Housing Matters, Services Might: Findings from the High Needs Families Program Evaluation

• Author: Clara A. Wagner,Kathryn A. Henderson,Debra J. Rog,Emily L. Abbruzzi
• Date: 01 January 2021
• DOI: 10.1177/0002716221997037
• Published date: 01 January 2021
• Subject Matter: Evaluating Interventions

ANNALS, AAPSS, 693, January 2021 209

DOI: 10.1177/0002716221997037

Housing

Matters,

Services Might:

Findings from

the High Needs

Families

Program

Evaluation

By

DEBRA J. ROG,

KATHRYN A. HENDERSON,

CLARA A. WAGNER,

and

EMILY L. ABBRUZZI

997037ANN THE ANNALS OF THE AMERICAN ACADEMYHOUSING MATTERS, SERVICES MIGHT

research-article2021

Permanent supportive housing for families experienc-

ing homelessness—typically, subsidized housing that is

not time limited and provides access to a range of sup-

port services—has substantially increased over the past

10 years, despite an absence of rigorous evidence of its

effectiveness. We examine the benefits of subsidized

housing with supportive services compared to subsi-

dized housing alone. Our findings suggest that support-

ive housing offers more opportunities for access to

services and benefits than subsidized housing alone,

but it may not be beneficial to families’ housing stability

or to family members’ employment or involvement

with the criminal justice system. We argue that housing

that is coupled with intensive case management, that is

service rich, and that provides and adheres to harm

reduction principles may help to strengthen supportive

housing’s effectiveness.

Keywords: housing; supportive housing; homeless

families; subsidized housing

To address the enduring problem of home-

lessness, communities across the country

have increasingly moved from a reliance on

shelter and transitional housing to placing

greater priority on permanent housing solu-

tions (United States Interagency Council on

Homelessness [USICH] 2018). Among the

housing approaches that communities use, per-

manent supportive housing has increased over

the past 10 years for both individuals and

Debra J. Rog, a Westat vice president and president of

its nonprofit affiliate, the Rockville Institute, has more

than 30 years of experience in research and evaluation

of homelessness. Some of her current studies include

evaluations of homeless service and housing systems

initiatives for families and youth.

Kathryn A. Henderson is a sociologist and senior study

director with experience conducting research and eval-

uations on homeless service delivery systems, housing,

supportive employment programs, and health initia-

tives for individuals and families living in poverty.

Correspondence: DebraRog@Westat.com

210 THE ANNALS OF THE AMERICAN ACADEMY

families. According to the Housing Inventory Charts that the U.S. Department

of Housing and Urban Development (HUD; 2019) maintains, between 2009 and

2019, the number of permanent supportive housing beds grew 41 percent for

families (up to 43,199 units) and 85 percent for single adults (up to 243,528

units).

Originally developed for single adults who have experienced chronic home-

lessness and have one or more disabilities, permanent supportive housing is long-

term housing in the community, typically subsidized, that is paired with intensive

case management and other supportive services (e.g., National Academies of

Sciences 2018; USICH 2018). Permanent supportive housing typically includes

housing that is affordable, not time limited, and provides access to a range of

services based on tenants’ needs and preferences. To illustrate, Joan, a single

mother with three children under the age of 10, lives in a three-bedroom apart-

ment located in a newly renovated small apartment complex where more than

half of the apartments provide supportive housing. In meeting space on site, Joan

participates in parenting classes and AA meetings. She has a case manager who

helps her to navigate the health system and other services and stays in touch to

provide her any support she needs.

Numerous studies have been conducted on the effects of supportive housing

for single adults (see Lachaud etal., this volume). Overall, the studies provide

evidence of its effectiveness in reducing homelessness and housing instability

(Bassuk et al. 2014; Stergiopoulos et al. 2015; Tsemberis, Gulcur, and Nakae

2004; Gulcur etal. 2007; Rog, Marshall, etal. 2014), hospitalizations (e.g., Gulcur

etal. 2007; Rog, Marshall, et al. 2014), and emergency department (ED) visits

(e.g., Srebnik, Connor, and Sylla 2013; Rog, Marshall, etal. 2014).

Far fewer studies have focused on examining the effectiveness of supportive

housing for homeless families (National Academies of Sciences 2018). As sup-

portive housing was first developed for single adults and is much more widely

used for this population, it is not surprising that the majority of research attention

on permanent supportive housing has been on this population. With the increas-

ing implementation of permanent supportive housing as an option that families

use, however, program providers and policy-makers need to understand if per-

manent supportive housing has the same benefits for families and adults.

Moreover, with service delivery systems having limited resources for housing and

Clara A. Wagner is a developmental psychologist and senior study director at Westat with 15

years of experience in research and evaluation. Her work involves mixed-methods evaluations

of programs addressing housing, health, and service needs of vulnerable populations.

Emily L. Abbruzzi is an epidemiologist and research analyst at Westat with six years of experi-

ence in evaluating health and housing initiatives for vulnerable populations.

NOTE: The authors acknowledge and appreciate the support that the Robert Wood Johnson

Foundation provided for the evaluation. They also acknowledge the assistance that Jim

Mayfield, senior research manager with the Research and Data Analysis Department of the

Washington State Department of Social and Health Services, provided in accessing administra-

tive data and developing propensity score models. The views expressed here, however, are

solely those of the authors.