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: Sen. Padilla, Alex [D-CA]
Target Audience
Population: Individuals who are homeless and suffer from substance use disorders
Estimated Size: 150000
- The global homeless population is estimated at around 150 million people as of recent data.
- Estimated global prevalence of substance use disorders is about 5.5% of the adult population.
- Not all individuals who have substance use disorders are homeless, but a significant subset of the homeless population deals with substance use issues.
- The bill targets specifically those who are homeless and have substantial behavioral health issues, particularly substance use disorders, a subset of the total homeless population.
Reasoning
- The policy targets a very specific subset of the homeless population—those with significant behavioral health issues, including substance use disorders.
- The policy's budget is substantial, but the complexity of issues faced by this population means the impact may vary widely depending on local implementation and integration with health services.
- Many people with similar challenges but varying degrees of homelessness or health severity may not directly feel the policy's impact, reflecting the policy's targeted nature.
- Given the target group's size and complexity, a range of outcomes should be considered, from impactful personal transformations to little perceived change due to limited resources in some areas.
Simulated Interviews
Unemployed (San Francisco, CA)
Age: 35 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I hope the policy will finally give me a stable place to stay and regular treatments.
- It's been hard to navigate services on my own; coordination could make a big difference.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 2 |
| Year 10 | 7 | 2 |
| Year 20 | 6 | 1 |
Retired nurse (New York City, NY)
Age: 62 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- This policy sounds promising, but I've seen many programs come and go.
- I'm concerned about how long services will be available.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 5 | 3 |
| Year 5 | 4 | 2 |
| Year 10 | 3 | 2 |
| Year 20 | 3 | 1 |
Construction worker (Chicago, IL)
Age: 45 | Gender: male
Wellbeing Before Policy: 2
Duration of Impact: 2.0 years
Commonness: 12/20
Statement of Opinion:
- Any help is better than none, but I wonder if the coordination will actually help me find work.
- Getting housing quickly would be a miracle.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 2 |
| Year 2 | 5 | 2 |
| Year 3 | 5 | 1 |
| Year 5 | 4 | 1 |
| Year 10 | 3 | 1 |
| Year 20 | 2 | 0 |
Service industry (Austin, TX)
Age: 29 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 1.0 years
Commonness: 15/20
Statement of Opinion:
- If they can help coordinate better mental health and addiction services, that'd be helpful.
- I'd love to find a stable job and home someday.
- I want to make sure policies don't make assumptions about why all people like me are in these situations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 4 | 4 |
| Year 5 | 3 | 3 |
| Year 10 | 3 | 3 |
| Year 20 | 3 | 2 |
Freelancer (Seattle, WA)
Age: 50 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 9/20
Statement of Opinion:
- Better access to health care would change things for me.
- I hope this policy makes that access consistent and reliable.
- I feel like the policy could help, but only if they actually implement it well.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
Former IT specialist (Philadelphia, PA)
Age: 38 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 3.0 years
Commonness: 11/20
Statement of Opinion:
- I'd like to see more focus on not just housing, but really helping us get back on our feet.
- I'm skeptical about the policy unless it creates more job opportunities or skill development.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 2 |
| Year 5 | 6 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
Retiree (Baltimore, MD)
Age: 55 | Gender: female
Wellbeing Before Policy: 2
Duration of Impact: 2.0 years
Commonness: 13/20
Statement of Opinion:
- Coordination sounds good, but I need to see it to believe it.
- I've been burned by the system before, so I'm cautious.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 3 | 2 |
| Year 2 | 3 | 2 |
| Year 3 | 3 | 2 |
| Year 5 | 3 | 2 |
| Year 10 | 3 | 1 |
| Year 20 | 2 | 1 |
Day laborer (Los Angeles, CA)
Age: 41 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- If this policy means better access to addiction counseling, I am all for it.
- Help needs to be consistent, because sporadic support doesn’t lead to change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 5 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
Part-time retail (Portland, OR)
Age: 27 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 16/20
Statement of Opinion:
- I want a chance to go back to school and start fresh.
- Housing is one thing, but personal growth can change my life.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 4 |
| Year 3 | 5 | 3 |
| Year 5 | 5 | 3 |
| Year 10 | 4 | 2 |
| Year 20 | 3 | 1 |
Street vendor (Phoenix, AZ)
Age: 48 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 1.0 years
Commonness: 17/20
Statement of Opinion:
- I think any effort to coordinate services can be beneficial, but it must reach all who need it.
- I'm concerned the policy won't include people like me who aren't consistently in shelters.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 4 | 3 |
| Year 3 | 4 | 2 |
| Year 5 | 3 | 2 |
| Year 10 | 3 | 1 |
| Year 20 | 2 | 1 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $515000000 (Low: $410000000, High: $618000000)
Year 3: $530450000 (Low: $422300000, High: $636540000)
Year 5: $561556350 (Low: $446086450, High: $673867620)
Year 10: $628894626 (Low: $499115700, High: $754673551)
Year 100: $1530286060 (Low: $1214913973, High: $1837196351)
Key Considerations
- The effectiveness of coordination between housing and health services is crucial for success.
- The policy targets a vulnerable subset of the homeless population, which can be challenging to reach and retain in services.
- Funding will need to be sustained over a period to show substantial effects on both homelessness and substance use disorder management.
- Inter-agency collaboration might face bureaucratic challenges and delays, impacting immediate outcomes.