Introduction
Homelessness is a severe social problem that requires measures to address it effectively. In February 2023, the H.R. 773: Homelessness and Behavioral Health Care Coordination Act of 2023 was submitted for consideration. Its purpose is to provide the required medical care to homeless people with mental disorders and housing to reduce homelessness in the United States. Therefore, this paper analyzes the submitted bill and considers possible alternatives.
Defining the Problem
Homelessness is an urgent issue in modern society. In 2020, the total number of homeless people in the country was 580,466, with the highest rate in California (161,548 homeless) (National Alliance to End Homelessness [NAEH], 2022). Although there is no updated data on the number of homeless people, there is reason to believe that these figures could rise due to the loss of jobs and stable income due to the COVID-19 pandemic (NAEH, 2022). People can no longer meet their basic housing needs and are forced to live on the streets.
While there are people of different races, genders, and ages among the homeless, certain groups in society are at greater risk. There is a significant gender gap among people without housing, as men are more likely to become homeless than women. According to 2020 statistics, 352,211 men were homeless compared to 223,578 women (NAEH, 2022).
In addition, race and ethnic origin often become decisive factors in determining a person’s socioeconomic status. People of color are more likely to be marginalized and have difficulty finding employment and a stable income (National Alliance to End Homelessness, 2022). Therefore, measures are needed to eliminate social inequality and provide additional social security guarantees for people of color and Indigenous people.
Although there are temporary shelters that provide housing for people experiencing homelessness, their number does not match the number of people in need. As a result, many homeless people are forced to live in public places not designed for this (NAEH, 2022). It threatens the safety of others, as the homeless are often forced to engage in criminal activities, including taking and distributing drugs.
Moreover, homelessness is directly related to the deterioration of mental health, which makes people dangerous to others. Studies show that 20% to 50% of homeless people have serious mental health problems (Butler & Sheriff, 2023). The presence of these problems is often associated with the abuse of substances that hurt brain function. Moreover, homelessness can exacerbate the mental health of people with disorders by increasing stress, anxiety, and fear (Butler & Sheriff, 2023). Therefore, the issue of providing the necessary medical services to solve the problem of homelessness in the United States is of great importance.
Policy Goals
The main objective of the proposed bill is to provide the necessary medical care to people without homes before providing them with accommodation. Simply providing housing cannot solve the problems associated with the manifestation of deviant behavior among people experiencing homelessness. Therefore, collaborative action between the housing and healthcare system is needed to provide “streamlined services, including substance use and other health services” (National Low Income Housing Coalition [NLIHC], 2023, para. 2). That being said, coercive mental health treatment for people without homes may raise some ethical considerations that need to be taken into account.
Thus, the main goal of the presented bill is to provide comprehensive medical care to people experiencing homelessness to create opportunities for their effective integration into society. It includes providing services to cope with substance use disorders, which are statistically higher among people without houses than those with stable housing (Dean, 2023). It, in turn, will help reduce the overall level of drug abuse and dependence by reducing public access to drugs.
Another bill goal is to help manage substance-related comorbidities (Dean, 2023). They include physical illnesses, HIV and hepatitis, and behavioral disorders. This approach will increase the level of public safety and can create optimal conditions for the provision of housing for people experiencing homelessness and their integration into the community.
Policy Alternatives
To effectively combat the problem of homelessness, it is necessary to take measures to address its consequences and eliminate its cause. The first step is to stop the rise in the number of homeless people by providing supportive services. One suggested solution to this problem is to use “housing vouchers that would reduce housing instability for about 300,000 households with the lowest incomes” (Oliva, 2022, para. 42). These vouchers can reduce the rise in homelessness by providing people with additional financial resources to maintain their living conditions.
Another alternative solution to the problem of homelessness is providing temporary housing, like shelters. According to the National Alliance to End Homelessness (2022), the number of places in temporary shelters increased by 7,000 people from 2019 to 2021. However, according to statistics, over the past ten years, this number has decreased by 8% (NAEH, 2022). Consequently, the existing shelters cannot provide the necessary housing for all people and are ineffective for a long-term solution to this issue. Funding allocated for maintaining temporary housing can be redirected to implementing other programs that are more effective in addressing homelessness in the long term.
In addition, some public policies aim to provide medical services, food access, and employment assistance for people without housing. Although they have a positive impact, they do not solve the overall problem and its causes. After receiving health care services, people often end up on the street again. Moreover, Oliva (2022) notes that many people experiencing homelessness are employed and have a stable income, which is insufficient to provide suitable housing conditions. Therefore, since the problem of homelessness is complex and includes many factors, its solution requires the coordinated action of all services.
