What is the cost of one hour of visiting support under the Housing First model?
£184 – Yes that does say ONE HUNDRED AND EIGHTY FOUR POUNDS!
Surely that must be absurdly false? No it isn’t as this brief post explains.
The three large-scale Housing First pilots have provided 534 complex need homeless persons with 162,750 nights of visiting support which gives this average support only cost of £184 per person per night and which excludes rent cost.
The official evaluation report released by MHCLG on 28 July does not give any breakdown of cost or any accurate breakdown on the length of tenancy sustainment for the HF pilots. However, we know the 3 pilots were granted £28 million of funding and the LCR pilot had an additional £1.7m of Homeless Trailblazer Funding so I am working on a total funding for the 3 pilots of not less than £30 million which is cautiously low as it is likely the GM and WM pilots also had additional funding streams and all three pilot areas could additionally have in-house combined authority funding as well.
In short £30 million is a very cautious total funding figure for the support only of HF pilot clients.
The evaluation report is vague on tenancy duration (and deliberately so?) and merely places the length of HF tenancy duration into very broad bands which I reproduce below: –
Using the mid point of each band so “up to 1 month” is 15 days and “1 – 6 months” being 91 days and so on we find that a total duration of the 534 HF clients is 162,750 days and nights for an average of 304 nights each HF client housed and 43 weeks and 3 days. By dividing the cautious £30 million support only HF cost (rent is additional) by 162,750 nights we see the support only cost for each Housing First pilot client housed equates to £184.33 per day per person.
- 42 housed HF clients at < 1 month = 42×15 = 630 days
- 169 at 1 – 6 months is 169×91 days = 15,379 days
- 148 at 6-12 months is 148×272 days = 40,256 days
- 149 at 1 – 2 years is 149×548 days = 81,652 days
- 26 at 2 – 3 years is 26×913 days = 23,738 days
- 1 at 3 years is 1×1095 days = 1,095 days
The total housed days / nights of the 534 HF clients housed using these mid-point figures is 162,750 which gives an average duration of tenure at 305 days and by dividing the £30 million funding for support by 162,750 total support days gives a daily cost of housed support to be £184.33 per person receiving housed support.
Quad erat demonstrandum
There is nothing wrong with the arithmetic above and as I always say 2 plus 2 always equals 4, which it does.
The £30 million figure is a cautious one for the total funding of these pilots however the support cost is only for the 59% of HF clients who were actually housed and it excludes the costs of providing pre-tenancy support to the total 902 persons ‘recruited’ by the HF pilot teams. Conversely, the cost figures do NOT include rent costs and so the overall housign and support costs per person and per day will be higher than the £184 pppd support only cost.
However, the HF model is, in its theory, the immediate housing of persons with no conditionality or assessment of client support needs prior to housing. The clients are housed first and immediately and then support is delivered yet this is NOT the case with the 3 pilots who have filtered out hundreds of prospective clients are not being suitable or not meeting the correct ‘conditionality’ of this supposedly unconditional Housing First model.
An April 2020 research report into 20 years of the Housing First model in the USA gave a very concise and apt description on the HF model and its tenets:
The Manhattan Institute (US think tank) report concludes that Housing First does not work and is not cost-effective and twenty years of the HF model for example has seen the homeless numbers in New York increase from 33,000 to over 78,000.
All of these same conclusions are borne out in the MHCLG incredibly light-touch evaluation for the comparatively embryonic HF pilot models in England with 3 years of history vis-a-vis 20 years history in the USA. The 534 who have been housed will contain the same small number of “high utilizer” homeless people which in the UK we label very high complex need and which many have been weeded out of the 3 English pilots and not permitted access to the HF schemes as their needs are too high.
I will summarise by saying the 3 large-scale purportedly HF pilot schemes are NOT the HF model or theory and that the 3 English pilots are botched together hotchpotch of service models which include outreach (pre housing) and also versions of the staged resettlement models such as hostels. The 3 pilots despite the very light touch MHCLG commissioned evaluation report are also doctrinaire by design and so much so that support staff are chosen only if they ‘buy in’ to the incredibly superficial HF theory and for which the report narrates that external scrutiny ofthese pilots HF ‘fidelity’ is given greater priority than supporting individual tenant support needs. This is one example of the many overbearing top-down doctrinaire HF pilot structures which jump off the page despite the MHCLG report being overtly vague and overtly light touch and have an absence of primary data upon which to comment fully and assess these HF pilots in the detail they and single homeless persons deserve.
The HF pilots in England do however give enough urgent cause for concern over costs and operational practise and the support costs especially give cause for an immediate thorough investigation and similar to ones that all local authorities had with the Supporting People Audit Commission investigations of 2003 – 2006.
The faux HF models of the pilots require robust external investigation and immediately so as the pilots are seeking continuation funding and the zealous HF advocates are demanding HF is scaled up from circa 2000 persons today to 16,450 persons. To do either without a robust investigation would in common paralance be spaffing taxpayers money up the wall and, far more importantly, setting up MORE homeless persons up to fail in a system that due to its costs can never be financially sustainable.