Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research. Accountability, Cost-Effectiveness, and Program Performance: Progress Since 1998.. Appendix: The U.S. Interagency Council on Homelessness

03/01/2007

Studies

  • Summary of Cost Offset Studies
  • Intervention Studies

Summary of Cost Offset Studies
Location Funder/
Sponsor
Researchers/
Contact
Number of Subjects Sampling Frame Data Sources Years Costs Status
Asheville, North Carolina Ten Year Plan Asheville TYP Committee 37 Convenience sample identified by police department as chronically homeless individuals with high levels of interaction. County jail, EMS provider, county health center, area hospitals, mental health facility, homeless shelters. 2001-2002 $39,444 per person per year Completed
Boston Boston Health Care for the Homeless Program (BHCHP) Jim O'Connell, Boston Health Care for the Homeless 119 Convenience sample of street dwellers living on the street at least six consecutive months and one or more identified risk factors. Medicaid records. 1999-2003 $27,563 per person per year Completed
Durham, North Carolina Ten Year Plan Liz Clasen, Duke University 147 Convenience sample of chronically homeless individuals collected through data of three local service agencies and verified “chronic” by at least two sources. Duke Hospital System, public health department, VA, EMS, shelter, police, courts, sheriff’s department, corrections department, courts, social service department. 2004-2005 $10,334 per person per year Completed
Indianapolis I Coalition for Homeless Intervention and Prevention Dr. Eric Wright, Indiana University-Purdue University 80-120 Convenience sample of homeless individuals identified and screened (standardized protocol) by outreach workers as high users of public services. Regional medical records system, police department, jail, homeless services (HMIS). 2006 Not yet available. Ongoing
Key West, Florida Ten Year Plan Office of former Mayor Jimmie Weekley 418 All individuals arrested in Monroe County in 2004 known to be homeless. Jail (incarceration costs only). 2004 $5,360 per person per year Completed
Louisville Coalition for the Homeless, City of Louisville Rod Barber, University of Louisville NA Individuals and families counted in annual census. (Future work will include more specific frames.) Area hospitals, corrections, jail, mental health providers, substance abuse providers, TANF. 2004-2005 Not yet available. Ongoing
Minneapolis Hennepin County Hennepin County Criminal Justice Coordinating Committee 33 Convenience sample of repeat offenders with police interaction during course of study (April-June 2005). Jail, prison, county courts, county detox, county substance abuse, county mental health services, county hospital and clinics. 1985-2005 $112,967 per person Completed
Reno Reno Police Department Officers Steve Johns, Patrick O'Bryan, Reno Police Department 3 Convenience sample of homeless chronic inebriates known to police officers. Hospitalization costs reported by one area hospital. 2005 $50,000-$100,000 per person per year Completed
Richmond, Virginia Virginia Department of Mental Health Michael Shank, Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services 541 All homeless individuals enrolled in Greater Richmond HMIS who had used inpatient psychiatric care in 2002-2004. HelpNet (HMIS), statewide hospital database. 2002-2004 $9,000 per person per year. A subset of high utilizers (3+ annual stays) accounted for $21,000 per person per year. Ongoing
San Diego University of California-San Diego, City and County of San Diego Jim Dunford, City EMS Medical Director 15 Convenience sample of known chronic public inebriates who were frequent users of hospital emergency room. USCD Medical Center (hospital admissions and paramedic runs), police. 1998 $133,333 per person per year. Completed
Seattle King County Mental Health King County Mental Health, Chemical Abuse and Dependency Division 20 Sample included highest users of Sobering Center and Crisis Triage Center. Jail, county hospital, detoxes, and sobering center. 2003 $54,542 per person per year Completed
Waco, Texas City of Waco Baylor University, Business Excellence Scholarship Team NA Looked at aggregate costs to municipal, nonprofit, law enforcement and hospital services related to homelessness. City expenditures, local business donations, nonprofit spending on direct care, jail, police emergency response records, area hospitals. 2001-2003 Aggregate costs related to homelessness were $7,607,349. Completed
Santa Barbara, California Santa Barbara County Roger Heroux, Health Care Consultant NA Looked at aggregate costs to three municipalities, county, public safety, medical, and emergency services related to homelessness. Police, public works, parks and recreation, library, fire department, shelters, county departments, jail, ambulance service, three area hospitals, emergency shelters. 2006 Aggregate municipal and county costs related to homelessness were $36,897,012. Completed
Gainesville, Florida Alachua County Jon Decarmine, Alachua County Housing Authority NA Looked at aggregate costs to emergency, public safety and medical systems related to homelessness. Fire department calls, jail, sheriff’s department and police emergency response calls to homeless shelters, records from one area hospital. No client level data. 2002-2005 Aggregate law enforcement and emergency services costs related to homelessness were $3,844,156. Completed