Policy Evaluation
Several factors must be considered to evaluate the proposed public policy. The main factors in evaluating a program are its effectiveness, feasibility, costs, equity, and ethical considerations (Kraft & Furlong, 2021). Analyzing these factors will help determine whether implementing the proposed policy is necessary to solve the identified problem. In addition, an analysis of the program and its alternatives helps identify changes that can be made to make the bill more effective.
The effectiveness of the policy is one of the critical factors to consider during the analysis. It helps to establish how much a bill or program could potentially contribute to a solution to a problem (Kraft & Furlong, 2021). While the Homelessness and Behavioral Health Care Coordination Act of 2023 does not directly address homelessness, it does address the accompanying problems of homelessness. Provision of the necessary medical assistance will help increase public safety and, in the long term, may create favorable conditions for integrating homeless people into society by providing them with housing. Thus, the bill is not aimed at a momentary solution to the problem but at the result in the long term.
Moreover, the policy has a reasonably high feasibility level since such programs are already being implemented. Today, supportive housing services and medical programs focus on helping people experiencing homelessness (NAEH, 2023). Therefore, the bill proposes transforming existing policies and their coordinated actions to assist people experiencing homelessness. The interaction between different departments and the adaptability of the proposed policy could potentially contribute to its effectiveness.
Given the gender difference in homelessness statistics and the increased risks for people of color, the issue of equity is significant for analyzing the effectiveness of the bill. The program recognizes that people of color and Indigenous people do not receive equal treatment from government support services (Dean, 2023). Therefore, one of the program’s goals is to level social inequality in providing services for people experiencing homelessness.
Another critical factor in the analysis of public policy is its cost. The program’s funding should not exceed the targets set by the state budget (Kraft & Furlong, 2021). The implementation of the policy is proposed in the form of grants. Over five years, grants of $500,000 are planned for government agencies and Public Housing Authorities (PHA) to cover the costs needed to provide medical and housing services for people experiencing homelessness (Ravina, 2023). According to the state budget, the government can allocate “$20M for each of fiscal years 2023 through 2028” (NAEH, 2023, para. 15). However, these financial resources may not be sufficient to address the problem of all homeless people, given the difference in the scale of needed medical services.
Moreover, the implementation of the program may have some ethical issues. The policy does not set out how people without housing who require medical attention in the first place will be selected. The program will not be able to provide the necessary services to all those in need immediately, and this process will be gradual.
In addition, forced treatment can be a violation of human rights. Another ethical consideration is the search for sources of policy funding. Most of the state budget comes from taxes paid by citizens, so the allocation of funds by the government can cause public disapproval if the importance of solving the problem is not adequately communicated. These factors must be considered when implementing public policy to avoid ethical issues.
Conclusion
In conclusion, the proposed bill has the potential to positively impact addressing the problem of homelessness in the long term. It is aimed not at providing people with housing but, above all, at providing the necessary medical care. People who do not have a stable home are more likely to abuse psychoactive substances and have comorbid physical and psychological disorders.
Therefore, providing health care services is essential for effectively integrating people into the community. However, the policy has several ethical considerations and accessibility issues that may arise during its implementation. In addition, to achieve the program’s effectiveness, it is necessary to stop the increase in the number of people experiencing homelessness by providing low-income households with additional social protection.
References
Butler, S. M., & Sheriff, N. (2023). 3 social triggers for behavioral health needs – and what to do about them. Brookings. Web.
Dean, M. (2023). H.R. 773: Homelessness and Behavioral Health Care Coordination Act of 2023. Govtrack. Web.
Kraft, M. E., and Furlong, S. R. (2021). Public Policy: Politics, analysis, and alternatives (7th ed.). CQ Press.
National Alliance to End Homelessness. (2023). Homelessness and Behavioral Health Care Coordination Act (H.R. 773). Web.
National Alliance to End Homelessness. (2022). State of homelessness: 2022 edition. Web.
National Low Income Housing Coalition. (2023). Representative Dean introduces the “Homelessness and Behavioral Health Care Coordination Act” in the House. Web.
Oliva, A. (2022). Ending homelessness: Addressing local challenges in housing the most vulnerable. Center on Budget and Policy Priorities. Web.
Ravina, R. (2023). U.S. Rep. Madeleine Dean reintroduces Homelessness and Behavioral Health Care Coordination Act. The Reporter. Web.