Impacts of Heading Home Hennepin's Housing First programs for long-term homeless adults

This paper evaluates the impact of Heading Home Hennepin’s Housing First programs for long-term homeless individuals with work-limiting disabilities. These programs combine subsidized housing and extensive case management services to help program participants maintain stable housing. Using a matched comparison of housing-first participants and nonparticipants residing in public shelters, this study finds that housing-first placement is associated with a substantial decrease in public shelter use, an increase in public health insurance coverage, and a decrease in arrests and incarceration. Most of the decline in arrests is due to decreases in arrests for livability and drug-related charges and not for violent or property crime.     

DOWN TO BUSINESS: THE COMMODIFICATION OF NONPROFIT SOCIAL SERVICES

Private nonprofit organizations play a major role in delivering a range of publicly funded social services. Aggregate data from a recent Urban Institute study reveal that recent federal cutbacks have affected the services, programs and clients of NPOs. An examination of specific agencies in Maricopa County (Phoenix) reveals that many service providers have adopted a business approach to their services and clients, treating them as commodities. In general, agencies serving clients with Resource Mobilization Potential-youth and elderly-have fared better than those dealing primarily with poor adults.     

Human service reorganization and its effects: a preliminary assessment of Florida's services integration 'experiment.'

The present discussion reports on some of the first statewide data gathering and analysis to assess the consequences of the 1975 reorganization of the Florida Department of Health and Rehabilitative Services. Two major concepts guiding the reorganization were: (1) integration of services in order to cover more adequately the needs of clients, including "multi-problem" clients, and (2) decentralization of administrative authority of all programs under a single, district-wide management structure. Despite widespread interest in the Florida system, and two previous studies, no systematic, detailed study of the impact of reorganization at the service delivery level has been conducted until now. The results of this study indicate that departmental employees perceive substantial decentralization of authority and progress toward integration of services since the 1975 reorganization. Perceived improvement in client services is also indicated. Major factors cited as influential in the change are the move toward collocation of services, the establishment of administratively interlinked service networks, and to a lesser extent, the development of generalist managers.     

Leaving Homelessness Behind: Housing Decisions Among Families Exiting Shelter

Because homelessness assistance programs are designed to help families, it is important for policymakers and practitioners to understand how families experiencing homelessness make housing decisions, particularly when they decide not to use available services. This study explores those decisions using in-depth qualitative interviews with 80 families recruited in shelters across four sites approximately six months after they were assigned to one of four conditions (permanent housing subsidies, project-based transitional housing, community-based rapid re-housing, or usual care). Familiar neighborhoods near children's schools, transportation, family and friends, and stability were important to families across conditions. Program restrictions on eligibility constrained family choices. Subsidized housing was the most desired intervention, and families leased up at higher rates than in other studies of poor families. Respondents were least comfortable in and most likely to leave transitional housing. Uncertainty associated with community-based rapid re-housing generated considerable anxiety. Across interventions, many families had to make unhappy compromises, often leading to further moves. Policy recommendations are offered.     

Are prisoners Clients?

Public servants should identify their clients. As a statement of modern practice it seems unobjectionable. The emphasis of modern management has shifted from die inputs and processes to the outputs and recipients of government services. The language of the public sector has been infused with the rhetoric of the private, with discussion of customers and clients, rather than, as previously, recipients and patients. In many places the benefits are apparent, with officials less concerned with ensuring that every minute process is satisfied and more directed to the needs of those whom they service. My concern here is not to challenge the notion that a concentration on clients and customers is desirable; in places it clearly is. Rather I want to suggest that while a client focus may be applicable in some facets of public policy it is not universally so. There are instances where the attempt to classify everyone as clients may be counterproductive and strip the concept of useful meaning.     