Intervention Studies
Location Funder/
Sponsor
Researchers/
Contact
Number of Subjects Sampling Frame Intervention Data Sources Years Cost Reductions Status
Atlanta Georgia Rehabilitation Outreach Georgia Rehabilitation Outreach 60 Convenience sample of mentally ill individuals referred from criminal justice, health care and homeless service agencies. FACT team. (Some subjects received housing but this aspect was not included in study.) Admissions records from one local psychiatric hospital, jail, FACT team budget. 2004-2005 $18,333 per person per year Completed
Atlanta United Way of Metropolitan Atlanta Dr. James Emshoff, Georgia State University 30 Random sampling of dually-diagnosed chronically homeless individuals in Atlanta. Comparison group. Education and Community Services Engagement Linkage (ECSEL) Housing First program. Housing and utilities costs, homeless services, three area hospitals, vocational services, police, sheriff, jail, courts, prison, probation, parole, statewide databases of Medicaid, disability and SSI data. 2005-2006 Not yet available. Ongoing
Broward County, Florida Ten Year Planners Camille Franzoni, HHOPE Project Director 44 All participants enrolled in HHOPE Housing First program for chronically homeless individuals. Permanent supportive housing. Inpatient hospital stays at one local hospital, jail, shelter. 2004-2005 $13,456 per person per year Ongoing
California State of California Stephen Mayberg, California Department of Mental Health 4,881 All individuals enrolled AB 2034, a statewide, state-funded supportive housing program for homeless mentally ill individuals. Permanent supportive housing. Self-reported baseline data including psychiatric inpatient care, incarceration, emergency room visits. 1999-2003 $5,614 per person per year Completed
Chicago Housing and Health Partnership Arturo Bendixen, AIDS Foundation of Chicago 436 Randomly assigned individuals who are homeless and have one chronic illness being discharged from one of three Chicago hospitals. Comparison group. Permanent supportive housing. Inpatient care and emergency room visits from the three major hospitals engaged in the Housing and Health Partnership. 2003-2007 Not yet available. Ongoing
Dayton, Ohio Ten Year Planners Kathleen Shanahan, Shelter Policy Board 4 Convenience sample of dually-diagnosed chronically homeless individuals enrolled in Housing First. Permanent supportive housing. Self-reported hospitalizations, substance abuse treatment, emergency shelter. 2004-2005 $43,045 per person per year Completed
Denver Colorado Coalition for the Homeless Jennifer Perlman, Colorado Coalition for the Homeless 19 Chronically homeless individuals in Federal Collaborative Initiative and 16th Street Housing First programs who had been enrolled for 24 or more months. Permanent supportive housing. Local hospitals, substance abuse treatment facilities, jails, state prisons and homeless shelters. 2002-2006 $15,772 per person per year Completed
Hennepin County, Minnesota Hennepin County Kelby Grovender, Hennepin County 120 Chronic inebriates enrolled in one of two supportive housing programs. Permanent supportive housing. County medical center, housing program records of detox utilization. 2003 $6,659 per person per year Completed
Indianapolis II Coalition for Homeless Intervention and Prevention Dr. Eric Wright, Indiana University-Purdue University 49 Individuals enrolled in Action Coalition to Ensure Stability (ACES) program between 1999 through September 2003. Permanent supportive housing. Hospitals included in regional medical information system and two unaffiliated hospitals. 1999-2004 $9,049 per person per year  Completed
Los Angeles Los Angeles Homeless Services Authority Los Angeles Homeless Services Authority 120 Chronically homeless individuals enrolled in Federal Collaborative Initiative Housing First program in Skid Row. Permanent supportive housing. County health, county mental health and county jail facilities.  2004-2007 Not yet available. Ongoing
