Fmily Options Study Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies U.S. Deprtment of Housing nd Urbn Development Office of Policy Development nd Reserch
Fmily Options Study Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies Prepred for U.S. Deprtment of Housing nd Urbn Development Office of Policy Development nd Reserch Prepred by Dniel Gubits Mrybeth Shinn Stephen Bell Michelle Wood Smuel Dstrup Cludi D. Solri Scott R. Brown Steven Brown Luren Dunton Winston Lin Debi McInnis Json Rodriguez Glen Svidge Brooke E. Spellmn Abt Assocites, Inc. In prtnership with Vnderbilt University July 2015 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies i
ACKNOWLEDGMENTS The uthors of this report grtefully cknowledge the efforts of mny individuls who hve ssisted in crrying out the Fmily Options Study since it begn in 2008. They prticulrly thnk the Government Technicl Reviewer (GTR), Anne Fletcher, for her unwvering guidnce nd support throughout ll phses of the reserch. Other stff members t the U.S. Deprtment of Housing nd Urbn Development (HUD), Office of Policy Development nd Reserch (PD&R) hve provided vluble guidnce nd technicl oversight for the study. In prticulr, the uthors thnk Pul Dornn, the study s former GTR, for his substntil input into the study s design nd specifiction of study interventions. HUD s Office of Specil Needs Assistnce Progrms hs been n ctive prtner in the design nd implementtion of the Fmily Options Study, nd the reserch tem is grteful for tht office s guidnce nd support in developing the study design nd implementtion pln. In ddition, the uthors thnk Lynn Rodgers of PD&R for her ssistnce with cquiring HUD Public nd Indin Housing Informtion Center (PIC) nd Tennt Rentl Assistnce Certifiction System (TRACS) dt. Specil thnks re due to the fmilies prticipting in the Fmily Options Study who hve continued to shre their experiences nd open their lives to the study tem. The Fmily Options Study hs benefited from the contributions of number of technicl experts. The study design reflects guidnce from experts in rndom ssignment methodology nd from subject mtter experts knowledgeble bout nd close to the opertionl relities of the homeless ssistnce service delivery system. The uthors re especilly grteful to Ellen Bssuk (The Center for Socil Innovtion), Mrth Burt (independent consultnt), Dennis Culhne (University of Pennsylvni), Lrry Orr (The Johns Hopkins University), nd Beth Weitzmn (New York University) for their help in designing the study interventions nd the reserch pproch. Stephen Bell (Abt Assocites) nd Mrybeth Shinn (Vnderbilt University) re the study s Co-Principl Investigtors. Michelle Wood (Abt Assocites) is the Project Director. Dniel Gubits (Abt Assocites) is the study s Director of Anlysis. Implementing the study design required the efforts of lrge tem to recruit sites, develop site-specific implementtion plns, nd conduct rndom ssignment. Brooke Spellmn (Abt Assocites) led the site recruitment nd implementtion ctivities, with contributions from site reserch liisons Burt, Culhne, Shinn, Donld Chmberlin (independent consultnt), Wendy Vulton (formerly with The Center for Socil Innovtion), Mtt White (Abt Assocites), nd Suznne Zerger (formerly with The Center for Socil Innovtion). Styendr Ptrbnsh (formerly with Abt Assocites) designed the complex rndom ssignment lgorithm used to ssign fmilies, nd Sge Computing developed the rndomiztion softwre. Scott Brown (Vnderbilt University), Luren Dunton, Nichole Fiore, nd Meghn Henry (Abt Assocites) monitored rndom ssignment, collecting updtes bout the vilbility of intervention slots nd the sttus of fmilies enrolled in ech intervention. The Fmily Options Study involved n extensive field dt collection effort to collect informtion directly from study prticipnts t severl junctures. AbtSRBI led the prticipnt dt collection ctivities under the direction of Ricki Jrmon nd Brend Rodriquez, the study s survey director. Ashley Brdbury nd Brinn Roche (AbtSRBI) nd Debi McInnis (Abt Assocites) lso plyed key roles in coordinting nd monitoring dt collection ctivities. Kthy Gill nd Lynn Reneu (Abt SRBI) served s survey field mngers nd over - sw the 17 field interviewers working in the study sites. Smuel Dstrup (Abt Assocites) led the cost dt collection efforts, ssisted by Scott Brown, Burt, Dunton, Fiore, Ktherine Buck (Abt Assocites), nd Glen Svidge (Abt Assocites). Dunton nd Cludi Solri (Abt Assocites) mnged the collection nd nlysis of Homeless Mngement Informtion System (HMIS) dt from the 12 study sites, nd Steven Brown (formerly with Abt Assocites) coordinted nlysis of HUD dministrtive dt from PIC nd TRACS. Under the direction of Gubits, Scott Brown nd Steven Brown plyed key roles in estimting impcts using survey nd dministrtive dt. The study s co-project qulity dvisors, Jill Khdduri nd Jcob Klermn (Abt Assocites), provided technicl guidnce throughout ll phses of the project nd thoughtful nd constructive comments on this report. Missy Robinson (Abt Assocites) did n excellent job producing this complex document. Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies ii
Acknowledgments The study would not be possible without the enthusism nd dediction of locl service providers, Continuum of Cre (CoC) leders, nd public housing gencies in the 12 prticipting communities: (1) Almed County, Cliforni; (2) Atlnt, Georgi; (3) Bltimore, Mrylnd; (4) Boston, Msschusetts; (5) the New Hven nd Bridgeport regions of Connecticut; (6) Denver, Colordo; (7) Honolulu, Hwii; (8) Knss City, Missouri; (9) Louisville, Kentucky; (10) Minnepolis, Minnesot; (11) Phoenix, Arizon; nd (12) Slt Lke City, Uth. The study tem is grteful for their mny contributions nd continued commitment to the study. The study tem would lso like to thnk the HMIS dministrtors in ech of the CoCs for providing HMIS dt for prticipting fmilies. A grnt to Vnderbilt University by the Eunice Kennedy Shriver Ntionl Institute of Child Helth nd Humn Development (NICHD) supported child dt collection nd nlysis for this study. DISCLAIMER The contents of this report re the views of the contrctor nd do not necessrily reflect the views or policies of the U.S. Deprtment of Housing nd Urbn Development or the U.S. Government. Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies iii
