1. Factors Contributing to Eviction from HUD-VASH
Dennis Culhane, PhD
Director of Research, National Center on Homelessness Among Veterans
Dana and Andrew Stone Professor of Social Policy, School of Social Policy and Practice, University of Pennsylvania

2. Exits from Permanent Supportive Housing
High rate of housing retention in PSH, but exits may be associated with a number of factors
Nonpayment of rent1
Use of emergency services2
Substance abuse3–5
About 1 in 10 Veterans leave HUD-VASH due to eviction, which is associated with negative consequences
Ongoing residential instability6
Relocation to neighborhoods with higher poverty and crime7
Relocation to substandard, lower-quality housing, which may directly impact health8–10
Material hardship11
Homelessness4,11,12

3. Study Objectives
To identify correlates of eviction—both tenant characteristics and precipitating events—that may signal imminent eviction
To assess potential utility of a real-time, data-driven system of notification for services providers

4. Methods Potential Correlates Sample & Analysis
Veterans’ characteristics
Tenure in HUD-VASH housing
Sex
Age
Military experience
Service-connected disability
Medical, mental, and behavioral health diagnoses
Precipitating events
Inpatient admissions
Emergency Department (ED) visits
Outpatient care
Sample: 20,146 Veterans who exited HUD-VASH (10/2008–2/2016)
Evicted
Accomplished goals
Analysis: logistic regressions—controlling for demographics, diagnoses—with 3 patterns of precipitating events/services use

5. Precipitating Events Services Use Model Eviction
Used inpatient, ED, outpatient care
Services Use Model
Eviction
Increased Services Use Model
Eviction
Increased use of inpatient, ED, outpatient care
1 inpatient admission or 2 ED visits
Acute Care Use Model
Eviction
Inpatient and ED care categorized as medical, mental health, substance use; outpatient care categorized as primary care, medical, mental health, substance use, HUD-VASH case management; acute care includes any type of inpatient or ED service

6. Veterans’ Characteristics
Evicted
(n=4,684)
Accomplished Goals
(n=15,462) p
Length of residence (months)
19.2
27.2
<.001
Female (%)
9.1
14.5
Age (%)
< 35
11.3
10.6
35–54
43.4
39.2
55+
45.4
50.3
Combat exposure (%)
4.7
5.5
.011
Service-connected disability (%)
41.4
46.8
Diagnoses (%)
Chronic medical condition
36.2
31.5
Depression
43.2
36.1
PTSD
18.0
15.6
Psychosis
9.5
4.8
Suicide/self-harm
10.7
1.5
Alcohol use disorder
32.5
11.2
Drug use disorder
38.6
12.2

7. Services Use 90 Days Prior to Exit
Inpatient Admissions
Emergency Department Visits
Acute Care Use

8. Veterans’ Characteristics  Eviction
Decreased Odds of Eviction
Increased Odds of Eviction

9. Services Use Model
Outpatient
Emergency
Inpatient

10. Increased Services Use Model
Outpatient
Emergency
Inpatient

11. Acute Care Use Model

12. Precipitating Events  Eviction
Any inpatien t admissio n or ED visit, particula rly related to substanc e use
Acute care
Outpatie nt care related to substanc e use
(Best predictor s: increases in use over time and use 30 days prior to exit)
Primary care and medical outpatie nt care
HUD- VASH case manage ment
Increased odds of eviction
Decreased odds of eviction

13. Potential Utility of Predictive Model
Veterans’ characteristics and precipitating events (patterns of acute health services use) are related to increased likelihood of eviction
In each model, the use of specific types of acute care within 30 days of exit are the best predictors
Allows little time to intervene but may serve as an efficient, and hopefully effective, warning flag
Other variables (e.g., nonpayment of rent) may also predict eviction, but are not readily available

14. For More Information
Montgomery, A. E., Cusack, M. C., Szymkowiak, D., Fargo, J. D., & O’Toole, T. P. (2017). Factors contributing to eviction from permanent supportive housing: Lessons from HUD-VASH. Evaluation and Program Planning, 61, 55–63. doi: /j.evalprogplan

15. References
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