Families? Impacts and Cost Estimates from the Family Options Study - PowerPoint PPT Presentation

What Interventions Work Best for Homeless Families? Impacts and Cost Estimates from the Family Options Study Jill Khadduri Principal Associate and Senior Fellow Abt Associates Wisconsin Family Impact Seminar Madison, WI January 25, 2017

Family homelessness in U.S.  150,000 homeless families each year  Many families in shelter have young children  Federal goal: end family homelessness by 2020 Abt Associates | pg 2

T oday’s presentation  High points of Family Options study  Lessons learned  For more info, HUDUser: Family Options (U.S. Department of Housing and Urban Development) Abt Associates | pg 3

Comparing Housing and Service Interventions for Families Family Options Study: Comparing Housing and Service Interventions for Families Long-term housing subsidies (SUB) : Typically Housing Choice Vouchers that hold rent to 30% of income Rapid re-housing (CBRR) : Temporary rental subsidies with some housing-related services Project-based transitional housing (PBTH) : Supervised housing with intensive services and case management Usual care (UC): Shelter and whatever mix of services families can access Abt Associates | pg 4

12 communities participated  2,282 families  148 programs 5,397 children Abt Associates | pg 5

Study families  Typical family: 29 year old woman with 1-2 children  $7,400 median annual household income  30% with psychological distress or PTSD symptoms  63% had a prior episode of homelessness  24% separated from a child at baseline  Spouses/partners: – 27% had spouse or partner in shelter – 10% had spouse or partner NOT in shelter, sometimes because of shelter rules Abt Associates | pg 6

Study design Families in shelter who consent to participate in study Screening Random Assignment SUB CBRR PBTH UC PRIORITY ACCESS Abt Associates | pg 7

Study timeline and sample Enrollment 20-month 37-month Survey Survey Mar. 2014 – Sept. 2010 – July 2012 – Jan. 2012 Oct. 2013 Dec. 2014 1,857 1,784 2,282 families families families (81%) (78%) Abt Associates | pg 8

Which interventions were most attractive to participants? 100 90 % used program type 80 70 60 50 88 40 30 59 53 20 38 35 23 10 0 Any Permanent Rapid Transitional Subsidy Re-housing Housing SUB vs. UC CBRR vs. UC PBTH vs. UC Abt Associates | pg 9

100% No known program use Using Program Type 90% Percent of Families 80% 70% in Month Any Permanent housing subsidy Long- 60% 50% Term 40% Rapid rehousing 30% Subsidy Transitional housing 20% Emergency shelter 10% (SUB) 0% 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 100% Using Program Type in 90% Percent of Families 80% No known program use Usual 70% Month 60% Care 50% 40% Any Permanent housing subsidy (UC) 30% Rapid rehousing 20% Transitional housing 10% Emergency shelter 0% 0 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 Month after Random Assignment Abt Associates | pg 10

Outcomes in five domains 1 Housing stability 2 Family preservation 3 Adult well-being 4 Child well-being 5 Self-sufficiency Abt Associates | pg 11

Did access to a long-term housing subsidy (SUB) lead to less housing instability? 30 30 25 25 % of families % of families - 17*** 20 20 15 15 - 9*** 28 28 - 14*** SUB SUB 10 10 19 19 18 18 11 UC UC 5 5 9 0 0 0 5 0 0 Homeless in Homeless in Shelter stay in Shelter stay in Doubled up in Doubled up in last 6 months last 6 months months months last 6 months last 6 months 21 to 32 21 to 32 *p<.10 **p<.05 ***p<.01 Abt Associates | pg 12

Did access to rapid re-housing (CBRR) lead to less housing instability? 35 30 3 % of families 25 20 0 -2 15 30 28 CBRR 10 19 17 17 16 UC 5 0 Homeless in Shelter stay in Doubled up in last 6 months months last 6 months 21 to 32 *p<.10 **p<.05 ***p<.01 Abt Associates | pg 13

Did access to transitional housing (PBTH) lead to less housing instability? 35 - 2 30 % of families 25 0 20 32 15 29 PBTH - 6** 10 19 18 15 UC 5 9 0 Homeless in Shelter stay in Doubled up in last 6 months months last 6 months 21 to 32 *p<.10 **p<.05 ***p<.01 Abt Associates | pg 14