FOREWORD Fmily homelessness hs stubbornly persisted despite more thn three decdes of federl investment. The 2010 relese of Opening Doors: Federl Strtegic Pln To Prevent nd End Homelessness estblished n mbitious gol to end homelessness mong children, fmilies, nd youth by 2020. Until now, HUD hd little empiricl evidence compring outcomes cross interventions to guide policy nd progrm decisions towrd this gol. The Fmily Options Study, lunched by HUD in 2008 (nd still under wy), is rigorously designed experimentl study intended to provide the strongest evidence possible bout the effectiveness nd reltive costs of four min interventions vilble to homeless fmilies permnent housing subsidy, project-bsed trnsitionl housing, community-bsed rpid re-housing, or usul cre. More thn 2,200 homeless fmilies, including more thn 5,000 children in 12 communities, were rndomly ssigned to one of four interventions. The fmilies re being trcked for minimum of 3 yers nd were extensively interviewed t bseline, 18 months fter rndom ssignment, nd gin 36 months fter rndom ssignment to ssess outcomes relted to housing stbility, fmily preservtion, dult well-being, child well-being, nd self-sufficiency. This report documents outcomes t 18 months, presenting striking evidence of the power of offering permnent subsidy to homeless fmily. Fmilies who were offered housing voucher experienced significnt reductions in subsequent homelessness, mobility, child seprtions, dult psychologicl distress, experiences of intimte prtner violence, school mobility mong children, nd food insecurity t 18 months. Moreover, the benefits of the voucher intervention were chieved t comprble cost to rpid re-housing nd emergency shelter nd t lower cost thn trnsitionl housing. The study design is both rigorous nd mbitious, nd the rndom ssignment nd subsequent contrsts in progrm use will provide strong bsis for informing future federl policy ddressing fmily homelessness. Results t 36 months will revel if the study findings re sustined over time. In the interim, this report provides unprecedented evidence tht housing vouchers mesurbly improve outcomes for homeless fmilies. It is impossible to thnk individully ll the people who hve contributed to this report nd the broder study since its inception in 2008, so I simply echo the pprecition expressed in the report s cknowledgments. I would be remiss, however, if I did not explicitly thnk Anne Fletcher for her mzing diligence s the Government Technicl Reviewer for this importnt but potentilly unwieldy study or if I did not remind reders of the true generosity of the fmilies who continue to prticipte in this study. Ktherine M. O Regn Assistnt Secretry for Policy Development & Reserch U.S. Deprtment of Housing nd Urbn Development Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies iv
TABLE OF CONTENTS List of Acronyms nd Abbrevitions... xv Executive Summry... xvi Study Interventions... xvi Rndom Assignment Design... xvii Dt Sources... xviii Previous Findings From the Fmily Options Study... xix Hypothesized Effects of the Interventions... xx Mening of Impct Comprisons... xxii Study Findings... xxii Conclusions... xxx Chpter 1. Introduction...1 1.1 Bckground on the Homeless Services System...1 1.1.1 The Continuum of Cre...1 1.1.2 Progrmmtic Approches...2 1.2 Evlution Design...4 1.3 Bseline Chrcteristics of the Reserch Smple...5 1.4 Orgniztion of the Report...10 Chpter 2. Implementing the Study...11 2.1 Interventions Studied...11 2.2 Site Selection...11 2.3 Chrcteristics of Prticipting Sites...13 2.4 Implementing Rndom Assignment...16 Chpter 3. Hypotheses About Intervention Effects (Conceptul Frmework)...18 3.1 Chllenges Tht Fmilies Experiencing Homelessness Fce...18 3.1.1 Chllenges Tht Homeless Mothers Fce...18 3.1.2 Chllenges Tht Children Experiencing Homelessness Fce...19 3.1.3 Heterogeneity Among Fmilies in Ptterns of Homelessness nd Use of Other Services...20 3.2 Conceptul Frmework nd Hypothesized Effects for the Fmily Options Study Interventions...21 3.3 Conceptul Rtionle for SUB nd CBRR...21 3.3.1 Predictions Regrding Housing Stbility...22 3.3.2 Predictions Regrding More Distl Outcomes...24 3.3.3 Predictions Regrding Costs...26 3.3.4 Hypotheses for Pirwise Comprisons Involving SUB, CBRR, nd UC...27 3.4 Conceptul Rtionle for PBTH...27 3.4.1 Predictions Regrding Housing Stbility...28 3.4.2 Predictions Regrding Self-Sufficiency...29 3.4.3 Predictions Regrding Adult Well-Being...29 3.4.4 Predictions Regrding Distl Outcomes...30 3.4.5 Predictions Regrding Costs...30 3.4.6 Hypotheses for Pirwise Comprisons...31 3.5 Wht Works for Whom?...31 3.5.1 Predictions Regrding Wht Works for Whom...33 Chpter 4. Dt Sources nd Methodology...34 4.1 Dt Sources...34 4.1.1 Bseline Dt Collection...35 4.1.2 Followup Dt Collection...35 4.1.3 Construction of Progrm Usge Dt...36 4.2 Methodology...37 4.2.1 Impct Estimtion Model for Fmily nd Adult Outcomes...38 4.2.2 Impct Estimtion Model for Child Well-Being Outcomes...39 4.2.3 Impct Estimtion Model for Modertor Anlysis...39 4.2.4 Strtegy for Addressing the Multiple Comprisons Problem...39 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies v
Tble of Contents Chpter 5. Description of Usul Cre (UC) nd Outcomes Mesured in the Study...41 5.1 The Emergency Shelter Experience of Usul Cre (UC) Fmilies...41 5.1.1 UC Shelters in the Study Sites...41 5.1.2 Housing Assistnce in UC Shelters...41 5.1.3 Assessment of Fmilies in UC Shelters...45 5.1.4 Supportive Services in UC Shelters...45 5.2 Use of Other Homeless nd Housing Assistnce Progrms by Usul Cre (UC) Fmilies...46 5.3 Outcomes for Fmilies Rndomly Assigned to Usul Cre (UC)...48 5.3.1 Mesures of Housing Stbility...48 5.3.2 Mesures of Fmily Preservtion...51 5.3.3 Mesures of Adult Well-Being...52 5.3.4 Mesures of Child Well-Being...53 5.3.5 Mesures of Self-Sufficiency...58 Chpter 6. Impcts of Permnent Housing Subsidy (SUB) Compred With Usul Cre (UC)...62 6.1 Permnent Housing Subsidy (SUB) Intervention...62 6.1.1 Housing Assistnce in SUB...62 6.1.2 Supportive Services in SUB...63 6.1.3 Eligibility Criteri for SUB...63 6.2 Progrm Use by Fmilies in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...63 6.3 Impcts on Housing Stbility in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...66 6.4 Impcts on Fmily Preservtion in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...70 6.5 Impcts on Adult Well-Being in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...71 6.6 Impcts on Child Well-Being in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...72 6.7 Impcts on Self-Sufficiency in the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison...73 6.8 Summry of the Permnent Housing Subsidy (SUB) Versus Usul Cre (UC) Comprison Across Domins...75 Chpter 7. Impcts of Community-Bsed Rpid Re- Housing (CBRR) Compred With