HSI programs prioritize the most vulnerable homeless populations, who have been homeless the longest, have disabilities, and are in greatest need of permanent shelter and services. Under the Department of Housing and Urban Development's (HUD) definition, a chronically homeless individual is "one who has experienced homelessness for a year or longer, or who has experienced at least four episodes of homelessness in the last three years and has a disability."
In 2022, on a single January night, there were 127,768 adults experiencing chronic homelessness in America; two thirds of whom were unsheltered and living on the streets as reported in the 2022 Annual Homeless Assessment Report to Congress. Many chronically homeless people have serious mental illness like schizophrenia, bi-polar and PTSD. Many are veterans with co-occurring mental illness and substance abuse disorders. The combination of challenges faced by those experiencing chronic homelessness includes complex health conditions, poor access to coordinated care services, prolonged time living on the streets, in shelters, and in and out of institutional settings, which leads to worsening health conditions, premature mortality, and represents costs to the public that do not result in a decrease in homelessness.
Studies have found that people experiencing chronic homelessness cost the public between $30,000 and $50,000 per person per year through their repeated use of emergency rooms, hospitals, jails, psychiatric centers, detox and other crisis services – the use of which make little improvements to their health and well-being. Given the cost it bears in human lives and public dollars, ending chronic homelessness is a moral and fiscal imperative.
The mortality rate for those experiencing chronic homelessness is four to nine times higher than that of the general population.
Health care is the major expense due to frequent emergency room visits, inpatient hospitalizations, detox centers and nursing homes.
People experiencing chronic homelessness have high rates of incarceration often for offenses that are non-violent and are related to mental illness or the harsh realities of living on the street.
40% of HSI supportive housing residents
were chronically homeless
100% of them are now housed with
the stabilizing services they need