Applying the Housing First approach to single-site permanent supportive housing

This study explored how the U.S. Departments of Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) program applies Housing First principles in the context of ten single-site programs. Focus group discussions with 64 HUD-VASH staff and community partners explored how the programs were influenced by Housing First principles and specific strategies to implement these principles in a single-site setting. Focus group respondents described resourceful ways that the principles of Housing First were implemented in their programs specifically related to (1) housing choice and structure, (2) separation of housing and services, (3) service philosophy, and (4) service array. Several of the Housing First domains cite the importance of integrated housing and the provision of services off-site; it was of particular interest to learn how single-site programs address these issues logistically. Lessons learned from this study include the importance of leveraging the independent yet overlapping tasks of case management and property management to ensure functional – if not geographic – separation of housing and services; maintaining staff on-site to address Veterans’ needs; working with community service organizations to complement the array of service available to residents; and housing single-site programs in mixed-use buildings.     

“At times I kinda felt I was in an institution”: Supportive housing for transition age youth and young adults

Housing stability is essential for young adult development. Older youth and young adults transitioning from public systems of care, such as foster care, the public mental health system and residential settings, commonly experience high levels of transience and housing instability. In recent years, supportive housing policies and programs have emerged to address this situation, yet we know little about whether (or not) new programs are meeting the needs of youth in transition, and, if so, how they are addressing the unique developmental, social, and emotional needs of this population. This study is one of the first to speak directly with young adults living in a supportive housing program designed specifically for youth transitioning out of children's systems of care. Study participants spoke about both their overall transition experience and their views on the housing program where they reside. The study conducted four focus groups (N = 26) with transitioning youth and young adults, ages 18 to 25 (Mean age = 22), in order to explore the following three broad research questions: 1) what is it like to make the transition to adulthood from public children's systems of care?; 2) how does the supportive housing model they reside in shape their transition experiences?; and, 3) how do they experience the services and staff who are part of the program? Data analysis included grounded theory coding techniques and constant comparison with four coders. Results suggest that participants feel like they continue to be treated as children, and they receive mixed messages regarding their need to be increasingly autonomous, yet follow the rules. Finally, they reported specific aspects of what they found to be helpful in both staff relationships and overall program components. These themes constitute the results of the study. Findings underscore the importance of both listening directly to service users, and developing young adult supportive housing programming expressly designed to meet the unique needs of marginalized young adults transitioning to increased independence and self-sufficiency.     

Linking federally assisted housing with services for frail older persons

Advocates of policies designed to link federally assisted housing with social services for the frail elderly have encountered barriers such as the historical separation of housing and services, political and bureaucratic fragmentation, and budget constraints. Over a 20-year period, they have attempted to address these issues by identifying the nature and extent of the problem, creating workable models, and developing a political constituency. Major reform, however, occurred only in 1990 when Congress passed the landmark National Affordable Housing Act (NAHA) which provided an "open policy window" for supportive housing legislation. NAHA's passage, however, still left many issues unresolved (e.g., targeting and funding for services). The future challenge is to develop new models of supportive housing and provide a range of residential settings and portable services to increase the choices for frail older persons.     

Factors contributing to eviction from permanent supportive housing: Lessons from HUD-VASH

IntroductionEviction from housing is associated with several negative outcomes, further exacerbated among high-need populations requiring financial and supportive services to maintain housing stability. This study investigated risk and protective factors—both characteristics and precipitating events of tenant eviction—informing permanent supportive housing (PSH) programs’ efforts to identify tenants at risk and intervene.MethodsUsing administrative data for a cohort of 20,146 Veterans participating in PSH, this study assessed differences in Veterans who exited the program due to eviction and Veterans who exited because they accomplished their goals. A series of logistic regressions identified patterns of health services use that may signal imminent eviction.ResultsVeterans with a drug use disorder and those who received inpatient, emergency, or outpatient care related to mental/behavioral health and substance use conditions proximal to program exit had greater risk for eviction. Receipt of outpatient primary medical care and supportive services was generally protective against eviction. The likelihood of eviction was greatest for Veterans with acute care use within 30 days of exit.DiscussionPSH providers may use these correlates of eviction to identify Veterans in need of an intervention to prevent eviction. Future work should focus on operationalizing these findings and identifying appropriate interventions.     

