The available evidence suggests that high-touch supportive programs involving case management are particularly effective for improving the lives and opportunities for poor and vulnerable families living in concentrated poverty. Many strategies that go beyond housing redevelopment and mobility have aimed to augment support for vulnerable families with various case management services. Although each of the programs described below aims to improve different outcomes (e.g. some strategies focus on violence prevention, whereas others may target increased education and employment), targeted case management strategies have proven promising for moving a variety of outcomes, particularly when case management programs are high-touch (usually entailing relatively small caseloads).
Studies of family case management strategies targeting youth find that programs using whole-family supportive service models can be effective in improving youth outcomes. The Children at Risk (CAR) program is one promising example of supportive services in the form of a drug and delinquency prevention program aimed at providing youth and household support to high-risk adolescents ages 11-13 in 5 cities across the country. This five-city demonstration program was funded by a group consisting of the Department of Justice (DOJ) Office of Juvenile Justice and Delinquency Prevention, other federal agencies, and a group of private foundations from 1992 through 1996. The evaluation of CAR indicates youth in the treatment group who received case management in close collaboration with schools and community organizations, exhibited less antisocial and high-risk behavior (Harrell, Cavanagh, and Sridharan 1999). In particular, relative to control group youth, youth enrolled in CAR participated in a higher number of positive activities, received more positive peer support, and were less likely to use drugs or commit violent crimes. Other experimental evaluations have found similar outcomes for at-risk youth receiving case management coordinated with services (Bloom et al. 1993, Long et al. 1996; Reid and Bailey-Dempsey 1995).
Supportive service and case management strategies aimed at supporting homeless families have produced similar outcomes to those targeting families in public or assisted housing. In many respects, families who were not able to relocate from the distressed public housing developments which were the target of HOPE VI grants are similar to homeless families. Like families who are homeless, families relocated through HOPE VI cannot afford housing in the absence of public housing assistance and have few options or opportunities as demonstrated by the fact that they had lived in distressed public housing developments, many of which were not only riddled with crime and concentrated poverty, but were also physically dilapidated or inadequately managed. Findings from the Sound Families Initiative, an effort to provide housing and services to homeless families (funded by the Gates Foundation, with support from local government and non-governmental organizations), highlight the need for accurate up-front assessments coupled with aggressive efforts to triage services (Bodonyi 2008). For example, the Sound Families Initiative found that providing stable housing, connecting families to training and education programs, creating partnerships with the child welfare system, and training case managers in trauma-informed strategies greatly informed trauma screening for children at intake, and as a result helped better target and meet children’s needs.
Another study provides insight into strategies necessary for improving vulnerable families’ conditions and opportunities, though more so for adults than for their children. The Urban Institute’s Chicago Family Case Management Demonstration tested the use of housing as a platform to provide services coupled with intensive case management. The demonstration lowered caseloads from 55 per case manager to nearly half that (Popkin et al. 2010b). Service components prioritized services and trainings in transitional jobs, financial literacy, and relocation for residents. Together, lower caseloads and aggressive efforts to engage clients and move outcomes resulted in understanding of the need to triage and match clients with specific services (Theodos et al. 2012).
Findings from the Chicago demonstration have also supported intensive case management as a strategy to support vulnerable public housing and voucher families. An evaluation of the demonstration finds strong improvements in health, education, and employment for adults. However, children and youth, who continued to struggle in school, engage in risky behavior, and have pregnancy and parenting rates far above average, did not share similar benefits (Popkin et. al 2010a). These findings suggest that while intensive case management may benefit adults substantially, there is a need for two-generation strategies that target the whole family (Popkin et al. 2012a).