The three federal agencies sponsoring the Initiative (HUD, DHHS & VA) enlisted the VA Northeast Program Evaluation Center (NEPEC) to conduct a national evaluation of CICH client outcomes to monitor the implementation and effectiveness of the $55 million Initiative ($35 million funding in 2003, with $20 million added in subsequent years) by using a common evaluation methodology across all 11 sites.
The goal of the national evaluation is to provide a site-by-site description of program implementation, as well as descriptive information on clients served; services received; longitudinal housing quality, stability, and satisfaction; and, client outcomes in health and functional domains. Outcome data from the evaluation were provided to the sites throughout the implementation of the program to guide program development, and have been provided quarterly to allow ongoing monitoring of service delivery and outcomes. Monthly site-level statistics were provided to local CICH grant recipients on the implementation of evaluation procedures as well as to federal sponsors, beginning in May 2004, and updated longitudinal client outcome statistics were provided beginning in January 2005 every 3 months. These data will also form the basis for the evaluation of program accomplishments after it is completed.
This report presents data on both services and client outcomes from the first two years of CICH program operation. It also establishes the definitions of measures and general format of analyses for the final summary report, and addresses the following series of related questions:
- First, who was seen in the CICH initiative including: a) how did those screened differ from those who were enrolled in the program, and how did those who enrolled differ from those who participated in the full outcome evaluation, i.e., CICH clients; and, b) how did CICH clients differ across the sites. "Enrolled" participants were individuals who CICH program staff indicated as "receiving permanent housing and/or case management/supportive services" on the CICH Screening Form.
- Second, what changes were observed in both use of services and outcomes over the course of the Initiative? Since 28% of clients were already housed at the time of baseline assessment we consider the relationship of housing status at the time of the baseline assessment to subsequent changes in housing and other outcome measures. While the protocol for the national evaluation was to administer baseline assessment interviews before clients were placed into housing, this was not always possible, especially true at sites where clients were typically placed into SRO housing (e.g., Los Angeles and San Francisco) or more centralized locations (e.g., Columbus and Denver) making it easier for program staff to place a larger number of clients into housing more quickly than VA research staff were able to recruit clients into the evaluation.
- Third, we examine differences in outcomes across sites and their relationship to baseline characteristics and site differences in patterns of service delivery.
- Finally, we consider how outcomes observed in the Initiative differed from those of similar clients recruited from other programs serving the homeless at a subset of sites, who did not have access to the services available through the CICH program.