Block 8 discusses leadership, co‑ordination, and capacity within the homelessness sector, emphasising their importance for effective governance. Co‑ordination challenges often arise due to the diverse range of actors and stakeholders involved in homelessness policies and services. This block explores the range of agencies and authorities responsible for homelessness across OECD and EU countries and provides guidance on improving horizontal and vertical co‑ordination. It also examines the capacity challenges facing local authorities and frontline workers in the homelessness sector, which constrain their ability to implement innovative practices effectively, and explores ways to improve working conditions and develop capacity.
OECD Toolkit to Combat Homelessness
Abstract
This section focuses on leadership, co‑ordination, and capacity in the homelessness sector – core dimensions of good governance – in light of the particular salience of these issues in this sector. The recommendations aim to ensure that “the social relief sector [can] function as a trampoline not only as a safety net” (Boesveldt, van Montfort and Boutellier, 2017[1]).
As is the case in many policy domains, co‑ordination challenges arise in the homelessness sector in light of the range of actors, agencies and stakeholders involved in designing, delivering and funding homelessness policies and services (Block 1). Governments can benefit from a culture of co‑operation that codifies the role of various levels of government in policy making, legislation, financing, standard setting, oversight and regular communication to improve effective governance and successful long-term reform (OECD, 2019[2]). Concretely, improving co‑ordination in the realm of homelessness can take many forms, including, among others, inter-ministerial councils as well as national Housing First Hubs, which provide a platform for training, mutual learning, exchange, and co‑ordination, and play a key role in mobilising different actors to collectively scale up Housing First solutions. Smooth co‑operation with regional and local governments, along with adequate resources and capacity, is critical, in light of their often significant role in delivering homelessness support services and housing solutions.
Further, homelessness service providers are under increasing strain. In OECD countries, health and social care systems employ more workers now than at any other time in history (OECD, 2023[3]). In 2021, more than one in every ten jobs (10.5%) was in health or social care, up from 9.5% in 2011 (Figure 8.1). The share of employment in health and social work ranges from over 20% in Norway, to less than 5% in Colombia, Costa Rica, Mexico and Romania. Across OECD countries with available data, the majority of workers in health and social care systems are women, representing on average roughly 80% of all workers.
Employment in health and social work as a share of total employment, by gender, 2021 (or nearest year)
Source: (OECD, 2023[3]), Health at a Glance 2023: OECD Indicators, https://doi.org/10.1787/7a7afb35-en.
Indeed, in many OECD and EU countries, homelessness services are under-resourced, fragmented, and suffer from shortages of both frontline and operational staff. Service providers and agencies in charge often lack the capacity to build momentum around more innovative or efficient practices, which can create service gaps, inequities across populations, and an inability to focus on targeted prevention (Mosley, 2021[4]; Gaetz, 2020[5]).
OECD countries exhibit vast differences in social and health services available (Block 6), ministry compositions and responsibilities and organisational structures (Block 1), national regulations and capacity to integrate housing services with social services. Thus, some of the recommendations in this section will not be uniformly applicable across all countries.
Ensuring good governance is a continuous process for public agencies at all levels and underpins the realisation of all other blocks in this Toolkit. The following set of operational questions is intended to guide policy makers and practitioners to improve leadership, co‑ordination and capacity in the homelessness sector in their country, city or community context:
Which governmental agency is best placed to lead on homelessness policies?
How to improve co‑ordination and coherence across different actors and policy domains to improve homelessness services?
How to improve working conditions and develop capacity for local governments and frontline staff in the homelessness sector?
Which governmental agency is best placed to lead on homelessness policies?
In terms of leadership, the responsible agency to tackle homelessness varies by country. In just over 50% of OECD countries, the ministry responsible for Social Welfare (e.g. Labour, Health, Family) is responsible for addressing homelessness. In other countries, the leading ministry falls under the authority of ministries of Housing, Economy, Finance, Economic Development, Environment, Regional Development or Social Affairs. Further, in some countries, homelessness policies are fragmented across multiple ministries.
Source: 2023 OECD Questionnaire on Affordable and Social Housing (QuASH).
