Core Performance Indicators for Homeless-Serving Programs Administered by the U.S. Department of Health and Human Services. Background and Study Objectives

09/01/2003

Recent studies suggest that homelessness is a problem that afflicts many adults and children in the nation and can have a broad range of short- and long-term negative consequences. It is estimated that up to 600,000 people in the United States are homeless each night.(4) A recent study by the U.S. Department of Health and Human Services, Ending Chronic Homelessness:  Strategies for Action, indicated that each year approximately one percent of the U.S. population  two to three million individuals  experiences a night of homelessness that puts them in contact with a homeless assistance provider.(5) The poor are particularly vulnerable to experiencing both short- and long-term periods of homelessness, with between four and six percent of the poor experience homelessness annually. This study also notes that the circumstances leading to homelessness are varied and that research conducted since the late 1980s shows that interactions among the supply of affordable housing, poverty, and disability account for most of the precipitating factors.

For those falling into homelessness  especially chronic homelessness  there can be a broad range of adverse effects. Without a stable residence, homeless individuals are faced daily with having to meet even their most basic and immediate needs to survive. Homelessness may threaten family integrity by exacerbating problems such as parental stress, emotional and health problems, alcohol and drug abuse, and family violence. Compared to families and individuals living in stable housing, those who are homelessness are more likely to be exposed to violence, illegal activity, illness, accident, malnutrition, depression, anxiety, and social isolation. Homelessness can make it very difficult to secure work, and even when a homeless individual is employed, the conditions of homelessness may jeopardize the ability to hold onto the job. Personal cleanliness, appropriate clothing, punctuality, and the energy to meet job expectations may all be difficult to maintain under unstable living arrangements.

Given the consequences of homelessness, effective intervention is important to prevent chronic or cyclical homelessness from occurring. For families and individuals, becoming homeless is a process that offers numerous points at which intervention and appropriate service might prevent the crisis that results in homelessness or mitigate its detrimental effects. Past studies  such as a recent Report to Congress(6)  have identified a broad continuum of services needed by homeless individuals to escape homelessness  particularly, housing assistance, health care services (including mental health care services and substance abuse treatment/counseling), employment and training services, and a range of support services (such as transportation, clothing, and food assistance). These services may help homeless individuals to overcome a current homeless episode or help individuals to avoid falling into a pattern of chronic homelessness.

In developing programs to address the needs of the homeless, it is important to specify clearly the program goals and objectives to guide implementation of program activities, as well as a set of performance measures to facilitate documentation and analysis of the effectiveness of program interventions. This study  conducted under a task order contract to the U.S. Department of Health and Human Services  explores the feasibility of developing a core set of performance measures for DHHS programs that focus on homelessness. It has two main objectives: (1) determine the feasibility of producing a core set of performance measures that describe accomplishments (as reflected in process and outcome measures) of the homeless-specific service programs of DHHS; and (2) determine if a core set of performance measures for homeless-specific programs in DHHS could be generated by other mainstream service programs supported by DHHS to assist low income or disabled persons.(7)

A key focus of the study is on enhancing performance measurement across four homeless-serving programs administered by DHHS: (1) Programs for Runaway and Homeless Youth (RHY), (2) the Health Care for the Homeless (HCH) Program, (3) Projects for Assistance in Transition from Homelessness (PATH), and (4) the Treatment for Homeless Persons Program.(8) This study builds upon the process and outcome measures that are already generated as part of the homeless registry/homeless administrative data system (HADS) systems. In addition, this project deals with an important government management requirement that has affected agencies and programs for the past several years: the Government Performance and Results Act (GPRA), which requires government agencies to develop measures of performance, set standards for the measures, and track their accomplishments in meeting the standards.(9)

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