At a June 21 reception hosted by Coast Capital Savings Credit Union, Philip Mangano, chair of the US Interagency Council on Homelessness, described a new administrative movement in more than 200 cities in the United States, to begin initiatives that will end chronic absolute homelessness within 10 years. He explained that the idea is predicated on the work of Malcom Gladwell’s book, “The Tipping Point”. It tells us, he said, that “modest resources invested in intelligent action can achieve success when we focus on the result of the investment.” Mangano said that this is equally true in business and social development. Baselines are required to define the problem; benchmarks incrementally define success; best practices (“that is, what actually works”) are applied with a modest but consistently available budget. Over time the objective is achievable. Why are these cities so sure that they can afford to end homelessness in 10 years? Because, he says, they’ve run cost-benefit analyses, and see that they can’t afford not to. In Boston,119 people “on the street” were studied over a five-year period. In that time they were admitted into hospitals a total of 18,000 times, at a cost of $1,000 each just for admission processing (not counting ambulance, police, treatment or medication). In Reno, two policemen tracked the costs of managing some of their most familiar homeless “clients” as they pinballed from services to shelters, jails, hospitals and so forth. They discovered that one person can cost $50,000-100,000 over only a few months. One man, who had been on the streets for ten years or more, had clearly cost the government over a million dollars, with no difference made to his lifestyle. In San Diego, Mangano said, 15 homeless people were followed for 18 months. In that time they cost $3 million in government services: an average of $200,000 per person. “The city fathers, having assumed that homelessness didn’t cost them much at all, were shocked. They realized that they could have rented these people oceanside condos with servants for less than that.” [For details of these cases and the US national initiative see http://www.newyorker.com/fact/content/articles/060213fa_fact and http://www.usich.gov ] Ad hoc, unco-ordinated crisis intervention is most expensive and least effective, Mangano said. Permanent supportive housing, as a package tailored individually to each client, is less expensive and more effective. The new effort involves a process of identification, outreach, and housing with concurrent wraparound services. There is no transition from a shelter through transitional or second-stage housing; clients are invited to come off the streets, directly into their own apartments. Housed clients are provided with an outreach worker and therapeutic team to help them stabilize and settle, and to make their way over the long term. Mangano said that 20 American federal agencies have now come together as partners on this issue. “Incremental investment that produces results and a return on investment are making a difference. We now have 222 cities involved.” He mentioned the success of the Rough Sleepers Initiative in the UK, in which the number of people sheltering on the street has dropped 75% in five years. (The RSI is recognized as a “best practice” by the UN. See http://www.unesco.org/most/westeu18.htm.) He also cited a 28% reduction in absolute homelessness in San Francisco since that city began its program. Mangano said that the use of sound business planning is a crucial element in the success of these programs. He encouraged the audience “not just to ladle soup or make emergency shelter beds – although you need to keep this going ­ but to plan with an end in mind. Without a business plan things only get worse.” “When modest resources are consistently focussed on intelligent action toward the most visible expression of the big social problem, change becomes possible. Change to a problem that was once deemed intractable reaches a tipping point. This creates a portal to address all the less visible housing issues and others related to them.”