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Summary of the Permanent Housing Subsidy

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Chapter 6. Impacts of Permanent Housing Subsidy (SUB)

6.8 Summary of the Permanent Housing Subsidy

(UC) Comparison Across Domains

For the SUB-versus-UC comparison, the study produced a notable contrast in program use. Of all families assigned to SUB, 84 percent received the SUB intervention compared with 12 percent of families assigned to UC. This contrast in program use led to striking differences between the experi-ences of SUB and UC families in several areas.

The most notable effect of SUB relative to UC was its greater prevention of subsequent stays in shelter or places not meant for human habitation. Of families assigned to SUB, 22 percent spent at least 1 night homeless or doubled up in the 6 months prior to the followup survey or at least 1 night in emergency shelter in the 12 months prior to the survey compared with 50 percent of families assigned to UC. That is, assignment to SUB after 7 days in emergency shelter reduced subsequent homelessness by half. The SUB intervention also caused substantial, statistically significant reductions in four other measures of homelessness during the followup period: the proportion of families who experienced (1) at least 1 night in a shelter or a place not meant for human habitation in the past 6 months; (2) at least 1 night doubled up in the past 6 months; (3) at least 1 night in shelter or places not meant for human habitation or doubled up in the past 6 months;

and (4) at least one stay in emergency shelter in months 7 to 18 after random assignment. Compared with UC, SUB also led to greater housing independence, with 73 percent of SUB families living in their own house or apartment compared with 58 percent of UC families. As expected, however, the proportion of SUB families living in their own dwelling place without housing assistance (10 percent) is much lower than

88 In fact, the only significant effect on five education and training outcomes showed that SUB caused a slight reduction in the proportion of family heads participating in basic education (1 percent of SUB family heads compared with 2 percent of UC family heads).

Short-Term Impacts of Housing and Services Interventions for Homeless Families 76 Chapter 6. Impacts of Permanent Housing Subsidy (SUB) Compared With Usual Care (UC)

the corresponding proportion of UC families (33 percent).

SUB also reduced the average number of places lived since random assignment and the proportion of families living in poor or fair quality housing.

Indirect benefits occurred in terms of selected family pres-ervation indicators and adult well-being measures. Relative to UC, SUB led to improvements in family preservation. For families with a child present at baseline, SUB reduced sub-sequent child separations by two-fifths (10 percent in SUB families compared with 17 percent in UC families). SUB also reduced foster care placements by more than half (from 5 to 2 percent) relative to UC. SUB also led to improvements in four measures of adult well-being. SUB increased positive goal-oriented thinking, reduced psychological distress, and reduced evidence of alcohol and drug problems. SUB also produced a substantial reduction in intimate partner vio-lence relative to UC. Incidence of intimate partner viovio-lence was 12 percent in UC families compared with 6 percent in SUB families.

Among children who remained with their families, little evidence exists that SUB improved child well-being relative to UC, apart from a reduction in the number of schools attended by focal children. No effects were detected on the physical health, behavior, or development of focal children.

Importantly, SUB reduced family self-sufficiency relative to UC. Labor market engagement declined while dependence

on public assistance (TANF and SNAP) rose. SUB caused a reduction in the proportion of family heads working at the time of the survey compared with UC (from 30 to 24 percent), a reduction in the proportion with any employment since random assignment (from 61 to 50 percent), and a reduction in the average number of months worked since random assignment. These results are consistent with eco - nomic theory, given that housing subsidies lessened the need for disposable income and reduced the returns to working at the margin. Relative to UC, SUB increased receipt of public assistance through TANF and SNAP (from 34 to 40 percent for TANF and from 84 to 90 percent for SNAP).

Even with the reduction in work effort, SUB families appeared be in a better financial position than UC families.

The additional resources represented by the housing subsidy led to an improvement in the food security of SUB families (lowering the percentage of households classified as food insecure from 36 to 26 percent, relative to UC) and a decrease in economic stress.

Overall, in several ways families assigned to SUB appear to be doing better at this point than families assigned to UC.

Families assigned to SUB have greater housing stability, are less likely to have had child separations, and experienced less psychological distress, less intimate partner violence, less food insecurity, and less economic stress than their counterparts assigned to UC. Chapter 9 reports on how SUB compares with the two other active interventions, CBRR and PBTH.

CHAPTER 7.