Governments will need to identify which institutional actors/agencies are best placed to co‑ordinate efforts on homelessness. The choice of appropriate agency will vary by national context, but some key characteristics to consider are that the agency should have: i) the mandate to convene all relevant stakeholders, ii) the capacity to effectively co‑ordinate national and local stakeholders, both within and outside the government, to prevent overlaps, and iii) sufficient financial, technical, and human resources to achieve these objectives (OECD, 2023[6]). Beyond the implementation of relevant policies to combat homelessness, this also includes defining indicators, developing a culture of monitoring, evaluation, and learning to increase capacity, and disseminate data and outputs to stakeholders.
Identifying the ministry with the adequate functional capacity and financial resources
Effective homelessness prevention and response requires adequate functional capacities and financial resources to implement the policies. These include strong internal policies and priorities to integrate budgets and service delivery, data-sharing and cross-team communication, and a heterogenous combination of specialists and generalists with formal and informal collaboration channels (such as co-locating services within the same building).
Homelessness policies often benefit from the establishment of a clear policy lead or co‑ordinator, whose responsibilities may include clarifying the roles of different actors (e.g. provider, financier, regulator), and identifying opportunities to institutionalise co‑operation (e.g. through the creation of different governing bodies with complementary mandates and tools among stakeholders).
A number of countries have a lead ministry responsible for homelessness, often with a considerable implementation role for regional and local governments. In Norway, the Ministry of Local Government and Regional Development is responsible for the National strategy for Social Housing Policies (2021‑24), “We all need a safe place to call home,” yet housing policy responsibilities are shared across national, subnational and non-public actors. The central government outlines the policy goals and sets the enabling framework (laws, regulations and financial tools distributed by the National Housing Bank); public health and social welfare services are responsible for people experiencing homelessness; municipalities provide housing support – including temporary accommodation – to vulnerable populations, in co‑operation with NGOs (FEANTSA, 2022[7]). In Germany, the Federal Ministry for Housing, Urban Development and Building is in charge of the development of the national action plan to combat homelessness, with key roles in affordable and social housing policies, and the provision of health and social services for subnational actors.
In several countries, inter-ministerial bodies facilitate the co‑ordination of homelessness policies, though their responsibilities vary. In France, since 2010, the DIHAL (Délégation interministérielle à l’hébergement et à l’accès au logement) co‑ordinates and monitors the implementation of public policies for shelter and access to housing for people experiencing homelessness or poorly housed people, under the authority of the Prime Minister and functionally attached to the Ministry of Territorial Cohesion. In the United States, the U.S. Interagency Council on Homelessness (USICH) co‑ordinates across 19 federal agencies and departments, and with partners in both the public and private sectors and people with lived experience, to prevent and end homelessness in the nation. Its primary focus is to reduce bureaucracy and promote the co‑ordination and combination of different federal programmes, and to improve efficiency across levels of government, helping state, local, and tribal partners use federal resources from different agencies to implement best practices and meet locally-determined needs.
Conducting a mapping of the roles and responsibilities of different stakeholders and their functions
One step to strengthening co‑ordination and multi-level governance can involve a mapping of the roles and responsibilities of different stakeholders and their functions. There are many ways to conduct a mapping; a selection of key questions in Box 8.1 could provide some useful guidance. The aim of the mapping exercise could be to identify both overlaps and gaps, along with clarity over who should be engaged at different parts of the process. This process can be useful for broad, inclusive processes, such as determining who to engage in the design of a national homelessness strategy (Block 1), as well as identifying a narrower subset of relevant actors and institutions to be mobilised for specific initiatives (such as rethinking shelter access rules).
The following questions could support the undertaking of a mapping exercise to identify existing and potential institutional actors to engage in homelessness policy making:
Who is engaged in homelessness strategies, policies and programmes? Which public actors and level(s) of government (national, regional, municipal)? Which non-government actors?
What are the roles of these actors? Who regulates? Who funds and/or finances? Who implements?
Which types of sectors are mobilised?
What services do they provide?
At what moment do they intervene?
Who is currently (in)eligible to access housing and support services for people experiencing homelessness? Who is supporting those who are ineligible?
Who is responsible for homelessness prevention? For housing-led and Housing First solutions?
Which non-governmental actors and people at risk of or currently experiencing homelessness be more meaningfully engaged, and in what ways?