Organizational form and performance: An empirical investigation of nonprofit and for‐profit job‐training service providers

While research on the distinctions between for‐profit and nonprofit organizations and their changing service sector shares is vast, there is comparatively little empirical evidence on the consequences of their differing attributes for social program outcomes. This article presents research on publicly subsidized for‐profit and nonprofit job‐training service providers, namely whether organizational form influences client enrollment, service delivery activities, or performance, as measured in terms of participant outcomes. The findings show that nonprofit providers were not more likely to serve more disadvantaged clients and that neither for‐profit nor nonprofit service providers were consistently more effective in increasing participants' earn‐ings and employment rates. When performance incentives were included in service providers' contracts, contractors of all forms performed significantly better across all participant outcomes examined. © 2000 by the Association for Public Policy and Management.     

Federalism and suitable housing for the frail elderly: A comparison of policies in Canada and the United States

Abstract

The frail elderly have special multidimensional housing needs beyond affordability, including shelter that is more adaptive to reduced function and offers supportive services. Suitable housing for this population comprises three policy areas—housing, health care, and social services. In a federal system, development and implementation of policies in these areas involves participation of several levels of government and the nongovernmental sector. This paper uses federalism as a conceptual framework to examine and compare these policy areas in Canada and the United States.

In both countries, general national housing policies—relying heavily on the nongovernmental sector and characterized by joint federal‐provincial programs in Canada and by important local government roles and age‐specific programs in the United States‐have benefited the elderly. The effects of such policies on the frail elderly, however, have been less positive because of the general lack of essential human services and, to a lesser degree, health care that enables them to live outside institutions. This is especially true in the United States, where health care policy is fragmented and is dominated by a private insurance system, partial federal financing of health insurance for the elderly, and tense federal‐state relations in financing health care for the poor. Although Canadian policies and programs operate autonomously and more uniformly within a national health plan, neither country has a universal, comprehensive long‐term care system. Geographically diverse patterns of social services, funded by grants to states and provinces and the nonprofit sector, are common to both countries. However, the United States has inadequately funded age‐specific programs and has relied on a growing commercial service provision. Housing outcomes for frail elders are moving in the right direction in both countries; however, Canada seems to be better positioned, largely because of its health care system. As increased decentralization continues to characterize the three policy areas that affect suitable housing for frail elders, the United States can learn from Canada's negotiated federalism approach to more uniform solutions to merging housing and long‐term care.     

Housing vouchers for the poor

Can the nation's social programs survive the push toward leaner appropriations, a greater use of the market, and a narrower definition of the needy? A program to provide housing assistance for the poor is proposed that fills all these requirements. Housing vouchers are found to be cheaper than other housing programs and more satisfactory for participants. Moreover, the political climate augers well for the new approach.     

What Interventions Work Best for Families Who Experience Homelessness? Impact Estimates from the Family Options Study

What housing and service interventions work best to reduce homelessness for families in the United States? The Family Options Study randomly assigned 2,282 families recruited in homeless shelters across 12 sites to priority access to one of three active interventions or to usual care in their communities. The interventions were long‐term rent subsidies, short‐term rent subsidies, and transitional housing in supervised programs with intensive psychosocial services. In two waves of follow‐up data collected 20 and 37 months later, priority access to long‐term rent subsidies reduced homelessness and food insecurity and improved other aspects of adult and child well‐being relative to usual care, at a cost 9 percent higher. The other interventions had little effect. The study provides support for the view that homelessness for most families is an economic problem that long‐term rent subsidies resolve and does not support the view that families must address psychosocial problems to succeed in housing. It has implications for focusing government resources on this important social problem.     

The Dilemmas of Frontline Staff Working With the Homeless: Housing First,Discretion, and the Task Environment

This article examines staff discretion in permanent supportive housing facilities run by a nonprofit agency claiming to use a Housing First approach. Field observation, archival data, and individual and group interviews with staff and clients were examined to better understand agency processes involved in intake, sanctions, and disposal of clients to evaluate Housing First fidelity. In their day-to-day interactions with clients, frontline workers' discretion is affected by working conditions such as lack of resources and heavy workloads, as well as by demands placed on the agency by members of its task environment. Implications for Housing First programs and homeless clients are discussed.     

Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing

Abstract

This article assesses the impact of public investment in supportive housing for homeless persons with severe mental disabilities. Data on 4,679 people placed in such housing in New York City between 1989 and 1997 were merged with data on the utilization of public shelters, public and private hospitals, and correctional facilities. A series of matched controls who were homeless but not placed in housing were similarly tracked.

Regression results reveal that persons placed in supportive housing experience marked reductions in shelter use, hospitalizations, length of stay per hospitalization, and time incarcerated. Before placement, homeless people with severe mental illness used about $40,451 per person per year in services (1999 dollars). Placement was associated with a reduction in services use of $16,281 per housing unit per year. Annual unit costs are estimated at $17,277, for a net cost of $995 per unit per year over the first two years.     

The FIRRE Act and Housing for Low-Income Families

During the 1980s, federal government real, direct expendituresfor low-income housing increased modestly, budget authorityfor future housing spending fell dramatically, and subsidiesshifted from primarily construction to tenant aid. These changesreflect the delicate balance struck between Reagan's "decentralizedfederalism" as it applied to low-income housing and the muchmore pro-active, centralized positions often advocated by theCongress. Although Congress did not win the budget battle, itdid add new resources to low-income housing in less direct ways.One of those less direct initiatives is the low-income housingprograms contained in FIRREA, which add both money and institutionsto the delivery of housing services for the poor. This articleevaluates these new FIRREA programs in expanding the supplyof housing for the poor. The article concludes that their successwill largely depend on the ability of the low-income housingdelivery system to integrate these new institutions and joinwith them in an active partnership to make efficient use ofthese new housing resources.     

Family self‐sufficiency and housing

Abstract

Since the early 1980s, an increasing number of initiatives have been introduced to link housing programs and policies with efforts designed to promote family economic self‐sufficiency. This article reviews a set of programs that have worked to manipulate various components of the housing bundle to improve the economic well‐being of acutely poor families. They include programs that modify the characteristics and services available in the local community, alter families’ residential location, provide incentives and opportunities for homeownership, and link the provision of housing subsidies to increasing local capacity for service delivery.

This article suggests that the centrality of housing in fostering or impeding economic mobility makes it a key element in dealing with acute poverty and part of a creative strategy for intervening in the dynamics of poverty. Several important areas need to be taken into account when evaluating current policy; and multiyear evaluations will be necessary to determine the success of these programs.     

Permanent supportive housing for domestic violence victims: program theory and client perspectives

The US Violence Against Women Act of 2005 allocated $10 million to support collaborative efforts to create permanent housing options for domestic violence victims. Such programs are relatively new and rare, and up to now little research has examined their efficacy. This research investigates one permanent housing option, the permanent supportive housing model, through an exploratory case study of a Connecticut-based program currently being developed. The study compares the program design articulated by administrators and advocates with perspectives of domestic violence agency clients.

Findings indicate important differences between the program activities and goals articulated by administrators, and those preferred by clients. Although everyone agreed that personal safety was a priority, administrators stressed independence and choice whereas clients sought a stricter, community-centered environment with time-limited stays. These themes can be used to develop hypotheses for larger studies and have important preliminary policy and program implications.     

The efficiency and distribution of mortgage revenue bond subsidies: The effects of behavioral responses

Mortgage revenue bond (MRB) programs are frequently justified on the basis that they enable low- or moderate-income families to purchase houses that they otherwise could not afford. This article argues that evaluations of MRB programs must include estimates of the responses of buyers and sellers to the subsidies. The empirical evidence indicates that the behavioral responses reduce the efficiency of MRB programs (the amount of the subsidies provided to targeted households) and cause the subsidies to be distributed more inequitably than previous research has shown. The capitalization of 10% to 14% of the value of MRB subsidies diverts some of the program benefits to sellers. Horizontal inequities are created because one group of moderate-income households use the subsidies to purchase more housing services than unsubsidized households with the same incomes.     