Usul Cre (UC)...77 7.1 Community-Bsed Rpid Re-Housing (CBRR) Intervention...77 7.1.1 Housing Assistnce in CBRR...77 7.1.2 Assessment of Fmily Needs in CBRR...78 7.1.3 Supportive Services Provided in CBRR..78 7.1.4 Eligibility Criteri for CBRR...80 7.2 Progrm Use by Fmilies in the Community- Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...80 7.3 Impcts on Housing Stbility in the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...83 7.4 Impcts on Fmily Preservtion in the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...86 7.5 Impcts on Adult Well-Being in the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...86 7.6 Impcts on Child Well-Being in the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...87 7.7 Impcts on Self-Sufficiency in the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison...88 7.8 Summry of the Community-Bsed Rpid Re-Housing (CBRR) Versus Usul Cre (UC) Comprison Across Domins...89 Chpter 8. Impcts of Project-Bsed Trnsitionl Housing (PBTH) Compred With Usul Cre (UC)...90 8.1 Project-Bsed Trnsitionl Housing (PBTH) Intervention...90 8.1.1 Housing Assistnce in PBTH...91 8.1.2 Assessment of Fmily Needs in PBTH...91 8.1.3 Supportive Services Provided in PBTH...92 8.1.4 Eligibility Criteri for PBTH...93 8.1.5 Progrm Rules in PBTH...94 8.2 Progrm Use by Fmilies in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...94 8.3 Impcts on Housing Stbility in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...97 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies vi
Tble of Contents 8.4 Impcts on Fmily Preservtion in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...100 8.5 Impcts on Adult Well-Being in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...101 8.6 Impcts on Child Well-Being in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...102 8.7 Impcts on Self-Sufficiency in the Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison...103 8.8 Summry of Project-Bsed Trnsitionl Housing (PBTH) Versus Usul Cre (UC) Comprison Across Domins...103 Chpter 9. Impcts of Permnent Housing Subsidy (SUB) Compred With Community-Bsed Rpid Re-Housing (CBRR), SUB Compred With Project-Bsed Trnsi tionl Housing (PBTH), nd CBRR Compred With PBTH...105 9.1 Anlysis Smples for Pirwise Comprisons...105 9.2 The Permnent Housing Subsidy (SUB) Versus Community-Bsed Rpid Re-Housing (CBRR) Comprison...106 9.2.1 Progrm Use by Fmilies in the SUB-Versus-CBRR Comprison...106 9.2.2 Impcts of SUB Compred With CBRR...107 9.3 The Permnent Housing Subsidy (SUB) Versus Project-Bsed Trnsitionl Housing (PBTH) Comprison...113 9.3.1 Progrm Use by Fmilies in the SUB-Versus-PBTH Comprison...113 9.3.2 Impcts of SUB Compred With PBTH...114 9.4 The Community-Bsed Rpid Re-Housing (CBRR) Versus Project-Bsed Trnsitionl Housing (PBTH) Comprison...120 9.4.1 Progrm Use by Fmilies in the CBRR-Versus-PBTH Comprison...120 9.4.2 Impcts of CBRR Compred With PBTH...121 Chpter 10. Impcts of Pooled Comprisons...127 Chpter 11. Do Certin Interventions Work Better When Offered to Fmilies Who Fce Greter Difficulties?...128 11.1 Descriptive Results...128 11.2 Differentil Impcts Depending on Psychosocil Chllenges...129 11.2.1 SUB Versus UC...131 11.2.2 CBRR Versus UC...131 11.2.3 PBTH Versus UC...131 11.2.4 SUB Versus CBRR...131 11.2.5 SUB Versus PBTH...131 11.2.6 CBRR Versus PBTH...131 11.3 Differentil Impcts Depending on Housing Brriers...132 11.3.1 SUB Versus UC...132 11.3.2 CBRR Versus UC...132 11.3.3 PBTH Versus UC...132 11.3.4 SUB Versus CBRR...132 11.3.5 SUB Versus PBTH...132 11.3.6 CBRR Versus PBTH...132 11.4 Summry...132 Chpter 12. Intervention Costs...134 12.1 Introduction nd Summry...134 12.1.1 Cost Dt Collection nd Anlysis Methodology...136 12.1.2 Summry of Findings...138 12.2 Cost of Permnent Housing Subsidy (SUB)...142 12.3 Cost of Community-Bsed Rpid Re-Housing (CBRR)...144 12.4 Cost of Project-Bsed Trnsitionl Housing (PBTH)...145 12.5 Cost of Emergency Shelter...148 12.6 Comprison of Costs Across Progrm Types...150 12.7 Cost of All Progrm Use During the Followup Period by Fmilies in Ech Intervention Arm...151 12.8 Monthly Cost of All Progrm Use t the Followup Survey by Fmilies in Ech Intervention Arm...153 Chpter 13. Conclusions...156 13.1 Mening of Impct Comprisons...156 13.2 Usul Cre (UC)...157 13.3 Permnent Housing Subsidy (SUB)...158 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies vii
Tble of Contents 13.4 Community-Bsed Rpid Re-Housing (CBRR)...159 13.5 Project-Bsed Trnsitionl Housing (PBTH)...159 13.6 Fmily Chllenges...160 13.7 Implictions for Theory...160 13.8 Questions for Longer Term Followup...161 13.9 Summry...161 References...162 Additionl Reding...168 Appendix A. Dt Sources nd Dtset Construction... A-1 Appendix B. Construction of Outcomes...B-1 Appendix C. Anlysis Methods... C-1 Appendix D. Anlysis of 18-Month Survey Nonresponse... D-1 Appendix E. Impcts on Use of Trnsitionl Housing...E-1 Appendix F. Impct Estimtes for Pooled Comprisons...F-1 Appendix G. Intervention Costs Methodology, Sites, nd Progrms... G-1 List of Exhibits Exhibit ES-1. Exhibit ES-2. Exhibit ES-3. Exhibit ES-4. Exhibit ES-5. Exhibit ES-6. Six Pirwise Comprisons Among the Four Interventions... xvii Totl Number of Fmilies Assigned to Ech Intervention nd Number of Followup Survey Respondents... xviii Dt Sources Used in the Anlysis of Short-Term Impcts... xviii Progrm Use Since Rndom Assignment for All Pirwise Impct Comprisons... xxiii Summry of Impcts for Six Policy Comprisons... xxv Averge Progrm Cost per Sty During the Followup Period Across Progrm Types... xxviii Exhibit 2-1. Exhibit 2-2. Exhibit 2-3. Exhibit 2-4. Exhibit 2-5. Exhibit 2-6. Exhibit 2-7. Exhibit 2-8. Intended Contrsts in Subsidy nd Services for the Fmily Options Interventions nd Usul Cre Group...11 Fmily Options Study Sites...12 Number of Progrms, by Site nd Intervention...13 Loction of Study Sites...14 Housing Mrket Chrcteristics of Study Sites...14 Homeless Popultion in Study Sites...15 Rndom Assignment Design...17 Interventions Avilble nd Prticipnt Enrollment by Assignment nd Site...17 Exhibit ES-7. Exhibit 1-1. Exhibit 1-2. Exhibit 1-3. Exhibit 1-4. Exhibit 1-5. Cost of Progrm Use Since Rndom Assignment for Ech Intervention Contrst... xxix Six Pirwise Comprisons Among the Experimentl Interventions...5 Fmily Chrcteristics: Fmily Composition...6 Fmily Chrcteristics: Housing Stbility nd History of Homelessness...7 Fmily Chrcteristics: Income Stbility nd Disbility...8 Fmily Chrcteristics: Brriers to Incresing Income or Finding Housing...9 Exhibit 3-1. Exhibit 3-2. Exhibit 3-3. Exhibit 4-1. Exhibit 4-2. Exhibit 5-1. Conceptul Intervention Model for SUB nd CBRR...22 Conceptul Intervention Model for PBTH...28 Hypotheticl Exmple in Which the Impct on the Outcome of Residentil Stbility of Intervention A Reltive to Intervention B Is Lrger for Fmilies With High Housing Brriers...32 Dt Sources Used in the Report...34 Progrm Types nd Their Dt Sources in the Progrm Usge Dt...37 Types of Living Spce Provided by UC Shelters...42 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies viii