In Spain, for instance, an Inter-ministerial Commission sets general policy guidelines, and a joint committee of national and autonomous bodies (the Territorial Council of Social Services and the System for the Autonomy and Care of People with Dependency) is intended to ensure the consistency of homelessness policies across levels of government. This same body, along with a Technical Co‑operation Group of regional and local actors, provides implementation, monitoring, and tracking support for the country’s homelessness strategy (the Framework Agreement). The Social Welfare Commission of the Spanish Federation of Municipalities and Provinces engages local actors to develop solutions in line with the national strategy, and the State Council of Non-Governmental Social Action Organisations incorporates inputs from NGOs and people with lived experience.
How to improve co‑ordination and coherence across different actors and policy domains to improve homelessness services?
Homelessness programmes tend to be fragmented across a range of citizen-facing agencies and service providers. As has been demonstrated throughout this Toolkit, this includes a broad range of national-level ministries, regional and local authorities, and non-governmental organisations. Without sufficient co‑ordination, reforms in specific policy areas may have unintended negative effects on other areas working with people experiencing homelessness. Moreover, in homelessness policy, as in any other policy that involves different agencies, the gains or losses of reforms are likely to be unequally distributed across agencies and ministries, creating additional barriers to enacting reforms. For example, a randomised controlled trial (RCT) of the Housing First (Un Chez Soi d’Abord) programme in France conducted across four sites: Paris, Marseille, Toulouse and Lille found cost savings for the French health insurance for participants with a diagnosis of schizophrenia or bipolar disorder but increased expenditure on housing and social services (Lemoine et al., 2021[8]).
Encouraging horizontal and vertical integration of critical homelessness services
As discussed in Block 6, there is growing evidence that integrating public services, in particular medical/health providers and social services is a major public policy priority for many OECD countries (Adams and Hakonarson, 2024[9]). Integration can be horizontal and/or vertical. Horizontal integration, which is a more common approach and the focus of many initiatives across the European Union, typically brings together policy groups, services, professions, and organisations from across different sectors and/or organisations to address the needs of service users. Vertical integration on the other hand is more likely to be systemic and involve the integration of governance and finance arrangements within multiple service settings.
An example of a horizontal integration approach includes programmes that provide care‑experienced young people with intensive wraparound support where they are linked to a professional support person. Since 2017, local authorities in England (the United Kingdom) are required to offer a Personal Adviser to all care leavers towards whom they had a duty for care under the Children Act 1989. (Box 3.1) In April 2022, the Department for Education announced GBP 36.4 million (USD 46 million) of funding for Personal Advisers over the next three years (Foley et al., 2023[10]). This includes responsibility for monitoring, reviewing, and implementing the young person’s “pathway plan”. A pathway plan details the kind of support the young person might expect their Personal Adviser to provide and address – for instance, information on housing options, benefit entitlements, or support in finding employment.
Vertical integration tends to be larger-scale and include a range of initiatives. In the province of Québec (Canada) the Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) was initiated in 1997 and has since become a mainstream approach to services for older people and people with disabilities in the province. The project blends various approaches to service integration, namely case management, single entry points, individualised service plans, a functional assessment tool and an information sharing system (MacAdam, 2015[11]).
A key barrier to greater integration is multi-governance finance issues and competition between service providers for resources (Adams and Hakonarson, 2024[9]). If full integration is not feasible, co-locating relevant services in one place can address time and resource allocation issues not only for the service users themselves but also for the service providers. For example, co-located services in the form of “family centres” for people leaving prisons are common in the Nordic countries, where multidisciplinary teams of specialists are located under one room. One example is the Red Cross re‑entry house in Oslo, Norway, where different state and municipal services are in the same building, so that people leaving prison can access services more easily. Similar one‑stop-shops have been introduced in other European countries, such as in the United Kingdom.
Fostering a heterogeneous representation in homelessness support service networks
Ensuring a heterogenous constellation of the policy network which involves a mixed composition of specialists and generalists, government, not-for-profit sector actors, and research sector actors, is conducive to a better quality of housing services (Boesveldt, van Montfort and Boutellier, 2017[1]). For example, in Portugal, the National Strategy for the Integration of Homelessness People: Prevention, Intervention and Monitoring, 2017‑23, involves a range of public agencies (e.g. ministries, public institutes, local authorities) and private stakeholders (e.g. NGOs, research institutes) (Baptista, 2018[12]). The monitoring and evaluation groups meets bimonthly to assess the progress of the strategy and is responsible for preparing a biennial Action Plan and annual evaluation reports. Each annual evaluation report provides an update on the status of the strategic objectives, the main constraints to achieving strategic objectives, as well as improvement proposals. The biennial Action Plans include consultations with partner entities and people with lived experiences of homelessness and provides updated goals and strategic objectives.