Housing vouchers in the United States,great Britain,and the Netherlands: Current issues and future perspectives

Abstract

We compare the current U.S. housing voucher program with the British housing benefit and the Dutch housing allowance programs. After presenting the theory behind income‐related housing support, which underpins both the U.S. and European systems, we compare the three programs with respect to their scope (the budgeted versus the entitlement approach), the relationship between housing support and rent levels, the poverty trap, moral hazards, and administrative problems.

The United States can learn from Great Britain and the Netherlands that a full entitlement program can best promote equity, but given the present political and economic climate, it is unlikely that Congress will adopt such a program anytime soon. Great Britain and the Netherlands can learn from the United States how to design a more efficient tenant subsidy program, one that provides incentives to find less expensive units and promotes family self‐sufficiency through enhanced job‐seeking behavior.     

History lessons for today's housing policy: the politics of low-income housing

History offers valuable lessons to housing policymakers. For those who would devise new low-income housing programs during today's trying economic circumstances, it is helpful to study the strategies that succeeded in achieving low-income housing programs in past difficult times. This article, History Lessons for Today's Housing Policy, examines the political processes that led to the adoption of new low-income housing policies during four political crises. The four crises were the Great Depression of the 1930s, the post-World War II housing shortage, the urban crisis of the 1960s, and the policy crisis of the 1970s. Among other history lessons, the article reveals that well-organized political support, especially from large institutions, is crucial to achieving distinctly different new programs; that decentralized programs are more politically resilient than centralized programs; that programs that appeal to the nation's broad middle-class are most popular; and that policy research is valuable but that politics trumps research.     

Child characteristics and successful use of housing vouchers: Estimates from the moving to opportunity demonstration

Abstract

Voucher‐based programs have become the most common form of housing assistance for low‐income families in the United States, yet only a slim majority of households that are offered vouchers actually move with them. This article uses data from 2,938 households in the Moving to Opportunity demonstration program to examine whether child characteristics influence the probability that a household will successfully use a housing voucher to lease‐up.

Our results suggest that while many child characteristics have little bearing on the use of housing vouchers, child health, behavioral, and educational problems, particularly the presence of multiple problems in a household, do have an influence. Households with two or more child problems are 7 percentage points less likely to move than those who have none of these problems or only one. Results suggest that such families may need additional support to benefit from housing vouchers or alternative types of affordable housing units.     

Property values in inner‐city neighborhoods: The effects of homeownership,housing investment,and economic development

Abstract

This article examines the determinants of property values in Cleveland with a focus on three approaches to improving or maintaining neighborhood quality: investing in new housing, attracting and retaining homeowners, and encouraging economic development. Data comprise home sales in 1996 and 1997, investments in new housing from 1991 to 1995, homeowner migration between 1991 and 1995, and changes in the number of business establishments from 1991 to 1995.

The results suggest that (1) investments in new houses have a positive impact on housing values, especially for houses close to the new investment; (2) homeowner out‐migration has a negative effect; and (3) growth in the number of business establishments, except for social service establishments, also has a negative effect. These results further suggest that while programs to encourage housing investment and homeowner‐ship can increase neighborhood property values, care should be taken to avoid an inappropriate mixing of land uses.     

Linking program implementation and effectiveness: Lessons from a pooled sample of welfare‐to‐work experiments

This paper addresses the question: How does implementation influence the effectiveness of mandatory welfare‐to‐work programs? Data from three large‐scale, multi‐site random assignment experiments were pooled; quantitative measures of program implementation were constructed; and multilevel statistical modeling was used to examine the relationship between program implementation and effects on short‐term client earnings. Individual‐level data were analyzed for 69,399 sample members and group‐level implementation data were analyzed for 59 local programs. Findings indicate that, other things being equal, earnings effects are increased by: an emphasis on quick client employment, an emphasis on personalized client attention, staff caseloads that do not get too large, and limited use of basic education. Findings also show that mandatory welfare‐to‐work programs can be effective for many types of people, and that focusing on clients who are especially job‐ready (or not) does not have a consistent influence on a program's effectiveness. © 2003 by the Association for Public Policy Analysis and Management