Advocates for homeless families are quick to point out that most Americans underestimate the extent to which homelessness affects families. About 600,000 families and 1.35 million children experience homelessness each year, and about half of the homeless population are part of a family. A homeless family typically comprises a woman in her late 20s who becomes homeless together with young children (Burt et al., 1999). In many ways, homeless families are similar to other low-income families that are not homeless. Their limited incomes make it difficult to find and keep housing that is safe and affordable, they face stagnant wages for workers with few skills, and they may be affected by welfare time limits or sanctions under Temporary Assistance for Needy Families (TANF).
HUDs Supportive Housing and Shelter Plus Care programs serve substantial numbers of homeless families. However, given the greater emphasis in recent years on addressing the needs of homeless single individuals, the need to devote a major portion of McKinney-Vento grant funds to renewing funding for existing grants rather than placing additional units under subsidy, and the reduced availability of mainstream assisted housing, fewer new permanent housing resources are available for homeless families.
Programs serving homeless families range from short-term assistance to shorten or avert shelter stays for families experiencing a crisis to long-term permanent supportive housing for families with complex supportive service needs. In addition, non-residential service providers, such as housing resource centers, housing locator services, and housing counseling agencies, may play important roles in helping people who are homeless or at risk of losing their housing to locate and retain stable housing.
In the following sections, we describe a number of approaches to assisting homeless families and review the evidence, where available, on the efficacy of each. However, services provided by residential programs for families are so diverse in their nature and intensity that it is difficult to identify a model used in different communities that links housing to a particular set of services in a particular way. This points to the need for rigor in classifying the housing and support services provided according to exact type and range, frequency, and duration.
Short-term assistance. Modest levels of financial assistance to families who are precariously housed or newly homeless have been used to help families that are experiencing a short-term crisis. For example, Portland, Oregons Transitions to Housing Program provides short-term emergency rent assistance to 400 individuals and families annually. The clients served may be homeless or at risk of homelessness; all have family-size adjusted incomes of no more than 20 percent of area median income. The average total assistance per household is $1,285. According to program data, this relatively small amount of assistance allows 70 percent of households to stabilize and remain in permanent housing for at least six months after intake (City of Portland, Oregon, 2004).
In the Minneapolis/St. Paul area, Hennepin County administers a state-funded Family Homeless Prevention and Assistance Program (FHPAP) through a network of providers. The legislation creating FHPAP established a set of intended outcomes, including preventing first-time shelter stays, reducing the length of shelter stays, and eliminating shelter reentry.
Prevention services are targeted to families that are threatened with housing loss because of nonpayment of rent, but for whom a resolution to the crisis is within reach. Case workers assess the amount of rent owed and the familys resources, credit history, rental history, and other circumstances to decide how much assistance the program will provide and what the family can contribute. Case workers also work with families for up to six months on budgeting, determining whether a move is necessary (e.g., to a smaller apartment), and other issues to ensure the family remains housed.
According to program data cited by Burt and Pearson (2005), FHPAPs screening system and prevention activities have reduced the average duration of shelter stays by one-half and reduced the daily census of families in shelter by 63 percent. The programs 2003 annual report (also cited in Burt & Pearson) shows that 95 percent of families in the prevention component did not use shelter within 12 months. The average cost to the county per family was $472.
Illinois, the District of Columbia, and Massachusetts also have begun testing strategies that divert families from becoming homeless or use short-term assistance to help them exit homelessness. Illinoiss Homeless Prevention Program, administered by the Department of Human Services (DHS), provides short-term rent and utility assistance and supportive services to families that are homeless or at imminent risk of homelessness. Program funds can be used for up to three months back rent to prevent eviction, up to two months rent or security deposit, and services such as housing location/inspection, job search, counseling, and case management. According to the DHS Web site, some 10,000 families were served by the program in 2004.
