1. Housing and Service Interventions for Family Homelessness: Results from a 12-site study and from Alameda County Marybeth Shinn (Beth) Vanderbilt University

2. Collaborators Vanderbilt University Jason Rodriquez Scott R. Brown Alameda County, especially EveryoneHome (Elaine de Coligny) Homelessness Management Information System Department of Housing and Community Development Abt Associates, especially: Daniel Gubits Michelle Wood Stephen Bell Samuel Dastrup Jill Khadduri Brooke Spellman

3. Today’s presentation Family homelessness in U.S. Family Options study overview Relationship between service systems in Alameda County: ▫ Homelessness ▫ Income support ▫ Child protection Lessons learned Google: HUD Family Options for reports (U.S. Department of Housing and Urban Development)

4. Hours per week at minimum wage to afford 2-bedroom apartment Source: National Low Income Housing Coalition Out of Reach 2013

5. Annual Shelter Use By Age (National %) Source: 2012 AHAR (HUD, 2013) and Census Data

6. The Face of Homelessness

7. Family Options Study: Comparing Housing and Service Interventions for Families SUB: Permanent Subsidies: Typically Housing Choice Vouchers that hold rent to 30% of income CBRR: Rapid Re-Housing: Temporary rental subsidies with some housing-related services PBTH: Transitional Housing: Congregate housing with intensive services and case management UC: Usual care: Shelter and whatever mix of services families can access

8. 12 Communities Participated 148 Programs 2,282 Families 20 month follow-up; 81% response rate

9. Alameda County participation Second largest site – one in 9 families 258 families 9 shelters 7 transitional housing programs 3 housing authorities 1 rapid re-housing program with multiple sites Programs in Alameda, Berkeley, Fremont, Hayward, Oakland, Alameda County

10. Study families Typical family: 29 year old woman with 1-2 children $7,400 median annual household income 30% with psychological distress or PTSD symptoms 63% had a prior episode of homelessness Spouses/partners: ▫ 27.4% had spouse or partner in shelter ▫ 10.1% had spouse or partner NOT in shelter

11. Alameda County families similar 95.7% of adults are women Mean age 30 Mean number of children 1.6 10.5% with partner in shelter Race/ethnicity ▫ 57% Black ▫ 19% Latino ▫ 12% White ▫ Mixed, Asian, Other

12. Study design: An experiment PRIORITY ACCESS Random Assignment Families in shelter who consent to participate in study SUB CBRR PBTH UC Screening

13. Getting Admission to Programs Screening prior to random assignment ▫ PBTH screened out more than a quarter of families ▫ CBRR and SUB accepted most families ▫ All families were eligible for Usual Care Moving in after random assignment ▫ Just over half of PBTH families ▫ Three fifths of CBRR families ▫ 84% of SUB families

14. The study estimates impacts in five domains Housing stability Family preservation Adult well-being Child well-being Self-sufficiency 1 1 2 2 3 3 4 4 5 5

15. SUB led to large improvements in housing stability

16. PBTH led to some more modest improvements

17. CBRR did not improve housing stability

18. Housing stability impacts Half of UC families had either been in shelter or doubled up recently. SUB reduced homelessness and doubling up by more than half. PBTH had more modest effects on homelessness only. CBRR had no effects. Alameda County: SUB reduced homelessness recorded in HMIS for 30 months

19. Family preservation impacts 15 percent of UC families had a child separated from the family in the past 6 months. 4 percent had a child placed in foster care SUB reduced child separations by two fifths SUB reduced foster care placements by three fifths CBRR and PBTH had no impacts on family preservation

20. Adult well-being impacts One in seven UC adults reported alcohol or drug dependency. One in eight reported intimate partner violence in the past 6 months. SUB reduced dependence on alcohol and drugs by almost a third and intimate partner violence by more than half. SUB also reduced psychological distress CBRR and PBTH had no impacts on these measures.

