Baseline survey results from an evaluation of a national supportive housing program designed to target high medical need homeless individuals

There is a growing belief among public health and homeless services professionals that the medical costs incurred by high-risk, medically needy homeless individuals, could be reduced through the use of integrative supportive housing services targeted at those who are most medically expensive. While there is support for the use of this model, information on the nature and extent of the medical and social challenges facing such a target population remain limited. To help fill this gap, this presentation is one of the first reports from the five-year, mixed-methods evaluation of the Corporation for Supportive Housing Social Innovation Fund (CSH-SIF) Supportive Housing Initiative. This national initiative uses data-driven strategies to target high-cost homeless individuals for placement in a supportive housing program that combines traditional case management with medical care management. 

We report here on preliminary results from the evaluation’s baseline survey (N = 338, response rate = 73%), which measured demographic information, homeless history, physical/mental health status and service utilization, alcohol/drug use, and interactions with the criminal justice system. Thirty percent of program participants were female, and 14% reported their sexual identity as non-heterosexual. The median age was 48 years old (range: 19-83). Approximately 40% of participants were white, 40% were African American, and the remaining 20% identified as Hispanic, Native American, or Asian. Baseline survey data indicates that individuals entering the program are a particularly vulnerable population in terms of both physical and mental health needs as well as other risk factors:

*Spent 5+ years living on street/in an emergency shelter: 36%

*Self-rated health as fair/poor: 63%

*Reported having a serious medical problem: 87%

*Sees someone on a regular basis for psychiatric problems: 48%

*Any emergency room visits in past year: 81%

*Any overnight hospitalizations in past year: 66%

*Regular alcohol user: 39%

*Regular drug user: 24%

*Ever been arrested: 82%

Preliminary analyses also indicate statistically significant differences between major demographic subgroups. While larger proportions of men reported interactions with the criminal justice system and regular use of alcohol, women more frequently reported being regular drug users and having recent psychiatric symptoms. Program participants under the age of 40 more frequently reported drug and alcohol use and recent psychiatric hospitalizations as compared to their older counterparts. Further, heterosexual-identified participants reported more frequent contacts with the criminal justice system and a longer history of non-stable housing than individuals who identified as a sexual orientation other than heterosexual.