Strengths,weaknesses, opportunities,and threats to housing first in Metro Vancouver

ObjectivesTo understand the experience of Metro Vancouver’s Homelessness Partnering Strategy-funded Housing First program and how it is functioning from the perspective of a representative sample of providers and clients who deliver and receive HF services.MethodsThirty-four clients and providers who currently or formerly delivered HF in Metro Vancouver participated in one-on-one interviews (n = 26) or focus groups (n = 8) between March and April 2017 and data were thematically analyzed.ResultsStrengths of the HF program included: the ability to transition persons from the street into housing with individualized service supports and, in certain cases, with 12-month rent subsidies, household goods, and connection to community resources. Identified program weaknesses were: eligibility criteria, limited rent subsidy funds, limited provider capacity, and workload burden. Suggested opportunities to improve HF were: streamlining federal and provincial reporting and rent subsidy systems and building friendly landlord networks. Potential threats to HF described were: limited affordable housing, stigma and discrimination toward clients, inadequate income assistance, and limited opportunity for cross-sector collaboration.ConclusionsThe delivery of HF in regions that have limited affordable housing presents unique challenges. Recommendations are provided to improve HF practice and policy in these contexts.     

Inadequate housing and the child protection system response

Involvement with child protective services (CPS) is common among families experiencing inadequate housing conditions. As with other issues of material deprivation, inadequate housing is an area where the distinction between neglect and poverty is difficult to ascertain, and the response of the child protection system to inadequately-housed families is largely understudied. This study uses a nationally representative sample of child protection investigations to explore the associations between two types of inadequate housing—doubling up and experiences of homelessness—and system outcomes. Specially, we identify that, after accounting for other risk factors, inadequate housing is significantly associated with the receipt of services, but not directly associated with either substantiation or case closure. Moreover, housing concerns may have a different association with case outcomes when interacted with other risk factors, specifically mental health and substance abuse, and domestic violence. Overall, results suggest that, while child protection workers do not view inadequate housing as neglect in and of itself, they do identify housing issues as a service need.     

Boom and bust: housing equity withdrawal and consumption decisions and their impacts on household wealth

The authors examine whether the surge in housing refinance and equity withdrawal generated by the housing boom disproportionately affected older households in terms of decisions on whether to refinance, whether to withdraw equity, and how much to withdraw, and how in turn these decisions affected their household wealth. Using the Federal Reserve's Survey of Consumer Finances, the authors found the highest rates of refinancing and cashing out equity among older (although not necessarily the oldest) households. The authors also found that appreciation in house value, being a baby boomer, and having higher household income were the factors that most increased the probability of refinancing and withdrawing equity. Amounts cashed out were higher among older than among younger households. Ordinary least squares (OLS) estimates showed that amounts withdrawn were increased by price appreciation, financial assets, and income, along with being a "pre-boomer" or "early boomer." Older cohorts displayed larger wealth effects than younger ones, but their withdrawn equity was a smaller percentage of total net worth. A relatively small percentage of respondents' dollars was used for consumption, and most dollars were used for home improvement, other investment, or debt repayment. However, massive equity withdrawal and the subsequent collapse of housing prices have caused housing leverage to soar, putting some homeowners "underwater" and jeopardizing others' retirement preparedness. The ensuing housing finance crisis raises numerous policy issues, from reform of mortgage underwriting, securitization, servicing, and foreclosure procedures, to potential limitations on borrowing against unrealized housing equity gains, to enhanced government transfers for distressed older homeowners, to local and state revenue policy changes.     

Using developmental evaluation and community-based participatory research to develop a model of supportive housing

Community-based participatory research (CBPR) and developmental evaluation (DE) have emerged over recent decades as separate approaches for addressing complex social issues. Current literature offers little with respect to the use of CBPR and DE in combination, although the two approaches are complementary. Through the current paper, we outline how CBPR and DE were used to develop a model of supportive housing for teen families. More specifically, we describe the structures and processes that contributed to this development, including (1) our partnership approach, (2) pooled resources, (3) regular opportunities for collaboration and reflection, (4) integration of multiple data sources, (5) ongoing feedback and knowledge dissemination, and (6) adjustments to program practices. We end by providing insights into the lessons that we learned through this project. Through this paper, we describe how researchers and community partners can collaboratively use CBPR and DE to develop a program model in complex community settings. Insights are offered that will be important for researchers, evaluators, and practitioners seeking to develop programming in response to complex community issues.     

