HUD/HHS/VA Collaborative Initiative to Help End Chronic Homelessness: Preliminary Client Outcomes Report. Client outcomes


CICH clients were housed quickly, and remained housed in one or more different settings thereafter. An examination of living arrangements among CICH clients at baseline and at each subsequent completed follow-up interview shows that 89% of CICH clients appeared to have been continuously housed throughout the 12-month follow-up period, where continuously housed is defined as living in their own place, in someone else's place, or in an SRO hotel at the time of the interview. In contrast, only 2% lacked housing at baseline and at all completed follow-up assessments thereafter, and 8% were housed during some quarterly assessments, and not housed during other assessments (data not shown). The average number of days housed in the previous 90 days increased dramatically from 18 at baseline to 68 at the 3-month follow-up, and rose steadily thereafter to 83 at the 12 month follow-up. The fact that housing satisfaction remained largely unchanged among those housed, averaging 4.1 (out of a total possible 5) at baseline and 4.0 thereafter, suggests that CICH clients were generally quite satisfied with their housing placements, and remained so (Table 7). Once housed, clients quickly got to know at least one of their neighbors well (increasing from 38% at baseline to 67% at 3-months, and then increasing to 76-77% thereafter). Subjective quality of life (i.e. life satisfaction) also increased rapidly, albeit modestly, from 4.3 at baseline to 4.6 at 3-months and thereafter (an increase of 7%). The community integration index (reflecting participation in everyday activities such as shopping or going to a restaurant) also increased from 6.8 at baseline to 7.2-7.3 at 6-months and thereafter (also a 7% increase).

One possible contributor to increased subjective quality of life and community integration is increased income. Average total income increased continuously from $380 at baseline to $579 at 12-months. The proportion of clients receiving any type of public support rose from 70% at baseline to 81%-85% at 3-months and thereafter. Consequently, average public support income rose by 55%, from $316 at baseline to $478 a year later (Table 7).

Mental health functioning also increased over time, from 38.8 at baseline to 39.9-40.6 at 3-months and thereafter (a 4% increase), while psychological distress decreased steadily and significantly over time from 1.53 at baseline to 1.29 at 12-months (a 16% decline).

Finally, total average quarterly treatment costs per person decreased by 51% over the first year of treatment, from $6,832 at baseline to $3,376 12-months later, reflecting substantial decreased use of inpatient services (Table 7, bottom panel). Medical and dental costs costs per quarter decreased from $3,219 at baseline to $1,512 at 12-months. Similarly, mental health quarterly costs decreased from $2,303 at baseline to $1,138 at 12-months, while substance use treatment costs per quarter decreased from $1,310 at baseline to $734 at 12-months. The primary source of the decline in these costs was reduced inpatient treatment which decreased by over $3,000 (from $5,776 at baseline to $2,677 a year later). The decrease in quarterly outpatient costs was significant, but smaller at about $350 from $1,056 to $698 during the first year of treatment (Table 7).

No significant changes were found on other outcome measures over time, including social support, days in jail, and level of physical health functioning.

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