21. Child well-being impacts Children in the SUB group moved schools less often SUB and CBRR both reduced school absences by equivalent amounts PBTH had no impacts on these outcomes None of the interventions affected child health or behavior problems

22. Self-sufficiency impacts Fewer than a third of UC families worked for pay in the week before the follow-up survey SUB reduced this number by a fifth. SUB and CBRR both increased families who reported they were secure in their access to food—from about two-thirds to three quarters of families CBRR resulted in a $1,100 increase in annual income, from $9,100 to $10,200. Annual income for SUB families was the same as for UC families

23. What works for whom? Examined whether effects of all interventions differed by: ▫ Psychosocial challenges ▫ Self-rated housing barriers No evidence of differential effects

24. Costs Total costs for families assigned to the interventions similar: between $27,600 and $30,800 over 20 months PBTH was most expensive CBRR was least expensive SUB was comparable to Usual Care

25. Intervention Impacts in Alameda Priority access to housing subsidies reduced Homelessness over 30 months Foster care placement after study entry based on administrative records Priority access to transitional housing and rapid re- housing did not have effects

26. Alameda service use in two years before and after study entry (admin records)

27. Shelter episodes (Jan 2002 – Aug 2014) n = 258 families n = 175 families % Families by Number of EpisodesAverage total days by episode group

28. Predictors of additional shelter episode in Alameda County Prior shelter episode Annual income below $5,000 at study entry And surprisingly: Low levels of psychosocial challenges Factors that did NOT predict include: CalWORKS Reported abuse/neglect prior to study entry

29. Child Welfare Involvement As in other studies, considerable overlap between homelessness and child protective service ▫ Self reports (full sample) ▫ Child protective service records (Alameda County) Self reports show that most parent-child separations are informal and not known to CPS

30. Outcomes of Child Welfare Referrals Evaluated out: results from a safety assessment led CPS worker to close case without in-person investigation Investigated and deemed: ▫ Unfounded ▫ Inconclusive ▫ Substantiated Next slides show patterns before and after FIRST shelter entry in Alameda County

31. Child welfare reports increase after shelter entry

32. Reports show upswing before shelter entry

33. Reports spike after shelter entry

34. Percentage of families with each outcome goes up with number of shelter episodes Percent

35. Predictors of child welfare outcomes after study entry in Alameda County Reports of abuse/neglect Report prior to study entry CalWORKS during or after study entry Prior shelter episode No work prior to shelter entry Non-white race

36. Predictors of child welfare outcomes after study entry in Alameda County Reports of abuse/neglect Report prior to study entry CalWORKS during or after study entry Prior shelter episode No work prior to shelter entry Non-white race Substantiated abuse neglect None Foster care placement Foster care before study entry

37. Lessons learned about intersections among systems in Alameda County Substantial overlap between child welfare and homeless service systems Child welfare reports spike after families enter shelter ▫ This is especially true for non-white families ▫ Most reports were evaluated out or unsubstantiated ▫ There is no racial difference for substantiated cases, so no evidence of bias within the child welfare system Avoiding homelessness could avoid unnecessary child welfare evaluations

38. Lessons learned about intersections among systems in Alameda County More modest increase in non-substantiated child welfare reports before families enter shelter ▫ Might this be an early warning system for homelessness? ▫ Could child welfare workers regularly investigate families’ housing circumstances and refer to homeless service system? Many families not fully using CalWORKS or CalFresh prior to shelter entry ▫ Might hooking families up with benefits prevent some homelessness?

39. Lessons about the Homeless Service System in Alameda as elsewhere The homeless service system has gotten better at serving full families, but not good enough. Programs screen out many families. Families “vote with their feet.” “Facilities” are particularly problematic. Implication: Coordinated Entry requires plan B

40. Lessons about Usual Care: No special offer Families spent on average 4 months in emergency shelter following random assignment They participated in homeless and housing assistance programs at fairly high rates with total cost of about $30,000 Many were not faring well 20 months after study enrollment

41. Lessons about Program-Based Transitional Housing Excluded many families Relatively low take up Reduced homelessness compared to UC, but few benefits in other domains The finding of “no impact” extends to families with higher psycho-social challenges Cost less than shelters on a per-family, per-month basis, but total costs were higher than for UC

42. Lessons about Rapid Re-Housing Excluded some families Relatively low take up More rapid departures from shelter than UC No improvements in preventing subsequent homelessness or improving housing stability Fewer school absences and increased family income and food security Lowest cost per month of the programs studied

43. Subsidies: not-so-surprising lessons Notable improvements in housing stability compared to CBRR, PBTH, and UC Reductions in homelessness in Alameda HMIS records Reduced labor market engagement, but without an impact on overall cash income

44. Sub: Surprising lessons Few families ineligible High take-up Cost comparable to Usual Care Radiating Impact