Comparing States' Medicaid Nursing Facilities and Home and Community-Based Services Long-Term Care Programs: Quality and Fit with Inclination,Capacity, and Need

States employ home and community-based services (HCBS) increasingly in Medicaid support of long-term care and rely less on nursing facilities. We examine how states' nursing facilities and HCBS programs compare and whether states' long-term care responses match their ideological inclination toward, material capacity for supporting, and their citizens' need for these public social programs. We use cross-sectional panel data on structural, process, and outcome quality for nursing facilities and HCBS congregate residential programs. We rank states, correlate these measures, and use regression to link inclination, capacity, and need to quality. We find that states' nursing facility and HCBS program quality are not closely related and that state HCBS congregate residential program quality is independent of inclination, capacity, and need. This latter result underscores a need for uniform HCBS standards and better data on quality.     

Designing and managing public housing self-sufficiency programs: the Youngs Lake Commons Program

This article evaluates an experimental public housing self-sufficiency program that encourages home ownership among low-income families. A quasi-experimental design, in combination with focus groups, records review, and key informant interviews, provides data to focus on four questions: (a) Do these programs simply accelerate move-outs for those who would have left without intervention? (b) Are program elements replicable given the importance of the local context in public housing move-outs? (c) How do housing authorities resolve tensions that arise between housing management and social service delivery? (d) What should housing authority response be to those who fail?     

Home for now: A mixed-methods evaluation of a short-term housing support program for homeless families

The use of short-term rental subsidy vouchers offers a new approach to addressing the housing needs of families facing homelessness. In Massachusetts, the Family Home pilot program placed homeless families in housing instead of shelter, providing two years of rental subsidy plus support services with the goal of enabling families to maintain market rate housing. This mixed-method case study complements staff and participant interview data with participant survey and administrative data to evaluate the implementation and short-term outcomes of Family Home in one region. Data point to improved family well-being in housing but also persistent barriers to achieving longer-term housing and economic stability. Of the families who had exited the program at the end of the study, one quarter were able to retain their housing at market rate, only 9% returned to shelter, and one in five moved in with families/friends. Lack of affordable housing in a high rental cost region and jobs that pay living wages were among the major reasons that families struggled to maintain housing. This research points to the need for integrating supportive services from the program's start, including targeted workforce development, to plan for the end of the short-term rental subsidy.     

Built community: architecture,community, and participation in a permanent supportive housing project

Housing and the social processes that create it are an important part of a better world. The permanent supportive housing movement holds that housing, in addition to a variety of human services, is the most dignified and effective way to help people without homes. But the design of such initiatives matters. This community-based, qualitative research project investigates the connection between space, participation, and community. It draws on the experiences of residents of an innovative housing organization on Skid Row in Los Angeles, California. Residents of the program find community space to be both promising and contested. Their experiences also reveal the way that institutional space can be trauma-informed and impact their overall wellbeing and opportunities for interacting with others. However, their feelings of being a part of the community and their involvement in activities are not always connected, as identity and social context can cause residents to identify or dis-identify with their community despite how involved or uninvolved they are. Intentionally designed community spaces in permanent supportive housing units can respond to trauma and set the stage for interaction, but they cannot solve all problems.     

Divorce and the cost of housing: evidence from Iran

Divorce trend in Iran has become a serious social concern that is suspected of being influenced by rising housing costs in an oil-based economy. Iran has the highest growth rate of divorce among Islamic countries in the Middle East and North Africa region. Using data from 30 provinces of Iran from 2002 to 2010, this paper examines the relationship between housing costs (house prices and rents) and divorce rate, controlling for other macroeconomic variables such as unemployment, inflation, and education in addition to regional, cultural, traditional, and conventional attitudes toward divorce. By applying panel fixed-effects and dynamic generalized methods of moments methods, our results suggest that increases in housing costs erode marital stability in Iran. Our main results are also supported when we focus on the shocks in housing costs, using the Vector autoregressive based impulse response and variance decomposition analyses of divorce rates at the national level from 1982 to 2010.     

