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Housing first


THE CITY plans to embark on a social experiment next month, placing two dozen chronically homeless men in permanent housing and providing them with intensive social services -- all in the hope of keeping them off the streets for good.

The plan is based on a homelessness prevention theory gaining currency around the country, and we are encouraged by the city's willingness to try it. The logic is a simple: If you give a homeless person a place to live, you've conquered half the problem. The other half, the reasons people land on the streets in the first place -- a lost job and subsequent eviction, a costly catastrophic illness, drug or alcohol addiction, family dysfunction, mental illness -- is secondary and can be better dealt with once the person is housed.

This reasoning was once counter to long-standing practice in Baltimore and other cities. Advocates for the homeless and government officials believed it made no sense to house people with problems likely to prevent them from keeping the housing. Mental health and addiction treatment, job counseling and other intensive social services were thought to be needed first.

Nowadays, the "housing first" approach is considered more effective. Given the city's growing homeless problem -- this year's homeless census counted 2,943, a 10 percent increase from 2003 -- and the failure of past attempts to decrease it, new models of solving old problems are worth a try.

Baltimore's current "housing readiness" model requires the homeless to be in drug treatment before being placed in public housing, a notion undermined by the high level of drug use in the city. Experts on homelessness have found that even homeless drug users and those with chronic mental illness benefit from the stabilizing influence of housing coupled with services, and are less likely to cycle in and out of treatment programs.

The city's willingness to try another approach, given current national trends, is welcome. New York, Philadelphia and Minnesota have all reported success using the "housing first" model.

Baltimore Homeless Services Inc. has teamed with the city housing authority, which will provide apartments, and with the city's substance abuse system, which has dedicated treatment slots. In addition, Health Care for the Homeless Inc., a local agency, will provide primary health care, including medical, mental and addiction treatment, and daily contact with a social worker, at a cost to the city of $50,000.

Though expensive, the alternative is more costly. Washington, D.C., which has a similar program for homeless families, spends $7,000 per family annually instead of $11,439 for six months in a family shelter. Baltimore's trial project will be closely tracked and evaluated over six months. If successful, it will be expanded citywide, and this small attempt at innovation may lead to a sensible solution to a big problem.

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