HOME&
HEALTHY
FOR GOOD
Permanent Supportive Housing:
A Solution-Driven Model
January 2021 Home & Healthy for Good
Progress Report
Prepared by:
Massachusetts Housing and Shelter Alliance
PO Box 8638 | Boston, MA 02114 | 617.367.6447 | edaubenspeck@mhsa.net| www.mhsa.net
TABLE OF CONTENTS
Introduction .......................................................................................................................page 2
Demographics ....................................................................................................................page 4
Outcomes ............................................................................................................................page 5
New Projects .......................................................................................................................page 8
Summary ............................................................................................................................page 9
Data Collection .................................................................................................................page 10
References .........................................................................................................................page 11
About the Massachusetts Housing and Shelter Alliance
The Massachusetts Housing and Shelter Alliance (MHSA) is a nonprofit public policy advocacy organization with the
singular mission of ending homelessness in Massachusetts.
Founded in 1988, MHSA represents nearly 100 community-based agencies statewide. MHSA works with these member
organizations to educate the public about homelessness and solutions that will end it; advocate for the strategic use of
resources based on research and best practices; advance innovative, cost-effective solutions to homelessness; and form
partnerships with government, private philanthropy, business leaders and service providers to ensure that homelessness
does not become a permanent part of the social landscape.
page 1
INTRODUCTION
Home & Healthy for Good (HHG) is a permanent supportive housing program for chronically homeless individuals.
HHG is run by the Massachusetts Housing and Shelter Alliance and is funded by the Commonwealth of Massachusetts.
HHG has provided chronically homeless adults with housing and supportive services, in accordance with the
Housing First model, since the program began in 2006. As of January 2021, HHG has served 1,321
homeless individuals.
HHG was created as a response to years of unsuccessful homelessness policy. For more than 30 years, emergency
shelter has been Massachusetts’ response to homelessness. While emergency shelters have indeed saved lives, shelters
only provide temporary relief for the Commonwealth’s most vulnerable residents — they do not offer homeless
individuals a permanent place to live. In addition to shelters, homeless individuals often rely on expensive emergency
room and hospital visits, the correctional system, and the streets to provide them with a place to stay. As a result, the
costs associated with homelessness are significant. Homelessness is also associated with significant health concerns.
Homeless individuals have disproportionately poor health outcomes and struggle with premature aging as a result of
the instability associated with homelessness.
> Housing First: A Low-Threshold Model for Success
The Housing First model represents a paradigm shift in the way chronic homelessness is
Health challenges
addressed. Often in traditional housing programs, homeless individuals are expected to faced by homeless
move forward through a linear service delivery system, with housing saved as a “reward” individuals include:
for individuals who are compliant with other requirements – such as maintaining sobriety
or finding employment. However, homeless individuals struggle to meet these demands - Lack of transportation
when they are also dealing with the challenges and instability of homelessness. Housing to hospitals, doctors’
First represents a shift toward “low-threshold” housing, in which the barriers to housing appointments and all forms
of primary care
have been removed. Housing First programs recognize that homeless individuals can more
easily maintain their sobriety, find employment, and achieve other health and life goals
- Stress, which negatively
when they have a permanent place to live. Housing First tenants live in leased, independent affects other conditions
apartments or shared living arrangements that are integrated into the community. Tenants
have access to a broad range of comprehensive community-based services, including - Higher risk of physical
medical and mental health care, substance abuse treatment, case management, vocational and sexual violence
training and life skills training. However, participants are not required to participate in
services – there are no compliance requirements in order to enter or stay in the program. - Lack of privacy for
By removing these barriers to housing, individuals are given an opportunity to deal with medication administration
the complex health and life issues they face as tenants, rather than as clients of a prescribed
system of care. - Lack of places to safely
keep medication, which
> Creating a Housing First Initiative in Massachusetts increases potential for theft
In Fiscal Year 2007, the Massachusetts Legislature included funding in the state budget - Lack of a safe, clean place
for a statewide Housing First program for chronically homeless individuals, as a result to rest and heal during
of increasing evidence from around the country that indicated Housing First is a cost- illness
effective model that decreases chronic homelessness. The FY07 budget allocated
$600,000 to the Massachusetts Housing and Shelter Alliance (MHSA) to operate the - Lack of access to critical
Home & Healthy for Good (HHG) program. The funding for HHG has been increased medical services, as a
over the years since 2007, and the program received $3.89 million in the FY21 state result of not having a
permanent address
budget. The budget allocation for HHG is flexible, which means the funding can
be used for housing subsidies, supportive services, or both.
page 2
> Target Population
Disability Status
HHG serves chronically homeless adults. A chronically homeless person
is defined by the federal government as “an unaccompanied homeless 69% of HHG tenants
individual with a disabling condition who has either been continuously report having a mental
homeless for a year or more or has had at least four episodes of homelessness health disability
in the past three years.”1
Historically, HHG tenants report that they are homeless for
50% of tenants report
an average of 5 years prior to entering the program. About 65 having a physical health
percent of HHG tenants are coming directly from the emergency disability
shelter system.