Planning for the Residential Needs of Lesbian,Gay, Bisexual,and Transgender Older Adults

Lesbian, gay, bisexual, and transgender (LGBT) older adults experience housing-related barriers. Previous research has described residential challenges experienced by this population, but few studies have examined implementation of housing solutions. This exploratory study conducted 7 semistructured phone interviews with program directors and/or development managers from initiatives offering residential services to LGBT older adults. Qualitative analysis identified themes that characterize the implementation of housing solutions. Study results suggest that future residential solutions for LGBT older adults should consider housing in relation to other aging-related barriers and frame solutions that promote collaboration among community actors (e.g., residential and service providers).     

State Units on Aging and Housing for the Elderly:

One major goal of the Older Americans Act (OAA) is to promote suitable housing for the elderly through the aging network that includes the State Units on Aging (SUAs). Little is known, however, about SUA activity in this area. This article reports on the results of a recent survey of SUA housing efforts and roles played, collaborations and networks, resources, and priorities, accomplishments and future initiatives. To better link housing and services and expand housing options as some SUAs are already doing-especially in services coordination in existing housing, board and care, home equity conversion mortgages and assisted living-they must redefine housing as part of community-based care, vigorously focus political and advocacy skills on housing issues, and expand their capacity building and expertise in housing by resetting priorities and reallocating budgets.     

Social problems clusters as contexts for claimsmaking: implications for the study of off-campus housing

ABSTRACT

Many social problems claims occur in a context that involves (1) actors’ recognition of other stakeholders, (2) relationships among those actors, and (3) varying temporal frameworks that influence how each claimsmaker views the current collection of issues. We call actors’ involvement in overlapping issues a social problems cluster, a set of claimsmaking efforts that involve many of the same people and groups as advocates, or opponents. Using a case study of local student housing issues as an example, we suggest the following regarding the social problems cluster. First, we consider how the interactions among social problems cluster members shape what happens with a particular issue. Second, we consider the way participants within one social problems cluster recognize links may reflect participants’ biographies, interests, ideologies, and so forth. Attending to how the social problems cluster’s members interact and link issues helps to locate a particular claim within its broader context.     

Separate and Unequal: The Housing Act of 1968 and the Section 235 Program

In recent years scholars have identified racial disparities in wealth and home ownership as crucial factors underlying patterns of racial inequality and residential segregation in American metropolitan housing markets. While numerous federal housing policies have been identified as responsible for reinforcing residential segregation and racial inequalities in home ownership, little research has focused on the segregative effects of the Section 235 program. As one component of the 1968 Housing Act, Section 235 was designed to shift the focus of federal housing policy away from dispensing aid to local housing authorities for building public housing to providing direct supply-side subsidies to the private sector to stimulate home ownership for nonwhites and the poor. Archival and census data, government reports and housing analyses, and oral histories and interviews are used to examine the segregative effects of the Section 235 program in Kansas City, Missouri from 1969 through the early 1970s. Findings indicate that while the housing subsidy program allowed a vast majority of participating white families to purchase new housing in suburban areas, most participating African American families purchased existing homes located in racially transitional neighborhoods in the inner city. These findings corroborate recent research showing how the market-centered focus of federal housing policy has impaired the ability of African Americans to accumulate wealth through home ownership and reinforced racially segregative housing patterns.     

The role of housing in the transition process of youth and young adults: a twenty-year perspective

Lighthouse Youth Services in Cincinnati, Ohio, began placing foster youth, ages sixteen to eighteen, in individual apartments and other living arrangements in 1981 as a way of preparing them for life after foster care. The program has assisted over thirteen hundred youth and their children using scattered-site apartments, shared homes, roommate situations, host homes, and subsidized housing. The agency works with referring agencies to develop a transition plan one youth at a time and allows youth to move along a continuum of housing options depending on their level of functioning and behavior. Aftercare services assist youth for years after they leave custody. This chapter includes some case studies and summarizes the author's observations from running the program for the past twenty years.     

Transition from Home Care to Nursing Home: Unmet Needs in a Home- and Community-Based Program for Older Adults

A major effort is under way nationally to shift long-term care services from institutional to home- and community-based settings. This article employs quantitative and qualitative methods to identify unmet needs of consumers who transition from a statewide home- and community-based service program for older adults to long-term nursing home residence. Administrative data, care manager notes, and focus group discussions identified program service gaps that inadequately accommodated acute health problems, mental health issues, and stressed family caregivers; additional unmet needs highlighted an inadequate workforce, transportation barriers, and limited supportive housing options. National and state-level policy implications are considered.