Evolution of a Solution: History of the 100,000 Homes Campaign

The 100,000 Homes Campaign is overseen by Community Solutions, a national spin-off of the New York City non-profit, Common Ground.

Beginning in 2003, Common Ground responded to the public health crisis of homelessness by developing a replicable system to end long term homelessness. The organization’s tested “Street to Home” approach helped reduce street homelessness in Times Square from an average of 55 people sleeping outside in the cold winter to one single person.  This strategy was subsequently adopted throughout New York City and forms the basis of the 100,000 Homes Campaign. Simply put, the approach 1) systematically surveys those on the street or in shelters to create a by-name registry prioritized on the basis of severe health risks and length of homelessness, and 2) re-aligns existing housing and service resources to match to these prioritized individuals and families.  In the course of adopting this model, Common Ground completely revised the intake criteria for its supportive housing units.  It began offering each new vacancy to the next most vulnerable person identified by street outreach teams. 

In 2005, the Street to Home team began sharing its strategy with other communities like Denver, Baltimore, Washington, DC, Atlanta, Chicago, Boston, and Greensboro.  These communities adopted the model and achieved measurable reductions in street homelessness by identifying those who had been homeless the longest and prioritizing them for housing.  The team's work took a significant leap forward when it was invited in 2007 to consult on Los Angeles County's Project 50. Championed by Supervisor Zev Yaroslavsky, the effort brought together 24 public and private agencies to find and house 50 of the most vulnerable people living on the streets of Skid Row. 

To identify the most vulnerable people on the streets of Skid Row, researchers at Common Ground adapted a survey tool that had initially been developed by the designers of the Manhattan Outreach Consortium in New York City.  After consulting with Dr. Jim O’Connell and Dr. Stephen Hwang with Boston Health Care for the Homeless, whose original research identified the causes of early mortality among those living on the street, researchers modified the survey to include the very latest research on mortality risk for homeless adults. The team titled the new instrument, "the Vulnerability Index®." 

LA County went on to house the most vulnerable people found on Skid Row at a median rate of 12 days from first outreach contact to housing placement, forever changing the landscape of what is possible.   

Since then, Common Ground's national team, now Community Solutions, has worked with over 20 communities to implement the Vulnerability Index as a tool to identify then house the most vulnerable people on their streets and in their shelters.  We’ve learned so much from what these vanguard communities have accomplished, especially once they had in their hands a by-name listing of everyone on the streets that was sorted and prioritized by mortality risk.  Every community that adopted the Vulnerability Index used the resulting person-specific data to reform their outreach or housing systems. 

In 2009, the team partnered with the Institute for Healthcare Improvement (IHI), to leverage their expertise in large-scale systems change in the health care system into our world of solving homelessness. IHI's campaigns (the 100,000 Lives Campaign and the 5 Million Lives Campaign) have provided helpful models for the 100,000 Homes effort. These groundbreaking initiatives, which ran between 2004-2008, mobilized 4,000 hospitals across the United States to avoid unnecessary death and harm through the introduction of simple interventions to reduce infection, medication error and surgical complication. The spirit of these campaigns inspires our own. 

Based on this promising work, Community Solutions, alongside our national partners, launched the 100,000 Homes Campaign to find and house 100,000 of the most long-term and vulnerable homeless individuals and families within three years, creating a collaboration of hundreds of communities seeking to eradicate the problem permanently. We can only do it together and we want to you to join us!