Tble of Contents Exhibit 5-2. Exhibit 5-3. Length of Time Spent in Emergency Shelters by UC Fmilies...43 UC Group Percent of Fmilies With t Lest 1-Night Sty in Emergency Shelter During Month, by Number of Months After RA...44 Exhibit 6-6. Exhibit 6-7. SUB Versus UC: Percent of Fmilies With t Lest 1 Night Sty in Emergency Shelter During Month, by Month After RA...70 SUB Versus UC: Impct on Length of Bseline Sty in Emergency Shelter...70 Exhibit 5-4. Fmily Rent Contributions nd Svings Requirements in UC Shelters...44 Exhibit 6-8. SUB Versus UC: Impcts on Fmily Preservtion...71 Exhibit 5-5. Exhibit 5-6. Exhibit 5-7. Types of Supportive Services Offered in UC Shelters nd How They Are Delivered, s Reported by Shelter Stff...45 Cse Mngement Intensity (rtio nd frequency)...46 Progrm Use Since Rndom Assignment for UC Group...47 Exhibit 6-9. Exhibit 6-10. Exhibit 6-11. SUB Versus UC: Impcts on Adult Well-Being...71 SUB Versus UC: Impcts on Child Well- Being Across Age Groups...72 SUB Versus UC: Impcts on Child Well- Being Developmentl Outcomes by Age Group...73 Exhibit 5-8. Fmily Options Study: Housing Stbility Outcomes...50 Exhibit 6-12. SUB Versus UC: Impcts on Self-Sufficiency...74 Exhibit 5-9. Fmily Options Study: Fmily Preservtion Outcomes...51 Exhibit 7-1. Methods Used To Clculte CBRR Subsidy Amounts...78 Exhibit 5-10. Exhibit 5-11. Fmily Options Study: Adult Well- Being Outcomes...53 Fmily Options Study: Child Well- Being Outcomes Mesured for Children Across Age Groups...55 Exhibit 7-2. Exhibit 7-3. Types of Supportive Services Offered in CBRR Progrms nd How They Are Delivered...79 CBRR Cse Mngement Intensity (rtio nd frequency)...79 Exhibit 5-12. Exhibit 5-13. Fmily Options Study: Child Well- Being Developmentl Outcomes for Children in Specific Age Groups...57 Fmily Options Study: Self-Sufficiency Outcomes...60 Exhibit 7-4. Exhibit 7-5. CBRR Versus UC: Progrm Use Since Rndom Assignment...81 Number of Months of CBRR Receipt During Followup Period by CBRR Fmilies Who Ever Used CBRR...82 Exhibit 6-1. Exhibit 6-2. Exhibit 6-3. Exhibit 6-4. Exhibit 6-5. Subsidy Type Provided by Site...61 SUB Versus UC: Progrm Use Since Rndom Assignment...64 Number of Months of Subsidy Receipt During Followup Period by SUB Fmilies Who Ever Used SUB...66 SUB Versus UC: Impcts on Housing Stbility...67 SUB Versus UC: Percent of Fmilies With t Lest 1 Night Sty in Emergency Shelter During Month, by Month After RA...68 Exhibit 7-6. Exhibit 7-7. Exhibit 7-8. Exhibit 7-9. Exhibit 7-10. CBRR Versus UC: Impcts on Housing Stbility...83 Housing Stbility Outcomes for the CBRR Rndom Assignment Group by Use of CBRR...84 CBRR Versus UC: Percent of Fmilies With t Lest 1 Night Sty in Emergency Shelter During Month, by Month After RA...85 CBRR Versus UC: Impct on Length of Bseline Sty in Emergency Shelter...85 CBRR Versus UC: Impcts on Fmily Preservtion...86 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies ix
Tble of Contents Exhibit 7-11. Exhibit 7-12. Exhibit 7-13. CBRR Versus UC: Impcts on Adult Well-Being...86 CBRR Versus UC: Impcts on Child Well-Being Across Age Groups...87 CBRR Versus UC: Impcts on Child Well-Being Developmentl Outcomes by Age Group...88 Exhibit 8-15. Exhibit 8-16. Exhibit 9-1. PBTH Versus UC: Impcts on Child Well-Being Developmentl Outcomes by Age Group...103 PBTH Versus UC: Impcts on Self- Sufficiency...104 Smple Sizes in the Six Pirwise Comprisons...106 Exhibit 7-14. CBRR Versus UC: Impcts on Self- Sufficiency...89 Exhibit 9-2. SUB Versus CBRR Progrm Use Since Rndom Assignment...107 Exhibit 8-1. Exhibit 8-2. Exhibit 8-3. PBTH Housing Settings...91 Fmily Rent Contributions nd Svings Requirements in PBTH...91 Types of Supportive Services Offered in PBTH Progrms nd How They Are Delivered...92 Exhibit 9-3. Exhibit 9-4. Exhibit 9-5. SUB Versus CBRR: Impcts on Housing Stbility...108 Impcts on Length of Bseline Sty in Emergency Shelter...108 SUB Versus CBRR: Impcts on Fmily Preservtion...109 Exhibit 8-4. PBTH Cse Mngement intensity (rtio nd frequency)...93 Exhibit 9-6. SUB Versus CBRR: Impcts on Adult Well-Being...109 Exhibit 8-5. Exhibit 8-6. Exhibit 8-7. Types of Progrm Rules in PBTH...94 PBTH Versus UC: Progrm Use Since Rndom Assignment...95 Number of Months of Trnsitionl Housing Receipt During Followup Period by PBTH Fmilies Who Ever Used TH...97 Exhibit 9-7. Exhibit 9-8. Exhibit 9-9. SUB Versus CBRR: Impcts on Child Well-Being Across Age Groups...110 SUB Versus CBRR: Impcts on Child Well-Being Developmentl Outcomes by Age Group...111 SUB Versus CBRR: Impcts on Self- Sufficiency...112 Exhibit 8-8. PBTH Versus UC: Impcts on Housing Stbility...98 Exhibit 9-10. SUB Versus PBTH Progrm Use Since Rndom Assignment...114 Exhibit 8-9. Exhibit 8-10. Exhibit 8-11. Exhibit 8-12. Exhibit 8-13. Exhibit 8-14. PBTH Versus UC: Percent of Fmilies With t Lest 1 Night Sty in Emergency Shelter During Month, by Month After RA...99 Housing Stbility Outcomes for the PBTH Rndom Assignment Group by Use of TH...100 PBTH Versus UC: Impct on Length of Bseline Sty in Emergency Shelter...100 PBTH Versus UC: Impcts on Fmily Preservtion...101 PBTH Versus UC: Impcts on Adult Well-Being...101 PBTH Versus UC: Impcts on Child Well-Being Across Age Groups...102 Exhibit 9-11. Exhibit 9-12. Exhibit 9-13. Exhibit 9-14. Exhibit 9-15. Exhibit 9-16. Exhibit 9-17. SUB Versus PBTH: Impcts on Housing Stbility...115 SUB Versus PBTH: Impcts on Fmily Preservtion...116 SUB Versus PBTH: Impcts on Adult Well-Being...116 SUB Versus PBTH: Impcts on Child Well-Being Across Age Groups...117 SUB Versus PBTH: Impcts on Child Well-Being Developmentl Outcomes by Age Group...118 SUB Versus PBTH: Impcts on Self- Sufficiency...119 CBRR Versus PBTH Progrm Use Since Rndom Assignment...121 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies x