Minneapolis Family Housing Fund Ellen Hart-Shegos, consultant 1 Convenience sample of mother and children experiencing long-term homelessness. Permanent supportive housing. County children and family services, emergency shelters, halfway house, county jail, probation, county juvenile services, county medical center, county economic assistance department, county training and employment services, child care and special education providers. 1991-1999 $39,500 per family per year Completed
Minnesota Hearth Connection Ellen L. Bassuk, National Center on Family Homelessness 616 Families and individuals having long histories of homelessness enrolled in state –funded Supportive Housing and Managed Care Pilot. Comparison group of those with similar use trajectory is being constructed. Permanent supportive housing. Minnesota Departments of Human Services, Medicaid, Social Services, corrections, education, county law enforcement. 2001-2006 Not yet available. Ongoing
Oregon Oregon Network of Independent Living Centers Oregon Network of Independent Living Centers 266 Convenience sample representing 10 percent of all disabled individuals in Oregon independent living programs with an open Consumer Service Record. Housing assistance, mental health services, independent living skills, employment services. This varied by subject. Self- reported foster care, mental health, incarceration, nursing home, assisted living, opportunity, shelter and opportunity costs. 2004 $5,266 per person per year Completed
Portland Central City Concern Thomas L. Moore, Consultant 35 Dually-diagnosed consumers previously enrolled in Community Engagement Program who volunteered to be part of study. Housing and ACT team. Self-reported physical and mental health care, incarceration, addiction services. 2005 $16,000 per person per year Completed
Quincy, MA The Boston Foundation, Father Bill’s Place  Boston Health Care for the Homeless Program, UMass McCormick Institute 37  Convenience sample of chronically homeless individuals identified by homeless service providers and enrolled in Housing First program. Permanent supportive housing. One local hospital, case notes, shelter, jail.   2004-2007  $10,000 per person per year Ongoing
Salt Lake City Utah James Wood, University of Utah 17 Convenience sample of chronically homeless individuals identified by area homeless providers. Comparison group. Permanent supportive housing. Shelter and outreach service providers, area medical clinic, nonprofit health care system, university hospital, detox, mental health service provider, housing authority, jail. 2004-2007 Not yet available. Ongoing
San Francisco San Francisco Department of Public Health San Francisco Department of Public Health 71 Homeless individuals enrolled in Direct Access to Housing program between October 2002 and October 2003. Permanent supportive housing. San Francisco General Hospital. 2002-2003 $16,300 per year per person Completed
San Diego II Department of Emergency Medicine, University of California-San Diego Jim Dunford, City EMS Medical Director 156 Homeless serial inebriates who had been transported to inebriate reception center five times in 30 days and who accepted treatment. Comparison group. Serial Inebriate Program, a six-month outpatient substance abuse treatment program in lieu of custody. City EMS provider, two regional hospitals. 2000-2003 $7,130 per person per year Completed
Seattle Robert Wood Johnson Foundation Mary Larimer, University of Washington 75 Selected homeless chronic inebriates based on health and jail costs. Comparison group of those on waiting list. 1811 Eastlake harm reduction housing program for chronic public inebriates. County hospital, county jail, county sobering center. 2006  Not yet available. Ongoing

 

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