We draw three general conclusions from our examination of the research evidence. First, both mainstream and targeted programs offer promise. Second, looking across the income support and employment programs of the various federal agencies, it is clear that specific groups within the homeless population receive much more assistance than other groups. Third, the research evidence about the effectiveness of programs in reaching the homeless population with income support and in encouraging employment and self-sufficiency while support is provided is plainly weak. In each case, steps could be taken to learn and accomplish more than we have so far.
Mainstream vs. Targeted Programs
Mainstream programs reach far more people than do programs specifically targeted to segments of the homeless population. They are available everywhere, their rules and benefits are relatively well understood by counselors and advocates, and all have grappled with the need to encourage employment and self-sufficiency. Their main drawback is that they are not tailored to the particular needs of homeless people. Several mainstream programs have demonstrated that this shortcoming can be addressed. In particular, the available evidence suggests that SOAR has reduced the barriers that people who are homeless face in accessing disability assistance. The efforts of selected One-Stop Career Centers appear to have increased involvement of homeless individuals in employment activities, although there is no evaluation evidence to gauge their effectiveness. Funding for such mainstream initiatives geared to the homeless, and for evaluating the effectiveness of these initiatives, would be a wise investment.
The rationale for targeted programs is clear: the programs can be tailored to the needs of people who are homeless, and program resources can be focused on the homeless population as opposed to other low-income groups. Targeted programs can also assemble resources for homeless families and individuals from multiple mainstream programs into an accessible package. Unfortunately, there is relatively little evaluation evidence on the effectiveness of such efforts, particularly for employment outcomes. An exception, the evaluation of the Next Step Jobs employment and training services for supportive housing residents, provides reasons to be optimistic that targeted efforts would produce substantial effects. A more systematic, larger-scale evaluation of such services would be extremely valuable.
Employment and Income Support of Specific Groups
One group within the homeless population, severely disabled heads of families, includes people with mental disabilities (such as schizophrenia and mental retardation) and physical disabilities (such as blindness, musculoskeletal problems, and HIV/AIDS). A family in this category is eligible for income support from SSDI if its head has a sufficient earnings history, or for SSI if he or she does not (assuming that the familys income is not too high to qualify for SSI). Both of these mainstream programs provide monthly cash benefits and Medicare or Medicaid coverage. Regardless of whether they receive disability benefits, families may qualify for food stamps, TANF, assisted housing, veterans benefits, unemployment insurance (UI), and other programs.
In some ways, the picture for family heads with disabilities who are homeless is encouraging. If they receive income support from SSI and/or SSDI, they are eligible for extensive employment, training, and rehabilitative services from the Ticket to Work program. Many have access to additional services through vocational rehabilitation, TANF, or other programs. The pertinent evidence on the effectiveness of these services is limited, but the results of research on hard-to-serve welfare recipients provide reason for optimism.
In other ways, the picture we see for this group is decidedly discouraging. One reason is that many people with severe disabilities do not receive SSI or SSDI and consequently may receive few services and little income support. The other reason is that, among SSI and SSDI beneficiaries, very few people currently use the employment-related services for which they are eligible.
A second group includes severely disabled single individuals. Individuals with documented disabilities can qualify for SSDI or SSI, which in turn gives them access to Medicaid or Medicare, Ticket to Work and other vocational rehabilitation services. Individuals may also qualify for VA aid and other forms of assistance. As with families, however, eligibility does not ensure program utilization. A small numbers of eligible individuals currently utilize these services. Findings from evaluations of employment services for SSDI and SSI beneficiaries suggest that, when services are used, improvement in employment outcomes can be achieved.
The third group, families whose heads are not severely disabled (according to the Social Security Administrations standards for disability assistance) includes many families whose heads are not living with a spouse. The families are eligible for TANF and food stamps so long as they meet income eligibility requirements. Families on TANF automatically receive Medicaid and other assistance. However, TANF is time-limited, and families lose eligibility after five or fewer years. Indeed, since welfare time limits were first imposed in 1996, a steady stream of families has lost eligibility for welfare and, at least temporarily, has experienced homelessness. Some of these heads have physical or mental impairments limiting their functioning. These families may qualify for exemptions from welfare time limits as well as assistance from other programs, including mainstream assisted housing when it is available.
While the income support provided to this group is not as generous as that available to severely disabled individuals and family heads, the evaluation research evidence on the effectiveness of employment services is more plentiful and promising. There is extensive evidence from research on services provided to welfare families, and these services generally appear to be as effective for hard-to-serve welfare recipients as for others. In addition, there is encouraging qualitative evidence from some initiatives targeted specifically to homeless families.
The last group, homeless individuals who are not severely disabled, is generally eligible for the fewest services and the least income support. They do not qualify for SSI, SSDI, TANF, or the employment services and public health insurance that accompany such assistance. This is also a heterogeneous and changeable group. Homelessness among this group more often consists of a single episode or is brief and often due to an event such as a job loss, medical emergency, house fire, or natural disaster.
Although challenged by a lack of permanent housing, these individuals apparently have employment prospects similar to those of housed individuals competing for employment in the labor market. However, there is very little hard evidence on the effectiveness of employment services in helping people who are homeless improve their labor market prospects. Numerous qualitative studies have highlighted promising program approaches to working with people who are homeless.
Limitations of the Available Research Evidence
A range of income support and employment programs is available to the homeless population. We know that many families and individuals who have experienced homelessness are served by these programs. We also know that some people who need assistance never gain access to the programs. We cannot assess the extent to which programs reach the homeless population. The best available evidence, the National Survey of Homeless Assistance Providers and Clients, is now more than a decade old. Changes in both the programs (program features, eligibility requirements, and outreach efforts) and the homeless population (due to immigration, the introduction of welfare time limits, and many other developments) leave the surveys findings clearly out of date.
There is research evidence, some of it very good, on the effectiveness of mainstream programs in encouraging employment and self-sufficiency in the people they serve. We have highlighted several rigorous evaluations of mainstream programs employment interventions. Unfortunately, none of these evaluations has isolated the impacts of employment-related services on homeless people, who represent a small fraction of mainstream programs' clienteles. Identification of homelessness, including family and individual homelessness, should become a standard part of research that targets a broader population,. For example, SSA and HHS could collect data on homelessness in their new research projects testing employment initiatives for SSI, SSDI, and TANF recipients. Similarly, while it may not be feasible to count the number of homeless job seekers served in the mainstream workforce investment system, a study using sampling techniques could provide insight into how well homeless people are being served by the system.
The evidence on programs specifically targeted to homeless people is limited. To date, none of these programs has evaluated its employment and training interventions rigorously.
The research we have examined suggests that now would be a good time to fill these gaps in our understanding of how to help the homeless population. A survey of the homeless population, measuring their use of income support and employment programs, would be enlightening. Substantial changes in eligibility requirements for and benefits of several mainstream programs, most notably welfare and disability assistance, have been fully implemented. New survey findings could provide a good picture of where we currently stand in meeting the immediate needs of the homeless population.
Finally, many of the studies we have cited have promising findings. The findings are, for the reasons we have given, far from conclusive. However, we now have a stronger basis for taking policy research related to homelessness to the next level rigorous evaluation research. Rigorous studies of mainstream programs can and should isolate program impacts for the homeless population and assess ways to increase those effects. Rigorous studies of programs targeted specifically to homeless people can realistically be undertaken. Such research will build our policy knowledge base, enabling policymakers to do more for the families and individuals who encounter homelessness.