Tble of Contents Exhibit 9-18. Exhibit 9-19. Exhibit 9-20. Exhibit 9-21. Exhibit 9-22. Exhibit 9-23. Exhibit 10-1. Exhibit 11-1. Exhibit 11-2. Exhibit 11-3. Exhibit 11-4. Exhibit 12-1. Exhibit 12-2. Exhibit 12-3. Exhibit 12-4. Exhibit 12-5. Exhibit 12-6. CBRR Versus PBTH: Impcts on Housing Stbility...122 CBRR Versus PBTH: Impcts on Fmily Preservtion...123 CBRR Versus PBTH: Impcts on Adult Well-Being...123 CBRR Versus PBTH: Impcts on Child Well-Being Across Age Groups...124 CBRR Versus PBTH: Impcts on Child Well-Being Developmentl Outcomes by Age Group...125 CBRR Versus PBTH: Impcts on Self- Sufficiency...126 Smple Sizes in the Four Pooled Comprisons...127 Percentges of Adult Respondents Reporting Psychosocil Chllenges t the Time of Study Enrollment (for fmilies interviewed t 18 months)...129 Percentge of Fmilies Reporting Tht Condition Ws Big or Smll Problem in Finding Plce to Live t the Time of Study Enrollment (for fmilies inter - viewed t 18 months)...129 Impcts Moderted by Psychosocil Chllenges Index...130 Impcts Moderted by Housing Brriers Index...133 Progrms Included in the Cost Anlysis...137 Averge Per-Fmily Monthly Cost of Supportive Services nd Housing or Shelter Across Progrm Types...138 Summry Sttistics of Per-Fmily Monthly Progrm Cost by Progrm Type...139 Averge Progrm Cost Per Sty During the Followup Period Across Progrm Types...140 Summry of Cost of Progrm Use Since Rndom Assignment...141 Summry of Monthly Cost of Progrm Use t the Time of the Followup Survey...141 Exhibit 12-7. Exhibit 12-8. Exhibit 12-9. SUB Progrm Cost Summry Sttistics for Fmilies Who Were Assigned To nd Took Up SUB Progrms...142 Per-Fmily Monthly Progrm Costs for SUB Progrms...143 SUB Per-Fmily Monthly Progrm Costs nd Fir Mrket Rents...143 Exhibit 12-10. Progrm-Level Cost Summry Sttistics for 12 CBRR Progrms...144 Exhibit 12-11. Per-Fmily Monthly Progrm Costs for CBRR Progrms...144 Exhibit 12-12. Progrm-Level Cost Summry Sttistics for 24 PBTH Progrms...145 Exhibit 12-13. Per-Fmily Monthly Progrm Costs for PBTH Progrms...146 Exhibit 12-14. Administrtive (pnel A) nd Prtner/In Kind (pnel B) Shre of Progrm Costs...147 Exhibit 12-15. Emergency Shelter Cost Summry Sttistics...148 Exhibit 12-16. Per-Fmily Monthly Progrm Costs for Emergency Shelter Progrms...149 Exhibit 12-17. Totl Monthly Costs nd Prtner/In-Kind Shre of Progrm Costs...150 Exhibit 12-18. Comprison of Cost Summry Sttistics Across Progrm Types...151 Exhibit 12-19. Cost of Progrm Use Since Rndom Assignment for Ech Intervention Contrst...152 Exhibit 12-20. Averge Per-Fmily Monthly Costs for Progrm Use t Time of the Followup Survey, by Comprison...154 Exhibit A-1. Exhibit A-2. Exhibit A-3. Exhibit A-4. Smple Enrollment Period nd Number of Fmilies Enrolled by Intervention nd Site... A-1 Length of Time From Rndom Assignment to the 18-Month Followup Survey... A-2 Content of Prticipnt Dt Collected for Fmily Options Study 18-Month Impct Anlysis... A-4 Focl Child Smple Distribution by Site nd Intervention Group... A-7 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xi
Tble of Contents Exhibit A-5. Exhibit A-6. Exhibit A-7. Exhibit A-8. Exhibit A-9. Exhibit A-10. Exhibit B-1. Overll Fmily Options Study Survey Response Rtes... A-11 Survey Response Sttus for Fmily Options Study Surveys... A-12 HMIS Prticiption Rtes for Emergency Shelter nd Trnsitionl Housing Providers in the Study Sites, 2011... A-13 HMIS Mtch Rtes With the Fmily Options Smple, by Site... A-14 Smple Fmilies in PIC/TRACS Dt nd Those Assigned to the SUB Intervention in PIC/TRACS Dt, by Site... A-15 Dt Source Relibility, by Progrm Use Dt Item... A-16 Children s Completion Rtes for WJ III Letter-Word Identifiction nd Applied Problems Tests...B-13 Exhibit C-1. Confirmtory Hypothesis Tests... C-8 Exhibit D-1. Exhibit D-2. Exhibit D-3. Exhibit D-4. Exhibit D-5. Exhibit D-6. Exhibit D-7. Exhibit D-8. Exhibit D-9. Survey Nonresponse Incidence by Impct Comprison Adult Followup Survey... D-3 Chrcteristics Exmined in Bseline Equivlency Testing... D-4 Summry of Equivlence Testing in Impct Comprisons, Adult Survey... D-4 Equivlence t Bseline of Anlysis Smple for SUB Versus UC Impct Comprison, Adult Survey... D-5 Equivlence t Bseline of Anlysis Smple for CBRR Versus UC Impct Comprison, Adult Survey... D-6 Equivlence t Bseline of Anlysis Smple for PBTH Versus UC Impct Comprison, Adult Survey... D-7 Equivlence t Bseline of Anlysis Smple for SUB Versus CBRR Impct Comprison, Adult Survey... D-8 Equivlence t Bseline of Anlysis Smple for SUB Versus PBTH Impct Comprison, Adult Survey... D-9 Equivlence t Bseline of Anlysis Smple for CBRR Versus PBTH Impct Comprison, Adult Survey... D-10 Exhibit D-10. Equivlence t Bseline of Anlysis Smple for SUB + CBRR + PBTH Versus UC Impct Comprison, Adult Survey... D-11 Exhibit D-11. Equivlence t Bseline of Anlysis Smple for SUB + PBTH Versus CBRR Impct Comprison, Adult Survey... D-12 Exhibit D-12. Equivlence t Bseline of Anlysis Smple for SUB + CBRR Versus PBTH Impct Comprison, Adult Survey... D-13 Exhibit D-13. Equivlence t Bseline of Anlysis Smple for CBRR + PBTH Versus SUB Impct Comprison, Adult Survey... D-14 Exhibit D-14. Summry of Equivlence Testing of Respondents Versus Nonrespondents, by Assigned Intervention... D-15 Exhibit D-15. Summry of Equivlence Testing of Respondents Versus Nonrespondents, by Impct Comprison... D-16 Exhibit D-16. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents ssigned to SUB... D-17 Exhibit D-17. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for CBRR... D-18 Exhibit D-18. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for PBTH... D-19 Exhibit D-19. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for UC... D-20 Exhibit D-20. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB Versus UC Impct Comprison, Adult Survey... D-21 Exhibit D-21. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for CBRR Versus UC Impct Comprison, Adult Survey... D-22 Exhibit D-22. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for PBTH Versus UC Impct Comprison, Adult Survey... D-23 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xii