IMPACTS OF COMMUNITY-BASED

RAPID RE-HOUSING (CBRR) COMPARED WITH USUAL CARE (UC)

T

his chapter presents the impacts observed in the community-based rapid re-housing (CBRR) intervention compared with outcomes of families served by the usual care (UC) homeless assistance systems in their communities. The goal is to determine whether offering temporary subsidies to help families exit shelter rapidly increases their housing stability and improves other family outcomes during a 20-month followup interval. The chapter begins with a description of the CBRR intervention as implemented in the study. It then shows the extent to which families in both the CBRR and UC groups used rapid re-housing and other housing and service programs avail-able to them in the study sites. The remainder of the chapter presents the effects of being offered the CBRR intervention (as compared with UC) on outcomes within the five study domains—housing stability, family preservation, adult well-being, child well-being, and self-sufficiency.

7.1 Community-Based Rapid Re-Housing (CBRR) Intervention

The CBRR intervention provides program participants with temporary rental assistance and limited services focused on housing search assistance and basic service coordination. In total, 569 families were referred to 27 CBRR programs across the 12 sites.89 The number of families assigned to CBRR in each site, ranging from 8 families in Denver, Colorado, to 80 families in Salt Lake City, Utah, is shown in Exhibit 2-8 in

Chapter 2. Of the 569 families, 455 (80 percent) responded to the 18-month followup survey and so are included in the impact analysis in this report.

Nearly all the CBRR providers in the Family Options Study were community-based nonprofit organizations. The only exceptions were in Louisville, Kentucky, and Phoenix, Arizona, where CBRR was provided by city government agencies. CBRR was funded by the rapid re-housing component of the Home - lessness Prevention and Rapid Re-Housing Program (HPRP) in all the sites except one.90, 91 The HPRP rapid re-housing funding could be used to provide rental assistance (up to 18 months), security deposits, utility deposits and payments, help with moving costs, and hotel and motel vouchers. HPRP also could fund case management for participating families.

Any rental assistance paid for with HPRP funds had to meet rent reasonableness standards, and units had to pass a habit-ability inspection. The inspection requirements were slightly less stringent than the Housing Quality Standards required for the Housing Choice Voucher (HCV) program form of permanent housing subsidy (SUB).

7.1.1 Housing Assistance in CBRR

The CBRR intervention provided short-term rental assistance (usually 7 to 8 months) to enable families to rent private- market housing. The intention was that the participants would remain in the unit that they obtained with CBRR assistance after the period of rental assistance ended, paying the full rent on their own.

89 Much of the information describing CBRR in this section is based on the 16 CBRR programs that provided program data. These 16 programs represent 521 of the 569 total CBRR referrals. More detail about specific CBRR programs is provided in Gubits et al. (2013), Appendixes A and B. Originally, 28 programs were intended to partici-pate in the study. The study referred families to 27 of these programs. The CBRR followup respondents represent 25 of the 27 programs.

90 HPRP was authorized through the American Recovery and Reinvestment Act of 2009 (ARRA). Across the nation, communities received $1.5 billion in HPRP funding, a one-time funding stream available for 3 years from program inception, to provide homelessness prevention and rapid re-housing assistance to individuals and families facing homelessness.

91 In Boston, the CBRR intervention was funded by the State of Massachusetts. The Boston programs offered assistance very similar to HPRP, although rental assistance could be provided for longer periods. The Minneapolis, Minnesota, and Salt Lake City CBRR programs supplemented HPRP funds with state funds and other ARRA funds, respectively.

Short-Term Impacts of Housing and Services Interventions for Homeless Families 78 Compared With Usual Care (UC)

HPRP regulations allowed for CBRR programs to provide up to 18 months of assistance, but HUD encouraged programs to provide the least amount of rental assistance needed to stabilize families in housing. Accordingly, HPRP regulations required CBRR programs to recertify families for income eligibility and need every 3 months (HUD, 2009). Nearly 40 percent of families assigned to CBRR were referred to pro-grams that also provided assistance with payment of arrears (either rental arrears or back payments owed on utilities), and most (84 percent) were referred to programs that pro-vided assistance with startup costs such as security deposits, utility setup costs, and moving expenses. About two-thirds of families assigned to CBRR were referred to programs that typically provided 4 to 6 months of assistance. The other one-third of CBRR families were referred to programs that typically provided more than 6 months of assistance.

Depth of CBRR Housing Assistance

The subsidy provided through CBRR represents a substan-tial fraction of monthly rent; however, the subsidy in CBRR was rarely determined based on participant contribution of a fixed percentage of income, as is the case in the HCV program and other housing assistance programs such as public housing. More than one-half of families were referred to CBRR programs that set the subsidy as a fixed monthly amount, regardless of monthly rent or family income. The fixed monthly amount was typically determined by CBRR case managers based on data collected through the client assessment, considering a standard set of criteria such as family income, debt, size, and local housing costs. For an-other 19 percent of families, the initial subsidy was set at the discretion of the program, based on what the program staff determined was needed to get the family into housing, and then the ongoing subsidy was adjusted based on a formula.

