan Yuen (x-PM of Singapore) from the solution.

In 2015, no one living unsheltered in Medicine Hat is left without permanent housing more than 10 days after the city learns of their circumstances. In 2009, when the goal was established and (future Mayor) Clugston was initially opposed to the strategy Medicine Hat wanted to implement. But the self-proclaimed conservative said that — after learning the hard facts — ensuring residents are housed is the fiscally responsible thing to do.

In 2009, the city of 60,000 people started with about 700 homeless (1332 homeless or at risk of becoming homeless). The city now has a population of about 76,000 and has no more than three people experiencing chronic homelessness in a community for three straight months.

Here is a link to the Medicine Hat Functionally Zero Homeless Case Study.

The Medicine Hat program the city housed 1,072 people, including 312 children April 2009 to Dec. 31, 2016.

Medicine Hat Homelessness 2018 Stats:
Total number of people estimated to be experiencing homelessness: 68
Unsheltered: 12
Emergency sheltered: 21
Transitionally housed: 19
Health system: 4
Chronically homeless: 17%
Episodically homeless: 33%

HOUSING
No. of public & subsidized housing units: 537 (2013)

No. of households on housing waitlist: 355 (2013)

Recent statistics for the US have about 17 homeless per 10,000 people. Forty-one per 10,000 people were homeless in California, and 70% of the homeless people in the state were without shelter. In Los Angeles City and County there were 63,706 people experiencing homelessness, 72% of whom had no shelter at all. California also experienced a large increase in the percentage of homeless people in families during 2019-2020, an increase of about 14.6% or 3,276 people. This is 15% of the people in families experiencing homelessness in the nation.

9 states (Alaska, California, Hawaii, Massachusetts, Nevada, New York, Oregon, Vermont, and Washington) and the District of Columbia that have homelessness ratios higher than the United States as a whole.

In the US 553,000 people are considered homeless on any individual night. The population of the US is 333 million vs 38 million in Canada. That would mean that the percentage of people homeless in the US on any one night is 0.016%, or four times higher than the rate in Canada.

There are 2,880 unsheltered homeless in Canada versus about 200,000 unsheltered homeless in the US. The US has 8.6 times more people than Canada.

Housing an individual is cheaper than having a city pay expenses often related to homeless people — like frequent hospital stays and run-ins with the law.

A 2005 study by Pomeroy looked at costs in four Canadian cities, institutional responses (jails, hospitals, etc.) cost $66,000-$120,000 annually, emergency shelters cost $13,000-$42,000 annually whereas supportive and transitional housing cost $13,000-$18,000 and affordable housing without supports was a mere $5,000-$8,000.

A two-year pilot project called The Canadian Model for Housing and Support for Veterans Experiencing Homelessness in 2012, was designed to address the needs of the Canadian veterans experiencing homelessness. The program included a Housing First approach and staff/volunteer resources for each participant. The program revealed promising results of an estimated $536, 000 per year (in terms of cost savings) due to reductions in 911 calls and emergency-shelter drop-ins.

By 2013, the Medicine Hat program there has been a decline in the use of emergency shelters by nearly 30%, while over 700 chronically and episodically homeless people have been housed. Moreover, there is a 72% success rate among program participants.

How did they do it?

Medicine Hat has been forging the path toward ending homelessness even preceding its work with Built for Zero Canada. The community is one of the first to implement By-Name Lists and Coordinated Access beginning in 2010.

The By-Name lists means they have a database of every person who is homeless, whether they have kids and other data. They are working on each case on individual and family basis. They know each person’s problems and why they are homeless.

Medicine Hat achieved functional zero by:
* Rallying around a defined goal to end homelessness. In 2009, Medicine Hat was one of the first Canadian cities to commit to ending homelessness, a goal that was updated in 2014. They continue to set measurable goals to end homelessness.

* Strong partnerships. Service providers, shelters and other stakeholders representing a broad cross section of interest and expertise locally (e.g., private sector, criminal justice, health care) work together on the Community Council on Homelessness. The community is also supported by all levels of government and the public-at-large where they’ve fostered a strong belief (and proven!) that ending homelessness is possible.

* Real-time data used to drive system transformations. Medicine Hat has a strong culture of data-driven decision-making – where data informs policy, program, and system improvement. Since 2010, a Homelessness Management Information System (HMIS) has been deployed in the community, which means Medicine Hat can see their data in real-time as well as enabling them to review and monitor trends and improvements over time. They use their data daily to provide service and monitor system functioning. In addition, all funded programs have annual targets that are monitored with monthly reporting. They support programs to read and utilize program and system-level data to inform their programs and leverage funding.

* Housing First and continuous housing focused system improvement. Medicine Hat is a strong advocate and user of Housing First principles. These principles have underpinned their continuous housing focused system improvements. Medicine Hat embarked on its own 10-year plan in 2009 and began implementing Coordinated Entry in 2010 (first in Province). Since that time, they have continued to evolve their system, shifting programs and resources in response to their data.

* Lived experience at the table. Medicine Hat engages with people with lived experience of homelessness via 1:1 engagement and feedback sessions that support system improvement. The community works hard to address the pipelines into homelessness and work with folks who’ve experienced the gaps and pitfalls in services to better address the problem areas.

SOURCES – Homeless Hub, Medicine Hat
Written By Brian Wang, Nextbigfuture.com