In the District of Columbia, all families entering the homeless services system go through a central intake center that focuses on resolving the crisis that is about to make the family homeless. Those who cannot be stabilized in their current housing but can stay there for at least 30 days are referred to a grant program that provides intensive case management, housing search assistance, and short-term assistance such as deposits and first month rents. Only families considered unlikely to succeed in a rapid housing placement are placed in emergency shelter. Factors considered in this assessment include current substance abuse, uncompensated mental illness, and whether the head of household has ever been employed and has ever been a leaseholder.
In Massachusetts, the rising costs of emergency shelters and the need for additional space in even more costly motels had increased the annual cost of sheltering a homeless family to an average of $47,000 by 2004. In response, Massachusetts implemented several pilot projects to explore alternative approaches to helping families find or retain housing. According to state data, three pilot programs kept 1,119 families housed for the same cost as 63 shelter rooms. The Rental Assistance for Families in Transition (RAFT) program provided flexible funds for first/last month rents, security deposits, or utility payments. Some 436 families were assisted over a two-month period at an average cost per household of $1,365. Similar assistance was provided to families eligible for the state TANF agencys emergency assistance program, helping another 476 families avoid homelessness or shorten a shelter stay, at an average cost of $3,080 per family. Finally, under the Shelter to Housing Pilot, 207 families were assisted with a one-time subsidy of $6,000 to cover rent and some stabilization services such as job search and household budget assistance. Two years later, 80 percent of the families were still housed (One Family, 2006).
None of these programs for using short-term assistance for prevention or rapid exit from homelessness has been studied using a rigorous evaluation methodology that controls for family characteristics and examines long-term outcomes. Therefore, we do not yet know how to distinguish families who can benefit from this approach from other types of families, nor can we assess the costs and benefits of short-term assistance compared with more expensive approaches to placing families in permanent housing. Nonetheless, preliminary evidence from program records suggests that short-term housing assistance can play an important role in reducing and ending family homelessness.
Transitional housing. Many communities continue to consider transitional housing to be an effective strategy for helping families secure and retain permanent housing. Since 2000, the Sound Families program sponsored by the Bill and Melinda Gates Foundation has supported the development of 1,100 units of service-enriched transitional housing for families that have experienced homelessness in Pierce, King, and Snohomish Counties in Washington. Several housing authorities in the region have allocated project-based housing voucher assistance to the Sound Families projects to make them affordable to homeless families and financially viable for project sponsors.
Sound Families provides supportive services during the transitional housing stay and assistance in moving to permanent housing, which can be public housing or private rental housing supported by a tenant-based voucher subsidy. In some program sites, a transition in place option allows families to continue living in the same complex (if not the same unit) where their transitional housing unit is located.
Preliminary results from an evaluation of 10 sites participating in the Sound Families program (Bodonyi & Erwin-Stewart, 2005; see also www.gatesfoundation.org/AboutUs/OurWork/Learning/SoundFamilies/) show that, of 139 families interviewed at intake, 80 percent remained in transitional housing until they graduated from the program. The average length of stay was 12.7 months. The researchers found increases in employment, from 27 percent employed full- or part-time at baseline to 41 percent at exit. These outcomes compare favorably with other social programs. Receipt of TANF benefits declined from 62 percent at baseline to 46 percent at exit. Children benefited as well. Some 80 percent of parents said their oldest child was doing very well or excellently in school six months after exit compared to 52 percent who said so at intake. The proportion of children attending more than two schools in the previous year declined from 53 percent at intake to 5 percent at exit.
Some 86 percent of families secured permanent housing at exit from their transitional program, and 89 percent continued to reside in permanent housing six months after exit. Of the 14 percent who were evicted or asked to leave their transitional housing unit, most had mental health or chemical dependency issues the program was not designed to address. A pilot program to provide permanent supportive housing that does address these issues is under development.
