Steve Hardy was in his early 30s when he unlocked the door to his first apartment. Until then, he had spent his entire adult life on the street or in jail.
“I felt such an intense sense of relief. I was like, ‘Thank God. I have a place that’s mine. I don’t have to worry about snow or rain,’” he said, describing his feeling when he entered his one-bedroom apartment in Gloucester. Having his own home changed his life’s trajectory. “I went from being unemployed to having a full-time job and car within three months,” he said.
Hardy, now 35, is among 1,055 formerly homeless people across 13 communities who obtained apartments through a statewide collaboration called the Massachusetts Alliance for Supportive Housing Pay for Success program. When the six-year program ended in June, 85 percent of participants remained in housing or had found an appropriate alternative, such as reuniting with their family or moving into a nursing home, according to a report the alliance put out this month.
The report coincides with Boston’s effort to grapple with the tent encampment near the intersection of Massachusetts Avenue and Melnea Cass Boulevard. Advocates and experts say programs like Pay for Success could make a difference in the homeless crisis there.
Pay for Success applied a philosophy, called “Housing First,” that has been shown effective in numerous cities. Such programs, also called “supportive housing,” give people their own homes without requiring them to get sober, take medication, or prove they’ve never been arrested. They also surround the tenants with optional social, health, and addiction services. With a place to stay, a door to close behind them, and help with day-to-day life, even those who have never known stability can achieve it, advocates say.
Massachusetts already has some 11,000 units of supportive housing. To accommodate more people who could benefit, the city and state need to find funding and housing stock, and overcome community opposition, said Joyce Tavon, senior director of policy and programs at the Massachusetts Housing and Shelter Alliance, one of the lead agencies in the Pay for Success program.
“We have the answers,” Tavon said. “We don’t have the resources.”
Pay for Success marshaled 18 social service providers from Northampton to Hyannis. These agencies located apartments, subsidized the rent with vouchers or other methods, and provided an array of social supports to the formerly homeless tenants, most suffering from mental illness and substance use disorders.
“For a significant number of the folks experiencing homelessness at Mass. and Cass, supportive housing is the perfect solution,” said Bob Giannino, chief executive officer of United Way of Massachusetts Bay and Merrimack Valley, another lead agency in the effort.
Still, leaders of the effort emphasize that the complex situation there won’t yield to a single solution. “There is no one magic bullet. If you look at Mass. and Cass, what you’re really looking at is system failure on multiple levels,” said Joe Finn, president and executive director of the Massachusetts Housing and Shelter Alliance.
Tavon noted that not everyone at Mass. and Cass is chronically homeless, although many are. She’s heard that people may be coming from all over the state, some just for the day, to take advantage of the open-air drug market. Others have severe mental illness and substance use disorders or have become so disconnected from society they don’t have driver’s licenses or any documentation.
These complexities are one reason why the city appears to be contemplating short-term housing, such as the temporary cottage community planned for the grounds of the Lemuel Shattuck Hospital campus in Jamaica Plain, where people can be housed, assessed, and stabilized. But to solve the problem, the city and state will have to provide permanent housing, Tavon said.
Pay for Success found housing for people with many health conditions and challenging lives — eight in 10 had a substance use disorder, nine in 10 had a mental illness. They were heavy users of hospital services. And yet, annual health care spending for each participant was on average $5,267 less than that of a comparable group of unhoused individuals, according to a study by the Blue Cross Blue Shield of Massachusetts Foundation. Once settled in their own homes, they had fewer ambulance runs, ER visits, and hospital stays.
In what Tavon called “a big win,” Pay for Success tested and established a system in which the state’s Medicaid program, MassHealth, now helps pay to house people who have been homeless, recognizing that housing reduces health care costs.
The “Pay for Success” title refers to the funding mechanism, which starts with private philanthropy and investment. Santander Bank, United Way, and the Corporation for Supportive Housing invested $3 million to start the program. But they did so with the promise that if 85 percent of those who moved into housing stayed there for a year, they would be eligible for reimbursement from the state.
Barbara Poppe, who was executive director of the United States Interagency Council on Homelessness from 2009 to 2014, has been following the progress of Pay for Success since its earliest days.
Most notable, she said, was that the program eased the requirements for housing vouchers, brokered the MassHealth payments, and united people working in housing with those in health care — groups who, she said, typically “speak different languages.”
“They have changed the way housing and services are provided to a vulnerable population, and this will live beyond Pay for Success,” said Poppe, who now leads a consulting firm.
Steve Hardy, the Gloucester Housing First tenant, said that being homeless takes a toll beyond the obvious physical discomfort and danger of being outside. “It’s very dehumanizing. It really tears you down,” he said.
Without a stable place to live, he could not hold down a job for more than a couple of months. “How can you work a job and not have a place to live?” he said. “You can’t shower. There’s no rhythm to anything.”
Through it all, Hardy said, he clung to the belief that God would eventually bring him housing. And a few years ago, a woman approached him to discuss Housing First. As Hardy recalls it, she asked him if he had ever applied for housing assistance. “I was like, ‘No, why would I?’” he said. He knew he was disqualified from public housing by his history of arrests and incarceration for what he said were mostly minor crimes like shoplifting.
The Housing First coordinator wasn’t worried about that. She wanted to know whether he’d been homeless for more than a year. That was an easy bar for Hardy — he’d been without housing for 13 years, ever since his father and stepmother asked him to leave at age 18.
In an interview with the Globe, Hardy attributed his homelessness to “trauma from my past which led to substance abuse. Probably depression thrown in there, too.”
He credits the stability of having his own apartment with helping him reestablish contact with his family, especially his father and brother. “It’s huge,” he said.
Recently, Hardy learned he had lost his most recent job, in shipping and receiving. He’s not sure why. But while he looks for another job, he doesn’t have to worry about being evicted. Under Housing First, he said, he pays one-third of his income toward rent if he’s working, and nothing if he has no income.
“I can’t begin to explain to you just how significant this program is,” he said. “I’d be dead without Housing First — either an overdose or freezing to death.”