The model of permanent supportive housing has evolved significantly since the Trust was founded nineteen years ago. When the Trust opened the doors of its first rehabilitated hotel, the Genesis, in 1989 the focus was on providing safe, decent, affordable permanent homes for poor and homeless men and women on Skid Row. While this met the housing needs of the residents, housing alone did not address the many issues that cause homelessness and extreme poverty. It quickly became apparent that our residents needed assistance in accessing the services that would address the issues underlying their homelessness.

In 1993 the Trust created its Supportive Housing Program. The program connects Trust residents to the services they need to overcome the barriers that had prevented them from achieving housing stability in the past. Supportive services staff initially provided case management and referred residents to primary healthcare, mental health treatment, substance abuse treatment, and other services in the community.

Trust supportive services staff had an immediate, measurable impact. A higher number of Trust Residents remained stable in their homes because once connected to services, they were able to better maintain their housing and move on to positive futures. The long-term chronically homeless individuals with severe mental illness and co-occurring drug and alcohol addiction presented an additional challenge, however, for these individuals, referrals to outside services and support groups was not enough.

In 2003 the Trust was selected as the lead agency on the Skid Row Collaborative, one of 11 national demonstration projects funded by the United States Interagency Council on Homelessness to address the problem of chronic homelessness in America’s large urban communities. In collaboration with numerous partners including LAMP Community and JWCH Institute, the Trust adapted its programs to the hardest-to-serve homeless by providing permanent housing with wrap-around supportive services on-site. Moving beyond the case management model, the Skid Row Collaborative sought to integrate the multiple services chronically homeless individuals need into their housing and to connect those individuals directly from the streets to that housing (the housing first model).

Recognizing that the service delivery system is fragmented and difficult to access, the Skid Row Collaborative integrated mental health treatment, primary health care, substance abuse recovery, money management, benefits advocacy, and other social services in permanent housing. The results were overwhelmingly positive – 85% of chronically homeless individuals with an average length of homelessness of over 8 years, severe mental illness, and co-occurring disorders were able to maintain their housing.

Building on the success locally of the Skid Row Collaborative and nationally on Common Ground Community’ Street to Home program, Los Angeles County developed Project 50 in 2007. Project 50 takes the concepts of housing first and integrated services in housing one step further by systematically reducing street homelessness through these practices. The project identified the 50 most vulnerable individuals on the streets of Skid Row and connects them directly to permanent housing and integrated services. By identifying target program participants by name, rather than a general description, the program ensures that no program participant falls through the cracks.

Today the Trust understands that systems integration in permanent housing is the key to ending homelessness. There are too many men and women with double, triple, even quadruple diseases being sentenced to life on the streets. With the Supportive Housing Program, the Skid Row Collaborative and Project 50 as the models, the Trust is pioneering the latest evolution of permanent supportive housing. Partnering with experienced service providers (see partners), the Trust provides integrated case management, mental health treatment, substance abuse recovery, and primary healthcare at multiple housing sites and with more in the pipeline.