Permanent Supportive Housing

Homelessness is one of the most complex social problems in the United States. Emergency shelters have provided an alternative for people who would otherwise be living on the streets, but these shelters are meant to be short-term interventions. In the past, it was believed that homeless people needed to address the issues that may have led to their situation before they could be housed successfully.

The Housing First program was introduced in Los Angeles in 1988, and has been spearheaded in Massachusetts by the Massachusetts Housing and Shelter Alliance (MHSA). Since 2006, MHSA’s Housing First programs across the Commonwealth have housed more than 2,100 people. This approach is based on the concept that stable housing is the primary need, and that other issues can and should be addressed once suitable housing is found.

Low-income individuals and families find affordable housing options through the Massachusetts Section 8 Housing Voucher program, which is funded by the Housing and Urban Development program (HUD). Eligibility is based on family income and at least 75 percent of the vouchers must be awarded to families whose income does not exceed 30 percent of the area’s median income. Waiting lists are long, and the homeless are usually given priority.

Permanent Supportive Housing (PSH) is a Housing First Intervention typically targeted to people who have experienced chronic homelessness and who also face the challenges of chronic illnesses, mental health needs or substance abuse disorders. In addition to affordable housing, supportive services are offered to help people stay housed and to improve their quality of life. People living in supportive housing have case managers from social service agencies such as the Community Support Program for People Experiencing Chronic Homelessness (CSPECH), which helps then stay on track with needs including medical care, addiction treatment, job training and budgeting. CSPECH receives reimbursement from the Massachusetts Behavioral Health Partnership (MBHP), which is part of MassHealth. While provision of these services has increased behavioral health costs significantly, studies have shown a reduction in inpatient and outpatient costs such as emergency room visits, which more than compensates for the cost of support services. Other studies have noted a reduction in emergency shelter use, criminal justice system costs and property damage, and increases in employment and earnings following permanent housing.

In Boston, Pine Street Inn is at the forefront of this increased focus on PSH, partnering with the City of Boston to provide housing for formerly homeless individuals throughout Greater Boston. More than 91% of people placed in housing remain long-term. Pine Street is planning a large complex of permanent housing for the homeless in Jamaica Plain, and has recently partnered with Beacon Communities and Mount Vernon Company to plan for the provision of more than 100 affordable supportive units for the formerly homeless in the newly purchased YWCA building at 140 Clarendon Street in the Back Bay.

There are currently 41 supportive housing sites across the state, with 6,060 units available. PSH projects are available in cities such as Springfield, Westfield, Haverhill and Lowell among others. A project in Worcester, which partners MHSA with the city, will develop two modular buildings of micro-units with support services on site. The units are expected to cost less than half what it costs to develop traditional affordable housing.

Massachusetts Housing and Shelter Alliance:

Pine Street Inn:

Article about PSH at the YWCA:

Women’s Institute for Housing and Economic Development:

Friends of Boston’s Homeless:

Supportive Housing and Eligibility