Tble of Contents Exhibit D-23. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB Versus CBRR Impct Comprison, Adult Survey... D-24 Exhibit D-24. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB Versus PBTH Impct Comprison, Adult Survey... D-25 Exhibit D-25. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for CBRR Versus PBTH Impct Comprison, Adult Survey... D-26 Exhibit D-26. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB + CBRR + PBTH Versus UC Impct Comprison, Adult Survey... D-27 Exhibit D-27. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB + PBTH Versus CBRR Impct Comprison, Adult Survey... D-28 Exhibit D-28. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for SUB + CBRR Versus PBTH Impct Comprison, Adult Survey... D-29 Exhibit D-29. Equivlence t Bseline of Anlysis Smple for Respondents Versus Nonrespondents for PBTH + CBRR Versus SUB Impct Comprison, Adult Survey... D-30 Exhibit D-30. Executive Summry Impct Estimtes, Estimted Without Nonresponse Weights... D-32 Exhibit E-1. Exhibit E-2. Exhibit E-3. Exhibit E-4. Exhibit E-5. SUB Versus UC: Impcts on Use of ES nd TH...E-2 CBRR Versus UC: Impcts on Use of ES nd TH...E-2 PBTH Versus UC: Impcts on Use of ES nd TH...E-3 SUB Versus CBRR: Impcts on Use of ES nd TH...E-3 SUB Versus PBTH: Impcts on Use of ES nd TH...E-4 Exhibit E-6. Exhibit F-1. Exhibit F-2. Exhibit F-3. Exhibit F-4. Exhibit F-5. Exhibit F-6. Exhibit F-7. Exhibit F-8. Exhibit F-9. Exhibit F-10. Exhibit F-11. Exhibit F-12. Exhibit F-13. Exhibit F-14. Exhibit F-15. Exhibit F-16. CBRR Versus PBTH: Impcts on Use of ES nd TH...E-4 SUB + CBRR + PBTH Versus UC: Impcts on Housing Stbility...F-2 SUB + CBRR + PBTH Versus UC: Impcts on Fmily Preservtion...F-3 SUB + CBRR + PBTH Versus UC: Impcts on Adult Well-Being...F-3 SUB + CBRR + PBTH Versus UC: Impcts on Child Well-Being Across Age Groups...F-4 SUB + CBRR + PBTH Versus UC: Impcts on Child Well-Being Developmentl Outcomes by Age Group...F-5 SUB + CBRR + PBTH Versus UC: Impcts on Self-Sufficiency...F-6 SUB + CBRR Versus PBTH: Impcts on Housing Stbility...F-7 SUB + CBRR Versus PBTH: Impcts on Fmily Preservtion...F-8 SUB + CBRR Versus PBTH: Impcts on Adult Well-Being...F-8 SUB + CBRR Versus PBTH: Impcts on Child Well-Being Across Age Groups...F-9 SUB + CBRR Versus PBTH: Impcts on Child Well-Being Developmentl Outcomes by Age Group...F-10 SUB + CBRR Versus PBTH: Impcts on Self- Sufficiency...F-11 SUB + PBTH Versus CBRR: Impcts on Housing Stbility...F-12 SUB + PBTH Versus CBRR: Impcts on Fmily Preservtion...F-13 SUB + PBTH Versus CBRR: Impcts on Adult Well-Being...F-13 SUB + PBTH Versus CBRR: Impcts on Child Well-Being Across Age Groups...F-14 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xiii
Tble of Contents Exhibit F-17. SUB + PBTH Versus CBRR: Impcts on Child Well-Being Developmentl Outcomes by Age Group...F-15 Exhibit F-23. CBRR + PBTH Versus SUB: Impcts on Child Well-Being Developmentl Outcomes by Age Group...F-20 Exhibit F-18. SUB + PBTH Versus CBRR: Impcts on Self- Sufficiency...F-16 Exhibit F-24. CBRR + PBTH Versus SUB: Impcts on Self-Sufficiency...F-21 Exhibit F-19. Exhibit F-20. Exhibit F-21. Exhibit F-22. CBRR + PBTH Versus SUB: Impcts on Housing Stbility...F-17 CBRR + PBTH Versus SUB: Impcts on Fmily Preservtion...F-18 CBRR + PBTH Versus SUB: Impcts on Adult Well-Being...F-18 CBRR + PBTH Versus SUB: Impcts on Child Well-Being Across Age Groups...F-19 Exhibit G-1. Exhibit G-2. Exhibit G-3. Number of Progrms From Which Cost Dt Ws Collected nd Presence of SUB Intervention by Study Site... G-2 Cost Dt Collection Ctegories nd Associted Item Prompts... G-3 Determining Inclusion of Externl Services... G-4 Exhibit G-4. Vluing In-Kind Services... G-5 Exhibit G-5. Progrm Level Averge Per Fmily Cost Clcultions... G-7 Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xiv
LIST OF ACRONYMS AND ABBREVIATIONS AHAR AMI ARRA ASQ-3 CBRR CDC CoC Annul Homeless Assessment Report Are Medin Income Americn Recovery nd Reinvestment Act Ages nd Stges Questionnire community-bsed rpid re-housing intervention Centers for Disese Control nd Prevention Continuum of Cre DAST-10 Drug Abuse Screening Test FDS FWER GED HCV HMIS HOME HPRP HTKS ITT NCS-R Finncil Dt Schedule fmilywise error rte generl eductionl development housing choice voucher Homeless Mngement Informtion System Home Observtion for Mesurement of the Environment (inventory) Homelessness Prevention nd Rpid Re-Housing Progrm Hed Toes Knees Shoulders (tsk) intention to tret Ntionl Comorbidity Survey Repliction NSHAPC Ntionl Survey of Homeless Assistnce Providers nd Clients PBTH project-bsed trnsitionl housing intervention PDS PHA PIC PSH PTSD RAPS4 SCHIP SDQ SHIFT SHP SNAP SSDI SSI STAIC SUB TANF TRACS UC WIC WJ III Posttrumtic Stress Dignostic Scle public housing gency Public nd Indin Housing Informtion Center permnent supportive housing post-trumtic stress disorder Rpid Alcohol Problems Screen Stte Children s Helth Insurnce Progrm Strengths nd Difficulties Questionnire Service nd Housing Interventions for Fmilies in Trnsition Supportive Housing Progrm Supplementl Nutrition Assistnce Progrm Socil Security Disbility Insurnce Supplementl Security Income Stte-Trit Anxiety Inventory for Children permnent housing subsidy intervention Temporry Assistnce for Needy Fmilies Tennt Rentl Assistnce Certifiction System usul cre Specil Supplementl Nutrition Progrm for Women, Infnts, nd Children Woodcock-Johnson III Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xv
EXECUTIVE SUMMARY The U.S. Deprtment of Housing nd Urbn Develop - ment (HUD) undertook the Fmily Options Study to gther evidence bout which types of housing nd services interventions work best for homeless fmilies. The study compres the effects of three ctive interventions permnent housing subsidy (SUB), community-bsed rpid re-housing (CBRR), nd project-bsed trnsitionl housing (PBTH) to one nother nd to the usul cre (UC) vilble to homeless fmilies. SUB, CBRR, nd PBTH re distinguished from one nother by the durtion of housing ssistnce provided nd the type nd intensity of socil services offered. UC consists of emergency shelter nd housing or services tht fmilies ccess without immedite referrl to one of the three ctive interventions. From September 2010 through Jnury 2012, 2,282 fmilies enrolled in the Fmily Options Study cross 12 communities 1 fter spending t lest 7 dys in emergency shelter. After providing informed consent nd completing bseline survey, the fmilies were rndomly ssigned to one of the three ctive interventions or to UC. Rndom ssignment yielded groups of fmilies with no systemtic differences in bseline chrcteristics. Fmilies were free to tke up their ssigned interventions or to mke other rrngements, so fmilies used mix of progrms, often including progrms other thn the type to which they were ssigned. Nonetheless, ptterns of progrm use mong the groups of fmilies contrsted sub - stntilly, nd the study provides strong bsis for conclusions bout the reltive impcts of the interventions on severl spects of fmily well-being. The Fmily Options Study will follow the full set of 2,282 study fmilies for 36 months. The study tem conducted short trcking surveys with the fmilies 6, 12, nd 27 months fter rndom ssignment. The study tem lso conducted more extensive followup survey pproximtely 20 months fter rndom ssignment to collect detiled informtion bout fmily outcomes. Another followup survey will be conducted pproximtely 36 months fter rndom ssignment. The first of the extensive followup surveys chieved response rte of 81 percent, with 1,857 fmilies responding to the survey. 