Evaluating a statewide permanent housing program for the chronically homeless: The Massachusetts Home and Healthy for Good Initiative

Chronic homelessness is associated with myriad social and medical needs. A traditional approach to meeting these needs has coupled sheltering with treatment, and housing may eventually exist for those able to successfully comply with treatment programs. But many persons' disabilities limit them from entering housing that is contingent upon complex service plans, compliance-based housing, or the acknowledgment of certain labels or diagnoses. The Home and Healthy for Good Initiative (HHGI) is a Massachusetts pilot program providing chronically homeless people with stable, non-compliance-based housing in eight communities across the state. Tenants will live in leased, independent apartments. Case managers will offer life skills support in tenants' apartments and provide linkage to a range of services, including medical, mental health and substance abuse treatment. HHGI differs from traditional approaches in that ongoing tenancy is not conditional on acceptance of services, representing a shift toward “low-threshold” housing aimed at sustaining the tenancies. This presentation focuses on evaluation of the HHGI pilot's first year. Subjects include 130 individuals, all of whom were “chronically homeless” (i.e., unaccompanied persons with a disabling condition of long duration who were continuously homeless for a year or more, or had at least four episodes of homelessness in the past three years) and homeless at the time of selection. Self-report data collected at 3-month intervals are used to test the hypothesis that HHGI involvement will increase their length of time housed and decrease their episodes of emergency room visits, hospitalizations, and incarcerations compared to the previous year.