Toward Understanding Homelessness: The 2007 National Symposium on Homelessness Research. Accountability, Cost-Effectiveness, and Program Performance: Progress Since 1998.. Literature Review: The Cost of Homelessness and Its Alternatives


Some advances in knowledge about the effectiveness of homeless assistance programs and the costs of intervening — or not — have been achieved since the publication of the Culhane et al. (1999) accountability paper. A growing interest in demonstrating the cost and cost offsets associated with programs targeting people who experience “chronic” homelessness has led to a recent growth of research in this area. Not all of this research has yet made it into academic journals; indeed, some of it has been intended foremost for a policy audience. Most commonly, cost and cost offset studies are based on aggregations of services utilization data, and costs are imputed based on unit costs derived from budget documents or reimbursement rates. More formal cost-effectiveness and cost-benefit studies have seldom been conducted.

Culhane et al. (1999) provide a framework for comparing and describing the differences among the various cost-based evaluation research methodologies, and readers are referred to that document for more complete descriptions of their approaches. In this paper, we focus on the lessons from the published research on the costs and cost offsets of homeless assistance programs, and we examine and discuss the implications of the rapidly emerging literature on chronic homelessness.

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