In her review, Dickey (2000) also addresses the issue of homelessness prevention, and the need for cost-effectiveness and evaluation research in this area. She includes the Critical Time Intervention study from New York in that category, Otherwise, this is an area where little formal research or experimentation has been done. Lindblom (1991) and Shinn, Baumohl, and Hopper (2001) have written very thoughtful papers on the subject and helped to distinguish program types. Interventions that are based in the community and work with “at risk” households are probably the least likely to be able to demonstrate an impact, because it is not possible to know who would have become homeless had an intervention not been provided. An evaluation of a neighborhood-based homelessness prevention intervention in Philadelphia found that, while few of the people assisted became homeless, there was no net impact on rates of shelter admission from the areas served (Wong et al., 1999). It is likely that greater potential impact on shelter use can be achieved by targeting people who recently became homeless with interventions designed to prevent continuing or recurrent homelessness. By targeting newly homeless people the intervention can more directly assist households whose risk of homelessness is known (they are in shelter), and the effect on continued or repeat shelter stays is more immediately realizable. Moreover, if client assessments can carefully profile people and match them with the appropriate type and amount of the intervention(s), they may also be more likely to be able to demonstrate cost-effectiveness. Caton et al. (2005) suggest that the results of their study of long-term homelessness can be used to identify people at greatest risk of chronic homelessness early on in their homelessness experience, and that they can be targeted with various interventions to prevent chronic homelessness. Similar assessment tools and service matching strategies are needed for families.
Practice and research on homeless families may be beginning to show some promise in the area of prevention. The National Alliance to End Homelessness (2006) has recently documented the experiences of six jurisdictions that are systematically diverting families from shelter or providing relocation assistance as an alternative to shelter stays or unnecessarily long shelter stays. The anecdotal experience of these jurisdictions suggests that many families can be successfully prevented from having to stay in shelter for more than 30 days by providing modest relocation grants or time-limited rental subsidies. As noted previously, recent research on typologies of families’ shelter stay patterns has suggested that long shelter stays are not associated with personal barriers of families, but with program and policy factors that promote long stays (Culhane et al., in press). The costliness of these stays suggests that resources currently being spent to provide long-term shelter2 could be reallocated to a prevention and rapid relocation purpose and could serve families in more normalized environments and in a more cost efficient manner. Future research and demonstration projects could investigate the various packages of housing assistance and services that can maximally achieve independent living among families and in the most cost-efficient manner. New initiatives under consideration in Massachusetts, New York, and Philadelphia may herald a new period of experimentation in an area that has been historically understudied.