Chapter 12. Intervention Costs
12.1 Introduction and Summary
12.1.2 Summary of Findings
The Family Options Study interventions were intended to vary in both intensity and duration. SUB programs provide a deep housing subsidy but limited supportive services for an indefinite duration. PBTH programs provide deep housing and services support for a relatively long duration. CBRR programs provide a short-term housing subsidy with little supportive services. Finally, emergency shelter programs often offer supportive services and housing for a very limited time. This section summarizes findings for each of the four cost measures: per-family monthly program cost, program cost per stay during the followup period, cost of all program use during the followup period, and monthly cost of all pro - gram use at the followup survey. Subsequent sections provide additional detail and explanation for these reported costs.
Per-Family Monthly Program Costs
Monthly costs of serving a typical family vary considerably by program type. Exhibit 12-2 presents the average per- family monthly program cost for each type of program. SUB programs, on average, cost slightly less than $1,200 per fam-ily per month, which consists wholly of the cost of housing, because this intervention provides no supportive services.
CBRR programs have the lowest per-family monthly program cost among the program types, with a program average of slightly less than $900. Housing costs, on average, make up 72 percent of CBRR program costs.
Exhibit 12-2. Average Per-Family Monthly Cost of Supportive Services and Housing or Shelter Across Program Types
CBRR = community-based rapid re-housing. ES = emergency shelter. PBTH = project-based transitional housing. SUB = permanent housing subsidy.
Sources: Family Options Study cost data (CBRR, PBTH, and ES); HUD Public and Indian Housing Information Center, Tenant Rental Assistance Certification System, and Financial Data Schedule records (SUB)
$6,000
$5,000
SUB CBRR PBTH ES
$1,162
$878
$2,706
$4,819
Supportive services Housing or shelter
$4,000
$3,000
$2,000
$1,000
$0
Average monthly cost per family
Emergency shelter programs have the highest per-family monthly program cost for both supportive services and housing or shelter, which, on average, total slightly more than $4,800.Supportive services make up 63 percent of emergency shelter costs, the highest share among the four program types. The higher monthly cost of housing or shel-ter for emergency shelshel-ter programs reflects both program structure and the approach to classifying costs. Emergency shelters tend to have higher per-family levels of facility staffing and expenditure for maintenance and materials than PBTH programs or than what is reflected in rents paid by CBRR and SUB programs. In addition, housing or shelter costs include the capital cost value of all physical space provided by the program, including facilities such as class-rooms, case management offices, kitchens, and dedicated childcare centers.142
PBTH programs have an average per-family monthly program cost of slightly more than $2,700, with supportive services, on average, constituting 42 percent of PBTH program costs.
Within each study intervention, the study team also found substantial variation in the costs of the individual programs.
Exhibit 12-3 shows this variation among per-family monthly program costs for each program type. PBTH and emergency shelter programs have substantial variation, driven largely by variation in supportive services costs but also by varia-tion in capital costs and administrative expenses. For the 24 PBTH programs in the cost analysis, per-family monthly program cost ranges from slightly more than $1,260 to
slightly less than $6,300. Per-family monthly program cost for the 45 emergency shelter programs ranges from $1,900 to slightly more than $9,000.
Variation in CBRR and SUB costs across programs is driven largely by housing costs. For the 12 CBRR programs in the cost analysis, per-family monthly program cost ranges from slightly more than $550 to slightly less than $1,400. Across the 10 sites with the SUB intervention, average per-family monthly program cost ranges from $770 to $2,100, largely reflecting differences in the local cost of rental housing.
Program Costs Per Stay During the Followup Period We now turn to program costs per stay during the followup period. This cost concept reflects differences in duration of assistance and shows a different cost ordering of the programs.
Exhibit 12-4 reports program costs per stay for each pro-gram type. This cost concept accounts for duration between random assignment and the followup survey, measured for families who were assigned to and enrolled in programs of each type. Using this measure, the costliest program type is PBTH, at an average of slightly more than $32,500 with an average duration of 13 months.143 The next most costly pro-gram is SUB, with an average of slightly more than $18,800 with an average duration of 16 months.Emergency shelter program costs per stay averaged slightly more than $16,800 with an average length of stay of 4 months.144 Finally, per- family total costs for families who used rapid re-housing aver - aged slightly more than $6,500 for an average of 7 months of assistance.
