The Johnson County Board of Supervisors on Thursday heard a presentation from Phoebe Trepp, the program-development director at Shelter House, on the logistics of implementing a program to reduce the cost of chronic homelessness to the county.

Frequent Users Systems Engagement is a housing-first program, Trepp said, designed to provide housing to the small percentage of the homeless population who have been shown to be otherwise unable to operate inside the system.

This small subgroup known as frequent users, she said, only makes up about 4 percent of all people experiencing homelessness, as the vast majority — up to 84 percent — are only short-term homeless.

“Frequent users are people who go between services repeatedly,” Trepp said. “And are not able to maintain stability and go through expensive treatment programs. The system isn’t working for these particular people; they often they have complex problems with mental illnesses or substance abuse.”

The planned housing program would consist of 10 to 15 individual units that would each have their own small bathroom, kitchenette, and laundry facility.

After a screening process, Trepp said, the units would be given to individuals with little restrictions on their behavior.

“This is not about behavior change,” she said. “They would not be required to go to substance-abuse treatment and wouldn’t be kicked out of their housing if they don’t engage in treatment, but what we’ve seen in the models shows that if people have housing, they’re able to stabilize enough over time to seek treatment.”

The supervisors raised several questions about the proposal. Supervisor Terrence Neuzil who asked whether limited resources should be provided to one group over others who are following rules and the laws.

“That’s the tough part,” he said. “Should the funding be going to these folks versus others who are waiting on a list right now?”

The concept that allows the housing program to work, Trepp said, is that between hospital inpatient, ER services, psychiatric care, ambulances, detox, jail, and emergency shelter—these frequent users already cost Johnson County around $138,070 a year in unpaid services per person. By implementing the program, she said, those costs would actually be lowered.

The program has been implemented in several counties across the country, including Hennepin County, Minnesota, and has shown dramatic before and after price differences.

According to a report by Hennepin County, in 2008, six chronically homeless individuals cost the county $95,000 in services. One year after they were placed in the program, they had used only $16,000 worth of services.

A similar program Trepp presented, implemented in San Diego and called Project 25, showed an average reduction in costs per person per year of $120,000 to $44,400.

The aupervisors also raised the question of if, by adopting this policy, it would this make Iowa City a destination for those seeking services.

Iowa City police Officer David Schwindt, the downtown liaison officer, said he didn’t believe this would be the case if the program were adopted.

“Part of what they’re working toward is designing a minimum threshold for services,” he said. “So if people come here as a destination for services, they’re going to have to be on the street here for years. I find it difficult to believe people would spend two or three years going between hospitals and jail to build up your service level to qualify.”

The next step, Trepp said, would be to acquire property and funds with which to build the units and to keep up engagement in the community.

Ultimately, the supervisors said, they hope other communities in the county will join to help fund the program.

“This is a community problem,” said Neuzil. “And it needs to have a community solution.”