Evaluation Strategies for a Multi-site Initiative Implementing “Housing First” Peteria Chan, MPH Jill Bellinger, Ph.D. Stacey Stevens Manser, Ph.D.

The ‘Housing First’ Model Prevention vs. management Challenges traditional model Recovery-oriented framework

Healthy Community Collaborative (HCC) Project Goal: House and coordinate care of persons who are homeless and have a mental illness or co- occurring psychiatric and substance use disorder Main objectives: –Implement “coordinated assessment” –Engage clients in MHSA and wraparound services –House the most vulnerable persons in PSH –Manage data quality and analysis

Data Collection Total number clients for select services Mental health service data Service and assessment data for PSH clients Verified reliability and validity of data

Participant Demographics Average age: 44 years 63% Male 37% Female 52% Black 48% White 89% Non- Hispanic 5 Sites 5,805 Participants

Assessments and Housing PSH= Permanent Supportive Housing RRH = Rapid Re-housing AH = Affordable Housing TH = Transitional Housing 5,805 HCC Clients 285 in PSH 484 in RRH 79 in AH 39 in TH 14,503 Coordinated Assessments

Percent of Clients (n= 1,063) who Received MH Services by Service Type Pharm. Management Case Management MH Crisis Benefits Assistance Medication Training Client Evaluation

MH Service Engagement by Site Site A (n=305) Site B (n=48) Site C (n=664) Site D (n= 46)

Engagement in Support Services by Service Type Food (n=8649) Clothing (n=6042) Peer (n=2067) Shelter (n=7781)

Challenges for Evaluators Creating shared definitions of data elements Verifying data Managing and cleaning non-uniform data Differing levels of capacity and project development Chain of communication and organizational bureaucracy

Challenges for Implementing ‘Housing First’ Limited housing stock Building trust with property managers Promoting engagement in MHSA services Finding clients once housing is available Providing services off-site

Lessons Learned for Evaluation Evaluation Design Being present from beginning is ideal Data Management & Collection Data definitions, reviewing, data cleaning and preparation were time intensive activities Sites need time to create data collection and reporting procedures ‘Usability’ of Results Allow feedback from entities Present results in clear, understandable visuals

Acknowledgements This work was funded by the Texas Department of State Health Services. Views expressed by speakers do not necessarily reflect the official policies of the Texas Department of State Health Services; nor does mention of trade names, commercial practices or organizations imply endorsement by the Texas State government. Thank you to the Texas Department of State Health Services and HCC project sites for their ongoing work in support of people experiencing homelessness.

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