Rental assistance for the remaining 26 percent of families was calculated by formula, most often as a percentage of the rent established by the landlord. The standard housing assistance formula, rent minus a percentage of income, was used by programs to which only 3 percent of CBRR families were assigned. In one of the sites, the CBRR program paid

the full monthly rent. Some programs established caps on the total amount of subsidy paid to a given family. Exhibit 7-1 summarizes the methods used by CBRR providers to calculate subsidies for families in the study.

7.1.2 Assessment of Family Needs in CBRR

All CBRR programs indicated that they conducted a formal assessment of study families at the beginning of the program.

In addition, all programs reported that they reassessed family needs as part of the 3-month program recertification. The assessments typically examined family needs related to hous - ing, self-sufficiency, and employment, but three-fourths of families were referred to CBRR programs that also reported exploring health, mental health, and substance abuse issues in the assessments. Slightly more than one-half of families were referred to CBRR programs that assessed for children’s needs. Other domains, such as parenting and life skills, were formally incorporated into only a handful of programs’

assessments.

In all programs, the assessments resulted in a formal service plan, with goals for the adults in the household designed to help families obtain and remain in stable housing and to guide subsequent case management and referrals to other service programs. Thirty percent of families were referred to CBRR programs that also worked with families to develop goals for the children.

7.1.3 Supportive Services Provided in CBRR

Participating CBRR programs provided limited case manage-ment with linkages to other programs for additional support.

CBRR services were heavily focused on housing and self- sufficiency. Self-sufficiency services included help with budg - eting, obtaining public benefits, education, transportation, and child care. Most families were referred to CBRR programs in which the CBRR case manager took primary responsibility for providing housing search and placement assistance.

One program (representing 8 percent of family referrals) had a housing specialist to provide that function instead.

Exhibit 7-1. Methods Used To Calculate CBRR Subsidy Amounts

CBRR Subsidy Calculation Percent of Families Assigned to

CBRR Programs With Each Type of Subsidy Calculation (N = 521)a

Subsidy amount is set by case managers on a case-by-case basis 55

Hybrid (initial subsidy set by case managers, then adjusted based on a formula related to family contribution to rent) 19

Subsidy amount is a percentage of rent established by the landlord 23

Subsidy amount is difference between rent and family contribution of some percent of income 3 CBRR = community-based rapid rehousing.

a Program data were not collected from 11 programs that collectively had 48 CBRR family referrals.

Note: Percentages are unweighted.

Sources: Program data; random assignment records

Three-fourths of CBRR referrals were to programs in which case managers provided self-sufficiency services, but a small proportion of families were referred to programs that linked families to other agencies for these services.

No other types of services were provided to the same extent.

Slightly more than one-third of families were referred to pro - grams that provided employment training support. Other service areas were explicitly offered at even fewer programs.

Exhibit 7-2 shows the array of services offered in CBRR pro-grams and the extent to which the services were provided through case management, by other program or agency staff beyond the case manager, or through a dedicated linkage with an external agency that was guaranteed to provide the service because of CBRR enrollment. Dedicated linkages were rare.

Case Management Intensity in CBRR

Exhibit 7-3 shows the relative intensity of case management for families referred to CBRR—both the ratio of clients to case managers and the frequency of meetings. The average case management ratio for CBRR programs in the study was 36 families per case manager.92 Nearly one-half of clients were referred to programs in which a case manager worked with more than 30 families at a time, and most of the case managers with heavy caseloads met with their clients monthly rather than more frequently. About one-fifth of families were referred to programs with 11 to 20 clients per case manager, and these case managers more often met with clients every 1 or 2 weeks or reported that the frequency of meetings was variable. Some programs indicated that case managers met more frequently up front to support families as they searched

Exhibit 7-2. Types of Supportive Services Offered in CBRR Programs and How They Are Delivered

Types of Supportive Services Percent of Families Referred to CBRR Programs That Offer

These Services (N = 521)a

Percent of Families Referred to CBRR Programs That Offer Services of This Type

Through Case

Management By Other Program or Agency Staff

Through Dedicated Linkages With Other Agencies

Housing search and placement assistance 100 92 8 0

Self-sufficiency (for example, financial literacy, money management, help obtaining public benefits, education, transportation, childcare, and after-school care)

78 78 6 3

Employment and training 37 25 12 12

Life skills 30 30 0 0

Physical health care 23 23 0 0

Child advocacy 18 18 0 0

Parenting skills 15 15 0 0

Mental health care 2 2 0 0

CBRR = community-based rapid rehousing.

a Program data were not collected from 11 programs that collectively had 48 CBRR family referrals.

