Bill Overview
Title: Coordinating Substance Use and Homelessness Care Act of 2022
Description: This bill requires the Department of Housing and Urban Development to award competitive grants to improve coordination of health care and homelessness services for individuals who are homeless, have significant behavioral health issues (e.g., substance use disorders), and voluntarily seek assistance. Entities eligible for these grants include local and tribal governments, public housing agencies that administer housing choice vouchers, and certain nonprofits.
Sponsors: Rep. Dean, Madeleine [D-PA-4]
Target Audience
Population: Individuals globally who are homeless or with significant behavioral health issues voluntarily seeking assistance.
Estimated Size: 2500000
- The bill targets individuals who are homeless, which is a significant portion of the population worldwide, estimated by some sources to be around 150 million people, though not all would be impacted directly by the legislation as it focuses on those seeking care.
- Another important factor is substance use disorders. The World Health Organization estimates that approximately 35 million people worldwide are affected by drug use disorders alone.
- Considering an overlap between homelessness and substance abuses, and voluntary seeking of assistance, a careful estimate of the global target population has been made.
- Individuals impacted are only those who are homeless and have behavioral health issues, thus a narrow subset of those with either condition.
- A critical aspect of the target population is their willingness to seek help, which could further reduce large target estimates.
Reasoning
- The population affected includes people experiencing both homelessness and substance use disorders. From the U.S. data, an estimated population size of 2.5 million is derived, acknowledging the voluntary assistance condition, narrowing the focus further.
- The budget constraints mean the policy must effectively target aid, possibly prioritizing locales with higher populations of homeless individuals and robust support networks.
- Forcing competition among local governments for grant money ensures efficient allocation but might limit reach if some areas lack capacity to compete.
- Given the projected scale of the affected population, not everyone may experience a statistically noticeable impact, with localized high-impact zones.
Simulated Interviews
Unemployed (San Francisco, CA)
Age: 35 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- I hope these services become more accessible as I really want to get back on my feet.
- Housing is a big issue, but dealing with my addiction feels even tougher, so coordinated support means a lot.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 7 | 2 |
Part-time cashier (New York, NY)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I've seen a lot of people slip through the cracks because there aren't enough resources.
- It's encouraging that there's a focus on both housing and health care together.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Freelance writer (Detroit, MI)
Age: 27 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I'm skeptical about seeking help because systems failed me in the past.
- If caseworkers were more understanding, I'd consider getting help.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Construction worker (Phoenix, AZ)
Age: 42 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Helping people find stable ground is crucial for long-term sobriety.
- Policy should ensure the workforce in these programs is well-trained.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 4 |
Waitress (Seattle, WA)
Age: 30 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 9/20
Statement of Opinion:
- It's hard juggling healthcare and keeping a roof over my head.
- Integrated shelters should become the norm, making it easier for everyone.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Retired (Miami, FL)
Age: 60 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I've been battling this for years; new programs seem helpful but I need to see more tangible results.
- More mental health support alongside substance care would be a game changer.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Student (Chicago, IL)
Age: 21 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Having a stable support system has been pivotal for me to pursue my studies.
- I think young adults need more focus, as we stand at a critical point in life.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Uber driver (Austin, TX)
Age: 39 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Affordable housing is key but there's need for integrated programs.
- Hope grants will help, but proper execution is critical.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Caretaker (Boston, MA)
Age: 48 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- I think linking rehab services with housing helps a lot, considering past struggles.
- Focus should also be on employment opportunities post-recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Busker (Los Angeles, CA)
Age: 55 | Gender: male
Wellbeing Before Policy: 2
Duration of Impact: 15.0 years
Commonness: 5/20
Statement of Opinion:
- Suppressing homelessness isn't enough, addressing the root causes like addiction is critical.
- If these opportunities come my way, I might stand a chance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 2 |
| Year 2 | 4 | 2 |
| Year 3 | 5 | 2 |
| Year 5 | 5 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
Cost Estimates
Year 1: $1000000000 (Low: $800000000, High: $1200000000)
Year 2: $1100000000 (Low: $900000000, High: $1300000000)
Year 3: $1200000000 (Low: $950000000, High: $1400000000)
Year 5: $1300000000 (Low: $1000000000, High: $1500000000)
Year 10: $1500000000 (Low: $1200000000, High: $1800000000)
Year 100: $2000000000 (Low: $1600000000, High: $2400000000)
Key Considerations
- The scope of the program must be clearly defined to ensure target populations are effectively reached without overwhelming system capacities.
- Grants should be distributed equitably to ensure various geographical areas, including tribal and rural regions, receive necessary funding.
- Monitoring and evaluation frameworks are crucial to measure the program's effectiveness and guide future budget allocations.