25% of tenants report
Chronically homeless individuals constitute about 10 percent of the having a substance
homeless population yet consume more than half of homeless resources.2 abuse disorder
This subset of people suffers from complex medical, mental and
addiction disabilities that are virtually impossible to manage in the
unstable setting of homelessness. Housing provides individuals with 48% report multiple
stability, which allows them to address the complex issues and disabilities
disabilities that affect them.
> Program Geography
In FY20, MHSA entered into a contract with DHCD to continue to administer the HHG program throughout
Massachusetts. Twenty homeless service providers now participate in the program as agencies subcontracted by
MHSA.
Commonwealth Land Trust
(CLT)
SMOC/ Lowell Transitional
Living Center
Action Inc.
DIAL/ SELF Youth & North Shore
Community Services Community
Action Programs
AIDS Action Boston Health Care for the Homeless Program
Committee and Boston Public Health Commission
Heading Home HomeStart
Metro Housing Boston
SMOC Pine Street Inn
and Justice Resource Institute
Soldier On Friends of the Homeless/ Veterans Inc.
Clinical & Support Options, Inc.
and South Middlesex Father Bill’s
Mental Health Association Opportunity Council (SMOC) & MainSpring
Worcester Housing
Authority - Building
Futures Inc.
The resources allocated through HHG
allow the following organizations to provide housing
and supportive services:
- Action Inc. (Gloucester)
- AIDS Action Committee/Youth on Fire (Cambridge)*
- Boston Health Care for the Homeless Program (Boston) Housing Assistance
Corporation/ Duffy
- Boston Public Health Commission (Boston) Health Center
- Commonwealth Land Trust (Lawrence)
- DIAL/SELF Youth & Community Services (Greenfield)*
- Father Bill’s & MainSpring (Quincy, Brockton, Plymouth) - North Shore Community Action Programs, Inc. (Peabody)
- Friends of the Homeless/ Clinical & Support Options, Inc. (Springfield) - Pine Street Inn (Boston)
- Heading Home (Cambridge) - South Middlesex Opportunity Council/Lowell Transitional Living Center
- HomeStart (Boston) (Framingham/Worcester/Lowell)
- Housing Assistance Corporation/Duffy Health Center (Cape Cod) - Soldier On
- Justice Resource Institute (Boston)*
- Veterans Inc. (Worcester)
- Mental Health Association (Springfield)
- Worcester Housing Authority - Building Futures Inc.*
- Metro Housing Boston (Boston)
page 3 * Provider for LGBTQ Pilot Program
* Provider for "A Place to Live" Micro-Units
DEMOGRAPHICS
Most HHG participants are white, non-Hispanic, aged 35-61, and come from the state’s emergency shelter system.
This is to be expected given the demographics of the nationwide homeless population. Middle-aged white males are the
most common demographic category among chronically homeless individuals.3,4
Count Percentage Count Percentage
GENDER RACE
Male 983 74% White 920 70%
Female 287 21% Black or African American 296 22%
Transgender 12 <1% American Indian or Alaska 14 1%
Gender not reported 39 3% Native
Asian 7 <1%
Count Percentage Multi-Racial 13 1%
AGE as of today Native Hawaiian or Other 1%
10
18-24 years 96 7% Pacific Islander
25-34 139 11% Race not reported 61 5%
35-44 282 21%
45-54 418 32% Count Percentage
55-61 268 20% ETHNICITY
62+ 106 8% Hispanic/Latinx 149 11%
Age not reported 11 <1% Non-Hispanic/Latinx 1157 88%
Count Percentage Ethnicity not reported 15 1%
U.S. MILITARY VETERAN
TOTAL COUNT: 1,321
Yes 118 9%
No 412 31%
Veteran status not reported 791 60%
Subpopulation Highlights
Young Adults
In FY14, MHSA launched a pilot program specifically targeting homeless young adults between the ages of
18 and 24 who identify as LGBTQ. This pilot provides up to 32 units of housing in the Boston, Cambridge,
and Greenfield areas.
Veterans
Home & Healthy for Good has provided housing to 118 veterans since it began, which represents
approximately 10 percent of the total number of people served by HHG. As Massachusetts moves toward
implementation of its new plan for ending veteran homelessness, various service planning and
grantmaking bodies have identified HHG as a model for housing homeless veterans.
page 4
OUTCOMES
OUTCOMES
> Current Enrollment and Tenant Destinations
*30% remain in permanent supportive housing, 27% exited HHG to other permanent housing, 8% died in permanent housing
HHG has produced significant positive outcomes for participants, both during and after
their enrollment in the program. Since HHG was founded in 2006, 1,321
385 individuals chronically homeless adults have been placed into permanent housing with
currently housed supportive services, which have been provided by 20 service agencies across the
through HHG Commonwealth.
As demonstrated above, 65 percent of HHG participants are currently housed through
361 individuals have HHG, have left the program to move on to another type of permanent
housing, or have passed away in permanent housing (many from chronic health
exited HHG directly to
conditions). An additional 7 percent of the population has transitioned from HHG to
other permanent
long-term treatment or a more appropriate health care setting. Remarkably, only 77
housing
individuals — 6 percent of HHG participants — are known to have recidivated to
homelessness after obtaining permanent housing. As the chart above shows, 19 percent
77 individuals known of participants exited to an “unknown” destination, meaning that the agencies
providing supporti