Note: Percentages are unweighted.

Sources: Program data; random assignment records

Exhibit 7-3. CBRR Case Management Intensity (ratio and frequency)

Average Number of Clients per Case Manager

Percentage of Families Referred to CBRR Programs

That Offer Case Management in Each of the Following Packages (N = 464)a Total

Weekly Biweekly Monthly Quarterly Variable

10 or fewer clients 0 0 11 0 0 11

11 to 20 clients 4 4 0 0 11 20

21 to 30 clients 3 0 3 0 0 3

More than 30 clients 0 3 30 13 0 46

Variable 0 0 18 0 0 18

Total 7 7 61 13 11 100

CBRR = community-based rapid rehousing.

a Program data on case management ratios were not collected from 13 programs that collectively had 105 CBRR family referrals.

Note: Percentages are unweighted.

Sources: Program data; random assignment records

92 The average case management ratio is calculated as the weighted average of the program’s typical point-in-time caseloads (collected in interviews with program staff), wherein the weights are the number of families referred to the programs. Thus, the average case management ratio in CBRR was derived by first multiplying each program’s case management ratio by the number of people referred to that program, then summing the products, and then dividing the sum by the total number of families referred to CBRR.

Short-Term Impacts of Housing and Services Interventions for Homeless Families 80 Compared With Usual Care (UC)

for and moved into housing, meeting less frequently after the family was housed. Visits of approximately 1 hour were fairly typical for CBRR programs.93 Case management typically ended when the CBRR rental assistance ceased.

7.1.4 Eligibility Criteria for CBRR

CBRR programs sometimes had screening criteria that excluded certain families from participating. For example, those who were not working might be considered “not ready” for CBRR because they had little chance of being able to afford their units when CBRR assistance ended. Just under 5 percent of study families answered baseline survey questions in a way that screened them out from possible assignment to CBRR, and 10.4 percent of those assigned to CBRR were determined ineligible by the programs. Families screened out at baseline are not included in the study sample, but those determined ineligible after random assignment are. Those families deter - mined ineligible by programs must be included in the impact estimates to preserve the comparability of the CBRR families and UC families—that is, some of the UC families might also have been screened out had they been assigned to CBRR.

In order to continue to receive assistance for the period offered by the CBRR program to which they were referred, families had to have incomes below certain thresholds, and most CBRR programs to which study families were referred asked questions about income every 3 months. Some CBRR programs also imposed additional program requirements with which families had to comply to maintain eligibility for assistance, such as working with a case manager to achieve employment or increase earned income.

7.2 Program Use by Families in the Community-Based Rapid Re-Housing (CBRR) Versus Usual Care (UC) Comparison

Each impact comparison in the study may be thought of as a distinct experiment or test, and this chapter addresses only

the comparison between CBRR and UC, without reference to the families who were randomized to the SUB or project- based transitional housing (PBTH) interventions. In total, 1,144 families took part in the test of CBRR versus UC. These families all had the opportunity to be assigned to either CBRR or UC at the point of random assignment and were assigned to one of these two interventions—569 families to CBRR and 575 families to UC.94 Of these 1,144 families, 79 percent (455 CBRR families and 451 UC families) responded to the 18-month followup survey, and thus 906 families are in-cluded in the CBRR-versus-UC impact comparison reported in this chapter. This section describes the extent to which the 455 CBRR families used the CBRR intervention and other programs that were available in the community—both

the comparison between CBRR and UC, without reference to the families who were randomized to the SUB or project- based transitional housing (PBTH) interventions. In total, 1,144 families took part in the test of CBRR versus UC. These families all had the opportunity to be assigned to either CBRR or UC at the point of random assignment and were assigned to one of these two interventions—569 families to CBRR and 575 families to UC.94 Of these 1,144 families, 79 percent (455 CBRR families and 451 UC families) responded to the 18-month followup survey, and thus 906 families are in-cluded in the CBRR-versus-UC impact comparison reported in this chapter. This section describes the extent to which the 455 CBRR families used the CBRR intervention and other programs that were available in the community—both

문서에서 Family Options Study (페이지 107-0)