Many transitional housing programs have a primary focus not on getting the highest-needs families ready for placement into permanent housing, but on other objectives, such as employment, income growth, and better life chances for children. Some transitional housing providers admit only families deemed able to take advantage of services the transitional housing program offers. They may screen out families with severe mental illness, current chemical dependency, or no employment history. Many transitional housing providers describe their programs in this way, and a recent analysis of patterns of use of emergency shelter and transitional housing in Philadelphia and Massachusetts suggests that such screening is common. The study found that the families with the longest stays in residential facilities within the homeless services system (most long stays were in transitional housing) were less likely to have histories of inpatient behavioral health treatment, had lower rates of disability, and had higher rates of employment than families with shorter stays (Culhane, 2006).
A recent survey of HUD-funded transitional housing programs for families shows that, although most programs screen out families with active substance abuse and about a third of programs would not accept families with severe and persistent mental illness, the families served have high needs. About one-quarter of parents take psychotropic medications for mental or emotional problems, and at least as many have histories of drug abuse. Addiction relapse is the primary reason for families being asked to leave transitional housing programs (Burt, 2006).
This study also collected information about housing outcomes for transitional program participants. On average across the 53 programs surveyed, 70 percent of families exited to permanent housing. More than one-third (36 percent) went to unsubsidized mainstream housing, while 22 percent left for housing with a rent subsidy, and 13 percent went to permanent supportive housing. A subsequent phase of the study will attempt to relate these and other outcomes to the different characteristics of transitional housing programs, such as whether the program provides scattered-site housing, whether it permits transition in place, and the programs staffing levels (Burt, 2006).
Permanent supportive housing. Permanent supportive housing for families may take several forms. The transition in place model mentioned above may offer security of tenure by allowing a family to stay in what is initially treated as a transitional placement while continuing with case management support and other linked services. HUDs Shelter Plus Care (S+C) program provides permanent supportive housing to families if the head of household is disabled. S+C may be used to provide tenant- or project-based rental assistance. Regardless of the form of the rental assistance, the organizations that receive Shelter Plus Care funding must provide services that, in the aggregate, are equal in value to the value of the S+C rental assistance. S+C rental assistance is often used to provide the housing component of programs created by mental health or substance abuse treatment providers for their clients.
A study of San Franciscos Family Permanent Supportive Housing Initiative (FPSH) offers lessons from permanent housing programs designed to serve families with the kinds of supportive services needs that the Sound Families transitional housing programs had difficulty addressing (Nolan et al., 2005). The seven programs studied offer access to affordable permanent housing and voluntary services to address mental health and addiction issues as well as a variety of health and social services for adults and their children. The housing situations varied across the seven programs and included scattered-site units; buildings dedicated to homeless families; and mixed buildings housing low-income people, only some of whom had been homeless. Residents reported high levels of satisfaction with their living environments as well as with the services they received. According to the researchers:
No single program model appears to be significantly better than any other at helping tenants achieve the primary goal of housing stability, as long as the model succeeds in creating an atmosphere of respect and trust among tenants and staff and is able to provide the resources that tenants need.
According to program staff, services for children are an important component of permanent supportive housing for homeless families. Many mothers in these families have been separated from their children at some point in their lives, and housing stability with their children is an important objective for residents.
A 2006 study prepared by the National Center on Family Homelessness combined results from a number of studies of permanent supportive housing programs for families to identify client and program characteristics and client outcomes and to assess whether certain combinations of program characteristics are associated with improved client outcomes (Bassuk, 2006). The study examined 13 programs, all located in the San Francisco area or in Minnesota. The researchers assembled data on program context, housing arrangements, program control (that is, strictness of program rules for participation), the range of services available for adults and children, and the intensity of adult services (derived from the number of households per case manager and services per family per month). Participant outcomes in terms of residential stability, family reunification, and self-sufficiency were ranked as high, medium, or low for each program.
Although the authors caution that the analyses are limited by inconsistencies in the data collected across studies, the high control programs seem to have better reunification and self-sufficiency outcomes, but their attrition rates are high. By contrast, low control programs may have higher residential stability but are not as successful at helping families reunify or move to greater economic self-sufficiency.