2 This report presents the short-term impcts of the interventions in five domins relted to fmily well-being: (1) housing stbility, (2) fmily preservtion, (3) dult well-being, (4) child well-being, nd (5) self-sufficiency. The report lso describes the reltive costs of the interventions bsed on progrm use during the first followup period. A subsequent report in 2016 will present impcts on study fmilies 36 months fter rndom ssignment long with intervention costs over the longer period. Study Interventions The study exmines four interventions: 1. Permnent housing subsidy, or SUB, usully housing choice voucher (HCV), could include ssistnce to find housing but no other supportive services. 2. Community-bsed rpid re-housing, or CBRR, provides temporry rentl ssistnce, potentilly renewble for up to 18 months, pired with limited, housing-focused services to help fmilies find nd rent conventionl, privte-mrket housing. 3. Project-bsed trnsitionl housing, or PBTH, provides temporry housing for up to 24 months in gency-controlled buildings or prtment units, pired with intensive supportive services. 4. Usul cre, or UC, is defined s ny housing or services tht fmily ccesses in the bsence of immedite referrl to the other interventions. This intervention typiclly includes t lest some dditionl sty in the emergency shelter from which fmilies were enrolled. The study tem nlyzed ll six possible contrsts mong these four interventions, s shown in Exhibit ES-1. The 1 The 12 communities prticipting in the study re Almed County, Cliforni; Atlnt, Georgi; Bltimore, Mrylnd; Boston, Msschusetts; Bridgeport nd New Hven, Connecticut; Denver, Colordo; Honolulu, Hwii; Knss City, Missouri; Louisville, Kentucky; Minnepolis, Minnesot; Phoenix, Arizon; nd Slt Lke City, Uth. 2 This report nlyzes short-term impcts of the interventions. The study tem ttempted to contct fmilies for the study s first followup survey beginning in the 18th month fter rndom ssignment. The medin time from rndom ssignment to the followup survey ws 20 months. Anlysis of progrm use nd cost of totl progrm use used dt over medin of 21 clendr months. Dt collection for the second followup survey ws completed in erly 2015 nd chieved 79-percent response rte. Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xvi
Executive Summry Exhibit ES-1. Six Pirwise Comprisons Among the Four Interventions order of the presenttion of findings for the vrious pirwise comprisons is reflected in the lphbetic ordering of the rrows (for exmple, discussion begins with Contrst A between SUB nd UC). Rndom Assignment Design To be eligible for the study, fmilies hd to include t lest one child ge 15 or younger nd hd to hve resided in emer - gency shelter for 7 or more dys. The study tem excluded fmilies who left shelter in fewer thn 7 dys becuse the interventions exmined my not be necessry for fmilies who cn resolve housing crisis quickly. As soon s ws fesible fter the 7-dy mrk, the evlution tem rndomly ssigned fmilies to SUB, CBRR, PBTH, or UC. Implementing the rndom ssignment design presented severl chllenges. In the originl design, ech fmily ws to hve hd chnce of being ssigned to ll four groups (SUB, CBRR, PBTH, or UC). A number of fctors prevented the study from being implemented exctly s plnned. First, 3 of the 12 sites were ble to provide only two of the three ctive interventions. Second, the rndom ssignment groups vilble to fmilies were confined to groups for which provider hd n vilble slot t the time of rndomiztion. Third, some service providers hd unique eligibility require - ments for fmilies. Before rndom ssignment, the study tem screened fmilies ginst the eligibility criteri of providers tht hd vilble slots. The purpose of this screening ws to minimize the likelihood of ssigning fmilies to interventions they would not be eligible to receive. As result, for n intervention option to be vilble to fmily undergoing rndom ssignment, t lest one slot needed to be vilble t n intervention provider for which the fmily ppered to meet provider-specific eligibility requirements bsed on preliminry screening. These fctors cumultively resulted in most study fmilies not hving ll four options vilble to them t rndom ssignment. Of the 2,282 fmilies enrolled in the study, 474 hd ll four rndomiztion options vilble, 1,544 fmilies hd three rndomiztion options, nd 264 fmilies hd two rn - domiztion options. All nlyses were conducted pirwise, contrsting n ctive intervention to nother ctive intervention or to UC. Only fmilies who were eligible for both interventions in pirwise comprison (for exmple, SUB Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xvii
Executive Summry nd CBRR) nd rndomized to one of them were included in ech comprison. Hence, ech comprison cn be thought of s two-wy experiment between two well-mtched groups tht differ only in the intervention to which they were ssigned. Exhibit ES-2 shows the totl number of fmilies ssigned to ech intervention. The exhibit lso shows the number of fmilies who responded to the followup survey conducted pproximtely 20 months fter rndom ssignment; this set of fmilies is included in the impct nlyses in this report. Dt Sources The impct findings reported here bout the 1,857 fmilies re bsed on dt from severl sources described in Exhibit ES-3. Exhibit ES-2. Totl Number of Fmilies Assigned to Ech Intervention nd Number of Followup Survey Respondents Intervention Fmilies Assigned Fmilies Responding to the Followup Survey Response Rte (%) Permnent housing subsidy (SUB) 599 530 88.5 Community-bsed rpid re-housing (CBRR) 569 455 80.0 Project-bsed trnsitionl housing (PBTH) 368 294 79.9 Usul cre (UC) 746 578 77.5 Totl 2,282 1,857 81.4 Sources: Rndom ssignment records; Fmily Options Study 18-month followup survey Exhibit ES-3. Dt Sources Used in the Anlysis of Short-Term Impcts Study implementtion records Rndom ssignment enrollment dt Study fmilies Bseline survey Trcking surveys 18-month followup survey Child ssessments Child survey Study intervention providers Enrollment verifiction dt Progrm informtion Cost informtion Administrtive dt systems HMIS records HUD s PIC records HUD s TRACS records Rndom ssignment enrollment dt contin identifiers for