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How Will Connecticut's Budget Crisis Affect Efforts to End Homelessness?

May 24, 2016

Advocates worry that recent cuts threaten the state’s position as a national leader in ending homelessness.

When state governments  -- in Maine, Utah, and elsewhere  -- want to learn about ending homelessness, they often look to Connecticut.

And why wouldn’t they? The state’s milestones are impressive. In the last year, Connecticut has effectively ended homelessness among veterans, both those who have been homeless for a short time, and those who are have been on the streets for years.

The state is also on track to end chronic homelessness -- the most pernicious kind -- for everyone, non-veterans included, by the end of this year. And a recent point-in-time survey among Connecticut people who are homeless showed nearly across-the-board decreases in numbers.

The success of Connecticut has been nothing short of astounding, but activists and advocates worry that recent budget cuts -- both proposed and those already implemented -- may threaten the state’s position as a national leader in preventing and ending homelessness.

"The mantra in the state and private sector is 'We’re doing the best with what we have,'" said Carl J. Schiessl, Connecticut Hospital Association director of regulatory advocacy. "When you’re operating in that mode for so long, and as resources continue to dwindle, you find it harder and harder to achieve your mission with fewer and fewer resources."

Some of the state’s cuts to counter a $960 million deficit include closing group homes, and layoffs at the Department of Social Services, Department of Mental Health and Addiction Services, and Department of Children and Families, among other state agencies.

Case manager Tim Brown (right) meets with members of an addiction recovery program at The Connection in New Haven.
Credit Ryan Caron King / WNPR

What those cuts mean in terms of ending homelessness is anyone’s guess. But in the '90s, a similar upheaval in services occurred when state mental hospitals closed. The number of people on the streets spiked.

“There will still be services, but some people will be on the streets,” said Claire Bien, of the most recent cuts.

Bien is the associate director of communications at The Connection in Middletown. She is also in recovery. 

Claire Bien, associate director of communications at The Connection.
Credit Ryan Caron King / WNPR

She began hearing voices, she said, in 1983. She suffered from depression, and was diagnosed with schizophreniform disorder, which is similar to schizophrenia. 

Family members were supportive. Her insurance allowed her the best care, but at her job, she works with people who lack that kind of support.

In a recent opinion piece about non-profits and the cuts, Bien echoed Schiessl’s sentiments. From the piece:

Each year we are required to do more, and more, and more, with less and less: less funding, fewer resources, fewer staff. The continuing budget crisis threatens to create a black hole of non-services and supports for the neediest and most vulnerable members of our communities. This is a hole from which they – and we -- may never climb out.

Governor Dannel Malloy continues to win kudos for his commitment to create more affordable housing, but vulnerable people who’ve been homeless need supportive services, as well. At the least, the cuts reduce services available to some of the state’s most vulnerable people.

That’s the principle behind Housing First, an approach to ending homelessness that includes providing housing, and then services -- such as mental health counseling, or case management -- after. For people who’ve been on the streets for decades, simply handing over an apartment key isn’t enough.

According to the federal Substance Abuse and Mental Health Services Administration, in January 2014, one in five people who were experiencing homelessness had a serious mental illness. About the same number was living with a chronic substance abuse disorder. Then there are those who are living with both, called co-occurring in the vernacular.

“What I can tell you is we see mostly co-occurring, addiction, and mental health issues,” said Jessica Smith, Wheeler Clinic director of adult outpatient services. “They’re homeless and it can be really difficult to access resources and put it all back together again when you’ve got maybe a month’s clean time, or you’ve been on medication and stable for your mental health issues for a month, let’s say, and then you’re released into a community.”

Claire Bien stands in front of handwritten lists from session at a mental health symposium at the Yale Program for Recovery and Community Health in New Haven.
Credit Ryan Caron King / WNPR

One answer may be hospital-based community care teams, where social services providers and medical professionals work together to reduce the number of expensive emergency department visits by people with mental illness or addiction issues.

Schiessl, a former state representative, said a $3 million investment to expand the program statewide would have saved $25 million in Medicaid-funded emergency visits. But the budget crisis tabled the expansion.

“When we go to state legislators and we say we’re doing such decent work that other states are noticing, they say, ‘Keep doing a good job,’ but there’s no funding,” Schiessl said.

In the '90s, state mental hospitals closed, and the number of people on the streets spiked.

Multiple studies show that homelessness costs exponentially more than housing, even housing with services. A 2014 Florida study said that it costs three times as much to leave people on the street than it does to provide them supportive housing. People who are homeless spend more time in jail, more time in emergency departments, and more time in psychiatric wards. One study said the rate of psychiatric hospitalizations is 100 times higher than people who are stably housed.

In Connecticut, Lisa Tepper Bates, Connecticut Coalition to End Homelessness executive director, said housing people who are chronically homeless saves as much as 70 percent the cost of having them remain on the streets. 

Lisa Tepper-Bates of the Connecticut Coalition to End Homelessness in a WNPR file photo.
Credit Chion Wolf / WNPR

“Even though we are a great state, and we’ve been recognized as a leader nationwide, we still have a long way to go,” said Daniela Giordano, public policy director at state’s National Alliance on Mental Illness (NAMI Connecticut). Now, rather than working independently, state agencies -- both public and private -- work together to provide mental health and housing services for state residents. “I’m afraid that’s going to fall apart,” Giordano said.

Bates's Connecticut Coalition to End Homelessness recently announced its annual census of people who are homeless in the state.

Homelessness was down four percent from last year, and down 13 percent compared to 2007 numbers.

Chronic homelessness was down a walloping 20 percent compared since 2015.

Surveyors saw a small uptick among people who were sleeping outside of shelters, but advocates said that might be attributed to unseasonably warm temperatures the day of the count, January 26.

Bien, who has written a memoir that will be published next month, said she’s dedicated herself to advocating for the people she sees at The Connection – people coming out of prison, those who grew up in poverty, women struggling to hold it together for themselves, and their children who must navigate a reduced mental health care system.

“These are people who have something to lose,” said Bien.