Exhibit 12-3. Summary Statistics of Per-Family Monthly Program Cost by Program Type
Program Type
Per-Family Monthly Program Cost Summary Statistic
Families Programs Mean Minimum 25th Percentile Median 75th Percentile Maximum
($) ($) ($) ($) ($) ($)
SUB 454 10 $1,162 $770 $844 $1,085 $1,370 $2,095
CBRR 268 12 878 563 713 847 977 1,388
PBTH 107 24 2,706 1,261 1,738 2,352 3,535 6,292
ES 667 45 4,819 1,888 3,907 4,352 5,786 9,170
CBRR = community-based rapid re-housing. ES = emergency shelter. PBTH = project-based transitional housing. SUB = permanent housing subsidy.
Notes: CBRR, PBTH, and ES statistics are calculated from program-level data, weighted by the number of study families that enrolled in the program. SUB statistics are calculated from household-level data.
Sources: Family Options Study cost data (CBRR, PBTH, and ES); HUD Public and Indian Housing Information Center, Tenant Rental Assistance Certification System, and Financial Data Schedule records (SUB)
142 This study’s finding of higher monthly costs for family shelter programs than for other homelessness assistance program types is consistent with previous estimates re-ported in HUD’s Costs Associated With First-Time Homelessness for Families and Individuals (Spellman, et al., 2010), which found emergency shelter monthly costs for families were higher than transitional housing costs and higher than the local Fair Market Rent (FMR) in three of four cities. By contrast, shelters serving individuals had costs that, on average, were equal to or substantially lower than transitional housing costs and the FMR.
143 Average durations for program costs per stay during the followup period are calculated differently than durations reported in Chapters 6 through 9 for PBTH and CBRR programs. Average durations for program costs per stay are the averages, weighted by the number of study families enrolled in programs represented in the cost study, of site-level average durations for families enrolled in programs of the type to which they were assigned.
144 This average is the length after random assignment of the initial shelter stay for families assigned to UC. (See Chapter 5, Exhibit 5-2.)
Short-Term Impacts of Housing and Services Interventions for Homeless Families 140 Chapter 12. Intervention Costs
Exhibit 12-4. Average Program Cost Per Stay During the Followup Period Across Program Types
CBRR = community-based rapid re-housing. ES = emergency shelter. PBTH = project-based transitional housing. SUB = permanent housing subsidy.
Note: The durations reported in this exhibit are weighted to align with the program-level cost data and so differ slightly from the durations reported for CBRR and PBTH in other exhibits.
Sources: Family Options Study cost data (CBRR, PBTH, and ES); Family Options Study 18-month followup survey (CBRR and PBTH); HUD Public and Indian Housing Information Center, Tenant Rental Assistance Certification System, and Financial Data Schedule records (SUB).
These estimated costs per stay incorporate costs of assistance provided only through the end of the followup period (ap-proximately 21 calendar months after random assignment).
Costs will continue to accrue after the end of the followup period for this study, and these longer term costs will differ across interventions. CBRR and PBTH are explicitly tempo-rary programs. For nearly all study participants, the term of CBRR or PBTH had ended or would end shortly by the end of the followup period. By contrast, SUB is a long-term in-tervention. Thus, during a longer time horizon, the costs per stay in CBRR, PBTH, and emergency shelter are unlikely to rise much; the cost per stay of SUB is likely to increase sub-stantially. Of the families who used the SUB intervention, 89 percent were still receiving SUB at the followup survey. Our monthly estimates imply that costs for a family who remains in SUB for 5 years, as an example, would total more than
$60,000 (using a 5-percent discount rate). Some literature describes the length of time that families use housing vouchers.
For example, Thompson (2007) reports that nonelderly/
nondisabled households with children that enter the voucher program receive assistance for an average of 3.8 years (as reported in 2002). This mean includes 30 percent of fami-lies accessing assistance for less than 1 year. The litera ture does not include reported duration based on homelessness
experience, however. One could argue such families would have a longer length of stay than typical families because they have more needs or a shorter length of stay (because they have more barriers to maintaining housing).
Cost of All Program Use During the Followup Period We now consider the total costs of all types of shelter or housing assistance used by families in the different inter-vention groups during the followup period after random assignment. Relative to monthly costs or per-stay costs, these costs are more homogenous. As observed in the Program Use Since Random Assignment exhibits in Chapters 6 through 9, random assignment to a particular intervention changed us-age patterns for other types of shelter programs or housing assistance. For example, assignment to the SUB intervention reduced use of both emergency shelter and PBTH relative to assignment to each of the other intervention arms.
