Public Health & Economic Recovery Response Framework: Part 5

Last week’s blog post covered parts four and five (of the six total) impact areas for communities to consider as part of a public health and economic recovery framework response to address housing instability and homelessness.

These impact areas are locally extrapolated from a new tool, A Framework for COVID-19 Homelessness Response, which was released in May 2020 by the National Alliance to End Homelessness; the National Low Income Housing Coalition; and the Center for Budget Policies and Priorities. The framework provides guidance to homelessness assistance systems (like Continuums of Care or CoCs) on how to maximize new funding (whether from the CARES Act or other sources) to both respond to the immediate crisis and plan for a lengthy economic recovery using an equity lens. Communities can begin to adapt and implement this framework as part of both their near- and longer-term COVID-19 housing responses.

Using the framework as a starting point, this week’s blog post takes a deeper dive into the sixth (and final) impact area: strengthening systems.

WHY SYSTEMS MATTER

The primary reason that housing remains out of reach for so many is because there is a significant (and increasing) gap between what housing costs and what households can afford. Each year the National Low Income Housing Coalition (NLIHC) releases a report documenting this gap.

According to the 2020 report, released in March, in the Charlotte-Concord-Gastonia Metropolitan Statistical Area, there is a deficit of 40,545 affordable and available units for households with income at or below 30% of AMI. For a family of four, this equates to $26,200 annually, or a $12.60 hourly rate for a full-time position. Put another way, there are only 33 affordable and available units per 100 households at or below 30% AMI. In comparison, there are 103 affordable and available units per 100 households at or below 80% AMI.  For a family of four, this represents a $66,800 annual income, or $32.11 hourly rate for a full-time position. All of this data reflects the situation prior to the COVID-19 pandemic.

In addition to housing deficits, the NLIHC report notes that renter households at or below 30% AMI are more likely to be severely housing cost-burdened (paying more than 50% of their household income on housing-related costs) than other income groups. According to the 2019 State of Housing Instability & Homelessness Report released by Mecklenburg County, 72% of families earning at or below 30% of AMI are severely cost-burdened. Conversely, only 5% of families earning between 50% and 80% of AMI are cost-burdened. Households at or below 30% of AMI are also more likely to be people of color; seniors; or individuals with disabilities.

The COVID-19 pandemic has underscored the fact that housing is truly public health. Without a safe space to shelter-in-place, isolate, or quarantine, households are at increased risk for being exposed to and transmitting the novel coronavirus. However, even before COVID-19, there were significant negative health impacts upon those experiencing housing instability and homelessness. These implications are summed up as the “social determinants of health,” which are defined as “conditions in the environment in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Examples include the availability of resources to meet daily needs; access to health care services; public safety; quality education; socioeconomic conditions; and social support.

Lack of stable housing and poor health are connected in a negative feedback loop, in which poor health increases the risk for homelessness and health problems; this, in turn, can create added stressors that cripple household budgets and result in housing instability, eviction, and homelessness. With little to no wiggle room for other expenses, households earning the least are forced to make impossible choices between housing and food, education, healthcare, transportation, childcare, and other basic needs. It is, therefore, critical that communities look beyond housing to effectively close the gap between housing cost and income limits.

HOW TO STRENGTHEN SYSTEMS

A household budget provides a helpful lens to think about how systems can ameliorate or amplify the housing cost gap. There are essentially two intervention points: increase income; or decrease expenses. Efforts to increase income as a system center around higher wages (access to higher paying jobs, wage supplements, continuing education); and/or supplemental income (access to public benefits, disability income). Linking housing providers with employment resources is critical so that rental assistance need not be predicated on or rescinded because of a change in employment. Employment resources can also be pushed upstream to Coordinated Entry, so that households facing housing instability and/or homelessness get connected to jobs or training as quickly as possible. Conversely, employment resources can prioritize members of households facing housing instability and/or homelessness.

Decreasing expenses can include means to reduce the cost of necessities, such as childcare subsidies and access to affordable healthcare. An example includes prioritizing childcare subsidies for households facing housing instability and/or homelessness, and linking households with those resources when they first face a housing crisis. Childcare is essential to both obtain and maintain employment. In addition, it is important that subsidies like these be flexible to adjust to the need of households if there is a change in employment to support them between jobs or while in continuing education.

Closing the housing gap also requires coordination across systems; this means that housing supports and other community infrastructure have to commit to removing all barriers to obtaining and sustaining housing. Complementary systems like childcare; healthcare; employment; continuing education and training; and transportation must coordinate with each other.  Collaboration and cooperation will help the entire system to set clear funding priorities; align partner requirements; tailor services to match need across the housing continuum; and identify common evaluation metrics.

In response to COVID-19 and new funding infusions, communities have a real opportunity to address the underlying and pre-existing conditions that perpetuate housing instability and homelessness, especially among the most vulnerable households.

Some of the priority actions from the framework are highlighted below:

• Assess impact of cessation of eviction moratoria; rent forbearance; unemployment compensation; and other temporarily enacted policies and/or assistance on housing instability and homelessness.
• Monitor data on households receiving assistance; households exiting homelessness; and households returning to homelessness to ensure that there is equity in access and prioritization of resources.
• Establish links to employment services and jobs, and use data to ensure that employment, income, and access to benefits outcomes are equitable.
• Strengthen coordination and partnerships between state and local public health systems and homelessness services and housing systems to both reduce homelessness and strengthen future public health responses.
• Use data to, first, quantify and then publicly communicate the inequitable health and economic impacts of COVID-19 on communities of color and marginalized communities; and develop strategies to limit such disparate impacts in the areas of health, financial well-being, and housing as a result of future public health crises.

Click this link for a full list of action priorities related to strengthening systems.

SO, WHAT

To comprehensively tackle the complex and interconnected issues that impact housing requires communities to link strategy, funding, and programs from multiple sectors across the entire continuum: from housing instability to homelessness.

Communities must also examine existing systems and resources, and pause to consider how to best leverage them with new COVID-19 related funding to make the most of every dollar available. Importantly, communities must identify desired outcomes to help them understand if all the dollars allocated made an impact. Did households experiencing homelessness move into permanent housing? Did households experiencing housing instability avoid eviction? Was there an increase in new households entering and/or returning to homelessness? Were there disparities in access to and prioritization of resources? Who benefited? Who did not? What changed?

Alignment of funding sources and services providers to clearly defined outcomes will most effectively help households find and maintain housing.  More significantly, this alignment will provide pathways to enhanced economic opportunity and improved public health outcomes for all.