Co-creating homelessness service delivery with impacted individuals
As discussed in Block 1, advocates of user-centred government service design and delivery emphasise the importance of moving from human- centred design to co-designing services with impacted individuals throughout the ongoing development process of a service, rather than a one‑off formal consultations or observational user research (Service Design Network gGMbH, 2016[13]; OECD, 2022[14]). Co-designing can allow individuals directly affected by homelessness to participate in the development process of a service or prevention programme. This is also critical when thinking about cross-agency collaboration for wraparound service delivery. This also includes empowering frontline staff or civil servants to co-create better institutional solutions from the bottom-up based on their direct experience. Such efforts can help ensure that limited resources are used effectively. Austrian- and UK-based researchers found that co-designed mental health interventions positively affect people experiencing homelessness’ mental health and housing situations, while also leading to reduced hospital and emergency department admissions and increased primary care utilisation (Schiffler et al., 2023[15]). Once implemented, establishing a monitoring system to measure service and the user journey, and whole outcomes (instead of focusing on individual agencies) can help promote iterative process improvements and successful delivery.
Leveraging data-sharing partnerships to best address individual needs
In early 2012, a data-sharing partnerships was established with the County Hospital system in Houston, the United States known as the Harris Health system to address the needs of high-needs, high-cost populations which was later expanded to include the emergency medical services (EMS) system (Baptista, 2018[12]). Analysing the overlap between the data from these two systems revealed that individuals were not limited to accessing just one agency or hospital, such as the Harris Health System, but were also seeking care at other hospitals based on EMS drop-offs. This initiative demonstrated that cross-sector data integration plays a crucial role in achieving care co‑ordination for socially and medically vulnerable individuals. Building successful data sharing partnerships required establishing trust with agency partners through transparent communication about data usage and demonstrating the proof of concept from initial data sharing initiatives with the county. Data privacy must be ensured.
In Chile, the Social Information Registry (RIS) functions as a registry of socio‑economic and administrative data for individuals and households, covering an estimated 98% of the national population. The Red de Protección Social was established in 2021 as an information platform for social services and benefits available in situations of need, including difficulties in finding housing. The platform links administrative data across various registries, namely, the RIS, the Household Registry (Registro Social de Hogares), the Civil Registry and Identification Service, and the National Health Fund. This enables the platform to identify the services and benefits available to households across 20 institutions. The goal is to inform individuals about the benefits and services they qualify for and how to request and access them (Frey, Hyee and Minondo Canto, 2024[16]).
How to improve working conditions and develop capacity for local governments and frontline staff in the homelessness sector?
The frontline homelessness workforce, including shelter and service agency workers, plays a critical part in providing immediate accommodation, food, security, and support services to individuals experiencing homelessness. Yet they often receive little support themselves, and insufficient attention is paid to advancing the capacity of shelter workers (Burke, 2005[17]; Kulkarni et al., 2013[18]; Mullen and Leginksi, 2010[19]; Hopper, Bassuk and Olivet, 2010[20]). OECD work on long-term care (LTC) workers shows that the workforce frequently experiences overwork, poor working conditions, financial insecurity, vicarious trauma, lack of social recognition, and frustration (e.g. from the challenges to overcome the systemic barriers to support people experiencing homelessness) (OECD, 2023[21]). Similarly, in the homelessness sector, service providers face numerous challenges, including physical and psychological strain, long working hours, low wages, limited training opportunities and a lack of social recognition, and the sector often suffers from high turnover (Peters, Hobson and Samuel, 2021[22]).