Exhibit 12-5 reports estimates of the total costs of all housing assistance programs (both those assigned and other assistance families accessed) that resulted from these various patterns.
In this approach, costs are tallied from random assignment through the date of the followup survey. Furthermore, this approach considers all shelter and housing programs provid - ing services to families.
$35,000
$30,000
$18,821
SUB
(16 months) CBRR
(7 months) PBTH
(13 months) ES
(4 months)
Supportive services Housing or shelter
$6,578
$32,557
$16,829
$25,000
$20,000
$15,000
$10,000
$5,000
$0
Average program cost per stay during followup period
Exhibit 12-5. Summary of Cost of Program Use Since Random Assignment
Contrast Estimated Average Total Cost ($) of Observed Housing Assistance of all Types for Families in Comparison Assigned To—
SUB PBTH CBRR UC
SUB vs. UC $30,832 $30,336
CBRR vs. UC $27,605 $30,629
PBTH vs. UC $30,817 $28,295
SUB vs. CBRR $31,158 $29,680
SUB vs. PBTH $27,864 $30,914
CBRR vs. PBTH $30,510 $22,524
CBRR = community-based rapid re-housing. ES = emergency shelter. PBTH = project-based transitional housing. SUB = permanent housing subsidy. UC = usual care.
Sources: Family Options Study cost data; Program Usage Data
Using this cost concept, families assigned to SUB have average costs similar to families assigned to UC, slightly higher aver-age costs than families assigned to CBRR, and clearly lower costs than families assigned to PBTH. This pattern is very different from the pattern shown in Exhibit 12-4, which—
by only taking the much longer program stays for SUB into account—shows much higher costs for SUB than for CBRR.
The only slightly higher cost of SUB as compared with UC for the cost of total program use is driven both by decreased time in emergency shelter and by a decreased use of rela-tively more expensive PBTH programs by SUB families as compared with UC families. Similarly, the SUB and CBRR interventions differ by only $1,500 (5 percent) in costs be-cause the greater use of SUB programs by families assigned to the SUB intervention is offset by the greater use of CBRR, TH, permanent supportive housing, and emergency shelter programs by families assigned to the CBRR intervention.
As with cost per stay, an important caveat must be applied to these estimates of the total cost of all use of shelter and housing assistance programs during the followup period.
The SUB intervention is likely to last beyond that followup period for most families. Thus, SUB may become relatively more costly, even after taking into account use of programs other than those to which families were randomly assigned.
These subsequent costs will be analyzed for the longer timeframe and reported in the 36-month report along with impacts measured at 36 months.
Monthly Cost of All Program Use at the Followup Survey
Exhibit 12-6 reports the cost of program use at the time of the followup survey for each assigned program type of each pairwise impact comparison.
The cost of program use at the followup survey—the average per-family monthly program cost of programs that study families were using at followup—follows a similar pattern across treatment arms as the cost of program use since ran - dom assignment. For example, because more families as-signed to UC are in relatively costly emergency shelters at the followup survey as compared with more families receiv-ing SUB assistance among families assigned to SUB, the cost of program use at the followup survey is nearly equal for the two treatment arms. The extent to which these ongoing cost levels persist will be an important topic of the cost analysis for the 36-month report for the Family Options Study.
Following this high-level summary of the cost findings, the next four sections of this chapter provide a more indepth review of the per-family monthly program costs and pro-gram costs per stay during the followup period for the SUB, CBRR, and PBTH interventions and for emergency shelter programs from which families were assigned.
Exhibit 12-6. Summary of Monthly Cost of Program Use at the Time of the Followup Survey
Contrast
Estimated Average Total Monthly Cost ($) of Observed Housing Assistance of all Types for Families in Comparison Assigned To—
SUB PBTH CBRR UC
SUB vs. UC $1,086 $1,066
CBRR vs. UC $895 $1,098
PBTH vs. UC $1,009 $1,012
SUB vs. CBRR $1,081 $979
SUB vs. PBTH $1,065 $977
CBRR vs. PBTH $718 $989
CBRR = community-based rapid re-housing. ES = emergency shelter. PBTH = project-based transitional housing. SUB = permanent housing subsidy. UC = usual care.
Sources: Family Options Study cost data; Program Usage Data
Short-Term Impacts of Housing and Services Interventions for Homeless Families 142 Chapter 12. Intervention Costs