Family Options Study: 3-Year Impacts of Housing and Services Interventions for Homeless Families
HUD’s recently released report, Family Options Study: Three-year Impacts of Housing and Services Interventions for Homeless Families, offers critical insights about the long-term effectiveness of various programs to address homelessness for families with children. Launched in 2008, the study follows 2,282 families randomly assigned to different housing and/or services interventions between September 2010 and January 2012 across 12 sites: Alameda County, California; Atlanta, Georgia; Baltimore, Maryland; Boston, Massachusetts; Bridgeport and New Haven, Connecticut; Denver, Colorado; Honolulu, Hawaii; Kansas City, Missouri; Louisville; Kentucky; Minneapolis, Minnesota; Phoenix, Arizona; and Salt Lake City, Utah. Each family participating in the study had spent at least 7 days in emergency shelter and had at least one child aged 15 or younger at the point of enrollment.
Study Design and Research Questions
The study is designed as an experiment, in which families were randomly assigned to one of four possible interventions that differ in the duration of housing assistance provided and/or in the intensity of social services offered, including: 1) a long-term housing subsidy (SUB), which offers a long-term, deep housing subsidy, usually in the form of a housing choice voucher, with no specialized services; 2) community based rapid re-housing (CBRR), which is temporary rental assistance for up to 18 months with limited housing-related services; 3) project-based transitional housing (PBTH), which is temporary housing for up to 24 months in an agency-controlled building coupled with intensive supportive services; and 4) usual care (UC), which refers to the mix of housing and services that homeless families may access from shelter on their own without direct referral to one of the other interventions. Families were followed for three years following random assignment, with extensive surveys of families conducted at baseline and again approximately 20 and 37 months after random assignment.
The goal of the Family Options Study was to understand which housing and services interventions work best for families with children experiencing homelessness, and to learn whether or not certain types of families benefit more or less from different interventions. The fundamental research question guiding the analysis seeks to understand if priority access to a particular intervention yields differences in outcomes for homeless families over the short-term (roughly 20 months after random assignment) and/or the long-term (roughly 37 months after random assignment). While the primary outcome of interest was housing stability, and, in particular, preventing families from returning to homelessness, additional outcome domains of interest include family preservation, adult well-being, child well-being, and self-sufficiency. In addition to collecting data about the well-being of families and children at different points in time following random assignment, extensive cost data on each of the interventions studied was also collected, in order to calculate the fiscal costs of achieving the outcomes that were documented.
The findings at 37-months in large part mirror the findings documented at 20 months, with the long-terms outcomes again demonstrating the power of a long term housing subsidy to convey significantly improved housing outcomes to formerly homeless families. Families offered a subsidy experienced less than half as many episodes of subsequent homelessness, and vast improvements across a broad set of measures related to residential stability when compared to families offered any of the other interventions. In addition to improved housing outcomes, families offered a long-term subsidy continue to demonstrate significantly improved outcomes in non-housing domains, including adult well-being (reductions in psychological distress, intimate partner violence), child well-being (reductions in school mobility, behavior problems and sleep problems, and more pro-social behavior), as well as increased food security and decreased economic stress. Families offered community-based rapid re-housing or usual care have outcomes that are largely similar to the outcomes of the families assigned to usual care.
The benefits conferred to subsidy families were achieved, on average, for roughly $45,500 over the 37-month period—a cost which is only 9% higher than the costs which accrued to the families assigned to usual care, who utilized, on average, $41,000 in housing and services over the 37-month period. Similar to what was observed at 20-months, rapid re-housing remains the lowest cost intervention, with an average cost of $4,000 less than the other interventions over the full 37-month period. Also similar to the finding at 20-months, families assigned to transitional housing continue to incur higher costs than families assigned to rapid re-housing or usual care (roughly $10,000 more and $1,500 more, respectively), but at 37-months, families assigned to transitional housing have used roughly $4,000 less in housing and services than subsidy families.
Conclusions and Implications
The findings from the Family Options Study provide powerful evidence on how we can end homelessness among families. Moreover, it also shows that by ending homelessness among families, there are substantial spillover benefits, such as dramatic reductions in a host of negative outcomes for children, families and communities, including homelessness and housing instability, intimate partner violence, psychological distress, economic stress, food insecurity, and school mobility—all of which are measures linked by research to have powerful effects on child well-being. The study also demonstrates that families who experience homelessness can successfully use and retain housing vouchers. The striking impacts of assignment to the subsidy intervention in reducing subsequent stays in shelter and places not meant for human habitation provide support for the view that, for most families, homelessness is a housing affordability problem that can be remedied with long-term housing subsidies without specialized services.
For the crisis response system, the study provides clear evidence that the high cost of emergency shelter and transitional housing programs do not yield improved outcomes for families when compared to the outcomes of families offered rapid re-housing. Community-based rapid re-housing continues to be the lowest cost intervention, while yielding similar outcomes for families as the outcomes experienced by the families assigned to usual care and transitional housing. In the absence of a sufficient supply of long-term subsidies for families experiencing homelessness, rapid re-housing becomes the most useful response for communities seeking to assist homeless families, as the lower cost of rapid re-housing enables communities to serve more families with their limited resources.