enrolled fmilies, responses to eligibility screening questions, informtion bout intervention vilbility t the time of rndom ssignment, nd rndom ssignment result. The bseline survey conducted immeditely before rndom ssignment provides informtion bout the dult respondent nd the fmily. Trcking surveys conducted 6 nd 12 months fter rndom ssignment contin updted contct informtion nd detils bout fmily composition nd housing sttus. The 18-month followup survey conducted with dult respondents t medin durtion of 20 months mesures fmily outcomes. Adults reported on themselves nd up to two children, clled focl children, who were prt of the fmily t the time of study enrollment. Focl children were rndomly selected within specified ge groups. Child ssessments, which were conducted with focl children ges 3 yers, 6 months to 7 yers, 11 months in conjunction with the dult followup survey, mesure child well-being outcomes. The child survey conducted with focl children ges 8 to 17 yers in conjunction with the dult followup survey mesures child well-being outcomes. Enrollment verifiction dt collected from study providers mesure use of the ssigned intervention for ech fmily. Progrm informtion bout the housing nd services offered during the study period collected from intervention providers describes the interventions. Cost informtion collected from intervention providers mesures costs of overhed, rentl ssistnce, fcility opertions, supportive services, nd cpitl costs. Homeless Mngement Informtion System (HMIS) records provide indictors of study fmilies prticiption in homeless ssistnce progrms. HUD s Public nd Indin Housing Informtion Center (PIC) records mesure receipt of housing ssistnce from the Housing Choice Voucher progrm, public housing progrms, nd project-bsed voucher progrms. HUD s Tennt Rentl Assistnce Certifiction System (TRACS) records mesure receipt of housing ssistnce through project-bsed Section 8 progrms. Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xviii
Executive Summry Previous Findings From the Fmily Options Study A previous study report (Gubits et l., 2013) provides infor - mtion bout the bseline chrcteristics of the study smple nd insights regrding the homeless ssistnce system in the study communities. Bseline Chrcteristics of the Study Smple The bseline survey collected informtion bout ll 2,282 fmilies enrolled in the Fmily Options Study. 3 Fmily Composition The typicl fmily in the study consisted of n dult womn, 29 yers old, living with one or two of her children in n emergency shelter. At bseline, 30 percent of fmilies hd more thn one dult present. Nerly ll fmilies with two dults present were heded by couples. A plurlity of fmilies (43 percent) hd only one child younger thn ge 18 with them in the shelter, nother 30 percent hd two children present, nd 27 percent hd three or more child - ren present. One-hlf of the fmilies hd child younger thn ge 3 in the shelter, nd 10 percent of dult respondents reported tht they were pregnnt. Housing Stbility nd History of Homelessness Most fmilies in the study (79 percent) were not homeless immeditely before entering the shelter from which they were recruited into the study. About 63 percent of fmily heds in the study hd experienced homelessness t some other point in their lifetime, with 16 percent of dult respond - ents hving experienced homelessness s child. An even greter proportion (85 percent) indicted tht they lived doubled up t some point s n dult, defined in the survey s stying with fmily or friends becuse you couldn t find or fford plce of your own. Employment nd Other Sources of Income The employment, income, nd progrm prticiption of fmilies t bseline provide insight into the severity of income brriers tht fmilies fce in emergency shelters. Most fmily heds were not working t the time of rndom ssignment (83 percent), nd more thn one-hlf hd not worked for py in the previous 6 months. The medin nnul household income of ll fmilies in the study t bseline ws $7,410. Most fmilies in the study received some form of public ssistnce t the time of rndom ssignment. Most (88 percent) received ssistnce from the Supplementl Nutrition Assistnce Progrm, or SNAP, nd 41 percent received ssistnce from Temporry Assistnce for Needy Fmilies, or TANF. Most fmilies in the study (86 percent) reported receiving some combintion of Medicid benefits, stte helth insurnce benefits, nd the Stte Children s Helth Insurnce Progrm, or SCHIP. Other Brriers to Finding Housing or Incresing Income The bseline survey sked fmilies explicitly bout fctors tht would ffect their bility to find plce to live. Mny reported tht they either hd poor rentl history (26 percent hd been evicted) or hd never been leseholder (35 percent). In 11 percent of fmilies, the fmily hed hd previous felony conviction. Approximtely 22 percent of dult respondents gve survey responses tht indicted symptoms of post-trumtic stress disorder, or PTSD; 22 percent reported symptoms of serious psychologicl distress; nd 30 percent reported evidence of one or the other. A history of drug use in the yer before rndom ssignment ws indicted by the survey responses of 14 percent of the dult respondents; survey responses lso suggested lcohol buse within the pst yer for 11 percent of respondents. Intervention Eligibility Screening nd Fmily Decisions Gubits et l. (2013) lso exmined intervention vilbility nd fmily eligibility t rndomiztion for the 2,282 fmilies in the Fmily Options Study. Both vilbility of interventions nd fmily eligibility, ccording to screening before rndom ssignment, were most constrined for PBTH. CBRR ws more vilble thn SUB but hd slightly more restrictive eligibility requirements. All fmilies were eligible for UC by definition. For fmily to use the progrm to which it hd been ssigned, it hd to (1) pss n eligibility determintion conducted by the progrm to which it ws ssigned nd (2) choose to tke up the progrm. Gubits et l. (2013) found tht some of the fmilies who pssed the initil screening by the study were lter deemed ineligible by the progrms to which they were ssigned. Other fully eligible fmilies chose not to tke up the ssigned progrm. Compred with CBRR nd SUB, PBTH hd both the highest proportion of fmilies found ineligible 3 Gubits et l. (2013) compre the chrcteristics of Fmily Options Study fmilies with ntionl estimtes for homeless fmilies from HUD s 2010 Annul Homeless Assessment Report nd the 1996 Ntionl Survey of Homeless Assistnce Providers nd Clients. Short-Term Impcts of Housing nd Services Interventions for Homeless Fmilies xix