What is Permanent Supportive Housing?

You may have heard the term “Permanent Supportive Housing” as an approach to addressing houselessness in our community. But what is it, actually?

Permanent Supportive Housing (PSH) is an approach to supporting people exiting chronic homelessness consisting of deeply affordable housing paired with services tailored to the person’s needs. PSH helps those with the highest barriers to housing both secure housing and address the other challenges they face that contribute to those barriers. 

People whose barriers to stable housing are primarily financial may need a relatively straightforward housing voucher, assistance paying a deposit, or just a list of affordable housing options. But many people who have experienced homelessness for years at a time, or at several different times through their lives, need more support. That’s where PSH comes in.

The overall aim of PSH is to help people move from just surviving to being fully engaged in their own lives by providing permanent access to a safe and stable home. Permanent Supportive Housing packages affordable housing and services into a holistic solution for a particular individual. The housing is made affordable through ongoing rental assistance that might be an apartment with a project-based rental subsidy (attached to a particular building), or a tenant-based rental subsidy that can be used to make any housing affordable. Support services might include community-based health care, behavioral health treatment, employment counseling, or ongoing in-home care. 

Once in housing, clients set their own goals to achieve independent living. Their PSH case manager helps them navigate the often complex systems so they can meet their goals. Support services might be ongoing or change over time based on what the person needs. While PSH has been shown to be extremely effective in increasing housing stability, improving health, and lowering the costs of services such as emergency rooms, service limitations (for example, the availability of behavioral health care) may affect the support PSH case managers are able to offer clients. 

Portland Metro Supportive Housing Services Program

In a June 2019 forum sponsored by the City Club of Portland, people who have experienced homelessness spoke about their experiences and the critical role played by services in their ability to move into stable housing. “A big part of health care for me—accessing those mental health resources to help give me the ability to hold down a job so that I could stay housed—was being treated with dignity and respect,” said Rei Skoczylas, a care coordinator at Housecall Providers. The need for more services and additional rent assistance resources led to a significant next step to the implementation of a regional PSH approach to housing chronically homeless community members.

In 2020, voters in the Metro regional government area—the three-county jurisdiction that includes Portland, Oregon—funded a Supportive Housing Services (SHS) Program through a tax measure that expands dedicated funding for PSH and eviction prevention services. The program’s 10-year goals are to connect 5,000 chronically homeless households with supportive housing and to stabilize 10,000 households at risk of or experiencing homelessness in permanent housing. As Metro’s website states, “The program is built on the philosophy that housing is a human right. It uses best practices such as housing first, because everyone can better address life’s challenges, maintain wellness and thrive when they have housing.”

The SHS program, carried out by community-based service partners like Northwest Pilot Project (NWPP), includes services such as outreach and shelter, housing navigation and placement, and case management. SHS funds can be used for a range of supports to help households permanently exit homelessness, such as long-term rent assistance, as well as services for health, language and cultural needs, employment, and support for tenants’ rights.

Funding from the SHS measure first reached service providers like NWPP in July 2021. From that month to March 2022, Multnomah County stabilized 502 people in permanent housing, with another 400 people in the process of searching for housing. The county added 539 housing units or vouchers and housed 298 people through rapid-rehousing programs. Another 2,500 people received eviction prevention services.

Permanent Supportive Housing at Northwest Pilot Project

NWPP has been providing housing placement and ongoing supportive services to residents in a number of buildings over the years. Until the SHS funding reached us this past year, however, we did not have staff dedicated solely to PSH. In our new program PSH case managers work with an average of 15 clients and do most of their work outside the office—either in the community or at the client’s home once the client is housed. 

In a typical week, a PSH case manager at NWPP contacts clients in person or by phone. There are usually a few visits to prospective landlords, the Social Security office or Department of Motor Vehicles, or to check on a client in their new home. The case manager also coordinates with medical care teams, in-home care providers, and transportation services as needed to ensure that each client can continue to receive the services they need.

NWPP is currently providing Permanent Supportive Housing for 55 clients in our Older Adult PSH program using local rental subsidies, and will be expanding our team to provide on-site supportive services to 35 additional clients at Emmons Place, a new apartment building opening in Northwest Portland in October 2022. 

Next steps for Permanent Supportive Housing

NWPP receives thousands of calls each year from older adults who are experiencing homelessness or housing instability. Increasingly, low-income older adults struggle to find safe and affordable housing. And for those experiencing long periods of homelessness, case management and ongoing support services are often a critical part of exiting homelessness into permanent and stable housing. Permanent Supportive Housing offers people the chance to overcome obstacles that might otherwise feel insurmountable.  

Our team is looking ahead to newly funded buildings and projects opening to meet the needs of PSH clients in 2024 and 2025. These partnerships will allow NWPP and other agencies to continue to apply this comprehensive, effective service model to addressing the housing and service needs of our most vulnerable community members.

If you or someone you know is a low-income senior in need of housing, Northwest Pilot Project may be able to help! And if you’d like to support our work, you can donate or contribute in other ways. 

Photo by Neil Thomas on Unsplash