Impacts of Housing and Services Interventions for Homeless Families
HUD’s recently released report, Family Options Study: Short-Term Impacts of Housing and Services Interventions for Homeless Families, offers critical insights into the effectiveness of programs for homeless families. Launched in 2008, the study tracks 2,282 families who were randomly assigned to homelessness interventions from emergency shelters between September 2010 and January 2012 across 12 sites: Alameda County, California; Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Bridgeport and New Haven, Connecticut; Denver, Colorado; Honolulu, Hawaii; Kansas City, Missouri; Louisville; Kentucky; Minneapolis, Minnesota; Phoenix, Arizona; and Salt Lake City, Utah. Each family participating in the study had spent at least 7 days in emergency shelter and had at least one child aged 15 or younger at the point of enrollment.
Study Design and Research Questions
The study is designed as an experiment, in which families are randomly assigned to one of four possible interventions that differ in the duration of housing assistance provided and/or in the intensity of social services offered: a permanent housing subsidy (SUB), which offers indefinite housing assistance only, with no supportive services, usually a housing choice voucher; community based rapid re-housing (CBRR), which is temporary rental assistance for up to 18 months with limited housing-related services; project-based transitional housing (PBTH), which is temporary housing for up to 24 months in an agency-controlled building coupled with intensive supportive services; and usual care (UC), which refers to the housing and services that homeless families access from shelter without direct referral to the other interventions. The study consists of data collection from families and administrative data sources for a full three years following random assignment—with extensive surveys of families at baseline and at 18 and 36 months after random assignment. This report documents outcomes of families at roughly 20 months ; a subsequent report on outcomes at 36 months is expected in 2016.
The impact of the interventions was measured across five outcome domains: housing stability, family preservation, adult well-being, child well-being, and self-sufficiency. Researchers compared SUB, CBRR, and PBTH against each another and against the UC intervention for a total of six impact comparisons. The impact estimates include all families who received an offer of assistance, not just those who took up their assigned intervention. Researchers relied on telephone and in-person interviews with study families; details from program providers, including cost information; and administrative data of individual records.
The primary purpose of the Family Options Study was to determine which interventions were most effective at improving housing stability and other outcomes for homeless families. The researchers also documented the costs associated with each intervention and investigated whether certain interventions were more effective for families with varying levels of housing barriers and psychosocial needs. With the lack of existing research comparing intervention models, the study is a compelling test of the theories underlying homelessness assistance programs.
Of the interventions tested in the Family Options Study, SUB was overall the most effective intervention for homeless families. SUB was especially effective at improving housing stability. Families assigned to SUB experienced a significant reduction in homelessness, shelter stays, and doubling up during the period of observation as compared with families assigned to the other interventions. For example, only 22 percent of SUB families spent at least one night homeless or doubled up in the 6 months, or at least 1 night in emergency shelter in the 12 months, prior to the follow-up survey as compared with 50 percent of UC families. Only 15 percent of SUB families had a stay of any length in emergency shelter in months 7 to 18 after random assignment, compared with 28 percent of CBRR families.
SUB’s positive impacts extended beyond housing stability. SUB families experienced lower rates of intimate partner violence than UC and CBRR families, lower levels of psychological stress than UC and PBTH families, and lower numbers of schools attended than all other interventions. Researchers assert that the strength of the SUB results supports the homelessness assistance model underlying permanent housing subsidies, which address homelessness as principally a housing affordability problem without providing the specialized homeless-specific psychosocial services that PBTH does. SUB’s positive effects on nonhousing outcomes such as adult and child well-being further reinforce this approach. This finding is especially interesting because PBTH, which emphasizes addressing nonhousing barriers, did not produce strong positive effects on outcomes related to family well-being, compared with the other interventions. Researchers were surprised to discover, for example, that families assigned to PBTH fared worse than families assigned to CBRR on most indicators of adult well-being. For example, 23 percent of heads of CBRR families reported that their health was poor or fair in the 30 days before the follow-up survey as compared with 34 percent of PBTH families.
While families were randomly assigned to receive one of the four interventions being tested, families were not required to accept their assignment, and were therefore free pursue alternative arrangements, and many did. As such, many families used a mix of assistance during the follow-up period. SUB was the most utilized intervention, with 84 percent of assigned families taking it up during the first 20 months, compared with 60 percent for CBRR and 54 percent for PBTH. Researchers indicate that this finding reflects both the stricter eligibility requirements of PBTH and the value families place on SUB.
As measured by per family monthly program costs, UC was the most expensive intervention at an average of $4,819 per month, followed by PBTH ($2,706), SUB ($1,162), and CBRR ($878). In terms of the average duration of use for the programs, PBTH averaged 13 months of use at a total cost of $32,500, followed by SUB (16 months at $18,800), UC (4 months of emergency shelter at $16,800) and CBRR (7 months at $6,500). Researchers also measured costs based on all programs that participating families accessed over the period of observation. According to this measurement, SUB had average costs comparable to UC, slightly higher than CBRR, and significantly lower than PBTH. For example, the average total cost of all program use over the first 20 months by families originally assigned to SUB was $27,864 compared with $30,914 for families assigned to PBTH. Cost accrual will differ across interventions; researchers point out that CBRR and PBTH are both temporary in nature, whereas SUB is a longer-term intervention likely to continue to accrue costs. Past research indicates that stays in voucher programs average 3.8 years, but it is not known if this is applicable to homeless families.
Researchers found no evidence that interventions had differential impacts on families with greater or lesser levels of psychosocial and housing challenges. The strongest findings were discovered across all families and not within categories of families.
Consistent with earlier studies, assignment to SUB reduced labor market engagement as compared with other interventions. For example, 61 percent of UC families had worked for pay at some point since being randomly assigned compared with 50 percent of SUB families. In addition, families assigned to SUB had worked for pay for an average of 5.4 months since random assignment, compared with 7.5 months for families assigned to CBRR.
Conclusions and Implications
The Family Options Study provides valuable guidance for federal and local policymakers by demonstrating the relative effectiveness and cost of four homelessness assistance interventions. Through a rigorously designed, random assignment experiment, researchers established a solid foundation for comparing the relative effectiveness of several housing and service interventions that communities may employ to address family homelessness. Some questions remain about the findings at 20 months, however, and the long-term outcomes of families at 36 months will be an opportunity for further investigation. In particular, will SUB sustain its considerable positive impacts at 36 months? Will the benefits from this intervention cease after families exit housing subsidy programs? Will PBTH’s focus on addressing nonhousing barriers through intensive supportive services lead to positive benefits in the long term that were not evident at 20 months? How will the costs compare over a longer period of observation? HUD and the research team look forward to exploring these questions and others in the final report documenting the 36-month outcomes of study families in late 2016.
Attempts to reach families began in the 18th month after random assignment, and the median time from random assignment to the followup survey was 20 months.×