Summary of housing stability impacts  39% of usual care (UC) families had either been in shelter or reported being homeless or doubled up recently (down from half at 20 months)  Long-term subsidies (SUB) reduced homelessness by half and shelter stays and doubling up by more than half  Transitional housing (PBTH) had modest effects on shelter use  Rapid re-housing (CBRR) had no effects  Similar results at 20 months Abt Associates | pg 15

What effect did access to programs have on whether families stay together?  New or ongoing separations in past 6 months in usual care (UC) families: – 17% from child – 38% from partner with family in shelter (reduced sample)  At 20 months, long-term subsidies (SUB) reduced child separations by two fifths  At 37 months long-term subsidies (SUB) increased partner separations by two fifths  Rapid re-housing (CBRR) and transitional housing (PBTH) had no impacts on family preservation Abt Associates | pg 16

What effect did access to programs have on the well-being of adults? • One in nine usual care (UC) adults reported alcohol dependence or drug abuse. One in ten reported intimate partner violence in the past 6 months. A third reported fair or poor health.  Long-term subsidies (SUB) reduced intimate partner violence by a third and reduced psychological distress at both time points  At 20 months, long-term subsidies (SUB) additionally reduced substance dependence by almost a third  Rapid re-housing (CBRR) and transitional housing (PBTH) had no impacts on these measures  No intervention affected physical health Abt Associates | pg 17

What effect did access to programs have on the well-being of children?  Usual care (UC) children attended 2.1 schools in three years, were absent 1.1 days per month, and had elevated behavior problems  Long-term subsidies (SUB) reduced school mobility (full period), absences (20 months) and behavior problems (37 months)  Rapid re-housing (CBRR) reduced school absences at (20 months) and behavior problems (37 months)  Transitional housing (PBTH) had no impacts on these outcomes  No intervention affected child health Abt Associates | pg 18

What effect did access to programs have on self-sufficiency?  37% of usual care (UC) families worked for pay in the week before the follow-up survey, almost half were food insecure, and median income was $12,099 (all improvements from 20 months)  Long-term subsidies (SUB) reduced work effort by 6 percentage points at 20 months and between the survey waves  Long-term subsidies (SUB) increased food security by 10 percentage points (both times)  Rapid re-housing (CBRR) increased food security and incomes (20 months)  Transitional housing (PBTH) had no effect Abt Associates | pg 19

Summary of 20- & 37-Month Impact Results SUB vs. UC CBRR vs. UC PBTH vs. UC Outcomes 20 mos. 37 mos. 20 mos. 37 mos. 20 mos. 37 mos. + + + + + + + + + Housing stability  + Family preservation + + + + + Adult well-being + + + + + + Child well-being ‒ + + + + Self-sufficiency + : beneficial effect ‒ : detrimental effect  : ambiguous effect Abt Associates | pg 20

Per family monthly program costs $5,000 Average monthly cost per family $4,000 $3,000 $4,819 $2,000 $2,706 $1,000 $1,162 $880 $- Permanent Rapid Transitional Emergency subsidy re-housing housing shelter Abt Associates | pg 21

Lessons about usual care (UC)--no special offer  Families spent on average 3 months in emergency shelter following random assignment  They participated in homeless and housing assistance programs at fairly high rates with total cost of about $41,000  Many were still not faring well 37 months after study enrollment Abt Associates | pg 22

Lessons about project-based transitional housing (PBTH)  Screened out many families; relatively low take-up  Reduced stays in shelter compared to usual care (UC) during period when some families remained in transitional housing (PBTH), but few benefits in other domains  No benefits for psychosocial outcomes or self-sufficiency at either time  Total costs were slightly higher than for usual care (UC) Abt Associates | pg 23

Lessons about rapid re-housing (CBRR)  Relatively low take up  No improvements in preventing subsequent homelessness or improving housing stability  Scattered effects: income and food security (20 months only), school absences (20 months), child behavior problems (37 months)  Lowest cost of the programs studied Abt Associates | pg 24

Lessons about long-term subsidies (SUB): not-so-surprising lessons  Notable improvements in housing stability compared to rapid re-housing (CBRR), transitional housing (PBTH), and usual care (UC)  Reduced labor market engagement, but without an impact on overall cash income Abt Associates | pg 25

Lessons about long-term subsidies (SUB): surprising lessons • Few families Homelessness ineligible • High take-up, Child Child Problems Separations maintenance SUB reduces • Radiating impacts Domestic Violence, Food Insecurity Substance Use, Distress Abt Associates | pg 26