Frontline staff workers are also prone to experience emotional distress. Research in Canada found that frequent exposure to chronic stressors, stemming from direct contact with service users, was positively correlated with post-traumatic stress and psychological distress. This impact was especially pronounced among early-career workers with frequent direct contact with service users (Kerman et al., 2022[23]). Similarly, qualitative studies capturing conversations with homelessness service providers and surveys show that frontline workers often experience burnout symptoms and psychological exhaustion (Twis et al., 2021[24]; Peters, Hobson and Samuel, 2021[22]; Mette et al., 2020[25]; National Alliance to End Homelessness, 2023[26]). These findings suggests that frontline workers could potentially benefit from more comprehensive in-work counselling support. The following quotes, taken from (Peters, Hobson and Samuel, 2021[22]), illustrate the difficulties of homelessness care work:
“Constantly battling a biased social system with inadequate resources, [...] can [...] lead to feeling overwhelmed and defeated.”
“I love my job […]. Nevertheless, I have never felt so much despair and helplessness before in all my life.”
A critical component to tackle homelessness will be to improve conditions and develop capacity and training for local governments and frontline staff in homelessness services. The homelessness sector can draw on insights from recent reforms enacted in the LTC sector, following the COVID‑19 pandemic to address similar challenges. Reforms include allocating greater resources to improve working conditions, reduce labour shortages, strengthen training programmes, and emphasise preventive measures (OECD, 2023[21]). Considering that many countries plan to significantly scale‑up service‑intensive programmes like Housing First to combat homelessness, attracting new staff will likely require improving the attractiveness of homelessness services.
Proposed solutions include i) increasing the wage and working condition protections of workers, ii) supporting collective bargaining, iii) boosting opportunities for training, iv) increasing the use of new technologies particularly to improve digital skills, v) promoting the transitions of undeclared foreign care workers to formal employment, and vi) providing more counselling services, regular supervision, and mental health resources. In addition, campaigns to increase social recognition can help promote recruitment.
Increasing wages and improving working conditions of workers in the health, social services and homelessness sectors
In response to the COVID‑19 pandemic, a number of countries permanently or temporarily increased the remuneration of LTC workers, including Canada, Czechia, France, Hungary, Korea, Latvia, the Netherlands and Slovenia. The largest increases were observed in Hungary and Slovenia, with pay rising by 20% and 16%, respectively. Additionally, in 2021, Luxembourg granted LTC workers two extra days of leave, leading to an overall increase in their hourly earnings (OECD, 2023[21]).
Boosting training opportunities, including obligatory training
In Belgium, LTC workers are required to complete a formal training programme, along with two additional days of training each year. In Ireland, quality assessments of LTC providers include a review of the educational qualifications of their care staff. Additionally, LTC workers are required to complete periodic courses or additional training based on the specific needs of the care recipients. This helps enhance the skills of care providers while elevating the overall quality of care (OECD, 2023[21]). In Norway, as part of the Competency lift 2025 action plan, the central government provides grants to municipalities to offer different types of training to complement formal training programmes and help LTC workers strengthen their skills and improve their motivation (OECD, 2022[27]). Finally, quantitative studies show that access to training might be positively associated with workers’ well-being: a cross-country study across eight European countries (France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain and Sweden) found that working in a care setting with access to training is linked to lower levels of psychophysical exhaustion and disillusionment (HOME_EU Consortium Study Group, 2020[28]).
In light of the diversity of actors and policy domains engaged in the homelessness sector, effective policy delivery depends on strong leadership and smooth co‑ordination. Further, across OECD and EU countries, homelessness services tend to be fragmented and under-resourced, and the workforce suffers from physical and psychological strain, long working hours, low wages, limited training opportunities and a lack of social recognition. To scale‑up service‑intensive programmes like Housing First, policy makers will need to improve the attractiveness of homelessness services. Building on these operational issues, the following recommendations can help policy makers and practitioners to strengthen leadership, co‑ordination and capacity in the homelessness sector:
Establish a clear policy lead on homelessness and clarify the roles and responsibilities of different actors (provider, financier, regulator), ensuring that the agency has the necessary mandate, capacity and resources.
Strengthen horizontal and vertical co‑ordination – and, where possible, encourage integration – of critical homelessness services.
Encourage information sharing and mutual learning across different levels of government and relevant authorities, NGOs, and the private sector, including through national networks such as Housing First hubs.
Engage a range of relevant stakeholders in support service networks, and co-create homelessness service delivery with impacted individuals.
Improve conditions and develop capacity and training for local governments and frontline staff in the homelessness sector.
References
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